code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
,,Bilateral Procedures,,,,,0
,,Bilateral Services,,,,,0
,,CT services furnished with equipment that don't meet NEMA standard,,,,,0
,,Computed radiography x-ray,,,,,0
,,Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (NEMA) XR-29-2013 standard,,,,,0
,,Discontinued OP Hospital/ASC Procedure Prior to Administration of Anesthesia,,,,,0
,,Discontinued Procedure,,,,,0
,,Excepted off-campus service,,,,,0
,,Non-excepted off-campus service,,,,,0
,,X-ray taken using film,,,,,0
,,X-ray was performed using film,,,,,0
,,X-ray was taken using computed radiography technology/cassette-based imaging,,,,,0
APR-DRG,0011,APR-DRG 38.00: Liver Transplant And/Or Intestinal Transplant,,,39510.46,286771.0,6
APR-DRG,0012,APR-DRG 38.00: Liver Transplant And/Or Intestinal Transplant,,,39510.46,286771.0,6
APR-DRG,0013,APR-DRG 38.00: Liver Transplant And/Or Intestinal Transplant,,,46785.59,286771.0,6
APR-DRG,0014,APR-DRG 38.00: Liver Transplant And/Or Intestinal Transplant,,,99308.48,286771.0,6
APR-DRG,0021,APR-DRG 38.00: Heart And/Or Lung Transplant,,,52227.15,272449.0,6
APR-DRG,0022,APR-DRG 38.00: Heart And/Or Lung Transplant,,,67546.33,272449.0,6
APR-DRG,0023,APR-DRG 38.00: Heart And/Or Lung Transplant,,,80558.76,272449.0,6
APR-DRG,0024,APR-DRG 38.00: Heart And/Or Lung Transplant,,,153250.91,272449.0,6
APR-DRG,0041,APR-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure,,,37203.71,37203.71,5
APR-DRG,0042,APR-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure,,,44183.11,44183.11,5
APR-DRG,0043,APR-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure,,,63051.13,63051.13,5
APR-DRG,0044,APR-DRG 38.00: Tracheostomy With Mv >96 Hours With Extensive Procedure,,,92210.8,92210.8,5
APR-DRG,0051,APR-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure,,,24605.32,24605.32,5
APR-DRG,0052,APR-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure,,,33477.43,33477.43,5
APR-DRG,0053,APR-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure,,,42526.98,42526.98,5
APR-DRG,0054,APR-DRG 38.00: Tracheostomy With Mv >96 Hours Without Extensive Procedure,,,60507.79,60507.79,5
APR-DRG,0061,APR-DRG 38.00: Pancreas Transplant,,,44242.26,146558.0,6
APR-DRG,0061,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,0062,APR-DRG 38.00: Pancreas Transplant,,,44242.26,146558.0,6
APR-DRG,0062,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,0063,APR-DRG 38.00: Pancreas Transplant,,,49388.08,146558.0,6
APR-DRG,0063,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,0064,APR-DRG 38.00: Pancreas Transplant,,,82096.59,146558.0,6
APR-DRG,0064,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,0071,APR-DRG 38.00: Allogeneic Bone Marrow Transplant,,,34305.49,34305.49,5
APR-DRG,0072,APR-DRG 38.00: Allogeneic Bone Marrow Transplant,,,49683.82,49683.82,5
APR-DRG,0073,APR-DRG 38.00: Allogeneic Bone Marrow Transplant,,,59798.02,59798.02,5
APR-DRG,0074,APR-DRG 38.00: Allogeneic Bone Marrow Transplant,,,116224.64,116224.64,5
APR-DRG,0081,APR-DRG 38.00: Autologous Bone Marrow Transplant Or T-Cell Immunotherapy,,,23363.22,23363.22,5
APR-DRG,0082,APR-DRG 38.00: Autologous Bone Marrow Transplant Or T-Cell Immunotherapy,,,28035.87,28035.87,5
APR-DRG,0083,APR-DRG 38.00: Autologous Bone Marrow Transplant Or T-Cell Immunotherapy,,,32826.81,32826.81,5
APR-DRG,0084,APR-DRG 38.00: Autologous Bone Marrow Transplant Or T-Cell Immunotherapy,,,52404.6,52404.6,5
APR-DRG,0091,APR-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo),,,27799.28,27799.28,5
APR-DRG,0092,APR-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo),,,27799.28,27799.28,5
APR-DRG,0093,APR-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo),,,46489.86,46489.86,5
APR-DRG,0094,APR-DRG 38.00: Extracorporeal Membrane Oxygenation (Ecmo),,,104986.63,104986.63,5
APR-DRG,0201,APR-DRG 38.00: Open Craniotomy For Trauma,,,12598.4,12598.4,5
APR-DRG,0202,APR-DRG 38.00: Open Craniotomy For Trauma,,,15792.36,15792.36,5
APR-DRG,0203,APR-DRG 38.00: Open Craniotomy For Trauma,,,20465.0,20465.0,5
APR-DRG,0204,APR-DRG 38.00: Open Craniotomy For Trauma,,,33832.31,33832.31,5
APR-DRG,0211,APR-DRG 38.00: Open Craniotomy Except Trauma,,,11415.45,11415.45,5
APR-DRG,0212,APR-DRG 38.00: Open Craniotomy Except Trauma,,,14905.14,14905.14,5
APR-DRG,0213,APR-DRG 38.00: Open Craniotomy Except Trauma,,,23126.63,23126.63,5
APR-DRG,0214,APR-DRG 38.00: Open Craniotomy Except Trauma,,,37795.19,37795.19,5
APR-DRG,0221,APR-DRG 38.00: Ventricular Shunt Procedures,,,7275.13,7275.13,5
APR-DRG,0222,APR-DRG 38.00: Ventricular Shunt Procedures,,,9345.29,9345.29,5
APR-DRG,0223,APR-DRG 38.00: Ventricular Shunt Procedures,,,15319.18,15319.18,5
APR-DRG,0224,APR-DRG 38.00: Ventricular Shunt Procedures,,,33773.17,33773.17,5
APR-DRG,0231,APR-DRG 38.00: Spinal Procedures,,,8872.11,8872.11,5
APR-DRG,0232,APR-DRG 38.00: Spinal Procedures,,,12184.36,12184.36,5
APR-DRG,0233,APR-DRG 38.00: Spinal Procedures,,,21766.24,21766.24,5
APR-DRG,0234,APR-DRG 38.00: Spinal Procedures,,,34246.34,34246.34,5
APR-DRG,0241,APR-DRG 38.00: Open Extracranial Vascular Procedures,,,5145.82,5145.82,5
APR-DRG,0242,APR-DRG 38.00: Open Extracranial Vascular Procedures,,,7097.69,7097.69,5
APR-DRG,0243,APR-DRG 38.00: Open Extracranial Vascular Procedures,,,13012.43,13012.43,5
APR-DRG,0244,APR-DRG 38.00: Open Extracranial Vascular Procedures,,,23777.25,23777.25,5
APR-DRG,0261,APR-DRG 38.00: Other Nervous System And Related Procedures,,,7570.87,7570.87,5
APR-DRG,0262,APR-DRG 38.00: Other Nervous System And Related Procedures,,,9581.88,9581.88,5
APR-DRG,0263,APR-DRG 38.00: Other Nervous System And Related Procedures,,,14372.82,14372.82,5
APR-DRG,0264,APR-DRG 38.00: Other Nervous System And Related Procedures,,,28923.08,28923.08,5
APR-DRG,0271,APR-DRG 38.00: Other Open Craniotomy,,,9522.73,9522.73,5
APR-DRG,0272,APR-DRG 38.00: Other Open Craniotomy,,,11770.33,11770.33,5
APR-DRG,0273,APR-DRG 38.00: Other Open Craniotomy,,,18394.84,18394.84,5
APR-DRG,0274,APR-DRG 38.00: Other Open Craniotomy,,,34601.23,34601.23,5
APR-DRG,0291,APR-DRG 38.00: Other Percutaneous Intracranial Procedures,,,11178.86,11178.86,5
APR-DRG,0292,APR-DRG 38.00: Other Percutaneous Intracranial Procedures,,,11178.86,11178.86,5
APR-DRG,0293,APR-DRG 38.00: Other Percutaneous Intracranial Procedures,,,15141.73,15141.73,5
APR-DRG,0294,APR-DRG 38.00: Other Percutaneous Intracranial Procedures,,,27148.66,27148.66,5
APR-DRG,0301,APR-DRG 38.00: Percutaneous Intracranial And Extracranial Vascular Procedures,,,11001.42,11001.42,5
APR-DRG,0302,APR-DRG 38.00: Percutaneous Intracranial And Extracranial Vascular Procedures,,,15792.36,15792.36,5
APR-DRG,0303,APR-DRG 38.00: Percutaneous Intracranial And Extracranial Vascular Procedures,,,22061.98,22061.98,5
APR-DRG,0304,APR-DRG 38.00: Percutaneous Intracranial And Extracranial Vascular Procedures,,,31111.53,31111.53,5
APR-DRG,0401,APR-DRG 38.00: Spinal Disorders And Injuries,,,5796.45,5796.45,5
APR-DRG,0402,APR-DRG 38.00: Spinal Disorders And Injuries,,,7866.6,7866.6,5
APR-DRG,0403,APR-DRG 38.00: Spinal Disorders And Injuries,,,11770.33,11770.33,5
APR-DRG,0404,APR-DRG 38.00: Spinal Disorders And Injuries,,,19696.08,19696.08,5
APR-DRG,0411,APR-DRG 38.00: Nervous System Malignancy,,,4436.06,4436.06,5
APR-DRG,0412,APR-DRG 38.00: Nervous System Malignancy,,,4968.38,4968.38,5
APR-DRG,0413,APR-DRG 38.00: Nervous System Malignancy,,,6624.51,6624.51,5
APR-DRG,0414,APR-DRG 38.00: Nervous System Malignancy,,,10350.8,10350.8,5
APR-DRG,0421,APR-DRG 38.00: Degenerative Nervous System Disorders Except Multiple Sclerosis,,,3785.43,3785.43,5
APR-DRG,0422,APR-DRG 38.00: Degenerative Nervous System Disorders Except Multiple Sclerosis,,,4554.35,4554.35,5
APR-DRG,0423,APR-DRG 38.00: Degenerative Nervous System Disorders Except Multiple Sclerosis,,,6920.25,6920.25,5
APR-DRG,0424,APR-DRG 38.00: Degenerative Nervous System Disorders Except Multiple Sclerosis,,,14550.26,14550.26,5
APR-DRG,0431,"APR-DRG 38.00: Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies",,,4850.09,4850.09,5
APR-DRG,0432,"APR-DRG 38.00: Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies",,,6624.51,6624.51,5
APR-DRG,0433,"APR-DRG 38.00: Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies",,,10291.65,10291.65,5
APR-DRG,0434,"APR-DRG 38.00: Multiple Sclerosis, Other Demyelinating Disease And Inflammatory Neuropathies",,,19814.38,19814.38,5
APR-DRG,0441,APR-DRG 38.00: Intracranial Hemorrhage,,,4672.64,4672.64,5
APR-DRG,0442,APR-DRG 38.00: Intracranial Hemorrhage,,,6151.33,6151.33,5
APR-DRG,0443,APR-DRG 38.00: Intracranial Hemorrhage,,,8694.67,8694.67,5
APR-DRG,0444,APR-DRG 38.00: Intracranial Hemorrhage,,,12066.07,12066.07,5
APR-DRG,0451,APR-DRG 38.00: Cva And Precerebral Occlusion With Infarction,,,4140.32,4140.32,5
APR-DRG,0452,APR-DRG 38.00: Cva And Precerebral Occlusion With Infarction,,,5204.97,5204.97,5
APR-DRG,0453,APR-DRG 38.00: Cva And Precerebral Occlusion With Infarction,,,7511.72,7511.72,5
APR-DRG,0454,APR-DRG 38.00: Cva And Precerebral Occlusion With Infarction,,,13544.75,13544.75,5
APR-DRG,0461,APR-DRG 38.00: Nonspecific Cva And Precerebral Occlusion Without Infarction,,,4081.17,4081.17,5
APR-DRG,0462,APR-DRG 38.00: Nonspecific Cva And Precerebral Occlusion Without Infarction,,,4790.94,4790.94,5
APR-DRG,0463,APR-DRG 38.00: Nonspecific Cva And Precerebral Occlusion Without Infarction,,,6328.77,6328.77,5
APR-DRG,0464,APR-DRG 38.00: Nonspecific Cva And Precerebral Occlusion Without Infarction,,,11356.3,11356.3,5
APR-DRG,0471,APR-DRG 38.00: Transient Ischemia,,,3607.99,3607.99,5
APR-DRG,0472,APR-DRG 38.00: Transient Ischemia,,,4022.02,4022.02,5
APR-DRG,0473,APR-DRG 38.00: Transient Ischemia,,,5204.97,5204.97,5
APR-DRG,0474,APR-DRG 38.00: Transient Ischemia,,,9581.88,9581.88,5
APR-DRG,0481,"APR-DRG 38.00: Peripheral, Cranial And Autonomic Nerve Disorders",,,3667.14,3667.14,5
APR-DRG,0482,"APR-DRG 38.00: Peripheral, Cranial And Autonomic Nerve Disorders",,,4199.47,4199.47,5
APR-DRG,0483,"APR-DRG 38.00: Peripheral, Cranial And Autonomic Nerve Disorders",,,5973.89,5973.89,5
APR-DRG,0484,"APR-DRG 38.00: Peripheral, Cranial And Autonomic Nerve Disorders",,,12361.81,12361.81,5
APR-DRG,0491,APR-DRG 38.00: Bacterial And Tuberculous Infections Of Nervous System,,,4909.23,4909.23,5
APR-DRG,0492,APR-DRG 38.00: Bacterial And Tuberculous Infections Of Nervous System,,,10705.68,10705.68,5
APR-DRG,0493,APR-DRG 38.00: Bacterial And Tuberculous Infections Of Nervous System,,,14195.38,14195.38,5
APR-DRG,0494,APR-DRG 38.00: Bacterial And Tuberculous Infections Of Nervous System,,,22890.04,22890.04,5
APR-DRG,0501,APR-DRG 38.00: Non-Bacterial Infections Of Nervous System Except Viral Meningitis,,,3726.29,3726.29,5
APR-DRG,0502,APR-DRG 38.00: Non-Bacterial Infections Of Nervous System Except Viral Meningitis,,,6742.8,6742.8,5
APR-DRG,0503,APR-DRG 38.00: Non-Bacterial Infections Of Nervous System Except Viral Meningitis,,,11829.48,11829.48,5
APR-DRG,0504,APR-DRG 38.00: Non-Bacterial Infections Of Nervous System Except Viral Meningitis,,,23954.7,23954.7,5
APR-DRG,0511,APR-DRG 38.00: Viral Meningitis,,,2661.63,2661.63,5
APR-DRG,0512,APR-DRG 38.00: Viral Meningitis,,,4022.02,4022.02,5
APR-DRG,0513,APR-DRG 38.00: Viral Meningitis,,,7570.87,7570.87,5
APR-DRG,0514,APR-DRG 38.00: Viral Meningitis,,,13071.58,13071.58,5
APR-DRG,0521,APR-DRG 38.00: Alteration In Consciousness,,,3371.4,3371.4,5
APR-DRG,0522,APR-DRG 38.00: Alteration In Consciousness,,,3844.58,3844.58,5
APR-DRG,0523,APR-DRG 38.00: Alteration In Consciousness,,,4909.23,4909.23,5
APR-DRG,0524,APR-DRG 38.00: Alteration In Consciousness,,,11533.74,11533.74,5
APR-DRG,0531,APR-DRG 38.00: Seizure,,,3134.81,3134.81,5
APR-DRG,0532,APR-DRG 38.00: Seizure,,,3785.43,3785.43,5
APR-DRG,0533,APR-DRG 38.00: Seizure,,,5027.53,5027.53,5
APR-DRG,0534,APR-DRG 38.00: Seizure,,,12539.25,12539.25,5
APR-DRG,0541,APR-DRG 38.00: Migraine And Other Headaches,,,3371.4,3371.4,5
APR-DRG,0542,APR-DRG 38.00: Migraine And Other Headaches,,,3962.88,3962.88,5
APR-DRG,0543,APR-DRG 38.00: Migraine And Other Headaches,,,4850.09,4850.09,5
APR-DRG,0544,APR-DRG 38.00: Migraine And Other Headaches,,,9167.85,9167.85,5
APR-DRG,0551,APR-DRG 38.00: Head Trauma With Coma > 1 Hour Or Hemorrhage,,,4022.02,4022.02,5
APR-DRG,0552,APR-DRG 38.00: Head Trauma With Coma > 1 Hour Or Hemorrhage,,,5500.71,5500.71,5
APR-DRG,0553,APR-DRG 38.00: Head Trauma With Coma > 1 Hour Or Hemorrhage,,,8398.93,8398.93,5
APR-DRG,0554,APR-DRG 38.00: Head Trauma With Coma > 1 Hour Or Hemorrhage,,,16916.16,16916.16,5
APR-DRG,0561,"APR-DRG 38.00: Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma",,,3667.14,3667.14,5
APR-DRG,0562,"APR-DRG 38.00: Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma",,,5264.12,5264.12,5
APR-DRG,0563,"APR-DRG 38.00: Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma",,,8398.93,8398.93,5
APR-DRG,0564,"APR-DRG 38.00: Brain Contusion Or Laceration And Complicated Skull Fracture, Coma < 1 Hour Or No Coma",,,15792.36,15792.36,5
APR-DRG,0571,"APR-DRG 38.00: Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma",,,3667.14,3667.14,5
APR-DRG,0572,"APR-DRG 38.00: Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma",,,5086.68,5086.68,5
APR-DRG,0573,"APR-DRG 38.00: Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma",,,7097.69,7097.69,5
APR-DRG,0574,"APR-DRG 38.00: Concussion, Closed Skull Fracture Nos, And Uncomplicated Intracranial Injury, Coma < 1 Hour Or No Coma",,,13663.05,13663.05,5
APR-DRG,0581,APR-DRG 38.00: Other Disorders Of Nervous System,,,4731.79,4731.79,5
APR-DRG,0582,APR-DRG 38.00: Other Disorders Of Nervous System,,,6328.77,6328.77,5
APR-DRG,0583,APR-DRG 38.00: Other Disorders Of Nervous System,,,8162.34,8162.34,5
APR-DRG,0584,APR-DRG 38.00: Other Disorders Of Nervous System,,,12125.22,12125.22,5
APR-DRG,0591,APR-DRG 38.00: Anoxic And Other Severe Brain Damage,,,3607.99,3607.99,5
APR-DRG,0592,APR-DRG 38.00: Anoxic And Other Severe Brain Damage,,,5678.15,5678.15,5
APR-DRG,0593,APR-DRG 38.00: Anoxic And Other Severe Brain Damage,,,8280.64,8280.64,5
APR-DRG,0594,APR-DRG 38.00: Anoxic And Other Severe Brain Damage,,,12953.28,12953.28,5
APR-DRG,0731,APR-DRG 38.00: Orbit And Eye Procedures,,,5264.12,5264.12,5
APR-DRG,0732,APR-DRG 38.00: Orbit And Eye Procedures,,,7511.72,7511.72,5
APR-DRG,0733,APR-DRG 38.00: Orbit And Eye Procedures,,,12775.84,12775.84,5
APR-DRG,0734,APR-DRG 38.00: Orbit And Eye Procedures,,,24250.43,24250.43,5
APR-DRG,0821,APR-DRG 38.00: Eye Infections And Other Eye Disorders,,,3253.11,3253.11,5
APR-DRG,0822,APR-DRG 38.00: Eye Infections And Other Eye Disorders,,,3962.88,3962.88,5
APR-DRG,0823,APR-DRG 38.00: Eye Infections And Other Eye Disorders,,,6033.03,6033.03,5
APR-DRG,0824,APR-DRG 38.00: Eye Infections And Other Eye Disorders,,,14077.08,14077.08,5
APR-DRG,0891,APR-DRG 38.00: Major Cranial Or Facial Bone Procedures,,,9286.14,9286.14,5
APR-DRG,0892,APR-DRG 38.00: Major Cranial Or Facial Bone Procedures,,,12125.22,12125.22,5
APR-DRG,0893,APR-DRG 38.00: Major Cranial Or Facial Bone Procedures,,,21293.06,21293.06,5
APR-DRG,0894,APR-DRG 38.00: Major Cranial Or Facial Bone Procedures,,,35902.47,35902.47,5
APR-DRG,0911,APR-DRG 38.00: Other Major Head And Neck Procedures,,,8162.34,8162.34,5
APR-DRG,0912,APR-DRG 38.00: Other Major Head And Neck Procedures,,,12243.51,12243.51,5
APR-DRG,0913,APR-DRG 38.00: Other Major Head And Neck Procedures,,,21470.51,21470.51,5
APR-DRG,0914,APR-DRG 38.00: Other Major Head And Neck Procedures,,,36079.91,36079.91,5
APR-DRG,0921,APR-DRG 38.00: Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures,,,7570.87,7570.87,5
APR-DRG,0922,APR-DRG 38.00: Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures,,,9641.03,9641.03,5
APR-DRG,0923,APR-DRG 38.00: Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures,,,15141.73,15141.73,5
APR-DRG,0924,APR-DRG 38.00: Facial Bone Procedures Except Major Cranial Or Facial Bone Procedures,,,27207.8,27207.8,5
APR-DRG,0951,APR-DRG 38.00: Cleft Lip And Palate Repair,,,4317.76,4317.76,5
APR-DRG,0952,APR-DRG 38.00: Cleft Lip And Palate Repair,,,4672.64,4672.64,5
APR-DRG,0953,APR-DRG 38.00: Cleft Lip And Palate Repair,,,7275.13,7275.13,5
APR-DRG,0954,APR-DRG 38.00: Cleft Lip And Palate Repair,,,16324.68,16324.68,5
APR-DRG,0971,APR-DRG 38.00: Tonsil And Adenoid Procedures,,,3193.96,3193.96,5
APR-DRG,0972,APR-DRG 38.00: Tonsil And Adenoid Procedures,,,4672.64,4672.64,5
APR-DRG,0973,APR-DRG 38.00: Tonsil And Adenoid Procedures,,,8162.34,8162.34,5
APR-DRG,0974,APR-DRG 38.00: Tonsil And Adenoid Procedures,,,14491.11,14491.11,5
APR-DRG,0981,"APR-DRG 38.00: Other Ear, Nose, Mouth And Throat Procedures",,,5204.97,5204.97,5
APR-DRG,0982,"APR-DRG 38.00: Other Ear, Nose, Mouth And Throat Procedures",,,7393.43,7393.43,5
APR-DRG,0983,"APR-DRG 38.00: Other Ear, Nose, Mouth And Throat Procedures",,,12716.69,12716.69,5
APR-DRG,0984,"APR-DRG 38.00: Other Ear, Nose, Mouth And Throat Procedures",,,23363.22,23363.22,5
APR-DRG,1101,"APR-DRG 38.00: Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies",,,4140.32,4140.32,5
APR-DRG,1102,"APR-DRG 38.00: Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies",,,5027.53,5027.53,5
APR-DRG,1103,"APR-DRG 38.00: Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies",,,7689.16,7689.16,5
APR-DRG,1104,"APR-DRG 38.00: Ear, Nose, Mouth, Throat And Cranial Or Facial Malignancies",,,13130.72,13130.72,5
APR-DRG,1111,APR-DRG 38.00: Vertigo And Other Labyrinth Disorders,,,3253.11,3253.11,5
APR-DRG,1112,APR-DRG 38.00: Vertigo And Other Labyrinth Disorders,,,3548.84,3548.84,5
APR-DRG,1113,APR-DRG 38.00: Vertigo And Other Labyrinth Disorders,,,4495.2,4495.2,5
APR-DRG,1114,APR-DRG 38.00: Vertigo And Other Labyrinth Disorders,,,5914.74,5914.74,5
APR-DRG,1131,APR-DRG 38.00: Infections Of Upper Respiratory Tract,,,2011.01,2011.01,5
APR-DRG,1132,APR-DRG 38.00: Infections Of Upper Respiratory Tract,,,2839.08,2839.08,5
APR-DRG,1133,APR-DRG 38.00: Infections Of Upper Respiratory Tract,,,4140.32,4140.32,5
APR-DRG,1134,APR-DRG 38.00: Infections Of Upper Respiratory Tract,,,7925.75,7925.75,5
APR-DRG,1141,APR-DRG 38.00: Dental Diseases And Disorders,,,2425.04,2425.04,5
APR-DRG,1142,APR-DRG 38.00: Dental Diseases And Disorders,,,3253.11,3253.11,5
APR-DRG,1143,APR-DRG 38.00: Dental Diseases And Disorders,,,5500.71,5500.71,5
APR-DRG,1144,APR-DRG 38.00: Dental Diseases And Disorders,,,13426.46,13426.46,5
APR-DRG,1151,"APR-DRG 38.00: Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses",,,2898.22,2898.22,5
APR-DRG,1152,"APR-DRG 38.00: Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses",,,3844.58,3844.58,5
APR-DRG,1153,"APR-DRG 38.00: Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses",,,6033.03,6033.03,5
APR-DRG,1154,"APR-DRG 38.00: Other Ear, Nose, Mouth, Throat And Cranial Or Facial Diagnoses",,,11415.45,11415.45,5
APR-DRG,1201,APR-DRG 38.00: Major Respiratory And Chest Procedures,,,9700.17,9700.17,5
APR-DRG,1202,APR-DRG 38.00: Major Respiratory And Chest Procedures,,,12006.92,12006.92,5
APR-DRG,1203,APR-DRG 38.00: Major Respiratory And Chest Procedures,,,18276.55,18276.55,5
APR-DRG,1204,APR-DRG 38.00: Major Respiratory And Chest Procedures,,,32057.89,32057.89,5
APR-DRG,1211,APR-DRG 38.00: Other Respiratory And Chest Procedures,,,7156.84,7156.84,5
APR-DRG,1212,APR-DRG 38.00: Other Respiratory And Chest Procedures,,,9759.32,9759.32,5
APR-DRG,1213,APR-DRG 38.00: Other Respiratory And Chest Procedures,,,15141.73,15141.73,5
APR-DRG,1214,APR-DRG 38.00: Other Respiratory And Chest Procedures,,,26202.3,26202.3,5
APR-DRG,1301,APR-DRG 38.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours,,,16088.09,16088.09,5
APR-DRG,1302,APR-DRG 38.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours,,,19104.61,19104.61,5
APR-DRG,1303,APR-DRG 38.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours,,,22476.01,22476.01,5
APR-DRG,1304,APR-DRG 38.00: Respiratory System Diagnosis With Ventilator Support > 96 Hours,,,30165.17,30165.17,5
APR-DRG,1311,APR-DRG 38.00: Cystic Fibrosis - Pulmonary Disease,,,7038.54,7038.54,5
APR-DRG,1312,APR-DRG 38.00: Cystic Fibrosis - Pulmonary Disease,,,8635.52,8635.52,5
APR-DRG,1313,APR-DRG 38.00: Cystic Fibrosis - Pulmonary Disease,,,11770.33,11770.33,5
APR-DRG,1314,APR-DRG 38.00: Cystic Fibrosis - Pulmonary Disease,,,15614.91,15614.91,5
APR-DRG,1321,APR-DRG 38.00: Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period,,,2661.63,2661.63,5
APR-DRG,1322,APR-DRG 38.00: Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period,,,3548.84,3548.84,5
APR-DRG,1323,APR-DRG 38.00: Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period,,,5914.74,5914.74,5
APR-DRG,1324,APR-DRG 38.00: Bpd And Other Chronic Respiratory Diseases Arising In Perinatal Period,,,10291.65,10291.65,5
APR-DRG,1331,APR-DRG 38.00: Respiratory Failure,,,2365.9,2365.9,5
APR-DRG,1332,APR-DRG 38.00: Respiratory Failure,,,3903.73,3903.73,5
APR-DRG,1333,APR-DRG 38.00: Respiratory Failure,,,5973.89,5973.89,5
APR-DRG,1334,APR-DRG 38.00: Respiratory Failure,,,10469.09,10469.09,5
APR-DRG,1341,APR-DRG 38.00: Pulmonary Embolism,,,3193.96,3193.96,5
APR-DRG,1342,APR-DRG 38.00: Pulmonary Embolism,,,4199.47,4199.47,5
APR-DRG,1343,APR-DRG 38.00: Pulmonary Embolism,,,6269.62,6269.62,5
APR-DRG,1344,APR-DRG 38.00: Pulmonary Embolism,,,9641.03,9641.03,5
APR-DRG,1351,APR-DRG 38.00: Major Chest And Respiratory Trauma,,,4081.17,4081.17,5
APR-DRG,1352,APR-DRG 38.00: Major Chest And Respiratory Trauma,,,4790.94,4790.94,5
APR-DRG,1353,APR-DRG 38.00: Major Chest And Respiratory Trauma,,,6742.8,6742.8,5
APR-DRG,1354,APR-DRG 38.00: Major Chest And Respiratory Trauma,,,11711.19,11711.19,5
APR-DRG,1361,APR-DRG 38.00: Respiratory Malignancy,,,3962.88,3962.88,5
APR-DRG,1362,APR-DRG 38.00: Respiratory Malignancy,,,5204.97,5204.97,5
APR-DRG,1363,APR-DRG 38.00: Respiratory Malignancy,,,7393.43,7393.43,5
APR-DRG,1364,APR-DRG 38.00: Respiratory Malignancy,,,10942.27,10942.27,5
APR-DRG,1371,APR-DRG 38.00: Major Respiratory Infections And Inflammations,,,3371.4,3371.4,5
APR-DRG,1372,APR-DRG 38.00: Major Respiratory Infections And Inflammations,,,4436.06,4436.06,5
APR-DRG,1373,APR-DRG 38.00: Major Respiratory Infections And Inflammations,,,6210.48,6210.48,5
APR-DRG,1374,APR-DRG 38.00: Major Respiratory Infections And Inflammations,,,9108.7,9108.7,5
APR-DRG,1381,APR-DRG 38.00: Bronchiolitis And Rsv Pneumonia,,,1833.57,1833.57,5
APR-DRG,1382,APR-DRG 38.00: Bronchiolitis And Rsv Pneumonia,,,2720.78,2720.78,5
APR-DRG,1383,APR-DRG 38.00: Bronchiolitis And Rsv Pneumonia,,,4554.35,4554.35,5
APR-DRG,1384,APR-DRG 38.00: Bronchiolitis And Rsv Pneumonia,,,10705.68,10705.68,5
APR-DRG,1391,APR-DRG 38.00: Other Pneumonia,,,2484.19,2484.19,5
APR-DRG,1392,APR-DRG 38.00: Other Pneumonia,,,3371.4,3371.4,5
APR-DRG,1393,APR-DRG 38.00: Other Pneumonia,,,4850.09,4850.09,5
APR-DRG,1394,APR-DRG 38.00: Other Pneumonia,,,7748.31,7748.31,5
APR-DRG,1401,APR-DRG 38.00: Chronic Obstructive Pulmonary Disease,,,2898.22,2898.22,5
APR-DRG,1402,APR-DRG 38.00: Chronic Obstructive Pulmonary Disease,,,3607.99,3607.99,5
APR-DRG,1403,APR-DRG 38.00: Chronic Obstructive Pulmonary Disease,,,4495.2,4495.2,5
APR-DRG,1404,APR-DRG 38.00: Chronic Obstructive Pulmonary Disease,,,7097.69,7097.69,5
APR-DRG,1411,APR-DRG 38.00: Asthma,,,2306.75,2306.75,5
APR-DRG,1412,APR-DRG 38.00: Asthma,,,3371.4,3371.4,5
APR-DRG,1413,APR-DRG 38.00: Asthma,,,4022.02,4022.02,5
APR-DRG,1414,APR-DRG 38.00: Asthma,,,7630.01,7630.01,5
APR-DRG,1421,APR-DRG 38.00: Interstitial And Alveolar Lung Diseases,,,3430.55,3430.55,5
APR-DRG,1422,APR-DRG 38.00: Interstitial And Alveolar Lung Diseases,,,4376.91,4376.91,5
APR-DRG,1423,APR-DRG 38.00: Interstitial And Alveolar Lung Diseases,,,6033.03,6033.03,5
APR-DRG,1424,APR-DRG 38.00: Interstitial And Alveolar Lung Diseases,,,9286.14,9286.14,5
APR-DRG,1431,"APR-DRG 38.00: Other Respiratory Diagnoses Except Signs, Symptoms And Miscellaneous Diagnoses",,,2779.93,2779.93,5
APR-DRG,1432,"APR-DRG 38.00: Other Respiratory Diagnoses Except Signs, Symptoms And Miscellaneous Diagnoses",,,4022.02,4022.02,5
APR-DRG,1433,"APR-DRG 38.00: Other Respiratory Diagnoses Except Signs, Symptoms And Miscellaneous Diagnoses",,,5796.45,5796.45,5
APR-DRG,1434,"APR-DRG 38.00: Other Respiratory Diagnoses Except Signs, Symptoms And Miscellaneous Diagnoses",,,9049.55,9049.55,5
APR-DRG,1441,"APR-DRG 38.00: Respiratory Signs, Symptoms And Miscellaneous Diagnoses",,,3016.52,3016.52,5
APR-DRG,1442,"APR-DRG 38.00: Respiratory Signs, Symptoms And Miscellaneous Diagnoses",,,3844.58,3844.58,5
APR-DRG,1443,"APR-DRG 38.00: Respiratory Signs, Symptoms And Miscellaneous Diagnoses",,,5382.41,5382.41,5
APR-DRG,1444,"APR-DRG 38.00: Respiratory Signs, Symptoms And Miscellaneous Diagnoses",,,9226.99,9226.99,5
APR-DRG,1451,APR-DRG 38.00: Acute Bronchitis And Related Symptoms,,,2779.93,2779.93,5
APR-DRG,1452,APR-DRG 38.00: Acute Bronchitis And Related Symptoms,,,3312.25,3312.25,5
APR-DRG,1453,APR-DRG 38.00: Acute Bronchitis And Related Symptoms,,,4436.06,4436.06,5
APR-DRG,1454,APR-DRG 38.00: Acute Bronchitis And Related Symptoms,,,7570.87,7570.87,5
APR-DRG,1601,APR-DRG 38.00: Major Cardiothoracic Repair Of Heart Anomaly,,,18927.17,18927.17,5
APR-DRG,1602,APR-DRG 38.00: Major Cardiothoracic Repair Of Heart Anomaly,,,22298.57,22298.57,5
APR-DRG,1603,APR-DRG 38.00: Major Cardiothoracic Repair Of Heart Anomaly,,,30283.47,30283.47,5
APR-DRG,1604,APR-DRG 38.00: Major Cardiothoracic Repair Of Heart Anomaly,,,63820.04,63820.04,5
APR-DRG,1611,APR-DRG 38.00: Implantable Heart Assist Systems,,,65949.35,65949.35,5
APR-DRG,1612,APR-DRG 38.00: Implantable Heart Assist Systems,,,65949.35,65949.35,5
APR-DRG,1613,APR-DRG 38.00: Implantable Heart Assist Systems,,,94162.66,94162.66,5
APR-DRG,1614,APR-DRG 38.00: Implantable Heart Assist Systems,,,135033.51,135033.51,5
APR-DRG,1621,APR-DRG 38.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,,,23304.08,23304.08,5
APR-DRG,1622,APR-DRG 38.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,,,26912.07,26912.07,5
APR-DRG,1623,APR-DRG 38.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,,,36139.06,36139.06,5
APR-DRG,1624,APR-DRG 38.00: Cardiac Valve Procedures With Ami Or Complex Principal Diagnosis,,,55657.7,55657.7,5
APR-DRG,1631,APR-DRG 38.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,,,19991.82,19991.82,5
APR-DRG,1632,APR-DRG 38.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,,,22121.13,22121.13,5
APR-DRG,1633,APR-DRG 38.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,,,29514.55,29514.55,5
APR-DRG,1634,APR-DRG 38.00: Cardiac Valve Procedures Without Ami Or Complex Principal Diagnosis,,,46312.41,46312.41,5
APR-DRG,1651,APR-DRG 38.00: Coronary Bypass With Ami Or Complex Principal Diagnosis,,,19459.49,19459.49,5
APR-DRG,1652,APR-DRG 38.00: Coronary Bypass With Ami Or Complex Principal Diagnosis,,,23008.34,23008.34,5
APR-DRG,1653,APR-DRG 38.00: Coronary Bypass With Ami Or Complex Principal Diagnosis,,,29159.67,29159.67,5
APR-DRG,1654,APR-DRG 38.00: Coronary Bypass With Ami Or Complex Principal Diagnosis,,,42763.57,42763.57,5
APR-DRG,1661,APR-DRG 38.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis,,,17093.6,17093.6,5
APR-DRG,1662,APR-DRG 38.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis,,,19104.61,19104.61,5
APR-DRG,1663,APR-DRG 38.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis,,,23954.7,23954.7,5
APR-DRG,1664,APR-DRG 38.00: Coronary Bypass Without Ami Or Complex Principal Diagnosis,,,36848.83,36848.83,5
APR-DRG,1671,APR-DRG 38.00: Other Cardiothoracic And Thoracic Vascular Procedures,,,16502.12,16502.12,5
APR-DRG,1672,APR-DRG 38.00: Other Cardiothoracic And Thoracic Vascular Procedures,,,16502.12,16502.12,5
APR-DRG,1673,APR-DRG 38.00: Other Cardiothoracic And Thoracic Vascular Procedures,,,25729.12,25729.12,5
APR-DRG,1674,APR-DRG 38.00: Other Cardiothoracic And Thoracic Vascular Procedures,,,44833.73,44833.73,5
APR-DRG,1691,APR-DRG 38.00: Major Abdominal Vascular Procedures,,,14431.97,14431.97,5
APR-DRG,1692,APR-DRG 38.00: Major Abdominal Vascular Procedures,,,15260.03,15260.03,5
APR-DRG,1693,APR-DRG 38.00: Major Abdominal Vascular Procedures,,,21174.77,21174.77,5
APR-DRG,1694,APR-DRG 38.00: Major Abdominal Vascular Procedures,,,36020.77,36020.77,5
APR-DRG,1701,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock",,,11238.01,11238.01,5
APR-DRG,1702,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock",,,13249.02,13249.02,5
APR-DRG,1703,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock",,,15437.47,15437.47,5
APR-DRG,1704,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant With Ami, Heart Failure Or Shock",,,25492.53,25492.53,5
APR-DRG,1711,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock",,,8458.08,8458.08,5
APR-DRG,1712,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock",,,9641.03,9641.03,5
APR-DRG,1713,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock",,,12716.69,12716.69,5
APR-DRG,1714,"APR-DRG 38.00: Permanent Cardiac Pacemaker Implant Without Ami, Heart Failure Or Shock",,,20405.85,20405.85,5
APR-DRG,1741,APR-DRG 38.00: Percutaneous Cardiac Intervention With Ami,,,10173.35,10173.35,5
APR-DRG,1742,APR-DRG 38.00: Percutaneous Cardiac Intervention With Ami,,,11238.01,11238.01,5
APR-DRG,1743,APR-DRG 38.00: Percutaneous Cardiac Intervention With Ami,,,14550.26,14550.26,5
APR-DRG,1744,APR-DRG 38.00: Percutaneous Cardiac Intervention With Ami,,,21411.36,21411.36,5
APR-DRG,1751,APR-DRG 38.00: Percutaneous Cardiac Intervention Without Ami,,,11178.86,11178.86,5
APR-DRG,1752,APR-DRG 38.00: Percutaneous Cardiac Intervention Without Ami,,,12657.54,12657.54,5
APR-DRG,1753,APR-DRG 38.00: Percutaneous Cardiac Intervention Without Ami,,,15496.62,15496.62,5
APR-DRG,1754,APR-DRG 38.00: Percutaneous Cardiac Intervention Without Ami,,,23718.11,23718.11,5
APR-DRG,1761,"APR-DRG 38.00: Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices",,,9581.88,9581.88,5
APR-DRG,1762,"APR-DRG 38.00: Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices",,,11711.19,11711.19,5
APR-DRG,1763,"APR-DRG 38.00: Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices",,,18039.96,18039.96,5
APR-DRG,1764,"APR-DRG 38.00: Insertion, Revision And Replacements Of Pacemaker And Other Cardiac Devices",,,30934.09,30934.09,5
APR-DRG,1771,APR-DRG 38.00: Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,,,7097.69,7097.69,5
APR-DRG,1772,APR-DRG 38.00: Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,,,10409.94,10409.94,5
APR-DRG,1773,APR-DRG 38.00: Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,,,14254.52,14254.52,5
APR-DRG,1774,APR-DRG 38.00: Cardiac Pacemaker And Defibrillator Revision Except Device Replacement,,,19459.49,19459.49,5
APR-DRG,1781,APR-DRG 38.00: External Heart Assist Systems,,,24841.91,24841.91,5
APR-DRG,1782,APR-DRG 38.00: External Heart Assist Systems,,,27976.72,27976.72,5
APR-DRG,1783,APR-DRG 38.00: External Heart Assist Systems,,,32826.81,32826.81,5
APR-DRG,1784,APR-DRG 38.00: External Heart Assist Systems,,,46785.59,46785.59,5
APR-DRG,1791,APR-DRG 38.00: Defibrillator Implants,,,19636.94,19636.94,5
APR-DRG,1792,APR-DRG 38.00: Defibrillator Implants,,,22239.42,22239.42,5
APR-DRG,1793,APR-DRG 38.00: Defibrillator Implants,,,27089.51,27089.51,5
APR-DRG,1794,APR-DRG 38.00: Defibrillator Implants,,,36671.39,36671.39,5
APR-DRG,1801,APR-DRG 38.00: Other Circulatory System Procedures,,,6624.51,6624.51,5
APR-DRG,1802,APR-DRG 38.00: Other Circulatory System Procedures,,,8753.82,8753.82,5
APR-DRG,1803,APR-DRG 38.00: Other Circulatory System Procedures,,,12539.25,12539.25,5
APR-DRG,1804,APR-DRG 38.00: Other Circulatory System Procedures,,,23540.67,23540.67,5
APR-DRG,1811,APR-DRG 38.00: Lower Extremity Arterial Procedures,,,7925.75,7925.75,5
APR-DRG,1812,APR-DRG 38.00: Lower Extremity Arterial Procedures,,,11474.6,11474.6,5
APR-DRG,1813,APR-DRG 38.00: Lower Extremity Arterial Procedures,,,18572.28,18572.28,5
APR-DRG,1814,APR-DRG 38.00: Lower Extremity Arterial Procedures,,,31407.27,31407.27,5
APR-DRG,1821,APR-DRG 38.00: Other Peripheral Vascular Procedures,,,10823.97,10823.97,5
APR-DRG,1822,APR-DRG 38.00: Other Peripheral Vascular Procedures,,,12125.22,12125.22,5
APR-DRG,1823,APR-DRG 38.00: Other Peripheral Vascular Procedures,,,14786.85,14786.85,5
APR-DRG,1824,APR-DRG 38.00: Other Peripheral Vascular Procedures,,,26498.04,26498.04,5
APR-DRG,1831,APR-DRG 38.00: Percutaneous Structural Cardiac Procedures,,,22653.45,22653.45,5
APR-DRG,1832,APR-DRG 38.00: Percutaneous Structural Cardiac Procedures,,,23836.4,23836.4,5
APR-DRG,1833,APR-DRG 38.00: Percutaneous Structural Cardiac Procedures,,,28390.75,28390.75,5
APR-DRG,1834,APR-DRG 38.00: Percutaneous Structural Cardiac Procedures,,,41225.74,41225.74,5
APR-DRG,1901,APR-DRG 38.00: Acute Myocardial Infarction,,,4317.76,4317.76,5
APR-DRG,1902,APR-DRG 38.00: Acute Myocardial Infarction,,,4850.09,4850.09,5
APR-DRG,1903,APR-DRG 38.00: Acute Myocardial Infarction,,,6447.07,6447.07,5
APR-DRG,1904,APR-DRG 38.00: Acute Myocardial Infarction,,,10055.06,10055.06,5
APR-DRG,1911,APR-DRG 38.00: Cardiac Catheterization For Coronary Artery Disease,,,5145.82,5145.82,5
APR-DRG,1912,APR-DRG 38.00: Cardiac Catheterization For Coronary Artery Disease,,,6033.03,6033.03,5
APR-DRG,1913,APR-DRG 38.00: Cardiac Catheterization For Coronary Artery Disease,,,8044.05,8044.05,5
APR-DRG,1914,APR-DRG 38.00: Cardiac Catheterization For Coronary Artery Disease,,,12657.54,12657.54,5
APR-DRG,1921,APR-DRG 38.00: Cardiac Catheterization For Other Non-Coronary Conditions,,,5500.71,5500.71,5
APR-DRG,1922,APR-DRG 38.00: Cardiac Catheterization For Other Non-Coronary Conditions,,,6861.1,6861.1,5
APR-DRG,1923,APR-DRG 38.00: Cardiac Catheterization For Other Non-Coronary Conditions,,,9995.91,9995.91,5
APR-DRG,1924,APR-DRG 38.00: Cardiac Catheterization For Other Non-Coronary Conditions,,,16206.39,16206.39,5
APR-DRG,1931,APR-DRG 38.00: Acute And Subacute Endocarditis,,,4672.64,4672.64,5
APR-DRG,1932,APR-DRG 38.00: Acute And Subacute Endocarditis,,,6269.62,6269.62,5
APR-DRG,1933,APR-DRG 38.00: Acute And Subacute Endocarditis,,,9700.17,9700.17,5
APR-DRG,1934,APR-DRG 38.00: Acute And Subacute Endocarditis,,,13899.64,13899.64,5
APR-DRG,1941,APR-DRG 38.00: Heart Failure,,,2839.08,2839.08,5
APR-DRG,1942,APR-DRG 38.00: Heart Failure,,,3785.43,3785.43,5
APR-DRG,1943,APR-DRG 38.00: Heart Failure,,,5382.41,5382.41,5
APR-DRG,1944,APR-DRG 38.00: Heart Failure,,,8753.82,8753.82,5
APR-DRG,1961,APR-DRG 38.00: Cardiac Arrest And Shock,,,2425.04,2425.04,5
APR-DRG,1962,APR-DRG 38.00: Cardiac Arrest And Shock,,,3312.25,3312.25,5
APR-DRG,1963,APR-DRG 38.00: Cardiac Arrest And Shock,,,4790.94,4790.94,5
APR-DRG,1964,APR-DRG 38.00: Cardiac Arrest And Shock,,,9759.32,9759.32,5
APR-DRG,1971,APR-DRG 38.00: Peripheral And Other Vascular Disorders,,,3016.52,3016.52,5
APR-DRG,1972,APR-DRG 38.00: Peripheral And Other Vascular Disorders,,,3903.73,3903.73,5
APR-DRG,1973,APR-DRG 38.00: Peripheral And Other Vascular Disorders,,,5441.56,5441.56,5
APR-DRG,1974,APR-DRG 38.00: Peripheral And Other Vascular Disorders,,,11297.15,11297.15,5
APR-DRG,1981,APR-DRG 38.00: Angina Pectoris And Coronary Atherosclerosis,,,2957.37,2957.37,5
APR-DRG,1982,APR-DRG 38.00: Angina Pectoris And Coronary Atherosclerosis,,,3430.55,3430.55,5
APR-DRG,1983,APR-DRG 38.00: Angina Pectoris And Coronary Atherosclerosis,,,4554.35,4554.35,5
APR-DRG,1984,APR-DRG 38.00: Angina Pectoris And Coronary Atherosclerosis,,,8872.11,8872.11,5
APR-DRG,1991,APR-DRG 38.00: Hypertension,,,2957.37,2957.37,5
APR-DRG,1992,APR-DRG 38.00: Hypertension,,,3430.55,3430.55,5
APR-DRG,1993,APR-DRG 38.00: Hypertension,,,4790.94,4790.94,5
APR-DRG,1994,APR-DRG 38.00: Hypertension,,,7748.31,7748.31,5
APR-DRG,2001,APR-DRG 38.00: Cardiac Structural And Valvular Disorders,,,3134.81,3134.81,5
APR-DRG,2002,APR-DRG 38.00: Cardiac Structural And Valvular Disorders,,,3962.88,3962.88,5
APR-DRG,2003,APR-DRG 38.00: Cardiac Structural And Valvular Disorders,,,5678.15,5678.15,5
APR-DRG,2004,APR-DRG 38.00: Cardiac Structural And Valvular Disorders,,,10469.09,10469.09,5
APR-DRG,2011,APR-DRG 38.00: Cardiac Arrhythmia And Conduction Disorders,,,2484.19,2484.19,5
APR-DRG,2012,APR-DRG 38.00: Cardiac Arrhythmia And Conduction Disorders,,,3253.11,3253.11,5
APR-DRG,2013,APR-DRG 38.00: Cardiac Arrhythmia And Conduction Disorders,,,4909.23,4909.23,5
APR-DRG,2014,APR-DRG 38.00: Cardiac Arrhythmia And Conduction Disorders,,,8812.96,8812.96,5
APR-DRG,2031,APR-DRG 38.00: Chest Pain,,,3075.66,3075.66,5
APR-DRG,2032,APR-DRG 38.00: Chest Pain,,,3489.7,3489.7,5
APR-DRG,2033,APR-DRG 38.00: Chest Pain,,,4317.76,4317.76,5
APR-DRG,2034,APR-DRG 38.00: Chest Pain,,,6033.03,6033.03,5
APR-DRG,2041,APR-DRG 38.00: Syncope And Collapse,,,3312.25,3312.25,5
APR-DRG,2042,APR-DRG 38.00: Syncope And Collapse,,,3726.29,3726.29,5
APR-DRG,2043,APR-DRG 38.00: Syncope And Collapse,,,4731.79,4731.79,5
APR-DRG,2044,APR-DRG 38.00: Syncope And Collapse,,,7630.01,7630.01,5
APR-DRG,2051,APR-DRG 38.00: Cardiomyopathy,,,3075.66,3075.66,5
APR-DRG,2052,APR-DRG 38.00: Cardiomyopathy,,,3844.58,3844.58,5
APR-DRG,2053,APR-DRG 38.00: Cardiomyopathy,,,5619.0,5619.0,5
APR-DRG,2054,APR-DRG 38.00: Cardiomyopathy,,,11178.86,11178.86,5
APR-DRG,2061,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure",,,4199.47,4199.47,5
APR-DRG,2062,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure",,,4376.91,4376.91,5
APR-DRG,2063,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure",,,6328.77,6328.77,5
APR-DRG,2064,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Cardiac Or Vascular Device Or Procedure",,,13603.9,13603.9,5
APR-DRG,2071,APR-DRG 38.00: Other Circulatory System Diagnoses,,,3016.52,3016.52,5
APR-DRG,2072,APR-DRG 38.00: Other Circulatory System Diagnoses,,,3844.58,3844.58,5
APR-DRG,2073,APR-DRG 38.00: Other Circulatory System Diagnoses,,,5559.86,5559.86,5
APR-DRG,2074,APR-DRG 38.00: Other Circulatory System Diagnoses,,,9759.32,9759.32,5
APR-DRG,2201,"APR-DRG 38.00: Major Stomach, Esophageal And Duodenal Procedures",,,7511.72,7511.72,5
APR-DRG,2202,"APR-DRG 38.00: Major Stomach, Esophageal And Duodenal Procedures",,,11415.45,11415.45,5
APR-DRG,2203,"APR-DRG 38.00: Major Stomach, Esophageal And Duodenal Procedures",,,17803.37,17803.37,5
APR-DRG,2204,"APR-DRG 38.00: Major Stomach, Esophageal And Duodenal Procedures",,,33714.02,33714.02,5
APR-DRG,2221,"APR-DRG 38.00: Other Stomach, Esophageal And Duodenal Procedures",,,4258.61,4258.61,5
APR-DRG,2222,"APR-DRG 38.00: Other Stomach, Esophageal And Duodenal Procedures",,,6861.1,6861.1,5
APR-DRG,2223,"APR-DRG 38.00: Other Stomach, Esophageal And Duodenal Procedures",,,11474.6,11474.6,5
APR-DRG,2224,"APR-DRG 38.00: Other Stomach, Esophageal And Duodenal Procedures",,,23185.78,23185.78,5
APR-DRG,2231,APR-DRG 38.00: Other Small And Large Bowel Procedures,,,5678.15,5678.15,5
APR-DRG,2232,APR-DRG 38.00: Other Small And Large Bowel Procedures,,,8221.49,8221.49,5
APR-DRG,2233,APR-DRG 38.00: Other Small And Large Bowel Procedures,,,12302.66,12302.66,5
APR-DRG,2234,APR-DRG 38.00: Other Small And Large Bowel Procedures,,,23067.49,23067.49,5
APR-DRG,2241,APR-DRG 38.00: Peritoneal Adhesiolysis,,,6506.21,6506.21,5
APR-DRG,2242,APR-DRG 38.00: Peritoneal Adhesiolysis,,,8517.23,8517.23,5
APR-DRG,2243,APR-DRG 38.00: Peritoneal Adhesiolysis,,,12243.51,12243.51,5
APR-DRG,2244,APR-DRG 38.00: Peritoneal Adhesiolysis,,,22476.01,22476.01,5
APR-DRG,2261,APR-DRG 38.00: Anal Procedures,,,4790.94,4790.94,5
APR-DRG,2262,APR-DRG 38.00: Anal Procedures,,,6624.51,6624.51,5
APR-DRG,2263,APR-DRG 38.00: Anal Procedures,,,9581.88,9581.88,5
APR-DRG,2264,APR-DRG 38.00: Anal Procedures,,,22535.16,22535.16,5
APR-DRG,2271,"APR-DRG 38.00: Hernia Procedures Except Inguinal, Femoral And Umbilical",,,6328.77,6328.77,5
APR-DRG,2272,"APR-DRG 38.00: Hernia Procedures Except Inguinal, Femoral And Umbilical",,,7984.9,7984.9,5
APR-DRG,2273,"APR-DRG 38.00: Hernia Procedures Except Inguinal, Femoral And Umbilical",,,12420.95,12420.95,5
APR-DRG,2274,"APR-DRG 38.00: Hernia Procedures Except Inguinal, Femoral And Umbilical",,,22061.98,22061.98,5
APR-DRG,2281,"APR-DRG 38.00: Inguinal, Femoral And Umbilical Hernia Procedures",,,4909.23,4909.23,5
APR-DRG,2282,"APR-DRG 38.00: Inguinal, Femoral And Umbilical Hernia Procedures",,,6328.77,6328.77,5
APR-DRG,2283,"APR-DRG 38.00: Inguinal, Femoral And Umbilical Hernia Procedures",,,9463.58,9463.58,5
APR-DRG,2284,"APR-DRG 38.00: Inguinal, Femoral And Umbilical Hernia Procedures",,,18039.96,18039.96,5
APR-DRG,2291,APR-DRG 38.00: Other Digestive System And Abdominal Procedures,,,6269.62,6269.62,5
APR-DRG,2292,APR-DRG 38.00: Other Digestive System And Abdominal Procedures,,,8103.19,8103.19,5
APR-DRG,2293,APR-DRG 38.00: Other Digestive System And Abdominal Procedures,,,11711.19,11711.19,5
APR-DRG,2294,APR-DRG 38.00: Other Digestive System And Abdominal Procedures,,,22949.19,22949.19,5
APR-DRG,2301,APR-DRG 38.00: Major Small Bowel Procedures,,,7393.43,7393.43,5
APR-DRG,2302,APR-DRG 38.00: Major Small Bowel Procedures,,,10232.5,10232.5,5
APR-DRG,2303,APR-DRG 38.00: Major Small Bowel Procedures,,,15082.59,15082.59,5
APR-DRG,2304,APR-DRG 38.00: Major Small Bowel Procedures,,,29100.52,29100.52,5
APR-DRG,2311,APR-DRG 38.00: Major Large Bowel Procedures,,,7630.01,7630.01,5
APR-DRG,2312,APR-DRG 38.00: Major Large Bowel Procedures,,,9759.32,9759.32,5
APR-DRG,2313,APR-DRG 38.00: Major Large Bowel Procedures,,,15023.44,15023.44,5
APR-DRG,2314,APR-DRG 38.00: Major Large Bowel Procedures,,,25551.68,25551.68,5
APR-DRG,2321,APR-DRG 38.00: Gastric Fundoplication,,,5441.56,5441.56,5
APR-DRG,2322,APR-DRG 38.00: Gastric Fundoplication,,,7215.98,7215.98,5
APR-DRG,2323,APR-DRG 38.00: Gastric Fundoplication,,,11356.3,11356.3,5
APR-DRG,2324,APR-DRG 38.00: Gastric Fundoplication,,,39037.28,39037.28,5
APR-DRG,2331,APR-DRG 38.00: Appendectomy With Complex Principal Diagnosis,,,5441.56,5441.56,5
APR-DRG,2332,APR-DRG 38.00: Appendectomy With Complex Principal Diagnosis,,,7097.69,7097.69,5
APR-DRG,2333,APR-DRG 38.00: Appendectomy With Complex Principal Diagnosis,,,10528.24,10528.24,5
APR-DRG,2334,APR-DRG 38.00: Appendectomy With Complex Principal Diagnosis,,,17685.07,17685.07,5
APR-DRG,2341,APR-DRG 38.00: Appendectomy Without Complex Principal Diagnosis,,,4909.23,4909.23,5
APR-DRG,2342,APR-DRG 38.00: Appendectomy Without Complex Principal Diagnosis,,,6092.18,6092.18,5
APR-DRG,2343,APR-DRG 38.00: Appendectomy Without Complex Principal Diagnosis,,,9049.55,9049.55,5
APR-DRG,2344,APR-DRG 38.00: Appendectomy Without Complex Principal Diagnosis,,,17271.04,17271.04,5
APR-DRG,2401,APR-DRG 38.00: Digestive Malignancy,,,4376.91,4376.91,5
APR-DRG,2402,APR-DRG 38.00: Digestive Malignancy,,,5027.53,5027.53,5
APR-DRG,2403,APR-DRG 38.00: Digestive Malignancy,,,7156.84,7156.84,5
APR-DRG,2404,APR-DRG 38.00: Digestive Malignancy,,,13308.17,13308.17,5
APR-DRG,2411,APR-DRG 38.00: Peptic Ulcer And Gastritis,,,3489.7,3489.7,5
APR-DRG,2412,APR-DRG 38.00: Peptic Ulcer And Gastritis,,,4199.47,4199.47,5
APR-DRG,2413,APR-DRG 38.00: Peptic Ulcer And Gastritis,,,6210.48,6210.48,5
APR-DRG,2414,APR-DRG 38.00: Peptic Ulcer And Gastritis,,,13544.75,13544.75,5
APR-DRG,2421,APR-DRG 38.00: Major Esophageal Disorders,,,3134.81,3134.81,5
APR-DRG,2422,APR-DRG 38.00: Major Esophageal Disorders,,,4022.02,4022.02,5
APR-DRG,2423,APR-DRG 38.00: Major Esophageal Disorders,,,5855.59,5855.59,5
APR-DRG,2424,APR-DRG 38.00: Major Esophageal Disorders,,,13663.05,13663.05,5
APR-DRG,2431,APR-DRG 38.00: Other Esophageal Disorders,,,3193.96,3193.96,5
APR-DRG,2432,APR-DRG 38.00: Other Esophageal Disorders,,,3844.58,3844.58,5
APR-DRG,2433,APR-DRG 38.00: Other Esophageal Disorders,,,5619.0,5619.0,5
APR-DRG,2434,APR-DRG 38.00: Other Esophageal Disorders,,,11119.71,11119.71,5
APR-DRG,2441,APR-DRG 38.00: Diverticulitis And Diverticulosis,,,2839.08,2839.08,5
APR-DRG,2442,APR-DRG 38.00: Diverticulitis And Diverticulosis,,,3785.43,3785.43,5
APR-DRG,2443,APR-DRG 38.00: Diverticulitis And Diverticulosis,,,5914.74,5914.74,5
APR-DRG,2444,APR-DRG 38.00: Diverticulitis And Diverticulosis,,,11356.3,11356.3,5
APR-DRG,2451,APR-DRG 38.00: Inflammatory Bowel Disease,,,3193.96,3193.96,5
APR-DRG,2452,APR-DRG 38.00: Inflammatory Bowel Disease,,,4081.17,4081.17,5
APR-DRG,2453,APR-DRG 38.00: Inflammatory Bowel Disease,,,6151.33,6151.33,5
APR-DRG,2454,APR-DRG 38.00: Inflammatory Bowel Disease,,,11592.89,11592.89,5
APR-DRG,2461,APR-DRG 38.00: Gastrointestinal Vascular Insufficiency,,,3253.11,3253.11,5
APR-DRG,2462,APR-DRG 38.00: Gastrointestinal Vascular Insufficiency,,,4022.02,4022.02,5
APR-DRG,2463,APR-DRG 38.00: Gastrointestinal Vascular Insufficiency,,,6151.33,6151.33,5
APR-DRG,2464,APR-DRG 38.00: Gastrointestinal Vascular Insufficiency,,,10764.83,10764.83,5
APR-DRG,2471,APR-DRG 38.00: Intestinal Obstruction,,,2602.49,2602.49,5
APR-DRG,2472,APR-DRG 38.00: Intestinal Obstruction,,,3489.7,3489.7,5
APR-DRG,2473,APR-DRG 38.00: Intestinal Obstruction,,,5619.0,5619.0,5
APR-DRG,2474,APR-DRG 38.00: Intestinal Obstruction,,,10764.83,10764.83,5
APR-DRG,2481,APR-DRG 38.00: Major Gastrointestinal And Peritoneal Infections,,,2898.22,2898.22,5
APR-DRG,2482,APR-DRG 38.00: Major Gastrointestinal And Peritoneal Infections,,,3962.88,3962.88,5
APR-DRG,2483,APR-DRG 38.00: Major Gastrointestinal And Peritoneal Infections,,,6033.03,6033.03,5
APR-DRG,2484,APR-DRG 38.00: Major Gastrointestinal And Peritoneal Infections,,,11770.33,11770.33,5
APR-DRG,2491,"APR-DRG 38.00: Other Gastroenteritis, Nausea And Vomiting",,,2661.63,2661.63,5
APR-DRG,2492,"APR-DRG 38.00: Other Gastroenteritis, Nausea And Vomiting",,,3134.81,3134.81,5
APR-DRG,2493,"APR-DRG 38.00: Other Gastroenteritis, Nausea And Vomiting",,,4613.5,4613.5,5
APR-DRG,2494,"APR-DRG 38.00: Other Gastroenteritis, Nausea And Vomiting",,,9404.44,9404.44,5
APR-DRG,2511,APR-DRG 38.00: Abdominal Pain,,,2957.37,2957.37,5
APR-DRG,2512,APR-DRG 38.00: Abdominal Pain,,,3548.84,3548.84,5
APR-DRG,2513,APR-DRG 38.00: Abdominal Pain,,,4731.79,4731.79,5
APR-DRG,2514,APR-DRG 38.00: Abdominal Pain,,,8872.11,8872.11,5
APR-DRG,2521,"APR-DRG 38.00: Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure",,,3371.4,3371.4,5
APR-DRG,2522,"APR-DRG 38.00: Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure",,,4258.61,4258.61,5
APR-DRG,2523,"APR-DRG 38.00: Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure",,,6447.07,6447.07,5
APR-DRG,2524,"APR-DRG 38.00: Malfunction, Reaction And Complication Of Gastrointestinal Device Or Procedure",,,13663.05,13663.05,5
APR-DRG,2531,APR-DRG 38.00: Other And Unspecified Gastrointestinal Hemorrhage,,,3193.96,3193.96,5
APR-DRG,2532,APR-DRG 38.00: Other And Unspecified Gastrointestinal Hemorrhage,,,4081.17,4081.17,5
APR-DRG,2533,APR-DRG 38.00: Other And Unspecified Gastrointestinal Hemorrhage,,,6033.03,6033.03,5
APR-DRG,2534,APR-DRG 38.00: Other And Unspecified Gastrointestinal Hemorrhage,,,10764.83,10764.83,5
APR-DRG,2541,APR-DRG 38.00: Other Digestive System Diagnoses,,,3016.52,3016.52,5
APR-DRG,2542,APR-DRG 38.00: Other Digestive System Diagnoses,,,3903.73,3903.73,5
APR-DRG,2543,APR-DRG 38.00: Other Digestive System Diagnoses,,,5737.3,5737.3,5
APR-DRG,2544,APR-DRG 38.00: Other Digestive System Diagnoses,,,10942.27,10942.27,5
APR-DRG,2601,"APR-DRG 38.00: Major Pancreas, Liver And Shunt Procedures",,,10173.35,10173.35,5
APR-DRG,2602,"APR-DRG 38.00: Major Pancreas, Liver And Shunt Procedures",,,12894.13,12894.13,5
APR-DRG,2603,"APR-DRG 38.00: Major Pancreas, Liver And Shunt Procedures",,,18749.73,18749.73,5
APR-DRG,2604,"APR-DRG 38.00: Major Pancreas, Liver And Shunt Procedures",,,39747.05,39747.05,5
APR-DRG,2611,APR-DRG 38.00: Major Biliary Tract Procedures,,,7866.6,7866.6,5
APR-DRG,2612,APR-DRG 38.00: Major Biliary Tract Procedures,,,10883.12,10883.12,5
APR-DRG,2613,APR-DRG 38.00: Major Biliary Tract Procedures,,,16265.53,16265.53,5
APR-DRG,2614,APR-DRG 38.00: Major Biliary Tract Procedures,,,31229.83,31229.83,5
APR-DRG,2631,APR-DRG 38.00: Cholecystectomy,,,5855.59,5855.59,5
APR-DRG,2632,APR-DRG 38.00: Cholecystectomy,,,7334.28,7334.28,5
APR-DRG,2633,APR-DRG 38.00: Cholecystectomy,,,9641.03,9641.03,5
APR-DRG,2634,APR-DRG 38.00: Cholecystectomy,,,19577.79,19577.79,5
APR-DRG,2641,"APR-DRG 38.00: Other Hepatobiliary, Pancreas And Abdominal Procedures",,,7630.01,7630.01,5
APR-DRG,2642,"APR-DRG 38.00: Other Hepatobiliary, Pancreas And Abdominal Procedures",,,7689.16,7689.16,5
APR-DRG,2643,"APR-DRG 38.00: Other Hepatobiliary, Pancreas And Abdominal Procedures",,,8753.82,8753.82,5
APR-DRG,2644,"APR-DRG 38.00: Other Hepatobiliary, Pancreas And Abdominal Procedures",,,22890.04,22890.04,5
APR-DRG,2791,APR-DRG 38.00: Hepatic Coma And Other Major Acute Liver Disorders,,,2839.08,2839.08,5
APR-DRG,2792,APR-DRG 38.00: Hepatic Coma And Other Major Acute Liver Disorders,,,3607.99,3607.99,5
APR-DRG,2793,APR-DRG 38.00: Hepatic Coma And Other Major Acute Liver Disorders,,,5737.3,5737.3,5
APR-DRG,2794,APR-DRG 38.00: Hepatic Coma And Other Major Acute Liver Disorders,,,13544.75,13544.75,5
APR-DRG,2801,APR-DRG 38.00: Alcoholic Liver Disease,,,2957.37,2957.37,5
APR-DRG,2802,APR-DRG 38.00: Alcoholic Liver Disease,,,3844.58,3844.58,5
APR-DRG,2803,APR-DRG 38.00: Alcoholic Liver Disease,,,6033.03,6033.03,5
APR-DRG,2804,APR-DRG 38.00: Alcoholic Liver Disease,,,14372.82,14372.82,5
APR-DRG,2811,APR-DRG 38.00: Malignancy Of Hepatobiliary System And Pancreas,,,3962.88,3962.88,5
APR-DRG,2812,APR-DRG 38.00: Malignancy Of Hepatobiliary System And Pancreas,,,5086.68,5086.68,5
APR-DRG,2813,APR-DRG 38.00: Malignancy Of Hepatobiliary System And Pancreas,,,6683.66,6683.66,5
APR-DRG,2814,APR-DRG 38.00: Malignancy Of Hepatobiliary System And Pancreas,,,10764.83,10764.83,5
APR-DRG,2821,APR-DRG 38.00: Disorders Of Pancreas Except Malignancy,,,2898.22,2898.22,5
APR-DRG,2822,APR-DRG 38.00: Disorders Of Pancreas Except Malignancy,,,3844.58,3844.58,5
APR-DRG,2823,APR-DRG 38.00: Disorders Of Pancreas Except Malignancy,,,6328.77,6328.77,5
APR-DRG,2824,APR-DRG 38.00: Disorders Of Pancreas Except Malignancy,,,15969.8,15969.8,5
APR-DRG,2831,APR-DRG 38.00: Other Disorders Of The Liver,,,3134.81,3134.81,5
APR-DRG,2832,APR-DRG 38.00: Other Disorders Of The Liver,,,3844.58,3844.58,5
APR-DRG,2833,APR-DRG 38.00: Other Disorders Of The Liver,,,5619.0,5619.0,5
APR-DRG,2834,APR-DRG 38.00: Other Disorders Of The Liver,,,12066.07,12066.07,5
APR-DRG,2841,APR-DRG 38.00: Disorders Of Gallbladder And Biliary Tract,,,3726.29,3726.29,5
APR-DRG,2842,APR-DRG 38.00: Disorders Of Gallbladder And Biliary Tract,,,4790.94,4790.94,5
APR-DRG,2843,APR-DRG 38.00: Disorders Of Gallbladder And Biliary Tract,,,6861.1,6861.1,5
APR-DRG,2844,APR-DRG 38.00: Disorders Of Gallbladder And Biliary Tract,,,13071.58,13071.58,5
APR-DRG,3031,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back,,,23304.08,23304.08,5
APR-DRG,3032,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back,,,30106.03,30106.03,5
APR-DRG,3033,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back,,,43059.31,43059.31,5
APR-DRG,3034,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure For Curvature Of Back,,,56012.59,56012.59,5
APR-DRG,3041,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,,,14491.11,14491.11,5
APR-DRG,3042,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,,,18217.4,18217.4,5
APR-DRG,3043,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,,,27740.13,27740.13,5
APR-DRG,3044,APR-DRG 38.00: Dorsal And Lumbar Fusion Procedure Except For Curvature Of Back,,,40101.94,40101.94,5
APR-DRG,3051,APR-DRG 38.00: Amputation Of Lower Limb Except Toes,,,5678.15,5678.15,5
APR-DRG,3052,APR-DRG 38.00: Amputation Of Lower Limb Except Toes,,,7807.46,7807.46,5
APR-DRG,3053,APR-DRG 38.00: Amputation Of Lower Limb Except Toes,,,12598.4,12598.4,5
APR-DRG,3054,APR-DRG 38.00: Amputation Of Lower Limb Except Toes,,,25137.65,25137.65,5
APR-DRG,3081,APR-DRG 38.00: Hip And Femur Fracture Repair,,,7097.69,7097.69,5
APR-DRG,3082,APR-DRG 38.00: Hip And Femur Fracture Repair,,,8221.49,8221.49,5
APR-DRG,3083,APR-DRG 38.00: Hip And Femur Fracture Repair,,,11238.01,11238.01,5
APR-DRG,3084,APR-DRG 38.00: Hip And Femur Fracture Repair,,,16857.01,16857.01,5
APR-DRG,3091,APR-DRG 38.00: Other Significant Hip And Femur Surgery,,,7748.31,7748.31,5
APR-DRG,3092,APR-DRG 38.00: Other Significant Hip And Femur Surgery,,,10291.65,10291.65,5
APR-DRG,3093,APR-DRG 38.00: Other Significant Hip And Femur Surgery,,,15082.59,15082.59,5
APR-DRG,3094,APR-DRG 38.00: Other Significant Hip And Femur Surgery,,,24664.47,24664.47,5
APR-DRG,3101,APR-DRG 38.00: Intervertebral Disc Excision And Decompression,,,6269.62,6269.62,5
APR-DRG,3102,APR-DRG 38.00: Intervertebral Disc Excision And Decompression,,,8044.05,8044.05,5
APR-DRG,3103,APR-DRG 38.00: Intervertebral Disc Excision And Decompression,,,11474.6,11474.6,5
APR-DRG,3104,APR-DRG 38.00: Intervertebral Disc Excision And Decompression,,,22653.45,22653.45,5
APR-DRG,3121,"APR-DRG 38.00: Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses",,,7334.28,7334.28,5
APR-DRG,3122,"APR-DRG 38.00: Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses",,,12420.95,12420.95,5
APR-DRG,3123,"APR-DRG 38.00: Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses",,,21056.47,21056.47,5
APR-DRG,3124,"APR-DRG 38.00: Skin Graft, Except Hand, For Musculoskeletal And Connective Tissue Diagnoses",,,39747.05,39747.05,5
APR-DRG,3131,APR-DRG 38.00: Knee And Lower Leg Procedures Except Foot,,,6861.1,6861.1,5
APR-DRG,3132,APR-DRG 38.00: Knee And Lower Leg Procedures Except Foot,,,9286.14,9286.14,5
APR-DRG,3133,APR-DRG 38.00: Knee And Lower Leg Procedures Except Foot,,,14550.26,14550.26,5
APR-DRG,3134,APR-DRG 38.00: Knee And Lower Leg Procedures Except Foot,,,23658.96,23658.96,5
APR-DRG,3141,APR-DRG 38.00: Foot And Toe Procedures,,,6151.33,6151.33,5
APR-DRG,3142,APR-DRG 38.00: Foot And Toe Procedures,,,6624.51,6624.51,5
APR-DRG,3143,APR-DRG 38.00: Foot And Toe Procedures,,,9345.29,9345.29,5
APR-DRG,3144,APR-DRG 38.00: Foot And Toe Procedures,,,17980.81,17980.81,5
APR-DRG,3151,"APR-DRG 38.00: Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement",,,5737.3,5737.3,5
APR-DRG,3152,"APR-DRG 38.00: Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement",,,8517.23,8517.23,5
APR-DRG,3153,"APR-DRG 38.00: Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement",,,13071.58,13071.58,5
APR-DRG,3154,"APR-DRG 38.00: Shoulder, Upper Arm And Forearm Procedures Except Joint Replacement",,,24546.17,24546.17,5
APR-DRG,3161,APR-DRG 38.00: Hand And Wrist Procedures,,,4909.23,4909.23,5
APR-DRG,3162,APR-DRG 38.00: Hand And Wrist Procedures,,,6506.21,6506.21,5
APR-DRG,3163,APR-DRG 38.00: Hand And Wrist Procedures,,,10409.94,10409.94,5
APR-DRG,3164,APR-DRG 38.00: Hand And Wrist Procedures,,,19696.08,19696.08,5
APR-DRG,3171,"APR-DRG 38.00: Tendon, Muscle And Other Soft Tissue Procedures",,,5382.41,5382.41,5
APR-DRG,3172,"APR-DRG 38.00: Tendon, Muscle And Other Soft Tissue Procedures",,,7452.57,7452.57,5
APR-DRG,3173,"APR-DRG 38.00: Tendon, Muscle And Other Soft Tissue Procedures",,,12066.07,12066.07,5
APR-DRG,3174,"APR-DRG 38.00: Tendon, Muscle And Other Soft Tissue Procedures",,,23481.52,23481.52,5
APR-DRG,3201,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Procedures,,,5796.45,5796.45,5
APR-DRG,3202,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Procedures,,,8398.93,8398.93,5
APR-DRG,3203,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Procedures,,,13012.43,13012.43,5
APR-DRG,3204,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Procedures,,,21588.8,21588.8,5
APR-DRG,3211,APR-DRG 38.00: Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression,,,9167.85,9167.85,5
APR-DRG,3212,APR-DRG 38.00: Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression,,,11533.74,11533.74,5
APR-DRG,3213,APR-DRG 38.00: Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression,,,17921.66,17921.66,5
APR-DRG,3214,APR-DRG 38.00: Cervical Spinal Fusion And Other Back Or Neck Procedures Except Disc Excision Or Decompression,,,30224.32,30224.32,5
APR-DRG,3221,APR-DRG 38.00: Shoulder And Elbow Joint Replacement,,,8458.08,8458.08,5
APR-DRG,3222,APR-DRG 38.00: Shoulder And Elbow Joint Replacement,,,9641.03,9641.03,5
APR-DRG,3223,APR-DRG 38.00: Shoulder And Elbow Joint Replacement,,,13367.31,13367.31,5
APR-DRG,3224,APR-DRG 38.00: Shoulder And Elbow Joint Replacement,,,22357.72,22357.72,5
APR-DRG,3231,APR-DRG 38.00: Non-Elective Or Complex Hip Joint Replacement,,,8339.78,8339.78,5
APR-DRG,3232,APR-DRG 38.00: Non-Elective Or Complex Hip Joint Replacement,,,9463.58,9463.58,5
APR-DRG,3233,APR-DRG 38.00: Non-Elective Or Complex Hip Joint Replacement,,,12834.99,12834.99,5
APR-DRG,3234,APR-DRG 38.00: Non-Elective Or Complex Hip Joint Replacement,,,19282.05,19282.05,5
APR-DRG,3241,APR-DRG 38.00: Elective Hip Joint Replacement,,,7275.13,7275.13,5
APR-DRG,3242,APR-DRG 38.00: Elective Hip Joint Replacement,,,8103.19,8103.19,5
APR-DRG,3243,APR-DRG 38.00: Elective Hip Joint Replacement,,,11652.04,11652.04,5
APR-DRG,3244,APR-DRG 38.00: Elective Hip Joint Replacement,,,19459.49,19459.49,5
APR-DRG,3251,APR-DRG 38.00: Non-Elective Or Complex Knee Joint Replacement,,,10764.83,10764.83,5
APR-DRG,3252,APR-DRG 38.00: Non-Elective Or Complex Knee Joint Replacement,,,13071.58,13071.58,5
APR-DRG,3253,APR-DRG 38.00: Non-Elective Or Complex Knee Joint Replacement,,,16738.71,16738.71,5
APR-DRG,3254,APR-DRG 38.00: Non-Elective Or Complex Knee Joint Replacement,,,24309.58,24309.58,5
APR-DRG,3261,APR-DRG 38.00: Elective Knee Joint Replacement,,,7038.54,7038.54,5
APR-DRG,3262,APR-DRG 38.00: Elective Knee Joint Replacement,,,7748.31,7748.31,5
APR-DRG,3263,APR-DRG 38.00: Elective Knee Joint Replacement,,,10883.12,10883.12,5
APR-DRG,3264,APR-DRG 38.00: Elective Knee Joint Replacement,,,16324.68,16324.68,5
APR-DRG,3401,APR-DRG 38.00: Fracture Of Femur,,,2661.63,2661.63,5
APR-DRG,3402,APR-DRG 38.00: Fracture Of Femur,,,3253.11,3253.11,5
APR-DRG,3403,APR-DRG 38.00: Fracture Of Femur,,,4790.94,4790.94,5
APR-DRG,3404,APR-DRG 38.00: Fracture Of Femur,,,8694.67,8694.67,5
APR-DRG,3411,APR-DRG 38.00: Fracture Of Pelvis Or Dislocation Of Hip,,,2720.78,2720.78,5
APR-DRG,3412,APR-DRG 38.00: Fracture Of Pelvis Or Dislocation Of Hip,,,3312.25,3312.25,5
APR-DRG,3413,APR-DRG 38.00: Fracture Of Pelvis Or Dislocation Of Hip,,,4436.06,4436.06,5
APR-DRG,3414,APR-DRG 38.00: Fracture Of Pelvis Or Dislocation Of Hip,,,9226.99,9226.99,5
APR-DRG,3421,"APR-DRG 38.00: Fractures And Dislocations Except Femur, Pelvis And Back",,,3075.66,3075.66,5
APR-DRG,3422,"APR-DRG 38.00: Fractures And Dislocations Except Femur, Pelvis And Back",,,3844.58,3844.58,5
APR-DRG,3423,"APR-DRG 38.00: Fractures And Dislocations Except Femur, Pelvis And Back",,,5441.56,5441.56,5
APR-DRG,3424,"APR-DRG 38.00: Fractures And Dislocations Except Femur, Pelvis And Back",,,10646.53,10646.53,5
APR-DRG,3431,APR-DRG 38.00: Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy,,,4731.79,4731.79,5
APR-DRG,3432,APR-DRG 38.00: Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy,,,5619.0,5619.0,5
APR-DRG,3433,APR-DRG 38.00: Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy,,,8517.23,8517.23,5
APR-DRG,3434,APR-DRG 38.00: Musculoskeletal Malignancy And Pathological Fracture Due To Musculoskeletal Malignancy,,,14964.29,14964.29,5
APR-DRG,3441,"APR-DRG 38.00: Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections",,,4140.32,4140.32,5
APR-DRG,3442,"APR-DRG 38.00: Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections",,,5204.97,5204.97,5
APR-DRG,3443,"APR-DRG 38.00: Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections",,,7689.16,7689.16,5
APR-DRG,3444,"APR-DRG 38.00: Osteomyelitis, Septic Arthritis And Other Musculoskeletal Infections",,,13426.46,13426.46,5
APR-DRG,3461,APR-DRG 38.00: Connective Tissue Disorders,,,3726.29,3726.29,5
APR-DRG,3462,APR-DRG 38.00: Connective Tissue Disorders,,,5027.53,5027.53,5
APR-DRG,3463,APR-DRG 38.00: Connective Tissue Disorders,,,8398.93,8398.93,5
APR-DRG,3464,APR-DRG 38.00: Connective Tissue Disorders,,,19282.05,19282.05,5
APR-DRG,3471,"APR-DRG 38.00: Other Back And Neck Disorders, Fractures And Injuries",,,3667.14,3667.14,5
APR-DRG,3472,"APR-DRG 38.00: Other Back And Neck Disorders, Fractures And Injuries",,,4436.06,4436.06,5
APR-DRG,3473,"APR-DRG 38.00: Other Back And Neck Disorders, Fractures And Injuries",,,5973.89,5973.89,5
APR-DRG,3474,"APR-DRG 38.00: Other Back And Neck Disorders, Fractures And Injuries",,,11711.19,11711.19,5
APR-DRG,3491,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure",,,3075.66,3075.66,5
APR-DRG,3492,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure",,,4554.35,4554.35,5
APR-DRG,3493,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure",,,6861.1,6861.1,5
APR-DRG,3494,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Orthopedic Device Or Procedure",,,12598.4,12598.4,5
APR-DRG,3511,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Diagnoses,,,3016.52,3016.52,5
APR-DRG,3512,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Diagnoses,,,3489.7,3489.7,5
APR-DRG,3513,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Diagnoses,,,5500.71,5500.71,5
APR-DRG,3514,APR-DRG 38.00: Other Musculoskeletal System And Connective Tissue Diagnoses,,,10409.94,10409.94,5
APR-DRG,3611,APR-DRG 38.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses,,,8576.37,8576.37,5
APR-DRG,3612,APR-DRG 38.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses,,,10587.38,10587.38,5
APR-DRG,3613,APR-DRG 38.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses,,,17389.34,17389.34,5
APR-DRG,3614,APR-DRG 38.00: Skin Graft For Skin And Subcutaneous Tissue Diagnoses,,,33536.58,33536.58,5
APR-DRG,3621,APR-DRG 38.00: Mastectomy Procedures,,,7097.69,7097.69,5
APR-DRG,3622,APR-DRG 38.00: Mastectomy Procedures,,,9759.32,9759.32,5
APR-DRG,3623,APR-DRG 38.00: Mastectomy Procedures,,,12480.1,12480.1,5
APR-DRG,3624,APR-DRG 38.00: Mastectomy Procedures,,,14727.7,14727.7,5
APR-DRG,3631,APR-DRG 38.00: Breast Procedures Except Mastectomy,,,6861.1,6861.1,5
APR-DRG,3632,APR-DRG 38.00: Breast Procedures Except Mastectomy,,,11770.33,11770.33,5
APR-DRG,3633,APR-DRG 38.00: Breast Procedures Except Mastectomy,,,14491.11,14491.11,5
APR-DRG,3634,APR-DRG 38.00: Breast Procedures Except Mastectomy,,,20405.85,20405.85,5
APR-DRG,3641,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Related Procedures",,,4436.06,4436.06,5
APR-DRG,3642,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Related Procedures",,,6210.48,6210.48,5
APR-DRG,3643,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Related Procedures",,,10232.5,10232.5,5
APR-DRG,3644,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Related Procedures",,,19577.79,19577.79,5
APR-DRG,3801,APR-DRG 38.00: Skin Ulcers,,,3253.11,3253.11,5
APR-DRG,3802,APR-DRG 38.00: Skin Ulcers,,,3962.88,3962.88,5
APR-DRG,3803,APR-DRG 38.00: Skin Ulcers,,,6092.18,6092.18,5
APR-DRG,3804,APR-DRG 38.00: Skin Ulcers,,,12775.84,12775.84,5
APR-DRG,3811,APR-DRG 38.00: Major Skin Disorders,,,2484.19,2484.19,5
APR-DRG,3812,APR-DRG 38.00: Major Skin Disorders,,,4495.2,4495.2,5
APR-DRG,3813,APR-DRG 38.00: Major Skin Disorders,,,8398.93,8398.93,5
APR-DRG,3814,APR-DRG 38.00: Major Skin Disorders,,,20228.41,20228.41,5
APR-DRG,3821,APR-DRG 38.00: Malignant Breast Disorders,,,3607.99,3607.99,5
APR-DRG,3822,APR-DRG 38.00: Malignant Breast Disorders,,,4613.5,4613.5,5
APR-DRG,3823,APR-DRG 38.00: Malignant Breast Disorders,,,6447.07,6447.07,5
APR-DRG,3824,APR-DRG 38.00: Malignant Breast Disorders,,,10883.12,10883.12,5
APR-DRG,3831,APR-DRG 38.00: Cellulitis And Other Skin Infections,,,2543.34,2543.34,5
APR-DRG,3832,APR-DRG 38.00: Cellulitis And Other Skin Infections,,,3371.4,3371.4,5
APR-DRG,3833,APR-DRG 38.00: Cellulitis And Other Skin Infections,,,5086.68,5086.68,5
APR-DRG,3834,APR-DRG 38.00: Cellulitis And Other Skin Infections,,,10232.5,10232.5,5
APR-DRG,3841,"APR-DRG 38.00: Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue",,,3312.25,3312.25,5
APR-DRG,3842,"APR-DRG 38.00: Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue",,,4022.02,4022.02,5
APR-DRG,3843,"APR-DRG 38.00: Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue",,,5914.74,5914.74,5
APR-DRG,3844,"APR-DRG 38.00: Contusion, Open Wound And Other Trauma To Skin And Subcutaneous Tissue",,,11178.86,11178.86,5
APR-DRG,3851,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Breast Disorders",,,2661.63,2661.63,5
APR-DRG,3852,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Breast Disorders",,,3371.4,3371.4,5
APR-DRG,3853,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Breast Disorders",,,5264.12,5264.12,5
APR-DRG,3854,"APR-DRG 38.00: Other Skin, Subcutaneous Tissue And Breast Disorders",,,11119.71,11119.71,5
APR-DRG,4011,APR-DRG 38.00: Adrenal Procedures,,,7097.69,7097.69,5
APR-DRG,4012,APR-DRG 38.00: Adrenal Procedures,,,13899.64,13899.64,5
APR-DRG,4013,APR-DRG 38.00: Adrenal Procedures,,,18749.73,18749.73,5
APR-DRG,4014,APR-DRG 38.00: Adrenal Procedures,,,23244.93,23244.93,5
APR-DRG,4031,APR-DRG 38.00: Procedures For Obesity,,,6151.33,6151.33,5
APR-DRG,4032,APR-DRG 38.00: Procedures For Obesity,,,7097.69,7097.69,5
APR-DRG,4033,APR-DRG 38.00: Procedures For Obesity,,,11415.45,11415.45,5
APR-DRG,4034,APR-DRG 38.00: Procedures For Obesity,,,25019.35,25019.35,5
APR-DRG,4041,"APR-DRG 38.00: Thyroid, Parathyroid And Thyroglossal Procedures",,,5145.82,5145.82,5
APR-DRG,4042,"APR-DRG 38.00: Thyroid, Parathyroid And Thyroglossal Procedures",,,7630.01,7630.01,5
APR-DRG,4043,"APR-DRG 38.00: Thyroid, Parathyroid And Thyroglossal Procedures",,,14136.23,14136.23,5
APR-DRG,4044,"APR-DRG 38.00: Thyroid, Parathyroid And Thyroglossal Procedures",,,26852.92,26852.92,5
APR-DRG,4051,"APR-DRG 38.00: Other Procedures For Endocrine, Nutritional And Metabolic Disorders",,,7630.01,7630.01,5
APR-DRG,4052,"APR-DRG 38.00: Other Procedures For Endocrine, Nutritional And Metabolic Disorders",,,9049.55,9049.55,5
APR-DRG,4053,"APR-DRG 38.00: Other Procedures For Endocrine, Nutritional And Metabolic Disorders",,,13603.9,13603.9,5
APR-DRG,4054,"APR-DRG 38.00: Other Procedures For Endocrine, Nutritional And Metabolic Disorders",,,30046.88,30046.88,5
APR-DRG,4201,APR-DRG 38.00: Diabetes,,,2543.34,2543.34,5
APR-DRG,4202,APR-DRG 38.00: Diabetes,,,3075.66,3075.66,5
APR-DRG,4203,APR-DRG 38.00: Diabetes,,,4672.64,4672.64,5
APR-DRG,4204,APR-DRG 38.00: Diabetes,,,10055.06,10055.06,5
APR-DRG,4211,"APR-DRG 38.00: Malnutrition, Failure To Thrive And Other Nutritional Disorders",,,2779.93,2779.93,5
APR-DRG,4212,"APR-DRG 38.00: Malnutrition, Failure To Thrive And Other Nutritional Disorders",,,3607.99,3607.99,5
APR-DRG,4213,"APR-DRG 38.00: Malnutrition, Failure To Thrive And Other Nutritional Disorders",,,5796.45,5796.45,5
APR-DRG,4214,"APR-DRG 38.00: Malnutrition, Failure To Thrive And Other Nutritional Disorders",,,12953.28,12953.28,5
APR-DRG,4221,APR-DRG 38.00: Hypovolemia And Related Electrolyte Disorders,,,2070.16,2070.16,5
APR-DRG,4222,APR-DRG 38.00: Hypovolemia And Related Electrolyte Disorders,,,2779.93,2779.93,5
APR-DRG,4223,APR-DRG 38.00: Hypovolemia And Related Electrolyte Disorders,,,4258.61,4258.61,5
APR-DRG,4224,APR-DRG 38.00: Hypovolemia And Related Electrolyte Disorders,,,8517.23,8517.23,5
APR-DRG,4231,APR-DRG 38.00: Inborn Errors Of Metabolism,,,3312.25,3312.25,5
APR-DRG,4232,APR-DRG 38.00: Inborn Errors Of Metabolism,,,4790.94,4790.94,5
APR-DRG,4233,APR-DRG 38.00: Inborn Errors Of Metabolism,,,7275.13,7275.13,5
APR-DRG,4234,APR-DRG 38.00: Inborn Errors Of Metabolism,,,17093.6,17093.6,5
APR-DRG,4241,APR-DRG 38.00: Other Endocrine Disorders,,,3016.52,3016.52,5
APR-DRG,4242,APR-DRG 38.00: Other Endocrine Disorders,,,4022.02,4022.02,5
APR-DRG,4243,APR-DRG 38.00: Other Endocrine Disorders,,,5973.89,5973.89,5
APR-DRG,4244,APR-DRG 38.00: Other Endocrine Disorders,,,11474.6,11474.6,5
APR-DRG,4251,APR-DRG 38.00: Other Non-Hypovolemic Electrolyte Disorders,,,2425.04,2425.04,5
APR-DRG,4252,APR-DRG 38.00: Other Non-Hypovolemic Electrolyte Disorders,,,3075.66,3075.66,5
APR-DRG,4253,APR-DRG 38.00: Other Non-Hypovolemic Electrolyte Disorders,,,4376.91,4376.91,5
APR-DRG,4254,APR-DRG 38.00: Other Non-Hypovolemic Electrolyte Disorders,,,9226.99,9226.99,5
APR-DRG,4261,APR-DRG 38.00: Non-Hypovolemic Sodium Disorders,,,2543.34,2543.34,5
APR-DRG,4262,APR-DRG 38.00: Non-Hypovolemic Sodium Disorders,,,3371.4,3371.4,5
APR-DRG,4263,APR-DRG 38.00: Non-Hypovolemic Sodium Disorders,,,5145.82,5145.82,5
APR-DRG,4264,APR-DRG 38.00: Non-Hypovolemic Sodium Disorders,,,10173.35,10173.35,5
APR-DRG,4271,APR-DRG 38.00: Thyroid Disorders,,,2779.93,2779.93,5
APR-DRG,4272,APR-DRG 38.00: Thyroid Disorders,,,3844.58,3844.58,5
APR-DRG,4273,APR-DRG 38.00: Thyroid Disorders,,,6151.33,6151.33,5
APR-DRG,4274,APR-DRG 38.00: Thyroid Disorders,,,11415.45,11415.45,5
APR-DRG,4401,APR-DRG 38.00: Kidney Transplant,,,25965.71,25965.71,5
APR-DRG,4401,Kidney Cad,,,127350.0,127350.0,1
APR-DRG,4401,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,4402,APR-DRG 38.00: Kidney Transplant,,,27562.69,27562.69,5
APR-DRG,4402,Kidney Cad,,,127350.0,127350.0,1
APR-DRG,4402,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,4403,APR-DRG 38.00: Kidney Transplant,,,31998.74,31998.74,5
APR-DRG,4403,Kidney Cad,,,127350.0,127350.0,1
APR-DRG,4403,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,4404,APR-DRG 38.00: Kidney Transplant,,,49210.64,49210.64,5
APR-DRG,4404,Kidney Cad,,,127350.0,127350.0,1
APR-DRG,4404,Simultaneous Kidney/Pancreas,,,200895.0,200895.0,1
APR-DRG,4411,APR-DRG 38.00: Major Bladder Procedures,,,8398.93,8398.93,5
APR-DRG,4412,APR-DRG 38.00: Major Bladder Procedures,,,12420.95,12420.95,5
APR-DRG,4413,APR-DRG 38.00: Major Bladder Procedures,,,15969.8,15969.8,5
APR-DRG,4414,APR-DRG 38.00: Major Bladder Procedures,,,33181.69,33181.69,5
APR-DRG,4421,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Malignancy,,,7511.72,7511.72,5
APR-DRG,4422,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Malignancy,,,8635.52,8635.52,5
APR-DRG,4423,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Malignancy,,,13308.17,13308.17,5
APR-DRG,4424,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Malignancy,,,23304.08,23304.08,5
APR-DRG,4431,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Non-Malignancy,,,6624.51,6624.51,5
APR-DRG,4432,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Non-Malignancy,,,7748.31,7748.31,5
APR-DRG,4433,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Non-Malignancy,,,12125.22,12125.22,5
APR-DRG,4434,APR-DRG 38.00: Kidney And Urinary Tract Procedures For Non-Malignancy,,,22712.6,22712.6,5
APR-DRG,4441,APR-DRG 38.00: Renal Dialysis Access Device Procedures And Vessel Repair,,,5737.3,5737.3,5
APR-DRG,4442,APR-DRG 38.00: Renal Dialysis Access Device Procedures And Vessel Repair,,,8812.96,8812.96,5
APR-DRG,4443,APR-DRG 38.00: Renal Dialysis Access Device Procedures And Vessel Repair,,,14017.93,14017.93,5
APR-DRG,4444,APR-DRG 38.00: Renal Dialysis Access Device Procedures And Vessel Repair,,,25137.65,25137.65,5
APR-DRG,4451,APR-DRG 38.00: Other Bladder Procedures,,,5382.41,5382.41,5
APR-DRG,4452,APR-DRG 38.00: Other Bladder Procedures,,,7038.54,7038.54,5
APR-DRG,4453,APR-DRG 38.00: Other Bladder Procedures,,,10055.06,10055.06,5
APR-DRG,4454,APR-DRG 38.00: Other Bladder Procedures,,,20465.0,20465.0,5
APR-DRG,4461,APR-DRG 38.00: Urethral And Transurethral Procedures,,,4554.35,4554.35,5
APR-DRG,4462,APR-DRG 38.00: Urethral And Transurethral Procedures,,,5619.0,5619.0,5
APR-DRG,4463,APR-DRG 38.00: Urethral And Transurethral Procedures,,,9463.58,9463.58,5
APR-DRG,4464,APR-DRG 38.00: Urethral And Transurethral Procedures,,,17093.6,17093.6,5
APR-DRG,4471,"APR-DRG 38.00: Other Kidney, Urinary Tract And Related Procedures",,,7807.46,7807.46,5
APR-DRG,4472,"APR-DRG 38.00: Other Kidney, Urinary Tract And Related Procedures",,,8398.93,8398.93,5
APR-DRG,4473,"APR-DRG 38.00: Other Kidney, Urinary Tract And Related Procedures",,,12184.36,12184.36,5
APR-DRG,4474,"APR-DRG 38.00: Other Kidney, Urinary Tract And Related Procedures",,,27503.54,27503.54,5
APR-DRG,4611,APR-DRG 38.00: Kidney And Urinary Tract Malignancy,,,4258.61,4258.61,5
APR-DRG,4612,APR-DRG 38.00: Kidney And Urinary Tract Malignancy,,,4672.64,4672.64,5
APR-DRG,4613,APR-DRG 38.00: Kidney And Urinary Tract Malignancy,,,7215.98,7215.98,5
APR-DRG,4614,APR-DRG 38.00: Kidney And Urinary Tract Malignancy,,,11238.01,11238.01,5
APR-DRG,4621,APR-DRG 38.00: Nephritis And Nephrosis,,,2720.78,2720.78,5
APR-DRG,4622,APR-DRG 38.00: Nephritis And Nephrosis,,,3962.88,3962.88,5
APR-DRG,4623,APR-DRG 38.00: Nephritis And Nephrosis,,,7984.9,7984.9,5
APR-DRG,4624,APR-DRG 38.00: Nephritis And Nephrosis,,,18690.58,18690.58,5
APR-DRG,4631,APR-DRG 38.00: Kidney And Urinary Tract Infections,,,2661.63,2661.63,5
APR-DRG,4632,APR-DRG 38.00: Kidney And Urinary Tract Infections,,,3253.11,3253.11,5
APR-DRG,4633,APR-DRG 38.00: Kidney And Urinary Tract Infections,,,4495.2,4495.2,5
APR-DRG,4634,APR-DRG 38.00: Kidney And Urinary Tract Infections,,,7925.75,7925.75,5
APR-DRG,4651,APR-DRG 38.00: Urinary Stones And Acquired Upper Urinary Tract Obstruction,,,2957.37,2957.37,5
APR-DRG,4652,APR-DRG 38.00: Urinary Stones And Acquired Upper Urinary Tract Obstruction,,,3607.99,3607.99,5
APR-DRG,4653,APR-DRG 38.00: Urinary Stones And Acquired Upper Urinary Tract Obstruction,,,5914.74,5914.74,5
APR-DRG,4654,APR-DRG 38.00: Urinary Stones And Acquired Upper Urinary Tract Obstruction,,,10409.94,10409.94,5
APR-DRG,4661,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure",,,2661.63,2661.63,5
APR-DRG,4662,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure",,,3548.84,3548.84,5
APR-DRG,4663,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure",,,5441.56,5441.56,5
APR-DRG,4664,"APR-DRG 38.00: Malfunction, Reaction, Complication Of Genitourinary Device Or Procedure",,,9345.29,9345.29,5
APR-DRG,4681,"APR-DRG 38.00: Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms",,,2957.37,2957.37,5
APR-DRG,4682,"APR-DRG 38.00: Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms",,,3785.43,3785.43,5
APR-DRG,4683,"APR-DRG 38.00: Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms",,,5678.15,5678.15,5
APR-DRG,4684,"APR-DRG 38.00: Other Kidney And Urinary Tract Diagnoses, Signs And Symptoms",,,9936.76,9936.76,5
APR-DRG,4691,APR-DRG 38.00: Acute Kidney Injury,,,2543.34,2543.34,5
APR-DRG,4692,APR-DRG 38.00: Acute Kidney Injury,,,3430.55,3430.55,5
APR-DRG,4693,APR-DRG 38.00: Acute Kidney Injury,,,5559.86,5559.86,5
APR-DRG,4694,APR-DRG 38.00: Acute Kidney Injury,,,10764.83,10764.83,5
APR-DRG,4701,APR-DRG 38.00: Chronic Kidney Disease,,,2661.63,2661.63,5
APR-DRG,4702,APR-DRG 38.00: Chronic Kidney Disease,,,3607.99,3607.99,5
APR-DRG,4703,APR-DRG 38.00: Chronic Kidney Disease,,,5323.27,5323.27,5
APR-DRG,4704,APR-DRG 38.00: Chronic Kidney Disease,,,10055.06,10055.06,5
APR-DRG,4801,APR-DRG 38.00: Major Male Pelvic Procedures,,,6801.95,6801.95,5
APR-DRG,4802,APR-DRG 38.00: Major Male Pelvic Procedures,,,7630.01,7630.01,5
APR-DRG,4803,APR-DRG 38.00: Major Male Pelvic Procedures,,,12125.22,12125.22,5
APR-DRG,4804,APR-DRG 38.00: Major Male Pelvic Procedures,,,26912.07,26912.07,5
APR-DRG,4821,APR-DRG 38.00: Transurethral Prostatectomy,,,4258.61,4258.61,5
APR-DRG,4822,APR-DRG 38.00: Transurethral Prostatectomy,,,4909.23,4909.23,5
APR-DRG,4823,APR-DRG 38.00: Transurethral Prostatectomy,,,9995.91,9995.91,5
APR-DRG,4824,APR-DRG 38.00: Transurethral Prostatectomy,,,18808.87,18808.87,5
APR-DRG,4831,"APR-DRG 38.00: Penis, Testes And Scrotal Procedures",,,5973.89,5973.89,5
APR-DRG,4832,"APR-DRG 38.00: Penis, Testes And Scrotal Procedures",,,7866.6,7866.6,5
APR-DRG,4833,"APR-DRG 38.00: Penis, Testes And Scrotal Procedures",,,11592.89,11592.89,5
APR-DRG,4834,"APR-DRG 38.00: Penis, Testes And Scrotal Procedures",,,20819.88,20819.88,5
APR-DRG,4841,APR-DRG 38.00: Other Male Reproductive System And Related Procedures,,,6624.51,6624.51,5
APR-DRG,4842,APR-DRG 38.00: Other Male Reproductive System And Related Procedures,,,7452.57,7452.57,5
APR-DRG,4843,APR-DRG 38.00: Other Male Reproductive System And Related Procedures,,,9049.55,9049.55,5
APR-DRG,4844,APR-DRG 38.00: Other Male Reproductive System And Related Procedures,,,22830.9,22830.9,5
APR-DRG,5001,"APR-DRG 38.00: Malignancy, Male Reproductive System",,,3607.99,3607.99,5
APR-DRG,5002,"APR-DRG 38.00: Malignancy, Male Reproductive System",,,4436.06,4436.06,5
APR-DRG,5003,"APR-DRG 38.00: Malignancy, Male Reproductive System",,,6387.92,6387.92,5
APR-DRG,5004,"APR-DRG 38.00: Malignancy, Male Reproductive System",,,11297.15,11297.15,5
APR-DRG,5011,APR-DRG 38.00: Male Reproductive System Diagnoses Except Malignancy,,,2779.93,2779.93,5
APR-DRG,5012,APR-DRG 38.00: Male Reproductive System Diagnoses Except Malignancy,,,3607.99,3607.99,5
APR-DRG,5013,APR-DRG 38.00: Male Reproductive System Diagnoses Except Malignancy,,,5323.27,5323.27,5
APR-DRG,5014,APR-DRG 38.00: Male Reproductive System Diagnoses Except Malignancy,,,10469.09,10469.09,5
APR-DRG,5101,"APR-DRG 38.00: Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Procedures",,,7275.13,7275.13,5
APR-DRG,5102,"APR-DRG 38.00: Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Procedures",,,9226.99,9226.99,5
APR-DRG,5103,"APR-DRG 38.00: Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Procedures",,,13958.79,13958.79,5
APR-DRG,5104,"APR-DRG 38.00: Pelvic Evisceration, Radical Hysterectomy And Other Radical Gynecological Procedures",,,28804.78,28804.78,5
APR-DRG,5111,APR-DRG 38.00: Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy,,,7511.72,7511.72,5
APR-DRG,5112,APR-DRG 38.00: Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy,,,8990.4,8990.4,5
APR-DRG,5113,APR-DRG 38.00: Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy,,,14136.23,14136.23,5
APR-DRG,5114,APR-DRG 38.00: Uterine And Adnexa Procedures For Ovarian And Adnexal Malignancy,,,25965.71,25965.71,5
APR-DRG,5121,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy,,,6861.1,6861.1,5
APR-DRG,5122,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy,,,7984.9,7984.9,5
APR-DRG,5123,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy,,,13485.61,13485.61,5
APR-DRG,5124,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Ovarian And Non-Adnexal Malignancy,,,22949.19,22949.19,5
APR-DRG,5131,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Malignancy Except Leiomyoma,,,5086.68,5086.68,5
APR-DRG,5132,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Malignancy Except Leiomyoma,,,6033.03,6033.03,5
APR-DRG,5133,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Malignancy Except Leiomyoma,,,10350.8,10350.8,5
APR-DRG,5134,APR-DRG 38.00: Uterine And Adnexa Procedures For Non-Malignancy Except Leiomyoma,,,19045.46,19045.46,5
APR-DRG,5141,APR-DRG 38.00: Female Reproductive System Reconstructive Procedures,,,4258.61,4258.61,5
APR-DRG,5142,APR-DRG 38.00: Female Reproductive System Reconstructive Procedures,,,6565.36,6565.36,5
APR-DRG,5143,APR-DRG 38.00: Female Reproductive System Reconstructive Procedures,,,11829.48,11829.48,5
APR-DRG,5144,APR-DRG 38.00: Female Reproductive System Reconstructive Procedures,,,21529.65,21529.65,5
APR-DRG,5171,APR-DRG 38.00: Dilation And Curettage For Non-Obstetric Diagnoses,,,3962.88,3962.88,5
APR-DRG,5172,APR-DRG 38.00: Dilation And Curettage For Non-Obstetric Diagnoses,,,5027.53,5027.53,5
APR-DRG,5173,APR-DRG 38.00: Dilation And Curettage For Non-Obstetric Diagnoses,,,8694.67,8694.67,5
APR-DRG,5174,APR-DRG 38.00: Dilation And Curettage For Non-Obstetric Diagnoses,,,21174.77,21174.77,5
APR-DRG,5181,APR-DRG 38.00: Other Female Reproductive System And Related Procedures,,,4909.23,4909.23,5
APR-DRG,5182,APR-DRG 38.00: Other Female Reproductive System And Related Procedures,,,6624.51,6624.51,5
APR-DRG,5183,APR-DRG 38.00: Other Female Reproductive System And Related Procedures,,,13012.43,13012.43,5
APR-DRG,5184,APR-DRG 38.00: Other Female Reproductive System And Related Procedures,,,18158.25,18158.25,5
APR-DRG,5191,APR-DRG 38.00: Uterine And Adnexa Procedures For Leiomyoma,,,4968.38,4968.38,5
APR-DRG,5192,APR-DRG 38.00: Uterine And Adnexa Procedures For Leiomyoma,,,6151.33,6151.33,5
APR-DRG,5193,APR-DRG 38.00: Uterine And Adnexa Procedures For Leiomyoma,,,10705.68,10705.68,5
APR-DRG,5194,APR-DRG 38.00: Uterine And Adnexa Procedures For Leiomyoma,,,20524.15,20524.15,5
APR-DRG,5301,APR-DRG 38.00: Female Reproductive System Malignancy,,,3371.4,3371.4,5
APR-DRG,5302,APR-DRG 38.00: Female Reproductive System Malignancy,,,4436.06,4436.06,5
APR-DRG,5303,APR-DRG 38.00: Female Reproductive System Malignancy,,,6683.66,6683.66,5
APR-DRG,5304,APR-DRG 38.00: Female Reproductive System Malignancy,,,12243.51,12243.51,5
APR-DRG,5311,APR-DRG 38.00: Female Reproductive System Infections,,,2720.78,2720.78,5
APR-DRG,5312,APR-DRG 38.00: Female Reproductive System Infections,,,3667.14,3667.14,5
APR-DRG,5313,APR-DRG 38.00: Female Reproductive System Infections,,,5914.74,5914.74,5
APR-DRG,5314,APR-DRG 38.00: Female Reproductive System Infections,,,10705.68,10705.68,5
APR-DRG,5321,APR-DRG 38.00: Menstrual And Other Female Reproductive System Disorders,,,2602.49,2602.49,5
APR-DRG,5322,APR-DRG 38.00: Menstrual And Other Female Reproductive System Disorders,,,3134.81,3134.81,5
APR-DRG,5323,APR-DRG 38.00: Menstrual And Other Female Reproductive System Disorders,,,4613.5,4613.5,5
APR-DRG,5324,APR-DRG 38.00: Menstrual And Other Female Reproductive System Disorders,,,9995.91,9995.91,5
APR-DRG,5391,APR-DRG 38.00: Cesarean Section With Sterilization,,,3016.52,3016.52,5
APR-DRG,5392,APR-DRG 38.00: Cesarean Section With Sterilization,,,3489.7,3489.7,5
APR-DRG,5393,APR-DRG 38.00: Cesarean Section With Sterilization,,,5441.56,5441.56,5
APR-DRG,5394,APR-DRG 38.00: Cesarean Section With Sterilization,,,13663.05,13663.05,5
APR-DRG,5401,APR-DRG 38.00: Cesarean Section Without Sterilization,,,3016.52,3016.52,5
APR-DRG,5402,APR-DRG 38.00: Cesarean Section Without Sterilization,,,3667.14,3667.14,5
APR-DRG,5403,APR-DRG 38.00: Cesarean Section Without Sterilization,,,5027.53,5027.53,5
APR-DRG,5404,APR-DRG 38.00: Cesarean Section Without Sterilization,,,9936.76,9936.76,5
APR-DRG,5411,APR-DRG 38.00: Vaginal Delivery With Sterilization And/Or D&C,,,2720.78,2720.78,5
APR-DRG,5412,APR-DRG 38.00: Vaginal Delivery With Sterilization And/Or D&C,,,2839.08,2839.08,5
APR-DRG,5413,APR-DRG 38.00: Vaginal Delivery With Sterilization And/Or D&C,,,3844.58,3844.58,5
APR-DRG,5414,APR-DRG 38.00: Vaginal Delivery With Sterilization And/Or D&C,,,6210.48,6210.48,5
APR-DRG,5421,APR-DRG 38.00: Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,,,2011.01,2011.01,5
APR-DRG,5422,APR-DRG 38.00: Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,,,2425.04,2425.04,5
APR-DRG,5423,APR-DRG 38.00: Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,,,3785.43,3785.43,5
APR-DRG,5424,APR-DRG 38.00: Vaginal Delivery With O.R. Procedure Except Sterilization And/Or D&C,,,10942.27,10942.27,5
APR-DRG,5431,"APR-DRG 38.00: Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,2839.08,2839.08,5
APR-DRG,5432,"APR-DRG 38.00: Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,3489.7,3489.7,5
APR-DRG,5433,"APR-DRG 38.00: Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,4850.09,4850.09,5
APR-DRG,5434,"APR-DRG 38.00: Abortion With D&C, Aspiration Curettage Or Hysterotomy",,,11178.86,11178.86,5
APR-DRG,5471,APR-DRG 38.00: Antepartum With O.R. Procedure,,,3371.4,3371.4,5
APR-DRG,5472,APR-DRG 38.00: Antepartum With O.R. Procedure,,,4790.94,4790.94,5
APR-DRG,5473,APR-DRG 38.00: Antepartum With O.R. Procedure,,,7689.16,7689.16,5
APR-DRG,5474,APR-DRG 38.00: Antepartum With O.R. Procedure,,,14372.82,14372.82,5
APR-DRG,5481,APR-DRG 38.00: Postpartum And Post Abortion Diagnosis With O.R. Procedure,,,2070.16,2070.16,5
APR-DRG,5482,APR-DRG 38.00: Postpartum And Post Abortion Diagnosis With O.R. Procedure,,,4495.2,4495.2,5
APR-DRG,5483,APR-DRG 38.00: Postpartum And Post Abortion Diagnosis With O.R. Procedure,,,8753.82,8753.82,5
APR-DRG,5484,APR-DRG 38.00: Postpartum And Post Abortion Diagnosis With O.R. Procedure,,,27326.1,27326.1,5
APR-DRG,5601,APR-DRG 38.00: Vaginal Delivery,,,1774.42,1774.42,5
APR-DRG,5602,APR-DRG 38.00: Vaginal Delivery,,,2011.01,2011.01,5
APR-DRG,5603,APR-DRG 38.00: Vaginal Delivery,,,2779.93,2779.93,5
APR-DRG,5604,APR-DRG 38.00: Vaginal Delivery,,,4199.47,4199.47,5
APR-DRG,5611,APR-DRG 38.00: Postpartum And Post Abortion Diagnoses Without Procedure,,,1537.83,1537.83,5
APR-DRG,5612,APR-DRG 38.00: Postpartum And Post Abortion Diagnoses Without Procedure,,,2306.75,2306.75,5
APR-DRG,5613,APR-DRG 38.00: Postpartum And Post Abortion Diagnoses Without Procedure,,,3785.43,3785.43,5
APR-DRG,5614,APR-DRG 38.00: Postpartum And Post Abortion Diagnoses Without Procedure,,,7925.75,7925.75,5
APR-DRG,5641,"APR-DRG 38.00: Abortion Without D&C, Aspiration Curettage Or Hysterotomy",,,1715.27,1715.27,5
APR-DRG,5642,"APR-DRG 38.00: Abortion Without D&C, Aspiration Curettage Or Hysterotomy",,,2247.6,2247.6,5
APR-DRG,5643,"APR-DRG 38.00: Abortion Without D&C, Aspiration Curettage Or Hysterotomy",,,3548.84,3548.84,5
APR-DRG,5644,"APR-DRG 38.00: Abortion Without D&C, Aspiration Curettage Or Hysterotomy",,,8458.08,8458.08,5
APR-DRG,5661,APR-DRG 38.00: Antepartum Without O.R. Procedure,,,1596.98,1596.98,5
APR-DRG,5662,APR-DRG 38.00: Antepartum Without O.R. Procedure,,,2070.16,2070.16,5
APR-DRG,5663,APR-DRG 38.00: Antepartum Without O.R. Procedure,,,3075.66,3075.66,5
APR-DRG,5664,APR-DRG 38.00: Antepartum Without O.R. Procedure,,,6742.8,6742.8,5
APR-DRG,5801,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Not Born Here",,,1360.39,1360.39,5
APR-DRG,5802,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Not Born Here",,,1951.86,1951.86,5
APR-DRG,5803,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Not Born Here",,,3312.25,3312.25,5
APR-DRG,5804,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Not Born Here",,,5914.74,5914.74,5
APR-DRG,5811,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Born Here",,,591.47,591.47,5
APR-DRG,5812,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Born Here",,,887.21,887.21,5
APR-DRG,5813,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Born Here",,,1478.68,1478.68,5
APR-DRG,5814,"APR-DRG 38.00: Neonate, Transferred < 5 Days Old, Born Here",,,2779.93,2779.93,5
APR-DRG,5831,APR-DRG 38.00: Neonate With Ecmo,,,94813.28,94813.28,5
APR-DRG,5832,APR-DRG 38.00: Neonate With Ecmo,,,120010.07,120010.07,5
APR-DRG,5833,APR-DRG 38.00: Neonate With Ecmo,,,176909.87,176909.87,5
APR-DRG,5834,APR-DRG 38.00: Neonate With Ecmo,,,220205.77,220205.77,5
APR-DRG,5881,APR-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure,,,51339.94,51339.94,5
APR-DRG,5882,APR-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure,,,51339.94,51339.94,5
APR-DRG,5883,APR-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure,,,106347.03,106347.03,5
APR-DRG,5884,APR-DRG 38.00: Neonate Birth Weight < 1500 Grams With Major Procedure,,,174425.68,174425.68,5
APR-DRG,5891,"APR-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention",,,73579.37,73579.37,5
APR-DRG,5892,"APR-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention",,,70976.88,70976.88,5
APR-DRG,5893,"APR-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention",,,64529.81,64529.81,5
APR-DRG,5894,"APR-DRG 38.00: Neonate Birth Weight < 500 Grams, Or Birth Weight 500-999 Grams And Gestational Age <24 Weeks, Or Birth Weight 500-749 Grams With Major Anomaly Or Without Life Sustaining Intervention",,,12243.51,12243.51,5
APR-DRG,5911,APR-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure,,,46134.97,46134.97,5
APR-DRG,5912,APR-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure,,,64056.63,64056.63,5
APR-DRG,5913,APR-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure,,,70799.44,70799.44,5
APR-DRG,5914,APR-DRG 38.00: Neonate Birth Weight 500-749 Grams Without Major Procedure,,,119063.72,119063.72,5
APR-DRG,5931,APR-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure,,,15496.62,15496.62,5
APR-DRG,5932,APR-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure,,,59324.84,59324.84,5
APR-DRG,5933,APR-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure,,,68492.69,68492.69,5
APR-DRG,5934,APR-DRG 38.00: Neonate Birth Weight 750-999 Grams Without Major Procedure,,,98894.45,98894.45,5
APR-DRG,6021,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,16265.53,16265.53,5
APR-DRG,6022,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,46726.45,46726.45,5
APR-DRG,6023,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,52168.01,52168.01,5
APR-DRG,6024,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,76536.74,76536.74,5
APR-DRG,6031,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition,,,15378.32,15378.32,5
APR-DRG,6032,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition,,,29100.52,29100.52,5
APR-DRG,6033,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition,,,44656.29,44656.29,5
APR-DRG,6034,APR-DRG 38.00: Neonate Birth Weight 1000-1249 Grams With Or Without Significant Condition,,,92624.83,92624.83,5
APR-DRG,6071,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,18749.73,18749.73,5
APR-DRG,6072,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,32826.81,32826.81,5
APR-DRG,6073,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,40930.0,40930.0,5
APR-DRG,6074,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition Or Major Anomaly,,,63760.9,63760.9,5
APR-DRG,6081,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,,,8753.82,8753.82,5
APR-DRG,6082,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,,,23777.25,23777.25,5
APR-DRG,6083,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,,,34778.67,34778.67,5
APR-DRG,6084,APR-DRG 38.00: Neonate Birth Weight 1250-1499 Grams With Or Without Significant Condition,,,56485.77,56485.77,5
APR-DRG,6091,APR-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure,,,31643.86,31643.86,5
APR-DRG,6092,APR-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure,,,31643.86,31643.86,5
APR-DRG,6093,APR-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure,,,46667.3,46667.3,5
APR-DRG,6094,APR-DRG 38.00: Neonate Birth Weight 1500-2499 Grams With Major Procedure,,,116638.67,116638.67,5
APR-DRG,6111,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly,,,10705.68,10705.68,5
APR-DRG,6112,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly,,,17330.19,17330.19,5
APR-DRG,6113,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly,,,29632.85,29632.85,5
APR-DRG,6114,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Major Anomaly,,,51399.09,51399.09,5
APR-DRG,6121,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,13308.17,13308.17,5
APR-DRG,6122,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,20287.56,20287.56,5
APR-DRG,6123,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,27917.57,27917.57,5
APR-DRG,6124,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,42172.1,42172.1,5
APR-DRG,6131,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection,,,11474.6,11474.6,5
APR-DRG,6132,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection,,,19222.9,19222.9,5
APR-DRG,6133,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection,,,26498.04,26498.04,5
APR-DRG,6134,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Congenital Or Perinatal Infection,,,42408.69,42408.69,5
APR-DRG,6141,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition,,,7156.84,7156.84,5
APR-DRG,6142,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition,,,13958.79,13958.79,5
APR-DRG,6143,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition,,,23836.4,23836.4,5
APR-DRG,6144,APR-DRG 38.00: Neonate Birth Weight 1500-1999 Grams With Or Without Other Significant Condition,,,33063.4,33063.4,5
APR-DRG,6211,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly,,,4317.76,4317.76,5
APR-DRG,6212,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly,,,12361.81,12361.81,5
APR-DRG,6213,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly,,,22949.19,22949.19,5
APR-DRG,6214,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Major Anomaly,,,39865.35,39865.35,5
APR-DRG,6221,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,8635.52,8635.52,5
APR-DRG,6222,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,12598.4,12598.4,5
APR-DRG,6223,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,17211.89,17211.89,5
APR-DRG,6224,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,30815.8,30815.8,5
APR-DRG,6231,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection,,,6565.36,6565.36,5
APR-DRG,6232,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection,,,11533.74,11533.74,5
APR-DRG,6233,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection,,,21884.54,21884.54,5
APR-DRG,6234,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Congenital Or Perinatal Infection,,,35902.47,35902.47,5
APR-DRG,6251,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condition,,,7452.57,7452.57,5
APR-DRG,6252,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condition,,,11533.74,11533.74,5
APR-DRG,6253,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condition,,,19282.05,19282.05,5
APR-DRG,6254,APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams With Other Significant Condition,,,43532.49,43532.49,5
APR-DRG,6261,"APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem",,,1005.51,1005.51,5
APR-DRG,6262,"APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem",,,1478.68,1478.68,5
APR-DRG,6263,"APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem",,,3903.73,3903.73,5
APR-DRG,6264,"APR-DRG 38.00: Neonate Birth Weight 2000-2499 Grams, Normal Newborn Or Neonate With Other Problem",,,14254.52,14254.52,5
APR-DRG,6301,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,,,17211.89,17211.89,5
APR-DRG,6302,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,,,27858.43,27858.43,5
APR-DRG,6303,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,,,50038.7,50038.7,5
APR-DRG,6304,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Cardiovascular Procedure,,,100195.7,100195.7,5
APR-DRG,6311,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure,,,7925.75,7925.75,5
APR-DRG,6312,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure,,,18572.28,18572.28,5
APR-DRG,6313,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure,,,34660.38,34660.38,5
APR-DRG,6314,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Major Procedure,,,103981.13,103981.13,5
APR-DRG,6331,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Anomaly,,,1596.98,1596.98,5
APR-DRG,6332,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Anomaly,,,5973.89,5973.89,5
APR-DRG,6333,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Anomaly,,,16502.12,16502.12,5
APR-DRG,6334,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Major Anomaly,,,39214.73,39214.73,5
APR-DRG,6341,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,3726.29,3726.29,5
APR-DRG,6342,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,7275.13,7275.13,5
APR-DRG,6343,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,10469.09,10469.09,5
APR-DRG,6344,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Respiratory Distress Syndrome Or Other Major Respiratory Condition,,,26438.89,26438.89,5
APR-DRG,6361,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection,,,3844.58,3844.58,5
APR-DRG,6362,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection,,,6801.95,6801.95,5
APR-DRG,6363,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection,,,13722.2,13722.2,5
APR-DRG,6364,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Congenital Or Perinatal Infection,,,24723.61,24723.61,5
APR-DRG,6391,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Significant Condition,,,3312.25,3312.25,5
APR-DRG,6392,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Significant Condition,,,6506.21,6506.21,5
APR-DRG,6393,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Significant Condition,,,11238.01,11238.01,5
APR-DRG,6394,APR-DRG 38.00: Neonate Birth Weight > 2499 Grams With Other Significant Condition,,,14905.14,14905.14,5
APR-DRG,6401,"APR-DRG 38.00: Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem",,,591.47,591.47,5
APR-DRG,6402,"APR-DRG 38.00: Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem",,,828.06,828.06,5
APR-DRG,6403,"APR-DRG 38.00: Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem",,,2011.01,2011.01,5
APR-DRG,6404,"APR-DRG 38.00: Neonate Birth Weight > 2499 Grams, Normal Newborn Or Neonate With Other Problem",,,14786.85,14786.85,5
APR-DRG,6501,APR-DRG 38.00: Splenectomy,,,7689.16,7689.16,5
APR-DRG,6502,APR-DRG 38.00: Splenectomy,,,9877.62,9877.62,5
APR-DRG,6503,APR-DRG 38.00: Splenectomy,,,16206.39,16206.39,5
APR-DRG,6504,APR-DRG 38.00: Splenectomy,,,24250.43,24250.43,5
APR-DRG,6511,APR-DRG 38.00: Other Procedures Of Blood And Blood-Forming Organs,,,5855.59,5855.59,5
APR-DRG,6512,APR-DRG 38.00: Other Procedures Of Blood And Blood-Forming Organs,,,8339.78,8339.78,5
APR-DRG,6513,APR-DRG 38.00: Other Procedures Of Blood And Blood-Forming Organs,,,14550.26,14550.26,5
APR-DRG,6514,APR-DRG 38.00: Other Procedures Of Blood And Blood-Forming Organs,,,39096.43,39096.43,5
APR-DRG,6601,APR-DRG 38.00: Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagulation,,,3903.73,3903.73,5
APR-DRG,6602,APR-DRG 38.00: Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagulation,,,4554.35,4554.35,5
APR-DRG,6603,APR-DRG 38.00: Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagulation,,,7748.31,7748.31,5
APR-DRG,6604,APR-DRG 38.00: Major Hematologic Or Immunologic Diagnoses Except Sickle Cell Crisis And Coagulation,,,20524.15,20524.15,5
APR-DRG,6611,APR-DRG 38.00: Coagulation And Platelet Disorders,,,4613.5,4613.5,5
APR-DRG,6612,APR-DRG 38.00: Coagulation And Platelet Disorders,,,6033.03,6033.03,5
APR-DRG,6613,APR-DRG 38.00: Coagulation And Platelet Disorders,,,8812.96,8812.96,5
APR-DRG,6614,APR-DRG 38.00: Coagulation And Platelet Disorders,,,18039.96,18039.96,5
APR-DRG,6621,APR-DRG 38.00: Sickle Cell Anemia Crisis,,,3134.81,3134.81,5
APR-DRG,6622,APR-DRG 38.00: Sickle Cell Anemia Crisis,,,4199.47,4199.47,5
APR-DRG,6623,APR-DRG 38.00: Sickle Cell Anemia Crisis,,,6328.77,6328.77,5
APR-DRG,6624,APR-DRG 38.00: Sickle Cell Anemia Crisis,,,13899.64,13899.64,5
APR-DRG,6631,APR-DRG 38.00: Other Anemia And Disorders Of Blood And Blood-Forming Organs,,,2898.22,2898.22,5
APR-DRG,6632,APR-DRG 38.00: Other Anemia And Disorders Of Blood And Blood-Forming Organs,,,3785.43,3785.43,5
APR-DRG,6633,APR-DRG 38.00: Other Anemia And Disorders Of Blood And Blood-Forming Organs,,,5323.27,5323.27,5
APR-DRG,6634,APR-DRG 38.00: Other Anemia And Disorders Of Blood And Blood-Forming Organs,,,9345.29,9345.29,5
APR-DRG,6801,"APR-DRG 38.00: Major O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,8753.82,8753.82,5
APR-DRG,6802,"APR-DRG 38.00: Major O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,12420.95,12420.95,5
APR-DRG,6803,"APR-DRG 38.00: Major O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,20228.41,20228.41,5
APR-DRG,6804,"APR-DRG 38.00: Major O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,43177.6,43177.6,5
APR-DRG,6811,"APR-DRG 38.00: Other  O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,6624.51,6624.51,5
APR-DRG,6812,"APR-DRG 38.00: Other  O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,9345.29,9345.29,5
APR-DRG,6813,"APR-DRG 38.00: Other  O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,16797.86,16797.86,5
APR-DRG,6814,"APR-DRG 38.00: Other  O.R. Procedures For Lymphatic, Hematopoietic Or Other Neoplasms",,,38150.07,38150.07,5
APR-DRG,6901,APR-DRG 38.00: Acute Leukemia,,,7452.57,7452.57,5
APR-DRG,6902,APR-DRG 38.00: Acute Leukemia,,,12480.1,12480.1,5
APR-DRG,6903,APR-DRG 38.00: Acute Leukemia,,,25492.53,25492.53,5
APR-DRG,6904,APR-DRG 38.00: Acute Leukemia,,,40930.0,40930.0,5
APR-DRG,6911,"APR-DRG 38.00: Lymphoma, Myeloma And Non-Acute Leukemia",,,5796.45,5796.45,5
APR-DRG,6912,"APR-DRG 38.00: Lymphoma, Myeloma And Non-Acute Leukemia",,,7275.13,7275.13,5
APR-DRG,6913,"APR-DRG 38.00: Lymphoma, Myeloma And Non-Acute Leukemia",,,11533.74,11533.74,5
APR-DRG,6914,"APR-DRG 38.00: Lymphoma, Myeloma And Non-Acute Leukemia",,,23718.11,23718.11,5
APR-DRG,6921,APR-DRG 38.00: Radiotherapy,,,4495.2,4495.2,5
APR-DRG,6922,APR-DRG 38.00: Radiotherapy,,,8280.64,8280.64,5
APR-DRG,6923,APR-DRG 38.00: Radiotherapy,,,13544.75,13544.75,5
APR-DRG,6924,APR-DRG 38.00: Radiotherapy,,,21766.24,21766.24,5
APR-DRG,6941,APR-DRG 38.00: Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior,,,3667.14,3667.14,5
APR-DRG,6942,APR-DRG 38.00: Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior,,,4850.09,4850.09,5
APR-DRG,6943,APR-DRG 38.00: Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior,,,7275.13,7275.13,5
APR-DRG,6944,APR-DRG 38.00: Lymphatic And Other Malignancies And Neoplasms Of Uncertain Behavior,,,13899.64,13899.64,5
APR-DRG,6951,APR-DRG 38.00: Chemotherapy For Acute Leukemia,,,5204.97,5204.97,5
APR-DRG,6952,APR-DRG 38.00: Chemotherapy For Acute Leukemia,,,5204.97,5204.97,5
APR-DRG,6953,APR-DRG 38.00: Chemotherapy For Acute Leukemia,,,13722.2,13722.2,5
APR-DRG,6954,APR-DRG 38.00: Chemotherapy For Acute Leukemia,,,37322.01,37322.01,5
APR-DRG,6961,APR-DRG 38.00: Other Chemotherapy,,,4317.76,4317.76,5
APR-DRG,6962,APR-DRG 38.00: Other Chemotherapy,,,5500.71,5500.71,5
APR-DRG,6963,APR-DRG 38.00: Other Chemotherapy,,,9345.29,9345.29,5
APR-DRG,6964,APR-DRG 38.00: Other Chemotherapy,,,21825.39,21825.39,5
APR-DRG,7101,APR-DRG 38.00: Infectious And Parasitic Diseases Including Hiv With O.R. Procedure,,,6210.48,6210.48,5
APR-DRG,7102,APR-DRG 38.00: Infectious And Parasitic Diseases Including Hiv With O.R. Procedure,,,8990.4,8990.4,5
APR-DRG,7103,APR-DRG 38.00: Infectious And Parasitic Diseases Including Hiv With O.R. Procedure,,,14668.56,14668.56,5
APR-DRG,7104,APR-DRG 38.00: Infectious And Parasitic Diseases Including Hiv With O.R. Procedure,,,28213.31,28213.31,5
APR-DRG,7111,"APR-DRG 38.00: Post-Operative, Post-Trauma, Other Device Infections With O.R. Procedure",,,6033.03,6033.03,5
APR-DRG,7112,"APR-DRG 38.00: Post-Operative, Post-Trauma, Other Device Infections With O.R. Procedure",,,8044.05,8044.05,5
APR-DRG,7113,"APR-DRG 38.00: Post-Operative, Post-Trauma, Other Device Infections With O.R. Procedure",,,14136.23,14136.23,5
APR-DRG,7114,"APR-DRG 38.00: Post-Operative, Post-Trauma, Other Device Infections With O.R. Procedure",,,27917.57,27917.57,5
APR-DRG,7201,APR-DRG 38.00: Septicemia And Disseminated Infections,,,3253.11,3253.11,5
APR-DRG,7202,APR-DRG 38.00: Septicemia And Disseminated Infections,,,4199.47,4199.47,5
APR-DRG,7203,APR-DRG 38.00: Septicemia And Disseminated Infections,,,6387.92,6387.92,5
APR-DRG,7204,APR-DRG 38.00: Septicemia And Disseminated Infections,,,12480.1,12480.1,5
APR-DRG,7211,"APR-DRG 38.00: Post-Operative, Post-Traumatic, Other Device Infections",,,3371.4,3371.4,5
APR-DRG,7212,"APR-DRG 38.00: Post-Operative, Post-Traumatic, Other Device Infections",,,4436.06,4436.06,5
APR-DRG,7213,"APR-DRG 38.00: Post-Operative, Post-Traumatic, Other Device Infections",,,7275.13,7275.13,5
APR-DRG,7214,"APR-DRG 38.00: Post-Operative, Post-Traumatic, Other Device Infections",,,13189.87,13189.87,5
APR-DRG,7221,APR-DRG 38.00: Fever And Inflammatory Conditions,,,2365.9,2365.9,5
APR-DRG,7222,APR-DRG 38.00: Fever And Inflammatory Conditions,,,3312.25,3312.25,5
APR-DRG,7223,APR-DRG 38.00: Fever And Inflammatory Conditions,,,4495.2,4495.2,5
APR-DRG,7224,APR-DRG 38.00: Fever And Inflammatory Conditions,,,7570.87,7570.87,5
APR-DRG,7231,APR-DRG 38.00: Viral Illness,,,2188.45,2188.45,5
APR-DRG,7232,APR-DRG 38.00: Viral Illness,,,3075.66,3075.66,5
APR-DRG,7233,APR-DRG 38.00: Viral Illness,,,5027.53,5027.53,5
APR-DRG,7234,APR-DRG 38.00: Viral Illness,,,11533.74,11533.74,5
APR-DRG,7241,APR-DRG 38.00: Other Infectious And Parasitic Diseases,,,3312.25,3312.25,5
APR-DRG,7242,APR-DRG 38.00: Other Infectious And Parasitic Diseases,,,3962.88,3962.88,5
APR-DRG,7243,APR-DRG 38.00: Other Infectious And Parasitic Diseases,,,6861.1,6861.1,5
APR-DRG,7244,APR-DRG 38.00: Other Infectious And Parasitic Diseases,,,15674.06,15674.06,5
APR-DRG,7401,APR-DRG 38.00: Mental Illness Diagnosis With O.R. Procedure,,,7215.98,7215.98,5
APR-DRG,7402,APR-DRG 38.00: Mental Illness Diagnosis With O.R. Procedure,,,7334.28,7334.28,5
APR-DRG,7403,APR-DRG 38.00: Mental Illness Diagnosis With O.R. Procedure,,,15496.62,15496.62,5
APR-DRG,7404,APR-DRG 38.00: Mental Illness Diagnosis With O.R. Procedure,,,20228.41,20228.41,5
APR-DRG,7501,APR-DRG 38.00: Schizophrenia,,,3371.4,3371.4,5
APR-DRG,7502,APR-DRG 38.00: Schizophrenia,,,4081.17,4081.17,5
APR-DRG,7503,APR-DRG 38.00: Schizophrenia,,,6861.1,6861.1,5
APR-DRG,7504,APR-DRG 38.00: Schizophrenia,,,14964.29,14964.29,5
APR-DRG,7511,APR-DRG 38.00: Major Depressive Disorders And Other Or Unspecified Psychoses,,,2011.01,2011.01,5
APR-DRG,7512,APR-DRG 38.00: Major Depressive Disorders And Other Or Unspecified Psychoses,,,2839.08,2839.08,5
APR-DRG,7513,APR-DRG 38.00: Major Depressive Disorders And Other Or Unspecified Psychoses,,,5559.86,5559.86,5
APR-DRG,7514,APR-DRG 38.00: Major Depressive Disorders And Other Or Unspecified Psychoses,,,10232.5,10232.5,5
APR-DRG,7521,APR-DRG 38.00: Disorders Of Personality And Impulse Control,,,1833.57,1833.57,5
APR-DRG,7522,APR-DRG 38.00: Disorders Of Personality And Impulse Control,,,2365.9,2365.9,5
APR-DRG,7523,APR-DRG 38.00: Disorders Of Personality And Impulse Control,,,5500.71,5500.71,5
APR-DRG,7524,APR-DRG 38.00: Disorders Of Personality And Impulse Control,,,5500.71,5500.71,5
APR-DRG,7531,APR-DRG 38.00: Bipolar Disorders,,,2247.6,2247.6,5
APR-DRG,7532,APR-DRG 38.00: Bipolar Disorders,,,3075.66,3075.66,5
APR-DRG,7533,APR-DRG 38.00: Bipolar Disorders,,,5441.56,5441.56,5
APR-DRG,7534,APR-DRG 38.00: Bipolar Disorders,,,10587.38,10587.38,5
APR-DRG,7541,APR-DRG 38.00: Depression Except Major Depressive Disorder,,,1715.27,1715.27,5
APR-DRG,7542,APR-DRG 38.00: Depression Except Major Depressive Disorder,,,2365.9,2365.9,5
APR-DRG,7543,APR-DRG 38.00: Depression Except Major Depressive Disorder,,,4081.17,4081.17,5
APR-DRG,7544,APR-DRG 38.00: Depression Except Major Depressive Disorder,,,9167.85,9167.85,5
APR-DRG,7551,APR-DRG 38.00: Adjustment Disorders And Neuroses Except Depressive Diagnoses,,,1596.98,1596.98,5
APR-DRG,7552,APR-DRG 38.00: Adjustment Disorders And Neuroses Except Depressive Diagnoses,,,2425.04,2425.04,5
APR-DRG,7553,APR-DRG 38.00: Adjustment Disorders And Neuroses Except Depressive Diagnoses,,,3726.29,3726.29,5
APR-DRG,7554,APR-DRG 38.00: Adjustment Disorders And Neuroses Except Depressive Diagnoses,,,10232.5,10232.5,5
APR-DRG,7561,APR-DRG 38.00: Acute Anxiety And Delirium States,,,2543.34,2543.34,5
APR-DRG,7562,APR-DRG 38.00: Acute Anxiety And Delirium States,,,3253.11,3253.11,5
APR-DRG,7563,APR-DRG 38.00: Acute Anxiety And Delirium States,,,3371.4,3371.4,5
APR-DRG,7564,APR-DRG 38.00: Acute Anxiety And Delirium States,,,9167.85,9167.85,5
APR-DRG,7571,APR-DRG 38.00: Organic Mental Health Disturbances,,,2602.49,2602.49,5
APR-DRG,7572,APR-DRG 38.00: Organic Mental Health Disturbances,,,3430.55,3430.55,5
APR-DRG,7573,APR-DRG 38.00: Organic Mental Health Disturbances,,,6506.21,6506.21,5
APR-DRG,7574,APR-DRG 38.00: Organic Mental Health Disturbances,,,12480.1,12480.1,5
APR-DRG,7581,APR-DRG 38.00: Behavioral Disorders,,,2247.6,2247.6,5
APR-DRG,7582,APR-DRG 38.00: Behavioral Disorders,,,2898.22,2898.22,5
APR-DRG,7583,APR-DRG 38.00: Behavioral Disorders,,,5086.68,5086.68,5
APR-DRG,7584,APR-DRG 38.00: Behavioral Disorders,,,7807.46,7807.46,5
APR-DRG,7591,APR-DRG 38.00: Eating Disorders,,,6742.8,6742.8,5
APR-DRG,7592,APR-DRG 38.00: Eating Disorders,,,6861.1,6861.1,5
APR-DRG,7593,APR-DRG 38.00: Eating Disorders,,,9759.32,9759.32,5
APR-DRG,7594,APR-DRG 38.00: Eating Disorders,,,24132.14,24132.14,5
APR-DRG,7601,APR-DRG 38.00: Other Mental Health Disorders,,,3193.96,3193.96,5
APR-DRG,7602,APR-DRG 38.00: Other Mental Health Disorders,,,3785.43,3785.43,5
APR-DRG,7603,APR-DRG 38.00: Other Mental Health Disorders,,,5382.41,5382.41,5
APR-DRG,7604,APR-DRG 38.00: Other Mental Health Disorders,,,6861.1,6861.1,5
APR-DRG,7701,"APR-DRG 38.00: Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice",,,1360.39,1360.39,5
APR-DRG,7702,"APR-DRG 38.00: Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice",,,2129.31,2129.31,5
APR-DRG,7703,"APR-DRG 38.00: Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice",,,3785.43,3785.43,5
APR-DRG,7704,"APR-DRG 38.00: Drug And Alcohol Abuse Or Dependence, Left Against Medical Advice",,,8221.49,8221.49,5
APR-DRG,7721,APR-DRG 38.00: Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy,,,2957.37,2957.37,5
APR-DRG,7722,APR-DRG 38.00: Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy,,,3667.14,3667.14,5
APR-DRG,7723,APR-DRG 38.00: Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy,,,4495.2,4495.2,5
APR-DRG,7724,APR-DRG 38.00: Alcohol And Drug Dependence With Rehabilitation And/Or Detoxification Therapy,,,14195.38,14195.38,5
APR-DRG,7731,APR-DRG 38.00: Opioid Abuse And Dependence,,,1537.83,1537.83,5
APR-DRG,7732,APR-DRG 38.00: Opioid Abuse And Dependence,,,2188.45,2188.45,5
APR-DRG,7733,APR-DRG 38.00: Opioid Abuse And Dependence,,,4140.32,4140.32,5
APR-DRG,7734,APR-DRG 38.00: Opioid Abuse And Dependence,,,10587.38,10587.38,5
APR-DRG,7741,APR-DRG 38.00: Cocaine Abuse And Dependence,,,1951.86,1951.86,5
APR-DRG,7742,APR-DRG 38.00: Cocaine Abuse And Dependence,,,2188.45,2188.45,5
APR-DRG,7743,APR-DRG 38.00: Cocaine Abuse And Dependence,,,3903.73,3903.73,5
APR-DRG,7744,APR-DRG 38.00: Cocaine Abuse And Dependence,,,10823.97,10823.97,5
APR-DRG,7751,APR-DRG 38.00: Alcohol Abuse And Dependence,,,2070.16,2070.16,5
APR-DRG,7752,APR-DRG 38.00: Alcohol Abuse And Dependence,,,2898.22,2898.22,5
APR-DRG,7753,APR-DRG 38.00: Alcohol Abuse And Dependence,,,5204.97,5204.97,5
APR-DRG,7754,APR-DRG 38.00: Alcohol Abuse And Dependence,,,13130.72,13130.72,5
APR-DRG,7761,APR-DRG 38.00: Other Drug Abuse And Dependence,,,2011.01,2011.01,5
APR-DRG,7762,APR-DRG 38.00: Other Drug Abuse And Dependence,,,2365.9,2365.9,5
APR-DRG,7763,APR-DRG 38.00: Other Drug Abuse And Dependence,,,4495.2,4495.2,5
APR-DRG,7764,APR-DRG 38.00: Other Drug Abuse And Dependence,,,8990.4,8990.4,5
APR-DRG,7921,APR-DRG 38.00: Extensive O.R. Procedures For Other Complications Of Treatment,,,8162.34,8162.34,5
APR-DRG,7922,APR-DRG 38.00: Extensive O.R. Procedures For Other Complications Of Treatment,,,10173.35,10173.35,5
APR-DRG,7923,APR-DRG 38.00: Extensive O.R. Procedures For Other Complications Of Treatment,,,14964.29,14964.29,5
APR-DRG,7924,APR-DRG 38.00: Extensive O.R. Procedures For Other Complications Of Treatment,,,30106.03,30106.03,5
APR-DRG,7931,APR-DRG 38.00: Moderately Extensive O.R. Procedures For Other Complications Of Treatment,,,5264.12,5264.12,5
APR-DRG,7932,APR-DRG 38.00: Moderately Extensive O.R. Procedures For Other Complications Of Treatment,,,7452.57,7452.57,5
APR-DRG,7933,APR-DRG 38.00: Moderately Extensive O.R. Procedures For Other Complications Of Treatment,,,11947.77,11947.77,5
APR-DRG,7934,APR-DRG 38.00: Moderately Extensive O.R. Procedures For Other Complications Of Treatment,,,23895.55,23895.55,5
APR-DRG,7941,APR-DRG 38.00: Non-Extensive O.R. Procedures For Other Complications Of Treatment,,,4731.79,4731.79,5
APR-DRG,7942,APR-DRG 38.00: Non-Extensive O.R. Procedures For Other Complications Of Treatment,,,5678.15,5678.15,5
APR-DRG,7943,APR-DRG 38.00: Non-Extensive O.R. Procedures For Other Complications Of Treatment,,,9286.14,9286.14,5
APR-DRG,7944,APR-DRG 38.00: Non-Extensive O.R. Procedures For Other Complications Of Treatment,,,14905.14,14905.14,5
APR-DRG,8101,APR-DRG 38.00: Hemorrhage Or Hematoma Due To Complication,,,2898.22,2898.22,5
APR-DRG,8102,APR-DRG 38.00: Hemorrhage Or Hematoma Due To Complication,,,3844.58,3844.58,5
APR-DRG,8103,APR-DRG 38.00: Hemorrhage Or Hematoma Due To Complication,,,6092.18,6092.18,5
APR-DRG,8104,APR-DRG 38.00: Hemorrhage Or Hematoma Due To Complication,,,12125.22,12125.22,5
APR-DRG,8111,APR-DRG 38.00: Allergic Reactions,,,1951.86,1951.86,5
APR-DRG,8112,APR-DRG 38.00: Allergic Reactions,,,2898.22,2898.22,5
APR-DRG,8113,APR-DRG 38.00: Allergic Reactions,,,5559.86,5559.86,5
APR-DRG,8114,APR-DRG 38.00: Allergic Reactions,,,11119.71,11119.71,5
APR-DRG,8121,APR-DRG 38.00: Poisoning Of Medicinal Agents,,,2188.45,2188.45,5
APR-DRG,8122,APR-DRG 38.00: Poisoning Of Medicinal Agents,,,2898.22,2898.22,5
APR-DRG,8123,APR-DRG 38.00: Poisoning Of Medicinal Agents,,,4376.91,4376.91,5
APR-DRG,8124,APR-DRG 38.00: Poisoning Of Medicinal Agents,,,8398.93,8398.93,5
APR-DRG,8131,APR-DRG 38.00: Other Complications Of Treatment,,,3371.4,3371.4,5
APR-DRG,8132,APR-DRG 38.00: Other Complications Of Treatment,,,4140.32,4140.32,5
APR-DRG,8133,APR-DRG 38.00: Other Complications Of Treatment,,,6151.33,6151.33,5
APR-DRG,8134,APR-DRG 38.00: Other Complications Of Treatment,,,11947.77,11947.77,5
APR-DRG,8151,"APR-DRG 38.00: Other Injury, Poisoning And Toxic Effect Diagnoses",,,2484.19,2484.19,5
APR-DRG,8152,"APR-DRG 38.00: Other Injury, Poisoning And Toxic Effect Diagnoses",,,3253.11,3253.11,5
APR-DRG,8153,"APR-DRG 38.00: Other Injury, Poisoning And Toxic Effect Diagnoses",,,5441.56,5441.56,5
APR-DRG,8154,"APR-DRG 38.00: Other Injury, Poisoning And Toxic Effect Diagnoses",,,14254.52,14254.52,5
APR-DRG,8161,APR-DRG 38.00: Toxic Effects Of Non-Medicinal Substances,,,3312.25,3312.25,5
APR-DRG,8162,APR-DRG 38.00: Toxic Effects Of Non-Medicinal Substances,,,3312.25,3312.25,5
APR-DRG,8163,APR-DRG 38.00: Toxic Effects Of Non-Medicinal Substances,,,4258.61,4258.61,5
APR-DRG,8164,APR-DRG 38.00: Toxic Effects Of Non-Medicinal Substances,,,8694.67,8694.67,5
APR-DRG,8171,APR-DRG 38.00: Intentional Self-Harm And Attempted Suicide,,,2129.31,2129.31,5
APR-DRG,8172,APR-DRG 38.00: Intentional Self-Harm And Attempted Suicide,,,2661.63,2661.63,5
APR-DRG,8173,APR-DRG 38.00: Intentional Self-Harm And Attempted Suicide,,,4376.91,4376.91,5
APR-DRG,8174,APR-DRG 38.00: Intentional Self-Harm And Attempted Suicide,,,8812.96,8812.96,5
APR-DRG,8411,APR-DRG 38.00: Extensive Third Degree Burns With Skin Graft,,,31407.27,31407.27,5
APR-DRG,8412,APR-DRG 38.00: Extensive Third Degree Burns With Skin Graft,,,31407.27,31407.27,5
APR-DRG,8413,APR-DRG 38.00: Extensive Third Degree Burns With Skin Graft,,,48323.43,48323.43,5
APR-DRG,8414,APR-DRG 38.00: Extensive Third Degree Burns With Skin Graft,,,121547.91,121547.91,5
APR-DRG,8421,APR-DRG 38.00: Burns With Skin Graft Except Extensive Third Degree Burns,,,8517.23,8517.23,5
APR-DRG,8422,APR-DRG 38.00: Burns With Skin Graft Except Extensive Third Degree Burns,,,13367.31,13367.31,5
APR-DRG,8423,APR-DRG 38.00: Burns With Skin Graft Except Extensive Third Degree Burns,,,24605.32,24605.32,5
APR-DRG,8424,APR-DRG 38.00: Burns With Skin Graft Except Extensive Third Degree Burns,,,60448.64,60448.64,5
APR-DRG,8431,APR-DRG 38.00: Extensive Third Degree Burns Without Skin Graft,,,3430.55,3430.55,5
APR-DRG,8432,APR-DRG 38.00: Extensive Third Degree Burns Without Skin Graft,,,5796.45,5796.45,5
APR-DRG,8433,APR-DRG 38.00: Extensive Third Degree Burns Without Skin Graft,,,8162.34,8162.34,5
APR-DRG,8434,APR-DRG 38.00: Extensive Third Degree Burns Without Skin Graft,,,30106.03,30106.03,5
APR-DRG,8441,APR-DRG 38.00: Partial Thickness Burns Without Skin Graft,,,2602.49,2602.49,5
APR-DRG,8442,APR-DRG 38.00: Partial Thickness Burns Without Skin Graft,,,4436.06,4436.06,5
APR-DRG,8443,APR-DRG 38.00: Partial Thickness Burns Without Skin Graft,,,7275.13,7275.13,5
APR-DRG,8444,APR-DRG 38.00: Partial Thickness Burns Without Skin Graft,,,16383.83,16383.83,5
APR-DRG,8501,"APR-DRG 38.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Health Services",,,9463.58,9463.58,5
APR-DRG,8502,"APR-DRG 38.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Health Services",,,13012.43,13012.43,5
APR-DRG,8503,"APR-DRG 38.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Health Services",,,16797.86,16797.86,5
APR-DRG,8504,"APR-DRG 38.00: Procedure With Diagnosis Of Rehabilitation, Aftercare Or Other Contact With Health Services",,,37676.89,37676.89,5
APR-DRG,8601,APR-DRG 38.00: Rehabilitation,,,6269.62,6269.62,5
APR-DRG,8602,APR-DRG 38.00: Rehabilitation,,,8280.64,8280.64,5
APR-DRG,8603,APR-DRG 38.00: Rehabilitation,,,10587.38,10587.38,5
APR-DRG,8604,APR-DRG 38.00: Rehabilitation,,,13308.17,13308.17,5
APR-DRG,8611,"APR-DRG 38.00: Signs, Symptoms And Other Factors Influencing Health Status",,,2839.08,2839.08,5
APR-DRG,8612,"APR-DRG 38.00: Signs, Symptoms And Other Factors Influencing Health Status",,,3489.7,3489.7,5
APR-DRG,8613,"APR-DRG 38.00: Signs, Symptoms And Other Factors Influencing Health Status",,,5027.53,5027.53,5
APR-DRG,8614,"APR-DRG 38.00: Signs, Symptoms And Other Factors Influencing Health Status",,,8339.78,8339.78,5
APR-DRG,8621,APR-DRG 38.00: Other Aftercare And Convalescence,,,3785.43,3785.43,5
APR-DRG,8622,APR-DRG 38.00: Other Aftercare And Convalescence,,,5559.86,5559.86,5
APR-DRG,8623,APR-DRG 38.00: Other Aftercare And Convalescence,,,7570.87,7570.87,5
APR-DRG,8624,APR-DRG 38.00: Other Aftercare And Convalescence,,,7748.31,7748.31,5
APR-DRG,8631,APR-DRG 38.00: Neonatal Aftercare,,,3075.66,3075.66,5
APR-DRG,8632,APR-DRG 38.00: Neonatal Aftercare,,,8694.67,8694.67,5
APR-DRG,8633,APR-DRG 38.00: Neonatal Aftercare,,,23363.22,23363.22,5
APR-DRG,8634,APR-DRG 38.00: Neonatal Aftercare,,,60803.53,60803.53,5
APR-DRG,8901,APR-DRG 38.00: Hiv With Multiple Major Hiv Related Conditions,,,4968.38,4968.38,5
APR-DRG,8902,APR-DRG 38.00: Hiv With Multiple Major Hiv Related Conditions,,,5382.41,5382.41,5
APR-DRG,8903,APR-DRG 38.00: Hiv With Multiple Major Hiv Related Conditions,,,8990.4,8990.4,5
APR-DRG,8904,APR-DRG 38.00: Hiv With Multiple Major Hiv Related Conditions,,,18453.99,18453.99,5
APR-DRG,8921,APR-DRG 38.00: Hiv With Major Hiv Related Condition,,,3607.99,3607.99,5
APR-DRG,8922,APR-DRG 38.00: Hiv With Major Hiv Related Condition,,,4554.35,4554.35,5
APR-DRG,8923,APR-DRG 38.00: Hiv With Major Hiv Related Condition,,,6742.8,6742.8,5
APR-DRG,8924,APR-DRG 38.00: Hiv With Major Hiv Related Condition,,,11711.19,11711.19,5
APR-DRG,8931,APR-DRG 38.00: Hiv With Multiple Significant Hiv Related Conditions,,,3430.55,3430.55,5
APR-DRG,8932,APR-DRG 38.00: Hiv With Multiple Significant Hiv Related Conditions,,,4968.38,4968.38,5
APR-DRG,8933,APR-DRG 38.00: Hiv With Multiple Significant Hiv Related Conditions,,,7393.43,7393.43,5
APR-DRG,8934,APR-DRG 38.00: Hiv With Multiple Significant Hiv Related Conditions,,,10942.27,10942.27,5
APR-DRG,8941,APR-DRG 38.00: Hiv With One Significant Hiv Condition Or Without Significant Related Conditions,,,3371.4,3371.4,5
APR-DRG,8942,APR-DRG 38.00: Hiv With One Significant Hiv Condition Or Without Significant Related Conditions,,,4258.61,4258.61,5
APR-DRG,8943,APR-DRG 38.00: Hiv With One Significant Hiv Condition Or Without Significant Related Conditions,,,5737.3,5737.3,5
APR-DRG,8944,APR-DRG 38.00: Hiv With One Significant Hiv Condition Or Without Significant Related Conditions,,,8753.82,8753.82,5
APR-DRG,9101,APR-DRG 38.00: Craniotomy For Multiple Significant Trauma,,,19222.9,19222.9,5
APR-DRG,9102,APR-DRG 38.00: Craniotomy For Multiple Significant Trauma,,,19222.9,19222.9,5
APR-DRG,9103,APR-DRG 38.00: Craniotomy For Multiple Significant Trauma,,,24309.58,24309.58,5
APR-DRG,9104,APR-DRG 38.00: Craniotomy For Multiple Significant Trauma,,,42231.24,42231.24,5
APR-DRG,9111,APR-DRG 38.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,,,11060.56,11060.56,5
APR-DRG,9112,APR-DRG 38.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,,,12361.81,12361.81,5
APR-DRG,9113,APR-DRG 38.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,,,17566.78,17566.78,5
APR-DRG,9114,APR-DRG 38.00: Extensive Abdominal Or Thoracic Procedures For Multiple Significant Trauma,,,41462.33,41462.33,5
APR-DRG,9121,APR-DRG 38.00: Musculoskeletal And Other Procedures For Multiple Significant Trauma,,,11533.74,11533.74,5
APR-DRG,9122,APR-DRG 38.00: Musculoskeletal And Other Procedures For Multiple Significant Trauma,,,12480.1,12480.1,5
APR-DRG,9123,APR-DRG 38.00: Musculoskeletal And Other Procedures For Multiple Significant Trauma,,,20228.41,20228.41,5
APR-DRG,9124,APR-DRG 38.00: Musculoskeletal And Other Procedures For Multiple Significant Trauma,,,38918.99,38918.99,5
APR-DRG,9301,APR-DRG 38.00: Multiple Significant Trauma Without O.R. Procedure,,,4317.76,4317.76,5
APR-DRG,9302,APR-DRG 38.00: Multiple Significant Trauma Without O.R. Procedure,,,5559.86,5559.86,5
APR-DRG,9303,APR-DRG 38.00: Multiple Significant Trauma Without O.R. Procedure,,,8812.96,8812.96,5
APR-DRG,9304,APR-DRG 38.00: Multiple Significant Trauma Without O.R. Procedure,,,18335.69,18335.69,5
APR-DRG,9501,APR-DRG 38.00: Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,8044.05,8044.05,5
APR-DRG,9502,APR-DRG 38.00: Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,11652.04,11652.04,5
APR-DRG,9503,APR-DRG 38.00: Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,17448.48,17448.48,5
APR-DRG,9504,APR-DRG 38.00: Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,33477.43,33477.43,5
APR-DRG,9511,APR-DRG 38.00: Moderately Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,5855.59,5855.59,5
APR-DRG,9512,APR-DRG 38.00: Moderately Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,8517.23,8517.23,5
APR-DRG,9513,APR-DRG 38.00: Moderately Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,13249.02,13249.02,5
APR-DRG,9514,APR-DRG 38.00: Moderately Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,25078.5,25078.5,5
APR-DRG,9521,APR-DRG 38.00: Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,5086.68,5086.68,5
APR-DRG,9522,APR-DRG 38.00: Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,7156.84,7156.84,5
APR-DRG,9523,APR-DRG 38.00: Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,11711.19,11711.19,5
APR-DRG,9524,APR-DRG 38.00: Non-Extensive O.R. Procedure Unrelated To Principal Diagnosis,,,23185.78,23185.78,5
CDM,10124,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,10157,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,10165,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,10215,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,10256,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11015,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11023,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11031,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11049,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11064,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11122,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11130,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11155,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11346,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11486,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,11718,R&B NURSERY LEVEL 3,13031.0,4287.59,3521.0,9773.25,12
CDM,12146,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,12153,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,12187,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,12195,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,12435,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,125,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,12716,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13011,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13045,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13052,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13060,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13078,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13144,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13219,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13292,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13417,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13425,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,13524,R&B NURSERY LEVEL 3,13031.0,4287.59,3521.0,9773.25,12
CDM,14027,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,14068,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,15156,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,158,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,166,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,18234,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,18572,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,19109,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,19273,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,19349,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,19380,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,19836,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,19851,R&B ICU INTERMEDIATE,7819.0,2572.69,3518.55,5864.25,5
CDM,21014,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21022,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21030,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21048,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21063,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21121,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21139,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21154,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21345,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,21485,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,216,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22020,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22087,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22129,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22137,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22145,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22152,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22160,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22186,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22194,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22210,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22228,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22251,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22269,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22285,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22293,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22327,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22434,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22632,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22640,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,22715,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23010,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23044,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23051,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23069,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23077,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23143,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23218,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23291,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23416,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,23424,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,25015,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,257,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,2601359,INF IV HYDRATION 31-60MIN,469.0,178.69,31.58,478.0,63
CDM,2601367,INF IV HYDRATION ADDL HR,138.0,52.58,12.04,478.0,63
CDM,2601375,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,2601383,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,2601409,INF IV THRPY CONCURRENT,175.0,66.68,19.25,478.0,39
CDM,2601557,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,2601565,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,2601730,INF IV HYDRATION 31-60MIN,469.0,178.69,31.58,478.0,63
CDM,2601748,INF IV HYDRATION ADDL HR,138.0,52.58,12.04,478.0,63
CDM,2601755,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,2601763,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,2601789,INF IV THRPY CONCURRENT,175.0,66.68,19.25,478.0,39
CDM,2601979,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,2601987,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,2770006,IMP ADPT/EXT LD PACING/NEURO LVL 02,4397.0,1257.54,817.84,11779.23,42
CDM,2770055,CLIP APPLIER LVL 01,594.0,127.71,85.6,445.5,29
CDM,2770063,CLIP APPLIER LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2770170,BIT LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2770287,BLADE LVL 07,2157.0,463.76,310.82,1617.75,29
CDM,2770329,HYPO-HYPER THERMAL LVL 01,166.0,38.35,23.92,124.5,29
CDM,2770337,IMP BOLT LVL 01,709.0,202.77,131.87,1363.66,42
CDM,2770345,IMP BOLT LVL 02,1413.0,404.12,262.82,1363.66,42
CDM,2770352,IMP BONE HUMAN/SYNTHETIC LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2770360,IMP BONE HUMAN/SYNTHETIC LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,2770378,IMP BONE HUMAN/SYNTHETIC LVL 03,2157.0,616.9,401.2,1782.74,42
CDM,2770386,IMP BONE HUMAN/SYNTHETIC LVL 04,3083.0,881.74,573.44,2312.25,42
CDM,2770394,IMP BONE HUMAN/SYNTHETIC LVL 09,17524.0,5011.86,1312.53,13143.0,42
CDM,2770402,IMP BONE HUMAN/SYNTHETIC LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,2770410,IMP BONE HUMAN/SYNTHETIC LVL 06,6950.0,1987.7,1292.7,5212.5,42
CDM,2770428,IMP BONE HUMAN/SYNTHETIC LVL 07,9265.0,2649.79,1312.53,6948.75,42
CDM,2770436,IMP BONE HUMAN/SYNTHETIC LVL 08,13895.0,3973.97,1312.53,10421.25,42
CDM,2770444,IMP BONE HUMAN/SYNTHETIC LVL 10,21904.0,6264.54,1312.53,16428.0,42
CDM,2770451,BOWL CELL SAVER LVL 01,1132.0,243.38,163.12,849.0,29
CDM,2770469,BRA SURG POSTOP LVL 02,447.0,103.26,64.41,335.25,29
CDM,2770477,BRUSH LVL 02,447.0,96.1,64.41,335.25,29
CDM,2770485,BRUSH LVL 01,166.0,35.69,23.92,124.5,29
CDM,2770493,IMP AGENT COLLAGN BULK 2.5ML LVL 06,20152.0,5763.47,339.25,15114.0,43
CDM,2770501,IMP AGENT SYNTHETIC BULK 1ML LVL 01,166.0,47.48,30.88,602.41,43
CDM,2770519,BURR LVL 01,166.0,35.69,23.92,124.5,29
CDM,2770527,BURR LVL 02,313.0,67.3,45.1,234.75,29
CDM,2770535,BURR LVL 03,447.0,96.1,64.41,335.25,29
CDM,2770543,BURR LVL 04,594.0,127.71,85.6,445.5,29
CDM,2770550,BURR LVL 05,1132.0,243.38,163.12,849.0,29
CDM,2770568,BURR LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,2770576,BUTTON SEPTAL LVL 01,594.0,127.71,85.6,445.5,29
CDM,2770584,IMP CABLE LVL 01,313.0,89.52,58.22,1782.74,42
CDM,2770592,IMP CABLE LVL 02,844.0,241.38,156.98,1782.74,42
CDM,2770600,IMP CABLE LVL 03,1413.0,404.12,262.82,1782.74,42
CDM,2770618,IMP CABLE LVL 04,2157.0,616.9,401.2,1782.74,42
CDM,2770626,IMP CABLE LVL 05,3596.0,1028.46,668.86,2697.0,42
CDM,2770634,CANNULA LVL 01,166.0,35.69,23.92,124.5,29
CDM,2770642,CANNULA LVL 02,313.0,67.3,45.1,234.75,29
CDM,2770659,CANNULA LVL 03,594.0,127.71,85.6,445.5,29
CDM,2770667,CANNULA LVL 04,850.0,182.75,122.48,637.5,29
CDM,2770675,IMP PROSTH OPHTHALMIC LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,2770683,CANNULA LVL 05,1132.0,243.38,163.12,849.0,29
CDM,2770691,IMP VALVE LVL 08,35044.0,10022.58,1312.53,26283.0,42
CDM,2770709,IMP VALVE LVL 09,39424.0,11275.26,1312.53,29568.0,42
CDM,2770725,IMP VALVE LVL 10,43804.0,12527.94,1312.53,32853.0,42
CDM,2770733,IMP PROSTH OPHTHALMIC LVL 04,3596.0,1028.46,668.86,2697.0,42
CDM,2770741,CATH ABL COOL-TIP LVL 05,5861.0,1260.12,1090.15,8015.46,39
CDM,2770758,CATH ABL EP 3D/VECTOR LVL 01,2157.0,463.76,401.2,6049.13,39
CDM,2770766,CATH ABL EP NON 3D/VECTOR LVL 01,1619.0,348.08,301.13,4990.33,39
CDM,2770774,CATH ANGIO TRANSL LASER LVL 01,2695.0,579.42,501.27,8505.58,39
CDM,2770782,CATH ANGIO TRANSL NONLASER LVL 01,850.0,182.75,158.1,744.82,39
CDM,2770790,CATH ATHERECT TRANSL DIRECT LVL 01,4885.0,1050.28,908.61,10952.52,39
CDM,2770808,CATH ATHERECT TRANSL ROTAT LVL 01,4885.0,1050.28,908.61,10952.52,39
CDM,2770816,CATH BALLOON LVL 01,166.0,35.69,23.92,124.5,29
CDM,2770824,CATH BALLOON DILAT NONVASC LVL 01,1413.0,303.8,262.82,3297.73,39
CDM,2770857,CATH DIAGNOSTIC LVL 01,102.0,21.93,14.7,76.5,29
CDM,2770865,CATH CHOLANGIOGRAM LVL 01,313.0,67.3,45.1,234.75,29
CDM,2770873,CATH EP NON 3D 1-19 LVL 01,594.0,127.71,110.48,1633.6,39
CDM,2770881,CATH EP NON 3D 20+ LVL 01,3083.0,662.84,573.44,2968.92,39
CDM,2770899,CATH ENDOBRONCHIAL LVL 01,594.0,127.71,85.6,445.5,29
CDM,2770907,CATH FEEDING LVL 01,594.0,127.71,85.6,445.5,29
CDM,2770915,CATH GUIDE LVL 01,166.0,35.69,30.88,457.19,39
CDM,2770923,CATH HEM/PER SHORT TERM LVL 01,313.0,67.3,58.22,490.65,39
CDM,2770931,IMP CATH HEM/PER LONG TERM LVL 01,313.0,89.52,58.22,958.22,42
CDM,2770949,CATH HYDROPHYLIC LVL 01,2695.0,579.42,388.35,2021.25,29
CDM,2770956,CATH INF NON HEMODIALYSIS LVL 01,313.0,67.3,58.22,490.65,39
CDM,2770964,CATH INTRACARDIAC ECHO LVL 02,3596.0,773.14,668.86,2697.0,39
CDM,2770980,CATH INTRASPINAL LVL 04,1413.0,303.8,262.82,1952.83,39
CDM,2770998,CATH INTRAVASCULAR US LVL 01,850.0,182.75,158.1,2467.89,39
CDM,2771012,CATH OCCLUSION LVL 01,594.0,127.71,110.48,1957.48,39
CDM,2771020,CATH BALLOON PACING LVL 01,594.0,127.71,85.6,445.5,29
CDM,2771046,CATH SPINAL/NEURO LVL 01,850.0,182.75,122.48,637.5,29
CDM,2771053,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 01,251.0,53.96,46.69,299.61,39
CDM,2771061,CATH THROMBECTOMY/EMBOLECTMY LVL 01,313.0,67.3,58.22,781.68,39
CDM,2771079,CATH URETERAL LVL 01,313.0,67.3,58.22,234.75,39
CDM,2771087,CATH URETHRAL LVL 02,166.0,35.69,23.92,124.5,29
CDM,2771095,ELECTRODE ELECTROSURGICAL LVL 01,166.0,35.69,23.92,124.5,29
CDM,2771103,ELECTRODE ELECTROSURGICAL LVL 02,313.0,67.3,45.1,234.75,29
CDM,2771111,ELECTRODE ELECTROSURGICAL LVL 03,447.0,96.1,64.41,335.25,29
CDM,2771129,ELECTRODE ELECTROSURGICAL LVL 04,594.0,127.71,85.6,445.5,29
CDM,2771137,IMP VALVE LVL 11,52564.0,15033.3,1312.53,39423.0,42
CDM,2771145,ELECTRODE ELECTROSURGICAL LVL 05,850.0,182.75,122.48,637.5,29
CDM,2771152,ELECTRODE ELECTROSURGICAL LVL 06,1413.0,303.8,203.61,1059.75,29
CDM,2771160,ELECTRODE ELECTROSURGICAL LVL 07,1888.0,405.92,272.06,1416.0,29
CDM,2771178,ELECTRODE ELECTROSURGICAL LVL 08,2695.0,579.42,388.35,2021.25,29
CDM,2771186,IMP PROSTH ENT LVL 04,2695.0,770.77,501.27,2021.25,42
CDM,2771194,IMP CEMENT LVL 01,313.0,89.52,58.22,1363.66,42
CDM,2771202,CEMENT ACCESSORIES LVL 01,313.0,67.3,45.1,234.75,29
CDM,2771210,IMP CEMENT ACCESSORY LVL 01,313.0,89.52,58.22,1363.66,42
CDM,2771228,IMP CEMENT LVL 02,594.0,169.88,110.48,1363.66,42
CDM,2771236,IMP CEMENT LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,2771277,CLIP LVL 01,166.0,35.69,23.92,124.5,29
CDM,2771285,IMP CLIP ANEURYSM LVL 01,2695.0,770.77,501.27,2021.25,42
CDM,2771301,IMP DEV CLOSURE VASCULAR LVL 01,313.0,89.52,58.22,2334.85,42
CDM,2771319,IMP COIL EMBOLIZATION LVL 01,313.0,89.52,58.22,1782.74,42
CDM,2771327,COIL IMAGING MAGNETIC RESON LVL 01,313.0,67.3,58.22,307.99,39
CDM,2771335,THERAPY COLD LVL 02,850.0,182.75,122.48,637.5,29
CDM,2771343,IMP COVER BURR HOLE LVL 02,1132.0,323.75,210.55,1782.74,42
CDM,2771350,CATH ABL EP NON 3D/VECTOR LVL 02,3083.0,662.84,573.44,4990.33,39
CDM,2771368,CATH ABL EP NON 3D/VECTOR LVL 03,4885.0,1050.28,908.61,4990.33,39
CDM,2771376,CATH ABL EP NON 3D/VECTOR LVL 04,9265.0,1991.98,1723.29,6948.75,39
CDM,2771384,CATH ANGIO TRANSL LASER LVL 02,4885.0,1050.28,908.61,8505.58,39
CDM,2771400,IMP ACCESS SYSTEM DIALYS LVL 01,594.0,169.88,110.48,5703.09,42
CDM,2771418,DIALYSIS ACCESSORIES LVL 01,166.0,35.69,23.92,124.5,29
CDM,2771426,DILATOR LVL 01,166.0,35.69,23.92,124.5,29
CDM,2771434,DILATOR LVL 02,313.0,67.3,45.1,234.75,29
CDM,2771442,DILATOR LVL 03,850.0,182.75,122.48,637.5,29
CDM,2771459,DILATOR LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,2771467,DILATOR LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,2771475,DRAIN LVL 02,134.0,28.81,19.31,100.5,29
CDM,2771483,DRAIN LVL 03,313.0,67.3,45.1,234.75,29
CDM,2771491,DRAIN LVL 04,594.0,127.71,85.6,445.5,29
CDM,2771509,DRAIN LVL 05,1132.0,243.38,163.12,849.0,29
CDM,2771517,PUNCH LVL 02,594.0,127.71,85.6,445.5,29
CDM,2771525,RESERVOIR NEURO LVL 02,1619.0,348.08,233.3,1214.25,29
CDM,2771533,DRAIN REINFUSION LVL 01,594.0,127.71,85.6,445.5,29
CDM,2771558,DRAIN W ACCESSORIES LVL 01,190.0,40.85,27.38,142.5,29
CDM,2771566,DRESSING SPECIALTY LVL 02,166.0,35.69,23.92,124.5,29
CDM,2771574,DRESSING SPECIALTY LVL 03,313.0,67.3,45.1,234.75,29
CDM,2771582,DRESSING SPECIALTY LVL 04,594.0,127.71,85.6,445.5,29
CDM,2771590,DRESSING SPECIALTY LVL 05,1132.0,243.38,163.12,849.0,29
CDM,2771608,DRESSING SPECIALTY LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,2771616,IMP DEV JT KNEE TOTAL LVL 19,87604.0,25054.74,5497.98,65703.0,42
CDM,2771624,CATH BALLOON PACING LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2771632,IMP EXPANDER TISSUE LVL 01,2426.0,693.84,451.24,1819.5,42
CDM,2771640,IMP EXPANDER TISSUE LVL 02,4885.0,1397.11,908.61,3663.75,42
CDM,2771657,IMP EXPANDER TISSUE LVL 03,6950.0,1987.7,1292.7,5212.5,42
CDM,2771673,CATH ANGIO TRANSL NONLASER LVL 02,1413.0,303.8,262.82,1059.75,39
CDM,2771681,CATH ANGIO TRANSL NONLASER LVL 03,1888.0,405.92,351.17,1416.0,39
CDM,2771699,CATH ANGIO TRANSL NONLASER LVL 04,2695.0,579.42,501.27,2021.25,39
CDM,2771707,CATH ANGIO TRANSL NONLASER LVL 05,3083.0,662.84,548.37,2312.25,39
CDM,2771715,CATH EP NON 3D 20+ LVL 02,5861.0,1260.12,1090.15,4395.75,39
CDM,2771723,CATH ANGIO TRANSL NONLASER LVL 06,4397.0,945.36,548.37,3297.75,39
CDM,2771731,CATH ANGIO TRANSL NONLASER LVL 07,5861.0,1260.12,548.37,4395.75,39
CDM,2771749,CATH ANGIO TRANSL NONLASER LVL 08,7413.0,1593.8,548.37,5559.75,39
CDM,2771756,CATH ANGIO TRANSL NONLASER LVL 09,9265.0,1991.98,548.37,6948.75,39
CDM,2771764,CATH FEEDING LVL 02,850.0,182.75,122.48,637.5,29
CDM,2771772,CATH INF NON HEMODIALYSIS LVL 02,594.0,127.71,110.48,490.65,39
CDM,2771780,CATH INF NON HEMODIALYSIS LVL 03,850.0,182.75,158.1,637.5,39
CDM,2771798,CATH INF NON HEMODIALYSIS LVL 04,1132.0,243.38,210.55,849.0,39
CDM,2771806,CATH INF NON HEMODIALYSIS LVL 05,1619.0,348.08,301.13,1214.25,39
CDM,2771814,CATH INF NON HEMODIALYSIS LVL 06,2695.0,579.42,361.24,2021.25,39
CDM,2771822,CATH INF NON HEMODIALYSIS LVL 07,4885.0,1050.28,361.24,3663.75,39
CDM,2771830,CATH INF NON HEMODIALYSIS LVL 08,6950.0,1494.25,361.24,5212.5,39
CDM,2771848,CATH INF NON HEMODIALYSIS LVL 09,9265.0,1991.98,361.24,6948.75,39
CDM,2771855,CATH INTRAUTERN/HYST LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2771863,CATH INTRAVASCULAR US LVL 03,3853.0,828.4,716.66,2889.75,39
CDM,2771871,CATH INTRAUTERN/HYST LVL 03,1619.0,348.08,233.3,1214.25,29
CDM,2771889,CATH INTRAUTERN/HYST LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,2771897,CATH INTRAUTERN/HYST LVL 05,4885.0,1050.28,703.93,3663.75,29
CDM,2771905,CATH INTRAVASCULAR US LVL 02,2426.0,521.59,451.24,2467.89,39
CDM,2771921,CATH OCCLUSION LVL 02,1132.0,243.38,210.55,1957.48,39
CDM,2771939,CATH OCCLUSION LVL 03,2695.0,579.42,501.27,2021.25,39
CDM,2771947,CATH OCCLUSION LVL 04,4885.0,1050.28,908.61,3663.75,39
CDM,2771954,CATH OCCLUSION LVL 05,9265.0,1991.98,1441.19,6948.75,39
CDM,2771962,CATH OCCLUSION LVL 06,13895.0,2987.42,1441.19,10421.25,39
CDM,2771970,CATH BALLOON PACING LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2771988,CATH BALLOON PACING LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,2771996,CATH SPINAL/NEURO LVL 02,1888.0,405.92,272.06,1416.0,29
CDM,2772002,IMP EMBOLIZATION AGENT LVL 01,1132.0,323.75,210.55,1782.74,42
CDM,2772010,CATH SPINAL/NEURO LVL 03,2827.0,607.8,407.37,2120.25,29
CDM,2772028,CATH SPINAL/NEURO LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,2772044,IMP VALVE LVL 07,30664.0,8769.9,1312.53,22998.0,42
CDM,2772119,IMP FILTER VENA CAVA LVL 03,4885.0,1397.11,908.61,3663.75,42
CDM,2772143,IMP GRAFT VASCULAR LVL 01,594.0,169.88,110.48,5293.0,42
CDM,2772150,IMP GRAFT VASCULAR LVL 02,1132.0,323.75,210.55,5293.0,42
CDM,2772168,IMP GRAFT VASCULAR LVL 03,1619.0,463.03,301.13,5293.0,42
CDM,2772176,IMP GRAFT VASCULAR LVL 04,2157.0,616.9,401.2,5293.0,42
CDM,2772184,IMP GRAFT VASCULAR LVL 09,6950.0,1987.7,1292.7,5293.0,42
CDM,2772192,IMP GRAFT VASCULAR LVL 05,2695.0,770.77,501.27,5293.0,42
CDM,2772200,IMP GRAFT VASCULAR LVL 06,3083.0,881.74,573.44,5293.0,42
CDM,2772218,IMP GRAFT VASCULAR LVL 07,3909.0,1117.97,727.07,5293.0,42
CDM,2772226,IMP GRAFT VASCULAR LVL 08,4885.0,1397.11,908.61,5293.0,42
CDM,2772234,IMP GRAFT VASCULAR LVL 10,9265.0,2649.79,1723.29,6948.75,42
CDM,2772242,PIN GUIDE LVL 01,313.0,67.3,45.1,234.75,29
CDM,2772259,PIN GUIDE LVL 02,594.0,127.71,85.6,445.5,29
CDM,2772267,PIN GUIDE LVL 03,850.0,182.75,122.48,637.5,29
CDM,2772275,WIRE GUIDE LVL 01,166.0,35.69,30.88,1524.84,39
CDM,2772283,WIRE GUIDE LVL 02,313.0,67.3,58.22,1524.84,39
CDM,2772291,WIRE GUIDE LVL 03,594.0,127.71,110.48,1524.84,39
CDM,2772309,HANDPIECE LVL 01,594.0,127.71,85.6,445.5,29
CDM,2772317,HANDPIECE LVL 02,1619.0,348.08,233.3,1214.25,29
CDM,2772325,HANDPIECE LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2772333,HARVESTER LVL 01,1132.0,243.38,163.12,849.0,29
CDM,2772341,HEMOSTATIC AGENT LVL 01,313.0,67.3,45.1,234.75,29
CDM,2772358,HEMOSTATIC AGENT LVL 02,594.0,127.71,85.6,445.5,29
CDM,2772366,HEMOSTATIC AGENT LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2772374,IMP ICD CHAMBER NON SGL/DUAL LVL 04,96364.0,27560.1,17923.7,72273.0,42
CDM,2772382,IMP ICD CHAMBER DUAL LVL 02,65704.0,19908.31,12220.94,63194.0,42
CDM,2772390,IMP ICD CHAMBER SGL LVL 02,65704.0,19908.31,12220.94,63194.0,42
CDM,2772408,IMMOBILIZER LVL 01,166.0,38.35,23.92,124.5,29
CDM,2772416,IMMOBILIZER LVL 02,313.0,72.3,45.1,234.75,29
CDM,2772424,IMMOBILIZER LVL 03,594.0,137.21,85.6,445.5,29
CDM,2772432,IMMOBILIZER LVL 04,1132.0,261.49,163.12,849.0,29
CDM,2772440,RESERVOIR THORACIC LVL 02,850.0,182.75,122.48,637.5,29
CDM,2772457,IMP NEURO LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2772465,INSERTER LVL 01,166.0,35.69,23.92,124.5,29
CDM,2772473,INSERTER LVL 02,313.0,67.3,45.1,234.75,29
CDM,2772481,INSERTER LVL 03,594.0,127.71,85.6,445.5,29
CDM,2772499,IMP DEV URINARY W SLING LVL 02,4885.0,1397.11,908.61,15395.12,42
CDM,2772507,IMP DEV URINARY WO SLNG LVL 02,3853.0,1101.96,716.66,2889.75,42
CDM,2772515,INSTRUMENT DISP MULTIPLE LVL 02,594.0,127.71,85.6,445.5,29
CDM,2772523,INSTRUMENT DISP MULTIPLE LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2772531,INSTRUMENT DISP MULTIPLE LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,2772549,INSTRUMENT DISP MULTIPLE LVL 05,3083.0,662.84,444.26,2312.25,29
CDM,2772556,INSTRUMENT DISP MULTIPLE LVL 01,313.0,67.3,45.1,234.75,29
CDM,2772564,INSTRUMENT DISP SINGLE LVL 01,190.0,40.85,27.38,142.5,29
CDM,2772572,INSTRUMENT DISP SINGLE LVL 02,594.0,127.71,85.6,445.5,29
CDM,2772580,INSTRUMENT DISP SINGLE LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2772598,INSTRUMENT DISP SINGLE LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2772606,INSTRUMENT DISP SINGLE LVL 05,2157.0,463.76,310.82,1617.75,29
CDM,2772622,IMP FIX SPINE LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2772630,IMP FIX SPINE LVL 02,1132.0,323.75,210.55,1782.74,42
CDM,2772648,IMP FIX SPINE LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,2772655,IMP FIX SPINE LVL 04,4885.0,1397.11,908.61,3663.75,42
CDM,2772663,IMP STENT NONCOR TEMP WO DEL LVL 02,594.0,169.88,110.48,445.5,42
CDM,2772671,IMP FIX SPINE LVL 05,9265.0,2649.79,1312.53,6948.75,42
CDM,2772689,IMP FIX SPINE LVL 06,13895.0,3973.97,1312.53,10421.25,42
CDM,2772697,IMP FIX SPINE LVL 07,17524.0,5011.86,1312.53,13143.0,42
CDM,2772705,IMP FIX SPINE LVL 08,21904.0,6264.54,1312.53,16428.0,42
CDM,2772713,IMP STENT NONCOR TEMP WO DEL LVL 03,850.0,243.1,158.1,637.5,42
CDM,2772721,IMP STENT NONCOR TEMP WO DEL LVL 04,1132.0,323.75,210.55,849.0,42
CDM,2772739,IMP STENT NONCOR TEMP WO DEL LVL 05,1619.0,463.03,301.13,1214.25,42
CDM,2772770,INTRO EP FIX CRV NONPEEL LVL 01,594.0,127.71,110.48,665.33,39
CDM,2772788,INTRO EP FIX CRV PEEL LVL 01,313.0,67.3,58.22,295.55,39
CDM,2772804,INTRO LVL 01,166.0,35.69,23.92,124.5,29
CDM,2772812,INTRO LVL 02,313.0,67.3,45.1,234.75,29
CDM,2772820,INTRO LVL 03,594.0,127.71,85.6,445.5,29
CDM,2772846,INTRO EP STEER NONPEEL LVL 03,4885.0,1050.28,908.61,3663.75,39
CDM,2772853,TAPS LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2772861,TAPS LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2772879,IRRIGATOR/ACCESSORY LVL 01,313.0,67.3,45.1,234.75,29
CDM,2772887,IRRIGATOR/ACCESSORY LVL 02,594.0,127.71,85.6,445.5,29
CDM,2772895,IRRIGATOR/ACCESSORY LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2772903,KNOT PUSHER LVL 01,594.0,127.71,85.6,445.5,29
CDM,2772911,LASER FIBER LVL 01,594.0,127.71,85.6,445.5,29
CDM,2772929,LASER FIBER LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2772937,LASER FIBER LVL 03,1619.0,348.08,233.3,1214.25,29
CDM,2772945,LASER FIBER LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,2772952,LASER FIBER LVL 05,3083.0,662.84,444.26,2312.25,29
CDM,2772960,LASER PROBE LVL 01,1413.0,303.8,203.61,1059.75,29
CDM,2772978,LASER PROBE LVL 02,2695.0,579.42,388.35,2021.25,29
CDM,2772986,LASER PROBE LVL 03,3853.0,828.4,555.22,2889.75,29
CDM,2772994,LASER PROBE LVL 04,6105.0,1312.58,879.73,4578.75,29
CDM,2773000,LASER PROBE LVL 05,13895.0,2987.42,2002.27,10421.25,29
CDM,2773018,IMP LD ICD COIL DUAL LVL 01,2695.0,770.77,501.27,60907.18,42
CDM,2773026,IMP LD ICD NON SGL/DUAL LVL 04,6950.0,1987.7,1292.7,5958.8,42
CDM,2773034,IMP LD ICD COIL SGL LVL 01,2695.0,770.77,501.27,10514.88,42
CDM,2773042,IMP LD NEUROSTIM LVL 01,6950.0,1987.7,1292.7,7574.37,42
CDM,2773059,IMP LD NEUROSTIM TEST KIT LVL 06,2695.0,770.77,501.27,2624.81,42
CDM,2773067,IMP LD PCMKR/ICD COMBO LVL 01,594.0,169.88,110.48,63194.0,42
CDM,2773075,IMP LD PCMKR NON VDD LVL 01,2695.0,770.77,501.27,2025.13,42
CDM,2773083,IMP LD PCMKR VDD LVL 02,6950.0,1987.7,1292.7,5212.5,42
CDM,2773141,MAMMOTOME LVL 01,313.0,67.3,45.1,234.75,29
CDM,2773158,IMP MARKER TISSUE LVL 01,313.0,89.52,58.22,234.75,42
CDM,2773166,IMP MESH LVL 01,313.0,89.52,58.22,5596.13,42
CDM,2773174,IMP MESH LVL 02,594.0,169.88,110.48,5596.13,42
CDM,2773182,IMP MESH LVL 03,1132.0,323.75,210.55,5596.13,42
CDM,2773190,IMP MESH LVL 04,2157.0,616.9,401.2,5596.13,42
CDM,2773208,IMP MESH LVL 09,11580.0,3311.88,2153.88,8685.0,42
CDM,2773216,IMP MESH LVL 05,3596.0,1028.46,668.86,5596.13,42
CDM,2773224,IMP MESH LVL 06,4885.0,1397.11,908.61,5596.13,42
CDM,2773232,IMP MESH LVL 07,6950.0,1987.7,1292.7,5596.13,42
CDM,2773240,IMP MESH LVL 08,9265.0,2649.79,1723.29,6948.75,42
CDM,2773257,IMP MESH LVL 10,15334.0,4385.52,2852.12,11500.5,42
CDM,2773315,MORCELLATOR LVL 04,13895.0,2987.42,2584.47,10421.25,39
CDM,2773331,NEEDLE BIOPSY LVL 01,166.0,35.69,23.92,124.5,29
CDM,2773349,NEEDLE BIOPSY LVL 02,313.0,67.3,45.1,234.75,29
CDM,2773356,NEEDLE BIOPSY LVL 03,594.0,127.71,85.6,445.5,29
CDM,2773364,NEEDLE BRACHYTHERAPY LVL 01,166.0,35.69,30.88,745.56,39
CDM,2773380,NEEDLE INSUFFLATION LVL 01,166.0,35.69,23.92,124.5,29
CDM,2773398,NEEDLE INSUFFLATION LVL 02,313.0,67.3,45.1,234.75,29
CDM,2773406,NEEDLE SPECIALTY LVL 01,166.0,35.69,23.92,124.5,29
CDM,2773414,NEEDLE SPECIALTY LVL 02,313.0,67.3,45.1,234.75,29
CDM,2773422,NEEDLE SPECIALTY LVL 03,850.0,182.75,122.48,637.5,29
CDM,2773430,NEEDLE SPECIALTY LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,2773448,NEEDLE SPECIALTY LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,2773455,SUPPLY NEURO LVL 01,166.0,35.69,23.92,124.5,29
CDM,2773463,SUPPLY NEURO LVL 02,313.0,67.3,45.1,234.75,29
CDM,2773471,SUPPLY NEURO LVL 03,850.0,182.75,122.48,637.5,29
CDM,2773505,OBTURATOR DISPOSABLE LVL 01,313.0,67.3,45.1,234.75,29
CDM,2773513,OCCLUDER LVL 01,594.0,127.71,85.6,445.5,29
CDM,2773521,OCCLUDER LVL 02,4885.0,1050.28,703.93,3663.75,29
CDM,2773539,ERASER OPHTHALMIC LVL 01,166.0,35.69,23.92,124.5,29
CDM,2773570,SUPPLY OSTOMY LVL 02,134.0,30.95,19.31,100.5,29
CDM,2773588,SUPPLY OSTOMY LVL 03,359.0,82.93,51.73,269.25,29
CDM,2773596,SUPPLY OSTOMY LVL 04,709.0,163.78,102.17,531.75,29
CDM,2773604,PACER ACCESSORY LVL 01,313.0,67.3,45.1,234.75,29
CDM,2773620,IMP PCMKR DUAL NON RR LVL 03,28474.0,8627.62,5296.16,25942.8,42
CDM,2773638,IMP PCMKR DUAL RR LVL 02,21904.0,6636.91,4074.14,41774.56,42
CDM,2773646,IMP PCMKR NONSGL OR DUAL LVL 05,43804.0,13272.61,8147.54,32853.0,42
CDM,2773653,IMP PCMKR SGL NON RR LVL 04,28474.0,8627.62,5296.16,25942.8,42
CDM,2773661,IMP PCMKR SGL RR LVL 03,21904.0,6636.91,4074.14,41774.56,42
CDM,2773679,CATH/WIRE/SUTURE PASSER LVL 01,313.0,67.3,45.1,234.75,29
CDM,2773687,SUPPLY PERFUSION/ECMO LVL 01,102.0,21.93,14.7,76.5,29
CDM,2773695,SUPPLY PERFUSION/ECMO LVL 02,221.0,47.52,31.85,165.75,29
CDM,2773703,SUPPLY PERFUSION/ECMO LVL 03,447.0,96.1,64.41,335.25,29
CDM,2773711,SUPPLY PERFUSION/ECMO LVL 04,850.0,182.75,122.48,637.5,29
CDM,2773729,SUPPLY PERFUSION/ECMO LVL 05,1413.0,303.8,203.61,1059.75,29
CDM,2773737,IMP PIN/WIRE LVL 01,313.0,89.52,58.22,1363.66,42
CDM,2773745,IMP PIN/WIRE LVL 02,594.0,169.88,110.48,1363.66,42
CDM,2773752,IMP PIN/WIRE LVL 03,850.0,243.1,158.1,1363.66,42
CDM,2773778,RETRIEVER BASKET LVL 02,594.0,127.71,85.6,445.5,29
CDM,2773786,IMP PLATE LVL 01,313.0,89.52,58.22,1363.66,42
CDM,2773794,IMP PLATE LVL 02,594.0,169.88,110.48,1363.66,42
CDM,2773802,IMP PLATE LVL 03,850.0,243.1,158.1,1363.66,42
CDM,2773810,IMP PLATE LVL 04,1132.0,323.75,210.55,1363.66,42
CDM,2773828,IMP PLATE LVL 09,6105.0,1746.03,1003.99,4578.75,42
CDM,2773836,IMP PLATE LVL 05,1619.0,463.03,301.13,1363.66,42
CDM,2773844,IMP PLATE LVL 06,2695.0,770.77,501.27,2021.25,42
CDM,2773851,IMP PLATE LVL 07,3596.0,1028.46,668.86,2697.0,42
CDM,2773869,IMP PLATE LVL 08,4885.0,1397.11,908.61,3663.75,42
CDM,2773877,IMP PLATE LVL 10,6950.0,1987.7,1003.99,5212.5,42
CDM,2773885,IMP CATH PORT INDWELLING LVL 01,166.0,47.48,30.88,7147.71,42
CDM,2773893,PROBE LVL 01,166.0,35.69,23.92,124.5,29
CDM,2773901,PROBE LVL 02,594.0,127.71,85.6,445.5,29
CDM,2773919,PROBE LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2773927,RETRIEVER BASKET LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2773935,PROGRAMMER PT NEUROSTIM LVL 01,4885.0,1397.11,908.61,3820.84,42
CDM,2773943,IMP PROSTH ANKLE LVL 01,4885.0,1397.11,908.61,3663.75,42
CDM,2773950,IMP PROSTH ANKLE LVL 02,9265.0,2649.79,1312.53,6948.75,42
CDM,2773968,IMP PROSTH ANKLE LVL 03,13895.0,3973.97,1312.53,10421.25,42
CDM,2773976,IMP PROSTH ANKLE LVL 04,17524.0,5011.86,1312.53,13143.0,42
CDM,2773984,RETRIEVER BASKET LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2773992,IMP PROSTH ANKLE LVL 05,21904.0,6264.54,1312.53,16428.0,42
CDM,2774008,RETRIEVER BASKET LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,2774016,RETRIEVER SUTURE LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2774024,IMP RING CARDIAC LVL 01,9265.0,2649.79,1312.53,6948.75,42
CDM,2774032,IMP RING CARDIAC LVL 02,13895.0,3973.97,1312.53,10421.25,42
CDM,2774040,IMP ROD/NAIL LVL 07,6487.0,1855.28,1003.99,4865.25,42
CDM,2774099,IMP PROSTH BREAST LVL 01,2695.0,770.77,501.27,4536.66,42
CDM,2774107,IMP PROSTH BREAST LVL 02,4885.0,1397.11,908.61,4536.66,42
CDM,2774115,IMP PROSTH BREAST LVL 03,6950.0,1987.7,1292.7,5212.5,42
CDM,2774123,IMP VALVE LVL 01,4885.0,1397.11,908.61,3663.75,42
CDM,2774131,IMP VALVE LVL 02,9265.0,2649.79,1312.53,6948.75,42
CDM,2774149,IMP VALVE LVL 03,13895.0,3973.97,1312.53,10421.25,42
CDM,2774156,IMP VALVE LVL 04,17524.0,5011.86,1312.53,13143.0,42
CDM,2774164,IMP VALVE LVL 05,21904.0,6264.54,1312.53,16428.0,42
CDM,2774172,IMP DEV COCHLEAR INT&EXT CMP LVL 05,109504.0,31318.14,15261.64,82128.0,43
CDM,2774180,IMP DEV JT ELBOW TOTAL LVL 01,4885.0,1397.11,908.61,7467.6,42
CDM,2774198,IMP DEV JT ELBOW TOTAL LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,2774206,IMP DEV JT ELBOW TOTAL LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,2774214,IMP DEV JT ELBOW TOTAL LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,2774230,IMP DEV JT ELBOW TOTAL LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,2774248,IMP SHUNT LVL 06,3909.0,1117.97,727.07,2931.75,42
CDM,2774255,IMP SHUNT LVL 07,6487.0,1855.28,1206.58,4865.25,42
CDM,2774263,IMP SHUNT LVL 08,9265.0,2649.79,1312.53,6948.75,42
CDM,2774271,IMP SHUNT LVL 09,13895.0,3973.97,1312.53,10421.25,42
CDM,2774289,IMP STENT NONCOAT WO DEL LVL 07,9265.0,2649.79,979.5,6948.75,42
CDM,2774297,IMP STENT NONCOAT WO DEL LVL 08,11580.0,3311.88,979.5,8685.0,42
CDM,2774305,SNARE LVL 04,3596.0,773.14,518.18,2697.0,29
CDM,2774313,IMP EMBOLIZATION SPHERE LVL 02,3596.0,1028.46,668.86,2697.0,42
CDM,2774321,IMP EMBOLIZATION SPHERE LVL 03,4885.0,1397.11,908.61,3663.75,42
CDM,2774339,IMP PROSTH ENT LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2774347,IMP PROSTH ENT LVL 02,1132.0,323.75,210.55,1782.74,42
CDM,2774354,IMP PROSTH ENT LVL 03,1619.0,463.03,301.13,1782.74,42
CDM,2774362,IMP DEV JT FINGER LVL 01,4885.0,1397.11,908.61,7467.6,42
CDM,2774370,IMP DEV JT FINGER LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,2774388,IMP DEV JT FINGER LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,2774404,IMP DEV JT FINGER LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,2774412,TUBE CHEST LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2774420,TUBE SPECIALTY LVL 11,3596.0,773.14,518.18,2697.0,29
CDM,2774446,IMP TISSUE CONNECT NONHUMAN LVL 05,9265.0,2649.79,1723.29,8418.7,42
CDM,2774453,IMP TISSUE CONNECT NONHUMAN LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,2774461,TRANSDUCER LVL 02,850.0,182.75,122.48,637.5,29
CDM,2774479,TRANSDUCER LVL 03,1413.0,303.8,203.61,1059.75,29
CDM,2774487,TUBE CHEST LVL 02,313.0,67.3,45.1,234.75,29
CDM,2774495,TUBE CHEST LVL 03,594.0,127.71,85.6,445.5,29
CDM,2774503,IMP DEV JT FINGER LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,2774511,IMP DEV JT HIP TOTAL LVL 01,594.0,169.88,110.48,7467.6,42
CDM,2774529,IMP DEV JT HIP TOTAL LVL 02,1132.0,323.75,210.55,7467.6,42
CDM,2774537,IMP DEV JT HIP TOTAL LVL 03,1619.0,463.03,301.13,7467.6,42
CDM,2774545,IMP DEV JT HIP TOTAL LVL 04,2695.0,770.77,501.27,7467.6,42
CDM,2774552,IMP DEV JT HIP TOTAL LVL 09,21904.0,6264.54,4074.14,16428.0,42
CDM,2774560,IMP DEV JT HIP TOTAL LVL 05,4885.0,1397.11,908.61,7467.6,42
CDM,2774578,IMP DEV JT HIP TOTAL LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,2774586,IMP DEV JT HIP TOTAL LVL 07,13895.0,3973.97,2584.47,10421.25,42
CDM,2774594,IMP DEV JT HIP TOTAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
CDM,2774602,IMP DEV JT HIP TOTAL LVL 10,26284.0,7517.22,4888.82,19713.0,42
CDM,2774610,IMP DEV JT HIP TOTAL LVL 11,30664.0,8769.9,5497.98,22998.0,42
CDM,2774628,IMP DEV JT HIP TOTAL LVL 12,35044.0,10022.58,5497.98,26283.0,42
CDM,2774636,IMP DEV JT HIP TOTAL LVL 13,43804.0,12527.94,5497.98,32853.0,42
CDM,2774644,IMP DEV JT HIP TOTAL LVL 14,52564.0,15033.3,5497.98,39423.0,42
CDM,2774651,IMP EMBOLIZATION SPHERE LVL 04,6950.0,1987.7,1292.7,5212.5,42
CDM,2774669,IMP DEV JT HIP TOTAL LVL 15,65704.0,18791.34,5497.98,49278.0,42
CDM,2774677,IMP DEV JT HIP TOTAL LVL 16,87604.0,25054.74,5497.98,65703.0,42
CDM,2774685,IMP STAPLE BONE LVL 04,991.0,283.43,184.33,1363.66,42
CDM,2774693,STAPLE RELOAD LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2774701,STAPLE RELOAD LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,2774719,IMP DEV JT KNEE TOTAL LVL 15,56944.0,16285.98,5497.98,42708.0,42
CDM,2774727,IMP DEV JT KNEE TOTAL LVL 04,9265.0,2649.79,1723.29,7467.6,42
CDM,2774735,IMP DEV JT KNEE TOTAL LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,2774743,IMP DEV JT KNEE TOTAL LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,2774750,IMP DEV JT KNEE TOTAL LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,2774768,IMP DEV JT KNEE TOTAL LVL 12,43804.0,12527.94,5497.98,32853.0,42
CDM,2774776,IMP DEV JT KNEE TOTAL LVL 08,26284.0,7517.22,4888.82,19713.0,42
CDM,2774784,IMP DEV JT KNEE TOTAL LVL 09,30664.0,8769.9,5497.98,22998.0,42
CDM,2774792,IMP DEV JT KNEE TOTAL LVL 10,35044.0,10022.58,5497.98,26283.0,42
CDM,2774800,IMP DEV JT KNEE TOTAL LVL 11,39424.0,11275.26,5497.98,29568.0,42
CDM,2774818,IMP DEV JT KNEE TOTAL LVL 13,48184.0,13780.62,5497.98,36138.0,42
CDM,2774826,IMP DEV JT KNEE TOTAL LVL 14,52564.0,15033.3,5497.98,39423.0,42
CDM,2774834,IMP DEV JT KNEE TOTAL LVL 16,61324.0,17538.66,5497.98,45993.0,42
CDM,2774842,IMP DEV JT KNEE TOTAL LVL 17,70084.0,20044.02,5497.98,52563.0,42
CDM,2774859,IMP DEV JT KNEE TOTAL LVL 18,78844.0,22549.38,5497.98,59133.0,42
CDM,2774867,RESERVOIR OTHER LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2774875,IMP PROSTH MAXILLOFACIAL LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2774883,IMP PROSTH MAXILLOFACIAL LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,2774891,IMP PROSTH MAXILLOFACIAL LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,2774909,IMP PROSTH MAXILLOFACIAL LVL 04,3853.0,1101.96,716.66,2889.75,42
CDM,2774917,IMP PUMP INF NONPRG TMP LVL 05,43804.0,12527.94,8147.54,32853.0,42
CDM,2774925,IMP PROSTH MAXILLOFACIAL LVL 05,6105.0,1746.03,1135.53,4578.75,42
CDM,2774933,IMP PUMP INF NONPRG TMP LVL 02,2695.0,770.77,501.27,11191.46,42
CDM,2774941,IMP PUMP INF NONPRG TMP LVL 03,4885.0,1397.11,908.61,11191.46,42
CDM,2774958,IMP PUMP INF NONPRG TMP LVL 04,21904.0,6264.54,4074.14,16428.0,42
CDM,2774982,RESERVOIR OTHER LVL 02,1619.0,348.08,233.3,1214.25,29
CDM,2774990,RESERVOIR OTHER LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,2775005,RESERVOIR OTHER LVL 05,6950.0,1494.25,1001.5,5212.5,29
CDM,2775054,CATH URETHRAL LVL 06,1619.0,348.08,233.3,1214.25,29
CDM,2775070,CATH URETHRAL LVL 03,313.0,67.3,45.1,234.75,29
CDM,2775088,CATH URETHRAL LVL 04,594.0,127.71,85.6,445.5,29
CDM,2775096,CATH URETHRAL LVL 05,850.0,182.75,122.48,637.5,29
CDM,2775104,IMP PROSTH BREAST LVL 04,9265.0,2649.79,1723.29,6948.75,42
CDM,2775112,PROGRAMMER PT NEUROSTIM LVL 02,9265.0,2649.79,1723.29,6948.75,42
CDM,2775120,LASER FIBER LVL 06,4397.0,945.36,633.61,3297.75,29
CDM,2775153,IMP CEMENT ACCESSORY LVL 02,850.0,243.1,158.1,1363.66,42
CDM,2775161,IMP PROSTH OPHTHALMIC LVL 01,313.0,89.52,58.22,1782.74,42
CDM,2775179,IMP PROSTH OPHTHALMIC LVL 02,594.0,169.88,110.48,1782.74,42
CDM,2775187,IMP PROSTH OPHTHALMIC LVL 03,2157.0,616.9,401.2,1782.74,42
CDM,2775195,IMP PROSTH PENILE INFLT LVL 02,4885.0,1397.11,908.61,62427.29,42
CDM,2775203,IMP PROSTH PENILE INFLT LVL 03,9265.0,2649.79,1723.29,62427.29,42
CDM,2775211,IMP PROSTH PENILE INFLT LVL 04,21904.0,6264.54,4074.14,62427.29,42
CDM,2775229,IMP PROSTH PENILE NONINF LVL 01,4885.0,1397.11,908.61,20543.04,42
CDM,2775237,IMP PROSTH PENILE NONINF LVL 02,9265.0,2649.79,1723.29,20543.04,42
CDM,2775245,IMP PROSTH PENILE NONINF LVL 03,21904.0,6264.54,4074.14,20543.04,42
CDM,2775252,IMP PROSTH PLASTIC SURG LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2775260,IMP PROSTH PLASTIC SURG LVL 02,1619.0,463.03,301.13,1782.74,42
CDM,2775278,IMP PROSTH PLASTIC SURG LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,2775286,IMP DEV JT SHDR TOTAL LVL 05,4885.0,1397.11,908.61,7467.6,42
CDM,2775294,IMP DEV JT SHDR TOTAL LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,2775302,IMP DEV JT SHDR TOTAL LVL 07,13895.0,3973.97,2584.47,10421.25,42
CDM,2775310,IMP DEV JT SHDR TOTAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
CDM,2775328,STAPLE RELOAD LVL 06,3596.0,773.14,518.18,2697.0,29
CDM,2775336,IMP DEV JT SHDR TOTAL LVL 09,21904.0,6264.54,4074.14,16428.0,42
CDM,2775344,IMP DEV JT SHDR TOTAL LVL 10,26284.0,7517.22,4888.82,19713.0,42
CDM,2775351,STAPLER LVL 06,3596.0,773.14,518.18,2697.0,29
CDM,2775369,IMP STENT COAT W DEL LVL 02,2695.0,770.77,501.27,18372.82,42
CDM,2775377,IMP STENT COAT W DEL LVL 03,4885.0,1397.11,908.61,18372.82,42
CDM,2775385,IMP STENT COAT W DEL LVL 04,6950.0,1987.7,1292.7,18372.82,42
CDM,2775393,IMP STENT COAT W DEL LVL 05,9265.0,2649.79,1723.29,18372.82,42
CDM,2775401,IMP STENT COAT W DEL LVL 06,11580.0,3311.88,2153.88,18372.82,42
CDM,2775419,IMP STENT COAT W DEL LVL 07,13895.0,3973.97,2584.47,18372.82,42
CDM,2775427,IMP STENT COAT W DEL LVL 08,15334.0,4385.52,2852.12,18372.82,42
CDM,2775435,IMP PROSTH TESTICULAR LVL 01,6105.0,1746.03,1135.53,4578.75,42
CDM,2775443,IMP PROSTH TESTICULAR LVL 02,9265.0,2649.79,1312.53,6948.75,42
CDM,2775450,IMP PROSTH TESTICULAR LVL 03,13895.0,3973.97,1312.53,10421.25,42
CDM,2775468,IMP DEV JT TOE LVL 01,4885.0,1397.11,908.61,7467.6,42
CDM,2775476,IMP DEV JT TOE LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,2775484,IMP DEV JT TOE LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,2775492,IMP DEV JT TOE LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,2775518,IMP DEV JT TOE LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,2775526,CATH THROMBECTOMY/EMBOLECTMY LVL 05,3083.0,662.84,573.44,2312.25,39
CDM,2775534,CATH THROMBECTOMY/EMBOLECTMY LVL 06,4885.0,1050.28,575.51,3663.75,39
CDM,2775542,CATH THROMBECTOMY/EMBOLECTMY LVL 07,6950.0,1494.25,575.51,5212.5,39
CDM,2775559,CATH URETERAL LVL 02,850.0,182.75,141.24,637.5,39
CDM,2775567,CATH URETERAL LVL 03,1888.0,405.92,141.24,1416.0,39
CDM,2775575,CATH URETERAL LVL 04,2827.0,607.8,141.24,2120.25,39
CDM,2775583,CATH THROMBECTOMY/EMBOLECTMY LVL 02,594.0,127.71,110.48,781.68,39
CDM,2775591,CATH THROMBECTOMY/EMBOLECTMY LVL 03,1132.0,243.38,210.55,849.0,39
CDM,2775609,CATH THROMBECTOMY/EMBOLECTMY LVL 04,2157.0,463.76,401.2,1617.75,39
CDM,2775617,IMP PROSTH SPHINCTR URIN LVL 01,11580.0,3311.88,2153.88,8685.0,42
CDM,2775641,IMP PUMP INF NONPRG PERM LVL 01,26284.0,7517.22,4888.82,58151.78,42
CDM,2775658,IMP PUMP INF NONPRG TMP LVL 01,594.0,169.88,110.48,11191.46,42
CDM,2775666,IMP PUMP INF PRG LVL 01,6105.0,1746.03,1135.53,58151.78,42
CDM,2775674,PUNCH LVL 01,313.0,67.3,45.1,234.75,29
CDM,2775682,REAMER LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2775690,IMP STENT COAT W DEL LVL 09,17524.0,5011.86,3259.46,18372.82,42
CDM,2775708,IMP STENT NONCOAT W DEL LVL 02,1619.0,463.03,301.13,6652.0,42
CDM,2775716,IMP NEUROSTIM RECVR&/TRANS LVL 01,21904.0,6264.54,2614.58,16428.0,42
CDM,2775724,IMP CARDIAC EVENT REC LVL 04,24970.0,7141.42,4644.42,41774.56,42
CDM,2775732,RESERVOIR OTHER LVL 01,594.0,127.71,85.6,445.5,29
CDM,2775740,RESERVOIR THORACIC LVL 01,313.0,67.3,45.1,234.75,29
CDM,2775757,RESERVOIR THORACIC REINFUSN LVL 01,594.0,127.71,85.6,445.5,29
CDM,2775781,DEVICE INSERT RETRV LVL 01,1132.0,243.38,210.55,1773.49,39
CDM,2775799,RETRIEVER BASKET LVL 01,313.0,67.3,45.1,234.75,29
CDM,2775807,RETRIEVER SUTURE LVL 01,594.0,127.71,85.6,445.5,29
CDM,2775815,RETRIEVER VASCULAR LVL 01,1132.0,243.38,163.12,849.0,29
CDM,2775823,RETRIEVER VASCULAR LVL 02,2157.0,463.76,310.82,1617.75,29
CDM,2775831,IMP RING FALLOPE LVL 03,1619.0,463.03,301.13,1782.74,42
CDM,2775849,IMP RING LVL 01,2695.0,770.77,501.27,2021.25,42
CDM,2775856,IMP STENT NONCOAT W DEL LVL 03,3083.0,881.74,573.44,6652.0,42
CDM,2775864,IMP STENT NONCOAT W DEL LVL 04,4885.0,1397.11,908.61,6652.0,42
CDM,2775872,IMP ROD/NAIL LVL 01,313.0,89.52,58.22,1363.66,42
CDM,2775880,IMP ROD/NAIL LVL 02,850.0,243.1,158.1,1363.66,42
CDM,2775898,IMP ROD/NAIL LVL 03,1413.0,404.12,262.82,1363.66,42
CDM,2775906,IMP ROD/NAIL LVL 04,2695.0,770.77,501.27,2021.25,42
CDM,2775914,IMP ROD/NAIL LVL 05,3909.0,1117.97,727.07,2931.75,42
CDM,2775922,IMP ROD/NAIL LVL 06,5373.0,1536.68,999.38,4029.75,42
CDM,2775930,SCALPEL HARMONIC LVL 02,2426.0,521.59,349.59,1819.5,29
CDM,2776094,IMP STENT NONCOAT W DEL LVL 05,6950.0,1987.7,1292.7,6652.0,42
CDM,2776102,IMP STENT NONCOAT W DEL LVL 06,9265.0,2649.79,1723.29,6948.75,42
CDM,2776110,IMP STENT NONCOAT W DEL LVL 07,11580.0,3311.88,2153.88,8685.0,42
CDM,2776136,SEAL PROXIMAL SYS LVL 01,2695.0,579.42,388.35,2021.25,29
CDM,2776144,IMP SEALANT PULMONARY LIQUID LVL 01,2695.0,770.77,501.27,3552.17,42
CDM,2776151,IMP SEPTAL DEFECT INTRACARD LVL 01,15334.0,4385.52,2852.12,52268.89,42
CDM,2776169,IMP SHUNT LVL 01,313.0,89.52,58.22,1782.74,42
CDM,2776177,IMP SHUNT LVL 02,594.0,169.88,110.48,1782.74,42
CDM,2776185,IMP SHUNT LVL 03,1132.0,323.75,210.55,1782.74,42
CDM,2776193,IMP SHUNT LVL 04,1619.0,463.03,301.13,1782.74,42
CDM,2776201,IMP SHUNT LVL 05,2695.0,770.77,501.27,2021.25,42
CDM,2776219,IMP SHUNT TEMP LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2776227,IMP SHUNT TEMP LVL 02,1132.0,323.75,210.55,1782.74,42
CDM,2776235,IMP SHUNT TEMP LVL 03,1619.0,463.03,301.13,1782.74,42
CDM,2776250,SLEEVE SCD LVL 01,166.0,38.35,23.92,124.5,29
CDM,2776268,SLEEVE SCD LVL 02,535.0,123.58,77.09,401.25,29
CDM,2776276,SLEEVE SCD LVL 03,850.0,196.35,122.48,637.5,29
CDM,2776284,IMP STENT NONCOAT W DEL LVL 08,13895.0,3973.97,2584.47,10421.25,42
CDM,2776292,IMP STENT NONCOAT WO DEL LVL 02,850.0,243.1,158.1,1330.4,42
CDM,2776300,SNARE LVL 01,313.0,67.3,45.1,234.75,29
CDM,2776318,SNARE LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2776326,SNARE LVL 03,2157.0,463.76,310.82,1617.75,29
CDM,2776334,IMP EMBOLIZATION SPHERE LVL 01,1619.0,463.03,301.13,1782.74,42
CDM,2776342,IMP STAPLE BONE LVL 01,166.0,47.48,30.88,1363.66,42
CDM,2776359,IMP STAPLE BONE LVL 02,447.0,127.84,83.14,1363.66,42
CDM,2776367,IMP STAPLE BONE LVL 03,709.0,202.77,131.87,1363.66,42
CDM,2776375,STAPLE RELOAD LVL 01,166.0,35.69,23.92,124.5,29
CDM,2776383,STAPLE RELOAD LVL 02,447.0,96.1,64.41,335.25,29
CDM,2776391,STAPLE RELOAD LVL 03,850.0,182.75,122.48,637.5,29
CDM,2776409,STAPLER LVL 01,313.0,67.3,45.1,234.75,29
CDM,2776417,STAPLER LVL 02,594.0,127.71,85.6,445.5,29
CDM,2776425,STAPLER LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2776433,STAPLER LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2776441,STAPLER LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,2776458,IMP STENT COAT W DEL LVL 01,594.0,169.88,110.48,18372.82,42
CDM,2776466,IMP STENT COAT WO DEL LVL 06,9265.0,2649.79,1723.29,6948.75,42
CDM,2776474,IMP STENT NOS LVL 01,594.0,169.88,110.48,1782.74,42
CDM,2776482,IMP STENT NOS LVL 02,1132.0,323.75,210.55,1782.74,42
CDM,2776490,IMP STENT NOS LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,2776508,IMP STENT NOS LVL 04,4885.0,1397.11,908.61,3663.75,42
CDM,2776516,IMP STENT NONCOAT WO DEL LVL 03,1619.0,463.03,301.13,1330.4,42
CDM,2776524,IMP STENT NOS LVL 05,6950.0,1987.7,1292.7,5212.5,42
CDM,2776532,IMP STENT NOS LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,2776540,IMP STENT NOS LVL 07,11580.0,3311.88,1312.53,8685.0,42
CDM,2776557,IMP STENT NOS LVL 08,13895.0,3973.97,1312.53,10421.25,42
CDM,2776565,IMP STENT NONCOAT WO DEL LVL 04,2695.0,770.77,501.27,2021.25,42
CDM,2776573,IMP STENT NONCOAT W DEL LVL 01,594.0,169.88,110.48,6652.0,42
CDM,2776581,IMP STENT NONCOAT WO DEL LVL 01,447.0,127.84,83.14,1330.4,42
CDM,2776599,IMP STENT NONCOR TEMP W DEL LVL 01,850.0,243.1,158.1,1345.83,42
CDM,2776607,IMP STENT NONCOR TEMP WO DEL LVL 01,166.0,47.48,30.88,413.09,42
CDM,2776623,STYLET LVL 01,313.0,67.3,45.1,234.75,29
CDM,2776631,STYLET LVL 02,594.0,127.71,85.6,445.5,29
CDM,2776649,STYLET LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2776763,TIPS LVL 01,313.0,67.3,45.1,234.75,29
CDM,2776771,TIPS LVL 02,594.0,127.71,85.6,445.5,29
CDM,2776789,TIPS LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2776797,IMP TISSUE CONNECT HUMAN LVL 01,2695.0,770.77,501.27,8965.57,42
CDM,2776805,IMP TISSUE CONNECT HUMAN LVL 02,4885.0,1397.11,908.61,8965.57,42
CDM,2776813,IMP STENT NONCOAT WO DEL LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,2776821,IMP STENT NONCOAT WO DEL LVL 06,6950.0,1987.7,979.5,5212.5,42
CDM,2776854,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 02,594.0,127.71,110.48,445.5,39
CDM,2776862,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 03,1132.0,243.38,210.55,849.0,39
CDM,2776870,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 04,2157.0,463.76,220.58,1617.75,39
CDM,2776888,IMP TISSUE CONNECT NONHUMAN LVL 01,850.0,243.1,158.1,8418.7,42
CDM,2776896,IMP TISSUE CONNECT NONHUMAN LVL 02,2157.0,616.9,401.2,8418.7,42
CDM,2776904,IMP TISSUE CONNECT NONHUMAN LVL 03,3083.0,881.74,573.44,8418.7,42
CDM,2776912,IMP TISSUE CONNECT NONHUMAN LVL 04,4885.0,1397.11,908.61,8418.7,42
CDM,2776979,TRANSDUCER LVL 01,313.0,67.3,45.1,234.75,29
CDM,2776987,TREPHINE LVL 01,594.0,127.71,85.6,445.5,29
CDM,2776995,TREPHINE LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2777001,TROCAR LVL 01,313.0,67.3,45.1,234.75,29
CDM,2777019,TROCAR LVL 02,594.0,127.71,85.6,445.5,29
CDM,2777027,TROCAR LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2777035,TROCAR LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,2777043,TROCAR LVL 05,4885.0,1050.28,703.93,3663.75,29
CDM,2777050,TUBE CHEST LVL 01,102.0,21.93,14.7,76.5,29
CDM,2777068,IMP TUBE EAR LVL 01,166.0,47.48,30.88,1782.74,42
CDM,2777076,TUBE ENDOBRONCHIAL LVL 01,594.0,127.71,85.6,445.5,29
CDM,2777084,TUBE SPECIALTY LVL 01,32.0,6.88,4.61,24.0,29
CDM,2777092,TUBE SPECIALTY LVL 03,313.0,67.3,45.1,234.75,29
CDM,2777100,TUBE SPECIALTY LVL 02,166.0,35.69,23.92,124.5,29
CDM,2777118,TUBE SPECIALTY LVL 04,447.0,96.1,64.41,335.25,29
CDM,2777126,TUBE SPECIALTY LVL 09,1619.0,348.08,233.3,1214.25,29
CDM,2777134,TUBE SPECIALTY LVL 05,594.0,127.71,85.6,445.5,29
CDM,2777142,TUBE SPECIALTY LVL 06,709.0,152.44,102.17,531.75,29
CDM,2777159,TUBE SPECIALTY LVL 07,850.0,182.75,122.48,637.5,29
CDM,2777167,TUBE SPECIALTY LVL 08,1132.0,243.38,163.12,849.0,29
CDM,2777175,TUBE SPECIALTY LVL 10,2695.0,579.42,388.35,2021.25,29
CDM,2777258,IMP BAND LVL 02,850.0,243.1,158.1,1782.74,42
CDM,2777266,BIT LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2777274,BIT LVL 05,2157.0,463.76,310.82,1617.75,29
CDM,2777282,BIT LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,2777290,BLADE LVL 01,166.0,35.69,23.92,124.5,29
CDM,2777308,BLADE LVL 02,313.0,67.3,45.1,234.75,29
CDM,2777316,BLADE LVL 03,447.0,96.1,64.41,335.25,29
CDM,2777324,BLADE LVL 04,594.0,127.71,85.6,445.5,29
CDM,2777332,BLADE LVL 09,4397.0,945.36,633.61,3297.75,29
CDM,2777340,BLADE LVL 05,850.0,182.75,122.48,637.5,29
CDM,2777357,BLADE LVL 06,1132.0,243.38,163.12,849.0,29
CDM,2777365,BLADE LVL 08,3083.0,662.84,444.26,2312.25,29
CDM,2777373,BLADE LVL 10,5861.0,1260.12,844.57,4395.75,29
CDM,2777381,MASK AIRWAY LARYNGEAL LVL 01,166.0,35.69,23.92,124.5,29
CDM,2777399,CLIP APPLIER LVL 03,2157.0,463.76,310.82,1617.75,29
CDM,2777407,BAG DRAINAGE LVL 02,190.0,43.89,27.38,142.5,29
CDM,2777415,BAG DRAINAGE LVL 03,359.0,82.93,51.73,269.25,29
CDM,2777423,IMP BAND LVL 01,313.0,89.52,58.22,1782.74,42
CDM,2777431,IMP BAND LVL 03,1413.0,404.12,262.82,1782.74,42
CDM,2777449,BIT LVL 01,313.0,67.3,45.1,234.75,29
CDM,2777456,BIT LVL 02,594.0,127.71,85.6,445.5,29
CDM,2777464,BAG DRAINAGE LVL 01,102.0,23.56,14.7,76.5,29
CDM,2777621,CATH GLANDULAR LVL 01,166.0,35.69,23.92,124.5,29
CDM,2777639,CATH INTRAUTERN/HYST LVL 01,594.0,127.71,85.6,445.5,29
CDM,2777647,RESERVOIR NEURO LVL 01,1132.0,243.38,163.12,849.0,29
CDM,2777654,KIT/SET NON ROUTINE SURG LVL 01,166.0,35.69,23.92,124.5,29
CDM,2777662,INSERTS LVL 01,166.0,35.69,23.92,124.5,29
CDM,2777670,KIT/SET NON ROUTINE CARDIAC LVL 01,313.0,67.3,45.1,234.75,29
CDM,2777688,KIT/SET NON ROUTINE ORTH LVL 01,594.0,127.71,85.6,445.5,29
CDM,2777696,KIT/SET NON ROUTINE GI LVL 01,594.0,127.71,85.6,445.5,29
CDM,2777738,TAPS LVL 01,594.0,127.71,85.6,445.5,29
CDM,2777886,MASK AIRWAY LARYNGEAL LVL 02,594.0,127.71,85.6,445.5,29
CDM,2777894,MASK AIRWAY LARYNGEAL LVL 03,1619.0,348.08,233.3,1214.25,29
CDM,2777944,BLADE LVL 11,7413.0,1593.8,1068.21,5559.75,29
CDM,2777951,MASK AIRWAY LARYNGEAL LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,2777969,BLADE LVL 12,9265.0,1991.98,1335.09,6948.75,29
CDM,2777977,IMP BAND LVL 04,2695.0,770.77,501.27,2021.25,42
CDM,2777985,IMP BAND LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,2777993,IMP BAND LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,2778009,HYPO-HYPER THERMAL LVL 02,594.0,137.21,85.6,445.5,29
CDM,2778017,CATH ERCP LVL 01,594.0,127.71,85.6,445.5,29
CDM,2778025,CEMENT ACCESSORIES LVL 02,594.0,127.71,85.6,445.5,29
CDM,2778041,CLIP LVL 02,313.0,67.3,45.1,234.75,29
CDM,2778058,IMP COIL EMBOLIZATION LVL 02,594.0,169.88,110.48,1782.74,42
CDM,2778066,IMP COIL EMBOLIZATION LVL 03,1132.0,323.75,210.55,1782.74,42
CDM,2778074,IMP COIL EMBOLIZATION LVL 04,3083.0,881.74,573.44,2312.25,42
CDM,2778082,IMP COIL EMBOLIZATION LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,2778090,IMP COIL EMBOLIZATION LVL 06,6950.0,1987.7,1292.7,5212.5,42
CDM,2778108,IMP COIL EMBOLIZATION LVL 07,9265.0,2649.79,1312.53,6948.75,42
CDM,2778116,IMP COIL EMBOLIZATION LVL 08,11580.0,3311.88,1312.53,8685.0,42
CDM,2778124,IMP COIL EMBOLIZATION LVL 09,13895.0,3973.97,1312.53,10421.25,42
CDM,2778132,DRAIN REINFUSION LVL 02,1132.0,243.38,163.12,849.0,29
CDM,2778140,DRAIN REINFUSION LVL 03,2157.0,463.76,310.82,1617.75,29
CDM,2778157,DRAIN W ACCESSORIES LVL 02,476.0,102.34,68.59,357.0,29
CDM,2778165,DRAIN W ACCESSORIES LVL 03,850.0,182.75,122.48,637.5,29
CDM,2778173,DRAIN W ACCESSORIES LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,2778181,IMP FILTER VENA CAVA LVL 04,6950.0,1987.7,1292.7,5212.5,42
CDM,2778199,IMP FILTER VENA CAVA LVL 05,9265.0,2649.79,1723.29,6948.75,42
CDM,2778249,IMP GRAFT VASCULAR LVL 11,11580.0,3311.88,2153.88,8685.0,42
CDM,2778256,IMP GRAFT VASCULAR LVL 12,21904.0,6264.54,3896.94,16428.0,42
CDM,2778264,IMP GRAFT VASCULAR LVL 13,32854.0,9396.24,3896.94,24640.5,42
CDM,2778272,IMP GRAFT VASCULAR LVL 14,43804.0,12527.94,3896.94,32853.0,42
CDM,2778280,WIRE GUIDE LVL 04,850.0,182.75,158.1,1524.84,39
CDM,2778298,WIRE GUIDE LVL 05,1413.0,303.8,262.82,1524.84,39
CDM,2778306,WIRE GUIDE LVL 06,2695.0,579.42,501.27,2021.25,39
CDM,2778314,IMP ICD CHAMBER DUAL LVL 03,87604.0,26544.01,16294.34,65703.0,42
CDM,2778322,IMP ICD CHAMBER SGL LVL 03,87604.0,26544.01,16294.34,65703.0,42
CDM,2778330,INSERTS LVL 02,313.0,67.3,45.1,234.75,29
CDM,2778348,INSTRUMENT DISP SINGLE LVL 06,3083.0,662.84,444.26,2312.25,29
CDM,2778355,INSTRUMENT DISP MULTIPLE LVL 06,3909.0,840.44,563.29,2931.75,29
CDM,2778363,INSTRUMENT DISP MULTIPLE LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,2778371,IRRIGATOR/ACCESSORY LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,2778389,IRRIGATOR/ACCESSORY LVL 05,3596.0,773.14,518.18,2697.0,29
CDM,2778397,KIT/SET NON ROUTINE CARDIAC LVL 02,594.0,127.71,85.6,445.5,29
CDM,2778405,KIT/SET NON ROUTINE CARDIAC LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2778413,KIT/SET NON ROUTINE CARDIAC LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,2778421,KIT/SET NON ROUTINE CARDIAC LVL 05,3909.0,840.44,563.29,2931.75,29
CDM,2778439,KIT/SET NON ROUTINE CARDIAC LVL 06,5373.0,1155.2,774.25,4029.75,29
CDM,2778447,KNOT PUSHER LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,2778454,KNOT PUSHER LVL 03,2157.0,463.76,310.82,1617.75,29
CDM,2778462,TIPS LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,2778470,IMP MARKER TISSUE LVL 02,594.0,169.88,110.48,445.5,42
CDM,2778488,NEEDLE BIOPSY LVL 04,1132.0,243.38,163.12,849.0,29
CDM,2778496,NEEDLE BIOPSY LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,2778504,NEEDLE BIOPSY LVL 06,5861.0,1260.12,844.57,4395.75,29
CDM,2778512,CEMENT ACCESSORIES LVL 03,1132.0,243.38,163.12,849.0,29
CDM,2778520,SUPPLY NEURO LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,2778538,IMP CEMENT LVL 04,4885.0,1397.11,908.61,3663.75,42
CDM,2778546,IMP CEMENT LVL 05,6950.0,1987.7,1003.99,5212.5,42
CDM,2778561,OBTURATOR DISPOSABLE LVL 02,850.0,182.75,122.48,637.5,29
CDM,2778579,OCCLUDER LVL 03,13895.0,2987.42,2002.27,10421.25,29
CDM,2778587,OCCLUDER LVL 04,21904.0,4709.36,3156.37,16428.0,29
CDM,2778611,IMP DEV CLOSURE VASCULAR LVL 02,594.0,169.88,110.48,2334.85,42
CDM,2778629,WIRE GUIDE LVL 07,4885.0,1050.28,908.61,3663.75,39
CDM,2778637,WIRE GUIDE LVL 08,6950.0,1494.25,1122.65,5212.5,39
CDM,2778645,HEMOSTATIC AGENT LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2778652,IMP DEV CLOSURE VASCULAR LVL 04,1619.0,463.03,301.13,2334.85,42
CDM,2778660,INSTRUMENT DISP MULTIPLE LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,2778678,INTRO LVL 04,1132.0,243.38,163.12,849.0,29
CDM,2778686,INTRO LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,2778694,IMP DEV CLOSURE VASCULAR LVL 03,1132.0,323.75,210.55,2334.85,42
CDM,2778702,KIT/SET NON ROUTINE SURG LVL 02,313.0,67.3,45.1,234.75,29
CDM,2778710,KIT/SET NON ROUTINE SURG LVL 03,594.0,127.71,85.6,445.5,29
CDM,2778728,KIT/SET NON ROUTINE SURG LVL 04,1132.0,243.38,163.12,849.0,29
CDM,2778736,KIT/SET NON ROUTINE SURG LVL 05,1619.0,348.08,233.3,1214.25,29
CDM,2778744,KIT/SET NON ROUTINE SURG LVL 06,2157.0,463.76,310.82,1617.75,29
CDM,2778751,KIT/SET NON ROUTINE SURG LVL 07,2695.0,579.42,388.35,2021.25,29
CDM,2778769,KIT/SET NON ROUTINE SURG LVL 08,3853.0,828.4,555.22,2889.75,29
CDM,2778777,KIT/SET NON ROUTINE SURG LVL 09,4885.0,1050.28,703.93,3663.75,29
CDM,2778785,IMP DEV CLOSURE VASCULAR LVL 05,2157.0,616.9,401.2,2334.85,42
CDM,2778793,IMP LD PCMKR/ICD COMBO LVL 02,1132.0,323.75,210.55,63194.0,42
CDM,2778801,IMP LD PCMKR/ICD COMBO LVL 03,2695.0,770.77,501.27,63194.0,42
CDM,2778819,IMP LD PCMKR/ICD COMBO LVL 04,4885.0,1397.11,908.61,63194.0,42
CDM,2778827,IMP LD PCMKR/ICD COMBO LVL 05,9265.0,2649.79,1723.29,63194.0,42
CDM,2778835,IMP LD PCMKR/ICD COMBO LVL 06,13895.0,3973.97,2584.47,63194.0,42
CDM,2778843,IMP LD PCMKR/ICD COMBO LVL 07,17524.0,5011.86,3259.46,63194.0,42
CDM,2778850,IMP LD PCMKR/ICD COMBO LVL 08,21904.0,6264.54,4074.14,63194.0,42
CDM,2778868,IMP LD PCMKR/ICD COMBO LVL 09,26284.0,7517.22,4888.82,63194.0,42
CDM,2778876,SUPPLY NEURO LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,2778884,SUPPLY NEURO LVL 06,4885.0,1050.28,703.93,3663.75,29
CDM,2778892,SUPPLY NEURO LVL 07,9265.0,1991.98,1335.09,6948.75,29
CDM,2778900,SUPPLY NEURO LVL 08,13895.0,2987.42,2002.27,10421.25,29
CDM,2778918,BRUSH LVL 03,850.0,182.75,122.48,637.5,29
CDM,2778926,BURR LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,2778934,IMP CABLE LVL 06,4885.0,1397.11,908.61,3663.75,42
CDM,2778942,IMP DEV CLOSURE VASCULAR LVL 06,2695.0,770.77,501.27,2334.85,42
CDM,2778959,IMP COIL EMBOLIZATION LVL 10,15334.0,4385.52,1312.53,11500.5,42
CDM,2778967,COIL IMAGING MAGNETIC RESON LVL 02,594.0,127.71,110.48,445.5,39
CDM,2778975,THERAPY COLD LVL 03,1413.0,303.8,203.61,1059.75,29
CDM,2778983,IMP ACCESS SYSTEM DIALYS LVL 02,1132.0,323.75,210.55,5703.09,42
CDM,2778991,IMP ACCESS SYSTEM DIALYS LVL 03,2157.0,616.9,401.2,5703.09,42
CDM,2779007,DIALYSIS ACCESSORIES LVL 02,313.0,67.3,45.1,234.75,29
CDM,2779015,DIALYSIS ACCESSORIES LVL 03,594.0,127.71,85.6,445.5,29
CDM,2779023,DIALYSIS ACCESSORIES LVL 04,1132.0,243.38,163.12,849.0,29
CDM,2779031,DRAIN REINFUSION LVL 04,3596.0,773.14,518.18,2697.0,29
CDM,2779049,DRAIN REINFUSION LVL 05,4885.0,1050.28,703.93,3663.75,29
CDM,2779056,CATH ABL EP 3D/VECTOR LVL 02,3083.0,662.84,573.44,6049.13,39
CDM,2779064,CATH ABL EP 3D/VECTOR LVL 03,4885.0,1050.28,908.61,6049.13,39
CDM,2779072,CATH ABL EP 3D/VECTOR LVL 04,11580.0,2489.7,2153.88,8685.0,39
CDM,2779080,CATH ABL EP 3D/VECTOR LVL 05,17524.0,3767.66,3259.46,13143.0,39
CDM,2779098,CATH ABL EP 3D/VECTOR LVL 06,21904.0,4709.36,4074.14,16428.0,39
CDM,2779106,CATH ATHERECT TRANSL DIRECT LVL 02,9265.0,1991.98,1723.29,10952.52,39
CDM,2779114,CATH ATHERECT TRANSL ROTAT LVL 02,9265.0,1991.98,1723.29,10952.52,39
CDM,2779122,CATH BALLOON LVL 02,313.0,67.3,45.1,234.75,29
CDM,2779130,CATH BALLOON LVL 03,594.0,127.71,85.6,445.5,29
CDM,2779148,CATH BALLOON LVL 04,1132.0,243.38,163.12,849.0,29
CDM,2779155,CATH BALLOON LVL 05,1619.0,348.08,233.3,1214.25,29
CDM,2779163,CATH BALLOON LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,2779171,CATH BALLOON LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,2779189,CATH BALLOON DILAT NONVASC LVL 02,2695.0,579.42,501.27,3297.73,39
CDM,2779197,CATH BALLOON DILAT NONVASC LVL 03,4885.0,1050.28,908.61,3663.75,39
CDM,2779205,CATH BALLOON DILAT NONVASC LVL 04,6950.0,1494.25,1292.7,5212.5,39
CDM,2779213,CATH BALLOON DILAT NONVASC LVL 05,9265.0,1991.98,1723.29,6948.75,39
CDM,2779239,IMP CATH BRACHY SEED ADM LVL 06,13895.0,3973.97,590.83,10421.25,42
CDM,2779247,CATH CHOLANGIOGRAM LVL 02,850.0,182.75,122.48,637.5,29
CDM,2779254,CATH CHOLANGIOGRAM LVL 03,1413.0,303.8,203.61,1059.75,29
CDM,2779262,CATH CHOLANGIOGRAM LVL 04,1888.0,405.92,272.06,1416.0,29
CDM,2779270,CATH DIAGNOSTIC LVL 02,134.0,28.81,19.31,100.5,29
CDM,2779288,CATH DIAGNOSTIC LVL 03,251.0,53.96,36.17,188.25,29
CDM,2779296,CATH DIAGNOSTIC LVL 04,313.0,67.3,45.1,234.75,29
CDM,2779304,CATH DIAGNOSTIC LVL 05,594.0,127.71,85.6,445.5,29
CDM,2779312,CATH DIAGNOSTIC LVL 06,1132.0,243.38,163.12,849.0,29
CDM,2779320,CATH DIAGNOSTIC LVL 07,2157.0,463.76,310.82,1617.75,29
CDM,2779338,CATH DIAGNOSTIC LVL 08,3596.0,773.14,518.18,2697.0,29
CDM,2779346,CATH DIAGNOSTIC LVL 09,5861.0,1260.12,844.57,4395.75,29
CDM,2779353,CATH EP NON 3D 1-19 LVL 02,1132.0,243.38,210.55,1633.6,39
CDM,2779361,CATH EP NON 3D 1-19 LVL 03,2157.0,463.76,401.2,1633.6,39
CDM,2779379,CATH EP NON 3D 1-19 LVL 04,3083.0,662.84,573.44,2312.25,39
CDM,2779387,CATH EP NON 3D 1-19 LVL 05,4885.0,1050.28,908.61,3663.75,39
CDM,2779395,CATH EP NON 3D 1-19 LVL 06,9265.0,1991.98,1202.73,6948.75,39
CDM,2779403,CATH GUIDE LVL 02,313.0,67.3,58.22,457.19,39
CDM,2779411,CATH GUIDE LVL 03,447.0,96.1,83.14,457.19,39
CDM,2779429,CATH GUIDE LVL 04,594.0,127.71,110.48,457.19,39
CDM,2779437,CATH GUIDE LVL 05,850.0,182.75,158.1,637.5,39
CDM,2779445,CATH GUIDE LVL 06,1413.0,303.8,262.82,1059.75,39
CDM,2779452,CATH GUIDE LVL 07,2827.0,607.8,336.61,2120.25,39
CDM,2779460,CATH HEM/PER SHORT TERM LVL 02,594.0,127.71,110.48,490.65,39
CDM,2779478,CATH HEM/PER SHORT TERM LVL 03,1132.0,243.38,210.55,849.0,39
CDM,2779486,CATH HEM/PER SHORT TERM LVL 04,1619.0,348.08,301.13,1214.25,39
CDM,2779494,IMP CATH HEM/PER LONG TERM LVL 02,594.0,169.88,110.48,958.22,42
CDM,2779502,IMP CATH HEM/PER LONG TERM LVL 03,1132.0,323.75,210.55,958.22,42
CDM,2779510,IMP CATH HEM/PER LONG TERM LVL 04,1619.0,463.03,301.13,1214.25,42
CDM,2779528,IMP CATH HEM/PER LONG TERM LVL 05,2695.0,770.77,501.27,2021.25,42
CDM,2779536,IMP CATH HEM/PER LONG TERM LVL 06,3596.0,1028.46,668.86,2697.0,42
CDM,2779544,IMP CATH HEM/PER LONG TERM LVL 07,4885.0,1397.11,705.48,3663.75,42
CDM,2779551,IMP CATH HEM/PER LONG TERM LVL 08,6950.0,1987.7,705.48,5212.5,42
CDM,2779569,DRESSING SPECIALTY LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,2779577,IMP GRAFT VASCULAR LVL 15,54754.0,15659.64,3896.94,41065.5,42
CDM,2779585,HANDPIECE LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,2779593,HANDPIECE LVL 05,9265.0,1991.98,1335.09,6948.75,29
CDM,2779601,HANDPIECE LVL 06,13895.0,2987.42,2002.27,10421.25,29
CDM,2779619,HARVESTER LVL 02,2695.0,579.42,388.35,2021.25,29
CDM,2779627,HARVESTER LVL 03,4885.0,1050.28,703.93,3663.75,29
CDM,2779635,IMP NEURO LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,2779643,IMP NEURO LVL 03,4885.0,1397.11,908.61,3663.75,42
CDM,2779650,IMP NEURO LVL 04,9265.0,2649.79,1312.53,6948.75,42
CDM,2779668,IMP NEURO LVL 05,13895.0,3973.97,1312.53,10421.25,42
CDM,2779676,IMP NEURO LVL 06,21904.0,6264.54,1312.53,16428.0,42
CDM,2779684,IMP NEURO LVL 07,43804.0,12527.94,1312.53,32853.0,42
CDM,2779692,KIT/SET NON ROUTINE GI LVL 02,1619.0,348.08,233.3,1214.25,29
CDM,2779700,KIT/SET NON ROUTINE GI LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2779718,KIT/SET NON ROUTINE GI LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,2779726,KIT/SET NON ROUTINE GI LVL 05,9265.0,1991.98,1335.09,6948.75,29
CDM,2779734,KIT/SET NON ROUTINE ORTH LVL 02,1619.0,348.08,233.3,1214.25,29
CDM,2779742,KIT/SET NON ROUTINE ORTH LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,2779759,KIT/SET NON ROUTINE ORTH LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,2779767,KIT/SET NON ROUTINE ORTH LVL 05,9265.0,1991.98,1335.09,6948.75,29
CDM,2779775,KIT/SET NON ROUTINE ORTH LVL 06,13895.0,2987.42,2002.27,10421.25,29
CDM,2779783,MAMMOTOME LVL 02,594.0,127.71,85.6,445.5,29
CDM,2779791,MAMMOTOME LVL 03,1126.0,242.09,162.26,844.5,29
CDM,2779809,MAMMOTOME LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,2779817,IMP PCMKR DUAL RR LVL 03,26284.0,7964.05,4888.82,41774.56,42
CDM,2779825,IMP PCMKR DUAL RR LVL 04,43804.0,13272.61,8147.54,41774.56,42
CDM,2779833,SUPPLY PERFUSION/ECMO LVL 06,2426.0,521.59,349.59,1819.5,29
CDM,2779841,SUPPLY PERFUSION/ECMO LVL 07,3340.0,718.1,481.29,2505.0,29
CDM,2779858,SUPPLY PERFUSION/ECMO LVL 08,4153.0,892.9,598.45,3114.75,29
CDM,2779866,IMP CATH PORT INDWELLING LVL 02,447.0,127.84,83.14,7147.71,42
CDM,2779874,IMP CATH PORT INDWELLING LVL 03,850.0,243.1,158.1,7147.71,42
CDM,2779882,IMP PCMKR SGL RR LVL 04,26284.0,7964.05,4888.82,41774.56,42
CDM,2779890,CATH/WIRE/SUTURE PASSER LVL 02,594.0,127.71,85.6,445.5,29
CDM,2779908,IMP CATH PORT INDWELLING LVL 04,1413.0,404.12,262.82,7147.71,42
CDM,2779916,IMP CATH PORT INDWELLING LVL 05,1888.0,539.97,351.17,7147.71,42
CDM,2779924,IMP CATH PORT INDWELLING LVL 06,2695.0,770.77,501.27,7147.71,42
CDM,2779932,IMP CATH PORT INDWELLING LVL 07,3340.0,955.24,621.24,7147.71,42
CDM,2779940,PROBE LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,2779957,PROBE LVL 05,3083.0,662.84,444.26,2312.25,29
CDM,2779965,PROBE LVL 06,3909.0,840.44,563.29,2931.75,29
CDM,2779973,PROBE LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,2779981,IMP VALVE LVL 06,26284.0,7517.22,1312.53,19713.0,42
CDM,2783801,CATH CHOLANGIOGRAM LVL 05,2426.0,521.59,349.59,1819.5,29
CDM,2783819,CATH CHOLANGIOGRAM LVL 06,2827.0,607.8,407.37,2120.25,29
CDM,2783975,IMP RETRACTOR SYS TISS LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,2784411,HEMOSTATIC AGENT LVL 08,8107.0,1743.0,1168.22,6080.25,29
CDM,2784973,IMP FIX LW/UP/PELVIC LVL 09,30664.0,8769.9,1003.99,22998.0,42
CDM,2785053,IMP MESH LVL 24,76742.0,21948.21,4120.12,57556.5,42
CDM,2785061,IMP MESH LVL 25,81122.0,23200.89,4120.12,60841.5,42
CDM,2785079,IMP MESH LVL 26,85502.0,24453.57,4120.12,64126.5,42
CDM,2785087,IMP MESH LVL 27,89882.0,25706.25,4120.12,67411.5,42
CDM,2785095,IMP MESH LVL 28,94262.0,26958.93,4120.12,70696.5,42
CDM,2785186,CATH INTRACARDIAC ECHO LVL 07,17524.0,3767.66,1816.97,13143.0,39
CDM,2785202,KIT/SET NON ROUTINE CARDIAC LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,2785236,IMP MESH LVL 29,111694.0,31944.48,4120.12,83770.5,42
CDM,2785764,IMP ROD/NAIL LVL 18,45994.0,13154.28,1003.99,34495.5,42
CDM,2785772,IMP ROD/NAIL LVL 19,54754.0,15659.64,1003.99,41065.5,42
CDM,2785780,IMP ROD/NAIL LVL 20,65704.0,18791.34,1003.99,49278.0,42
CDM,2785798,IMP ROD/NAIL LVL 21,76654.0,21923.04,1003.99,57490.5,42
CDM,2785806,IMP ROD/NAIL LVL 22,87604.0,25054.74,1003.99,65703.0,42
CDM,2792398,IMP CATH BRACHY SEED ADM LVL 07,17524.0,5011.86,590.83,13143.0,42
CDM,2792406,IMP STENT NONCOR TEMP W DEL LVL 06,6487.0,1855.28,990.86,4865.25,42
CDM,2792976,IMP LD NEUROSTIM LVL 08,35044.0,10022.58,5576.59,26283.0,42
CDM,2792984,HEMOSTATIC AGENT LVL 09,11580.0,2489.7,1668.68,8685.0,29
CDM,2792992,IMP SENSOR PRESS PA ALL LVL 04,109504.0,31318.14,2614.58,82128.0,38
CDM,2793016,IMP STENT COAT W DEL LVL 24,85414.0,24428.4,13526.9,64060.5,42
CDM,2793073,VAD RPL E-E/P POWER MODULE 0-12,20352.0,7855.87,3785.47,31093.24,43
CDM,2793198,IMP MESH LVL 30,133594.0,38207.88,4120.12,100195.5,42
CDM,2793362,IMP PROSTH CUSTOM LVL 03,131404.0,37581.54,1312.53,98553.0,42
CDM,2793370,IMP PROSTH CUSTOM LVL 04,153304.0,43844.94,1312.53,114978.0,42
CDM,2793388,IMP PROSTH CUSTOM LVL 05,175204.0,50108.34,1312.53,131403.0,42
CDM,2793461,DEVICE SYS DIVRT FECAL INCNT LVL 01,166.0,35.69,30.88,124.5,39
CDM,2793479,DEVICE SYS DIVRT FECAL INCNT LVL 02,313.0,67.3,36.73,234.75,39
CDM,2793487,DEVICE SYS DIVRT FECAL INCNT LVL 03,594.0,127.71,36.73,445.5,39
CDM,2793495,DEVICE SYS DIVRT FECAL INCNT LVL 04,1413.0,303.8,36.73,1059.75,39
CDM,2793552,FIX EXTRNL LW/UP/PELVIC LVL 01,102.0,21.93,14.7,76.5,29
CDM,2793560,FIX EXTRNL LW/UP/PELVIC LVL 02,190.0,40.85,27.38,142.5,29
CDM,2793578,FIX EXTRNL LW/UP/PELVIC LVL 03,313.0,67.3,45.1,234.75,29
CDM,2793586,FIX EXTRNL LW/UP/PELVIC LVL 04,594.0,127.71,85.6,445.5,29
CDM,2793594,FIX EXTRNL LW/UP/PELVIC LVL 05,1413.0,303.8,203.61,1059.75,29
CDM,2793602,FIX EXTRNL LW/UP/PELVIC LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,2793610,FIX EXTRNL LW/UP/PELVIC LVL 07,3853.0,828.4,555.22,2889.75,29
CDM,2793628,FIX EXTRNL LW/UP/PELVIC LVL 08,4885.0,1050.28,703.93,3663.75,29
CDM,2793636,FIX EXTRNL LW/UP/PELVIC LVL 09,6950.0,1494.25,1001.5,5212.5,29
CDM,2793644,FIX EXTRNL LW/UP/PELVIC LVL 10,9265.0,1991.98,1335.09,6948.75,29
CDM,2793651,FIX EXTRNL LW/UP/PELVIC LVL 11,11580.0,2489.7,1668.68,8685.0,29
CDM,2793669,FIX EXTRNL LW/UP/PELVIC LVL 12,13895.0,2987.42,2002.27,10421.25,29
CDM,2793677,FIX EXTRNL LW/UP/PELVIC LVL 13,17524.0,3767.66,2525.21,13143.0,29
CDM,2793685,FIX EXTRNL LW/UP/PELVIC LVL 14,21904.0,4709.36,3156.37,16428.0,29
CDM,2793693,FIX EXTRNL LW/UP/PELVIC LVL 15,26284.0,5651.06,3787.52,19713.0,29
CDM,2793701,FIX EXTRNL LW/UP/PELVIC LVL 16,30664.0,6592.76,4418.68,22998.0,29
CDM,2793719,FIX EXTRNL LW/UP/PELVIC LVL 17,35044.0,7534.46,5049.84,26283.0,29
CDM,2793727,FIX EXTRNL LW/UP/PELVIC LVL 18,43804.0,9417.86,6312.16,32853.0,29
CDM,2793735,FIX EXTRNL LW/UP/PELVIC LVL 19,52564.0,11301.26,7574.47,39423.0,29
CDM,2793743,FIX EXTRNL LW/UP/PELVIC LVL 20,61324.0,13184.66,8836.79,45993.0,29
CDM,2793750,FIX EXTRNL LW/UP/PELVIC LVL 21,70084.0,15068.06,10099.1,52563.0,29
CDM,2793768,FIX EXTRNL LW/UP/PELVIC LVL 22,78844.0,16951.46,11361.42,59133.0,29
CDM,2793776,FIX EXTRNL LW/UP/PELVIC LVL 23,87604.0,18834.86,12623.74,65703.0,29
CDM,2793784,FIX EXTRNL LW/UP/PELVIC LVL 24,96364.0,20718.26,13886.05,72273.0,29
CDM,2793792,FIX EXTRNL LW/UP/PELVIC LVL 25,105124.0,22601.66,15148.37,78843.0,29
CDM,2793800,FIX EXTRNL LW/UP/PELVIC LVL 26,116512.0,25050.08,16789.38,87384.0,29
CDM,2793818,FIX EXTRNL LW/UP/PELVIC LVL 27,131404.0,28251.86,18935.32,98553.0,29
CDM,2793826,FIX EXTRNL LW/UP/PELVIC LVL 28,142354.0,30606.11,20513.21,106765.5,29
CDM,2793834,IMP DEV OCCL I-TUBAL CONTRCP LVL 06,3853.0,1101.96,555.22,2889.75,38
CDM,2793842,IMP DEV OCCL I-TUBAL CONTRCP LVL 07,6105.0,1746.03,769.35,4578.75,38
CDM,2793859,IMP DEV OCCL I-TUBAL CONTRCP LVL 08,11580.0,3311.88,769.35,8685.0,38
CDM,2793875,DEVICE HEART ARTIFICIAL 70CC,744600.0,212955.6,1312.53,558450.0,42
CDM,2793891,IMP PROSTH CUSTOM LVL 01,87604.0,25054.74,1312.53,65703.0,42
CDM,2793909,IMP PROSTH CUSTOM LVL 02,109504.0,31318.14,1312.53,82128.0,42
CDM,2793917,IMP RV/AD/RP SHDR STEM LVL 08,35044.0,10022.58,5497.98,26283.0,42
CDM,2793925,IMP RV/AD/RP SHDR STEM LVL 09,39424.0,11275.26,5497.98,29568.0,42
CDM,2793933,IMP RV/AD/RP SHDR STEM LVL 10,43804.0,12527.94,5497.98,32853.0,42
CDM,2794030,IMP FASTENERS W DEV DELIVERY LVL 01,3853.0,1101.96,716.66,2889.75,42
CDM,2794048,IMP FASTENERS W DEV DELIVERY LVL 02,6105.0,1746.03,1135.53,4578.75,42
CDM,2794055,IMP FASTENERS W DEV DELIVERY LVL 03,9265.0,2649.79,1312.53,6948.75,42
CDM,2794063,IMP FASTENERS W DEV DELIVERY LVL 04,13895.0,3973.97,1312.53,10421.25,42
CDM,2794071,IMP FASTENERS W DEV DELIVERY LVL 05,17524.0,5011.86,1312.53,13143.0,42
CDM,2794089,IMP FASTENERS W DEV DELIVERY LVL 06,21904.0,6264.54,1312.53,16428.0,42
CDM,2794097,IMP FASTENERS W DEV DELIVERY LVL 07,26284.0,7517.22,1312.53,19713.0,42
CDM,2794105,IMP SPACER ORTHOPEDIC LVL 12,35044.0,10022.58,1312.53,26283.0,42
CDM,2794121,NEEDLE INSUFFLATION LVL 03,594.0,127.71,85.6,445.5,29
CDM,2799245,IMP DEV OCCL I-TUBAL CONTRCP LVL 01,166.0,47.48,23.92,1044.96,38
CDM,2799252,IMP DEV OCCL I-TUBAL CONTRCP LVL 02,313.0,89.52,45.1,1044.96,38
CDM,2799260,IMP DEV OCCL I-TUBAL CONTRCP LVL 03,594.0,169.88,85.6,1044.96,38
CDM,2799278,IMP DEV OCCL I-TUBAL CONTRCP LVL 04,1413.0,404.12,203.61,1059.75,38
CDM,2799286,IMP DEV OCCL I-TUBAL CONTRCP LVL 05,2695.0,770.77,388.35,2021.25,38
CDM,2799443,IMP PROSTH PENILE NONINF LVL 07,41614.0,11901.6,7740.2,31210.5,42
CDM,2799450,FLEXHD FIX INT 11X20 SHAPED/SC,75.0,21.45,24.52,222.5,66
CDM,2799724,IMP DEV/S FUSN&FIX JT SI&PEL LVL 01,313.0,89.52,58.22,407.44,42
CDM,2799732,IMP DEV/S FUSN&FIX JT SI&PEL LVL 02,1413.0,404.12,262.82,1059.75,42
CDM,2799740,IMP DEV/S FUSN&FIX JT SI&PEL LVL 03,2695.0,770.77,299.97,2021.25,42
CDM,2799757,IMP DEV/S FUSN&FIX JT SI&PEL LVL 04,3853.0,1101.96,299.97,2889.75,42
CDM,2799765,IMP DEV/S FUSN&FIX JT SI&PEL LVL 05,6105.0,1746.03,299.97,4578.75,42
CDM,2799773,IMP DEV/S FUSN&FIX JT SI&PEL LVL 06,9265.0,2649.79,299.97,6948.75,42
CDM,2799781,IMP DEV/S FUSN&FIX JT SI&PEL LVL 07,13895.0,3973.97,299.97,10421.25,42
CDM,2799799,IMP DEV/S FUSN&FIX JT SI&PEL LVL 08,17524.0,5011.86,299.97,13143.0,42
CDM,2800001,IMP PCMKR SGL RR LVL 12,61324.0,18581.17,11406.26,45993.0,42
CDM,28233,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,29108,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,29272,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,29462,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,29595,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,29835,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,29850,R&B MEDICAL/SURGICAL SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,3000007,LAB IG FREE LIGHT CHAIN SERUM EA,61.0,9.76,17.27,74.8,63
CDM,3000015,LAB IG FREE LIGHT CHAIN URINE EA,69.0,11.04,17.27,74.8,63
CDM,30122,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,30155,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,30163,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3020112,LAB SUSCPT ETEST AGENT EA NS,66.0,14.59,4.75,49.5,63
CDM,3020120,LAB SUGARS SINGLE QL STOOL NS,64.0,10.24,5.5,48.0,63
CDM,3020922,LAB LEUKOCYTE HISTAMINE RELEASE,64.0,12.16,12.46,58.47,63
CDM,3021060,LAB LACTATE/LACTIC ACID NS,35.0,5.6,11.57,54.28,63
CDM,3021243,LAB SCR AB SYPHILIS,53.0,10.07,13.24,62.13,63
CDM,30213,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3021912,LAB DET IA COCCI IMMT PCR PRB AMP,521.0,115.14,35.09,390.75,63
CDM,3022191,LAB IMM RIA NEUROMYOTONIA QN,56.0,8.96,18.4,86.34,63
CDM,3022209,LAB SCR AB NEUROMYOTONIA FL,37.0,7.03,12.05,78.63,63
CDM,3022472,LAB EVEROLIMUS,60.0,9.6,13.73,64.46,63
CDM,3022480,LAB AG CELL MONONUC CD57&CD57 ABSOL,81.0,15.39,26.78,125.66,63
CDM,3022720,LAB HORMONE ANTIMULLERIAN,116.0,18.56,37.93,135.3,63
CDM,3022746,LAB AB HEPATITIS C NS,255.0,48.45,14.27,191.25,63
CDM,3022779,POC AGGREGATION PLT EA AGENT,79.0,14.46,24.91,107.89,63
CDM,3022787,POC FIBRINOGEN ACTIVITY,47.0,8.6,9.72,45.63,63
CDM,3022795,POC SCR FIBRINOLYSINS/COAG,47.0,8.6,15.48,157.25,63
CDM,3022878,LAB AB ID ANTI-NEUTROPHIL,46.0,8.74,15.05,70.64,63
CDM,3022886,LAB MCG IN SITU INT 25-99 CELL NS,128.0,31.62,42.38,223.31,63
CDM,3023058,LAB HEAVY METAL QN BISMUTH,67.0,10.72,21.96,103.11,63
CDM,3023199,LAB DET IA HIV-1 PRB AMP NS,108.0,23.87,35.09,164.7,63
CDM,3023348,LAB DET IA ENTEROVRS PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3023355,LAB DET IA ENTEROVRS PRB AMP NS,139.0,30.72,35.09,164.7,63
CDM,3023488,LAB DET IA HSV PRB AMP PCR CSF,106.0,23.43,35.09,164.7,63
CDM,3023538,LAB DET IA ENTEROVRS PRB AMP CSF,106.0,23.43,35.09,164.7,63
CDM,3023546,LAB LIPOPROTEIN CHOLESTEROL HDL NS,25.0,4.0,8.19,38.45,63
CDM,3024007,LAB GENOTYPE IA HEPATITIS B,773.0,170.83,257.45,1208.34,63
CDM,3024049,LAB DET IA RESP MLTPLX 12-25 TGT NS,1251.0,276.47,416.78,1956.15,63
CDM,3024114,LAB DET IA FLU REV T&PRB AMP 1-2,288.0,63.65,95.8,449.68,63
CDM,3024270,LAB SCR AG BLD TYPE SERUM PT U NS,153.0,26.32,16.34,114.75,63
CDM,3024387,LAB DET IA HEP C PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3024395,LAB DET IA HEP C QN,129.0,28.51,42.84,201.02,63
CDM,3024403,LAB DET IA HIV-1 QN,256.0,56.58,85.1,399.45,63
CDM,3024411,LAB DET IA HEP C QN NS,147.0,32.49,42.84,201.02,63
CDM,3025087,LAB GENOTYPE IA CYTOMEGALOVIRUS,773.0,170.83,257.45,1208.34,63
CDM,3025111,LAB GENE F2 VAR 20210G>A,198.0,55.24,65.69,346.17,63
CDM,30254,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3025426,LAB DET IA RESP MLTPLX 6-11 TGT,655.0,144.76,218.06,1023.48,63
CDM,3025889,LAB DET IA RESP MLTPLX 3-5 TGT,664.0,146.74,142.63,669.39,63
CDM,3025905,LAB GENE SEQ MUTATION FAM TARGETED,401.0,111.88,74.59,883.39,37
CDM,3026051,LAB AB HISTOPLASMA COMP FIXATION,63.0,11.97,13.79,64.72,63
CDM,3026077,LAB SCR AB CHAGAS,62.0,11.78,12.39,58.14,63
CDM,3026085,LAB AB CHAGAS RIPA,38.0,7.22,12.39,58.14,63
CDM,3026184,LAB BACLOFEN,132.0,21.12,18.64,99.0,63
CDM,3026234,LAB GENE ANLYS MUT C-KIT,989.0,275.93,329.51,1736.37,63
CDM,3026556,LAB HLA CLASS I&II AB QL,193.0,36.67,64.19,338.25,63
CDM,3026564,LAB HLA CLASS I AB HIGH DEF QL,972.0,184.68,323.75,1705.97,63
CDM,3026663,LAB GENE BCR/ABL1 REFLEX P210 NS,492.0,137.27,163.96,863.96,63
CDM,3026671,LAB GENE EGFR VAR COMMON NS,974.0,271.75,324.58,1710.3,63
CDM,3027018,LAB RNA NOROVIRUS AMP PROBE,109.0,24.09,35.09,164.7,63
CDM,3027554,LAB PRETREAT SERUM RBC AB DILUTION,170.0,32.3,1.99,127.5,63
CDM,3027612,LAB DET IA HIV-2 REV T&PRB AMP,122.0,26.96,35.09,164.7,63
CDM,3027653,LAB GENE PTEN SEQ FULL,1800.0,502.2,600.0,3161.63,63
CDM,3027729,LAB MICRODISSECTION LASER,909.0,252.7,71.61,681.75,39
CDM,3027737,LAB ONC BIOCHEMICAL PROT 5 SERUM,2691.0,750.79,387.77,4210.05,59
CDM,3027752,LAB DET IA RESP MLTPLX 12-25 TGT,1251.0,276.47,416.78,1956.15,63
CDM,3027778,LAB DET IA MYCOPLAS PNEU PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3027786,LAB AB CYTOMEGALOVIRUS NS,56.0,10.64,14.39,67.52,63
CDM,3027828,LAB TRYPSIN FLUID DUODENAL,22.0,3.52,7.2,33.79,63
CDM,3028024,LAB OXCARBAZEPINE,69.0,11.04,13.25,62.2,63
CDM,3028065,LAB BIOTIN,160.0,25.6,17.06,120.0,63
CDM,3028164,LAB COPPER SERUM,63.0,10.08,12.41,58.27,63
CDM,3028172,LAB ZINC,35.0,5.6,11.39,53.42,63
CDM,3028206,LAB IMM RIA BETAPROTEIN,360.0,57.6,18.4,270.0,63
CDM,3028230,LAB ITRACONAZOLE,131.0,20.96,27.11,117.41,63
CDM,3028313,LAB GENE PDGFRA,989.0,275.93,329.51,1736.37,63
CDM,3028347,LAB DET IA MUCORALES PCR PRB AMP,275.0,60.78,35.09,206.25,63
CDM,3028354,LAB DET IA NORCARDIA PCR PRB AMP,362.0,80.0,35.09,271.5,63
CDM,3028388,LAB DET IA COV19&FLU A&B PRB AMP,96.0,21.22,43.2,617.73,63
CDM,3028461,LAB THIOPURINE,160.0,25.6,18.64,120.0,63
CDM,3028669,LAB ESTRADIOL TOTAL,84.0,13.44,27.94,131.11,63
CDM,3028677,LAB ESTRADIOL TOTAL NS,84.0,13.44,27.94,131.11,63
CDM,3028701,LAB CARBAMAZEPINE -10 11-EPOXIDE,58.0,9.28,18.64,87.47,63
CDM,3028719,LAB CARBAMAZEPINE -10 11-EPOXIDE NS,90.0,14.4,18.64,87.47,63
CDM,3028727,LAB IMM AB QL/SEMI QN SGL COVID-19,136.0,25.84,45.23,207.81,63
CDM,3028735,LAB GENE NUDT15&TPMT VAR COMMON,1399.0,390.32,457.47,2456.45,63
CDM,3028768,LAB IMM AB BP180 QN,73.0,11.68,17.27,81.09,63
CDM,3028818,LAB LEFLUNOMIDE,116.0,18.56,38.57,167.05,63
CDM,3028842,LAB DRG DF ETOH BIOMRK TIS CORD 1-2,110.0,17.6,13.47,82.5,37
CDM,3028859,LAB IMM ELASTASE PANCREATIC QN,100.0,16.0,22.97,99.48,63
CDM,3028925,LAB GENE PLCG2 VAR COMMON,875.0,244.13,291.36,1535.28,63
CDM,3029121,LAB SCR AB PHOSPHOLIPAS A2 RECPT FL,190.0,36.1,12.05,142.5,63
CDM,3029139,LAB AB FL TITER PHOSPHOLPS A2 RECPT,285.0,54.15,12.05,213.75,63
CDM,3029147,LAB DIS INFCT DNA PLASMA NGS UNTGT,6379.0,1779.74,919.21,9979.33,59
CDM,3029162,LAB CROSS LINKS DEOXYPYRIDINOLINE,113.0,18.08,18.68,87.67,63
CDM,3029170,LAB AB ECHINOCOCCUS,71.0,13.49,13.01,61.07,63
CDM,3029188,LAB DRG DF SULFONAMIDES DAY 1-3,147.0,23.52,23.37,110.25,37
CDM,3029196,LAB ACID PHOSPHATASE TOTAL NS,63.0,10.08,7.64,47.25,63
CDM,3029204,LAB ACID URIC OTHER SOURCE NS,58.0,9.28,5.08,43.5,63
CDM,3029253,LAB CHROMAT MS METHOXYTYRAMINE,392.0,62.72,24.09,294.0,63
CDM,3029295,LAB DET IA VARICELLA-ZOSTER PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3029360,LAB AB FL TITER AQUAPORIN 4,219.0,41.61,12.05,164.25,63
CDM,3029402,LAB DET IA ASPERGILLUS PCR PRB AMP,115.0,25.42,35.09,164.7,63
CDM,3029428,LAB IMM ALZHEIMER EVALUATION,351.0,56.16,17.27,263.25,63
CDM,3029451,LAB TRNSPL DNA DNR DRV CELL-FREE QN,8260.0,2304.54,2701.02,11924.33,63
CDM,3029477,LAB DRG SC INST ALYZ MECON DAY,187.0,29.92,62.14,291.62,63
CDM,3029485,LAB PANEL DYSFNCT/DILAT AO DUP/DEL,4051.0,1130.23,583.75,7114.71,59
CDM,3029493,LAB AB ENA FIBRILLARIN,130.0,24.7,17.93,97.5,63
CDM,3029519,LAB BLOOD OCCULT FECES 1-3 IMM NS,62.0,9.92,15.92,74.77,63
CDM,3029527,LAB AB FL TITER NMDA,194.0,36.86,12.05,145.5,63
CDM,3029550,LAB CHROMAT MS GLOMERULONEPH FIBRIL,326.0,52.16,24.09,244.5,63
CDM,3029626,LAB IMMUNOFIXATION EP IGD IGE,142.0,26.98,22.34,106.5,63
CDM,3029642,LAB PROT FRCTN ELECTRO&QN SERUM NS,56.0,8.96,10.74,78.63,63
CDM,3029709,LAB IMMUNOFIXATION EP SERUM NS,74.0,14.06,22.34,96.75,63
CDM,3029717,LAB TRNSPL REJECT ALLOGRAFT KIDNEY,9479.0,2644.64,1365.92,16648.23,59
CDM,3029725,LAB ESTRADIOL FREE MEASURE DIRECT,84.0,13.44,27.94,131.11,63
CDM,3029733,LAB DET AG IA IMM ENZ SEMI QN,147.0,32.49,11.98,110.25,63
CDM,3029865,LAB AB ENA MYOSITIS,77.0,14.63,17.93,84.15,63
CDM,3029873,LAB PROT WB W INTRP ID MYOSITIS,88.0,14.08,29.21,126.51,63
CDM,3029907,LAB HLA CLASS I PHENOTYPE QL NS,287.0,54.53,95.52,503.36,63
CDM,3029923,LAB IMMUNOFIXATION EP TRANSFRN BETA,89.0,16.91,29.35,127.11,63
CDM,3029949,LAB GENE TYPING HLA 1 LR AG 1 EA NS,223.0,62.22,74.33,391.67,63
CDM,3029964,LAB IMM AB LDL OXIDIZED,100.0,16.0,17.27,81.09,63
CDM,3029972,LAB GSAP EPILEPSY,7346.0,2049.53,2448.56,12902.42,63
CDM,3029998,LAB AB CHAGAS IGG,72.0,13.68,12.39,58.14,63
CDM,3030004,LAB DET IA RESP MLTPLX 6-11 TGT NS,655.0,144.76,218.06,1023.48,63
CDM,3030053,LAB DET IA 16S&18S RRNA GENE NGS,1069.0,298.25,154.04,1671.51,59
CDM,3030111,LAB IMM MS PHOSPHAT/PROTHROMBIN NS,59.0,9.44,11.53,54.08,63
CDM,3030152,LAB HORMONE ANTIMULLERIAN NS,116.0,18.56,37.93,135.3,63
CDM,3030285,LAB IMM NEURO AMYLD 1-42&1-40 CSF,785.0,219.02,113.12,1222.64,59
CDM,3030293,LAB IMM RIA NITRATE/NITRITE QN,200.0,32.0,18.4,150.0,63
CDM,3030301,LAB DRG DF BENZ DAY 1-12 NON URINE,56.0,8.96,10.42,116.28,37
CDM,3030319,LAB DRG DF BUPRENORPHINE DAY NON UR,56.0,8.96,10.42,74.37,37
CDM,3030327,LAB DRG DF COCAINE DAY NON URINE,56.0,8.96,10.42,74.37,37
CDM,3030335,LAB DRG DF OPIATE DAY 1+ NON URINE,56.0,8.96,10.42,74.37,37
CDM,3030350,LAB DRG DF OXYCODONE DAY NON URINE,56.0,8.96,10.42,74.37,37
CDM,3030368,LAB DRG DF TRAMADOL NON URINE,56.0,8.96,10.42,74.37,37
CDM,3030376,LAB DRG DF FENTANYL DAY NON URINE,56.0,8.96,10.42,74.37,37
CDM,3030384,LAB DRG DF METHYLENEDIOXYAMP NON UR,56.0,8.96,10.42,74.37,37
CDM,3030400,LAB DRG DF AMPH/METH DAY 1-2 NON UR,56.0,8.96,10.42,91.27,37
CDM,3030418,LAB DRG DF BARB PHENOBARB NON URINE,56.0,8.96,10.42,74.37,37
CDM,3030434,LAB DRG DF METHADONE DAY NON URINE,56.0,8.96,10.42,95.99,37
CDM,3030442,LAB DRG DF PHENCYCLDN NON URINE,56.0,8.96,2.17,75.67,40
CDM,3030459,LAB DRG DF CANNABINOIDS DAY NON UR,56.0,8.96,10.42,74.37,37
CDM,3030491,LAB AG CARCINOEMBRYONIC ARUP NS,68.0,10.88,18.96,89.0,63
CDM,3030509,LAB AG CARCINOEMBRYONIC MAYO NS,329.0,52.64,18.96,246.75,63
CDM,3030517,LAB MOPATH LVL2 CARDIO IQ APOE GENO,411.0,114.67,137.0,721.88,63
CDM,3030533,LAB MOPATH LVL2 EML4-ALK,411.0,114.67,137.0,721.88,63
CDM,3030541,LAB MOPATH LVL2 RUNX1,411.0,114.67,137.0,721.88,63
CDM,3030574,LAB IG FREE LIGHT CHAIN CSF EA,263.0,42.08,17.27,197.25,63
CDM,3030582,LAB DET IA MOLD PANEL PCR PRB AMP,778.0,171.94,35.09,583.5,63
CDM,3030590,LAB GENE CHIMERISM WO CELL SLCT,623.0,173.82,207.46,1093.19,63
CDM,3030608,LAB DET IA ORGANISMS FNGL MULT PRB,638.0,141.0,70.2,478.5,63
CDM,3030632,LAB DET IA FUNGAL MULT PRB AMP,1372.0,303.21,70.2,1029.0,63
CDM,3030657,LAB DET IA PNEUM JIROVECII RFLX PRB,421.0,93.04,35.09,315.75,62
CDM,3030665,LAB DET IA TOXOPLASMA RFLX PCR PRB,421.0,93.04,35.09,315.75,63
CDM,3030699,LAB SCR CULT BRUCELLA,97.0,21.44,6.63,72.75,63
CDM,3030715,LAB SYPHILIS VDRL/RPR QL DNR TESTNG,134.0,25.46,4.27,100.5,63
CDM,3030756,LAB SYPHILIS VDRL/RPR QL NS,63.0,11.97,4.27,47.25,63
CDM,3030913,LAB IMM MS ANTI-COLLAGEN 7,294.0,47.04,11.53,220.5,63
CDM,3032257,LAB DRG DF METFORMIN DAY 1-3,182.0,29.12,23.37,136.5,37
CDM,3032265,LAB DRG DF ANLG OPIOID&OPIAT S/P 5+,347.0,55.52,15.93,260.25,37
CDM,3032273,LAB DRG DF ANLG OPIOID&NITAZ S/P 5+,428.0,68.48,15.93,321.0,37
CDM,3032281,LAB DRG DF ANLG OPIOID&OPIAT UR 5+,97.0,15.52,15.93,74.37,37
CDM,3060001,LAB ALDOSTERONE,270.0,43.2,40.75,202.5,63
CDM,3062015,LAB COUNT CELL W DIFF FLUID BODY,17.0,2.92,5.6,26.28,63
CDM,3062023,LAB COUNT CELL FLUID BODY,15.0,2.58,4.72,22.15,63
CDM,3062031,LAB COUNT CELL CSF,15.0,2.58,4.72,22.15,63
CDM,3062049,LAB COUNT CELL W DIFF CSF,17.0,2.92,5.6,26.28,63
CDM,3062056,LAB ID CRYSTAL MICROSCOPY LIGHT,22.0,3.78,7.33,78.63,63
CDM,3062080,LAB ASSESSMENT LEUKOCYTE FECAL,13.0,2.24,4.27,20.09,63
CDM,3062130,LAB SEMEN MOTILITY&CT WO HUHNER,26.0,4.47,3.75,40.44,59
CDM,3062171,LAB AB SPERM,78.0,13.42,10.67,58.5,59
CDM,3062189,LAB STAIN FAT/FECES/URINE/SPUTUM,18.0,3.1,5.88,27.61,63
CDM,3062205,LAB COLLECTION SWEAT IONTOPHORESIS,112.0,19.26,2.88,91.76,63
CDM,3062288,LAB KETONES ACETONE QN,25.0,4.0,8.17,38.32,63
CDM,3062312,LAB PANEL HEPATITIS ACUTE,299.0,47.84,47.63,224.25,63
CDM,3062338,LAB HORMONE ADRENOCORTICOTROPIC,116.0,18.56,38.62,181.27,63
CDM,3062346,LAB ALBUMIN SRM/PLASMA/BLD WHL,63.0,10.08,4.95,47.25,63
CDM,3062379,LAB ALCOHOL BREATH,90.0,14.4,30.0,140.82,63
CDM,3062387,LAB ALDOLASE,53.0,8.48,9.71,45.57,63
CDM,3062395,LAB ALDOSTERONE NS,123.0,19.68,40.75,191.25,63
CDM,3062403,LAB ALDOSTERONE URINE,123.0,19.68,40.75,191.25,63
CDM,3062411,LAB AFP AMNIOTIC FLUID,51.0,8.16,17.0,79.76,63
CDM,3062429,LAB AFP SERUM,51.0,8.16,16.77,78.69,63
CDM,3062445,LAB ALPHA-1-ANTITRYPSIN TOTAL NS,59.0,9.44,13.44,63.06,63
CDM,3062452,LAB ALPHA-1-ANTITRYPSIN PHENOTYPE,63.0,10.08,14.46,67.85,63
CDM,3062460,LAB TRANSFERASE AMINO ALANINE,65.0,10.4,5.3,48.75,63
CDM,3062478,LAB ALUMINUM,77.0,12.32,25.48,119.6,63
CDM,3062536,LAB ACIDS AMINO SGL QN SPEC EA,91.0,14.56,22.98,107.83,63
CDM,3062551,LAB ACIDS AMINO 6+ QN SPEC EA,51.0,8.16,16.87,79.23,63
CDM,3062569,LAB ACIDS AMINO 6+ QN URINE SPEC EA,141.0,22.56,16.87,105.75,63
CDM,3062585,LAB ACID AMINOLEVULINIC DELTA URINE,75.0,12.0,16.45,77.16,63
CDM,3062593,LAB AMIODARONE,90.0,14.4,18.64,87.47,63
CDM,3062619,LAB AMMONIA,69.0,11.04,14.57,68.38,63
CDM,3062650,LAB AMYLASE,20.0,3.2,6.48,30.4,63
CDM,3062668,LAB AMYLASE FLUID BODY,52.0,8.32,6.48,39.0,63
CDM,3062676,LAB AMYLASE TOTAL,54.0,8.64,6.48,40.5,63
CDM,3062684,LAB AMYLASE URINE,53.0,8.48,6.48,39.75,63
CDM,3062718,LAB ANDROSTENEDIONE,88.0,14.08,29.28,137.43,63
CDM,3062734,LAB ANGIOTENSIN I CONVERTING ENZYME,61.0,9.76,14.6,68.52,63
CDM,3062742,LAB ANGIOTENSIN 2,89.0,14.24,20.52,96.32,63
CDM,3062759,LAB APOLIPOPROTEIN EA,64.0,10.24,21.09,98.98,63
CDM,3062767,LAB APOLIPOPROTEIN A1 EA,64.0,10.24,21.09,98.98,63
CDM,3062775,LAB APOLIPOPROTEIN B EA,64.0,10.24,21.09,98.98,63
CDM,3062783,LAB ARSENIC BLOOD NS,63.0,10.08,18.97,89.07,63
CDM,3062791,LAB ARSENIC NON BLOOD,95.0,15.2,18.97,89.07,63
CDM,3062809,LAB TRANSFERASE AMINO ASPARTATE,65.0,10.4,5.18,48.75,63
CDM,3062866,LAB PANEL METAB BASIC W CA TOTAL,377.0,60.32,8.46,282.75,63
CDM,3062882,LAB MICROGLOBULIN BETA-2,58.0,9.28,16.18,75.97,63
CDM,3062890,LAB MICROGLOBULIN BETA-2 URINE,61.0,9.76,16.18,75.97,63
CDM,3062916,LAB KETONES BETA-HYDROXYBUTYRATE QN,60.0,9.6,8.17,45.0,63
CDM,3062932,LAB ACIDS BILE TOTAL,63.0,10.08,17.12,80.36,63
CDM,3062957,LAB BILIRUBIN DIRECT,78.0,12.48,5.02,58.5,63
CDM,3062965,LAB BILIRUBIN DIRECT FLUID BODY,78.0,12.48,5.02,58.5,63
CDM,3062973,LAB BILIRUBIN TOTAL,65.0,10.4,5.02,48.75,63
CDM,3062981,LAB BILIRUBIN TOTAL FLUID BODY,57.0,9.12,5.02,42.75,63
CDM,3063005,LAB GASES BLD ANY COMBO ARTERIAL,123.0,19.68,26.07,122.33,63
CDM,3063021,LAB GASES BLD ANY COMBO W SAT O2,237.0,37.92,78.77,369.72,63
CDM,3063039,LAB GASES BLD SAT O2 ONLY,30.0,4.8,9.77,45.83,63
CDM,3063047,LAB GASES BLD ANY COMBO VENOUS,123.0,19.68,26.07,122.33,63
CDM,3063070,LAB CADMIUM,71.0,11.36,23.64,110.96,63
CDM,3063088,LAB CAFFEINE,116.0,18.56,38.57,181.07,63
CDM,3063096,LAB CALCITONIN,81.0,12.96,26.79,125.72,63
CDM,3063104,LAB CALCIUM IONIZED,77.0,12.32,13.68,64.19,63
CDM,3063112,LAB CALCIUM TOTAL,66.0,10.56,5.16,49.5,63
CDM,3063120,LAB CALCIUM TOTAL URINE,56.0,8.96,5.16,42.0,63
CDM,3063138,LAB CALCIUM URINE QN TIMED,56.0,8.96,6.03,42.0,63
CDM,3063146,LAB CALCULUS SPECTROSCOPY INFRARED,74.0,11.84,12.9,60.53,63
CDM,3063179,LAB CARBAMAZEPINE TOTAL,52.0,8.32,14.57,68.38,63
CDM,3063187,LAB CARBON DIOXIDE HCO3,54.0,8.64,4.88,40.5,63
CDM,3063195,LAB CARBOXYHEMOGLOBIN QN NS,75.0,12.0,12.32,57.81,63
CDM,3063203,LAB AG CARCINOEMBRYONIC,57.0,9.12,18.96,89.0,63
CDM,3063229,LAB CARNITINE TOTAL&FREE QN URINE,115.0,18.4,16.87,86.25,63
CDM,3063237,LAB CARNITINE TOTAL&FREE QN,78.0,12.48,16.87,79.23,63
CDM,3063252,LAB CAROTENE,67.0,10.72,9.22,50.25,63
CDM,3063278,LAB CATECHOLAMINES FRACTIONATED,76.0,12.16,25.25,118.54,63
CDM,3063302,LAB CERULOPLASMIN,53.0,8.48,10.74,50.42,63
CDM,3063310,LAB CHEMILUMINESCENT NITRO URINE,43.0,6.88,14.12,66.25,63
CDM,3063328,LAB CHEMILUMINESCENT,70.0,11.2,14.12,66.25,63
CDM,3063351,LAB CHLORIDE BLOOD,47.0,7.52,4.6,35.25,63
CDM,3063369,LAB CHLORIDE FLUID BODY,15.0,2.4,5.0,23.48,63
CDM,3063385,LAB CHLORIDE OTHER SOURCE,15.0,2.4,5.0,23.48,63
CDM,3063401,LAB CHLORIDE URINE,18.0,2.88,5.75,27.01,63
CDM,3063419,LAB CHOLESTEROL SRM/BLD WHL TTL,55.0,8.8,4.35,41.25,63
CDM,3063427,LAB LIPOPROTEIN CHOLESTEROL HDL,62.0,9.92,8.19,46.5,63
CDM,3063450,LAB CHOLINESTERASE RBC,59.0,9.44,9.81,46.03,63
CDM,3063468,LAB CHOLINESTERASE SERUM,60.0,9.6,7.87,45.0,63
CDM,3063559,LAB CITRATE,84.0,13.44,27.8,130.51,63
CDM,3063641,LAB PANEL METAB COMP,671.0,107.36,10.56,503.25,63
CDM,3063674,LAB COPPER TISSUE NS,211.0,33.76,12.41,158.25,63
CDM,3063682,LAB COPPER URINE,65.0,10.4,12.41,58.27,63
CDM,3063690,LAB CORTICOSTERONE,83.0,13.28,22.52,105.7,63
CDM,3063708,LAB CORTISOL FREE,55.0,8.8,16.71,78.43,63
CDM,3063716,LAB CORTISOL TOTAL,58.0,9.28,16.3,76.5,63
CDM,3063724,LAB CORTISOL TOTAL NS,323.0,51.68,16.3,242.25,63
CDM,3063732,LAB C-PEPTIDE,63.0,10.08,20.81,97.72,63
CDM,3063740,LAB CREATINE KINASE ISOENZYMES,59.0,9.44,13.39,62.86,63
CDM,3063765,LAB CREATINE KINASE MB ONLY QN,66.0,10.56,11.55,54.21,63
CDM,3063781,LAB CREATINE URINE,60.0,9.6,4.64,45.0,63
CDM,3063799,LAB CREATININE BLOOD,60.0,9.6,5.12,45.0,63
CDM,3063807,LAB CREATININE FLUID BODY,56.0,8.96,5.18,42.0,63
CDM,3063815,LAB CREATININE CLEARANCE,29.0,4.64,9.46,44.37,63
CDM,3063823,LAB CREATINE KINASE TOTAL,158.0,25.28,6.51,118.5,63
CDM,3063831,LAB CREATININE OTHER SOURCE,26.0,4.16,5.18,24.35,63
CDM,3063849,LAB CREATININE URINE,26.0,4.16,5.18,24.35,63
CDM,3063864,LAB CRYOGLOBULIN QL/SEMI QN,63.0,10.08,6.47,47.25,63
CDM,3063872,LAB CYANIDE,78.0,12.48,19.4,91.07,63
CDM,3063880,LAB CYCLOSPORINE,55.0,8.8,18.05,84.75,63
CDM,3063898,LAB CYCLOSPORINE A,58.0,9.28,18.05,84.75,63
CDM,3063922,LAB DEOXYCORTISOL 11-,88.0,14.08,29.28,137.43,63
CDM,3063948,LAB DESOXYCORTICOSTERONE,93.0,14.88,30.98,145.41,63
CDM,3063955,LAB DEHYDROEPIANDROSTERONE,76.0,12.16,25.27,118.61,63
CDM,3063963,LAB DEHYDROEPIANDROSTERONE-SULFATE,67.0,10.72,22.23,104.3,63
CDM,3064482,LAB PANEL ELECTROLYTE,158.0,25.28,7.01,118.5,63
CDM,3064490,LAB PROT FRCTN ELECTRO&QN SERUM,57.0,9.12,10.74,78.63,63
CDM,3064516,LAB ELECTRO,185.0,29.6,61.5,288.7,63
CDM,3064532,LAB ACTIVITY ENZYME NONRADIOACTIVE,121.0,19.36,22.17,104.04,63
CDM,3064540,LAB ERYTHROPOIETIN,57.0,9.12,18.79,88.21,63
CDM,3064565,LAB ESTRIOL SERUM NS,73.0,11.68,24.18,113.48,63
CDM,3064581,LAB ESTROGEN TOTAL,66.0,10.56,21.7,132.37,63
CDM,3064607,LAB ESTRONE,75.0,12.0,24.95,117.08,63
CDM,3064631,LAB ETHOSUXIMIDE,107.0,17.12,16.34,80.25,63
CDM,3064649,LAB ETHYLENE GLYCOL,81.0,12.96,14.9,69.91,63
CDM,3064763,LAB FAT/LIPIDS FECES QN,51.0,8.16,16.8,78.83,63
CDM,3064771,LAB ACIDS FATTY NONESTERIFIED,69.0,11.04,18.77,88.14,63
CDM,3064789,LAB FELBAMATE,74.0,11.84,18.64,87.47,63
CDM,3064797,LAB FERRITIN,65.0,10.4,13.63,63.93,63
CDM,3064805,LAB FIBRONECTIN FETAL SEMI QL,194.0,31.04,64.41,302.33,63
CDM,3064813,LAB FLECAINIDE,68.0,10.88,18.64,87.47,63
CDM,3064888,LAB ACID FOLIC RBC,55.0,8.8,17.65,82.88,63
CDM,3064896,LAB ACID FOLIC SERUM,45.0,7.2,14.7,68.98,63
CDM,3064904,LAB GONADOTROPIN FSH SERUM,56.0,8.96,18.58,87.21,63
CDM,3064946,LAB GABAPENTIN SRM/PLASMA/BLD WHL,77.0,12.32,21.67,101.71,63
CDM,3064961,LAB SCR TRANSFERASE GALACTOSE-1,36.0,5.76,11.74,55.08,63
CDM,3064979,LAB IG IGE,58.0,9.28,16.46,77.23,63
CDM,3064987,LAB GASES BLD PH ONLY,33.0,5.28,11.0,51.62,63
CDM,3065000,LAB SCR AB ANCA FL EA AB,54.0,10.26,12.05,52.19,63
CDM,3065018,LAB AB CHANNEL CA VOLTAGE-GATED,444.0,84.36,12.05,333.0,63
CDM,3065026,LAB AB CYTOM FLOW MOG,211.0,40.09,12.05,158.25,63
CDM,3065455,LAB AMYLASE FLUID CYST PANCREATIC,341.0,54.56,6.48,255.75,63
CDM,3071370,LAB PROTHROMBIN TIME NS,63.0,11.53,4.29,47.25,63
CDM,3071560,LAB GONADOTROPIN FSH SERUM NS,58.0,9.28,18.58,87.21,63
CDM,3071578,LAB PROT C-REACTIVE NS,26.0,4.94,5.18,24.35,63
CDM,3071891,LAB CREATININE OTHER SOURCE NS,101.0,16.16,5.18,75.75,63
CDM,3072196,LAB DET IA HEP B PRB AMP,135.0,29.84,35.09,164.7,63
CDM,3072360,LAB IMM MS TRANSGLUTAMINASE NS,35.0,6.65,11.53,49.94,63
CDM,3072808,LAB GENOTYPE IA HIV-1 REV T NS,773.0,170.83,257.45,1208.34,63
CDM,3073004,LAB GASTRIN,58.0,9.28,17.63,82.75,63
CDM,3073038,LAB GENTAMICIN PEAK,50.0,8.0,16.38,76.9,63
CDM,3073046,LAB GENTAMICIN RANDOM,50.0,8.0,16.38,76.9,63
CDM,3073053,LAB GENTAMICIN TROUGH,50.0,8.0,16.38,76.9,63
CDM,3073061,LAB TRANSFERASE GAMMA-GLUTAMYL,22.0,3.52,7.2,33.79,63
CDM,3073079,LAB GLUCAGON,67.0,10.72,14.29,67.05,63
CDM,3073137,LAB GLUCOSE FLUID BODY,56.0,8.96,3.93,42.0,63
CDM,3073152,LAB GLUCOSE CSF,55.0,8.8,3.93,41.25,63
CDM,3073160,LAB GLUCOSE POST DOSE,15.0,2.4,4.75,22.28,63
CDM,3073186,LAB GLUCOSE TOLERANCE SPEC 1ST 3,39.0,6.24,12.87,60.4,63
CDM,3073194,LAB GLUCOSE TOLERANCE SPEC EA ADDL,12.0,1.92,3.92,18.43,63
CDM,3073202,LAB GLUCOSE URINE RANDOM,12.0,1.92,3.93,18.43,63
CDM,3073210,LAB GLUCOSE URINE TIMED,56.0,8.96,3.93,42.0,63
CDM,3073236,LAB PROT GLYCATED,53.0,8.48,16.76,78.69,63
CDM,3073251,LAB HORMONE HUMAN GROWTH,51.0,8.16,16.67,78.29,63
CDM,3073269,LAB H PYLORI UREASE NONRADIOACT,203.0,32.48,67.36,316.17,63
CDM,3073277,LAB HALOPERIDOL,99.0,15.84,15.78,74.25,63
CDM,3073285,LAB HAPTOGLOBIN QN,53.0,8.48,12.58,59.07,63
CDM,3073293,LAB HCG QL,188.0,30.08,7.52,141.0,63
CDM,3073301,LAB HCG QN,71.0,11.36,15.05,70.64,63
CDM,3073319,LAB HCG TUMOR MARKER QN,71.0,11.36,15.05,70.64,63
CDM,3073400,LAB HEAVY METAL QN EA,106.0,16.96,21.96,103.11,63
CDM,3073541,LAB HEMOGLOBIN FETAL QL,123.0,19.68,8.0,92.25,63
CDM,3073558,LAB HEMOGLOBIN PLASMA,59.0,9.44,7.31,44.25,63
CDM,3073566,LAB HEMOGLOBIN URINE,12.0,1.92,3.95,18.56,63
CDM,3073574,LAB HEMOSIDERIN QL,67.0,10.72,4.75,50.25,63
CDM,3073582,LAB PANEL FUNCTION HEPATIC,244.0,39.04,8.17,183.0,63
CDM,3073624,LAB HEMOGLOBIN A1C,47.0,7.52,9.71,45.57,63
CDM,3073632,LAB HISTAMINE,89.0,14.24,29.53,138.63,63
CDM,3073657,LAB HOMOCYSTEINE SERUM,58.0,9.28,17.92,84.08,63
CDM,3073665,LAB ACID HOMOVANILLIC,68.0,10.88,22.41,105.17,63
CDM,3073681,LAB ACID HYDROXYINDOLACETIC 5-,61.0,9.76,12.9,60.53,63
CDM,3073699,LAB HYDROXYPROGESTERONE 17-D NS,82.0,13.12,27.17,127.52,63
CDM,3073707,LAB HYDROXYPROLINE FREE,112.0,17.92,22.65,106.3,63
CDM,3073749,LAB IG IGA IGD IGG IGM SERUM EA,52.0,8.32,9.3,43.64,63
CDM,3073764,LAB IMM MS QL/SEMI QN NS,57.0,9.12,11.53,54.08,63
CDM,3073772,LAB IMM SGL STEP QL/SEMI QN NS,524.0,83.84,9.64,393.0,63
CDM,3073780,LAB IMM MS GLIADIN IGA QL,37.0,7.03,11.53,49.94,63
CDM,3073798,LAB IMM MS GLIADIN IGG QL,37.0,7.03,11.53,49.94,63
CDM,3073814,LAB IMM AB NEURONAL QN,52.0,8.32,17.27,81.09,63
CDM,3073830,LAB IMM ANALYTE OTHER QN,80.0,12.8,17.27,81.09,63
CDM,3073848,LAB IMM POLY PANCREATIC QN,91.0,14.56,17.27,81.09,63
CDM,3073855,LAB IMM RIA PB3 IGF QN,106.0,16.96,18.4,86.34,63
CDM,3073863,LAB IMM RIA QN,94.0,15.04,18.4,86.34,63
CDM,3073871,LAB IMM RIA TRYPSIN QN,82.0,13.12,18.4,86.34,63
CDM,3073897,LAB IG SUBCLASSES EA,59.0,9.44,8.02,44.25,63
CDM,3073905,LAB INSULIN FREE,79.0,12.64,12.95,60.8,63
CDM,3073913,LAB INSULIN TOTAL,57.0,9.12,11.43,53.68,63
CDM,3073921,LAB IRON,20.0,3.2,6.47,30.33,63
CDM,3073939,LAB CAPACITY IRON BINDING,27.0,4.32,8.74,40.98,63
CDM,3074010,LAB KETOSTEROIDS 17- TOTAL,80.0,12.8,12.8,60.07,63
CDM,3074036,LAB LACTATE/LACTIC ACID,115.0,18.4,11.57,86.25,63
CDM,3074044,LAB LACTATE/LACTIC ACID CSF,88.0,14.08,11.57,66.0,63
CDM,3074077,LAB LAMOTRIGINE,66.0,10.56,13.25,62.2,63
CDM,3074085,LAB LDH,30.0,4.8,6.04,28.34,63
CDM,3074093,LAB LDH FLUID BODY,30.0,4.8,6.04,28.34,63
CDM,3074101,LAB LDH CSF,56.0,8.96,6.04,42.0,63
CDM,3074119,LAB LDH ISOENZYMES,59.0,9.44,12.79,60.0,63
CDM,3074127,LAB LEAD BLOOD,59.0,9.44,12.11,56.81,63
CDM,3074135,LAB LEAD NON BLOOD,79.0,12.64,12.11,59.25,63
CDM,3074168,LAB LIDOCAINE,62.0,9.92,14.69,68.91,63
CDM,3074176,LAB LIPASE,187.0,29.92,6.89,140.25,63
CDM,3074184,LAB LIPASE FLUID BODY,52.0,8.32,6.89,39.0,63
CDM,3074192,LAB PANEL LIPID,171.0,27.36,13.39,128.25,63
CDM,3074200,LAB LIPOPROTEIN A,57.0,9.12,14.32,67.19,63
CDM,3074218,LAB LIPOPROTEIN ELECTRO,64.0,10.24,11.26,52.88,63
CDM,3074226,LAB LIPOPROTEIN FRCTN HR,102.0,16.32,33.86,158.92,63
CDM,3074234,LAB LITHIUM,52.0,8.32,6.61,39.0,63
CDM,3074259,LAB GONADOTROPIN LH,58.0,9.28,18.52,86.94,63
CDM,3074283,LAB MAGNESIUM,99.0,15.84,6.7,74.25,63
CDM,3074291,LAB MAGNESIUM STOOL,21.0,3.36,6.7,31.46,63
CDM,3074309,LAB MAGNESIUM URINE,52.0,8.32,6.7,39.0,63
CDM,3074325,LAB MANGANESE,80.0,12.8,26.65,125.12,63
CDM,3074390,LAB MERCURY BLOOD QN,49.0,7.84,16.26,76.3,63
CDM,3074408,LAB MERCURY NON BLOOD QN,88.0,14.08,16.26,76.3,63
CDM,3074416,LAB METANEPHRINES,66.0,10.56,16.94,79.49,63
CDM,3074473,LAB METHOTREXATE,116.0,18.56,38.57,167.05,63
CDM,3074515,LAB MICROALBUMIN URINE QN,56.0,8.96,5.78,42.0,63
CDM,3074770,LAB PROT MYELIN BASIC CSF,63.0,10.08,17.2,80.69,63
CDM,3074788,LAB MYOGLOBIN,59.0,9.44,12.92,60.67,63
CDM,3074796,LAB MYOGLOBIN URINE,59.0,9.44,12.92,60.67,63
CDM,3074820,LAB NEPHELOMETRY ANALYTE EA,41.0,6.56,13.6,63.79,63
CDM,3074861,LAB NUCLEOTIDASE 5-,99.0,15.84,11.15,74.25,63
CDM,3074887,LAB BLOOD OCCULT FECES SINGLE QL,14.0,2.24,4.38,20.55,63
CDM,3074903,LAB BLOOD OCCULT OTHER SOURCE QL,16.0,2.56,5.32,24.95,63
CDM,3074937,LAB BANDS OLIGOCLONAL CSF,83.0,13.28,27.39,128.52,63
CDM,3074952,LAB ACID ORGANIC SINGLE QN,195.0,31.2,21.21,146.25,63
CDM,3074960,LAB ACID ORGANIC SINGLE METHY QN NS,64.0,10.24,21.21,99.58,63
CDM,3074978,LAB ACIDS ORGANIC EA QL,50.0,8.0,16.45,77.16,63
CDM,3074986,LAB ACIDS ORGANIC URINE EA QL,50.0,8.0,16.45,77.16,63
CDM,3074994,LAB ACIDS ORGANIC TOTAL EA QN,406.0,64.96,23.6,304.5,63
CDM,3075009,LAB ACIDS ORGANIC TOTAL URINE EA QN,101.0,16.16,23.6,110.76,63
CDM,3075017,LAB OSMOLALITY BLOOD,56.0,8.96,6.61,42.0,63
CDM,3075033,LAB OSMOLALITY STOOL,68.0,10.88,12.65,176.48,37
CDM,3075041,LAB OSMOLALITY URINE,56.0,8.96,6.82,42.0,63
CDM,3075058,LAB OSTEOCALCIN,90.0,14.4,29.85,140.09,63
CDM,3075066,LAB OXALATE,109.0,17.44,14.45,81.75,63
CDM,3075074,LAB OXALATE URINE,67.0,10.72,14.45,67.85,63
CDM,3075132,LAB PH FLUID BODY NOS,51.0,8.16,3.58,38.25,63
CDM,3075165,LAB PHENOBARBITAL,53.0,8.48,15.3,71.78,63
CDM,3075181,LAB PHENYLALANINE BLOOD,17.0,2.72,5.5,25.81,63
CDM,3075215,LAB PHENYTOIN FREE,63.0,10.08,13.76,64.59,63
CDM,3075223,LAB PHENYTOIN TOTAL,53.0,8.48,13.25,62.2,63
CDM,3075249,LAB ACID PHOSPHATASE PROSTATIC,60.0,9.6,9.66,45.3,63
CDM,3075256,LAB ALKALINE PHOSPHATASE HEAT,25.0,4.0,8.26,38.78,63
CDM,3075264,LAB ALKALINE PHOSPHATASE ISOENZYMES,57.0,9.12,14.78,69.38,63
CDM,3075272,LAB ALKALINE PHOSPHATASE,70.0,11.2,5.18,52.5,63
CDM,3075298,LAB PHOSPHORUS INORGANIC,61.0,9.76,4.74,45.75,63
CDM,3075306,LAB PHOSPHORUS INORGANIC URINE,52.0,8.32,5.78,39.0,63
CDM,3075322,LAB PORPHOBILINOGEN URINE QN,62.0,9.92,8.44,46.5,63
CDM,3075330,LAB PORPHYRINS URINE QN&FRCTN,62.0,9.92,14.71,69.05,63
CDM,3075355,LAB POTASS SRM/PLASMA/BLD WHL,60.0,9.6,4.76,45.0,63
CDM,3075363,LAB POTASS FLUID BODY,56.0,8.96,10.42,176.48,37
CDM,3075389,LAB POTASS URINE,55.0,8.8,4.73,41.25,63
CDM,3075397,LAB PREALBUMIN,54.0,8.64,14.59,68.45,63
CDM,3075421,LAB PREGNENOLONE,63.0,10.08,20.67,97.05,63
CDM,3075439,LAB 17-HYDROXYPREGNENOLONE,69.0,11.04,22.81,107.03,63
CDM,3075454,LAB PEPTIDE NATRIURETIC PB,286.0,45.76,39.26,214.5,63
CDM,3075462,LAB PROCAINAMIDE W NAPA,51.0,8.16,16.75,78.63,63
CDM,3075470,LAB PROGESTERONE,63.0,10.08,20.86,97.92,63
CDM,3075488,LAB PROINSULIN,81.0,12.96,26.69,125.26,63
CDM,3075496,LAB PROLACTIN,59.0,9.44,19.38,90.93,63
CDM,3075553,LAB PROT FLUID BODY,12.0,1.92,4.0,18.76,63
CDM,3075561,LAB PROT FLUID CEREBROSPINAL,56.0,8.96,4.0,42.0,63
CDM,3075579,LAB PROT TTL SRM/PLASMA/BLD WHL,56.0,8.96,3.67,42.0,63
CDM,3075587,LAB PROT URINE,56.0,8.96,3.67,42.0,63
CDM,3075595,LAB PROT URINE TIMED,12.0,1.92,3.67,17.23,63
CDM,3075603,LAB PROTOPORPHYRIN RBC QN,111.0,17.76,14.35,83.25,63
CDM,3075645,LAB PSA FREE,56.0,8.96,18.39,86.34,63
CDM,3075652,LAB PSA TOTAL,56.0,8.96,18.39,86.34,63
CDM,3075660,LAB PARATHORMONE,124.0,19.84,41.28,193.71,63
CDM,3075678,LAB PARATHORMONE C-TERMINAL,124.0,19.84,41.28,193.71,63
CDM,3075694,LAB PARATHORMONE INTRAOP POST 10 MN,124.0,19.84,41.28,193.71,63
CDM,3075702,LAB PARATHORMONE INTRAOP POST 5 MN,124.0,19.84,41.28,193.71,63
CDM,3075710,LAB PARATHORMONE INTRAOP BASELINE 1,124.0,19.84,41.28,193.71,63
CDM,3075728,LAB PARATHORMONE INTRAOP BASELINE 2,124.0,19.84,41.28,193.71,63
CDM,3075736,LAB PARATHORMONE INTRAOP EA ADDL,124.0,19.84,41.28,193.71,63
CDM,3075751,LAB PYRUVATE,44.0,7.04,14.48,67.98,63
CDM,3075769,LAB QUINIDINE,60.0,9.6,14.6,68.52,63
CDM,3075777,LAB QUININE,136.0,21.76,11.63,102.0,63
CDM,3075819,LAB RECEPTOR ACETYLCHOLINE NON-ENDO,110.0,17.6,36.57,171.62,63
CDM,3075843,LAB PANEL FUNCTION RENAL,230.0,36.8,8.68,172.5,63
CDM,3075850,LAB RENIN,140.0,22.4,21.99,105.0,63
CDM,3075884,LAB SELENIUM,77.0,12.32,25.53,119.87,63
CDM,3075892,LAB SEROTONIN,93.0,14.88,30.98,145.41,63
CDM,3075900,LAB HORMONE SEX BINDING GLOBULIN,66.0,10.56,21.73,101.98,63
CDM,3075934,LAB SODIUM SRM/PLASMA/BLD WHL,48.0,7.68,4.81,36.0,63
CDM,3075942,LAB SODIUM FLUID BODY,15.0,2.4,4.86,22.82,63
CDM,3075975,LAB SODIUM URINE,16.0,2.56,5.06,23.75,63
CDM,3075983,LAB SODIUM URINE TIMED,16.0,2.56,5.06,23.75,63
CDM,3075991,LAB SODIUM OTHER SOURCE,15.0,2.4,4.86,22.82,63
CDM,3076015,LAB SOMATOSTATIN,82.0,13.12,18.28,85.81,63
CDM,3076031,LAB GRAVITY SPECIFIC FLUID BODY,10.0,1.6,3.28,15.37,63
CDM,3076049,LAB SPCTPHOT SULFONAMIDE,25.0,4.0,8.1,38.05,63
CDM,3076056,LAB SPCTPHOT ANALYTE NS,58.0,9.28,8.1,43.5,63
CDM,3076072,LAB SUGARS MULTIPLE QL EA,229.0,36.64,5.5,171.75,63
CDM,3076080,LAB SULFATE URINE,17.0,2.72,5.49,25.74,63
CDM,3076098,LAB HEMOGLOBIN SULFHEMOGLOBIN QN,172.0,27.52,8.8,129.0,63
CDM,3076114,LAB UPTAKE HORMONE T3,56.0,8.96,6.47,42.0,63
CDM,3076122,LAB TACROLIMUS FK-506,57.0,9.12,13.73,64.46,63
CDM,3076148,LAB TESTOSTERONE TOTAL,78.0,12.48,25.81,121.13,63
CDM,3076155,LAB TESTOSTERONE FREE,77.0,12.32,25.47,119.54,63
CDM,3076189,LAB THEOPHYLLINE,43.0,6.88,14.14,66.39,63
CDM,3076197,LAB THIOCYANATE,35.0,5.6,11.63,54.61,63
CDM,3076221,LAB THYROGLOBULIN,58.0,9.28,16.06,75.37,63
CDM,3076239,LAB THYROXINE BINDING GLOBULIN,45.0,7.2,14.78,69.38,63
CDM,3076247,LAB THYROID STIMULATING IMMUN GLOB,153.0,24.48,50.86,238.74,63
CDM,3076254,LAB THYROXINE T4 FREE,43.0,6.88,9.02,42.37,63
CDM,3076262,LAB THYROXINE T4 TOTAL,56.0,8.96,6.87,42.0,63
CDM,3076288,LAB TOBRAMYCIN PEAK,49.0,7.84,16.13,75.7,63
CDM,3076296,LAB TOBRAMYCIN RANDOM,49.0,7.84,16.13,75.7,63
CDM,3076304,LAB TOBRAMYCIN TROUGH,49.0,7.84,16.13,75.7,63
CDM,3076338,LAB TOPIRAMATE,36.0,5.76,11.92,55.94,63
CDM,3076353,LAB TRANSFERRIN,61.0,9.76,12.76,59.87,63
CDM,3076361,LAB DRG DF TRAZODONE DAY,70.0,11.2,12.75,74.37,37
CDM,3076395,LAB TRIGLYCERIDES,73.0,11.68,5.74,54.75,63
CDM,3076403,LAB TRIGLYCERIDES FLUID BODY,73.0,11.68,5.74,54.75,63
CDM,3076411,LAB TRIIODOTHYRONINE T3 FREE,54.0,8.64,16.94,79.49,63
CDM,3076429,LAB TRIIODOTHYRONINE T3 REVERSE,59.0,9.44,15.76,73.97,63
CDM,3076437,LAB TRIIODOTHYRONINE T3 TOTAL,43.0,6.88,14.18,66.52,63
CDM,3076460,LAB TROPONIN QN,249.0,39.84,12.47,186.75,63
CDM,3076486,LAB THYROID STIMULATING HORMONE,246.0,39.36,16.8,184.5,63
CDM,3076494,LAB TYROSINE,100.0,16.0,10.63,75.0,63
CDM,3076510,LAB NITROGEN UREA QN,83.0,13.28,3.95,62.25,63
CDM,3076536,LAB NITROGEN UREA URINE,52.0,8.32,5.56,39.0,63
CDM,3076544,LAB ACID URIC BLOOD,23.0,3.68,4.52,21.22,63
CDM,3076551,LAB ACID URIC FLUID BODY,16.0,2.56,5.08,23.81,63
CDM,3076569,LAB ACID URIC OTHER SOURCE,16.0,2.56,5.08,23.81,63
CDM,3076577,LAB ACID URIC URINE,56.0,8.96,5.08,42.0,63
CDM,3076619,LAB VANCOMYCIN PEAK,64.0,10.24,13.54,63.53,63
CDM,3076627,LAB VANCOMYCIN RANDOM,64.0,10.24,13.54,63.53,63
CDM,3076635,LAB VANCOMYCIN TROUGH,64.0,10.24,13.54,63.53,63
CDM,3076643,LAB ACID VANILLYLMANDELIC URINE,82.0,13.12,15.5,72.71,63
CDM,3076650,LAB VASOACTIVE INTS PEPTIDE NS,160.0,25.6,35.33,165.83,63
CDM,3076668,LAB VASOPRESSIN,102.0,16.32,33.94,159.32,63
CDM,3076700,LAB RIBOFLAVIN,74.0,11.84,20.24,94.99,63
CDM,3076718,LAB PYRIDOXAL PHOSPHATE,85.0,13.6,28.1,131.91,63
CDM,3076726,LAB ACID ASCORBIC BLOOD,59.0,9.44,9.89,46.43,63
CDM,3076734,LAB VITAMIN D 1 25 DIHYDROXY FRAC,116.0,18.56,38.5,234.88,63
CDM,3076759,LAB VITAMIN D 25 HYDROXY W FRAC NS,89.0,14.24,29.6,155.32,63
CDM,3076767,LAB TOCOPHEROL ALPHA,62.0,9.92,14.18,66.52,63
CDM,3076775,LAB VITAMIN A,62.0,9.92,11.61,54.48,63
CDM,3076783,LAB THIAMINE,64.0,10.24,21.23,99.65,63
CDM,3076791,LAB CYANOCOBALAMIN,72.0,11.52,15.08,70.78,63
CDM,3076809,LAB VITAMIN K,85.0,13.6,13.72,64.39,63
CDM,3076833,LAB PROT WB W INTRP ID BAND,139.0,22.24,29.21,126.51,63
CDM,3076841,LAB PROT WB W INTRP,104.0,16.64,17.03,78.63,63
CDM,3076874,LAB ZINC NS,135.0,21.6,11.39,101.25,63
CDM,3076924,LAB AB ADENOVIRUS,61.0,11.59,12.87,60.4,63
CDM,3076940,LAB AGGLUTININS FEBRILE AG EA,21.0,3.99,6.98,32.73,63
CDM,3076965,LAB AB AMOEBIC,65.0,12.35,12.39,58.14,63
CDM,3076973,LAB SCR ANA,53.0,10.07,12.09,56.74,63
CDM,3076981,LAB ANA TITER,59.0,11.21,11.16,52.35,63
CDM,3077005,LAB ANTISTREPTOLYSIN O TITER,57.0,10.83,7.3,42.75,63
CDM,3077013,LAB AB ASPERGILLUS,55.0,10.45,15.05,70.64,63
CDM,3077039,LAB AB BARTONELLA,62.0,11.78,10.18,62.13,63
CDM,3077047,LAB AB BETA 2 GLYCOPROTEIN I,77.0,14.63,25.45,119.47,63
CDM,3077054,LAB DET AB BLASTOMYCES NS,78.0,14.82,12.9,60.53,63
CDM,3077070,LAB BLOOD TYPE ABO,284.0,48.85,2.99,213.0,63
CDM,3077088,LAB BLOOD TYPE RHD,80.0,13.76,2.99,60.0,63
CDM,3077104,LAB AB BORDETELLA,70.0,13.3,13.19,61.93,63
CDM,3077112,LAB AB BRUCELLA,67.0,12.73,8.93,50.25,63
CDM,3077138,LAB AB CANDIDA,71.0,13.49,12.01,56.41,63
CDM,3077146,LAB AB CARDIOLIPIN IG EA,80.0,15.2,25.45,119.47,63
CDM,3077153,LAB AB CHLAMYDIA,81.0,15.39,11.82,60.75,63
CDM,3077179,LAB AB CHLAMYDIA PNEU IGG IGA,61.0,11.59,11.82,55.48,63
CDM,3077187,LAB AB CHLAMYDIA PNEUM IGM,61.0,11.59,12.68,59.47,63
CDM,3077195,LAB AB CHLAMYDIA PSITTACI IGG IGA,61.0,11.59,11.82,55.48,63
CDM,3077203,LAB AB CHLAMYDIA PSITTACI IGM,61.0,11.59,12.68,59.47,63
CDM,3077211,LAB AB CHLAMYDIA TRAC IGM,61.0,11.59,12.68,59.47,63
CDM,3077229,LAB AB CYTOMEGALOVIRUS,60.0,11.4,14.39,67.52,63
CDM,3077237,LAB AB CYTOMEGALOVIRUS IGM,61.0,11.59,16.85,79.09,63
CDM,3077245,LAB AB CYTOMEGALOVIRUS IGM NS,51.0,9.69,16.85,79.09,63
CDM,3077252,LAB AB COCCIDIOIDES,55.0,10.45,11.47,53.81,63
CDM,3077260,LAB AB COCCIDIOIDES IGG,63.0,11.97,11.47,53.81,63
CDM,3077278,LAB AB COCCIDIOIDES IGM,63.0,11.97,11.47,53.81,63
CDM,3077286,LAB SCR AGGLUTININ COLD,25.0,4.75,8.07,37.92,63
CDM,3077294,LAB AGGLUTININ COLD TITER,25.0,4.75,8.06,37.85,63
CDM,3077377,LAB COMPLEMENT ACT FUNC C1 ESTER,66.0,12.54,12.0,56.34,63
CDM,3077385,LAB COMPLEMENT AG C1Q COMP EA,76.0,14.44,12.0,57.0,63
CDM,3077393,LAB COMPLEMENT AG C2 COMP EA,36.0,6.84,12.0,56.34,63
CDM,3077401,LAB COMPLEMENT AG C3 COMP EA,36.0,6.84,12.0,56.34,63
CDM,3077419,LAB COMPLEMENT AG C4 COMP EA,53.0,10.07,12.0,56.34,63
CDM,3077427,LAB COMPLEMENT AG C5 COMP EA,77.0,14.63,12.0,57.75,63
CDM,3077443,LAB COMPLEMENT AG C1 ESTER NONFUNC,36.0,6.84,12.0,56.34,63
CDM,3077468,LAB COMPLEMENT ACT FUNC,66.0,12.54,12.0,56.34,63
CDM,3077484,LAB COMPLEMENT TOTAL HEMOLYTIC,61.0,11.59,20.32,95.39,63
CDM,3077492,LAB COOMBS INDIRECT TITER AB EA NS,363.0,68.97,5.18,272.25,63
CDM,3077500,LAB COOMBS INDIRECT TITER AB EA,363.0,68.97,5.18,272.25,63
CDM,3077526,LAB AB COXIELLA BRUNETII,57.0,10.83,12.12,56.87,63
CDM,3077534,LAB AB COXSACKIE,53.0,10.07,13.03,61.13,63
CDM,3077542,LAB PROT C-REACTIVE SENS HIGH,57.0,10.83,12.95,60.8,63
CDM,3077559,LAB PROT C-REACTIVE,26.0,4.94,5.18,24.35,63
CDM,3077567,LAB CROSSMATCH ANTIGLOBULIN,363.0,62.44,2.11,299.97,63
CDM,3077575,LAB CROSSMATCH SPIN IMMEDIATE,363.0,62.44,1.99,299.97,63
CDM,3077609,LAB SCR SERUM PRA CYTOTOXIC QUICK,90.0,17.1,29.68,156.39,63
CDM,3077617,LAB AB DEOXYRIBONUCLEASE,40.0,7.6,13.25,62.2,63
CDM,3077625,LAB AB DIPTHERIA,63.0,11.97,15.21,71.38,63
CDM,3077633,LAB AB DNA STRANDED NATVE/DOUBLE,42.0,7.98,13.74,64.46,63
CDM,3077658,LAB AB EBV EARLY AG,55.0,10.45,13.12,61.6,63
CDM,3077666,LAB AB EBV EBNA,46.0,8.74,15.29,71.78,63
CDM,3077674,LAB AB EBV VCA IGG,55.0,10.45,18.14,85.15,63
CDM,3077682,LAB AB EBV VCA IGM,62.0,11.78,18.14,85.15,63
CDM,3077690,LAB AB EBV VCA,55.0,10.45,18.14,85.15,63
CDM,3077716,LAB AB EHRLICHIA,80.0,15.2,10.18,60.0,63
CDM,3077732,LAB AB ENA RNP,55.0,10.45,17.93,84.15,63
CDM,3077757,LAB AB ENA SCLERODERMA,123.0,23.37,17.93,92.25,63
CDM,3077765,LAB AB ENA SMITH,55.0,10.45,17.93,84.15,63
CDM,3077773,LAB AB ENA SS-A/RO,55.0,10.45,17.93,84.15,63
CDM,3077781,LAB AB ENA SS-B/LA,55.0,10.45,17.93,84.15,63
CDM,3077799,LAB AB ENCEPHALITIS CALIFORNIA,65.0,12.35,13.19,61.93,63
CDM,3077807,LAB AB ENCEPHALITIS EQUINE EASTERN,65.0,12.35,13.19,61.93,63
CDM,3077815,LAB AB ENCEPHALITIS SAINT LOUIS NS,65.0,12.35,13.19,61.93,63
CDM,3077823,LAB AB ENCEPHALITIS EQUINE WEST NS,65.0,12.35,13.19,61.93,63
CDM,3077831,LAB AB ENTEROVIRUS,40.0,7.6,13.03,61.13,63
CDM,3077849,LAB THAWING PLASMA FRESH FROZEN,363.0,62.44,1.12,299.97,63
CDM,3077856,LAB SCR AB FL NS,55.0,10.45,12.05,78.63,63
CDM,3077872,LAB SCR AB ADRENAL FL,37.0,7.03,12.05,78.63,63
CDM,3077880,LAB SCR AB ANTICENTROMERE FL,37.0,7.03,12.05,78.63,63
CDM,3077906,LAB SCR AB ENDOMYSIAL FL,61.0,11.59,12.09,52.36,63
CDM,3077922,LAB SCR AB HISTONE FL,37.0,7.03,12.05,78.63,63
CDM,3077948,LAB SCR AB PARIETAL FL,55.0,10.45,12.05,78.63,63
CDM,3077955,LAB SCR AB RETICULUM FL,54.0,10.26,12.05,78.63,63
CDM,3077963,LAB SCR AB MUSCLE SMOOTH FL,60.0,11.4,11.53,49.94,63
CDM,3077971,LAB SCR AB MUSCLE STRIATED FL,37.0,7.03,12.05,78.63,63
CDM,3077989,LAB AB FL TITER,37.0,7.03,12.05,78.63,63
CDM,3078011,LAB AB FL TITER HU,55.0,10.45,12.05,78.63,63
CDM,3078029,LAB AB FL TITER MITOCHONDRIA,60.0,11.4,12.05,78.63,63
CDM,3078045,LAB AB FL TITER PARIETAL,55.0,10.45,12.05,78.63,63
CDM,3078052,LAB AB FL TITER PURKINJE,190.0,36.1,12.05,142.5,63
CDM,3078060,LAB AB FL TITER MUSCLE SMOOTH,37.0,7.03,12.05,78.63,63
CDM,3078078,LAB AB FL TITER MUSCLE STRIATED,65.0,12.35,12.05,78.63,63
CDM,3078086,LAB SCR AB FL,37.0,7.03,12.05,78.63,63
CDM,3078094,LAB AB FRANCISELLA TULARENSIS,100.0,19.0,14.16,75.0,63
CDM,3078110,LAB AB FUNGUS NOT SPECIFIED,55.0,10.45,12.25,57.47,63
CDM,3078128,LAB AB GIARDIA LAMBLIA,67.0,12.73,14.72,69.11,63
CDM,3078136,LAB AB HELICOBACTER PYLORI,78.0,14.82,16.85,79.09,63
CDM,3078144,LAB AB HELMINTH NONSPECIFIED,64.0,12.16,13.01,61.07,63
CDM,3078169,LAB AB HAEMOPHILUS INFLUENZA IGG,62.0,11.78,15.84,74.37,63
CDM,3078185,LAB AB HEPATITIS A IGM,84.0,15.96,11.26,63.0,63
CDM,3078201,LAB AB HEPATITIS B CORE IGM,89.0,16.91,11.77,66.75,63
CDM,3078219,LAB AB HEPATITIS B CORE TOTAL,55.0,10.45,12.05,56.54,63
CDM,3078227,LAB AB HEPATITIS B SURFACE,55.0,10.45,10.74,50.42,63
CDM,3078235,LAB AB HEPATITIS BE,59.0,11.21,11.57,54.28,63
CDM,3078243,LAB AB HEPATITIS C,93.0,17.67,14.27,69.75,63
CDM,3078250,LAB AB HEPATITIS C CONFIRMATORY,47.0,8.93,15.49,72.71,63
CDM,3078268,LAB AB HEPATITIS DELTA AGENT,85.0,16.15,17.16,80.56,63
CDM,3078276,LAB AB HERPES SIMPLEX NONSPECIFIC,44.0,8.36,14.39,67.52,63
CDM,3078284,LAB AB HERPES SIMPLEX TYPE 1,40.0,7.6,13.19,80.42,63
CDM,3078292,LAB AB HERPES SIMPLEX TYPE 2,59.0,11.21,19.35,118.14,63
CDM,3078300,LAB SCR AB HETEROPHILE,16.0,3.04,5.18,24.35,63
CDM,3078326,LAB AB HISTOPLASMA IMMUNODIFFUSION,68.0,12.92,13.79,64.72,63
CDM,3078334,LAB AB HIV-1,76.0,14.44,8.89,57.0,63
CDM,3078342,LAB AB HIV-1&HIV-2 RESULT SGL,42.0,7.98,13.71,64.32,63
CDM,3078359,LAB AB HIV-2,88.0,16.72,13.52,66.0,63
CDM,3078375,LAB BLOOD TYPE HLA B-27 AG SINGLE,78.0,14.82,25.81,183.46,63
CDM,3078417,LAB BLOOD TYPE HLA DR/DQ AG SGL,91.0,17.29,30.17,158.98,63
CDM,3078425,LAB AB HTLV-I,28.0,5.32,9.09,42.64,63
CDM,3078458,LAB IMMUNE COMPLEX,74.0,14.06,24.37,114.35,63
CDM,3078466,LAB IMMUNE COMPLEX C1Q BINDING,74.0,14.06,24.37,114.35,63
CDM,3078482,LAB IMM AB QL/SEMI QN SGL STEP,245.0,46.55,18.09,183.75,63
CDM,3078508,LAB IMM AG TUMOR CA 125,63.0,11.97,20.81,97.72,63
CDM,3078516,LAB IMM AG TUMOR CA 15-3,63.0,11.97,20.81,97.72,63
CDM,3078524,LAB IMM AG TUMOR CA 19-9,63.0,11.97,20.81,97.72,63
CDM,3078532,LAB IMM AG TUMOR CA 27-29,63.0,11.97,20.81,97.72,63
CDM,3078540,LAB IMM AG TUMOR OTHER QN NS,75.0,14.25,20.81,97.72,63
CDM,3078565,LAB IMDF,55.0,10.45,14.05,65.99,63
CDM,3078573,LAB IMDF GEL AB/AG QL,36.0,6.84,11.98,56.28,63
CDM,3078581,LAB IMMUNOELECTROPHORESIS OTHER,70.0,13.3,23.13,100.18,63
CDM,3078599,LAB IMMUNOELECTROPHORESIS SERUM,90.0,17.1,29.92,129.58,63
CDM,3078615,LAB IMMUNOFIXATION EP URINE/CSF,89.0,16.91,29.35,127.11,63
CDM,3078631,LAB AB INFLUENZA A,68.0,12.92,13.55,63.59,63
CDM,3078656,LAB AB INFLUENZA B,68.0,12.92,13.55,63.59,63
CDM,3078664,LAB INHIBIN A NS,77.0,14.63,15.59,73.17,63
CDM,3078672,LAB AB INSULIN,66.0,12.54,21.41,100.51,63
CDM,3078680,LAB AB INTRINSIC FACTOR,59.0,11.21,15.08,70.78,63
CDM,3078698,LAB AB ISLET CELL NS,71.0,13.49,23.57,110.62,63
CDM,3078714,LAB AB LEGIONELLA,72.0,13.68,15.3,71.78,63
CDM,3078722,LAB AB LEISHMANIA,37.0,7.03,12.25,57.47,63
CDM,3078748,LAB AB ID LEUKOCYTE,55.0,10.45,15.05,70.64,63
CDM,3078755,LAB AB ID LEUKOCYTE NS,54.0,10.26,15.05,70.64,63
CDM,3078813,LAB TRANSFORM LYMPHOCYTE MITOGEN,205.0,38.95,49.03,230.09,63
CDM,3078839,LAB AB CHORIOMENINGITIS LYMPHOCYTIC,62.0,11.78,12.87,60.4,63
CDM,3078854,LAB AB MICROSOMAL EA,44.0,8.36,14.55,68.25,63
CDM,3078862,LAB AB MICROSOMAL LIVER-KIDNEY EA,63.0,11.97,14.55,68.25,63
CDM,3078870,LAB AB MICROSOMAL THYROID EA,44.0,8.36,14.55,68.25,63
CDM,3078888,LAB AB MUMPS,61.0,11.59,13.05,61.26,63
CDM,3078896,LAB AB MUMPS IGG,56.0,10.64,13.05,61.26,63
CDM,3078904,LAB AB MUMPS IGM,62.0,11.78,13.05,61.26,63
CDM,3078938,LAB AB MYCOPLASMA IGM,55.0,10.45,13.24,62.13,63
CDM,3078953,LAB NEUTRALIZATION VIRAL,69.0,13.11,16.91,79.36,63
CDM,3078961,LAB DYE TETRAZOLIUM NITROBLUE NS,236.0,44.84,13.61,177.0,63
CDM,3078995,LAB SCR AB CRYPTO AGG PARTICLE,59.0,11.21,11.54,54.15,63
CDM,3079019,LAB SCR AB NEISS AGG PARTICLE,74.0,14.06,11.54,55.5,63
CDM,3079027,LAB SCR AB NEISS GRP A AGG PARTICLE,53.0,10.07,11.54,54.15,63
CDM,3079043,LAB SCR AB NEISS GRP C AGG PARTICLE,53.0,10.07,11.54,54.15,63
CDM,3079050,LAB SCR AB STREP PNEUMO AGGPARTICLE,53.0,10.07,11.54,54.15,63
CDM,3079076,LAB AGG PARTICLE TITER,59.0,11.21,10.64,49.89,63
CDM,3079092,LAB AB PARVOVIRUS B19 IGG,62.0,11.78,15.03,70.58,63
CDM,3079100,LAB AB PARVOVIRUS B19 IGM,62.0,11.78,15.03,70.58,63
CDM,3079118,LAB AB ANTIPHOSPHATIDYLSERINE,57.0,10.83,16.07,75.43,63
CDM,3079134,LAB AB ID PLATELET PATIENT SERUM,56.0,10.64,18.37,86.21,63
CDM,3079175,LAB SCR ALLG IGE QL MULTI,56.0,10.64,7.97,42.0,63
CDM,3079183,LAB ELUTION AB RBC EA,363.0,68.97,1.78,299.97,63
CDM,3079209,LAB FACTOR RHEUMATOID QL,70.0,13.3,6.14,52.5,63
CDM,3079217,LAB FACTOR RHEUMATOID QN,18.0,3.42,5.67,26.61,63
CDM,3079225,LAB AB RICKETTSIA,71.0,13.49,19.35,90.8,63
CDM,3079258,LAB AB RSV,72.0,13.68,15.89,74.57,63
CDM,3079274,LAB AB RUBELLA IGG,56.0,10.64,14.39,67.52,63
CDM,3079282,LAB AB RUBELLA IGM NS,56.0,10.64,14.39,67.52,63
CDM,3079290,LAB AB RUBELLA TITER,44.0,8.36,14.39,67.52,63
CDM,3079308,LAB AB RUBEOLA IGG,60.0,11.4,12.88,60.47,63
CDM,3079316,LAB AB RUBEOLA IGM,56.0,10.64,12.88,60.47,63
CDM,3079324,LAB AB RUBEOLA TITER NS,39.0,7.41,12.88,60.47,63
CDM,3079340,LAB AB SALMONELLA,73.0,13.87,13.19,61.93,63
CDM,3079373,LAB SYPHILIS VDRL/RPR QL,52.0,9.88,4.27,39.0,63
CDM,3079381,LAB SYPHILIS VDRL/RPR QL CSF,62.0,11.78,4.27,46.5,63
CDM,3079399,LAB SYPHILIS VDRL/RPR QN,52.0,9.88,4.4,39.0,63
CDM,3079407,LAB COUNT CELLS T CD4&CD8 RATIO,141.0,26.79,46.98,220.45,63
CDM,3079415,LAB COUNT TOTAL CELLS T,114.0,21.66,37.73,177.08,63
CDM,3079431,LAB AB TETANUS,63.0,11.97,14.8,69.51,63
CDM,3079449,LAB AB THYROGLOBULIN,57.0,10.83,15.91,74.64,63
CDM,3079456,LAB AB TOXOPLASMA,44.0,8.36,14.39,67.52,63
CDM,3079464,LAB AB TOXOPLASMA IGG NS,63.0,11.97,14.39,67.52,63
CDM,3079472,LAB AB TOXOPLASMA IGM NS,63.0,11.97,14.41,67.65,63
CDM,3079498,LAB AB TRICHINELLA,69.0,13.11,12.56,58.94,63
CDM,3079514,LAB AB VARICELLA-ZOSTER IGG,39.0,7.41,12.88,60.47,63
CDM,3079522,LAB AB VARICELLA-ZOSTER IGM,39.0,7.41,12.88,60.47,63
CDM,3079530,LAB AB VIRUS NONSPECIFIED,240.0,45.6,12.88,180.0,63
CDM,3079548,LAB PROT C ACT RESISTANCE,66.0,12.08,15.32,71.91,63
CDM,3079555,LAB ANTIPLASMIN ALPHA-2,24.0,4.39,7.71,36.19,63
CDM,3079563,LAB CLOTTING ACT ANTITHROM 3,63.0,11.53,11.85,55.61,63
CDM,3079589,LAB COUNT BLD LEUKO AUTO,8.0,1.46,2.54,11.91,63
CDM,3079605,LAB COUNT BLD PLATELET AUTOMATED,14.0,2.56,4.48,21.02,63
CDM,3079613,LAB COUNT BLD RBC AUTO,10.0,1.83,3.02,14.17,63
CDM,3079639,LAB COUNT BLD RETIC MANUAL,13.0,2.38,4.31,20.22,63
CDM,3079654,LAB COUNT BLD DIFF MANUAL WBC,54.0,9.88,3.8,40.5,63
CDM,3079688,LAB CBC AUTO W AUTO DIFF,142.0,25.99,7.77,106.5,63
CDM,3079696,LAB CBC AUTO WO DIFF,106.0,19.4,6.47,79.5,63
CDM,3079704,LAB SUBSTRATE CHROMOGENIC,62.0,11.35,11.89,55.81,63
CDM,3079720,LAB CLOTTING FACTOR 2 PROTHROM,64.0,11.71,12.98,60.93,63
CDM,3079738,LAB LYSIS EUGLOBULIN,26.0,4.76,8.41,39.51,63
CDM,3079746,LAB CLOTTING FACTOR 8 1-STG,66.0,12.08,17.9,84.01,63
CDM,3079761,LAB INHIBITOR FACTOR 9,39.0,7.14,12.87,60.4,63
CDM,3079779,LAB INHIBITOR FACTOR 8,97.0,17.75,12.87,72.75,63
CDM,3079787,LAB CLOTTING FACTOR 9 PTC/XMAS,79.0,14.46,19.04,89.34,63
CDM,3079795,LAB CLOTTING FACTOR 5 LABILE,75.0,13.72,17.65,82.88,63
CDM,3079803,LAB CLOTTING FACTOR 7,76.0,13.91,17.9,84.01,63
CDM,3079811,LAB CLOTTING FACTOR 8 AG RELATED,62.0,11.35,20.42,95.86,63
CDM,3079829,LAB CLOTTING FACTOR 8 VWF AG,74.0,13.54,22.94,107.7,63
CDM,3079837,LAB CLOTTING FACTOR 8 VWF MULTI,69.0,12.63,22.94,107.7,63
CDM,3079845,LAB CLOTTING FACTOR 8 VWF RIST,74.0,13.54,22.94,107.7,63
CDM,3079852,LAB CLOTTING FACTOR 10 STUART-PROWR,76.0,13.91,17.9,84.01,63
CDM,3079860,LAB CLOTTING FACTOR 11 PTA,69.0,12.63,17.9,84.01,63
CDM,3079878,LAB CLOTTING FACTOR 12 HAGEMAN,76.0,13.91,19.35,90.8,63
CDM,3079894,LAB CLOTTING FACTOR 13 SCR SOL,28.0,5.12,9.11,42.77,63
CDM,3079902,LAB FDP FSP AGG SEMI QN,21.0,3.84,6.89,32.33,63
CDM,3079928,LAB TRIIODOTHYRONINE T3 FREE TR DIA,71.0,11.36,16.94,79.49,63
CDM,3079944,LAB SCR ALLG IGE QL MULTI NS,59.0,11.21,7.97,44.25,63
CDM,3079951,LAB SCR AB MOG FL,86.0,16.34,12.05,64.5,63
CDM,3079969,LAB AB FL TITER MOG,837.0,159.03,12.05,627.75,63
CDM,3079977,LAB IG IGA SERUM NS,56.0,8.96,9.3,43.64,63
CDM,3079993,LAB PARATHORMONE INTRAOP BASELINE 3,124.0,19.84,41.28,193.71,63
CDM,3080041,LAB SCR AB LRP4 AUTO FL,850.0,161.5,12.05,637.5,63
CDM,3080074,LAB RECEPTOR INTERLEUK 2 SOL N-END,500.0,80.0,36.57,375.0,63
CDM,3080124,LAB POTASS BLD WHL RBC,82.0,13.12,4.76,61.5,63
CDM,3080132,LAB POTASS PLASMA,59.0,9.44,4.76,44.25,63
CDM,3086014,LAB HGB FETAL KLEIHAUER-BETKE,59.0,10.8,7.73,44.25,63
CDM,3086022,LAB HGB FETAL ROSETTE,29.0,5.31,9.36,43.97,63
CDM,3086055,LAB FDP D-DIMER QN,240.0,43.92,10.18,180.0,63
CDM,3086063,LAB FIBRINOGEN ACTIVITY,47.0,8.6,9.72,45.63,63
CDM,3086071,LAB FIBRINOGEN ANTIGEN,44.0,8.05,14.46,67.85,63
CDM,3086097,LAB COUNT BLD HEMATOCRIT,8.0,1.46,2.37,11.18,63
CDM,3086113,LAB HEMO PLT AUTO W AUTO SCAN,24.0,4.39,7.77,36.45,63
CDM,3086121,LAB COUNT BLD HEMOGLOBIN,13.0,2.38,2.37,11.18,63
CDM,3086147,LAB ASSAY HEPARIN,263.0,48.13,13.09,197.25,63
CDM,3086162,LAB CLOTTING KININOGEN WT HI MOLEC,229.0,41.91,18.93,171.75,63
CDM,3086188,LAB MURAMIDASE,57.0,10.43,18.75,88.01,63
CDM,3086196,LAB FRAGILITY OSMOTIC RBC INCUB,57.0,10.43,13.36,62.73,63
CDM,3086212,LAB PLASMINOGEN ACTIVATOR,84.0,15.37,17.19,80.69,63
CDM,3086220,LAB PLASMINOGEN ANTIGENIC,31.0,5.67,10.18,47.76,63
CDM,3086238,LAB PLASMINOGEN NON-ANTIGENIC,57.0,10.43,6.53,42.75,63
CDM,3086253,LAB CLOTTING PREKALLIKREIN,166.0,30.38,18.93,124.5,63
CDM,3086261,LAB CLOTTING ACT PROTEIN C,42.0,7.69,13.84,64.92,63
CDM,3086279,LAB CLOTTING AG PROTEIN C,65.0,11.9,12.01,56.41,63
CDM,3086287,LAB CLOTTING PROTEIN S FREE,66.0,12.08,15.32,71.91,63
CDM,3086295,LAB CLOTTING PROTEIN S TOTAL,64.0,11.71,11.61,54.48,63
CDM,3086303,LAB PROTHROMBIN TIME,95.0,17.38,4.29,71.25,63
CDM,3086311,LAB PROTHROMBIN TIME SUB,58.0,10.61,3.94,43.5,63
CDM,3086329,LAB PTT SUBSTITUTION FRAC PLASMA,103.0,18.85,6.47,77.25,63
CDM,3086337,LAB REPTILASE,80.0,14.64,9.85,60.0,63
CDM,3086345,LAB VENOM TIME RUSSELL VIPER DLT,60.0,10.98,9.58,45.0,63
CDM,3086360,LAB RATE SEDIMENTATION RBC AUTO,9.0,1.65,2.7,12.64,63
CDM,3086378,LAB RATE SEDIMENTATION RBC NONAUTO,13.0,2.38,4.27,20.09,63
CDM,3086402,LAB THROMBIN TIME PLASMA,56.0,10.25,5.77,42.0,63
CDM,3086428,LAB PTT PLASMA/BLD WHL,114.0,20.86,6.01,85.5,63
CDM,3086444,LAB VISCOSITY,57.0,10.43,11.67,54.75,63
CDM,3086469,LAB DET IA BARTONELLA PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3086493,LAB DET IA CHLAMYD TRAC PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3086519,LAB DET IA CMV PRB AMP NS,106.0,23.43,35.09,164.7,63
CDM,3086527,LAB DET IA CMV QN NS,129.0,28.51,42.84,201.02,63
CDM,3086535,LAB CONCENTRATION AFB IA,58.0,12.82,6.68,43.5,63
CDM,3086543,LAB CONCENTRATION ANY TYPE IA,21.0,4.64,6.68,31.33,63
CDM,3086550,LAB CULT BACT AEROBIC ID DF,39.0,8.62,8.08,37.92,63
CDM,3086568,LAB CULT BACT AEROBIC OTHER QN,61.0,13.48,9.89,46.43,63
CDM,3086576,LAB CULT AFB ID ISOLATES,63.0,13.92,10.8,50.69,63
CDM,3086584,LAB CULT AFB ID ISOLATES BLOOD,33.0,7.29,10.8,50.69,63
CDM,3086592,LAB CULT BACT ANAEROBIC OTHER,279.0,61.66,9.47,209.25,63
CDM,3086600,LAB CULT BACT ANAEROBIC ID DF,25.0,5.52,8.08,37.92,63
CDM,3086618,LAB CULT BACT AEROBIC BLOOD,270.0,59.67,10.32,202.5,63
CDM,3086626,LAB CULT BACT AEROBIC CATHETER TIP,42.0,9.28,8.62,40.44,63
CDM,3086634,LAB CULT CHLAMYDIA,71.0,15.69,19.6,92.0,63
CDM,3086642,LAB CULT BACT AEROBIC CSF,42.0,9.28,8.62,40.44,63
CDM,3086659,LAB ISO VIRUS SHELL VIAL ID W IF,64.0,14.14,19.56,91.8,63
CDM,3086667,LAB CULT BACT AEROBIC EAR,42.0,9.28,8.62,40.44,63
CDM,3086683,LAB CULT BACT AEROBIC EYE,42.0,9.28,8.62,40.44,63
CDM,3086691,LAB CULT FUNGI ID ISOLATES BLOOD,69.0,15.25,20.46,96.05,63
CDM,3086709,LAB CULT FUNGI ID DERMATOPHYTE,59.0,13.04,7.71,44.25,63
CDM,3086717,LAB CULT FUNGI ID DF MOLD,62.0,13.7,10.32,48.43,63
CDM,3086725,LAB CULT FUNGI ID DF YEAST,62.0,13.7,10.32,48.43,63
CDM,3086733,LAB CULT FUNGI ID ISOLATES,78.0,17.24,8.41,58.5,63
CDM,3086741,LAB CULT BACT AEROBIC GENITAL,42.0,9.28,8.62,40.44,63
CDM,3086758,LAB CULT BACT AEROBIC RESP LOWER,42.0,9.28,8.62,40.44,63
CDM,3086766,LAB CULT MYCOPLASMA/UREAPLASMA,63.0,13.92,15.39,72.24,63
CDM,3086774,LAB CULT MYCOBACTERIAL ID DF,64.0,14.14,14.61,68.58,63
CDM,3086790,LAB CULT BACT AEROBIC ID DF NOCARD,39.0,8.62,8.08,37.92,63
CDM,3086808,LAB CULT BACT AEROBIC OTHER,75.0,16.58,8.62,56.25,63
CDM,3086824,LAB SCR CULT BORDETELLA,20.0,4.42,6.63,31.13,63
CDM,3086840,LAB SCR CULT GONORRHEA,58.0,12.82,6.63,43.5,63
CDM,3086857,LAB SCR CULT LEGIONELLA,20.0,4.42,6.63,31.13,63
CDM,3086865,LAB SCR CULT ORGANISMS SGL,59.0,13.04,6.63,44.25,63
CDM,3086873,LAB SCR CULT STAPH MRSA,20.0,4.42,6.63,31.13,63
CDM,3086881,LAB SCR CULT STREP GROUP B,20.0,4.42,6.63,31.13,63
CDM,3086899,LAB SCR CULT VRE,58.0,12.82,6.63,43.5,63
CDM,3086915,LAB CULT BACT FLUID BODY STERILE,42.0,9.28,8.62,40.44,63
CDM,3086931,LAB CULT BACT AEROBIC STOOL CAMPY,29.0,6.41,9.44,44.3,63
CDM,3086949,LAB CULT BACT AEROBIC STOOL E COLI,29.0,6.41,9.44,44.3,63
CDM,3086956,LAB CULT BACT AEROBIC STOOL PATH,79.0,17.46,9.44,59.25,63
CDM,3086964,LAB CULT BACT AEROBIC STOOL,29.0,6.41,9.44,44.3,63
CDM,3086972,LAB CULT BACT AEROBIC STOOL VIBRO,29.0,6.41,9.44,44.3,63
CDM,3086980,LAB CULT BACT AEROBIC STOOL YERSNIA,29.0,6.41,9.44,44.3,63
CDM,3086998,LAB CULT BACT AEROBIC TISSUE,42.0,9.28,8.62,40.44,63
CDM,3087004,LAB CULT TYPING ID NUC ACID PRB DIR,73.0,16.13,20.05,94.06,63
CDM,3087012,LAB CULT TYPING GLC/HPLC,38.0,8.4,12.52,58.74,63
CDM,3087020,LAB CULT TYPING IF ANTISERUM EA,57.0,12.6,5.57,42.75,63
CDM,3087046,LAB CULT TYPING SEROLOGICAL,16.0,3.54,5.18,24.35,63
CDM,3087053,LAB CULT BACT AEROBIC RESP UPPER,42.0,9.28,8.62,40.44,63
CDM,3087061,LAB CULT BACT ID ISOLATE URINE,25.0,5.52,8.09,37.98,63
CDM,3087079,LAB CULT BACT COLONY COUNT URINE,201.0,44.42,8.07,150.75,63
CDM,3087087,LAB ISO VIRUS ID ACT ENZYMATIC,102.0,22.54,33.86,158.92,63
CDM,3087095,LAB ISO VIRUS INOC TISSUE ADDL,65.0,14.36,20.2,94.79,63
CDM,3087103,LAB ISO VIRUS INOC TISSUE,79.0,17.46,26.07,122.33,63
CDM,3087129,LAB CULT BACT AEROBIC WOUND,42.0,9.28,8.62,40.44,63
CDM,3087137,LAB CULT FUNGI YEAST ID ISOLATES,60.0,13.26,8.41,45.0,63
CDM,3087160,LAB DET AG IA IMM ENZ TOXIN C DIFF,60.0,13.26,11.98,56.28,63
CDM,3087210,LAB DET AG IA IMM H PYLORI STOOL,74.0,16.35,14.38,67.45,63
CDM,3087228,LAB DET AG IA HBSAG QL/SEMI QN,67.0,14.81,10.33,50.25,63
CDM,3087236,LAB DET AG IA IMM ENZ HEP BE,59.0,13.04,11.53,54.08,63
CDM,3087244,LAB DET AG IA IMM ENZ HISTOPLASMA,152.0,33.59,13.25,114.0,63
CDM,3087301,LAB DET AG IA IMM ENZ ROTAVIRUS,36.0,7.96,11.98,56.28,63
CDM,3087327,LAB DET AG IA IMM ENZ TOX SHIGA,64.0,14.14,11.98,56.28,63
CDM,3087350,LAB DET AG IA IMM ENZ QL,36.0,7.96,11.98,56.28,63
CDM,3087368,LAB DET IA GC PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3087459,LAB DET IA HERPES 6 PRB AMP,120.0,26.52,35.09,164.7,63
CDM,3087467,LAB DET IA HSV PRB AMP NS,106.0,23.43,35.09,164.7,63
CDM,3087491,LAB HOMOGENIZATION TISSUE,57.0,12.6,5.88,42.75,63
CDM,3087517,LAB DET AG IA IF ADENOVIRUS,44.0,9.72,14.43,67.72,63
CDM,3087533,LAB DET AG IA IF BORDETELLA,36.0,7.96,11.98,56.28,63
CDM,3087541,LAB DET AG IA IF CHLAMYDIA TRAC,36.0,7.96,11.98,56.28,63
CDM,3087566,LAB DET AG IA IF CRYPTOSPORIDIUM,61.0,13.48,11.98,56.28,63
CDM,3087582,LAB DET AG IA IF HSV TYPE 1,60.0,13.26,11.98,56.28,63
CDM,3087590,LAB DET AG IA IF HSV TYPE 2,60.0,13.26,11.98,56.28,63
CDM,3087608,LAB DET AG IA IF INFLUENZA A VIRUS,60.0,13.26,16.07,75.43,63
CDM,3087616,LAB DET AG IA IF INFLUENZA B VIRUS,60.0,13.26,12.25,57.47,63
CDM,3087632,LAB DET AG IA IF PARAINFLUENZA,50.0,11.05,16.43,77.1,63
CDM,3087640,LAB DET AG IA IF PNEUMOCYSTIS,36.0,7.96,11.98,56.28,63
CDM,3087657,LAB DET AG IA IF PLYVLT ORG MULT,60.0,13.26,11.98,56.28,63
CDM,3087665,LAB DET AG IA IF RSV,60.0,13.26,13.42,62.99,63
CDM,3087673,LAB DET AG IA IF VARICELLA-ZOSTER,60.0,13.26,13.42,62.99,63
CDM,3087681,LAB DET AG IA IMM OPTICAL,65.0,14.36,16.07,75.43,63
CDM,3087715,LAB DET AG IA INFLUENZA IMM OPT,50.0,11.05,16.55,77.7,63
CDM,3087749,LAB DET IA MYCOBCT TB PRB AMP NS,126.0,27.85,41.68,195.64,63
CDM,3087764,LAB EXAM MACROSCOPIC ARTHROPOD,13.0,2.87,4.27,20.09,63
CDM,3087772,LAB EXAM MACROSCOPIC PARASITE,58.0,12.82,4.31,43.5,63
CDM,3087798,LAB DET IA ORGANISMS MULT PRB AMP,211.0,46.63,70.2,329.47,63
CDM,3087806,LAB DET IA MYCOPLAS PNEU PRB AMP NS,106.0,23.43,35.09,164.7,63
CDM,3087822,LAB EXAM PINWORM,13.0,2.87,4.27,20.09,63
CDM,3087830,LAB SMEAR INCL BODIES/PARASITE,18.0,3.98,5.99,78.63,63
CDM,3087848,LAB SMEAR STAIN ACID FAST AFB,57.0,12.6,5.39,42.75,63
CDM,3087863,LAB SMEAR STAIN FL AFB,57.0,12.6,5.39,42.75,63
CDM,3087889,LAB SMEAR STAIN FL FUNGI,58.0,12.82,5.39,43.5,63
CDM,3087897,LAB SMEAR GRAM/GIEMSA,21.0,4.64,4.27,20.09,63
CDM,3087905,LAB SMEAR IA INDIA INK,18.0,3.98,5.82,27.34,63
CDM,3087913,LAB SMEARS DIRECT OVA&PARASITES,27.0,5.97,8.9,41.77,63
CDM,3087947,LAB SUSCPT DISK KIRBY BAUER,23.0,5.08,7.48,35.12,63
CDM,3087954,LAB SUSCPT DETECTION ENZYME EA,56.0,12.38,4.75,42.0,63
CDM,3087962,LAB SUSCPT ETEST AGENT EA,15.0,3.32,4.75,22.28,63
CDM,3087970,LAB SUSCPT DILUTION MACROBROTH,58.0,12.82,6.64,43.5,63
CDM,3087988,LAB SUSCPT MIC PLATE EA,162.0,35.8,8.65,121.5,63
CDM,3088002,LAB TISSUE KOH SKIN/HAIR/NAIL FUNGI,64.0,14.14,4.27,48.0,63
CDM,3088010,LAB TOXIN CULT TISSUE C DIFF NS,79.0,17.46,19.74,92.66,63
CDM,3088028,LAB SMEAR GRAM/GIEMSA URINE EOSNPHL,21.0,4.64,4.27,20.09,63
CDM,3088036,LAB SMEAR IA WET MOUNT,53.0,11.71,5.82,39.75,63
CDM,3088069,LAB UA REDUCING SUBSTANCE,11.0,3.03,3.48,16.3,63
CDM,3088085,LAB UA KETONES AUTO WO MICRO,12.0,3.3,2.25,10.58,63
CDM,3088093,LAB UA PH AUTO WO MICRO,12.0,3.3,2.25,10.58,63
CDM,3088101,LAB UA GRAVITY SPCFC AUTO WO MICRO,53.0,14.58,2.25,39.75,63
CDM,3088119,LAB UA AUTO W MICRO,91.0,25.02,3.17,68.25,63
CDM,3088127,LAB UA AUTO WO MICRO,12.0,3.3,2.25,10.58,63
CDM,3088135,LAB UA MICROSCOPIC ONLY,10.0,2.75,3.05,14.3,63
CDM,3088143,LAB UA NONAUTO WO MICRO,11.0,3.03,3.48,16.3,63
CDM,3088168,LAB UA QL/SEMI QN,7.0,1.93,2.17,10.18,63
CDM,3088192,LAB PREGNANCY URINE,58.0,15.95,8.61,43.5,63
CDM,3088200,LAB MEASUREMENT VOL COLL TIMED EA,11.0,3.03,3.64,17.1,63
CDM,3088226,COLLECT SPEC BLD CAPILLARY,38.0,6.54,0.5427,28.5,39
CDM,3088283,LAB PROT FRCTN ELECTRO&QN URINE,54.0,8.64,17.83,78.63,63
CDM,3088713,POC CALCIUM IONIZED,77.0,12.32,13.68,64.19,63
CDM,3088721,POC CHLORIDE BLOOD,47.0,7.52,4.6,35.25,63
CDM,3088788,POC POTASS SRM/PLASMA/BLD WHL,60.0,9.6,4.76,45.0,63
CDM,3088796,POC SODIUM SRM/PLASMA/WHOLE BLD,48.0,7.68,4.81,36.0,63
CDM,3088861,LAB ALPHA-1-ANTITRYPSIN TOTAL,41.0,6.56,13.44,63.06,63
CDM,3088879,POC UA NONAUTO WO MICRO DIPSTICK,11.0,3.03,3.48,16.3,63
CDM,3088903,LAB CYTOM FLOW CELL CYCLE/DNA NS,600.0,148.2,36.08,619.29,63
CDM,3088937,LAB STAIN SPECIAL 2 NS,326.0,90.63,24.53,340.72,63
CDM,3088945,LAB CONSULT SLIDES REFERRED NS,80.0,22.24,24.53,555.18,63
CDM,3088978,LAB MICROSCOPY ELECTRON DIAG NS,2082.0,578.8,398.84,1917.94,63
CDM,3088986,LAB MORPHO MUSCLE SKELETAL NS,363.0,100.91,51.19,601.97,63
CDM,3089000,LAB SCR AB AGG PARTICLE EA,74.0,14.06,11.54,55.5,63
CDM,3089059,LAB DET AG IA IMM CRYPTO PLEURAL,293.0,64.75,16.07,219.75,63
CDM,3090008,LAB CYTOP SLD LIQ NONGYN MAYO NS,613.0,151.41,36.08,459.75,63
CDM,3094034,LAB DET AG IA IF GIARDIA,61.0,13.48,13.61,63.86,63
CDM,3094042,LAB DET AG IA IMM ENZ GIARDIA NS,66.0,14.59,11.98,56.28,63
CDM,3094059,POC COLLECT SPEC SPUTUM AEROSOL,363.0,62.44,18.78,299.97,63
CDM,3094091,LAB SMEAR STAIN CMPLX OVA&PARASITES,71.0,15.69,17.98,84.35,63
CDM,3094109,LAB CULT BACT ANAEROBIC OTHER QN,392.0,86.63,9.66,294.0,63
CDM,3094125,LAB SCR CULT STREP GROUP A,20.0,4.42,6.63,31.13,63
CDM,3094182,LAB AGGREGATION PLT EA AGENT,79.0,14.46,24.91,107.89,63
CDM,3094265,PHLEBOTOMY THERAPEUTIC,897.0,266.41,81.16,945.0,63
CDM,3094497,POC COAGULATION TIME ACTIVATED,13.0,2.38,4.28,20.09,63
CDM,3094539,POC PREGNANCY URINE,42.0,11.55,8.61,40.44,63
CDM,3094638,POC GASES BLD ANY COMBO,123.0,19.68,26.07,122.33,63
CDM,3094646,LAB LEVETIRACETAM NS,63.0,10.08,13.25,62.2,63
CDM,3094661,LAB DET IA STREP GROUP A PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3094778,POC BLOOD OCCULT FECES 1-3 TESTS QL,13.0,2.08,4.23,19.82,63
CDM,3094786,POC SODIUM SRM/PLASMA/BLD WHL,48.0,7.68,4.81,36.0,63
CDM,3094794,POC POTASS SRM/PLASMA/BLD WHL,60.0,9.6,4.76,45.0,63
CDM,3094802,POC NITROGEN UREA QN,83.0,13.28,3.95,62.25,63
CDM,3094810,POC CHLORIDE BLOOD,47.0,7.52,4.6,35.25,63
CDM,3094844,POC CULT BACT H PYLORI FAST,39.0,8.62,8.08,37.92,63
CDM,3094968,POC CALCIUM IONIZED,77.0,12.32,13.68,64.19,63
CDM,3094976,LAB CYTOP SLD LIQ NONGYN,112.0,27.66,36.08,281.77,63
CDM,3095015,LAB ALKALINE PHOSPHATASE NS,70.0,11.2,5.18,52.5,63
CDM,3095049,LAB COUNT TOTAL CELLS CD56 NK,114.0,21.66,37.73,177.08,63
CDM,3095056,LAB B CELLS CD19 COUNT TOTAL,114.0,21.66,37.73,177.08,63
CDM,3095064,LAB CYTOM FLOW TECH MARKER 1ST,760.0,187.72,75.86,631.11,63
CDM,3095114,LAB PROT FRCTN ELECTRO&QN OTHER,54.0,8.64,17.83,78.63,63
CDM,3095130,LAB CYTOM FLOW TECH MARKER ADDL,333.0,82.25,12.26,332.53,40
CDM,3102811,LAB DET AG IA IMM ENZ HEP B SURF NS,85.0,18.78,10.33,63.75,63
CDM,3102852,LAB NEUTRALIZATION VIRAL RABIES,127.0,24.13,16.91,95.25,63
CDM,3102894,LAB CHROM W BND 15-20 CLL 2 KRTY NS,532.0,131.4,125.49,661.28,63
CDM,3102902,LAB CHROM W BND 15-20 CLL 2 KRTY,377.0,93.12,125.49,661.28,63
CDM,3102928,LAB CHROM W BND AF 6-12 COL 1 K,521.0,128.69,173.66,915.12,63
CDM,3102936,LAB MCG IN SITU CHROM 10-30 CELL,105.0,25.94,34.81,183.46,63
CDM,3102969,LAB MCG IN SITU INT 25-99 CELL,128.0,31.62,42.38,223.31,63
CDM,3102977,LAB MCG IN SITU INT 100-300 CELL,154.0,38.04,51.19,269.74,63
CDM,3102985,LAB CULT TISS NON-NEO AF/CELL CV,451.0,111.4,150.3,791.99,63
CDM,3102993,LAB CHROM STUDY CELLS COUNTED ADDL,81.0,20.01,26.91,141.75,63
CDM,3103009,LAB CHROM STUDY RES HIGH ADDL,104.0,25.69,34.43,181.4,63
CDM,3103017,LAB CHROM KARYOTYPES ADDL EA,101.0,24.95,33.47,176.34,63
CDM,3103025,LAB CHROM W BND 5 CLL 1 KRTY,794.0,196.12,264.34,1392.93,63
CDM,3103033,LAB CHROM W BND AF/CV 15 CLL 1 K,566.0,139.8,188.57,993.61,63
CDM,3103066,LAB CULT TISS NON-NEO LYMPHOCYTE,350.0,86.45,116.49,613.85,63
CDM,3103090,LAB CYTOPATH CONCENTRATION,80.0,19.76,24.53,357.61,63
CDM,3103157,LAB CYTOPATH EVAL FNA INTRP&RPT,466.0,115.1,36.08,666.15,63
CDM,3103199,LAB MCG PROBE DNA PROBE EA,65.0,16.06,21.42,112.88,63
CDM,3103223,LAB SCR MANUAL CYTOPATH CERV/VAG,61.0,15.07,20.26,127.05,63
CDM,3103272,LAB CYTOPATH OTH SRCE SMEARS SC&IN,62.0,15.31,17.89,311.27,63
CDM,3103298,LAB CULT TISS NON-NEO MARROW BLD,759.0,187.47,143.75,757.46,63
CDM,3103306,LAB CULT TISS NON-NEO SKIN/BX,423.0,104.48,140.73,741.56,63
CDM,3103314,LAB CULT TISS NEO TMR SOLID,443.0,109.42,147.52,777.35,63
CDM,3103322,LAB CONSULT SLIDES REFERRED,80.0,22.24,24.53,555.18,63
CDM,3103348,LAB CONSULT PATH SURGERY,126.0,35.03,40.35,236.28,63
CDM,3103355,LAB CONSULT PATH SURG BLOCK EA ADDL,108.0,30.02,12.26,230.67,40
CDM,3103363,LAB CONSULT PATH SURG BLOCK 1ST,363.0,100.91,40.21,434.49,63
CDM,3103371,LAB DECALCIFICATION,43.0,11.95,8.0,88.44,40
CDM,3103389,LAB MICROSCOPY ELECTRON DIAG,1684.0,468.15,398.84,1917.94,63
CDM,3103397,LAB PATH GROSS&MICRO LVL 2,80.0,22.24,24.53,146.21,63
CDM,3103405,LAB PATH GROSS&MICRO LVL 3,200.0,55.6,31.12,198.56,63
CDM,3103413,LAB PATH GROSS&MICRO LVL 4,282.0,78.4,34.68,301.7,63
CDM,3103421,LAB PATH GROSS&MICRO LVL 5,1291.0,358.9,203.34,1290.75,63
CDM,3103439,LAB PATH GROSS&MICRO LVL 6,1832.0,509.3,285.45,1838.03,63
CDM,3103447,LAB PATH GROSS ONLY LVL 1,62.0,17.24,11.64,64.45,63
CDM,3103462,LAB STAIN HISTOCHEM W BLOCK FROZEN,241.0,67.0,22.59,416.38,40
CDM,3103538,LAB CONSULT SLIDES PREP REQ,112.0,31.14,28.84,483.38,63
CDM,3103546,LAB STAIN SPECIAL 1,409.0,113.7,36.08,475.46,63
CDM,3103553,LAB STAIN SPECIAL 2,326.0,90.63,24.53,340.72,63
CDM,3103595,LAB AB MYCOPLASMA IGG NS,55.0,10.45,13.24,62.13,63
CDM,3103637,LAB CLOZAPINE/NORCLOZAPINE,68.0,10.88,20.15,94.59,63
CDM,3103652,LAB CARBAMAZEPINE FREE,90.0,14.4,13.25,67.5,63
CDM,3103686,LAB TACROLIMUS FK-506 NS,64.0,10.24,13.73,64.46,63
CDM,3103728,LAB CALCIUM TOTAL NS,65.0,10.4,5.16,48.75,63
CDM,3103736,LAB CHLORIDE STOOL NS,58.0,9.28,5.0,43.5,63
CDM,3103744,LAB CHOLESTEROL SRM/BLD WHL TTL NS,56.0,8.96,4.35,42.0,63
CDM,3103777,LAB CREATINE KINASE TOTAL NS,55.0,8.8,6.51,41.25,63
CDM,3103785,LAB CREATININE URINE NS,52.0,8.32,5.18,39.0,63
CDM,3103793,LAB CRYOGLOBULIN QL/SEMI QN NS,63.0,10.08,6.47,47.25,63
CDM,3103801,LAB TRANSFERASE GALACTOSE-1 QN,173.0,27.68,21.07,129.75,63
CDM,3103819,LAB IG IGA IGD IGG IGM CSF EA,63.0,10.08,9.3,47.25,63
CDM,3103827,LAB IG IGA IGD IGG IGM SERUM EA NS,59.0,9.44,9.3,44.25,63
CDM,3103850,LAB IMM ACHR BINDING QN,70.0,13.3,18.4,64.46,63
CDM,3103884,LAB IMM GANGLIOSIDE GM TRIPLE QN,70.0,11.2,17.27,81.09,63
CDM,3103918,LAB IMM GLYCPROT MYELIN ASSC IGM,69.0,11.04,17.27,81.09,63
CDM,3103942,LAB LDH NS,55.0,8.8,6.04,41.25,63
CDM,3103967,LAB LIPASE FLUID BODY NS,58.0,9.28,6.89,43.5,63
CDM,3104122,LAB SODIUM STOOL NS,58.0,9.28,4.86,43.5,63
CDM,3104130,LAB SPCTPHOT PORPHYRINS SERUM,70.0,11.2,8.1,52.5,63
CDM,3104148,LAB TESTOSTERONE TOTAL NS,78.0,12.48,25.81,121.13,63
CDM,3104155,LAB THYROXINE T4 FREE NS,66.0,10.56,9.02,49.5,63
CDM,3104163,LAB TRIGLYCERIDES NS,73.0,11.68,5.74,54.75,63
CDM,3104205,LAB CLOTTING ACT ANTITHROM 3 NS,56.0,10.25,11.85,55.61,63
CDM,3104213,LAB CLOTTING AG ANTITHROMBIN 3 NS,69.0,12.63,10.81,51.75,63
CDM,3104221,LAB FIBRINOGEN ACTIVITY NS,47.0,8.6,9.72,45.63,63
CDM,3104239,LAB AB ID PLATELET PATIENT SERUM NS,72.0,13.68,18.37,86.21,63
CDM,3104262,LAB COMPLEMENT AG C6 COMP EA,36.0,6.84,12.0,56.34,63
CDM,3104270,LAB COMPLEMENT FIX COCCI NS,31.0,5.89,10.01,46.96,63
CDM,3104296,LAB SCR AB ANCA INFL/BOWEL FL,57.0,10.83,12.05,52.19,63
CDM,3104304,LAB SCR AB ANTIMYOCARDIAL FL,37.0,7.03,12.05,78.63,63
CDM,3104320,LAB IMMUNE COMPLEX C3D CIRCULATING,74.0,14.06,24.37,114.35,63
CDM,3104338,LAB SCR AB H INFLUENZA AGG PARTICLE,53.0,10.07,11.54,54.15,63
CDM,3104353,LAB AB CHLAMYDIA TRAC IGG IGA,61.0,11.59,11.82,55.48,63
CDM,3104361,LAB SCR AB RBC SERUM EA NS,158.0,27.18,9.77,118.5,63
CDM,3104379,LAB ELUTION AB RBC EA NS,363.0,68.97,1.78,299.97,63
CDM,3104387,LAB PANEL AB RBC 4C EA TECH SERUM,760.0,130.72,2.44,631.11,63
CDM,3104395,LAB PANEL AB RBC EA TECH SERUM NS,760.0,130.72,2.44,631.11,63
CDM,3104403,LAB COOMBS DIR ANTISERUM EA NS,126.0,23.94,5.39,94.5,63
CDM,3104411,LAB BLOOD TYPE ABO NS,284.0,48.85,2.99,213.0,63
CDM,3104429,LAB BLOOD TYPE ABO DISCREPANCY,284.0,48.85,2.99,213.0,63
CDM,3104437,LAB BLOOD TYPE RHD NS,80.0,13.76,2.99,60.0,63
CDM,3104452,LAB BLOOD TYPE AG RBC PT EA,760.0,130.72,3.83,570.0,63
CDM,3104460,LAB BLOOD TYPE PHENOTYPING RH COMP,80.0,13.76,7.75,60.0,63
CDM,3104486,LAB PRETREAT RBC AB CHEMICAL NS,150.0,25.8,1.66,153.06,63
CDM,3104494,LAB PRETREAT SERUM ABSORP NS,277.0,52.63,1.99,214.26,63
CDM,3104502,LAB HLA SEARCH,62.0,10.66,17.89,376.04,62
CDM,3104536,LAB CULT BACT AEROBIC BARTONELLA,42.0,9.28,8.62,40.44,63
CDM,3104544,LAB ISO VIRUS SHELL VIAL ID W IF NS,106.0,23.43,19.56,91.8,63
CDM,3104551,LAB DET AG IA IMM ENZ LEGN URINE NS,66.0,14.59,11.98,56.28,63
CDM,3104569,LAB DET IA HSV QN,129.0,28.51,42.84,201.02,63
CDM,3104577,LAB DET IA PRB AMP NS,106.0,23.43,35.09,164.7,63
CDM,3104585,LAB GENOTYPE IA HEPATITIS C NS,773.0,170.83,257.45,1570.47,63
CDM,3104593,LAB CULT TISS NON-NEO LYMPHOCYTE NS,350.0,86.45,116.49,613.85,63
CDM,3104619,LAB INHIBIN A,57.0,10.83,15.59,73.17,63
CDM,3104643,LAB ESTRIOL SERUM,73.0,11.68,24.18,113.48,63
CDM,3104650,LAB SIROLIMUS,57.0,9.12,13.73,64.46,63
CDM,3104692,LAB DET AG IA RSV IMM OPT,40.0,8.84,13.1,61.53,63
CDM,3104718,POC CREATININE BLOOD,60.0,9.6,5.12,45.0,63
CDM,3104726,POC TROPONIN QN,38.0,6.08,12.47,58.54,63
CDM,3105020,POC AG EIA STREP GROUP A QL,51.0,11.27,16.81,78.89,63
CDM,3105129,LAB SICKLING RBC REDUCTION,56.0,10.25,5.51,42.0,63
CDM,3105178,LAB CHROM 20-25 CELLS,763.0,188.46,144.61,761.99,63
CDM,3105194,POC CARBOXYHEMOGLOBIN QN,37.0,5.92,12.32,57.81,63
CDM,3105210,POC GASES BLD ANY COMBO W SAT O2,237.0,37.92,78.77,369.72,63
CDM,3105244,LAB DET AG IA IMM ENZ HEP B SURF,59.0,13.04,10.33,48.49,63
CDM,3105343,LAB AMIKACIN PEAK,59.0,9.44,15.08,70.78,63
CDM,3105350,LAB AMIKACIN RANDOM,46.0,7.36,15.08,70.78,63
CDM,3105368,LAB AMIKACIN TROUGH,62.0,9.92,15.08,70.78,63
CDM,3105392,LAB IMM AB GBM QN NS,52.0,8.32,17.27,81.09,63
CDM,3105400,LAB IMM AG ANTI-SOLUBLE LIVER QN,71.0,11.36,17.27,81.09,63
CDM,3105434,LAB ACIDS FATTY VERY LONG CHAIN,205.0,32.8,19.75,153.75,63
CDM,3105467,LAB IMM AB QN NS,142.0,26.98,14.99,106.5,63
CDM,3105475,LAB DET IA PARVOVIRUS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3105509,LAB ALBUMIN SRM/PLASMA/BLD WHL NS,63.0,10.08,4.95,47.25,63
CDM,3105525,LAB HEMOGLOBIN FRCTN&QN ELECTRO NS,71.0,11.36,12.87,78.63,63
CDM,3105533,LAB ISO VIRUS INOC TISSUE NS,100.0,22.1,26.07,122.33,63
CDM,3105558,POC BILIRUBIN TOTAL TRANSQ,16.0,2.56,5.02,23.55,63
CDM,3105582,POC BILIRUBIN TOTAL TRANSQ,16.0,2.56,5.02,23.55,63
CDM,3105608,LAB ACYLCARNITINES QN EA,115.0,18.4,16.87,86.25,63
CDM,3105616,LAB AB ENA CENTROMERE B,60.0,11.4,17.93,84.15,63
CDM,3105657,LAB LACTOFERRIN FECAL QL,73.0,11.68,19.7,92.46,63
CDM,3105681,LAB DET AG IA STREP GROUP A IMM OPT,50.0,11.05,16.53,77.56,63
CDM,3105756,POC GASES BLD PH ONLY,33.0,5.28,11.0,51.62,63
CDM,3105772,LAB CROSS LINKS N-TELOPEPTIDE,68.0,10.88,18.68,87.67,63
CDM,3105855,LAB LEAD BLOOD NS,37.0,5.92,12.11,56.81,63
CDM,3105871,LAB SCR METABOLIC NEWBORN,268.0,46.1,49.85,266.08,36
CDM,3105954,LAB UROPORPHYRINOGEN-1-SYNTH,67.0,10.72,22.17,104.04,63
CDM,3106036,LAB AB LYME DISEASE CONFIRMATORY,61.0,11.59,15.49,72.71,63
CDM,3106051,LAB CULT TISS NON-NEO SKIN/BX NS,423.0,104.48,140.73,741.56,63
CDM,3106069,LAB CULT BACT AEROBIC ID DF ADDL,39.0,8.62,7.25,37.92,40
CDM,3106168,LAB CROSSMATCH ELECTRONIC,363.0,62.44,1.6,299.97,63
CDM,3106176,LAB AB PEPTIDE CYCLIC CITRUL,59.0,11.21,12.95,60.8,63
CDM,31062,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3106390,LAB NIACIN,94.0,15.04,17.06,80.09,63
CDM,3106440,LAB ALLG IGG QN/SEMI QN EA,24.0,4.56,7.82,36.72,63
CDM,3106531,LAB RENIN NS,66.0,10.56,21.99,103.24,63
CDM,3106556,LAB SUSCPT PHENOTYPE IA DRUG,392.0,86.63,130.35,611.78,63
CDM,3106622,LAB DET AG IA IMM ENZ GIARDIA,36.0,7.96,11.98,56.28,63
CDM,3106648,LAB AB FTA CONFIRM,40.0,7.6,13.24,62.13,63
CDM,3106689,LAB IMM TRYPTASE QN,77.0,12.32,17.27,81.09,63
CDM,3106721,LAB IMMUNOFIXATION EP SERUM,68.0,12.92,22.34,96.75,63
CDM,3106911,LAB TRANSFERASE AMINO ALANINE NS,59.0,9.44,5.3,44.25,63
CDM,3106929,LAB TRANSFERASE AMINO ASPARTATE NS,76.0,12.16,5.18,57.0,63
CDM,3106994,LAB AB YERSINIA,76.0,14.44,13.19,61.93,63
CDM,3107026,LAB VITAMIN D 25 HYDROXY W FRAC,89.0,14.24,29.6,155.32,63
CDM,3107133,LAB AB BACTERIUM NONSPECIFIED NS,153.0,29.07,12.88,114.75,63
CDM,3107141,LAB AB ENA NS,65.0,12.35,17.93,84.15,63
CDM,3107224,LAB DET IA CANDIDA PRB DIR,61.0,13.48,20.05,94.06,63
CDM,3107232,LAB DET IA GARDNERELLA VAG PRB DIR,61.0,13.48,20.05,94.06,63
CDM,3107240,LAB DET IA TRICHOMONAS VAG PRB DIR,61.0,13.48,20.05,94.06,63
CDM,3107265,LAB IMM RIA PTH REL PROT QN,72.0,11.52,18.4,86.34,63
CDM,3107273,LAB CYTOPATH CERV/VAG AUTO&MANUAL,80.0,19.76,26.61,166.9,63
CDM,3107356,LAB AFP-L3 ISOFORM FRAC&AFP TOTAL,194.0,31.04,64.41,302.33,63
CDM,3107364,LAB LIPOPROTEIN PHOSPHOLIPASE A2,139.0,22.24,46.31,217.39,63
CDM,3107422,LAB DET IA MRSA PRB AMP NS,106.0,23.43,35.09,164.7,63
CDM,3107430,LAB DET IA STREP GROUP B PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3107489,LAB AB WEST NILE VIRUS IGM NS,72.0,13.68,16.85,79.09,63
CDM,3107497,LAB AB WEST NILE VIRUS NS,72.0,13.68,14.39,67.52,63
CDM,3107505,LAB DET AG IA IMM ENZ ASPRGLS NS,152.0,33.59,11.98,114.0,63
CDM,3107596,LAB LIPOPROTEIN CHOLESTEROL LDL,32.0,5.12,10.5,49.29,63
CDM,3107612,LAB HCG QN NS,71.0,11.36,15.05,70.64,63
CDM,3107638,LAB PROT TTL SRM/PLASMA/BLD WHL NS,53.0,8.48,3.67,39.75,63
CDM,3107661,LAB PTT PLASMA/BLD WHL NS,54.0,9.88,6.01,40.5,63
CDM,3107679,LAB SMEAR GRAM/GIEMSA NS,91.0,15.65,4.27,68.25,63
CDM,3107687,LAB SUSCPT MIC PLATE EA NS,152.0,26.14,8.65,114.0,63
CDM,3107695,POC UA AUTO WO MICRO,107.0,29.42,2.25,80.25,63
CDM,3107703,LAB CORTISOL BINDING GLOBULIN,54.0,8.64,18.0,84.48,63
CDM,3107786,POC BLOOD OCCULT OTHER SOURCE QL,16.0,2.56,5.32,24.95,63
CDM,3107828,LAB DET IA EBV PCR QN,129.0,28.51,42.84,261.36,63
CDM,3107836,LAB IRON TISSUE LIVER,208.0,33.28,6.47,156.0,63
CDM,3107877,LAB SMEAR STAIN FL AFB NS,68.0,15.03,5.39,51.0,63
CDM,3107893,LAB INHIBITOR VWF PROTEASE,225.0,41.18,12.87,168.75,63
CDM,3107919,LAB COUNT BLD RETIC AUTO W PARAM,57.0,10.43,5.57,42.75,63
CDM,3108016,LAB DET IA BK VIRUS PCR QN,129.0,28.51,42.84,261.36,63
CDM,3108032,LAB CLOTTING PROTEIN S TOTAL NS,58.0,10.61,11.61,54.48,63
CDM,3108040,LAB CLOTTING PROTEIN S FREE NS,60.0,10.98,15.32,71.91,63
CDM,3108057,LAB PROT FLUID BODY NS,52.0,8.32,4.0,39.0,63
CDM,3108081,LAB THYROID STIMULATING HORMONE NS,51.0,8.16,16.8,78.83,63
CDM,3108123,LAB LACTOFERRIN FECAL QL NS,98.0,15.68,19.7,92.46,63
CDM,3108164,LAB TOXIN CULT TISSUE,60.0,13.26,19.74,92.66,63
CDM,3108180,LAB PATH GROSS&MICRO LVL 5 NS,1292.0,359.18,203.34,1290.75,63
CDM,3108198,LAB STAIN SPECIAL 1 NS,409.0,113.7,36.08,475.46,63
CDM,3108214,LAB PREPARATIONS NERVE TEASING,1684.0,468.15,118.34,1418.55,63
CDM,3108271,LAB PATH GROSS&MICRO LVL 4 NS,200.0,55.6,34.68,301.7,63
CDM,3108305,LAB CYTOM FLOW TECH MARKER 1ST NS,760.0,187.72,75.86,631.11,63
CDM,3108313,LAB CYTOM FLOW TECH MARKER ADDL NS,334.0,82.5,12.26,332.53,40
CDM,3108404,LAB LIPOPROTEIN PART NO/S&SBCLS QN,103.0,16.48,34.19,192.51,63
CDM,3108487,LAB SCR AB MICRO AGG PARTICLE,62.0,11.78,11.54,54.15,63
CDM,3108529,LAB CONSULT COMP REVIEW REC&SPEC,363.0,100.91,108.14,873.94,63
CDM,3108545,LAB IMM IL-2 RECPT SOLUBLE QN,368.0,58.88,17.27,276.0,63
CDM,3108628,POC HEMOGLOBIN METHEMOGLOBIN QN,25.0,4.0,8.2,38.52,63
CDM,3108651,LAB CALPROTECTIN FECAL,250.0,40.0,19.63,187.5,63
CDM,3108719,LAB BILIRUBIN TOTAL FLUID BODY NS,136.0,21.76,5.02,102.0,63
CDM,3108735,LAB IMM ACHR BLOCKING QN,99.0,18.81,18.4,74.25,63
CDM,3108768,LAB AB PROTOZOA BABESIA,58.0,11.02,12.39,58.14,63
CDM,3108784,LAB TRANSFERRIN CARBOHYDRATE DEF,55.0,8.8,18.06,84.75,63
CDM,3108800,LAB PORPHYRINS FECES QN,173.0,27.68,39.11,183.6,63
CDM,3108891,LAB DET IA HERPES 6 PCR QN,126.0,27.85,41.76,196.03,63
CDM,3108909,LAB DET IA JC VIRUS PCR PRB AMP,123.0,27.18,35.09,164.7,63
CDM,3108917,LAB DET IA JC VIRUS PCR QN,129.0,28.51,42.84,261.36,63
CDM,3108925,LAB DET IA BK VIRUS PCR QN NS,129.0,28.51,42.84,261.36,63
CDM,3108933,LAB VORICONAZOLE,127.0,20.32,27.11,117.41,63
CDM,3108958,LAB CONSULT SLIDES PREP REQ NS,112.0,31.14,28.84,483.38,63
CDM,3109022,LAB CYSTATIN C,56.0,8.96,18.52,86.94,63
CDM,3109055,LAB IMMUNOFIXATION EP URINE/CSF NS,89.0,16.91,29.35,127.11,63
CDM,3109097,LAB SCR CULT H PYLORI SGL,20.0,4.42,6.63,31.13,63
CDM,3109212,LAB AB DNA STRANDED NATVE/DOUBLE NS,62.0,11.78,13.74,64.46,63
CDM,3109287,LAB IG IGE NS,58.0,9.28,16.46,77.23,63
CDM,3109303,LAB GONADOTROPIN LH NS,57.0,9.12,18.52,86.94,63
CDM,3109311,LAB DEHYDROGENASE G6PD QN NS,56.0,8.96,9.7,45.57,63
CDM,3109352,LAB ANA TITER NS,115.0,21.85,11.16,86.25,63
CDM,3109360,LAB TRANSFERRIN NS,39.0,6.24,12.76,59.87,63
CDM,3109378,LAB AB COCCIDIOIDES NS,66.0,12.54,11.47,53.81,63
CDM,3109428,LAB SOMATOMEDIN NS,64.0,10.24,21.26,99.78,63
CDM,3109444,LAB AB HERPES SIMPLEX TYPE 1 NS,53.0,10.07,13.19,80.42,63
CDM,3109485,LAB FAT/LIPIDS FECES QL NS,68.0,10.88,5.1,51.0,63
CDM,3109493,LAB ETHYLENE GLYCOL NS,94.0,15.04,14.9,70.5,63
CDM,3109576,LAB CLOTTING FACTOR 8 1-STG NS,114.0,20.86,17.9,85.5,63
CDM,3109584,LAB CLOTTING FACTOR 9 PTC/XMAS NS,75.0,13.72,19.04,89.34,63
CDM,3109600,LAB CLOTTING FACTOR 11 PTA NS,89.0,16.29,17.9,84.01,63
CDM,3109626,LAB AB EBV EBNA NS,54.0,10.26,15.29,71.78,63
CDM,3109642,LAB AB EBV VCA IGM NS,55.0,10.45,18.14,85.15,63
CDM,3109659,LAB AB VARICELLA-ZOSTER IGM NS,39.0,7.41,12.88,60.47,63
CDM,3109667,LAB AB VARICELLA-ZOSTER IGG NS,53.0,10.07,12.88,60.47,63
CDM,3109675,LAB CLOTTING FACTOR 8 VWF RIST NS,87.0,15.92,22.94,107.7,63
CDM,3109709,LAB PHOSPHORUS INORGANIC URINE NS,18.0,2.88,5.78,27.14,63
CDM,3109758,LAB FACTOR RHEUMATOID QN NS,55.0,10.45,5.67,41.25,63
CDM,3109766,LAB LIPOPROTEIN A NS,58.0,9.28,14.32,67.19,63
CDM,3109873,LAB DET AG IA IF LEGIONELLA NS,47.0,10.39,15.6,73.24,63
CDM,3109915,LAB MICROGLOBULIN BETA-2 NS,93.0,14.88,16.18,75.97,63
CDM,3109956,LAB ESTROGEN TOTAL NS,66.0,10.56,21.7,132.37,63
CDM,3109980,LAB THYROGLOBULIN NS,57.0,9.12,16.06,75.37,63
CDM,3110038,LAB CLOTTING FACTOR 13 STB FBR NS,98.0,17.93,16.34,76.7,63
CDM,3110053,LAB PRIMIDONE NS,59.0,9.44,16.59,77.83,63
CDM,3110103,LAB CRYOFIBRINOGEN NS,69.0,11.04,14.14,66.39,63
CDM,3110137,LAB AB THYROGLOBULIN NS,96.0,18.24,15.91,74.64,63
CDM,3110152,LAB PROT C-REACTIVE SENS HIGH NS,131.0,24.89,12.95,98.25,63
CDM,3110160,LAB DET AG IA IMM H PYLORI STOOL NS,44.0,9.72,14.38,67.45,63
CDM,3110285,POC NEUTRALIZATION HEPARIN,36.0,6.59,11.84,55.54,63
CDM,3110293,POC TOLERANCE HEPARIN-PROTAMINE,40.0,7.32,13.09,61.46,63
CDM,3110301,LAB IMM MUSK QN,56.0,10.64,18.31,64.46,63
CDM,3110319,LAB SCR AB MUSCLE SMOOTH FL NS,56.0,10.64,11.53,49.94,63
CDM,3110327,LAB AB CRYPTOCOCCUS IFA,44.0,8.36,14.41,67.65,63
CDM,3110491,LAB IMM RIA GAD 65 QN,56.0,8.96,18.4,86.34,63
CDM,3110517,LAB CHROMIUM,61.0,9.76,20.28,95.19,63
CDM,3110574,LAB CHROM W BND 5 CLL 1 K CVS DIR,794.0,196.12,264.34,1392.93,63
CDM,3110582,LAB ALPHA2-MACROGLOBULIN QN,72.0,11.52,13.6,63.79,63
CDM,3110590,LAB IMM ACHR MODULATING QN,78.0,14.82,12.05,58.5,63
CDM,3110608,LAB ACID MYCOPHENOLIC,55.0,8.8,18.05,84.75,63
CDM,3110715,LAB SUSCPT DILUTION MACROBROTH NS,115.0,25.42,6.64,86.25,63
CDM,3110723,LAB CULT FUNGI ID DF YEAST NS,136.0,30.06,10.32,102.0,63
CDM,3110731,LAB CULT FUNGI ID DF MOLD NS,138.0,30.5,10.32,103.5,63
CDM,3110756,LAB SUSCPT AFB PROPORTION EA NS,63.0,13.92,7.31,47.25,63
CDM,3110764,LAB ELASTASE PANCREATIC FECAL,104.0,16.64,11.53,78.0,63
CDM,3110772,LAB DET IA EBV PCR QN NS,129.0,28.51,42.84,261.36,63
CDM,3110780,LAB VITAMIN E BETA/GAMMA TOCOPHER,52.0,8.32,17.06,80.09,63
CDM,3110798,LAB DET IA ADENOVIRUS PCR QN,129.0,28.51,42.84,261.36,63
CDM,3110806,LAB DET IA HHV NON 6 PCR QN,129.0,28.51,42.84,261.36,63
CDM,3110814,LAB DET IA HHV-8 PCR PRB AMP,124.0,27.4,35.09,164.7,63
CDM,3110822,LAB DET IA EBV PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3110830,LAB AB HERPES SIMPLEX TYPE 2 NS,59.0,11.21,19.35,118.14,63
CDM,3110863,LAB COAGULATION&FIBRINOLYSIS,164.0,30.01,30.86,144.88,63
CDM,3110871,LAB AB ENA JO1,123.0,23.37,17.93,92.25,63
CDM,3110889,LAB IMM MS RIBO P PROTEIN QL,35.0,5.6,11.53,54.08,63
CDM,3110897,LAB AB ENA CHROMATIN,124.0,23.56,17.93,93.0,63
CDM,3110905,LAB AB ENA SM/RNP,54.0,10.26,17.93,84.15,63
CDM,3110921,LAB AB LYME DISEASE IGG IGM,66.0,12.54,17.03,79.89,63
CDM,3110996,LAB KAPPA/LAMBDA LIGHT NS,55.0,8.8,13.6,63.79,63
CDM,3111002,LAB DET IA BK VIRUS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3111028,LAB DET IA CHLAMYD TRAC PRB AMP NS,115.0,25.42,35.09,164.7,63
CDM,3111036,LAB DET IA GC PRB AMP NS,106.0,23.43,35.09,164.7,63
CDM,3111069,LAB AB TOXOPLASMA IGM,60.0,11.4,14.41,67.65,63
CDM,3111077,LAB AB TOXOPLASMA IGG,60.0,11.4,14.39,67.52,63
CDM,3111085,LAB LEUKOCYTE ALK PHOS W COUNT NS,26.0,4.76,8.6,40.38,63
CDM,3111093,LAB AB PARAINFLUENZA,66.0,12.54,12.88,60.47,63
CDM,3111101,LAB IMM RIA POLY PANCREATIC QN,78.0,12.48,18.4,86.34,63
CDM,3111119,LAB AB STRONGYLOIDES,69.0,13.11,13.01,61.07,63
CDM,3111143,LAB FLUORIDE,285.0,45.6,18.54,213.75,63
CDM,3111168,LAB TRIIODOTHYRONINE T3 TOTAL NS,43.0,6.88,14.18,66.52,63
CDM,3111176,LAB HEMOGLOBIN FRCTN&QN CHROMAT NS,55.0,8.8,18.06,84.75,63
CDM,3111200,LAB AB MICROSOMAL LC-1 EA,44.0,8.36,14.55,68.25,63
CDM,3111234,LAB DET IA MYCOBCT AV-INTRA PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3111242,LAB IMDF AB ACID TEICHOIC,43.0,8.17,14.05,65.99,63
CDM,3111283,LAB IMM RIA RECEPTOR TSH QN,101.0,16.16,18.4,86.34,63
CDM,3111291,LAB NEPHELOMETRY C3PA COMPLEMENT,41.0,6.56,13.6,63.79,63
CDM,3111341,LAB IMM MS HISTONE QL,62.0,9.92,11.53,54.08,63
CDM,3111358,LAB CHROM BRK STRS CLASTGN 100 CELL,520.0,128.44,173.17,912.52,63
CDM,3111382,LAB ELECTRO LIPOPROTEIN,185.0,29.6,61.5,288.7,63
CDM,3111390,LAB SCR AB PURKINJE FL,64.0,12.16,12.05,78.63,63
CDM,3111416,LAB AGG PARTICLE TITER STREPTOZYME,81.0,15.39,10.64,60.75,63
CDM,3111432,LAB DET IA VZV PCR QN,129.0,28.51,42.84,261.36,63
CDM,3111473,LAB ONCOPROTEIN DCP,194.0,31.04,64.41,302.33,63
CDM,3111507,LAB CARBON DIOXIDE HCO3 URINE,131.0,20.96,4.88,98.25,63
CDM,3111630,LAB PROCALCITONIN,155.0,24.8,27.22,127.78,63
CDM,3111648,LAB FNCT CELL W STIM&DET BIOMARK,408.0,77.52,135.86,637.66,63
CDM,3111655,LAB AG CELL MONONUC QN EA AG,93.0,17.67,26.78,125.66,63
CDM,3111671,LAB AB ID IG PLATELET ASSOCIATED,236.0,44.84,12.46,177.0,63
CDM,3111804,LAB MCG PROBE DNA PROBE EA NS,65.0,16.06,21.42,112.88,63
CDM,3111812,LAB MCG IN SITU INT 100-300 CELL NS,357.0,88.18,51.19,269.74,63
CDM,3111820,LAB CONCENTRATION AFB IA NS,71.0,15.69,6.68,53.25,63
CDM,3111846,LAB PROT WB W INTRP ID MATA AUTOAB,380.0,60.8,29.21,285.0,63
CDM,3111895,LAB DET IA TOXIN C DIFF PRB AMP NS,112.0,24.75,37.27,174.95,63
CDM,3111911,LAB BLOOD OCCULT FECES 1-3 IMM QL,62.0,9.92,15.92,74.77,63
CDM,3111929,LAB IMM RECEPTOR TSH QN,52.0,8.32,17.27,81.09,63
CDM,3111952,LAB STAIN CONSTITUENTS ENZYME NS,1684.0,468.15,107.67,1418.55,63
CDM,3112026,LAB AB LEPTOSPIRA TITER,154.0,29.26,16.2,115.5,63
CDM,3112034,LAB AB FL TITER ANTIMYOCARDIAL,37.0,7.03,12.05,78.63,63
CDM,3112059,LAB AB CAMPYLOBACTER NS,40.0,7.6,13.12,61.6,63
CDM,3112075,LAB COUNT TOTAL CELLS CD56 NK NS,114.0,21.66,37.73,177.08,63
CDM,3112182,LAB IMM AB QN PNEUMOCOCCAL,51.0,9.69,14.99,70.38,63
CDM,3112208,LAB SCR HEMOLYSINS&AGGLUTININS AUTO,490.0,93.1,8.77,367.5,63
CDM,3112224,LAB TB MEAS IMMUNITY GAMMA INTERFRN,186.0,35.34,61.98,378.1,63
CDM,3112232,LAB VITAMIN B-12 CAPACITY BNDG NS,66.0,10.56,14.32,67.19,63
CDM,3112240,LAB DET IA HEP B QN,129.0,28.51,42.84,201.02,63
CDM,3112331,LAB CARBOXYHEMOGLOBIN QN,56.0,8.96,12.32,57.81,63
CDM,3112356,LAB CULT TYPING ID SEQ NUC ACID,347.0,59.68,50.0,541.47,59
CDM,3112372,LAB DET IA CHLAMYD PNEU PRB AMP NS,328.0,72.49,35.09,246.0,63
CDM,3112448,LAB BLOOD TYPE DONOR SERUM RGT,760.0,130.72,6.35,570.0,63
CDM,3112505,LAB CYTOPATH EVAL FNA IMMED 1ST,363.0,89.66,21.05,299.97,63
CDM,3112521,LAB CYTOPATH EVAL FNA IMMED ADDL,47.0,11.61,8.11,122.65,40
CDM,3112570,LAB NEUTRAL PHOSPHO HEXAGONAL,71.0,12.99,17.98,84.35,63
CDM,3112646,LAB TRANSFERASE GAMMA-GLUTAMYL NS,62.0,9.92,7.2,46.5,63
CDM,3112661,LAB PROT 4 HUMAN EPIDIDYMIS,97.0,18.43,13.98,97.72,59
CDM,3112679,POC PAMG-1 CERVICOVAGINAL QL,295.0,47.2,98.11,460.45,63
CDM,3112695,LAB IMM AB GBM QN,60.0,9.6,17.27,81.09,63
CDM,3112703,LAB GENOTYPE IA HIV-1 TROPISM CORCP,387.0,85.53,128.73,604.2,63
CDM,3112711,LAB ZONISAMIDE,79.0,12.64,13.25,62.2,63
CDM,3112737,LAB PH FLUID BODY NOS NS,104.0,16.64,3.58,78.0,63
CDM,3112786,LAB HEAVY METAL QN COBALT,288.0,46.08,21.96,216.0,63
CDM,3112802,POC COAGULATION TIME ACTIVAT TELCOR,13.0,2.38,4.28,20.09,63
CDM,3112810,POC NITROGEN UREA QN TELCOR,83.0,13.28,3.95,62.25,63
CDM,3112828,POC CREATININE BLOOD TELCOR,60.0,9.6,5.12,45.0,63
CDM,3112836,POC PROTHROMBIN TIME TELCOR,13.0,2.38,4.29,20.16,63
CDM,3112869,POC SODIUM SRM/PLASMA/BLD WHL TLCR,48.0,7.68,4.81,36.0,63
CDM,3112877,POC POTASS SRM/PLASMA/BLD WHL TLCR,60.0,9.6,4.76,45.0,63
CDM,3112885,POC CHLORIDE BLOOD TELCOR,47.0,7.52,4.6,35.25,63
CDM,3112893,POC GASES BLD ANY COMBO TELCOR,123.0,19.68,26.07,122.33,63
CDM,3112919,POC CALCIUM IONIZED TELCOR,77.0,12.32,13.68,64.19,63
CDM,3112927,POC GASES BLD PH ONLY TELCOR,33.0,5.28,11.0,51.62,63
CDM,3112935,POC PANEL ELECTROLYTE TELCOR,158.0,25.28,7.01,118.5,63
CDM,3112950,LAB SEPARATION RED CELL,268.0,46.1,17.89,376.04,62
CDM,3112992,LAB AGGREGATION PLT CLOPIDOGREL,79.0,14.46,24.91,107.89,63
CDM,3113008,LAB AGGREGATION PLT ASPIRIN,197.0,36.05,24.91,147.75,63
CDM,3113016,LAB SCR FIBRINOLYSINS/COAG,65.0,11.9,15.48,157.25,63
CDM,3113032,LAB PHENOBARBITAL NS,59.0,9.44,15.3,71.78,63
CDM,3113040,LAB PEPTIDE NATRIURETIC PB NS,121.0,19.36,39.26,184.26,63
CDM,3113073,LAB CULT BACT AEROBIC STOOL PATH NS,63.0,13.92,9.44,47.25,63
CDM,3113131,LAB PROT WB W INTRP ID CREUTZ-JAKOB,89.0,14.24,29.21,126.51,63
CDM,3113149,LAB IMM AB QN CREUTZFELDT-JAKOB,83.0,15.77,14.99,70.38,63
CDM,3113156,LAB SPCTPHOT 1-3-BETA-D-GLUCAN,157.0,25.12,8.1,117.75,63
CDM,3113206,LAB ELECTRO NS,185.0,29.6,61.5,288.7,63
CDM,3113214,LAB HEMOGLOBIN METHEMOGLOBIN QN,59.0,9.44,8.2,44.25,63
CDM,3113222,LAB DET IA TOXOPLASMA PCR QN,130.0,28.73,42.84,261.36,63
CDM,3113230,LAB DET IA PNEUMOCYSTIS PCR QN,275.0,60.78,42.84,261.36,63
CDM,3113248,LAB IMM MS NEUROMYLTS OPT IGG QL,35.0,5.6,11.53,54.08,63
CDM,3113255,LAB DET AG IA IMM ENZ ENTAM HIST NS,73.0,16.13,11.98,56.28,63
CDM,3113362,LAB TB MEAS IMMUNITY T-CELL SUSP,300.0,57.0,100.0,469.37,63
CDM,3113370,LAB PRETREAT SERUM INCUB INHIB,363.0,68.97,1.99,299.97,63
CDM,3113420,LAB DET IA PARVOVIRUS PCR QN,141.0,31.16,42.84,261.36,63
CDM,3113446,LAB DET AG IA IMM ENZ STREP PNEU QL,65.0,14.36,11.98,56.28,63
CDM,3113461,LAB DET IA TOXIN C DIFF PRB AMP,112.0,24.75,37.27,174.95,63
CDM,3113479,LAB IMM MS GLIADIN QL,59.0,11.21,11.53,49.94,63
CDM,3113487,LAB IMM MS TRANSGLUTAMINASE QL,59.0,11.21,11.53,49.94,63
CDM,3113495,LAB AB FL TITER NS,78.0,14.82,12.05,78.63,63
CDM,3113511,LAB CYTOPATH URIN MANUAL PRB 3-5 EA,603.0,148.94,108.14,3308.24,63
CDM,3113537,LAB PYRUVATE KINASE NS,187.0,29.92,9.44,140.25,63
CDM,3113545,LAB COUNT TOTAL CELLS T NS,114.0,21.66,37.73,177.08,63
CDM,3113552,LAB COUNT CELLS T CD4&CD8 RATIO NS,141.0,26.79,46.98,220.45,63
CDM,3113610,LAB BLOOD TYPE IMMUNOPHENOTYPE,760.0,130.72,3.83,570.0,63
CDM,3113628,LAB BLOOD TYPE DONOR SERUM RGT NS,760.0,130.72,6.35,570.0,63
CDM,3113644,LAB MICRODISSECTION MANUAL,230.0,63.94,42.78,884.04,39
CDM,3113685,LAB PLATELET RETICULATED,108.0,19.76,35.74,167.76,63
CDM,3113727,LAB PRETREAT SERUM INCUB W DRUGS,951.0,180.69,1.78,786.54,63
CDM,3113735,LAB SCR AGGLUTININ COLD NS,25.0,4.75,8.07,37.92,63
CDM,3113743,LAB PROT WB W INTRP ID RECOVERING,88.0,14.08,29.21,126.51,63
CDM,3113750,LAB KAPPA/LAMBDA LIGHT,69.0,11.04,13.6,63.79,63
CDM,3113784,LAB GENE BCR/ABL1 BREAKPOINT MAJOR,492.0,137.27,163.96,863.96,63
CDM,3113792,LAB GENE BCR/ABL1 BREAKPOINT MIN NS,435.0,121.36,144.84,763.18,63
CDM,3113800,LAB GENE BCR/ABL1 BREAKPOINT OTHER,644.0,179.68,214.62,1130.91,63
CDM,3113818,LAB GENE BLM VAR 2281DEL6INS7,118.0,32.92,39.31,207.14,63
CDM,3113826,LAB GENE BRAF VAR V600E NS,527.0,147.03,175.4,924.23,63
CDM,3113909,LAB GENE CFTR VAR COMMON,1670.0,465.93,556.6,2932.93,63
CDM,3113925,LAB GENE CFTR VAR DUP/DEL,1306.0,364.37,435.07,2292.55,63
CDM,3113933,LAB GENE CFTR SEQ FULL,1497.0,417.66,499.0,2629.47,63
CDM,3113958,LAB GENE CYP2C19 VAR COMMON NS,875.0,244.13,291.36,1535.28,63
CDM,3113974,LAB GENE CYP2C9 VAR COMMON NS,525.0,146.48,174.81,921.17,63
CDM,3114006,LAB GENE F2 VAR 20210G>A NS,198.0,55.24,65.69,346.17,63
CDM,3114014,LAB GENE F5 VAR LEIDEN,221.0,61.66,73.37,386.61,63
CDM,3114030,LAB GENE FMR1 DET ALLELES ABNORMAL,172.0,47.99,57.04,300.6,63
CDM,3114055,LAB GENE FLT3 VAR ITD,497.0,138.66,165.51,872.14,63
CDM,3114063,LAB GENE G6PC VAR COMMON,176.0,49.1,58.49,308.19,63
CDM,3114097,LAB GENE HFE VAR COMMON NS,197.0,54.96,65.36,344.37,63
CDM,3114105,LAB GENE HBA1/HBA2 DEL/VAR COMMON,307.0,85.65,102.26,538.88,63
CDM,3114121,LAB GENE IGH REARRANGEMENT AMP,594.0,165.73,197.99,1043.3,63
CDM,3114147,LAB GENE IGH MUT VARIABLE REGION,884.0,246.64,294.52,1551.91,63
CDM,3114154,LAB GENE IGK REARRANGEMENT CLONAL,519.0,144.8,172.73,910.19,63
CDM,3114162,LAB GENE MARKERS STR SPEC PT&CMP,700.0,195.3,233.07,1228.16,63
CDM,3114188,LAB GENE CHIMERISM WO CELL SLCT NS,1139.0,317.78,207.46,1093.19,63
CDM,3114196,LAB GENE CHIMERISM W CELL SLCT EA,783.0,218.46,260.79,1374.17,63
CDM,3114204,LAB GENE JAK2 VAR V617F NS,275.0,76.73,91.66,483.0,63
CDM,3114212,LAB GENE KRAS VAR CODONS 12&13 NS,580.0,161.82,193.25,1018.35,63
CDM,3114261,LAB GENE MTHFR VAR COMMON NS,197.0,54.96,65.34,344.31,63
CDM,3114360,LAB GENE INSTABILITY MICROSATELLITE,1046.0,291.83,348.56,1836.68,63
CDM,3114402,LAB GENE NPM1 VAR EXON 12,740.0,206.46,246.52,1299.0,63
CDM,3114410,LAB GENE PML/RARALPHA BREAKPOINTS,622.0,173.54,207.31,1092.39,63
CDM,3114477,LAB GENE SNRPN/UBE3A METHYLATION,198.0,55.24,51.07,269.14,63
CDM,3114485,LAB GENE SERPINA1 VAR COMMON,346.0,96.53,43.65,259.5,63
CDM,3114493,LAB GENE TRB REARRANGEMENT AMP,627.0,174.93,208.92,1100.91,63
CDM,3114519,LAB GENE TRG REARRANGEMENT CLONAL,605.0,168.8,201.5,1061.79,63
CDM,3114527,LAB GENE UGT1A1 VAR COMMON NS,702.0,195.86,234.0,1233.01,63
CDM,3114543,LAB GENE TYPING HLA 1&2 LR,1207.0,336.75,402.12,2118.93,63
CDM,3114550,LAB GENE TYPING HLA 1&2 LR VERIF,1214.0,338.71,404.52,2131.57,63
CDM,3114568,LAB GENE TYPING HLA 1 LR CMP,1211.0,337.87,403.59,2126.64,63
CDM,3114584,LAB GENE TYPING HLA 1 LR AG 1 EA,223.0,62.22,74.33,391.67,63
CDM,3114592,LAB TYPING HLA 2 LR ANTIGEN EQUIV,663.0,184.98,220.74,1163.17,63
CDM,3114600,LAB GENE TYPING HLA 2 LR LOCUS EA,367.0,102.39,122.22,644.05,63
CDM,3114626,LAB GENE TYPING HLA 1&2 HR,1037.0,289.32,345.57,1820.98,63
CDM,3114634,LAB GENE TYPING HLA 1 HR CMP,1007.0,280.95,335.38,1767.24,63
CDM,3114642,LAB GENE TYPING HLA 1 HR LOCUS EA,532.0,148.43,177.25,934.01,63
CDM,3114659,LAB GENE TYPING HLA 1 HR ALLE 1/GRP,510.0,142.29,169.9,895.29,63
CDM,3114667,LAB GENE TYPING HLA 2 HR LOCUS EA,372.0,103.79,123.68,651.7,63
CDM,3114675,LAB GENE TYPING HLA 2 HR ALLE 1/GRP,328.0,91.51,109.13,575.07,63
CDM,3114683,LAB PROC PATHOLOGY MOLEC LEVEL 1,192.0,53.57,63.96,336.99,63
CDM,3114709,LAB PROC PATHOLOGY MOLEC LEVEL 3,451.0,125.83,150.33,792.12,63
CDM,3114717,LAB PROC PATHOLOGY MOLEC LEVEL 4 NS,617.0,172.14,185.2,975.85,63
CDM,3114725,LAB PROC PATHOLOGY MOLEC LEVEL 5,825.0,230.18,274.83,1448.21,63
CDM,3114733,LAB PROC PATHOLOGY MOLEC LEVEL 6,905.0,252.5,301.35,1587.9,63
CDM,3114741,LAB PROC PATHOLOGY MOLEC LEVEL 7,1931.0,538.75,282.88,1490.65,63
CDM,3114758,LAB PROC PATHOLOGY MOLEC LEVEL 8,2539.0,708.38,846.27,4459.3,63
CDM,3114766,LAB PROC PATHOLOGY MOLEC LEVEL 9,6000.0,1674.0,2000.0,10538.76,63
CDM,3114824,LAB SCR AB NMDA RECEPTOR FL,167.0,31.73,12.05,125.25,63
CDM,3114832,LAB NEUTRAL PHOSPHO HEXAGONAL NS,64.0,11.71,17.98,84.35,63
CDM,3114840,LAB THROMBIN TIME PLASMA NS,18.0,3.29,5.77,27.07,63
CDM,3114865,LAB HOMOGENIZATION TISSUE NS,18.0,3.98,5.88,27.61,63
CDM,3114873,LAB ISO VIRUS INOC TISSUE ADDL NS,61.0,13.48,20.2,94.79,63
CDM,3114923,LAB SCR AB CSF FL,37.0,7.03,12.05,78.63,63
CDM,3114931,LAB GENE MA CYTO COPY NO&SNP BLD NS,3480.0,970.92,1160.0,6112.52,63
CDM,3114949,LAB GENE MA CYTO COPY NO&SNP POC,3480.0,970.92,1160.0,6112.52,63
CDM,3114956,LAB COUNT BLD RBC AUTO NS,10.0,1.83,3.02,14.17,63
CDM,3114964,LAB COUNT BLD HEMATOCRIT NS,8.0,1.46,2.37,11.18,63
CDM,3114972,LAB COUNT BLD HEMOGLOBIN NS,13.0,2.38,2.37,11.18,63
CDM,3114980,LAB GENE MGMT ANLYS METHYLATION,671.0,187.21,124.64,656.82,63
CDM,3114998,LAB DEXAMETHASONE,60.0,9.6,18.64,87.47,63
CDM,3115003,LAB FLUCONAZOLE,111.0,17.76,18.64,87.47,63
CDM,3115011,LAB SCR AB SYPHILIS NS,40.0,7.6,13.24,62.13,63
CDM,3115029,LAB GENE MA CYTO COPY NO&SNP BLD,3480.0,970.92,1160.0,6112.52,63
CDM,3115060,LAB DET IA TRICHOMONAS VAG PRB AMP,106.0,23.43,35.09,214.06,63
CDM,3115169,LAB DET IA B PERTUSSIS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3115193,LAB B CELLS CD19 COUNT TOTAL NS,114.0,21.66,37.73,177.08,63
CDM,3115227,LAB GENE JAK2 VAR V617F,275.0,76.73,91.66,483.0,63
CDM,31153,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3115649,LAB DET IA LEGIONELL PNEUM PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3115656,LAB CLOTTING FACTOR 10 STUART-PR NS,54.0,9.88,17.9,84.01,63
CDM,3115664,LAB POSACONAZOLE,118.0,18.88,27.11,117.41,63
CDM,3115672,LAB DIGOXIN TOTAL,53.0,8.48,13.28,62.33,63
CDM,3115680,LAB DIGOXIN FREE,40.0,6.4,13.28,62.33,63
CDM,3115698,LAB ACID VALPROIC TOTAL,53.0,8.48,13.54,63.53,63
CDM,3115722,LAB IMHST/IMCYT MLTPLX PER SPEC,760.0,211.28,132.37,718.04,63
CDM,3115730,LAB IMHST/IMCYT MLTPLX PER SPEC NS,760.0,211.28,132.37,718.04,63
CDM,3115748,LAB MORPHO HER2 MANUAL PER SPEC NS,374.0,103.97,78.18,510.54,63
CDM,3115755,LAB MORPHO HER2 COMP PER SPEC,760.0,211.28,75.26,638.06,63
CDM,3115763,LAB ISH PRB STAIN PER SPEC ADDL,366.0,101.75,68.08,582.13,39
CDM,3115771,LAB ISH PRB STAIN PER SPEC ADDL NS,366.0,101.75,68.08,582.13,39
CDM,3115789,LAB ISH 1ST PRB STAIN PER SPEC NS,363.0,100.91,108.14,758.49,63
CDM,3115797,LAB ISH 1ST PRB STAIN PER SPEC,363.0,100.91,108.14,758.49,63
CDM,3115805,LAB MORPHO ISH COMP 1ST SPEC NS,760.0,211.28,77.53,631.11,63
CDM,3115813,LAB MORPHO ISH MANUAL 1ST SPEC,760.0,211.28,104.42,631.11,63
CDM,3115821,LAB MORPHO ISH MANUAL 1ST SPEC NS,760.0,211.28,104.42,631.11,63
CDM,3115839,LAB MORPHO ISH MANUAL ADDL SPEC,335.0,93.13,62.31,486.63,39
CDM,3115862,LAB PATH GROSS&MICRO BX PROS NDL,1245.0,346.11,179.4,2645.23,59
CDM,3115888,LAB VOLATILE,52.0,8.32,17.11,80.29,63
CDM,3115896,LAB SCR VOLATILE,52.0,8.32,17.11,80.29,63
CDM,3115904,LAB IMHST/IMCYT AB 1ST PER SPEC NS,363.0,100.91,70.39,426.78,63
CDM,3115912,LAB IMHST/IMCYT AB PER SPEC NS ADDL,228.0,63.38,42.41,373.16,39
CDM,3115920,LAB IMHST/IMCYT AB 1ST PER SPEC,363.0,100.91,70.39,426.78,63
CDM,3115938,LAB IMHST/IMCYT AB PER SPEC ADDL,266.0,73.95,49.48,373.16,39
CDM,3115961,LAB DET IA HPV TYPES 16&18,122.0,26.96,40.55,214.06,63
CDM,3115979,LAB KETONES NS,61.0,9.76,8.17,45.75,63
CDM,3115987,LAB ISH MLTPLX PER SPEC,517.0,143.73,108.14,1201.55,63
CDM,3115995,LAB DET IA GI MULT PRB AMP 3-5 TGT,385.0,85.08,128.29,602.14,63
CDM,3116001,LAB MORPHO ISH COMP MULT SPEC NS,553.0,153.73,108.14,1373.45,63
CDM,3116019,LAB MORPHO ISH MAN MULT PER SPEC,872.0,242.42,108.14,1705.89,63
CDM,3116035,LAB FDP FSP AGG SEMI QN NS,80.0,14.64,6.89,60.0,63
CDM,3116043,LAB MORPHO ISH MAN MULT PER SPEC NS,872.0,242.42,108.14,1705.89,63
CDM,3116084,LAB IMM SOLUBLE CD163,808.0,129.28,17.27,606.0,63
CDM,3116126,LAB ACID VALPROIC TOTAL NS,66.0,10.56,13.54,63.53,63
CDM,3116134,LAB ACID VALPROIC FREE,66.0,10.56,13.54,63.53,63
CDM,3116142,LAB GENE TPMT NS,525.0,146.48,174.81,921.17,63
CDM,3116159,LAB DET IA CANDIDA PRB AMP,237.0,52.38,35.09,214.06,63
CDM,3116167,LAB CARBON DIOXIDE HCO3 NS,54.0,8.64,4.88,40.5,63
CDM,3116241,LAB SMEAR INCL BODIES/PARASITE NS,64.0,14.14,5.99,78.63,63
CDM,3116316,LAB DET AG IA IMM HIV1 W HIV 1&2,87.0,19.23,24.08,104.29,63
CDM,3116324,LAB LEVETIRACETAM,40.0,6.4,13.25,62.2,63
CDM,3116332,LAB DET IA HIV-1 QN NS,256.0,56.58,85.1,399.45,63
CDM,3116357,LAB PH STOOL NS,72.0,11.52,3.58,54.0,63
CDM,3116365,LAB SCR AB PARANEOPLASTIC FL,37.0,7.03,12.05,78.63,63
CDM,3116381,LAB HSP 70 WB W INTRP,174.0,27.84,17.03,130.5,63
CDM,3116399,LAB GENE BCR/ABL1 BREAKPOINT MIN,435.0,121.36,144.84,763.18,63
CDM,3116407,LAB GENE BCR/ABL1 REFLEX P210,492.0,137.27,163.96,863.96,63
CDM,3116423,LAB CONCENTRATION ANY TYPE IA NS,128.0,28.29,6.68,96.0,63
CDM,3116431,LAB DET AG IA IF PNEUMOCYSTIS NS,76.0,16.8,11.98,57.0,63
CDM,3116472,LAB GENE ANLYS MUT CALRETICULIN,365.0,101.84,121.63,640.92,63
CDM,3116498,LAB MORPHO HER2 MANUAL PER SPEC,363.0,100.91,78.18,510.54,63
CDM,3116506,LAB GENE MLH1 METHYLATION,577.0,160.98,192.32,1013.43,63
CDM,3116514,LAB CHROMAT MS NON-DRUG QL/QN NS,73.0,11.68,24.09,113.08,63
CDM,3116522,LAB MS&MS TNDM NON-DRUG QL/QN,73.0,11.68,24.11,113.15,63
CDM,3116530,LAB AB HEPATITIS A,55.0,10.45,12.39,58.14,63
CDM,3116548,LAB IF AB STAIN INITIAL PER SPEC,363.0,100.91,108.14,646.57,63
CDM,3116555,LAB IF AB STAIN PER SPEC ADDL,257.0,71.45,47.8,498.63,39
CDM,3116571,LAB CLOMIPRAMINE,62.0,9.92,18.64,87.47,63
CDM,3116589,LAB GENE KRAS VAR ADDL NS,580.0,161.82,193.25,1018.35,63
CDM,3116597,LAB GENE ABL1 VAR KD,900.0,251.1,300.0,1580.85,63
CDM,3116605,LAB GENE CEBPA SEQ FULL,726.0,202.55,241.9,1274.66,63
CDM,3116613,LAB BUSULFAN,56.0,8.96,18.64,87.47,63
CDM,3116662,LAB GENE FLT3 VAR TKD,249.0,69.47,83.0,1932.41,63
CDM,3116670,LAB DRG DF ANTD CYCL AMIT DAY 1-2,62.0,9.92,11.53,100.58,37
CDM,3116704,LAB DRG DF BENZ DAY 1-12,84.0,13.44,15.62,116.28,37
CDM,3116720,LAB DRG DF BENZ CLONAZEPM DAY 1-12,67.0,10.72,12.46,116.28,37
CDM,3116761,LAB DRG DF BENZ FLUNTRZPM DAY 1-12,166.0,26.56,23.37,124.5,37
CDM,3116837,LAB DRG DF ANTD CYCL DESI DAY 1-2NS,62.0,9.92,11.53,100.58,37
CDM,3116860,LAB DRG DF ANTD CYCL DOXE DAY 1-2,30.0,4.8,5.58,100.58,37
CDM,3116894,LAB DRG DF GOLD DAY 1-3,120.0,19.2,22.32,90.0,37
CDM,3116928,LAB DRG DF ANTD CYCL IMIPRM DAY 1-2,62.0,9.92,11.53,100.58,37
CDM,3116951,LAB DRG DF ANTD CYCL NORT DAY 1-2,68.0,10.88,12.65,100.58,37
CDM,3117017,LAB DRG DF ANLG SALICYLATE DAY 1-2,331.0,52.96,23.37,248.25,37
CDM,3117041,LAB DRG DF ANLG ACETAMINPHN DAY 1-2,331.0,52.96,23.37,248.25,37
CDM,3117074,LAB DRG DF ETOH EXCEPT BR DAY,312.0,49.92,23.37,234.0,37
CDM,3117082,LAB DRG DF ETOH EXCEPT BR DAY NS,61.0,9.76,11.35,101.51,37
CDM,3117108,LAB DRG DF AMPH/METH DAY 1-2 NS,73.0,11.68,13.58,91.27,37
CDM,3117132,LAB DRG DF BARB PHENOBARB DAY,174.0,27.84,23.37,130.5,37
CDM,3117181,LAB DRG DF BARB URINE DAY,73.0,11.68,13.58,74.37,37
CDM,3117199,LAB DRG DF COCAINE DAY,67.0,10.72,12.46,74.37,37
CDM,3117256,LAB DRG DF MSCL RELAX DAY 1-2,154.0,24.64,23.37,115.5,37
CDM,3117272,LAB DRG DF METHADONE DAY,158.0,25.28,23.37,118.5,37
CDM,3117280,LAB DRG DF METHADONE DAY NS,67.0,10.72,12.46,95.99,37
CDM,3117298,LAB DRG DF ALKALOIDS NICOTINE DAY,160.0,25.6,23.37,176.34,37
CDM,3117306,LAB DRG DF OPIATE DAY 1+,104.0,16.64,19.34,78.0,37
CDM,3117314,LAB DRG DF OXYCODONE DAY,104.0,16.64,19.34,78.0,37
CDM,3117322,LAB DRG DF OPIOID MEPRD DAY 1-2,162.0,25.92,23.37,121.5,37
CDM,3117405,LAB DRG DF CNFRM AMPH DAY 1-2,73.0,11.68,13.58,91.27,37
CDM,3117439,LAB DRG DF CNFRM METHADONE DAY,158.0,25.28,23.37,118.5,37
CDM,3117462,LAB DRG DF CNFRM PHENCYCLDN/PCP DAY,67.0,10.72,2.17,75.67,40
CDM,3117488,LAB DRG SCR DIRECT OPT OBS ONLY DAY,64.0,10.24,12.6,59.14,63
CDM,3117512,LAB DRG DF SULFONYLUREAS DAY 7+,178.0,28.48,23.37,133.5,37
CDM,3117538,LAB DRG DF CANNABINOIDS DAY,84.0,13.44,15.62,74.37,37
CDM,3117561,LAB GENE NRAS VAR EXON 2&3 NS,888.0,247.75,295.79,1558.63,63
CDM,3117611,LAB COMPLEMENT AG COMP EA NS,222.0,42.18,12.0,166.5,63
CDM,3117645,LAB DRG DF ANTIEPILEPTICS DAY 1-3,176.0,28.16,23.37,132.0,37
CDM,3117652,LAB IMM MS MYOSITIS,67.0,10.72,11.53,54.08,63
CDM,3117660,LAB DET IA GI MULT PRB 12-25TGT NS,1251.0,276.47,416.78,1956.15,63
CDM,3117678,LAB DRG DF DAY 1-3,366.0,58.56,23.37,274.5,37
CDM,3117686,LAB GENE MTHFR VAR COMMON,197.0,54.96,65.34,344.31,63
CDM,3117694,LAB IF AB STAIN PER SPEC ADDL NS,257.0,71.45,47.8,498.63,39
CDM,3117702,LAB IF AB STAIN INITIAL PER SPEC NS,363.0,100.91,108.14,646.57,63
CDM,3117710,LAB INTERLEUKIN 2 RECEPTOR,110.0,17.6,36.57,171.62,63
CDM,3117728,LAB DRG DF FENTANYL DAY,67.0,10.72,12.46,74.37,37
CDM,3117736,LAB DET IA MYCOBCT TB PRB AMP,126.0,27.85,41.68,195.64,63
CDM,3117744,LAB GENE BRCA1&2 SEQ&DUP/DEL FULL,5475.0,1527.52,1824.88,9616.0,63
CDM,3117769,LAB IMM INTERLEUKIN 6 QN,109.0,17.44,17.27,81.75,63
CDM,3117777,LAB GENE KIT VAR D816,375.0,104.63,124.87,658.02,63
CDM,3117785,LAB AB JOHN CUNNINGHAM VIRUS,51.0,9.69,16.89,79.29,63
CDM,3117793,LAB DET IA HIV-1 PRB AMP,152.0,33.59,35.09,164.7,63
CDM,3117819,LAB DRG DF METHYLENEDIOXYAMPH NS,70.0,11.2,13.02,74.37,37
CDM,3117835,LAB GENOMIC ANLY SEQ SO/HL 51+ NS,8759.0,2443.76,1262.17,15384.55,59
CDM,3117868,LAB DET IA HSV PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3117876,LAB MORPHO ISH COMP MULT PER SPEC,951.0,264.38,108.14,1373.45,63
CDM,3117884,LAB DRG DF ANLG NON-OPIOID DAY 1-2,57.0,9.12,10.6,118.94,37
CDM,3117892,LAB DET IA HEP E PCR QN,251.0,55.47,42.84,261.36,63
CDM,3117900,LAB DRG DF ANTD SEROTONERG DAY 1-2,208.0,33.28,23.37,156.0,37
CDM,3117926,LAB DRG DF ANTD CYCL DAY 6+,87.0,13.92,10.35,100.58,37
CDM,3117967,LAB HLA X-MATCH NON-CYTOTOXIC,329.0,62.51,109.49,576.93,63
CDM,3117975,LAB HLA CLASS I PHENOTYPE QL,287.0,54.53,95.52,503.36,63
CDM,3117983,LAB HLA CLASS II PHENOTYPE QL,246.0,46.74,81.88,431.45,63
CDM,3117991,LAB HLA CLASS II AB HIGH DEF QL,978.0,185.82,325.8,1716.75,63
CDM,3118031,LAB FETAL CHROMOSOMAL ANEUPLOIDY,2278.0,635.56,759.05,3999.78,63
CDM,3118049,LAB GENE ONCOLOGY TUMOR UNKNOWN ORG,11250.0,3138.75,1621.12,17600.66,59
CDM,3118064,LAB GENOMIC ANLY SEQ HL 5-50 NS,2395.0,668.2,759.53,4002.24,63
CDM,3118072,LAB NITROGEN UREA QN NS,67.0,10.72,3.95,50.25,63
CDM,3118080,LAB MORPHO TMR IHC MNL PER SPEC NS,363.0,100.91,78.18,510.54,63
CDM,3118106,LAB DET IA MYCOBCT PRB AMP,450.0,99.45,48.24,337.5,63
CDM,3118239,LAB DRG DF ANTPSY DAY 1-3,57.0,9.12,10.6,91.53,37
CDM,3118254,LAB PARATHORMONE NS,124.0,19.84,41.28,193.71,63
CDM,3118262,LAB COAGULATION TIME ACTIVATED,55.0,10.06,4.28,41.25,63
CDM,3118270,LAB IMM PHOS TAU/TTL TAU/BETA42,650.0,104.0,17.27,487.5,63
CDM,3118320,LAB GENE EGFR VAR COMMON,974.0,271.75,324.58,1710.3,63
CDM,3118361,LAB GENOMIC ANLY SEQ SO 5-50 NS,1794.0,500.53,597.91,3150.65,63
CDM,3118379,LAB IMM IGFBP 3 QN,64.0,10.24,17.27,81.09,63
CDM,3118387,LAB DRG DF HEROIN METABOLITE DAY,56.0,8.96,10.42,74.37,37
CDM,3118478,LAB PANEL GENETIC AHUS,1072.0,299.09,199.39,883.39,37
CDM,3118502,LAB DET AG IA HBSAG QL/SEMI QN NS,231.0,51.05,10.33,173.25,63
CDM,3118601,LAB DRG DF ETOH BIOMRK URINE 1-2,158.0,25.28,13.47,118.5,37
CDM,3118619,LAB DRG DF METHYLPHENIDATE DAY,67.0,10.72,12.46,74.37,37
CDM,3118684,LAB GLUCOSE FLUID BODY NS,131.0,20.96,3.93,98.25,63
CDM,3118726,LAB NOONAN SPECTRUM DISORDERS,6431.0,1794.25,926.71,11295.43,59
CDM,3118759,LAB SCR CULT ACANTHAMOEBA,20.0,4.42,6.63,31.13,63
CDM,3118767,LAB DRG DF TRAMADOL,67.0,10.72,12.46,74.37,37
CDM,3118775,LAB DET IA CNS PRB AMP 12-25 TGT,1251.0,276.47,416.78,1956.15,63
CDM,3118783,LAB DET IA CMV PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3118791,LAB DET IA CMV QN,129.0,28.51,42.84,201.02,63
CDM,3118809,LAB DET IA PERTUSSIS MULT PRB AMP,211.0,46.63,70.2,329.47,63
CDM,3118833,LAB AB HEPATITIS A NS,57.0,10.83,12.39,58.14,63
CDM,3118890,LAB GENOMIC ANLY SEQ SO 5-50,1794.0,500.53,597.91,3150.65,63
CDM,3118957,LAB PANTOTHENIC ACID B5,69.0,11.04,17.06,80.09,63
CDM,3118965,LAB GENE BRAF VAR V600E,527.0,147.03,175.4,924.23,63
CDM,3118999,LAB PROC PATHOLOGY MOLEC LEVEL 4,556.0,155.12,185.2,975.85,63
CDM,3119047,LAB ALBUMIN OTHER SOURCE QN EA,58.0,9.28,7.78,43.5,63
CDM,3119054,LAB ALBUMIN OTHER SOURCE QN EA NS,24.0,3.84,7.78,36.52,63
CDM,3119062,LAB ALLG IGE QN/SEMI QN CRUDE EA,56.0,10.64,5.22,42.0,63
CDM,3119070,LAB ALLG IGE QN/SEMI QN CRUDE EA NS,55.0,10.45,5.22,41.25,63
CDM,3119120,LAB DRG DF PREGABALIN,95.0,15.2,17.67,74.37,37
CDM,3119146,LAB CHROMAT/MS METHYLTETRAHYDOFOLAT,266.0,42.56,24.09,199.5,63
CDM,3119153,LAB CHROMAT/MS NEOPTERIN,275.0,44.0,24.09,206.25,63
CDM,3119211,LAB DET IA TRICHOMON VAG PRB AMP NS,111.0,24.53,35.09,214.06,63
CDM,3119260,LAB DRG DF BUPRENORPHINE DAY NS,109.0,17.44,16.36,81.75,37
CDM,3119286,LAB DRG DF GABAPENTN NON BLD DAY,56.0,8.96,10.42,74.37,37
CDM,3119294,LAB DRG DF KETAMN&NORKETMN DAY,145.0,23.2,23.37,108.75,37
CDM,3119302,LAB DRG DF HYPNOTICS SED DAY,56.0,8.96,10.42,74.37,37
CDM,3119310,LAB DRG DF STIMULANTS SYN DAY,160.0,25.6,23.37,120.0,37
CDM,3119328,LAB DRG DF TAPENTADOL DAY,56.0,8.96,10.42,74.37,37
CDM,3119377,LAB ALLG IGE QN/SEMI QN EA,64.0,12.16,17.93,84.15,63
CDM,3119385,LAB USTEKINUMAB,226.0,36.16,18.64,169.5,63
CDM,3119393,LAB AB VIRUS ZIKA IGM,325.0,61.75,16.85,243.75,63
CDM,3119401,LAB GENE IDH1 VAR COMMON,580.0,161.82,193.25,1018.35,63
CDM,3119419,LAB GENE IDH2 VAR COMMON,888.0,247.75,295.79,1558.63,63
CDM,3119492,LAB DRG DF CANNABINOIDS SYN DAY 7+,175.0,28.0,16.1,131.25,37
CDM,3119526,LAB IG IGD SERUM EA,63.0,10.08,9.3,47.25,63
CDM,3119534,LAB IMMUNOFIXATION EP CRYOGLOBULIN,68.0,12.92,22.34,96.75,63
CDM,3119542,LAB IG IGG SERUM EA,56.0,8.96,9.3,43.64,63
CDM,3119567,LAB DRG DF BENZ CLORAZEPAT DAY 1-12,98.0,15.68,18.23,116.28,37
CDM,3119575,LAB HANTAVIRUS,102.0,19.38,12.88,76.5,63
CDM,3119583,LAB THYROGLOBULIN FNA,82.0,13.12,16.06,75.37,63
CDM,3119617,LAB MORPHO ISH COMP 1ST SPEC,760.0,211.28,77.53,631.11,63
CDM,3119625,LAB MORPHO ISH COMP ADDL SPEC,201.0,55.88,37.39,293.47,39
CDM,3119666,LAB AB TREPONEMA PALLIDUM CONF,74.0,14.06,13.24,62.13,63
CDM,3119674,LAB DRG DF THIOPURINE DAY 1-3,160.0,25.6,23.37,120.0,37
CDM,3119682,LAB DET IA VIRUS ZIKA PRB AMP,200.0,44.2,51.31,240.8,63
CDM,3119708,LAB GENE HBA1/HBA2 VAR DUP/DEL,608.0,169.63,202.4,1066.52,63
CDM,3119716,LAB PANEL LIPID NS,69.0,11.04,13.39,69.11,63
CDM,3119732,LAB IMM RBA AB 21 HYDROXYLASE QN,114.0,18.24,18.4,86.34,63
CDM,3119773,LAB DET IA LEGIONELL PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3119781,LAB GROWTH STIMULATION GENE 2,900.0,144.0,75.6,675.0,63
CDM,3119799,LAB CULT TYPING IF ANTISERUM EA NS,56.0,12.38,5.57,42.0,63
CDM,3119807,LAB HAPTOGLOBIN QN NS,59.0,9.44,12.58,59.07,63
CDM,3119815,LAB APOLIPOPROTEIN A1 EA NS,77.0,12.32,21.09,98.98,63
CDM,3119823,LAB BILIRUBIN TOTAL NS,58.0,9.28,5.02,43.5,63
CDM,3119849,LAB AB ZINC TRANSPORTER,240.0,45.6,23.57,180.0,63
CDM,3119864,LAB GENOMIC ANLY SEQ SO/HL 51+,15385.0,4292.42,2216.98,15384.55,59
CDM,3119872,LAB GENOMIC ANLY SEQ HL 5-50,2279.0,635.84,759.53,4002.24,63
CDM,3119880,LAB VEDOLIZUMAB,317.0,50.72,38.57,237.75,63
CDM,3119898,LAB DET AG IA IMM ENZ FUNGITELL NS,157.0,34.7,11.98,117.75,63
CDM,3119930,LAB CULT TYPING ID SEQ NUC ACID NS,347.0,76.69,50.0,541.47,59
CDM,3119989,LAB DRG METAB ADVRS TGT SEQ ANLYS,2227.0,621.33,414.22,3214.77,40
CDM,3120052,LAB GENE HPA-1,367.0,102.39,122.22,644.05,63
CDM,3120060,LAB GENOTYPING HPA-2,367.0,102.39,122.22,644.05,63
CDM,3120078,LAB GENOTYPING HPA-3,367.0,102.39,122.22,644.05,63
CDM,3120086,LAB GENOTYPING HPA-4,367.0,102.39,122.22,644.05,63
CDM,3120094,LAB GENOTYPING HPA-6,367.0,102.39,122.22,644.05,63
CDM,3120102,LAB GENOTYPING HPA-9,367.0,102.39,122.22,644.05,63
CDM,3120110,LAB GENOTYPING HPA-15,367.0,102.39,122.22,644.05,63
CDM,3120151,LAB ISH 1ST PRB STAIN HPV PER SPEC,1335.0,371.13,108.14,1001.25,63
CDM,3120177,LAB IMM RIA VOLT GATED POTAS QN,470.0,75.2,18.4,352.5,63
CDM,3120300,LAB CHROMAT MS IODINE QL/QN,73.0,11.68,24.09,113.08,63
CDM,3120318,LAB GENE HBA1/HBA2 SEQ FULL,1800.0,502.2,600.0,3161.63,63
CDM,3120326,LAB GENE DPYD VAR COMMON NS,525.0,146.48,174.81,921.17,63
CDM,3120342,LAB GENE HBB SEQ FULL,974.0,271.75,324.58,1710.3,63
CDM,3120367,ASP NEEDLE FINE BX WO IMG LSN 1ST,927.0,331.87,53.2,5681.0,63
CDM,3120391,LAB AB VIRUS HEPATITIS E IGG,71.0,13.49,12.88,60.47,63
CDM,3120409,LAB IMM FIBRO GROWTH FACTOR,305.0,48.8,17.27,228.75,63
CDM,3120417,LAB DRG DF AMPH/METH MCNIUM DAY 1-2,83.0,13.28,15.44,91.27,37
CDM,3120425,LAB DRG DF COCAINE MECONIUM,149.0,23.84,23.37,111.75,37
CDM,3120433,LAB DRG DF METHADONE MECONIUM DAY,165.0,26.4,23.37,123.75,37
CDM,3120441,LAB DRG DF OPIATE MECONIUM DAY 1+,70.0,11.2,13.02,74.37,37
CDM,3120458,LAB DRG DF OXYCODONE MECONIUM DAY,70.0,11.2,13.02,74.37,37
CDM,3120490,LAB GENE DMPK DET ALLELES ABNRM MYO,825.0,230.18,137.0,721.88,63
CDM,3120516,LAB GENE NUDT15 VAR COMMON NS,875.0,244.13,291.36,1535.28,63
CDM,3120573,LAB HCV INFCT DIS CHRNC 6 ASSAYS,217.0,60.54,72.19,338.79,63
CDM,3120607,LAB INFLIXIMAB,266.0,42.56,38.57,199.5,63
CDM,3120615,LAB ISONIAZID,155.0,24.8,18.64,116.25,63
CDM,3120623,LAB PYRAZINAMIDE,155.0,24.8,18.64,116.25,63
CDM,3120631,LAB ETHAMBUTOL,155.0,24.8,18.64,116.25,63
CDM,3120649,LAB RIFAMPIN,155.0,24.8,18.64,116.25,63
CDM,3120656,LAB DIHYDROTESTOSTERONE,88.0,14.08,12.68,137.43,59
CDM,3120664,LAB GENE MYD88 VAR L265P,527.0,147.03,175.4,924.23,63
CDM,3120680,LAB PANEL DYSFNCT/DILAT AO GENES>=9,1512.0,421.85,217.88,2655.74,59
CDM,3120714,LAB COMPLEMENT ACT FUNC NS,185.0,35.15,12.0,138.75,63
CDM,3120755,LAB SCR AB PARANEOPLASTIC CSF FL,200.0,38.0,12.05,150.0,63
CDM,3120763,LAB CSF3R MUTATION EXONS 14&17,300.0,83.7,55.8,883.39,37
CDM,3120771,LAB DET IA PNEUMOCYSTIS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3120839,LAB NEURO CSF PRION PROT QUAL,1623.0,452.82,33.01,2343.03,63
CDM,3120847,LAB SCR AB COPEPTIN FL,300.0,57.0,12.05,225.0,63
CDM,3120854,LAB CHROMAT MS ORGANIC ACIDS,153.0,24.48,24.09,114.75,63
CDM,3120888,LAB DET AG IA IMM ENZ CAMPY,78.0,17.24,11.98,58.5,63
CDM,3120896,LAB GENE CYP2C19 VAR COMMON,875.0,244.13,291.36,1535.28,63
CDM,3120904,LAB GENE CYP2D6 VAR COMMON,1353.0,377.49,450.91,2376.03,63
CDM,3120912,LAB GENE CYP2C9 VAR COMMON,525.0,146.48,174.81,921.17,63
CDM,3120920,LAB GENE CYP3A4 VAR COMMON,525.0,146.48,174.81,921.17,63
CDM,3120938,LAB GENE CYP3A5 VAR COMMON,525.0,146.48,174.81,921.17,63
CDM,3120946,LAB GENE DPYD VAR COMMON,525.0,146.48,174.81,921.17,63
CDM,3120953,LAB GENE IFNL3,221.0,61.66,73.37,386.61,63
CDM,3120961,LAB GENE NUDT15 VAR COMMON,875.0,244.13,291.36,1535.28,63
CDM,3120979,LAB GENE SLCO1B1 VAR COMMON,525.0,146.48,174.81,921.17,63
CDM,3120987,LAB GENE TPMT,525.0,146.48,174.81,921.17,63
CDM,3120995,LAB GENE UGT1A1 VAR COMMON,702.0,195.86,234.0,1233.01,63
CDM,3121001,LAB GENE VKORC1 VAR COMMON,265.0,73.94,88.2,464.78,63
CDM,3121019,LAB GENE PHARMOCOGENOMICS PANEL,51.0,14.23,9.49,883.39,37
CDM,3121027,LAB LIPOPROTEIN CHOLESTEROL LDL NS,94.0,15.04,10.5,70.5,63
CDM,3121035,LAB ACTIVITY ENZYME ALPHA GALACTOS,375.0,60.0,22.17,281.25,63
CDM,3121050,LAB AMMONIA STONE RISK,115.0,18.4,14.57,86.25,63
CDM,3121068,LAB CALCIUM STONE RISK,77.0,12.32,6.03,57.75,63
CDM,3121076,LAB CITRATE STONE RISK,174.0,27.84,27.8,130.51,63
CDM,3121084,LAB CREATININE STONE RISK,73.0,11.68,5.18,54.75,63
CDM,3121092,LAB MAGNESIUM NS,88.0,14.08,6.7,66.0,63
CDM,3121100,LAB OXALATE STONE RISK,108.0,17.28,14.45,81.0,63
CDM,3121118,LAB PH STONE RISK,66.0,10.56,3.58,49.5,63
CDM,3121126,LAB PHOSPHORUS STONE RISK,74.0,11.84,5.78,55.5,63
CDM,3121134,LAB POTASSIUM STONE RISK,70.0,11.2,4.73,52.5,63
CDM,3121142,LAB SODIUM STONE RISK,72.0,11.52,5.06,54.0,63
CDM,3121159,LAB SULFATE STONE RISK,72.0,11.52,5.49,54.0,63
CDM,3121167,LAB URIC ACID STONE RISK,72.0,11.52,5.08,54.0,63
CDM,3121183,LAB IMM AB HMGCR IGG,315.0,50.4,17.27,236.25,63
CDM,3121191,LAB SCR CULT H PYLORI SGL NS,131.0,28.95,6.63,98.25,63
CDM,3121225,LAB DET IA IGM PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3121241,LAB DRG DF XYLAZINE DAY 1-3,583.0,93.28,23.37,437.25,37
CDM,3121258,LAB AB FL TITER ENDOMYSIAL,103.0,19.57,12.05,78.63,63
CDM,3121290,LAB HLA CLASS II AB HIGH DEF QL NS,978.0,185.82,325.8,1716.75,63
CDM,3121308,LAB GENE TYPING HLA 1 LR LOCUS NS,383.0,106.86,127.43,671.45,63
CDM,3121316,LAB GENE TYPING HLA 2 LR LOCUS NS,367.0,102.39,122.22,644.05,63
CDM,3121332,LAB HLA CLASS I AB HIGH DEF QL NS,972.0,184.68,323.75,1705.97,63
CDM,3121340,LAB GENE TYPING HLA 1&2 HR NS,1037.0,289.32,345.57,1820.98,63
CDM,3121357,LAB IMM NEUTRPHL GEL-ASSC LIPOCALIN,52.0,8.32,17.27,81.09,63
CDM,3121399,LAB CULT BACT ANAEROBIC ID DF NS,118.0,26.08,8.08,88.5,63
CDM,3121415,LAB PANEL GENE DEFECTS TELOMERE,1040.0,290.16,193.44,883.39,37
CDM,3121456,LAB ADALIMUMAB,300.0,48.0,38.57,225.0,63
CDM,3121464,LAB LACOSAMIDE,82.0,13.12,27.11,117.41,63
CDM,3121498,LAB DRG DF CONF PROPOXYPHENE DAY NS,56.0,8.96,10.42,74.37,37
CDM,3121506,LAB DRG DF BUPRENORPHINE DAY,88.0,14.08,16.36,74.37,37
CDM,3121563,LAB GENE TYPING HLA 2 HR LOCUS NS,372.0,103.79,123.68,651.7,63
CDM,3121571,LAB DRG DF BARB PHENOBARB DAY NS,158.0,25.28,23.37,118.5,37
CDM,3121589,LAB IMM MS 21-HYDROXYLASE QL,114.0,18.24,11.53,85.5,63
CDM,3121597,LAB GENE FLT3 VAR ITD QN,2340.0,652.86,407.43,1764.58,63
CDM,3121621,LAB DET IA MYCOPLAS GEN PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3121647,LAB SCR AB ENCEPHALITIS FL,98.0,18.62,12.05,78.63,63
CDM,3121654,LAB NPM1 GENE ANALYSIS QUAN,2275.0,634.72,407.43,2146.87,63
CDM,3121670,LAB GENE BTK VAR COMMON,674.0,188.05,175.4,924.23,63
CDM,3121688,LAB NGS MI PROFILE,3550.0,990.45,317.42,2662.5,37
CDM,3121696,LAB LIPOPROTEIN CHOLESTEROL LDL SD,103.0,16.48,34.19,160.51,63
CDM,3121712,LAB VOLATILE NS,184.0,29.44,17.11,138.0,63
CDM,3121720,LAB GENE PMP22 DUP/DEL,2276.0,635.0,758.36,3996.06,63
CDM,3121746,LAB DET IA RESP NA 18 VIRAL&2 BACT,827.0,230.73,270.43,1292.35,63
CDM,3121753,LAB DET IA HPV TYPES 16&18 NS,122.0,26.96,40.55,214.06,63
CDM,3121803,LAB ONC AML DNA DET/NONDET,746.0,208.13,243.94,1076.3,63
CDM,3121811,LAB DET IA COV19 PRB AMP NS,249.0,55.03,51.31,247.99,63
CDM,3121829,LAB DET IA COV19 PRB AMP,249.0,55.03,51.31,247.99,63
CDM,3121837,LAB GENE TERT TARGETED SEQ ANLYS,556.0,155.12,185.2,975.85,63
CDM,3121845,LAB GENE SO NEOPLSM DNA TGT SEQ 324,10500.0,2929.5,3500.0,18442.87,63
CDM,3121852,LAB GENE ANLYS NEOPLASIA CYTOGENOMC,3480.0,970.92,1160.0,6112.52,63
CDM,3121860,LAB EXOME ANALYSIS SEQ,14340.0,4000.86,4780.0,25187.73,63
CDM,3121902,LAB DET AG IA IF CRYPTOSPORIDIUM NS,111.0,24.53,11.98,83.25,63
CDM,3121910,LAB AB SARS-COV-2 COVID-19,127.0,24.13,42.13,193.37,63
CDM,3121928,LAB AB SARS-COV-2 COVID-19 NS,127.0,24.13,42.13,193.37,63
CDM,3121977,LAB HLA CLASS II PHENOTYPE QL NS,246.0,46.74,81.88,431.45,63
CDM,3121985,LAB HLA X-MATCH NON-CYTOTOXIC NS,329.0,62.51,109.49,576.93,63
CDM,3121993,LAB DIS INFCT ID FUNGAL DNA TGT 15,471.0,131.41,154.02,735.71,63
CDM,3122017,LAB GENE 5 CARDIOMYOPATH HRDTRY,1755.0,489.65,584.9,3082.07,63
CDM,3122058,LAB CHROMAT MS OMEGA FATTY ACIDS,100.0,16.0,24.09,113.08,63
CDM,3122082,LAB CERTOLIZUMAB,335.0,53.6,18.64,251.25,63
CDM,3122108,LAB GENE F5 VAR LEIDEN NS,221.0,61.66,73.37,386.61,63
CDM,3122124,LAB MORPHO TMR IHC MNL PER SPEC,363.0,100.91,78.18,510.54,63
CDM,3122165,LAB GENE TYPING HLA 1&2 LR VERIF NS,1214.0,338.71,404.52,2131.57,63
CDM,3122173,LAB GENE PIK3CA ANLYS SEQ TARGETED,825.0,230.18,274.83,1448.21,63
CDM,3122181,LAB GENE G6PD ANLYS SEQ FULL,1800.0,502.2,600.0,3161.63,63
CDM,3122199,LAB GENE MPL MUTATION EXON 10 ANLYS,556.0,155.12,185.2,975.85,63
CDM,3122207,LAB GENE JAK2 EXON TGT SEQ 12,556.0,155.12,185.2,975.85,63
CDM,3122249,LAB DRG SC INST ALYZ URINE DAY,290.0,46.4,62.14,291.62,63
CDM,3122256,LAB DRG SC INST ALYZ SERUM DAY,187.0,29.92,62.14,291.62,63
CDM,3122264,LAB DRG SC INST ALYZ URINE ETOH DAY,187.0,29.92,62.14,291.62,63
CDM,3122272,LAB DRG SC INST ALYZ URINE DAY NS,187.0,29.92,62.14,291.62,63
CDM,3122280,LAB DRG SC INST ALYZ SERUM DAY NS,187.0,29.92,62.14,291.62,63
CDM,3122298,LAB DRG SC INST ALYZ URINE PMGT DAY,449.0,71.84,62.14,336.75,63
CDM,3122306,LAB DRG SC INST ALYZ MECON DAY NS,187.0,29.92,62.14,291.62,63
CDM,3122322,LAB DRG DF BUPRENORPHINE MECON DAY,129.0,20.64,16.36,96.75,37
CDM,3122330,LAB DRG SC INST ALYZ CORD TIS DAYNS,187.0,29.92,62.14,291.62,63
CDM,3122348,LAB GENE T-CELL BETA REARRANGEMENT,51.0,8.16,9.49,176.48,37
CDM,3122363,LAB CULT TISS NON-NEO AF/CELL CV NS,451.0,111.4,150.3,791.99,63
CDM,3122371,LAB CHROM W BND AF 6-12 COL 1 K NS,521.0,128.69,173.66,915.12,63
CDM,3122389,LAB CULT BACT AEROBIC ID DF NS,96.0,21.22,8.08,72.0,63
CDM,3122397,LAB ISO VIRUS ID ACT ENZYMATIC NS,102.0,22.54,33.86,158.92,63
CDM,3122413,LAB CULT BACT AEROBIC STOOL NS,63.0,13.92,9.44,47.25,63
CDM,3122421,LAB CULT BACT AEROBIC ID DF ADDL NS,103.0,22.76,8.08,77.25,63
CDM,3122439,LAB CULT TYPING SEROLOGICAL NS,85.0,18.78,5.18,63.75,63
CDM,3122454,LAB DRG DF OPIOID DAY 1-2 SERUM,162.0,25.92,23.37,121.5,37
CDM,3122496,LAB AB ISLET ENCEPHALITIS,144.0,27.36,23.57,110.62,63
CDM,3122504,LAB SCR AB REFLEX ENCEPHALITIS FL,525.0,99.75,12.05,393.75,63
CDM,3122512,LAB AB FL TITER ENCEPHALITIS,194.0,36.86,12.05,145.5,63
CDM,3122520,LAB PROT WB W INTRP ENCEPHALITIS,155.0,24.8,29.21,126.51,63
CDM,3122629,LAB SUBSTRATE CHROMOGENIC NS,145.0,26.54,11.89,108.75,63
CDM,3122702,LAB DET IA HEP D PCR QN,690.0,152.49,42.84,517.5,63
CDM,3122710,LAB DIS INFCT ID BAC&FNG GRM+ RXRST,471.0,131.41,154.02,735.71,63
CDM,3122728,LAB DIS INFCT ID BAC&FNG GRM- RXRST,471.0,131.41,154.02,735.71,63
CDM,3122744,LAB SCR AB MITOCHONDRIAL,77.0,14.63,25.45,110.22,63
CDM,3122751,LAB SCR AQUAPORIN 4 AB IGG CSF,350.0,66.5,12.05,262.5,63
CDM,3122769,LAB SCR AQUAPORIN 4 AB IGG SERUM,225.0,42.75,12.05,168.75,63
CDM,3122777,LAB AQUAPORIN AB,268.0,50.92,11.53,201.0,63
CDM,3122785,LAB ISAVUCONAZOLE,135.0,21.6,18.64,101.25,63
CDM,3122793,LAB AQUAPORIN 4 AB FLOW CYTOMETRY,118.0,22.42,12.05,132.18,63
CDM,3122827,LAB DRG DF ANTD CLOM DAY 1-2,62.0,9.92,11.53,100.58,37
CDM,3122876,LAB GENE TP53 SEQ TARGETED,989.0,275.93,329.51,1736.37,63
CDM,3122892,LAB HYDROXYCHLOROQUINE,291.0,46.56,18.64,218.25,63
CDM,3122942,LAB GENE G6PD VAR COMMON,525.0,146.48,174.81,921.17,63
CDM,3122959,LAB IMM RIA OREXIN A/HYPROCRET-1 QN,1055.0,168.8,18.4,791.25,63
CDM,3122983,LAB IMM AB ADAMTS 13,300.0,48.0,17.27,225.0,63
CDM,3122991,LAB GENE ONC SO DNA PROFILE 257,10500.0,2929.5,3433.5,15158.5,63
CDM,3123007,LAB TISSUE KOH SKN/HAR/NAL FUNGI NS,215.0,47.52,4.27,161.25,63
CDM,3123031,LAB ONC BRCA1&2 ANLYS MUT SOMATIC,9090.0,2536.11,2972.43,15966.26,63
CDM,3123049,LAB CHROMAT MS IGF-2,222.0,35.52,24.09,166.5,63
CDM,3123072,LAB AB ENA PM/SC1-100,115.0,21.85,17.93,86.25,63
CDM,3123080,LAB IMM MS POLYMERASE III AB,107.0,17.12,11.53,80.25,63
CDM,3123122,LAB DET IA ORTHOPOXVIRUS PRB AMP,154.0,34.03,35.09,240.8,63
CDM,3123148,LAB ALLG IGE QN/SEMI QN EA NS,80.0,15.2,17.93,84.15,63
CDM,3123155,LAB IMM VWF BINDING ASSAY,145.0,23.2,17.27,108.75,63
CDM,3123171,LAB CHLORDIAZEPOXIDE,169.0,27.04,18.64,126.75,63
CDM,3123247,LAB AB HTLV/HIV CONFIRM DONOR NS,503.0,95.57,19.35,377.25,63
CDM,3123254,LAB PLASMINOGEN NON-ANTIGENIC NS,71.0,12.99,6.53,53.25,63
CDM,3123270,LAB IG PARAPROT IMPRC&MS BLD/UR QL,211.0,58.87,30.41,203.88,59
CDM,3123288,LAB TB MEAS IMMUNITY T-CELL SUSP NS,300.0,57.0,100.0,469.37,63
CDM,3123296,LAB IMM ANALYTE CYTOKINES QN,135.0,21.6,17.27,101.25,63
CDM,3123312,LAB IMM ANALYTE IL-18 QN,597.0,95.52,17.27,447.75,63
CDM,3123320,LAB COMPLEMENT AG SC5B-9 COMP EA,292.0,55.48,12.0,219.0,63
CDM,3123353,LAB IMM ANALYTE CXCL9 QN,431.0,68.96,17.27,323.25,63
CDM,3123395,LAB AB M FAENI,153.0,29.07,12.88,114.75,63
CDM,3123403,LAB AB S VIRIDIS,153.0,29.07,12.88,114.75,63
CDM,3123411,LAB AB T CANDIDUS,153.0,29.07,12.88,114.75,63
CDM,3123429,LAB AB T VULGARIS,153.0,29.07,12.88,114.75,63
CDM,3123437,LAB AB LISTERIA,153.0,29.07,12.88,114.75,63
CDM,3123445,LAB AB CYSTICERCUS CSF,64.0,12.16,13.01,61.07,63
CDM,3123452,LAB AB CYSTICERCUS SERUM,64.0,12.16,13.01,61.07,63
CDM,3123460,LAB AB SCHISTOSOMA SERUM,64.0,12.16,13.01,61.07,63
CDM,3123478,LAB DRG DF FUROSEMIDE DAY 1-3,120.0,19.2,22.32,90.0,37
CDM,3123486,LAB DRG DF MITOTANE DAY 1-3,187.0,29.92,23.37,140.25,37
CDM,3123494,LAB DRG DF TPMT ACTIVITY DAY 1-3,120.0,19.2,22.32,90.0,37
CDM,3123551,LAB GENOTYPING HPA-5,367.0,102.39,122.22,644.05,63
CDM,3123569,LAB THIOPURINE S-METHYLTRANSFERASE,112.0,17.92,22.17,84.0,63
CDM,3123577,LAB COMPLEMENT ACT FUNC C3NEF,300.0,57.0,12.0,225.0,63
CDM,3123619,LAB GENE HTT ALLELES CHARACTERIZATN,825.0,230.18,274.83,1448.21,63
CDM,3123635,LAB DGTZ SLIDE PTH LVL 2,54.0,15.07,0.04897,40.5,33
CDM,3123643,LAB DGTZ SLIDE PTH LVL 3,54.0,15.07,0.04897,40.5,33
CDM,3123650,LAB DGTZ SLIDE PTH LVL 4,54.0,15.07,0.04897,40.5,33
CDM,3123668,LAB DGTZ SLIDE PTH LVL 5,54.0,15.07,0.04897,40.5,33
CDM,3123676,LAB DGTZ SLIDE PTH LVL 6,54.0,15.07,0.04897,40.5,33
CDM,3123684,LAB DGTZ SLIDE STN ORG GRP 1,54.0,15.07,0.04897,40.5,33
CDM,3123692,LAB DGTZ SLIDE STN OTH GRP 2,54.0,15.07,0.04897,40.5,33
CDM,3123700,LAB DGTZ SLIDE STN HIS W BLOCK FRZ,54.0,15.07,0.04897,40.5,33
CDM,3123718,LAB DGTZ SLIDE STN CONSTI ENZ GRP3,54.0,15.07,0.04897,40.5,33
CDM,3123726,LAB DGTZ SLIDE STN IHC/ICC AB 1ST,54.0,15.07,0.04897,40.5,33
CDM,3123734,LAB DGTZ SLIDE STN IHC/ICC AB ADD,54.0,15.07,0.04897,40.5,33
CDM,3123742,LAB DGTZ SLIDE STN IHC/ICC AB MULT,54.0,15.07,0.04897,40.5,33
CDM,3123759,LAB DGTZ SLIDE STN MORPHO ANLYS AB,54.0,15.07,0.04897,40.5,33
CDM,3123767,LAB GSAP METAB RX >=6,3039.0,847.88,437.92,3037.44,59
CDM,3123817,LAB DET AG IA IMM ENZ FUNGITELL,97.0,21.44,11.98,72.75,63
CDM,3123825,LAB SUSCPT MIC PLATE EA LSI NS,200.0,34.4,8.65,150.0,63
CDM,3123833,LAB ANTI-CD19 CAR T-CELL,500.0,80.0,18.64,375.0,63
CDM,3123841,LAB GENOMIC ANLY SEQ SO/HL RNA 51+,8759.0,2443.76,1262.17,11584.72,59
CDM,3123858,LAB FETAL CHROMOSOMAL MICRODELTJ,2278.0,635.56,328.26,3999.78,59
CDM,3123874,LAB DIS INFCT SARS-COV-2 TGT 21,1926.0,537.35,66.17,1805.07,63
CDM,3123882,POC FERN,66.0,10.56,9.74,64.79,63
CDM,3123924,LAB GENE SNRPN/UBE3A METHYLATON ALD,475.0,132.52,51.07,356.25,63
CDM,3123965,LAB GENOMIC ANLY SEQ MITOCHNDRL WHL,3861.0,1077.22,556.37,6781.71,59
CDM,3123981,LAB IMM AB BP230 QN,90.0,14.4,17.27,81.09,63
CDM,3124021,LAB DET IA LEPTOSPIRA PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3124047,LAB DRG DF OPIOID DAY 1-2 TISSUE,56.0,8.96,10.42,74.37,37
CDM,3124088,LAB IMM MS ANTI-CFH AB,475.0,76.0,11.53,356.25,63
CDM,3124138,LAB IMM MS CARBAMYLATED PROTEIN AB,105.0,16.8,11.53,78.75,63
CDM,3124229,LAB HCV INFCT DIS CHRNC 6 ASSAYS NS,217.0,60.54,72.19,338.79,63
CDM,3124252,LAB NORTRIPTYLINE,68.0,10.88,18.64,87.47,63
CDM,3124286,LAB IMM INHIBIN B QN,104.0,16.64,17.27,81.09,63
CDM,3124294,LAB SCR AB MOG TITER,837.0,159.03,12.05,627.75,63
CDM,3124302,LAB SCR ANCA TITER AB EA,62.0,11.78,12.05,52.19,63
CDM,3124492,LAB DET IA RUBELLA PCR PRB AMP,106.0,23.43,35.09,164.7,63
CDM,3124518,LAB RBC DNA HEA 35 AG 11 BLD GRP NS,2160.0,410.4,311.26,3793.97,59
CDM,3124526,LAB SCR AB CIDP/NP EVALUATION FL,376.0,71.44,12.05,282.0,63
CDM,3124534,LAB ANLY MUTATION LCHAD,241.0,67.24,44.83,883.39,37
CDM,3124542,LAB DET IA ENTEROBACTR MULT PRB AMP,411.0,90.83,70.2,329.47,63
CDM,3124559,LAB DET IA BACTERIAL MULT PRB AMP,1309.0,289.29,70.2,981.75,63
CDM,3124567,LAB CLONAZEPAM,67.0,10.72,18.64,87.47,63
CDM,3124583,LAB GENE B-CELL CLONALITY PCR,51.0,8.16,9.49,176.48,37
CDM,3124617,LAB PANEL DISEASE LUNG INTERSTITIAL,1340.0,373.86,249.24,1005.0,37
CDM,3124625,LAB GENE HFE VAR COMMON,197.0,54.96,65.36,344.37,63
CDM,3124666,LAB DRG DF DIPHENHYDRAMINE DAY 1-3,132.0,21.12,23.37,99.0,37
CDM,3124690,LAB DET IA HPV TYPE RISK HIGH POOL,106.0,23.43,35.09,214.06,63
CDM,3124781,LAB GENE MARKERS STR SPEC PT&CMP NS,1427.0,398.13,233.07,1228.16,63
CDM,3124799,LAB MORPHO ER MANUAL PER SPEC,468.0,130.1,78.18,510.54,63
CDM,3124815,LAB MORPHO PR MANUAL PER SPEC,468.0,130.1,78.18,510.54,63
CDM,3124864,LAB BETA AMYLOID 1-42,387.0,61.92,102.94,290.25,62
CDM,3124872,LAB TAU TOTAL,387.0,61.92,102.94,290.25,62
CDM,3124880,LAB DET IA PNEUM JIROVECII PRB AMP,109.0,24.09,35.09,81.75,62
CDM,3124914,LAB AB STREP PNEU SEROT IA,372.0,70.68,92.03,279.0,62
CDM,3124930,LAB AB ID PLATELET BLOOD PRODUCT,238.0,45.22,18.37,178.5,63
CDM,3124971,LAB CYTOPATH EVAL FNA INTRP&RPT NS,466.0,115.1,36.08,666.15,63
CDM,3125010,LAB ONC SEQ NEXT GEN DNA&RNA FFPE,25365.0,7076.84,8294.35,36618.61,63
CDM,3125044,LAB BETA AMYLOID 1-40,387.0,61.92,102.94,290.25,62
CDM,3125051,LAB MOPATH LVL2 CBFB/MYH11 DET QN,411.0,114.67,137.0,721.88,63
CDM,3125069,LAB DRG SC INST ALYZ WHL BLOOD DAY,282.0,45.12,62.14,291.62,63
CDM,3125085,LAB AB KLHL11 SERUM/CSF QL,156.0,43.52,22.48,128.12,58
CDM,3125101,LAB TAU217 PHOSPHORYLATED EA,387.0,61.92,102.94,290.25,62
CDM,3125119,LAB TAU181 PHOSPHORYLATED EA,387.0,61.92,102.94,290.25,62
CDM,3125168,LAB ONC SEQ NEXT GEN DNA&MRNA 74,10800.0,3013.2,1556.28,12609.4,59
CDM,3125226,LAB NEUROFILAMENT LC PLASMA,350.0,56.0,93.1,262.5,62
CDM,3125267,LAB NEURO CSF PROTEIN ASYN MSFLD QN,1623.0,452.82,233.87,1894.89,59
CDM,3125291,LAB AB HTLV/HIV CONFIRM CSF,472.0,89.68,19.35,354.0,63
CDM,3125309,LAB AB HTLV/HIV CONFIRM SRM/PLASMA,472.0,89.68,19.35,354.0,63
CDM,3125317,LAB DET IA C BURNETII PCR PRB AMP,744.0,164.42,35.09,558.0,63
CDM,3125333,LAB IMM FACTOR H QN,328.0,52.48,17.27,246.0,63
CDM,3125341,LAB ACTIVITY ENZYME CHITOTRIOSIDASE,362.0,57.92,22.17,271.5,63
CDM,3125358,LAB IMM MS ANTI TH/TO AB,135.0,21.6,11.53,101.25,63
CDM,3125366,LAB DGTZ SLD CYTOP SMEAR NONGYN,54.0,15.07,0.04897,40.5,33
CDM,3125374,LAB DGTZ SLD CYTOP FLTR SMPL NONGYN,54.0,15.07,0.04897,40.5,33
CDM,3125382,LAB DGTZ SLD CYTOP CONCEN&SMR&INTRP,54.0,15.07,0.04897,40.5,33
CDM,3125390,LAB DGTZ SLD CYTOP SC ENHCMT NONGYN,54.0,15.07,0.04897,40.5,33
CDM,3125408,LAB DGTZ SLD CYTOP CRV/VAG W INTRP,54.0,15.07,0.04897,40.5,33
CDM,3125416,LAB DGTZ SLD CYTOP SMR/OTH SC&IN,54.0,15.07,0.04897,40.5,33
CDM,3125424,LAB DGTZ SLD CYTOP SMR/OTH PREP SCN,54.0,15.07,0.04897,40.5,33
CDM,3125432,LAB DGTZ SLD CYTOP SMR/OTH STDY EXT,54.0,15.07,0.04897,40.5,33
CDM,3125440,LAB DGTZ SLD CYTOP EVL FNA IMM 1ST,54.0,15.07,0.04897,40.5,33
CDM,3125457,LAB DGTZ SLD CYTOP EVL FNA IMM ADDL,54.0,15.07,0.04897,40.5,33
CDM,3125465,LAB DGTZ SLD CYTOP EVL FNA I&R,54.0,15.07,0.04897,40.5,33
CDM,3125473,LAB DGTZ SLD CNST&RPT REF SLD ELSWR,54.0,15.07,0.04897,40.5,33
CDM,3125481,LAB DGTZ SLD CNSLT PTH SRG BLK 1ST,54.0,15.07,0.04897,40.5,33
CDM,3125499,LAB DGTZ SLD CNSLT PTH SRG EA ADDL,54.0,15.07,0.04897,40.5,33
CDM,3125507,LAB DGTZ SLD CNSLT PTH SRG CYTO INT,54.0,15.07,0.04897,40.5,33
CDM,3125515,LAB DGTZ SLD CNSLT PTH SRG CYTO ADD,54.0,15.07,0.04897,40.5,33
CDM,3125523,LAB DGTZ SLD IF AB STN INT EA SPEC,54.0,15.07,0.04897,40.5,33
CDM,3125531,LAB DGTZ SLD IF AB STN ADDL EA SPEC,54.0,15.07,0.04897,40.5,33
CDM,3125549,LAB DGTZ SLD TISS ARCHVL ANLY MOLEC,54.0,15.07,0.04897,40.5,33
CDM,3125556,LAB DGTZ SLD ISH STN SGL PRB EA INT,54.0,15.07,0.04897,40.5,33
CDM,3125564,LAB DGTZ SLD ISH STN SGL PRB EA ADD,54.0,15.07,0.04897,40.5,33
CDM,3125572,LAB DGTZ SLD ISH STN MP EA,54.0,15.07,0.04897,40.5,33
CDM,3125580,LAB DGTZ SLD MORPHO ISH MAN SGL INT,54.0,15.07,0.04897,40.5,33
CDM,3125598,LAB DGTZ SLD MORPHO ISH MAN SGL ADD,54.0,15.07,0.04897,40.5,33
CDM,3125606,LAB DGTZ SLD MORPHO ISH MAN MP EA,54.0,15.07,0.04897,40.5,33
CDM,3125614,LAB DGTZ SLD SMEAR BLD PERIPH INTRP,54.0,15.07,0.04897,40.5,33
CDM,3125622,LAB DGTZ SLD SMEAR MARROW BN INTRP,54.0,15.07,0.04897,40.5,33
CDM,3125630,LAB DGTZ SLD MICROSCOPY ELECTRON DX,54.0,15.07,0.04897,40.5,33
CDM,3125697,LAB PANEL GENE DYSTONIA NGS,1040.0,290.16,193.44,883.39,37
CDM,3125721,LAB IMM ANALYTE SFIT-1,72.0,11.52,17.27,81.09,63
CDM,3125739,LAB IMM ANALYTE PIGF,72.0,11.52,17.27,81.09,63
CDM,3125762,LAB SCR AB GABA-BR FL,195.0,37.05,12.05,146.25,63
CDM,3125770,LAB GENE CRANIOSYNOSTOSIS,940.0,262.26,174.84,883.39,37
CDM,3125788,LAB DET IA EBV PCR PRB BF AMP,546.0,120.67,35.09,409.5,63
CDM,3125812,LAB PANEL GENE PA HYPERTENSION,1040.0,290.16,193.44,883.39,37
CDM,3125820,LAB DET IA TRYPANOSOMA CRUZI PCR QN,230.0,50.83,42.84,261.36,63
CDM,3125861,LAB GENE DEFICIENCY MCAD ANLY FULL,1754.0,489.37,317.42,1315.5,37
CDM,3125879,LAB STIM LYMPHOCYTE BERYLLIUM,378.0,71.82,49.03,283.5,63
CDM,3125895,LAB ONC GSA&NGS SEQ DOM CLONAL QN,6022.0,1680.14,867.77,9421.03,58
CDM,3125911,LAB DRG SC INST ALYZ CORD TIS DAY,187.0,29.92,62.14,291.62,63
CDM,3125937,LAB PROFILE TUMOR THYROID,2112.0,589.25,317.42,1584.0,37
CDM,3125945,LAB SUSCPT CARBAPENEMASE DET ENZ,56.0,12.38,8.07,42.0,35
CDM,3126034,LAB DET IA CT&NG PRB AMP MULTIPLEX,211.0,46.63,69.0,158.25,62
CDM,3126075,LAB D-LACTATE URINE,544.0,87.04,11.57,408.0,63
CDM,3126109,LAB IMM MS CYTOSOLC 5 NUCLEOTDAS 1A,315.0,50.4,11.53,236.25,63
CDM,3126117,LAB DET IA PATH JT&GENE RXRST 26+,2040.0,450.84,667.08,1530.0,62
CDM,3126125,LAB DRG DF BUPROPION DAY,198.0,31.68,12.75,148.5,37
CDM,3126166,LAB IMM AB ANTI-MOUSE HUMAN QN,263.0,42.08,17.27,197.25,63
CDM,3126190,LAB PANEL NGS DIS KIDNEY INHERITED,1840.0,513.36,317.42,1380.0,37
CDM,3126216,LAB MICRODISSECTION LASER FIB GN,1567.0,435.63,71.61,1175.25,39
CDM,3126232,LAB PANEL NGS POLYDACTYLY&SYNDACTYL,1640.0,457.56,305.04,1230.0,37
CDM,3126265,LAB GENO ANLY SEQ SO RNA 5-50 NGN,2088.0,582.55,300.88,2372.5,59
CDM,3126331,LAB AB LEPTOSPIRA IGM DOT BLOT,102.0,19.38,16.2,76.5,63
CDM,3126372,LAB PROSTAGLANDIN EA ARP,335.0,53.6,41.77,251.25,63
CDM,3126406,LAB DRG DF FLUCYTOSINE DAY 1-3,435.0,69.6,23.37,326.25,37
CDM,3126422,LAB IMM MS ANTI IFNG AB,197.0,31.52,11.53,147.75,63
CDM,3126448,LAB CULT TISS NON-NEO LYMPHOCYT MYO,1148.0,283.56,116.49,861.0,63
CDM,3126539,LAB GENE CHIMERISM W TCELL SLCT EA,783.0,218.46,260.79,1374.17,63
CDM,3126547,LAB GENE CHIMERISM W MYELOID SLCTEA,783.0,218.46,260.79,1374.17,63
CDM,31716,R&B NURSERY LEVEL 4,16754.0,5512.57,4809.0,12565.5,12
CDM,3200367,PLC STNT/S ART INM/INTRATH CAR S&I,5978.0,2140.12,786.64,7704.0,40
CDM,3200375,ABL CRYO TUMOR/S LIVER PERC,13673.0,4894.93,429.13,18715.8,63
CDM,3200649,INJ CHOLANGIOGRAM ACCESS NEW S&I,3926.0,1405.51,200.92,18194.0,63
CDM,3200813,PLC CATH DRN BILIARY PERC EXT S&I,5104.0,1827.23,250.22,18194.0,63
CDM,3200847,PLC CATH DRN BILIARY INT-EXT S&I,5360.0,1918.88,350.17,18194.0,63
CDM,3200870,CONVERSION CATH DRN BILIARY EXT S&I,5331.0,1908.5,186.02,18194.0,63
CDM,3200904,EXCHG CATH DRN BILIARY PERC S&I,4865.0,1741.67,125.39,18194.0,63
CDM,3200995,INJ ANES PLEXUS HYPOGASTRIC,1626.0,582.11,123.1,6689.0,63
CDM,3202074,CONVERSION TB CHEST CATH TUN PLRL,2614.0,935.81,392.67,7390.37,62
CDM,3202132,CANNULATION DUCT THORACIC,1785.0,639.03,273.16,4664.0,40
CDM,3202140,REM CALCULI BILI DUCT&/GALLBLDR S&I,5262.0,1883.8,148.34,5681.0,40
CDM,3202546,INJ NEPH&/URETERGRM ACC NEW RT S&I,1698.0,607.88,147.21,5988.0,40
CDM,3202553,INJ NEPH&/URETERGRM ACC NEW LT S&I,1698.0,607.88,147.21,5988.0,40
CDM,3202561,INJ NEPH&/URETERGRM ACC NEW BI S&I,2547.0,911.83,147.21,5988.0,40
CDM,3202603,EXCHG CATH PERITONEAL TUNNELED,2614.0,935.81,586.96,5681.0,62
CDM,3202645,CT LTD/FOLLOWUP,674.0,115.25,58.65,1218.0,63
CDM,3202728,INJ NEPH&/URETERGRM ACC EXST RT S&I,1314.0,470.41,63.72,5988.0,40
CDM,3202736,INJ NEPH&/URETERGRM ACC EXST LT S&I,1314.0,470.41,63.72,5988.0,40
CDM,3202744,INJ NEPH&/URETERGRM ACC EXST BI S&I,1971.0,705.62,63.72,5988.0,40
CDM,3202751,INSTILL AGENT FIBRIN TB/CTH 1ST DAY,2883.0,1032.11,64.77,5681.0,63
CDM,3202876,PLC CATH NEPHROSTOMY PERC RT S&I,3433.0,1229.01,195.15,14124.0,40
CDM,3202884,PLC CATH NEPHROSTOMY PERC LT S&I,3433.0,1229.01,195.15,14124.0,40
CDM,3202892,PLC CATH NEPHROSTOMY PERC BI S&I,5150.0,1843.7,195.15,14124.0,40
CDM,3202900,EXCHG CATH NEPH PERC RT S&I,3433.0,1229.01,95.52,5988.0,40
CDM,3202918,EXCHG CATH NEPH PERC LT S&I,3433.0,1229.01,95.52,5988.0,40
CDM,3202926,EXCHG CATH NEPH PERC BI S&I,5150.0,1843.7,95.52,5988.0,40
CDM,3202934,REM CALCULI BILI ENDO PERC T-TUBE,14985.0,5364.63,428.88,18715.8,63
CDM,3203114,PLC STNT URTR NEPH PREEXIST RT S&I,5150.0,1843.7,194.14,18194.0,40
CDM,3203122,PLC STNT URTR NEPH PREEXIST LT S&I,5150.0,1843.7,194.14,18194.0,40
CDM,3203130,PLC STNT URTR NEPH PREEXIST BI S&I,7725.0,2765.55,194.14,18194.0,40
CDM,3203148,PLC STNT URTR WO NEPH CATH RT S&I,6692.0,2395.74,253.48,18194.0,40
CDM,3203155,PLC STNT URTR WO NEPH CATH LT S&I,6692.0,2395.74,253.48,18194.0,40
CDM,3203163,PLC STNT URTR WO NEPH CATH BI S&I,10038.0,3593.6,253.48,18194.0,40
CDM,3203197,ECMO/ECLS REM CAN PERPH PERC 6+YRS,1836.0,604.1,224.8,6904.78,40
CDM,3203213,PLC STNT URTR W NEPH CATH RT S&I,8564.0,3065.91,325.16,18194.0,40
CDM,3203221,PLC STNT URTR W NEPH CATH LT S&I,8564.0,3065.91,325.16,18194.0,40
CDM,3203239,PLC STNT URTR W NEPH CATH BI S&I,12846.0,4598.87,325.16,18194.0,40
CDM,3203361,IMG 3D SEG ANAT PLAN&PREP&TRANS,275.0,47.03,33.89,1218.0,62
CDM,3204179,US INTRAVASCULAR NONCORNRY INIT S&I,3525.0,1261.95,84.15,5681.0,40
CDM,3204187,US INTRAVASCULAR NONCORNRY ADDL S&I,2821.0,1009.92,66.97,5681.0,40
CDM,3204195,INJ CHOLANGIOGRAM ACCESS EXIST S&I,1938.0,693.8,67.42,7697.0,63
CDM,3204203,INJ CHOLANGIOGRAM ACCESS NEW S&I,3926.0,1405.51,200.92,18194.0,63
CDM,3204211,PLC CATH DRN BILIARY PERC EXT S&I,5104.0,1827.23,250.22,18194.0,63
CDM,3204229,PLC CATH DRN BILIARY INT-EXT S&I,5360.0,1918.88,350.17,18194.0,63
CDM,3204237,CONVERSION CATH DRN BILIARY EXT S&I,5331.0,1908.5,186.02,18194.0,63
CDM,3204245,EXCHG CATH DRN BILIARY PERC S&I,4865.0,1741.67,125.39,18194.0,63
CDM,3204252,REM CATH DRN BILIARY PERC S&I,2841.0,1017.08,91.97,5681.0,63
CDM,3204260,PLC STNT/S DUCT BILE EXIST S&I,9650.0,3454.7,222.68,18194.0,63
CDM,3204278,PLC STNT/S DUCT BILE NEW S&I,10956.0,3922.25,404.32,18194.0,63
CDM,3204286,PLC STNT/S DUCT BILE NEW W DRN S&I,13803.0,4941.47,416.48,18194.0,63
CDM,3204294,PLC ACCS BILI TREE SM BOWEL NEW S&I,6749.0,2416.14,318.83,18194.0,63
CDM,3204302,REM CALCULI BILI DUCT&/GALLBLDR S&I,5262.0,1883.8,148.34,5681.0,40
CDM,3204559,ADM PRLNG AGNT RX INTRACRN EV INIT,4693.0,1680.09,560.84,15325.0,40
CDM,3204567,ENDOVASCULAR PRLNG ADM RX AGNT ADDL,4157.0,1488.21,239.45,15325.0,40
CDM,3204575,XR SPINE ENTIRE THOR&LUMB 1 VW,360.0,101.52,29.5,333.39,63
CDM,3204583,XR SPINE ENTIRE THOR&LUMB 2-3 VW,384.0,108.29,53.84,449.06,63
CDM,3204591,XR SPINE ENTIRE THOR&LUMB 4-5 VW,445.0,125.49,60.65,449.06,63
CDM,3204609,XR SPINE ENTIRE THOR&LUMB 6+ VW,530.0,149.46,76.84,451.6,63
CDM,3204617,XR HIP W PELVIS 1 VW RT,256.0,72.19,23.33,333.39,40
CDM,3204625,XR HIP W PELVIS 1 VW LT,256.0,72.19,23.33,333.39,40
CDM,3204633,INJ CHOLANGIOGRAM ACCESS EXIST S&I,1938.0,693.8,67.42,7697.0,63
CDM,3204641,XR HIP W PELVIS 2-3 VW RT,270.0,76.14,35.98,333.39,40
CDM,3204658,XR HIP W PELVIS 2-3 VW LT,270.0,76.14,35.98,333.39,40
CDM,3204674,XR HIP W PELVIS 4+ VW RT,282.0,79.52,45.72,449.06,40
CDM,3204682,XR HIP W PELVIS 4+ VW LT,282.0,79.52,45.72,449.06,40
CDM,3204690,PLC DEV/S MRKRS THRPY RAD NON-PROS,3220.0,1152.76,915.08,4664.0,59
CDM,3204708,XR HIPS W PELVIS 2 VW BI,322.0,90.8,29.82,449.06,63
CDM,3204716,XR HIPS W PELVIS 3-4 VW BI,350.0,98.7,38.91,449.06,63
CDM,3204724,XR HIPS W PELVIS 5+ VW BI,411.0,115.9,45.72,449.06,63
CDM,3204732,XR FEMUR 1 VW RT,158.0,44.56,20.73,333.39,40
CDM,3204740,XR FEMUR 1 VW LT,158.0,44.56,20.73,333.39,40
CDM,3204765,XR FEMUR 2+ VW RT,265.0,74.73,26.25,333.39,40
CDM,3204773,XR FEMUR 2+ VW LT,265.0,74.73,26.25,333.39,40
CDM,3204849,INJ/S EPID/SUB L/S WO IMG,1412.0,505.5,77.2,5681.0,63
CDM,3204856,INJ/S EPID/SUB L/S W IMG,1867.0,668.39,96.84,5681.0,63
CDM,3204948,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,3205564,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,1920.0,687.36,80.89,6689.0,63
CDM,3205572,PLC DEV/S LOC TIS SOFT PERC LSN ADD,979.0,350.48,40.87,5681.0,38
CDM,3205655,PLC CATH NEPHROURET PERC NEW BI S&I,7725.0,2765.55,242.28,14124.0,40
CDM,3205663,PLC CATH NEPHROURET PERC NEW LT S&I,5150.0,1843.7,242.28,14124.0,40
CDM,3205671,PLC CATH NEPHROURET PERC NEW RT S&I,5150.0,1843.7,242.28,14124.0,40
CDM,3205689,CNV CATH NEPH PERC PRE EXIST BI S&I,4694.0,1680.45,181.96,5988.0,40
CDM,3205697,CNV CATH NEPH PERC PRE EXIST LT S&I,3129.0,1120.18,181.96,5988.0,40
CDM,3205705,CNV CATH NEPH PERC PRE EXIST RT S&I,3129.0,1120.18,181.96,5988.0,40
CDM,3205713,DIL BLN DUCT BILIARY PERC EA S&I,4597.0,1645.73,128.71,5681.0,40
CDM,3205721,BX/S ENDOLMNL BILI TREE PERC S&I,4802.0,1719.12,135.94,5681.0,40
CDM,3205739,COLL FLUID SCLEROTX W IMG GD S&I,3139.0,1123.76,114.14,14124.0,63
CDM,3205747,EMB/OCCL URETERAL BI S&I,4758.0,1703.36,169.17,5681.0,40
CDM,3205754,DIL BLN STRICTURE URETERAL BI S&I,4709.0,1685.82,171.94,5681.0,40
CDM,3205762,THROMBECTOMY&/INF TRNSL ART PERC BI,7764.0,2779.51,812.51,10737.0,40
CDM,3205770,EMB/OCCL URETERAL LT S&I,3172.0,1135.58,169.17,5681.0,40
CDM,3205788,EMB/OCCL URETERAL RT S&I,3172.0,1135.58,169.17,5681.0,40
CDM,3205796,DIL BLN STRICTURE URETERAL LT S&I,3139.0,1123.76,171.94,5681.0,40
CDM,3205804,DIL BLN STRICTURE URETERAL RT S&I,3139.0,1123.76,171.94,5681.0,40
CDM,3205812,THROMBECTOMY&/INF TRNSL ART PERC LT,5176.0,1853.01,812.51,10737.0,40
CDM,3205820,THROMBECTOMY&/INF TRNSL ART PERC RT,5176.0,1853.01,812.51,10737.0,40
CDM,3205838,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,3205846,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,3205853,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,3205861,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,3205879,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,3206257,INJ/S EPID/SUB C/T WO IMG,1308.0,468.26,97.21,5681.0,63
CDM,3206265,INJ/S EPID/SUB C/T W IMG,1867.0,668.39,104.71,5681.0,63
CDM,3206273,INJ/S EPID/SUB L/S WO IMG,1412.0,505.5,77.2,5681.0,63
CDM,3206281,INJ/S EPID/SUB L/S W IMG,1867.0,668.39,96.84,5681.0,63
CDM,3206307,INJ/S PLC CATH EPID/SUB C/T W IMG,2469.0,883.9,107.48,5681.0,63
CDM,3206323,INJ/S PLC CATH EPID/SUB L/S W IMG,2469.0,883.9,104.63,5681.0,63
CDM,3206331,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,3206349,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,3206356,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,3206364,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,3206372,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,3206380,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,3206398,INTRO NDL&/CTH DIAL W DX ANG S&I,5262.0,1883.8,159.77,5681.0,63
CDM,3206406,INTRO NDL&/CTH DIAL W TBA S&I,8378.0,2999.32,227.98,11751.0,63
CDM,3206414,INTRO NDL&/CTH DIAL W PLC STNT/S IV,16356.0,5855.45,299.43,20325.69,63
CDM,3206422,THROMBECT&/INF PERC IMG ANG S&I,13803.0,4941.47,349.65,10352.25,63
CDM,3206430,THROMBECT&/INF PERC MECH W TBA S&I,16356.0,5855.45,420.2,20325.69,63
CDM,3206448,THROMBECT&/INF PERC W PLC STNT/S IV,26334.0,9427.57,484.88,32276.26,63
CDM,3206455,TBA DIAL CENTRAL SEG W IMG SI,6076.0,2175.21,138.62,10528.0,40
CDM,3206463,TBA OPN/PRC ART INT BI S&I,15387.0,5508.55,329.65,11751.0,40
CDM,3206471,TBA OPN/PRC ART ADL BI S&I,8099.0,2899.44,164.07,10528.0,40
CDM,3206489,TBA OPN/PRC VEIN INT BI S&I,15387.0,5508.55,282.07,11751.0,40
CDM,3206497,TBA OPN/PRC VEIN ADL BI S&I,7893.0,2825.69,137.95,10528.0,40
CDM,3206505,MAMMO DX W/WO CAD LT,467.0,213.89,84.99,485.06,40
CDM,3206513,MAMMO DX W/WO CAD RT,467.0,213.89,84.99,485.06,40
CDM,3206521,MAMMO DX W/WO CAD BI,599.0,274.34,108.97,683.56,40
CDM,3206539,MAMMO SCRN W/WO CAD 2 VW BI,563.0,309.65,89.86,550.77,40
CDM,3206877,PLC TRANSCTH STNT/S IVASC CDS S&I,9412.0,3369.5,196.38,7059.0,40
CDM,3206885,EMB/OCCL PERM CIRCUIT DIALYSIS S&I,6612.0,2367.1,190.59,5681.0,40
CDM,3206976,MAMMO SCRN W/WO CAD 2 VW BI RDC,375.0,206.25,69.75,512.54,40
CDM,3207172,TBA OPN/PRC ART INT NONPAIR/UNI S&I,10258.0,3672.36,329.65,11751.0,63
CDM,3207198,TBA OPN/PRC ART ADL NONPAIR/UNI S&I,5399.0,1932.84,164.07,10528.0,40
CDM,3207214,TBA OPN/PRC VEIN INT NONPAIR/UNIS&I,10258.0,3672.36,282.07,11751.0,63
CDM,3207230,TBA OPN/PRC VEIN ADL NONPAIR/UNIS&I,5262.0,1883.8,137.95,10528.0,40
CDM,3207248,ANGIO PELVIC S&I,7413.0,1564.14,89.78,19658.22,63
CDM,3207271,REM SHUNT PERITONEAL-VENOUS,6143.0,2199.19,444.8,7697.0,63
CDM,3207412,MAMMO SCRN W/WO CAD 2 VW BI MBL,563.0,309.65,89.86,550.77,40
CDM,3207420,MAMMO SCRN W/WO CAD 2 VW BI RDC MBL,375.0,206.25,69.75,512.54,40
CDM,3207438,TOMOSYNTHESIS SCRN DIG BRST BI MBL,52.0,28.6,9.67,226.21,40
CDM,3207446,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,3207453,RUPTURE CYST SYNOVIAL INJ,651.0,233.06,189.35,5681.0,62
CDM,3207545,CHEMODENERV MUSC/S FAC/TRI/CERV BI,591.0,211.58,119.09,5681.0,63
CDM,3207560,INJ INTRALESIONAL LSN 1-7,283.0,101.31,29.08,5681.0,63
CDM,3207578,INJ INTRALESIONAL LSN 8+,364.0,130.31,44.16,5681.0,63
CDM,3207586,INJ STEROID BREAST,176.0,63.01,79.2,6893.85,62
CDM,3207602,CHG TUBE CYSTO COMPLICATED,3433.0,1229.01,78.01,5681.0,63
CDM,3220001,XR ABSCESS/SINUS/FISTULA S&I,918.0,258.88,34.36,1989.95,63
CDM,3220019,XR ABDOMEN CMP 2+VW W CHEST 1 VW,971.0,273.82,34.04,728.25,63
CDM,3220043,ABL RF TUMOR/S LIVER PERC,9095.0,3256.01,704.21,10644.28,63
CDM,3220050,XR JTS ACROMIOCLAVICULAR BI,220.0,62.04,19.44,333.39,63
CDM,3220092,XR ANKLE CMP 3+ VW LT,298.0,84.04,27.54,333.39,40
CDM,3220100,XR ANKLE CMP 3+ VW RT,298.0,84.04,27.54,333.39,40
CDM,3220126,XR ANKLE 2 VW LT,221.0,62.32,23.97,333.39,40
CDM,3220134,XR ANKLE 2 VW RT,221.0,62.32,23.97,333.39,40
CDM,3220142,CATH/CANN ART SMP/MNTR/TRNS PERC,929.0,332.58,42.66,5681.0,40
CDM,3220159,ASP BLADDER NDL,742.0,265.64,37.89,5681.0,63
CDM,3220167,ASP BLADDER TROCAR/CATH,1374.0,491.89,49.33,5681.0,63
CDM,3220183,ASP PUNCT ABSCESS/CYST,651.0,233.06,94.84,5681.0,63
CDM,3220209,ASP&INJ CYST BONE,1183.0,423.51,159.68,5681.0,63
CDM,3220217,ASP&/INJ CYST THYROID,1291.0,462.18,46.82,5681.0,63
CDM,3220233,ASP&/INJ CYST/PELVIS RENAL BI,2064.0,738.91,90.4,5681.0,40
CDM,3220241,ASP&/INJ CYST/PELVIS RENAL LT,1376.0,492.61,90.4,5681.0,40
CDM,3220258,ASP&/INJ CYST/PELVIS RENAL RT,1376.0,492.61,90.4,5681.0,40
CDM,3220316,ENDO BILI W DIL DCT&STNT PERC,5503.0,1970.07,359.81,18715.8,63
CDM,3220332,BX TRANSCATHETER,3930.0,1406.94,204.09,15325.0,63
CDM,3220340,BX TRANSCATHETER S&I,1787.0,503.93,26.45,1340.25,37
CDM,3220357,STUDIES AGE BONE,307.0,86.57,16.51,449.06,63
CDM,3220365,STUDIES LENGTH BONE,278.0,78.4,31.44,449.06,63
CDM,3220373,XR SURVEY OSSEOUS CMP,486.0,137.05,71.65,477.01,63
CDM,3220381,XR SURVEY OSSEOUS INFANT,685.0,193.17,72.3,513.75,63
CDM,3220399,XR SURVEY OSSEOUS LTD,338.0,95.32,43.45,449.06,63
CDM,3220431,BX MASS ABD/RETRO NDL PERC,2983.0,1067.91,79.3,5681.0,63
CDM,3220449,BX BONE TROCAR/NDL DEEP,2957.0,1058.61,124.69,6689.0,63
CDM,3220456,BX BONE TROCAR/NDL SUPERFICIAL,2124.0,760.39,84.14,5681.0,63
CDM,3220464,BX LIVER NDL PERC,3139.0,3104.87,84.42,5681.0,63
CDM,3220506,BX MUSCLE NDL PERC,2139.0,765.76,55.27,5681.0,63
CDM,3220514,BX PLEURA NDL PERC,2408.0,862.06,80.58,5681.0,63
CDM,3220522,BX CORD SPINAL NDL PERC,3006.0,1076.15,250.68,5681.0,63
CDM,3220530,BX THYROID NDL CORE PERC,1291.0,462.18,73.96,5681.0,63
CDM,3220555,XR CALCANEUS 2+ VW LT,192.0,54.14,20.4,333.39,40
CDM,3220563,XR CALCANEUS 2+ VW RT,192.0,54.14,20.4,333.39,40
CDM,3220589,CATH TUBE FALLOPIAN LT S&I,789.0,222.5,50.76,591.75,33
CDM,3220597,CATH TUBE FALLOPIAN RT S&I,789.0,222.5,50.76,591.75,33
CDM,3220605,CAVERNOSOGRAPHY CORPORA S&I,818.0,230.68,2.64,613.5,63
CDM,3220613,CHG TUBE CYSTO SIMPLE,715.0,255.97,50.29,5681.0,63
CDM,3220662,CHG CATH DRN/TUBE PERC S&I,797.0,224.75,56.43,597.75,37
CDM,3220696,CHOLANGIO&/PANCREATOGRAM OR ADD S&I,370.0,104.34,17.12,277.5,37
CDM,3220704,CHOLANGIO&/PANCREATOGRAM OR S&I,436.0,122.95,22.83,327.0,37
CDM,3220738,CHOLECYSTOGRAPHY CNT ORAL,737.0,207.83,68.12,735.79,63
CDM,3220803,XR CLAVICLE CMP LT,238.0,67.12,23.98,333.39,40
CDM,3220811,XR CLAVICLE CMP RT,238.0,67.12,23.98,333.39,40
CDM,3220860,INS CVC CENTRAL NONTUN 5+YRS,5317.0,1903.49,81.34,5681.0,63
CDM,3220878,INS CVC CENTRAL NONTUN 0-4YRS,4220.0,1510.76,81.45,5681.0,63
CDM,3220886,INS CVC CENTRAL TUN WO P/P 0-4YRS,7413.0,2653.85,310.61,10065.0,63
CDM,3220894,INS CVC CENTRAL TUN WO P/P 5+YRS,6385.0,2285.83,248.88,7697.0,63
CDM,3220902,INS CAD CENTRAL TUN 2 CATH W PORT,8343.0,2986.79,343.13,14124.0,63
CDM,3220910,INS CAD CENTRAL TUN 2 CATH WO P/P,5262.0,1883.8,323.69,7704.0,63
CDM,3220928,INS CVD CENTRAL TUN W PORT 0-4YRS,5425.0,1942.15,371.05,7704.0,63
CDM,3220936,INS CVD CENTRAL TUN W PORT 5+YRS,5262.0,5014.03,319.34,7704.0,63
CDM,3220944,INS CAD CENTRAL TUN W PORT,8217.0,2941.69,347.95,10065.0,63
CDM,3220951,CYSTOGRAM 3+ VW S&I,743.0,209.53,25.6,1516.98,63
CDM,3220985,DECLOT CANNULA EXTERNAL W BLN,5580.0,1997.64,132.26,10065.0,63
CDM,3220993,DECLOT CANNULA EXTERNAL WO BLN,4597.0,1645.73,105.42,6689.0,63
CDM,3221009,DECLOT CATH/VAD W AGENT THROMB,711.0,254.54,33.67,5681.0,63
CDM,3221090,DIL ESOPHAGUS GD WIRE NO SCOPE,1737.0,621.85,84.14,5681.0,63
CDM,3221132,ENDO BILI W DIL DCT WO STNT PERC,4844.0,1734.15,317.64,11398.36,63
CDM,3221140,DIL STRICT&/OBSTRUCT INTRALUM S&I,717.0,202.19,7.51,537.75,37
CDM,3221157,DISCOGRAM LUMBAR S&I,3093.0,872.23,70.39,7229.66,63
CDM,3221181,I&D HEMATOMA/SEROMA/FLUID,3139.0,1123.76,116.33,5681.0,63
CDM,3221207,DRN ABSCESS LYMPH NODE SIMPLE,4543.0,1626.39,205.96,5681.0,63
CDM,3221231,XR ELBOW CMP 3+ VW LT,284.0,80.09,23.97,333.39,40
CDM,3221249,XR ELBOW CMP 3+ VW RT,284.0,80.09,23.97,333.39,40
CDM,3221264,XR ELBOW 2 VW LT,221.0,62.32,20.73,333.39,40
CDM,3221272,XR ELBOW 2 VW RT,221.0,62.32,20.73,333.39,40
CDM,3221306,CATH ENDO DUCT BILIARY S&I,725.0,204.45,7.51,543.75,37
CDM,3221314,CATH ENDO DUCT PANCREAS S&I,735.0,207.27,40.63,551.25,37
CDM,3221330,ENEMA THERAPEUTIC,920.0,259.44,129.45,1126.49,63
CDM,3221348,PLC TUBE ENTEROCLYSIS PERC S&I,720.0,203.04,6.16,540.0,37
CDM,3221363,ERCP DX W/WO SPEC,5103.0,1826.87,310.37,6788.28,63
CDM,3221371,CATH ENDO DUCT BILIARY&PANCREAS S&I,800.0,225.6,7.51,600.0,37
CDM,3221421,EXCHG CATH DRN ABSC/CYST,3433.0,1229.01,67.43,5681.0,63
CDM,3221470,XR BONES FACIAL 0-2 VW,285.0,80.37,22.02,333.39,63
CDM,3221488,XR BONES FACIAL CMP 3+ VW,351.0,98.98,34.04,449.06,63
CDM,3221496,XR FB NOSE TO RECTUM CHILD 1 VW,253.0,71.35,20.41,333.39,63
CDM,3221538,XR FINGER/S 2+ VW LT,186.0,52.45,30.79,333.39,40
CDM,3221546,XR FINGER/S 2+ VW RT,186.0,52.45,30.79,333.39,40
CDM,3221553,FLUORO GD PLC/REPL/REM CVAD,526.0,148.33,78.82,537.02,37
CDM,3221561,GD W PLC CATH DRN PERC S&I,962.0,271.28,55.46,721.5,37
CDM,3221579,FLUORO GD&LOC NEEDLE SPINE,497.0,140.15,74.93,503.82,37
CDM,3221603,FLUORO GD PLCMT NEEDLE,582.0,164.12,87.26,623.23,37
CDM,3221611,FLUORO 0-1HR TIME PHYS/QHCP,475.0,133.95,27.22,948.33,63
CDM,3221645,XR FOOT CMP 3+ VW LT,313.0,88.27,25.6,333.39,40
CDM,3221652,XR FOOT CMP 3+ VW RT,313.0,88.27,25.6,333.39,40
CDM,3221678,XR FOOT 2 VW LT,220.0,62.04,20.73,333.39,40
CDM,3221686,XR FOOT 2 VW RT,220.0,62.04,20.73,333.39,40
CDM,3221702,XR FOREARM 2 VW LT,260.0,73.32,21.05,333.39,40
CDM,3221710,XR FOREARM 2 VW RT,260.0,73.32,21.05,333.39,40
CDM,3221744,XR HAND 3+ VW LT,305.0,86.01,28.19,333.39,40
CDM,3221751,XR HAND 3+ VW RT,305.0,86.01,28.19,333.39,40
CDM,3221777,XR HAND 2 VW LT,216.0,60.91,23.01,449.06,40
CDM,3221785,XR HAND 2 VW RT,216.0,60.91,23.01,449.06,40
CDM,3221876,XR HUMERUS 2+ VW LT,273.0,76.99,23.65,333.39,40
CDM,3221884,XR HUMERUS 2+ VW RT,273.0,76.99,23.65,333.39,40
CDM,3221892,HYSTEROSALPINGOGRAM S&I,600.0,169.2,73.63,948.33,63
CDM,3221900,IMP/REV/REPOS CATH IT/EPIDURAL,8872.0,3176.18,390.92,15451.52,63
CDM,3221942,INJ CNT ABSC/CYST VIA PREV CATH/TB,599.0,214.44,35.69,5681.0,40
CDM,3221959,INJ CNT/AIR PERITONEAL CAVITY,555.0,198.69,86.4,5681.0,40
CDM,3221967,INJ ANES PLEXUS CELIAC,1822.0,652.28,92.23,5681.0,63
CDM,3221983,INJ ANES LUMB/THOR SYMPATHETIC,1866.0,668.03,83.04,5681.0,63
CDM,3222023,INJ ARTHRO ANKLE LT,620.0,221.96,49.89,5681.0,40
CDM,3222031,INJ ARTHRO ANKLE RT,620.0,221.96,49.89,5681.0,40
CDM,3222049,INJ ARTHRO ELBOW LT,659.0,235.92,64.18,5681.0,40
CDM,3222056,INJ ARTHRO ELBOW RT,659.0,235.92,64.18,5681.0,40
CDM,3222064,INJ ARTHRO HIP W ANES LT,659.0,235.92,79.23,5681.0,40
CDM,3222072,INJ ARTHRO HIP W ANES RT,659.0,235.92,79.23,5681.0,40
CDM,3222080,INJ ARTHRO HIP WO ANES LT,576.0,206.21,65.71,5681.0,40
CDM,3222098,INJ ARTHRO HIP WO ANES RT,576.0,206.21,65.71,5681.0,40
CDM,3222122,INJ ARTHRO SHOULDER LT,627.0,224.47,48.14,5681.0,40
CDM,3222130,INJ ARTHRO SHOULDER RT,627.0,224.47,48.14,5681.0,40
CDM,3222163,INJ ARTHRO WRIST LT,646.0,231.27,70.71,5681.0,40
CDM,3222171,INJ ARTHRO WRIST RT,646.0,231.27,70.71,5681.0,40
CDM,3222239,INJ CYSTOGRAM,689.0,246.66,41.91,4664.0,40
CDM,3222247,INJ DISCOGRAM CERVICAL/THORACIC,618.0,221.24,114.95,5681.0,40
CDM,3222254,INJ DISCOGRAM LUMBAR,659.0,235.92,122.57,5681.0,40
CDM,3222288,INJ EPID PATCH BLOOD/CLOT,1604.0,574.23,110.28,5681.0,63
CDM,3222338,INJ VENOGRAPHY EXTREMITY BI,750.0,268.5,45.26,5681.0,40
CDM,3222346,INJ VENOGRAPHY EXTREMITY LT,500.0,179.0,45.26,5681.0,40
CDM,3222353,INJ VENOGRAPHY EXTREMITY RT,500.0,179.0,45.26,5681.0,40
CDM,3222361,INJ SIS/HYSTEROSALPINGOGRAPHY,501.0,179.36,56.32,5681.0,40
CDM,3222452,INJ/INF NEUROLYTIC EPIDURAL C/T,1822.0,652.28,151.88,5681.0,63
CDM,3222460,INJ/INF NEUROLYTIC EPIDURAL L/S,1980.0,708.84,138.66,5681.0,63
CDM,3222478,INJ/INF NEUROLYTIC SUBARACHNOID,1807.0,646.91,156.24,5681.0,63
CDM,3222486,INJ EVAL SHUNT PERITONEAL-VENOUS,388.0,138.9,37.3,5681.0,40
CDM,3222510,INJ PROC SIALOGRAM LT,643.0,230.19,59.02,5681.0,40
CDM,3222528,INJ PROC SIALOGRAM RT,643.0,230.19,59.02,5681.0,40
CDM,3222536,INJ/S TRIGGER PT/S MUSC/S 1-2,491.0,175.78,35.93,5681.0,63
CDM,3222577,INJ SPLENOPORTOGRAM,659.0,235.92,122.57,5681.0,40
CDM,3222585,INJ TRACT SINOGRAM,369.0,132.1,35.08,5681.0,38
CDM,3222601,INJ/S TRIGGER PT/S MUSC/S 3+,560.0,200.48,40.83,5681.0,63
CDM,3222619,INJ PSEUDOANEURYSM EXT LT,1019.0,364.8,99.7,5681.0,40
CDM,3222627,INJ PSEUDOANEURYSM EXT RT,1019.0,364.8,99.7,5681.0,40
CDM,3222643,INJ URETHROCYSTOGRAM RETROGRADE,350.0,125.3,62.38,4664.0,40
CDM,3222650,INJ VENOGRAM NON EXTREMITY,446.0,159.67,82.96,4664.0,39
CDM,3222692,INJ VISUAL ILEAL CONDUIT,316.0,113.13,58.78,5681.0,40
CDM,3222759,ASP BLADDER W INS CATH SUPRAPUBIC,3433.0,1229.01,137.96,6226.0,63
CDM,3222775,INS TIPS,11303.0,4046.47,773.95,32276.26,63
CDM,3222783,INS CATH BLADDER INDWL SMPL,284.0,101.67,24.52,5681.0,63
CDM,3222791,XR MEATI AUDITORY INTERNAL CMP,766.0,216.01,43.78,1989.95,63
CDM,3222841,INTRO TUBE GI LONG W FLUORO S&I,344.0,97.01,6.16,258.0,37
CDM,3222866,INTRO CATH AORTA,1392.0,498.34,131.94,6689.0,40
CDM,3222908,INTRO CATH RT HEART/ART PULM MAIN,853.0,305.37,119.8,5681.0,40
CDM,3222916,INTRO CATH SVC/IVC,1244.0,445.35,103.09,5681.0,40
CDM,3222957,INTRO TUBE GI LONG,675.0,241.65,18.34,5444.0,63
CDM,3223005,INTRO NDL/CATH ARTERY EXTREMITY LT,867.0,310.39,84.4,5681.0,40
CDM,3223013,INTRO NDL/CATH ARTERY EXTREMITY RT,867.0,310.39,84.4,5681.0,40
CDM,3223039,UROGRAPHY INF&/BOLUS W NEPHRO,2730.0,769.86,124.87,2047.5,63
CDM,3223047,UROGRAPHY IV W/WO KUB,985.0,277.77,108.97,738.75,63
CDM,3223096,APPLY MANUAL STRESS JOINT UNI/BI,361.0,101.8,53.61,387.94,63
CDM,3223104,SURVEY JOINT SGL VW 2+ JTS,269.0,75.86,29.82,449.06,63
CDM,3223120,XR KNEE CMP 4+ VW LT,365.0,102.93,35.34,449.06,40
CDM,3223138,XR KNEE CMP 4+ VW RT,365.0,102.93,35.34,449.06,40
CDM,3223153,XR KNEE 1-2 VW LT,247.0,69.65,25.6,333.39,40
CDM,3223161,XR KNEE 1-2 VW RT,247.0,69.65,25.6,333.39,40
CDM,3223187,XR KNEE 3 VW LT,270.0,76.14,31.12,333.39,40
CDM,3223195,XR KNEE 3 VW RT,270.0,76.14,31.12,333.39,40
CDM,3223203,XR KNEES STANDING AP BI,258.0,72.76,31.12,333.39,63
CDM,3223229,XR EXT LOWER INFANT 2+ VW LT,307.0,86.57,23.33,333.39,40
CDM,3223237,XR EXT LOWER INFANT 2+ VW RT,307.0,86.57,23.33,333.39,40
CDM,3223336,XR MANDIBLE CMP 4+ VW,345.0,97.29,31.11,449.06,63
CDM,3223344,XR MANDIBLE PARTIAL 1-3 VW,223.0,62.89,29.49,333.39,63
CDM,3223377,MYELOGRAPHY CERVICAL S&I,1391.0,392.26,67.15,2947.19,63
CDM,3223385,MYELOGRAPHY LUMBOSACRAL S&I,1391.0,392.26,67.79,2947.19,63
CDM,3223401,MYELOGRAPHY THORACIC S&I,1392.0,392.54,63.25,2947.19,63
CDM,3223419,MYELOGRAPHY 2+ REGIONS S&I,1928.0,543.7,85.97,2947.19,63
CDM,3223427,XR BONES NASAL CMP 3+ VW,301.0,84.88,28.85,333.39,63
CDM,3223435,XR TISSUE SOFT NECK,237.0,66.83,22.03,333.39,63
CDM,3223567,XR ORBITS CMP 4+ VW,282.0,79.52,33.72,449.06,63
CDM,3223575,ORTHOPANTOGRAM,190.0,53.58,8.4,333.39,63
CDM,3223591,XR PELVIS CMP 3+ VW,339.0,95.6,29.5,449.06,63
CDM,3223609,XR PELVIS 1-2 VW,329.0,92.78,19.1,449.06,63
CDM,3223641,PERINEOGRAM/VAGINOGRAM,1434.0,404.39,3.56,1392.13,63
CDM,3223666,PERITONEOGRAM S&I,1117.0,314.99,3.06,3186.84,63
CDM,3223682,XR PHARYNX/LARYNX W FLUORO,505.0,142.41,58.65,484.2,63
CDM,3223724,INS PICD WO P/P 0-4YRS,6541.0,2341.68,322.23,7704.0,63
CDM,3223732,INS PICD WO P/P 5+YRS,5867.0,2100.39,301.48,7704.0,63
CDM,3223773,PLC G-TUBE NASO/ORO PHYS W FL GD,1211.0,433.54,38.57,6689.0,63
CDM,3223781,PLC DEV/S OCCLUSIVE,461.0,165.04,85.75,4664.0,33
CDM,3223815,CATH VEIN PORTAL PERC ANY METHOD,1108.0,396.66,206.09,5681.0,40
CDM,3223823,PORTOGRAM W EVAL HEMO S&I,4923.0,1388.29,70.35,11792.62,63
CDM,3223831,PORTOGRAM WO EVAL HEMO S&I,3952.0,1114.46,71.0,11792.62,63
CDM,3223997,PUNCT C1-C2 W INJ,1365.0,488.67,113.61,5681.0,63
CDM,3224003,PUNCT SHUNT TUBE/RESV ASP/INJ,1276.0,456.81,54.62,5681.0,63
CDM,3224045,REM OBSTRUCT MECH CVD INTRALUMINAL,3165.0,1133.07,43.35,5681.0,63
CDM,3224052,REM OBSTRUCT CVD INTRALUMINAL S&I,456.0,128.59,68.11,402.7,37
CDM,3224060,REM OBSTRUCT MECH CVD PERICATHETER,4597.0,1645.73,172.98,8715.0,63
CDM,3224078,REM OBSTRUCT CVD PERICATHETER S&I,1020.0,287.64,189.72,1174.48,37
CDM,3224094,REM FB ESOPHAGUS S&I,688.0,194.02,98.66,516.0,37
CDM,3224102,REM CVC TUN WO P/P,2314.0,828.41,131.32,5681.0,63
CDM,3224110,REM CVD TUN W P/P,3193.0,2905.77,182.8,5681.0,63
CDM,3224128,XR CYST RENAL TRANSLUMBAR S&I,1893.0,533.83,3.06,3186.84,63
CDM,3224136,RPR CVC WO P/P,2333.0,835.21,32.08,6689.0,63
CDM,3224144,RPR CVD W P/P,4597.0,1645.73,176.42,6689.0,63
CDM,3224151,REPOS G-TUBE NASO/ORO,1811.0,648.34,100.51,5681.0,63
CDM,3224169,REPOSITION CVC PREVIOUS W FLUORO,2668.0,955.14,57.52,5681.0,63
CDM,3224219,REV TIPS,13803.0,4941.47,355.36,13802.9,63
CDM,3224227,XR RIBS 2 VW LT,192.0,54.14,25.6,333.39,40
CDM,3224235,XR RIBS 2 VW RT,192.0,54.14,25.6,333.39,40
CDM,3224243,XR RIBS 3+ VW BI,306.0,86.29,29.49,449.06,63
CDM,3224276,XR RIBS W CXR 4+ VW BI,462.0,130.28,36.3,449.06,63
CDM,3224284,RPLC CATH CVD W P/P,4597.0,1645.73,196.11,7697.0,63
CDM,3224292,RPLC CICVC NONTUN WO P/P,3433.0,1229.01,62.4,5681.0,63
CDM,3224318,RPLC PICVD W PORT,5262.0,1883.8,268.8,7704.0,63
CDM,3224326,RPLC CICVC TUN WO P/P,4597.0,1645.73,175.61,7697.0,63
CDM,3224334,RPLC CICVC TUN W PORT,5262.0,1883.8,275.91,7704.0,63
CDM,3224342,RPLC CICVC TUN W PUMP,7413.0,2653.85,318.36,10065.0,63
CDM,3224359,XR SACRUM&COCCYX 2+ VW,253.0,71.35,23.65,333.39,63
CDM,3224367,XR GLAND SALIVARY CALCULUS,235.0,66.27,28.85,333.39,63
CDM,3224383,XR SCAPULA CMP LT,290.0,81.78,14.89,449.06,40
CDM,3224391,XR SCAPULA CMP RT,290.0,81.78,14.89,449.06,40
CDM,3224409,PLC CATH SEL ART PULM BI,1088.0,389.5,143.71,5681.0,40
CDM,3224417,PLC CATH SEL ART PULM LT,725.0,259.55,134.85,5681.0,40
CDM,3224425,PLC CATH SEL ART PULM RT,725.0,259.55,134.85,5681.0,40
CDM,3224433,PLC CATH SEL ART ABD/EXT 1ST ORD,2083.0,745.71,223.82,6689.0,40
CDM,3224441,PLC CATH SEL ART ABD/EXT 2ND ORD,2024.0,724.59,239.51,6689.0,40
CDM,3224458,PLC CATH SEL ART ABD/EXT 3RD ORD,2547.0,911.83,282.91,6689.0,40
CDM,3224466,PLC CATH SEL ART ABD/EXT ADDL,1311.0,469.34,45.79,6689.0,40
CDM,3224474,PLC CATH SEL ART PULM 2ND ORD LT,1315.0,470.77,163.1,5681.0,40
CDM,3224482,PLC CATH SEL ART PULM 2ND ORD RT,1315.0,470.77,163.1,5681.0,40
CDM,3224490,PLC CATH SEL ART THOR/BRACH 1ST ORD,2107.0,754.31,202.6,6689.0,40
CDM,3224508,PLC CATH SEL ART THOR/BRACH 2ND ORD,2729.0,976.98,258.66,6689.0,40
CDM,3224516,PLC CATH SEL ART THOR/BRACH 3RD ORD,3380.0,1210.04,316.77,6689.0,40
CDM,3224524,PLC CATH SEL ART THOR/BRACH ADDL,796.0,284.97,49.98,6689.0,40
CDM,3224532,PLC CATH SEL VENOUS BRANCH 1ST ORD,1465.0,524.47,148.19,5681.0,40
CDM,3224540,PLC CATH SEL VENOUS BRANCH 2+ ORD,1648.0,589.98,165.17,5681.0,40
CDM,3224565,XR SHOULDER CMP 2+ VW LT,279.0,78.68,25.28,333.39,40
CDM,3224573,XR SHOULDER CMP 2+ VW RT,279.0,78.68,25.28,333.39,40
CDM,3224599,XR SHOULDER 1 VW LT,252.0,71.06,13.92,333.39,40
CDM,3224607,XR SHOULDER 1 VW RT,252.0,71.06,13.92,333.39,40
CDM,3224623,SHUNTOGRAM NONVASCULAR S&I,336.0,94.75,57.73,449.06,63
CDM,3224631,XR JTS SACROILIAC 1-2 VW,212.0,59.78,24.63,449.06,63
CDM,3224649,XR JTS SACROILIAC 3+ VW,308.0,86.86,27.87,449.06,63
CDM,3224656,SIALOGRAPHY LT S&I,688.0,194.02,95.38,948.33,40
CDM,3224664,SIALOGRAPHY RT S&I,688.0,194.02,95.38,948.33,40
CDM,3224672,XR SINUSES PARANASAL 0-2 VW,235.0,66.27,23.32,333.39,63
CDM,3224680,XR SINUSES PARANASAL CMP 3+ VW,267.0,75.29,26.58,333.39,63
CDM,3224698,XR SKULL 0-3 VW,338.0,95.32,26.57,449.06,63
CDM,3224706,XR SKULL CMP 4+ VW,384.0,108.29,30.47,449.06,63
CDM,3224730,EVAL SPEECH COMPLEX CINE/VIDEO,486.0,137.05,66.49,948.33,63
CDM,3224748,XR SPINE 1 VW,202.0,56.96,16.18,333.39,63
CDM,3224771,XR SPINE CERVICAL 2-3 VW,293.0,82.63,28.19,333.39,63
CDM,3224797,XR SPINE LS 4+ VW,392.0,110.54,38.59,449.06,63
CDM,3224805,XR SPINE LS 2-3 VW,345.0,97.29,28.52,449.06,63
CDM,3224854,XR SPINE THORACIC 4+ VW,398.0,112.24,32.09,449.06,63
CDM,3224862,XR SPINE THORACIC 2 VW,284.0,80.09,22.68,449.06,63
CDM,3224870,XR SPINE THORACIC 3 VW,345.0,97.29,28.19,449.06,63
CDM,3224888,XR SPINE THORACOLUMBAR => 2 VW,300.0,84.6,23.98,333.39,63
CDM,3224896,SPLENOPORTOGRAPHY S&I,3643.0,1027.33,28.68,18420.25,63
CDM,3224920,XR JT/S STERNOCLAVICULAR 3+ VW,275.0,77.55,30.15,333.39,63
CDM,3224938,XR STERNUM 2+ VW,235.0,66.27,23.66,333.39,63
CDM,3224995,OCC EV ART BLN TEMP CNS W ANG,13803.0,4941.47,555.57,20325.69,63
CDM,3225042,THROMBECT GRAFT ARTERIAL/VENOUS,9241.0,3308.28,562.0,18194.0,63
CDM,3225059,THROMBOLYSIS CEREBRAL INF IV,1692.0,605.74,225.29,13802.9,63
CDM,3225091,XR TIBIA&FIBULA 2 VW LT,261.0,73.6,23.33,333.39,40
CDM,3225109,XR TIBIA&FIBULA 2 VW RT,261.0,73.6,23.33,333.39,40
CDM,3225117,INTRO NDL AORTA TRANSLUMBAR,809.0,289.62,117.2,6689.0,40
CDM,3225125,XR TMJ MOUTH OPEN&CLOSE BI,377.0,106.31,40.53,333.39,63
CDM,3225133,XR TMJ MOUTH OPEN&CLOSE LT,208.0,58.66,25.27,333.39,40
CDM,3225141,XR TMJ MOUTH OPEN&CLOSE RT,208.0,58.66,25.27,333.39,40
CDM,3225158,TOMOGRAPHY SGL EXCEPT URO,1085.0,305.97,60.32,813.75,63
CDM,3225190,THERAPY TRANSCATH EMB S&I,2708.0,763.66,56.0,2031.0,37
CDM,3225216,DIL STRICT DUCT BILI TRANSHEP S&I,1019.0,287.36,72.04,764.25,37
CDM,3225299,XR EXT UPPER INFANT 2+ VW LT,340.0,95.88,23.33,449.06,40
CDM,3225307,XR EXT UPPER INFANT 2+ VW RT,340.0,95.88,23.33,449.06,40
CDM,3225323,URETHROCYSTOGRAM RETROGRADE S&I,1434.0,404.39,3.56,1392.13,63
CDM,3225331,URETHROCYSTOGRAM VOIDING S&I,495.0,139.59,86.29,948.33,63
CDM,3225356,UROGRAPHY INF&/BOLUS,2339.0,659.6,115.78,1754.25,63
CDM,3225364,UROGRAPHY RETROGRADE W/WO KUB,716.0,201.91,52.54,1516.98,63
CDM,3225380,VASOGRAM S&I,702.0,197.96,77.86,948.33,63
CDM,3225414,VENOGRAM EPIDURAL S&I,2756.0,777.19,72.94,2231.96,63
CDM,3225422,VENOGRAM EXTREMITY LT S&I,2093.0,590.23,57.73,5794.55,40
CDM,3225430,VENOGRAM EXTREMITY RT S&I,2093.0,590.23,57.73,5794.55,40
CDM,3225448,VENOGRAM EXTREMITY BI S&I,2282.0,643.52,63.9,5794.55,63
CDM,3225455,VENOGRAM HEPATIC W EVAL HEMO S&I,4501.0,1269.28,70.35,11792.62,63
CDM,3225463,VENOGRAM HEPATIC WO EVAL HEMO S&I,4274.0,1205.27,71.0,11792.62,63
CDM,3225471,VENOGRAM IVC SERIAL S&I,4923.0,1388.29,60.0,11792.62,63
CDM,3225489,VENOGRAM SINUS VEN/JUG S&I,4220.0,1190.04,71.0,11792.62,63
CDM,3225497,VENOGRAM ORBITAL S&I,2160.0,609.12,72.62,2231.96,63
CDM,3225505,VENOGRAM RENAL SEL BI S&I,4393.0,1238.83,77.17,11792.62,63
CDM,3225513,VENOGRAM RENAL SEL LT S&I,4220.0,1190.04,66.78,11792.62,40
CDM,3225521,VENOGRAM RENAL SEL RT S&I,4220.0,1190.04,66.78,11792.62,40
CDM,3225539,VENOGRAM SINUS SAGITTAL SUP S&I,4220.0,1190.04,95.34,11792.62,63
CDM,3225547,VENOGRAM SVC SERIAL S&I,1731.0,488.14,64.23,5794.55,63
CDM,3225554,VENOGRAM ADRENAL SEL LT S&I,4220.0,1190.04,72.94,11792.62,40
CDM,3225562,VENOGRAM ADRENAL SEL RT S&I,4220.0,1190.04,72.94,11792.62,40
CDM,3225570,CATH VENOUS SAMPLE BLOOD ORGAN,1438.0,514.8,173.21,5681.0,40
CDM,3225588,SAMPLE VENOUS CATH W/WO ANG S&I,6289.0,1773.5,77.81,19658.22,63
CDM,3225620,XR WRIST CMP 3+ VW LT,276.0,77.83,32.09,333.39,40
CDM,3225638,XR WRIST CMP 3+ VW RT,276.0,77.83,32.09,333.39,40
CDM,3225653,XR WRIST 2 VW LT,266.0,75.01,25.28,333.39,40
CDM,3225661,XR WRIST 2 VW RT,266.0,75.01,25.28,333.39,40
CDM,3225687,XR ARTHRO SHOULDER LT S&I,716.0,219.81,102.52,1516.98,40
CDM,3225695,XR ARTHRO SHOULDER RT S&I,716.0,219.81,102.52,1516.98,40
CDM,3225703,XR ARTHRO ANKLE LT S&I,1101.0,338.01,98.3,1516.98,40
CDM,3225711,XR ARTHRO ANKLE RT S&I,1101.0,338.01,98.3,1516.98,40
CDM,3225729,XR ARTHRO ELBOW LT S&I,716.0,219.81,72.66,1516.98,40
CDM,3225737,XR ARTHRO ELBOW RT S&I,716.0,219.81,72.66,1516.98,40
CDM,3225745,XR ARTHRO HIP LT S&I,806.0,247.44,98.3,1516.98,40
CDM,3225752,XR ARTHRO HIP RT S&I,806.0,247.44,98.3,1516.98,40
CDM,3225760,XR ARTHRO KNEE LT S&I,716.0,219.81,78.18,1516.98,40
CDM,3225778,XR ARTHRO KNEE RT S&I,716.0,219.81,78.18,1516.98,40
CDM,3225802,XR ARTHRO WRIST LT S&I,709.0,217.66,105.44,1516.98,40
CDM,3225810,XR ARTHRO WRIST RT S&I,709.0,217.66,105.44,1516.98,40
CDM,3225844,ANGIO ADRENAL SEL LT S&I,4220.0,890.42,97.24,11792.62,40
CDM,3225851,ANGIO ADRENAL SEL RT S&I,4220.0,890.42,97.24,11792.62,40
CDM,3225869,ANGIO ADRENAL SEL BI S&I,4262.0,899.28,109.21,11792.62,63
CDM,3225992,ANGIO EXTREMITY BI S&I,6003.0,1266.63,70.02,11792.62,63
CDM,3226008,ANGIO EXTREMITY LT S&I,5894.0,1243.63,67.1,11792.62,40
CDM,3226016,ANGIO EXTREMITY RT S&I,5894.0,1243.63,67.1,11792.62,40
CDM,3226024,ANGIO MAMMARY INTERNAL S&I,4017.0,847.59,108.28,11792.62,63
CDM,3226057,ANGIO PULMONARY NONSEL S&I,4220.0,890.42,80.74,11792.62,63
CDM,3226065,ANGIO PULMONARY SEL BI S&I,4220.0,890.42,70.02,11792.62,63
CDM,3226073,ANGIO PULMONARY SEL LT S&I,4102.0,865.52,68.73,11792.62,40
CDM,3226081,ANGIO PULMONARY SEL RT S&I,4102.0,865.52,68.73,11792.62,40
CDM,3226123,ANGIO SEL VESSEL ADDL S&I,1487.0,313.76,49.61,1115.25,37
CDM,3226131,ANGIO SPINAL SEL S&I,7413.0,1564.14,131.97,19658.22,63
CDM,3226156,ANGIO VISCERAL SEL S&I,7413.0,1564.14,75.54,19658.22,63
CDM,3226164,AORTO ABD SERIAL S&I,4923.0,1038.75,58.38,11792.62,63
CDM,3226172,AORTO ABD ILIOFEM BI SERIAL S&I,5792.0,1222.11,62.88,11792.62,63
CDM,3226180,AORTO THORACIC SERIAL S&I,6871.0,1449.78,66.45,19658.22,63
CDM,3226198,AORTO THORACIC WO SERIAL S&I,4502.0,949.92,155.06,11792.62,63
CDM,3226206,INS&PLC CATH DIRECTED FLOW,5656.0,1657.21,84.35,16111.14,63
CDM,3226347,PTA BLN ART PULMONARY VSL ADDL,6283.0,1840.92,301.58,15325.0,40
CDM,3226354,PTA BLN ART PULMONARY VSL SGL,14057.0,4118.7,601.98,26761.0,63
CDM,3226370,BX ENDOMYOCARDIAL,7560.0,6831.17,405.28,16111.14,63
CDM,3226479,XR TOE/S 2+ VW LT,164.0,46.25,22.36,333.39,40
CDM,3226487,XR TOE/S 2+ VW RT,164.0,46.25,22.36,333.39,40
CDM,3227907,INJ TRACT SINOGRAM,369.0,132.1,35.08,5681.0,38
CDM,3227949,ASP&INJ CYST BONE,1183.0,423.51,159.68,5681.0,63
CDM,3228004,REPOS G-TUBE NASO/ORO,1811.0,648.34,100.51,5681.0,63
CDM,3228012,INTRO TUBE GI LONG,675.0,241.65,18.34,5444.0,63
CDM,3228020,BX LIVER NDL PERC,3139.0,3104.87,84.42,5681.0,63
CDM,3228046,ENDO BILI W DIL DCT WO STNT PERC,4844.0,1734.15,317.64,11398.36,63
CDM,3228053,ENDO BILI W DIL DCT&STNT PERC,5503.0,1970.07,359.81,18715.8,63
CDM,3228079,EXCHG CATH DRN ABSC/CYST,3433.0,1229.01,67.43,5681.0,63
CDM,3228087,INJ CNT ABSC/CYST VIA PREV CATH/TB,599.0,214.44,35.69,5681.0,40
CDM,3228103,INJ CYSTOGRAM,689.0,246.66,41.91,4664.0,40
CDM,3228111,INJ URETHROCYSTOGRAM RETROGRADE,350.0,125.3,62.38,4664.0,40
CDM,3228129,INS CATH BLADDER INDWL SMPL,284.0,101.67,24.52,5681.0,63
CDM,3228137,CHG TUBE CYSTO SIMPLE,715.0,255.97,50.29,5681.0,63
CDM,3228145,INJ SIS/HYSTEROSALPINGOGRAPHY,501.0,179.36,56.32,5681.0,40
CDM,3228160,PUNCT C1-C2 W INJ,1365.0,488.67,113.61,5681.0,63
CDM,3228178,PUNCT SHUNT TUBE/RESV ASP/INJ,1276.0,456.81,54.62,5681.0,63
CDM,3228186,PUNCT LUMBAR DIAGNOSTIC,1604.0,574.23,61.59,5681.0,63
CDM,3228194,PUNCT SPINE THER DRN CSF,1386.0,496.19,88.71,5681.0,63
CDM,3228202,INJ EPID PATCH BLOOD/CLOT,1604.0,574.23,110.28,5681.0,63
CDM,3228210,INJ/INF NEUROLYTIC SUBARACHNOID,1807.0,646.91,156.24,5681.0,63
CDM,3228228,INJ/INF NEUROLYTIC EPIDURAL C/T,1822.0,652.28,151.88,5681.0,63
CDM,3228236,INJ/INF NEUROLYTIC EPIDURAL L/S,1980.0,708.84,138.66,5681.0,63
CDM,3228392,INJ ANES LUMB/THOR SYMPATHETIC,1866.0,668.03,83.04,5681.0,63
CDM,3228400,INJ ANES PLEXUS CELIAC,1822.0,652.28,92.23,5681.0,63
CDM,3228418,REFILL PUMP/RESV IMP W/WO ANLYS,572.0,169.88,87.75,945.0,63
CDM,3228434,REM IMP DRUG DELIVERY,713.0,255.25,70.9,5681.0,63
CDM,3228459,CHEMO CNS REQ PUNCTURE SPINAL,747.0,249.5,117.45,950.0,63
CDM,3228467,INJ ARTHRO HIP WO ANES LT,576.0,206.21,65.71,5681.0,40
CDM,3228475,INJ ARTHRO HIP WO ANES RT,576.0,206.21,65.71,5681.0,40
CDM,3228483,INJ ARTHRO HIP W ANES LT,659.0,235.92,79.23,5681.0,40
CDM,3228491,INJ ARTHRO HIP W ANES RT,659.0,235.92,79.23,5681.0,40
CDM,3228541,INSTILL AGENT PLEURODESIS W TB/CATH,1301.0,465.76,73.01,6689.0,63
CDM,3228558,INJ VENOGRAPHY EXTREMITY BI,750.0,268.5,45.26,5681.0,40
CDM,3228566,INJ VENOGRAPHY EXTREMITY LT,500.0,179.0,45.26,5681.0,40
CDM,3228574,INJ VENOGRAPHY EXTREMITY RT,500.0,179.0,45.26,5681.0,40
CDM,3228616,IMP/REV/REPOS CATH IT/EPIDURAL,8872.0,3176.18,390.92,15451.52,63
CDM,3228632,XR SPINE 1 VW,202.0,56.96,16.18,333.39,63
CDM,3228640,XR ARTHRO HIP LT S&I,806.0,247.44,98.3,1516.98,40
CDM,3228657,XR ARTHRO HIP RT S&I,806.0,247.44,98.3,1516.98,40
CDM,3228699,CATH ENDO DUCT BILIARY S&I,725.0,204.45,7.51,543.75,37
CDM,3228707,CATH ENDO DUCT PANCREAS S&I,735.0,207.27,40.63,551.25,37
CDM,3228715,CATH ENDO DUCT BILIARY&PANCREAS S&I,800.0,225.6,7.51,600.0,37
CDM,3228723,INTRO TUBE GI LONG W FLUORO S&I,344.0,97.01,6.16,258.0,37
CDM,3228749,UROGRAPHY RETROGRADE W/WO KUB,716.0,201.91,52.54,1516.98,63
CDM,3228756,UROGRAPHY ANTEGRADE S&I,880.0,248.16,109.34,1516.98,63
CDM,3228764,CYSTOGRAM 3+ VW S&I,743.0,209.53,25.6,1516.98,63
CDM,3228772,VASOGRAM S&I,702.0,197.96,77.86,948.33,63
CDM,3228780,URETHROCYSTOGRAM RETROGRADE S&I,1434.0,404.39,3.56,1392.13,63
CDM,3228798,HYSTEROSALPINGOGRAM S&I,600.0,169.2,73.63,948.33,63
CDM,3228814,VENOGRAM EXTREMITY LT S&I,2093.0,590.23,57.73,5794.55,40
CDM,3228822,VENOGRAM EXTREMITY RT S&I,2093.0,590.23,57.73,5794.55,40
CDM,3228830,VENOGRAM EXTREMITY BI S&I,2282.0,643.52,63.9,5794.55,63
CDM,3228848,VENOGRAM SVC SERIAL S&I,1731.0,488.14,64.23,5794.55,63
CDM,3228913,FLUORO 0-1HR TIME PHYS/QHCP,475.0,133.95,27.22,948.33,63
CDM,3228939,FLUORO GD PLCMT NEEDLE,582.0,164.12,87.26,623.23,37
CDM,3228947,FLUORO GD&LOC NEEDLE SPINE,497.0,140.15,74.93,503.82,37
CDM,3228954,XR ABSCESS/SINUS/FISTULA S&I,918.0,258.88,34.36,1989.95,63
CDM,3228962,US GD ABLATION TISSUE,372.0,129.83,12.79,370.32,37
CDM,3228970,REFILL PUMP/RESV IMP W/WO ANLYS,572.0,169.88,87.75,945.0,63
CDM,3228996,CHEMO PUSH INTRAARTERIAL,613.0,204.74,99.21,950.0,63
CDM,3229002,CHEMO CNS REQ PUNCTURE SPINAL,747.0,249.5,117.45,950.0,63
CDM,3229028,FLUORO GD PLC/REPL/REM CVAD,526.0,148.33,78.82,537.02,37
CDM,3229036,PLC G-TUBE NASO/ORO PHYS W FL GD,1211.0,433.54,38.57,6689.0,63
CDM,3229267,INS CATH PLEURAL INDWL W CUFF,5104.0,1827.23,195.82,18194.0,63
CDM,3229275,ABL EV RF VEIN EXT 1ST LT S&I,6851.0,2452.66,264.29,18194.0,40
CDM,3229283,ABL EV RF VEIN EXT 1ST RT S&I,6851.0,2452.66,264.29,18194.0,40
CDM,3229291,ABL EV RF VEIN EXT SUBSQ LT S&I,3310.0,1184.98,126.53,5681.0,40
CDM,3229309,ABL EV RF VEIN EXT SUBSQ RT S&I,3310.0,1184.98,126.53,5681.0,40
CDM,3229317,ABL EV LASER VEIN EXT 1ST LT S&I,6818.0,2440.84,264.53,18194.0,40
CDM,3229325,ABL EV LASER VEIN EXT 1ST RT S&I,6818.0,2440.84,264.53,18194.0,40
CDM,3229333,ABL EV LASER VEIN EXT SUBSQ LT S&I,3330.0,1192.14,129.16,5681.0,40
CDM,3229341,ABL EV LASER VEIN EXT SUBSQ RT S&I,3330.0,1192.14,129.16,5681.0,40
CDM,3229507,PHLEBECTOMY VEIN EXT 10-20 LT,5262.0,1883.8,258.6,7704.0,40
CDM,3229515,PHLEBECTOMY VEIN EXT 10-20 RT,5262.0,1883.8,258.6,7704.0,40
CDM,3229523,PHLEBECTOMY VEIN EXT 10-20 BI,7893.0,2825.69,258.6,7704.0,40
CDM,3229531,PHLEBECTOMY VEIN EXT 21+ LT,6465.0,2314.47,316.97,7704.0,40
CDM,3229549,PHLEBECTOMY VEIN EXT 21+ RT,6465.0,2314.47,316.97,7704.0,40
CDM,3229556,PHLEBECTOMY VEIN EXT 21+ BI,9698.0,3471.88,316.97,7704.0,40
CDM,3229820,INJ/S CNT EVAL CVD FLUORO S&I,937.0,335.45,34.09,6689.0,63
CDM,3229846,THROMBECT MECH PRIM ART SUBSQ W FL,6905.0,2471.99,154.03,6904.78,40
CDM,3229853,THROMBECT MECH SEC ART W FL,6905.0,2471.99,230.46,6904.78,40
CDM,3229861,THROMBECT MECH VEIN W FL,13803.0,4941.47,372.97,20325.69,63
CDM,3229879,THROMBECT MECH VEIN SUBSQ W FL,11588.0,4148.5,266.45,18194.0,63
CDM,3229895,RPLC STENT URETER INT PERC LT S&I,3790.0,1356.82,239.69,6226.0,40
CDM,3229903,RPLC STENT URETER INT PERC RT S&I,3790.0,1356.82,239.69,6226.0,40
CDM,3229911,RPLC STENT URETER INT PERC BI S&I,5685.0,2035.23,239.69,6226.0,40
CDM,3229929,REM STENT URETER INT PERC LT S&I,3433.0,1229.01,216.43,6226.0,40
CDM,3229937,REM STENT URETER INT PERC RT S&I,3433.0,1229.01,216.43,6226.0,40
CDM,3229945,REM STENT URETER INT PERC BI S&I,5150.0,1843.7,216.43,6226.0,40
CDM,3229952,RPLC CATH NEPHROURETER FL GD LT S&I,3124.0,1118.39,79.27,5681.0,40
CDM,3229960,RPLC CATH NEPHROURETER FL GD RT S&I,3124.0,1118.39,79.27,5681.0,40
CDM,3229978,RPLC CATH NEPHROURETER FL GD BI S&I,4686.0,1677.59,79.27,5681.0,40
CDM,3229986,REM TUBE NEPHRO W FLUORO LT S&I,1434.0,513.37,51.06,5681.0,40
CDM,3229994,REM TUBE NEPHRO W FLUORO RT S&I,1434.0,513.37,51.06,5681.0,40
CDM,3230000,REM TUBE NEPHRO W FLUORO BI S&I,2151.0,770.06,51.06,5681.0,40
CDM,3230018,PTA INTRACRANIAL PERC,15089.0,5401.86,982.0,13802.9,36
CDM,3230026,PLC STNT/S INTRAVASC INTRACRN,16981.0,6079.2,982.0,13802.9,40
CDM,3230034,DIL BLN VASO INTRACRN INIT S&I,13393.0,4794.69,458.14,10044.75,36
CDM,3230042,DIL BLN VASO INTRACRN ADDL S&I,10045.0,3596.11,160.91,7533.75,36
CDM,3230059,DIL BLN VASO INTRACRN ADD FAM S&I,10045.0,3596.11,321.81,7533.75,36
CDM,3230133,CHG TB/STNT URETER CONDUIT ILEAL,2584.0,925.07,75.45,5681.0,63
CDM,3231131,SHUNTOGRAM NONVASCULAR S&I,336.0,94.75,57.73,449.06,63
CDM,3232907,CAD CHEST REMOTE,161.0,45.4,15.37,120.75,27
CDM,3232915,CAD CHEST CONCURRENT,161.0,45.4,23.2,120.75,33
CDM,3234705,I&R FB TISSUE SUBQ SIMPLE,801.0,286.76,103.94,5681.0,63
CDM,3234754,INS TUBE GASTRO PERC S&I,3442.0,1232.24,194.08,6689.0,63
CDM,3234762,INS TUBE DUO/JEJUNOSTOMY PERC S&I,4103.0,1468.87,230.64,6689.0,63
CDM,3234770,INS TUBE CECOSTOMY PERC S&I,3879.0,1388.68,198.47,10059.0,63
CDM,3234788,CHG G-TUBE TO G-J TUBE PERC S&I,2767.0,990.59,139.48,5681.0,63
CDM,3234796,RPLC TUBE GASTRO/CECOSTOMY PERC S&I,1242.0,444.64,62.52,5681.0,63
CDM,3234804,RPLC TUBE DUO/JEJUNOSTOMY PERC S&I,1681.0,601.8,84.46,5681.0,63
CDM,3234812,RPLC TUBE G-J PERC S&I,2069.0,740.7,130.02,5681.0,63
CDM,3234820,REM OBSTRUCT MECH TUBE G/COLON S&I,906.0,324.35,48.63,5681.0,63
CDM,3234838,INJ CNT TUBE G/COLON PERC S&I,492.0,176.14,29.16,5681.0,63
CDM,3234994,INJ CNT TUBE G/COLON PERC S&I,492.0,176.14,29.16,5681.0,63
CDM,3241395,CAUT CHEMICAL TISSUE GRANULATION,383.0,137.11,36.77,5681.0,63
CDM,3241551,INJ/S JT FCT C/T IMG 1 LVL BI,1427.0,510.87,102.7,5681.0,40
CDM,3241569,INJ/S JT FCT C/T IMG 1 LVL LT,951.0,340.46,102.7,5681.0,40
CDM,3241577,INJ/S JT FCT C/T IMG 1 LVL RT,951.0,340.46,102.7,5681.0,40
CDM,3241585,INJ/S JT FCT C/T IMG 2 LVL BI,1253.0,448.57,57.6,5681.0,40
CDM,3241593,INJ/S JT FCT C/T IMG 2 LVL LT,835.0,298.93,57.6,5681.0,40
CDM,3241601,INJ/S JT FCT C/T IMG 2 LVL RT,835.0,298.93,57.6,5681.0,40
CDM,3241619,INJ/S JT FCT C/T IMG 3+ LVL BI,1365.0,488.67,58.58,5681.0,40
CDM,3241627,INJ/S JT FCT C/T IMG 3+ LVL LT,910.0,325.78,58.58,5681.0,40
CDM,3241635,INJ/S JT FCT C/T IMG 3+ LVL RT,910.0,325.78,58.58,5681.0,40
CDM,3241643,INJ/S JT FCT L/S IMG 1 LVL BI,4019.0,1438.8,88.29,5681.0,40
CDM,3241650,INJ/S JT FCT L/S IMG 1 LVL LT,2679.0,959.08,88.29,5681.0,40
CDM,3241668,INJ/S JT FCT L/S IMG 1 LVL RT,2679.0,959.08,88.29,5681.0,40
CDM,3241676,INJ/S JT FCT L/S IMG 2 LVL BI,1421.0,508.72,49.44,5681.0,40
CDM,3241684,INJ/S JT FCT L/S IMG 2 LVL LT,947.0,339.03,49.44,5681.0,40
CDM,3241692,INJ/S JT FCT L/S IMG 2 LVL RT,947.0,339.03,49.44,5681.0,40
CDM,3241700,INJ/S JT FCT L/S IMG 3+ LVL BI,1445.0,517.31,50.41,5681.0,40
CDM,3241718,INJ/S JT FCT L/S IMG 3+ LVL LT,963.0,344.75,50.41,5681.0,40
CDM,3241726,INJ/S JT FCT L/S IMG 3+ LVL RT,963.0,344.75,50.41,5681.0,40
CDM,3241734,INJ/S JT FCT C/T IMG 1 LVL BI,1427.0,510.87,102.7,5681.0,40
CDM,3241742,INJ/S JT FCT C/T IMG 1 LVL LT,951.0,340.46,102.7,5681.0,40
CDM,3241759,INJ/S JT FCT C/T IMG 1 LVL RT,951.0,340.46,102.7,5681.0,40
CDM,3241767,INJ/S JT FCT C/T IMG 2 LVL BI,1253.0,448.57,57.6,5681.0,40
CDM,3241775,INJ/S JT FCT C/T IMG 2 LVL LT,835.0,298.93,57.6,5681.0,40
CDM,3241783,INJ/S JT FCT C/T IMG 2 LVL RT,835.0,298.93,57.6,5681.0,40
CDM,3241791,INJ/S JT FCT C/T IMG 3+ LVL BI,1365.0,488.67,58.58,5681.0,40
CDM,3241809,INJ/S JT FCT C/T IMG 3+ LVL LT,910.0,325.78,58.58,5681.0,40
CDM,3241817,INJ/S JT FCT C/T IMG 3+ LVL RT,910.0,325.78,58.58,5681.0,40
CDM,3241825,INJ/S JT FCT L/S IMG 1 LVL BI,4019.0,1438.8,88.29,5681.0,40
CDM,3241833,INJ/S JT FCT L/S IMG 1 LVL LT,2679.0,959.08,88.29,5681.0,40
CDM,3241841,INJ/S JT FCT L/S IMG 1 LVL RT,2679.0,959.08,88.29,5681.0,40
CDM,3241858,INJ/S JT FCT L/S IMG 2 LVL BI,1421.0,508.72,49.44,5681.0,40
CDM,3241866,INJ/S JT FCT L/S IMG 2 LVL LT,947.0,339.03,49.44,5681.0,40
CDM,3241874,INJ/S JT FCT L/S IMG 2 LVL RT,947.0,339.03,49.44,5681.0,40
CDM,3241882,INJ/S JT FCT L/S IMG 3+ LVL BI,1445.0,517.31,50.41,5681.0,40
CDM,3241890,INJ/S JT FCT L/S IMG 3+ LVL LT,963.0,344.75,50.41,5681.0,40
CDM,3241908,INJ/S JT FCT L/S IMG 3+ LVL RT,963.0,344.75,50.41,5681.0,40
CDM,3241916,REM CATH PLEURAL INDWL W CUFF,2250.0,805.5,151.86,5681.0,63
CDM,3241924,PLC DEV/S INTRSTL RT GD INTRATH,1500.0,537.0,168.0,10059.0,63
CDM,3241932,PLC DEV/S RT GD INTRABD/PLVC/RETRO,3018.0,1080.44,178.16,5681.0,63
CDM,3242237,XR EYE FOREIGN BODY LT,189.0,53.3,23.66,333.39,40
CDM,3242245,XR EYE FOREIGN BODY RT,189.0,53.3,23.66,333.39,40
CDM,3242351,INJ ARTHRO SHOULDER BI,941.0,336.88,48.14,5681.0,40
CDM,3242856,INJ ANES GANGLION IMPAR FLUORO GD,1305.0,467.19,189.35,5681.0,62
CDM,3243326,XR RIBS W CXR 3+ VW,216.0,60.91,28.84,449.06,63
CDM,3243342,BX PANCREAS NDL PERC,2435.0,871.73,226.28,5681.0,63
CDM,3243359,CT GD PLCMT NEEDLE S&I,1529.0,261.46,68.76,1218.0,37
CDM,3243367,CT GD ABLATION TISSUE,1791.0,306.26,333.13,1343.25,37
CDM,3243516,ABL EV ADH CHEM EXT VEIN 1ST BI,12515.0,4480.37,170.73,10065.0,40
CDM,3243524,ABL EV ADH CHEM EXT VEIN 1ST LT,8343.0,2986.79,170.73,10065.0,40
CDM,3243532,ABL EV ADH CHEM EXT VEIN 1ST RT,8343.0,2986.79,170.73,10065.0,40
CDM,3243540,INJ CATH URETERAL BI,432.0,154.66,49.6,5681.0,40
CDM,3243557,INJ CATH URETERAL LT,288.0,103.1,49.6,5681.0,40
CDM,3243565,INJ CATH URETERAL RT,288.0,103.1,49.6,5681.0,40
CDM,3243573,INTRO CATH FALLOPIAN TUBE BI,5103.0,1826.87,284.06,6226.0,36
CDM,3243581,INTRO CATH FALLOPIAN TUBE LT,3402.0,1217.92,284.06,6226.0,36
CDM,3243599,INTRO CATH FALLOPIAN TUBE RT,3402.0,1217.92,284.06,6226.0,36
CDM,3243946,XR MASTOIDS 0-2 VW PER SIDE LT,334.0,94.19,28.84,449.06,40
CDM,3243953,XR MASTOIDS 0-2 VW PER SIDE RT,334.0,94.19,28.84,449.06,40
CDM,3243979,XR MASTOIDS CMP 3+ VW PER SIDE LT,836.0,235.75,44.75,627.0,40
CDM,3243987,XR MASTOIDS CMP 3+ VW PER SIDE RT,836.0,235.75,44.75,627.0,40
CDM,3244753,INJ/S SHTH TNDN SGL/LIG/AP BI,891.0,318.98,37.87,5681.0,40
CDM,3244761,INJ/S SHTH TNDN SGL/LIG/AP LT,594.0,212.65,37.87,5681.0,40
CDM,3244779,INJ/S SHTH TNDN SGL/LIG/AP RT,594.0,212.65,37.87,5681.0,40
CDM,3244886,INJ SCLEROSANT VEIN INCMPT SGL BI,345.0,123.51,36.37,5681.0,40
CDM,3244894,INJ SCLEROSANT VEIN INCMPT SGL LT,230.0,82.34,36.37,5681.0,40
CDM,3244902,INJ SCLEROSANT VEIN INCMPT SGL RT,230.0,82.34,36.37,5681.0,40
CDM,3244910,INJ SCLEROSANT VEIN INCMPT MULTI BI,689.0,246.66,72.42,5681.0,40
CDM,3244928,INJ SCLEROSANT VEIN INCMPT MULTI LT,459.0,164.32,72.42,5681.0,40
CDM,3244936,INJ SCLEROSANT VEIN INCMPT MULTI RT,459.0,164.32,72.42,5681.0,40
CDM,3244969,BX/S MARROW BONE DX NP/UNI,1386.0,496.19,68.17,5681.0,63
CDM,3244977,BX/S MARROW BONE DX BI,2079.0,744.28,68.17,5681.0,40
CDM,3244985,ASP/S&BX/S MARROW BONE DX BI,2219.0,3566.39,72.77,5681.0,40
CDM,3244993,XR CHEST 1 VW,368.0,88.32,16.84,333.39,63
CDM,3245016,XR CHEST 2 VW,443.0,106.32,22.68,333.39,63
CDM,3245032,XR CHEST 3 VW,495.0,118.8,28.52,371.25,63
CDM,3245057,XR CHEST 4+ VW,599.0,143.76,30.47,449.25,63
CDM,3245297,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,3566.39,72.77,5681.0,63
CDM,3245479,XR ABDOMEN 1 VW,597.0,168.35,21.05,447.75,63
CDM,3245495,XR ABDOMEN 2 VW,721.0,203.32,25.27,540.75,63
CDM,3245511,XR ABDOMEN 3+ VW,845.0,238.29,29.49,633.75,63
CDM,3245586,THROMBOLYSIS INF CATH PERITONEAL,1253.0,448.57,563.85,5681.0,62
CDM,3245677,BX GLAND SALIVARY NDL,2229.0,797.98,51.61,5681.0,63
CDM,3245735,REPOSITION CVC PREVIOUS PORT ONLY,2365.0,846.67,392.67,6689.0,62
CDM,3245743,ASP NEEDLE FINE BX US GD LSN 1ST,1966.0,1964.55,70.67,5681.0,63
CDM,3245750,ASP NEEDLE FINE BX US GD LSN ADDL,1757.0,629.01,48.46,5681.0,40
CDM,3245768,ASP NEEDLE FINE BX FL GD LSN 1ST,2450.0,877.1,86.63,5681.0,63
CDM,3245776,ASP NEEDLE FINE BX FL GD LSN ADDL,1475.0,528.05,49.71,5681.0,40
CDM,3245800,INJ ARTHRO KNEE CNT/CNT ENHANCE BI,629.0,225.18,38.9,5681.0,40
CDM,3245818,INJ ARTHRO KNEE CNT/CNT ENHANCE LT,419.0,150.0,38.9,5681.0,40
CDM,3245826,INJ ARTHRO KNEE CNT/CNT ENHANCE RT,419.0,150.0,38.9,5681.0,40
CDM,3245917,REPOS TUBE CHEST W IMG,1912.0,684.5,392.67,7390.37,62
CDM,3245933,ACCESS DIRECT JUGULAR VEIN,1467.0,525.19,272.86,4664.0,39
CDM,3245974,REM ELCTRD ICD SGL/DUAL EXTRACT TV,8645.0,3094.91,824.37,10257.38,63
CDM,3246014,REPOS TUBE JEJUNOSTOMY,1245.0,445.71,560.25,5681.0,62
CDM,3246139,BX/EXCISE NODE NDL SUPERFICIAL BI,3543.0,1268.39,82.79,5681.0,40
CDM,3246147,BX/EXCISE NODE NDL SUPERFICIAL LT,2362.0,845.6,82.79,5681.0,40
CDM,3246154,BX/EXCISE NODE NDL SUPERFICIAL RT,2362.0,845.6,82.79,5681.0,40
CDM,3246220,REM STONE KIDNEY LITHO <=2CM BI,11130.0,3984.54,678.95,8755.0,40
CDM,3246238,REM STONE KIDNEY LITHO <=2CM LT,7420.0,2656.36,678.95,8755.0,40
CDM,3246246,REM STONE KIDNEY LITHO <=2CM RT,7420.0,2656.36,678.95,8755.0,40
CDM,3246253,STUDY MANOMETRIC RENAL TB/CATH BI,1671.0,598.22,111.65,5681.0,40
CDM,3246261,STUDY MANOMETRIC RENAL TB/CATH LT,1114.0,398.81,111.65,5681.0,40
CDM,3246279,STUDY MANOMETRIC RENAL TB/CATH RT,1114.0,398.81,111.65,5681.0,40
CDM,3246287,INJ CATH URETERAL BI,432.0,154.66,49.6,5681.0,40
CDM,3246295,INJ CATH URETERAL LT,288.0,103.1,49.6,5681.0,40
CDM,3246303,INJ CATH URETERAL RT,288.0,103.1,49.6,5681.0,40
CDM,3246311,INTRO CATH FALLOPIAN TUBE BI,5103.0,1826.87,284.06,6226.0,36
CDM,3246329,INTRO CATH FALLOPIAN TUBE LT,3402.0,1217.92,284.06,6226.0,36
CDM,3246337,INTRO CATH FALLOPIAN TUBE RT,3402.0,1217.92,284.06,6226.0,36
CDM,3247038,INJ ARTHRO HIP WO ANES BI,864.0,309.31,65.71,5681.0,40
CDM,3247046,INJ ARTHRO HIP W ANES BI,989.0,354.06,79.23,5681.0,40
CDM,3247087,INJ ARTHRO ANKLE BI,930.0,332.94,49.89,5681.0,40
CDM,3247095,INJ ARTHRO HIP W ANES BI,989.0,354.06,79.23,5681.0,40
CDM,3247103,INJ ARTHRO ELBOW BI,989.0,354.06,64.18,5681.0,40
CDM,3247111,INJ ARTHRO WRIST BI,969.0,346.9,70.71,5681.0,40
CDM,3247129,INJ ARTHRO HIP WO ANES BI,864.0,309.31,65.71,5681.0,40
CDM,3247590,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,3932.0,1407.66,127.31,5681.0,40
CDM,3247608,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2621.0,938.32,127.31,5681.0,40
CDM,3247616,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2621.0,938.32,127.31,5681.0,40
CDM,3248259,CHOLECYSTOSTOMY PERC W IMG GD S&I,6790.0,2430.82,319.81,10257.38,63
CDM,3248267,INS CATH INTRAPERIT TUN W PORT SQ,7413.0,2653.85,404.73,10065.0,63
CDM,3248283,REM CATH INTRAPERIT,5534.0,1981.17,213.06,7697.0,63
CDM,3248291,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,3932.0,1407.66,127.31,5681.0,40
CDM,3248309,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2621.0,938.32,127.31,5681.0,40
CDM,3248317,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2621.0,938.32,127.31,5681.0,40
CDM,3248325,INJ/S EPID TRFR C/T FL/CT GD ADD BI,2046.0,732.47,59.3,5681.0,40
CDM,3248333,INJ/S EPID TRFR C/T FL/CT GD ADD LT,1364.0,488.31,59.3,5681.0,40
CDM,3248341,INJ/S EPID TRFR C/T FL/CT GD ADD RT,1364.0,488.31,59.3,5681.0,40
CDM,3248358,INJ/S EPID TRFR L/S FL/CT GD 1LV BI,3699.0,1324.24,108.61,5681.0,40
CDM,3248366,INJ/S EPID TRFR L/S FL/CT GD 1LV LT,2466.0,882.83,108.61,5681.0,40
CDM,3248374,INJ/S EPID TRFR L/S FL/CT GD 1LV RT,2466.0,882.83,108.61,5681.0,40
CDM,3248382,INJ/S EPID TRFR L/S FL/CT GD ADD BI,1752.0,627.22,50.09,5681.0,40
CDM,3248390,INJ/S EPID TRFR L/S FL/CT GD ADD LT,1168.0,418.14,50.09,5681.0,40
CDM,3248408,INJ/S EPID TRFR L/S FL/CT GD ADD RT,1168.0,418.14,50.09,5681.0,40
CDM,3248432,ATHERECT PERIPH ART RENAL W S&I,14057.0,5032.41,2220.42,20325.69,63
CDM,3248440,ATHERECT PERIPH ART VISC W S&I,10258.0,3672.36,982.0,10257.38,40
CDM,3248457,ATHERECT PERIPH AORTA ABD W S&I,14057.0,5032.41,4299.0,20325.69,63
CDM,3248465,ATHERECT PERIPH TR&BR BRACH W S&I,14057.0,5032.41,588.29,20325.69,63
CDM,3248473,ATHERECT PERIPH ART ILIAC W S&I,16839.0,6028.36,743.03,32276.26,63
CDM,3248630,INS CATH INTRAPERIT TUN W IMG,5104.0,1827.23,191.43,18194.0,63
CDM,3248879,INS SHUNT PERITONEAL-VENOUS,10845.0,3882.51,715.3,13802.9,41
CDM,3249307,XR SPINE LS CMP W BEND 6+ VW,413.0,116.47,45.73,449.06,63
CDM,3249414,INJ JT SI ANES/STRD FL/CT GD BI,989.0,354.06,80.83,5681.0,40
CDM,3249422,INJ JT SI ANES/STRD FL/CT GD LT,659.0,235.92,80.83,5681.0,40
CDM,3249430,INJ JT SI ANES/STRD FL/CT GD RT,659.0,235.92,80.83,5681.0,40
CDM,3249471,PLC CATH SEL 1ST ART RENAL UNI S&I,4220.0,1510.76,242.66,7697.0,63
CDM,3249489,PLC CATH SEL 1ST ART RENAL BI S&I,5138.0,1839.4,338.12,7697.0,63
CDM,3249497,PLC CATH SEL 2ND+ ART RENAL UNI S&I,7413.0,2653.85,336.5,10065.0,63
CDM,3249505,PLC CATH SEL 2ND+ ART RENAL BI S&I,8810.0,3153.98,394.3,7697.0,63
CDM,3249513,INS FILTER VENA CAVA ENDV S&I,9306.0,3331.55,209.54,10257.38,63
CDM,3249521,REPOS FILTER VENA CAVA ENDV S&I,10258.0,3672.36,325.04,10257.38,63
CDM,3249539,REM FILTER VENA CAVA ENDV S&I,10258.0,3672.36,329.11,10257.38,63
CDM,3249562,PARACENTESIS ABDOMINAL W IMG,2449.0,1882.45,102.12,6689.0,63
CDM,3249570,LAVAGE PERITONEAL W/WO IMG,1770.0,633.66,102.74,6689.0,63
CDM,3249760,BX RENAL TROCAR/NDL PERC LT,3132.0,3245.64,121.75,5681.0,40
CDM,3249778,BX RENAL TROCAR/NDL PERC RT,3132.0,3245.64,121.75,5681.0,40
CDM,3249786,BX RENAL TROCAR/NDL PERC BI,4698.0,3245.64,121.75,5681.0,40
CDM,3249828,INTRO NDL/INTRACATHETER VEIN,88.0,31.5,8.83,2481.0,40
CDM,3249836,INTRO NDL/INTRACATHETER VEIN,88.0,31.5,8.83,2481.0,40
CDM,3249851,LYMPHANGIOGRAPHY PLVC/ABD UNI S&I,2534.0,714.59,14.58,18420.25,63
CDM,3249869,LYMPHANGIOGRAPHY PLVC/ABD BI S&I,3672.0,1035.5,196.71,18420.25,63
CDM,3249877,INJ LYMPHANGIOGRAPHY LT,771.0,276.02,79.46,5681.0,40
CDM,3249885,INJ LYMPHANGIOGRAPHY RT,771.0,276.02,79.46,5681.0,40
CDM,3249893,INJ LYMPHANGIOGRAPHY BI,1157.0,414.21,79.46,5681.0,40
CDM,3250693,ASP INTERDISCAL DX PERC,2769.0,991.3,148.96,13802.9,63
CDM,3250768,REM STENT URETER TRANSURETH LT S&I,2375.0,850.25,156.51,6226.0,40
CDM,3250776,REM STENT URETER TRANSURETH RT S&I,2375.0,850.25,156.51,6226.0,40
CDM,3250784,REM STENT URETER TRANSURETH BI S&I,3563.0,1275.55,156.51,6226.0,40
CDM,3250941,INJ ANES GANGLION SPHENO LT,810.0,289.98,102.52,5681.0,40
CDM,3250958,INJ ANES GANGLION SPHENO RT,810.0,289.98,102.52,5681.0,40
CDM,3250966,INJ ANES GANGLION SPHENO BI,1215.0,434.97,102.52,5681.0,40
CDM,3251246,LYMPHANGIOGRAPHY EXT LT S&I,3186.0,898.45,12.79,3659.86,40
CDM,3251253,LYMPHANGIOGRAPHY EXT RT S&I,3186.0,898.45,12.79,3659.86,40
CDM,3251261,LYMPHANGIOGRAPHY EXT BIL S&I,4069.0,1147.46,12.79,9183.29,63
CDM,3252293,XR SPINE CERVICAL 4-5 VW,402.0,113.36,39.88,449.06,63
CDM,3252301,XR SPINE CERVICAL 6+ VW,463.0,130.57,47.02,449.06,63
CDM,3252400,CT REND 3D W I&R W PP SAME WRKST,440.0,75.24,15.22,1218.0,37
CDM,3252418,CT REND 3D W I&R W PP DIFF WRKST,542.0,92.68,39.51,1218.0,37
CDM,3252434,ANGIO SUBSQ THRPY EMB/INF NONTHROMB,2927.0,617.6,2.64,11792.62,63
CDM,3252475,THORACENTESIS ASP WO IMG LT,2537.0,908.25,85.38,5681.0,40
CDM,3252483,THORACENTESIS ASP WO IMG RT,2537.0,908.25,85.38,5681.0,40
CDM,3252491,THORACENTESIS ASP WO IMG BI,3806.0,1362.55,85.38,5681.0,40
CDM,3252509,THORACENTESIS ASP W IMG LT,3045.0,1034.68,104.86,5681.0,40
CDM,3252517,THORACENTESIS ASP W IMG RT,3045.0,1034.68,104.86,5681.0,40
CDM,3252525,THORACENTESIS ASP W IMG BI,4568.0,1034.68,104.86,5681.0,40
CDM,3252590,DRN PLEURA INS CATH INDWL WO IMG LT,2329.0,833.78,119.38,6689.0,40
CDM,3252608,DRN PLEURA INS CATH INDWL WO IMG RT,2329.0,833.78,119.38,6689.0,40
CDM,3252616,DRN PLEURA INS CATH INDWL WO IMG BI,3494.0,1250.85,119.38,6689.0,40
CDM,3252624,DRN PLEURA INS CATH INDWL W IMG LT,2781.0,995.6,143.18,6689.0,40
CDM,3252632,DRN PLEURA INS CATH INDWL W IMG RT,2781.0,995.6,143.18,6689.0,40
CDM,3252640,DRN PLEURA INS CATH INDWL W IMG BI,4172.0,1493.58,143.18,6689.0,40
CDM,3252673,INJ TRACT SINUS THERAPEUTIC,3433.0,1229.01,87.77,5681.0,63
CDM,3252830,DIL URETER(S)/URETHRA S&I,3129.0,882.38,78.83,7388.73,63
CDM,3252962,REM FB INTRAVASC W IMG S&I,4597.0,1645.73,285.27,18194.0,63
CDM,3252970,THROMBOLYSIS INF ART INIT DAY S&I,7413.0,2653.85,366.62,15325.0,63
CDM,3252988,THROMBOLYSIS INF VEN INIT S&I,4597.0,1645.73,319.95,15325.0,63
CDM,3252996,THROMBOLYSIS INF ART/VEN SUBSQ S&I,3635.0,1301.33,218.79,18194.0,63
CDM,3253002,CESSAT THROMBOLYSIS&REM CATH S&I,3138.0,1123.4,115.48,18194.0,63
CDM,3253010,PLC CATH AORTA THOR ANG EC&/IC S&I,4220.0,1510.76,189.58,7697.0,63
CDM,3253044,PLC CATH SEL CAR/INM ANG EC LT S&I,5176.0,1853.01,272.43,7697.0,40
CDM,3253051,PLC CATH SEL CAR/INM ANG EC RT S&I,5176.0,1853.01,272.43,7697.0,40
CDM,3253069,PLC CATH SEL CAR/INM ANG EC BI S&I,7764.0,2779.51,272.43,7697.0,40
CDM,3253077,PLC CATH SEL CAR/INM ANG IC LT S&I,7413.0,2653.85,313.97,10065.0,40
CDM,3253085,PLC CATH SEL CAR/INM ANG IC RT S&I,7413.0,2653.85,313.97,10065.0,40
CDM,3253093,PLC CATH SEL CAR/INM ANG IC BI S&I,11120.0,3980.96,313.97,10065.0,40
CDM,3253101,PLC CATH SEL ART CAR ANG IC LT S&I,7413.0,2653.85,352.24,10065.0,40
CDM,3253119,PLC CATH SEL ART CAR ANG IC RT S&I,7413.0,2653.85,352.24,10065.0,40
CDM,3253127,PLC CATH SEL ART CAR ANG IC BI S&I,11120.0,3980.96,352.24,10065.0,40
CDM,3253135,PLC CATH SEL ART SUB/INM ANG LT S&I,5205.0,1863.39,311.41,7697.0,40
CDM,3253143,PLC CATH SEL ART SUB/INM ANG RT S&I,5205.0,1863.39,311.41,7697.0,40
CDM,3253150,PLC CATH SEL ART SUB/INM ANG BI S&I,7808.0,2795.26,311.41,7697.0,40
CDM,3253168,PLC CATH SEL ART VERT ANG LT S&I,7413.0,2653.85,350.09,10065.0,40
CDM,3253176,PLC CATH SEL ART VERT ANG RT S&I,7413.0,2653.85,350.09,10065.0,40
CDM,3253184,PLC CATH SEL ART VERT ANG BI S&I,11120.0,3980.96,350.09,10065.0,40
CDM,3253192,PLC CATH SEL ART CAR EXT ANG LT S&I,2163.0,774.35,115.39,5681.0,40
CDM,3253200,PLC CATH SEL ART CAR EXT ANG RT S&I,2163.0,774.35,115.39,5681.0,40
CDM,3253218,PLC CATH SEL ART CAR EXT ANG BI S&I,3245.0,1161.71,115.39,5681.0,40
CDM,3253226,PLC CATH SEL BR INTRACRN ANG LT S&I,4017.0,1438.09,237.58,5681.0,40
CDM,3253234,PLC CATH SEL BR INTRACRN ANG RT S&I,4017.0,1438.09,237.58,5681.0,40
CDM,3253242,PLC CATH SEL BR INTRACRN ANG BI S&I,6026.0,2157.31,237.58,5681.0,40
CDM,3253259,VENIPUNCTURE FEM/JUG HCP 0-2YRS,59.0,21.12,10.97,165.5,37
CDM,3253267,VENIPUNCTURE VEIN OTH HCP 0-2YRS,58.0,20.76,8.55,84.48,37
CDM,3253358,PLC STNT/S ART OPEN/PERC INIT S&I,14254.0,5102.93,416.31,20325.69,63
CDM,3253366,PLC STNT/S ART OPEN/PERC ADDL S&I,5733.0,2052.41,199.27,15325.0,40
CDM,3253374,PLC STNT/S VEIN OPEN/PERC INIT S&I,11612.0,4157.1,290.34,20325.69,63
CDM,3253382,PLC STNT/S VEIN OPEN/PERC ADDL S&I,4777.0,1710.17,142.25,15325.0,40
CDM,3253390,EMB/OCCL VASC VENOUS S&I,11612.0,4157.1,405.51,20325.69,63
CDM,3253408,EMB/OCCL VASC ARTERIAL S&I,13748.0,4921.78,451.13,32276.26,63
CDM,3253416,EMB/OCCL VASC TMRS/ORG S&I,15098.0,5405.08,532.54,20325.69,63
CDM,3253424,EMB/OCCL VASC HEMORRHAGE S&I,11612.0,4157.1,627.57,20325.69,63
CDM,3253432,DRN CATH FLUID VISCERAL IMG GD,3029.0,1084.38,185.74,18194.0,63
CDM,3253440,DRN CATH FLUID PERI PERC IMG GD,3139.0,1123.76,185.74,18194.0,63
CDM,3253457,DRN CATH FLUID TRNSVAG/REC IMG GD,4214.0,1508.61,196.66,7704.0,63
CDM,3253465,DRN CATH FLUID TISSUE SOFT IMG GD,3433.0,1229.01,129.89,6689.0,63
CDM,3253523,INJ PSEUDOANEURYSM EXT BI,1529.0,547.38,99.7,5681.0,40
CDM,3254083,ASP&/INJ JT/BUR SM WO US GD LT,663.0,237.35,34.91,5681.0,40
CDM,3254091,ASP&/INJ JT/BUR SM WO US GD RT,663.0,237.35,34.91,5681.0,40
CDM,3254109,ASP&/INJ JT/BUR SM WO US GD BI,995.0,356.21,34.91,5681.0,40
CDM,3254117,ASP&/INJ JT/BUR INTR WO US GD RT,689.0,246.66,35.9,5681.0,40
CDM,3254125,ASP&/INJ JT/BUR INTR WO US GD BI,1034.0,370.17,35.9,5681.0,40
CDM,3254158,ASP&/INJ JT/BUR INTR WO US GD LT,689.0,246.66,35.9,5681.0,40
CDM,3254174,ASP&/INJ JT/BUR MAJ WO US GD RT,840.0,300.72,44.27,5681.0,40
CDM,3254182,ASP&/INJ JT/BUR MAJ WO US GD BI,1260.0,451.08,44.27,5681.0,40
CDM,3254190,ASP&/INJ JT/BUR MAJ WO US GD LT,840.0,300.72,44.27,5681.0,40
CDM,3254257,INJ MYELOGRAM&/CT LUMBAR,660.0,236.28,80.44,5681.0,40
CDM,3261328,ASP&/INJ JT/BUR SM W US GD BI,1577.0,564.57,44.48,5681.0,40
CDM,3261443,ASP&/INJ JT/BUR SM W US GD LT,1051.0,376.26,44.48,5681.0,40
CDM,3261518,ASP&/INJ JT/BUR SM W US GD RT,1051.0,376.26,44.48,5681.0,40
CDM,3261948,PLC STNT/S VERT ART OPN/PERC INIT,12779.0,4574.88,776.16,10257.38,36
CDM,3261955,PLC STNT/S VERT ART OPN/PERC ADDL,9585.0,3431.43,460.98,7188.75,36
CDM,3261963,AUG SACRAL PERC INJ UNI,8646.0,3095.27,982.0,14124.0,59
CDM,3261971,AUG SACRAL PERC INJ BI,10799.0,3866.04,982.0,18194.0,59
CDM,3261989,ASP&/INJ JT/BUR SM WO US GD LT,663.0,237.35,34.91,5681.0,40
CDM,3261997,ASP&/INJ JT/BUR SM WO US GD RT,663.0,237.35,34.91,5681.0,40
CDM,3262003,ASP&/INJ JT/BUR SM WO US GD BI,995.0,356.21,34.91,5681.0,40
CDM,3262045,ASP&/INJ JT/BUR MAJ WO US GD RT,840.0,300.72,44.27,5681.0,40
CDM,3262052,ASP&/INJ JT/BUR MAJ WO US GD BI,1260.0,451.08,44.27,5681.0,40
CDM,3262060,ASP&/INJ JT/BUR MAJ WO US GD LT,840.0,300.72,44.27,5681.0,40
CDM,3262078,ABL RF TUMOR/S BONE PERC IMG GD,11796.0,4222.97,352.66,30871.55,63
CDM,3262086,PLC STNT/S ART CRV CAR W EMB S&I,9840.0,3522.72,938.83,7704.0,40
CDM,3262094,PLC STNT/S ART CRV CAR WO EMB S&I,9326.0,3338.71,954.64,7704.0,40
CDM,3262102,INJ MYELOGRAM&/CT LUMBAR,660.0,236.28,80.44,5681.0,40
CDM,3262110,VERTEBROPLASTY CRVTHOR PERC,5456.0,1953.25,418.34,18194.0,63
CDM,3262128,VERTEBROPLASTY LUMBOSACRAL PERC,4992.0,1787.14,393.85,18194.0,63
CDM,3262136,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4389.0,1571.26,199.38,18194.0,38
CDM,3262144,AUG VERTEBRAL THORACIC PERC,13730.0,4915.34,494.28,13802.9,63
CDM,3262169,AUG VERTEBRAL LUMBAR PERC,10799.0,3866.04,460.82,13802.9,63
CDM,3262177,AUG VERTEBRAL LUMBAR/THOR PERC ADDL,4724.0,1691.19,209.44,6904.78,38
CDM,3262185,US BREAST CMP LT,409.0,142.74,66.49,449.06,40
CDM,3262193,US BREAST CMP RT,409.0,142.74,66.49,449.06,40
CDM,3262201,US BREAST LTD LT,323.0,112.73,51.57,333.39,40
CDM,3262219,US BREAST LTD RT,323.0,112.73,51.57,333.39,40
CDM,3262227,DXA VERTEBRAL FRACTURE ASSESSMENT,202.0,56.96,24.95,333.39,63
CDM,3262235,TOMOSYNTHESIS DX DIG BRST UNI/BI,52.0,23.82,9.67,104.95,40
CDM,3263373,TOMOSYNTHESIS SCRN DIG BRST BI,52.0,28.6,9.67,226.21,40
CDM,3263381,ASP&/INJ JT/BUR MAJ W US GD BI,2057.0,736.41,57.43,5681.0,40
CDM,3263399,ASP&/INJ JT/BUR MAJ W US GD LT,1371.0,490.82,57.43,5681.0,40
CDM,3263407,ASP&/INJ JT/BUR MAJ W US GD RT,1371.0,490.82,57.43,5681.0,40
CDM,3263415,INJ LUMB MYELOGRPHY CERVICAL S&I,1847.0,661.23,114.94,8022.0,63
CDM,3263431,INJ LUMB MYELOGRPHY THORACIC S&I,1648.0,589.98,114.98,8022.0,63
CDM,3263456,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,1383.0,495.11,113.61,8022.0,63
CDM,3263464,INJ LUMB MYELOGRPHY 2+ S&I,2077.0,743.57,117.91,8022.0,63
CDM,3263472,ASP&/INJ JT/BUR INTR W US GD BI,1811.0,648.34,50.61,5681.0,40
CDM,3263480,ASP&/INJ JT/BUR INTR W US GD LT,1207.0,432.11,50.61,5681.0,40
CDM,3263498,ASP&/INJ JT/BUR INTR W US GD RT,1207.0,432.11,50.61,5681.0,40
CDM,3264363,DXA STUDY DENSITY 1+SKEL AX FX VERT,482.0,135.92,38.22,449.06,63
CDM,3264389,ASP&/INJ JT/BUR INTR W US GD BI,1811.0,648.34,50.61,5681.0,40
CDM,3264587,ASP&/INJ JT/BUR MAJ W US GD BI,2057.0,736.41,57.43,5681.0,40
CDM,3264595,ASP&/INJ JT/BUR MAJ W US GD LT,1371.0,490.82,57.43,5681.0,40
CDM,3264603,ASP&/INJ JT/BUR MAJ W US GD RT,1371.0,490.82,57.43,5681.0,40
CDM,3264637,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,2127.0,761.47,113.61,8022.0,63
CDM,3264652,ASP&/INJ JT/BUR INTR W US GD LT,1207.0,432.11,50.61,5681.0,40
CDM,3264660,ASP&/INJ JT/BUR INTR W US GD RT,1207.0,432.11,50.61,5681.0,40
CDM,3264728,US BREAST LTD BI,485.0,169.26,51.57,363.75,40
CDM,3264736,US BREAST CMP BI,614.0,214.29,66.49,460.5,40
CDM,3265212,REV SHUNT PERITONEAL-VENOUS,8033.0,2875.81,654.44,7697.0,63
CDM,3265279,PLC CATH SEL ART PULM 2ND ORD BI,1973.0,706.33,163.1,5681.0,40
CDM,3265337,XR HUMERUS 2 VW RT RDC,273.0,76.99,23.65,333.39,40
CDM,3265345,XR HUMERUS 2 VW LT RDC,273.0,76.99,23.65,333.39,40
CDM,3265352,XR ELBOW 2 VW RT RDC,221.0,62.32,20.73,333.39,40
CDM,3265360,XR ELBOW 2 VW LT RDC,221.0,62.32,20.73,333.39,40
CDM,3265386,XR FOREARM 2 VW RT RDC,260.0,73.32,21.05,333.39,40
CDM,3265394,XR FOREARM 2 VW LT RDC,260.0,73.32,21.05,333.39,40
CDM,3265410,XR WRIST 2 VW RT RDC,266.0,75.01,25.28,333.39,40
CDM,3265428,XR WRIST 2 VW LT RDC,266.0,75.01,25.28,333.39,40
CDM,3265444,XR HAND 2 VW RT RDC,216.0,60.91,23.01,449.06,40
CDM,3265451,XR HAND 2 VW LT RDC,216.0,60.91,23.01,449.06,40
CDM,3265477,XR TIBIA&FIBULA 2 VW RT RDC,261.0,73.6,23.33,333.39,40
CDM,3265485,XR TIBIA&FIBULA 2 VW LT RDC,261.0,73.6,23.33,333.39,40
CDM,3265501,XR ANKLE 2 VW RT RDC,221.0,62.32,23.97,333.39,40
CDM,3265519,XR ANKLE 2 VW LT RDC,221.0,62.32,23.97,333.39,40
CDM,3265535,XR FOOT 2 VW RT RDC,220.0,62.04,20.73,333.39,40
CDM,3265543,XR FOOT 2 VW LT RDC,220.0,62.04,20.73,333.39,40
CDM,3265600,ASP NEEDLE FINE BX US GD LSN 1ST,1966.0,1964.55,70.67,5681.0,63
CDM,3265618,ASP NEEDLE FINE BX US GD LSN ADDL,1757.0,629.01,48.46,5681.0,40
CDM,3265626,ASP NEEDLE FINE BX FL GD LSN 1ST,2450.0,877.1,86.63,5681.0,63
CDM,3265634,ASP NEEDLE FINE BX FL GD LSN ADDL,1475.0,528.05,49.71,5681.0,40
CDM,3265642,ASP NEEDLE FINE BX CT GD LSN 1ST,2502.0,895.72,104.85,5681.0,63
CDM,3265659,ASP NEEDLE FINE BX CT GD LSN ADDL,1966.0,703.83,69.66,5681.0,40
CDM,3265667,INS PICC WO P/P W IMG 0-4YRS,3433.0,1229.01,77.83,5988.0,63
CDM,3265675,INS PICC WO P/P W IMG 5+YRS,3433.0,1229.01,79.92,12090.0,63
CDM,3265683,DIL TRACT EXIST PERC BI S&I,4727.0,1692.27,143.3,18194.0,40
CDM,3265691,DIL TRACT EXIST PERC LT S&I,3151.0,1128.06,143.3,18194.0,40
CDM,3265709,DIL TRACT EXIST PERC RT S&I,3151.0,1128.06,143.3,18194.0,40
CDM,3265717,DIL TRACT EXIST PERC NEW ACC BI S&I,8012.0,2868.3,237.44,7697.0,40
CDM,3265725,DIL TRACT EXIST PERC NEW ACC LT S&I,5341.0,1912.08,237.44,7697.0,40
CDM,3265733,DIL TRACT EXIST PERC NEW ACC RT S&I,5341.0,1912.08,237.44,7697.0,40
CDM,3265741,INS PICC WO P/P WO IMG 0-4YRS,2862.0,1024.6,88.38,5681.0,63
CDM,3265758,INS PICC WO P/P WO IMG 5+YRS,3698.0,1323.88,90.96,5681.0,63
CDM,3265766,RPLC PICC WO P/P SA S&I,4273.0,1529.73,56.01,5681.0,63
CDM,3265816,BX TESTIS NEEDLE LT,5108.0,1828.66,72.5,5681.0,40
CDM,3265824,BX TESTIS NEEDLE RT,5108.0,1828.66,72.5,5681.0,40
CDM,3265832,BX TESTIS NEEDLE BI,7662.0,2743.0,72.5,5746.5,40
CDM,3265857,REM&PUNCT CATH BLN BLADDER PERC,616.0,220.53,192.95,5681.0,62
CDM,3265873,CHEMODENERV MUSC/S NRV FAC UNI,585.0,209.43,116.8,5681.0,63
CDM,3265949,REM MASS ICRD W REINFSN BLD PERC,10433.0,3735.01,1381.25,11751.0,59
CDM,3266012,XR PHARYNX&/CERV ESOPHAGUS STDY CNT,467.0,131.69,65.52,735.79,63
CDM,3266020,XR ESOPHAGUS STUDY CNT SINGLE,508.0,143.26,67.47,735.79,63
CDM,3266038,FNCT SWALLOW W CINE/VIDEO STUDY CNT,619.0,174.56,97.0,735.79,63
CDM,3266046,XR UGI STUDY CNT SINGLE,606.0,170.89,82.72,735.79,63
CDM,3266053,XR UGI STUDY CNT DOUBLE,615.0,173.43,94.41,735.79,63
CDM,3266061,XR INTESTINE SM STUDY FOLLOW THRU,279.0,78.68,48.32,366.49,37
CDM,3266079,XR INTESTINE SM STUDY CNT SINGLE,549.0,154.82,81.74,735.79,63
CDM,3266087,XR INTESTINE SM STUDY CNT DOUBLE,1285.0,362.37,129.45,1650.89,63
CDM,3266095,XR COLON STUDY CNT SINGLE,610.0,172.02,102.2,735.79,63
CDM,3266103,XR COLON STUDY CNT DOUBLE,898.0,253.24,129.45,980.24,63
CDM,3266202,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,63
CDM,3266210,INJ/S ANES NRV OCCIPITAL GREAT BI,1920.0,687.36,51.18,5681.0,40
CDM,3266228,INJ/S ANES NRV OCCIPITAL GREAT LT,1280.0,458.24,51.18,5681.0,40
CDM,3266236,INJ/S ANES NRV OCCIPITAL GREAT RT,1280.0,458.24,51.18,5681.0,40
CDM,3266269,INJ/S ANES NRV/BR PERPH OTHER BI,2079.0,744.28,40.83,5681.0,40
CDM,3266277,INJ/S ANES NRV/BR PERPH OTHER LT,1386.0,496.19,40.83,5681.0,40
CDM,3266285,INJ/S ANES NRV/BR PERPH OTHER RT,1386.0,496.19,40.83,5681.0,40
CDM,3266293,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,1604.0,1562.17,82.54,5681.0,63
CDM,3266301,PUNCT SPINE THER DRN CSF W FL/CT GD,1604.0,574.23,100.77,5681.0,63
CDM,3266319,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,1604.0,1562.17,82.54,5681.0,63
CDM,3266327,PUNCT SPINE THER DRN CSF W FL/CT GD,1604.0,574.23,100.77,5681.0,63
CDM,3266335,XR ESOPHAGUS STUDY CNT DOUBLE,512.0,144.38,74.93,735.79,63
CDM,3266343,INJ/S ANES NRV JT SI W FL/CT GD BI,1692.0,605.74,79.57,5681.0,40
CDM,3266350,INJ/S ANES NRV JT SI W FL/CT GD LT,1128.0,403.82,79.57,5681.0,40
CDM,3266368,INJ/S ANES NRV JT SI W FL/CT GD RT,1128.0,403.82,79.57,5681.0,40
CDM,3266376,INJ/S ANES NRV GENICULAR INCL IMGBI,1692.0,605.74,80.22,5681.0,40
CDM,3266384,INJ/S ANES NRV JT SI W FL/CT GD BI,1692.0,605.74,79.57,5681.0,40
CDM,3266392,INJ/S ANES NRV JT SI W FL/CT GD LT,1128.0,403.82,79.57,5681.0,40
CDM,3266400,INJ/S ANES NRV JT SI W FL/CT GD RT,1128.0,403.82,79.57,5681.0,40
CDM,3266418,ABL RF JOINT SI INCL IMG GD BI,4640.0,1661.12,191.07,14124.0,40
CDM,3266426,ABL RF JOINT SI INCL IMG GD LT,3093.0,1107.29,191.07,14124.0,40
CDM,3266434,ABL RF JOINT SI INCL IMG GD RT,3093.0,1107.29,191.07,14124.0,40
CDM,3266442,DST NRV BR GENICULAR INCL IMG GD BI,4728.0,1692.62,142.66,6226.0,40
CDM,3266459,INJ/S ANES NRV GENICULAR INCL IMGLT,1128.0,403.82,80.22,5681.0,40
CDM,3266467,INJ/S ANES NRV GENICULAR INCL IMGRT,1128.0,403.82,80.22,5681.0,40
CDM,3266475,DST NRV BR GENICULAR INCL IMG GD LT,3152.0,1128.42,142.66,6226.0,40
CDM,3266483,DST NRV BR GENICULAR INCL IMG GD RT,3152.0,1128.42,142.66,6226.0,40
CDM,3266491,PUNCT C1-C2 WO INJ,778.0,278.52,77.65,5681.0,63
CDM,3266558,DISRUPT CHYLI CISTERN/THOR DUCT NDL,13803.0,4941.47,287.87,10352.25,62
CDM,3266962,PLC STENT NEPHROURTR CONDUIT ILEAL,5492.0,1966.14,192.95,5681.0,62
CDM,3267044,INJ/S ANES NRV SCIATIC W IMG BI,2406.0,861.35,70.05,5681.0,40
CDM,3267051,INJ/S ANES NRV SCIATIC W IMG LT,1604.0,574.23,70.05,5681.0,40
CDM,3267069,INJ/S ANES NRV SCIATIC W IMG RT,1604.0,574.23,70.05,5681.0,40
CDM,3267150,PLCMT MARKER SPINE THOR FLUORO GD,1500.0,537.0,149.49,5681.0,62
CDM,3267309,INJ/S ANES NRV INTRCST LVL SGL BI,2348.0,840.58,56.64,5681.0,40
CDM,3267317,INJ/S ANES NRV INTRCST LVL SGL RT,1565.0,560.27,56.64,5681.0,40
CDM,3267325,INJ/S ANES NRV INTRCST LVL SGL LT,1565.0,560.27,56.64,5681.0,40
CDM,3267333,INJ/S ANES NRV INTRCST LVL ADD BI,2937.0,1051.45,24.23,5681.0,40
CDM,3267341,INJ/S ANES NRV INTRCST LVL ADD RT,1958.0,700.96,24.23,5681.0,40
CDM,3267358,INJ/S ANES NRV INTRCST LVL ADD LT,1958.0,700.96,24.23,5681.0,40
CDM,3271806,REVSC IVT ANGIO SF VSL INIT BI,18749.0,6712.14,3487.31,14061.75,39
CDM,3271814,REVSC IVT ANGIO SF VSL INIT LT,12499.0,4474.64,2324.81,13802.9,39
CDM,3271822,REVSC IVT ANGIO SF VSL INIT RT,12499.0,4474.64,2324.81,13802.9,39
CDM,3271830,REVSC IVT ANGIO SF VSL ADD BI,7556.0,2705.05,1088.82,6904.78,37
CDM,3271848,REVSC IVT ANGIO SF VSL ADD LT,5037.0,1803.25,725.83,6904.78,37
CDM,3271855,REVSC IVT ANGIO SF VSL ADD RT,5037.0,1803.25,725.83,6904.78,37
CDM,3271863,REVSC IVT ANGIO CMPLX VSL INIT BI,27480.0,9837.84,4215.76,20610.0,39
CDM,3271871,REVSC IVT ANGIO CMPLX VSL INIT LT,18320.0,6558.56,3407.52,13802.9,39
CDM,3271889,REVSC IVT ANGIO CMPLX VSL INIT RT,18320.0,6558.56,3407.52,13802.9,39
CDM,3271897,REVSC IVT ANGIO CMPLX VSL ADD BI,9765.0,3495.87,1407.14,7323.75,37
CDM,3271905,REVSC IVT ANGIO CMPLX VSL ADD LT,6510.0,2330.58,938.09,6904.78,37
CDM,3271913,REVSC IVT ANGIO CMPLX VSL ADD RT,6510.0,2330.58,938.09,6904.78,37
CDM,3271921,REVSC IVT STNT SF VSL INIT BI,19512.0,6985.3,3629.23,14634.0,39
CDM,3271939,REVSC IVT STNT SF VSL INIT LT,13008.0,4656.86,2419.49,13802.9,39
CDM,3271947,REVSC IVT STNT SF VSL INIT RT,13008.0,4656.86,2419.49,13802.9,39
CDM,3271954,REVSC IVT STNT SF VSL ADD BI,10124.0,3624.39,1458.87,7593.0,37
CDM,3271962,REVSC IVT STNT SF VSL ADD LT,6749.0,2416.14,972.53,6904.78,37
CDM,3271970,REVSC IVT STNT SF VSL ADD RT,6749.0,2416.14,972.53,6904.78,37
CDM,3271988,REVSC IVT STNT CMPLX VSL INIT BI,28203.0,10096.67,5245.76,21152.25,39
CDM,3271996,REVSC IVT STNT CMPLX VSL INIT LT,18802.0,6731.12,3497.17,14101.5,39
CDM,3272002,REVSC IVT STNT CMPLX VSL INIT RT,18802.0,6731.12,3497.17,14101.5,39
CDM,3272010,REVSC IVT STNT CMPLX VSL ADD BI,10757.0,3851.01,1550.08,8067.75,37
CDM,3272028,REVSC IVT STNT CMPLX VSL ADD LT,7171.0,2567.22,1033.34,6904.78,37
CDM,3272036,REVSC IVT STNT CMPLX VSL ADD RT,7171.0,2567.22,1033.34,6904.78,37
CDM,3272044,REVSC F&P VT ANG SF VSL INIT BI,14973.0,5360.33,2784.98,13802.9,39
CDM,3272051,REVSC F&P VT ANG SF VSL INIT LT,9982.0,3573.56,1856.65,13802.9,39
CDM,3272069,REVSC F&P VT ANG SF VSL INIT RT,9982.0,3573.56,1856.65,13802.9,39
CDM,3272077,REVSC F&P VT ANG SF VSL ADD BI,5732.0,2052.06,825.98,6904.78,37
CDM,3272085,REVSC F&P VT ANG SF VSL ADD LT,3821.0,1367.92,550.61,6904.78,37
CDM,3272093,REVSC F&P VT ANG SF VSL ADD RT,3821.0,1367.92,550.61,6904.78,37
CDM,3272101,REVSC F&P VT ANG CMPLX VSL INIT BI,20241.0,7246.28,3764.83,15180.75,39
CDM,3272119,REVSC F&P VT ANG CMPLX VSL INIT LT,13494.0,4830.85,2509.88,13802.9,39
CDM,3272127,REVSC F&P VT ANG CMPLX VSL INIT RT,13494.0,4830.85,2509.88,13802.9,39
CDM,3272135,REVSC F&P VT ANG CMPLX VSL ADD BI,7628.0,2730.82,1099.19,6904.78,37
CDM,3272143,REVSC F&P VT ANG CMPLX VSL ADD LT,5085.0,1820.43,732.75,6904.78,37
CDM,3272150,REVSC F&P VT ANG CMPLX VSL ADD RT,5085.0,1820.43,732.75,6904.78,37
CDM,3272168,REVSC F&P VT STNT SF VSL INIT BI,21123.0,7562.03,3928.88,15842.25,39
CDM,3272176,REVSC F&P VT STNT SF VSL INIT LT,14082.0,5041.36,2619.25,13802.9,39
CDM,3272184,REVSC F&P VT STNT SF VSL INIT RT,14082.0,5041.36,2619.25,13802.9,39
CDM,3272192,REVSC F&P VT STNT SF VSL ADD BI,8928.0,3196.22,1286.52,6904.78,37
CDM,3272200,REVSC F&P VT STNT SF VSL ADD LT,5952.0,2130.82,857.68,6904.78,37
CDM,3272218,REVSC F&P VT STNT SF VSL ADD RT,5952.0,2130.82,857.68,6904.78,37
CDM,3272226,REVSC F&P VT STNT CMPLX VSL INIT BI,35481.0,12702.2,6599.47,26610.75,39
CDM,3272234,REVSC F&P VT STNT CMPLX VSL INIT LT,23654.0,8468.13,4399.64,17740.5,39
CDM,3272242,REVSC F&P VT STNT CMPLX VSL INIT RT,23654.0,8468.13,4399.64,17740.5,39
CDM,3272259,REVSC F&P VT STNT CMPLX VSL ADD BI,11985.0,4290.63,1727.04,8988.75,37
CDM,3272267,REVSC F&P VT STNT CMPLX VSL ADD LT,7990.0,2860.42,1151.36,6904.78,37
CDM,3272275,REVSC F&P VT STNT CMPLX VSL ADD RT,7990.0,2860.42,1151.36,6904.78,37
CDM,3272283,REVSC F&P VT ATHR SF VSL INIT BI,21905.0,7841.99,4074.33,16428.75,39
CDM,3272291,REVSC F&P VT ATHR SF VSL INIT LT,14603.0,5227.87,2716.16,13578.3,39
CDM,3272309,REVSC F&P VT ATHR SF VSL INIT RT,14603.0,5227.87,2716.16,13578.3,39
CDM,3272317,REVSC F&P VT ATHR SF VSL ADD BI,9654.0,3456.13,1391.14,7240.5,37
CDM,3272325,REVSC F&P VT ATHR SF VSL ADD LT,6436.0,2304.09,927.43,6904.78,37
CDM,3272333,REVSC F&P VT ATHR SF VSL ADD RT,6436.0,2304.09,927.43,6904.78,37
CDM,3272341,REVSC F&P VT ATHR CMPLX VSL INIT BI,30651.0,10973.06,5701.09,22988.25,39
CDM,3272358,REVSC F&P VT ATHR CMPLX VSL INIT LT,20434.0,7315.37,3800.72,15325.5,39
CDM,3272366,REVSC F&P VT ATHR CMPLX VSL INIT RT,20434.0,7315.37,3800.72,15325.5,39
CDM,3272374,REVSC F&P VT ATHR CMPLX VSL ADD BI,13281.0,4754.6,1913.79,9960.75,37
CDM,3272382,REVSC F&P VT ATHR CMPLX VSL ADD LT,8854.0,3169.73,1275.86,6904.78,37
CDM,3272390,REVSC F&P VT ATHR CMPLX VSL ADD RT,8854.0,3169.73,1275.86,6904.78,37
CDM,3272408,REVSC F&P VT ST&AT SF VSL INIT BI,26315.0,9420.77,4894.59,19736.25,39
CDM,3272416,REVSC F&P VT ST&AT SF VSL INIT LT,17543.0,6280.39,3263.0,13578.3,39
CDM,3272424,REVSC F&P VT ST&AT SF VSL INIT RT,17543.0,6280.39,3263.0,13578.3,39
CDM,3272432,REVSC F&P VT ST&AT SF VSL ADD BI,10098.0,3615.08,1455.12,7573.5,37
CDM,3272440,REVSC F&P VT ST&AT SF VSL ADD LT,6732.0,2410.06,970.08,6904.78,37
CDM,3272457,REVSC F&P VT ST&AT SF VSL ADD RT,6732.0,2410.06,970.08,6904.78,37
CDM,3272465,REVSC F&P VT ST&AT CMPLX VSL INITBI,35781.0,12809.6,6655.27,26835.75,39
CDM,3272473,REVSC F&P VT ST&AT CMPLX VSL INITLT,23854.0,8539.73,4436.84,17890.5,39
CDM,3272481,REVSC F&P VT ST&AT CMPLX VSL INITRT,23854.0,8539.73,4436.84,17890.5,39
CDM,3272499,REVSC F&P VT ST&AT CMPLX VSL ADD BI,14219.0,5090.4,2048.96,10664.25,37
CDM,3272507,REVSC F&P VT ST&AT CMPLX VSL ADD LT,9479.0,3393.48,1365.92,7109.25,37
CDM,3272515,REVSC F&P VT ST&AT CMPLX VSL ADD RT,9479.0,3393.48,1365.92,7109.25,37
CDM,3272523,REVSC T&P VT ANG SF VSL INIT BI,17418.0,6235.64,3239.75,13063.5,39
CDM,3272531,REVSC T&P VT ANG SF VSL INIT LT,11612.0,4157.1,2159.83,11278.0,39
CDM,3272549,REVSC T&P VT ANG SF VSL INIT RT,11612.0,4157.1,2159.83,11278.0,39
CDM,3272556,REVSC T&P VT ANG SF VSL ADD BI,6630.0,2373.54,955.38,5128.69,37
CDM,3272564,REVSC T&P VT ANG SF VSL ADD LT,4420.0,1582.36,636.92,5128.69,37
CDM,3272572,REVSC T&P VT ANG SF VSL ADD RT,4420.0,1582.36,636.92,5128.69,37
CDM,3272580,REVSC T&P VT ANG CMPLX VSL INIT BI,21266.0,7613.23,3955.48,15949.5,39
CDM,3272598,REVSC T&P VT ANG CMPLX VSL INIT LT,14177.0,5075.37,2636.92,11278.0,39
CDM,3272606,REVSC T&P VT ANG CMPLX VSL INIT RT,14177.0,5075.37,2636.92,11278.0,39
CDM,3272614,REVSC T&P VT ANG CMPLX VSL ADD BI,9426.0,3374.51,1358.29,7069.5,37
CDM,3272622,REVSC T&P VT ANG CMPLX VSL ADD LT,6284.0,2249.67,905.52,5128.69,37
CDM,3272630,REVSC T&P VT ANG CMPLX VSL ADD RT,6284.0,2249.67,905.52,5128.69,37
CDM,3272648,REVSC T&P VT STNT SF VSL INIT BI,21743.0,7783.99,4044.2,16307.25,39
CDM,3272655,REVSC T&P VT STNT SF VSL INIT LT,14495.0,5189.21,2696.07,13578.3,39
CDM,3272663,REVSC T&P VT STNT SF VSL INIT RT,14495.0,5189.21,2696.07,13578.3,39
CDM,3272671,REVSC T&P VT STNT SF VSL ADD BI,7592.0,2717.94,1094.01,5694.0,37
CDM,3272689,REVSC T&P VT STNT SF VSL ADD LT,5061.0,1811.84,729.29,5128.69,37
CDM,3272697,REVSC T&P VT STNT SF VSL ADD RT,5061.0,1811.84,729.29,5128.69,37
CDM,3272705,REVSC T&P VT STNT CMPLX VSL INIT BI,29175.0,10444.65,5426.55,21881.25,39
CDM,3272713,REVSC T&P VT STNT CMPLX VSL INIT LT,19450.0,6963.1,3617.7,14587.5,39
CDM,3272721,REVSC T&P VT STNT CMPLX VSL INIT RT,19450.0,6963.1,3617.7,14587.5,39
CDM,3272739,REVSC T&P VT STNT CMPLX VSL ADD BI,11421.0,4088.72,1645.77,8565.75,37
CDM,3272747,REVSC T&P VT STNT CMPLX VSL ADD LT,7614.0,2725.81,1097.18,5710.5,37
CDM,3272754,REVSC T&P VT STNT CMPLX VSL ADD RT,7614.0,2725.81,1097.18,5710.5,37
CDM,3272762,REVSC T&P VT ATH SF VSL INIT BI,30285.0,10842.03,5633.01,22713.75,39
CDM,3272770,REVSC T&P VT ATH SF VSL INIT LT,20190.0,7228.02,3755.34,15142.5,39
CDM,3272788,REVSC T&P VT ATH SF VSL INIT RT,20190.0,7228.02,3755.34,15142.5,39
CDM,3272796,REVSC T&P VT ATH SF VSL ADD BI,13244.0,4741.35,1908.46,9933.0,37
CDM,3272804,REVSC T&P VT ATH SF VSL ADD LT,8829.0,3160.78,1272.26,6621.75,37
CDM,3272812,REVSC T&P VT ATH SF VSL ADD RT,8829.0,3160.78,1272.26,6621.75,37
CDM,3272820,REVSC T&P VT ATH CMPLX VSL INIT BI,38123.0,13648.03,7090.88,28592.25,39
CDM,3272838,REVSC T&P VT ATH CMPLX VSL INIT LT,25415.0,9098.57,4727.19,19061.25,39
CDM,3272846,REVSC T&P VT ATH CMPLX VSL INIT RT,25415.0,9098.57,4727.19,19061.25,39
CDM,3272853,REVSC T&P VT ATH CMPLX VSL ADD BI,18044.0,6459.75,2233.0,13533.0,37
CDM,3272861,REVSC T&P VT ATH CMPLX VSL ADD LT,12029.0,4306.38,1733.38,9021.75,37
CDM,3272879,REVSC T&P VT ATH CMPLX VSL ADD RT,12029.0,4306.38,1733.38,9021.75,37
CDM,3272887,REVSC T&P VT ST&AT SF VSL INIT BI,33980.0,12164.84,6320.28,25485.0,39
CDM,3272895,REVSC T&P VT ST&AT SF VSL INIT LT,22653.0,8109.77,4213.46,16989.75,39
CDM,3272903,REVSC T&P VT ST&AT SF VSL INIT RT,22653.0,8109.77,4213.46,16989.75,39
CDM,3272911,REVSC T&P VT ST&AT SF VSL ADD BI,19583.0,7010.71,2233.0,14687.25,37
CDM,3272929,REVSC T&P VT ST&AT SF VSL ADD LT,13055.0,4673.69,1881.23,9791.25,37
CDM,3272937,REVSC T&P VT ST&AT SF VSL ADD RT,13055.0,4673.69,1881.23,9791.25,37
CDM,3272945,REVSC T&P VT ST&AT CMPLX VSL INITBI,40731.0,14581.7,7551.94,30548.25,39
CDM,3272952,REVSC T&P VT ST&AT CMPLX VSL INITLT,27154.0,9721.13,5050.64,20365.5,39
CDM,3272960,REVSC T&P VT ST&AT CMPLX VSL INITRT,27154.0,9721.13,5050.64,20365.5,39
CDM,3272978,REVSC T&P VT ST&AT CMPLX VSL ADD BI,24687.0,8837.95,2233.0,18515.25,37
CDM,3272986,REVSC T&P VT ST&AT CMPLX VSL ADD LT,16458.0,5891.96,2233.0,12343.5,37
CDM,3272994,REVSC T&P VT ST&AT CMPLX VSL ADD RT,16458.0,5891.96,2233.0,12343.5,37
CDM,3273000,EMB/OCCL PERM TRANSCTH CNS IM GD,5818.0,2082.84,1119.88,32276.26,63
CDM,3273018,EMB/OCCL PERM TRANSCTH NO CNS IM GD,5600.0,2004.8,872.13,20325.69,63
CDM,3273091,THROMBOLYSIS INF CATH TISSUE SUBQ,1253.0,448.57,130.17,5681.0,62
CDM,3283330,EXCHG TUBE CHEST VIA WIRE,740.0,264.92,333.0,7390.37,62
CDM,33019,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33043,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33050,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3305026,INSTILL BLADDER ANTICARCINOGENIC,1268.0,656.82,42.15,1267.21,63
CDM,3305141,CHEMO CNS REQ PUNCTURE SPINAL,747.0,249.5,117.45,950.0,63
CDM,3305158,CHEMO SUBARACHNOID/INTRAVENTRICULAR,546.0,182.36,64.74,950.0,63
CDM,3305372,CHEMO SUBQ/IM NONHORMONAL,562.0,187.71,44.93,950.0,63
CDM,3305380,CHEMO SUBQ/IM HORMONAL,308.0,102.87,34.48,950.0,63
CDM,3305398,CHEMO IVP DRUG INITIAL,900.0,300.6,97.32,950.0,63
CDM,3305406,CHEMO IVP DRUG ADDL,512.0,171.01,44.93,950.0,63
CDM,3305414,CHEMO INF IV 1ST HR,979.0,334.82,125.88,1221.24,63
CDM,3305422,CHEMO INF IV ADDL HR,225.0,76.95,27.02,950.0,63
CDM,3305430,CHEMO INF IV SEQ 1ST HR,461.0,157.66,44.93,950.0,63
CDM,3305570,CHEMO INTRALESIONAL LSN 1-7,246.0,82.16,43.93,950.0,63
CDM,3305588,CHEMO INTRALESIONAL LSN 8+,357.0,119.24,68.44,950.0,63
CDM,3305737,CHEMO SUBQ/IM NONHORMONAL,562.0,187.71,44.93,950.0,63
CDM,3305745,CHEMO SUBQ/IM HORMONAL,308.0,102.87,34.48,950.0,63
CDM,3305752,CHEMO IVP DRUG INITIAL,900.0,300.6,97.32,950.0,63
CDM,3305760,CHEMO IVP DRUG ADDL,512.0,171.01,44.93,950.0,63
CDM,3305778,CHEMO INF IV 1ST HR,979.0,334.82,125.88,1221.24,63
CDM,3305786,CHEMO INF IV ADDL HR,225.0,76.95,27.02,950.0,63
CDM,3305794,CHEMO INF IV SEQ 1ST HR,461.0,157.66,44.93,950.0,63
CDM,3305828,CHEMO CNS REQ PUNCTURE SPINAL,747.0,249.5,117.45,950.0,63
CDM,3305901,CHEMO CAVITY PERTNL PORT/CATH,529.0,176.69,40.13,950.0,57
CDM,3305927,CHEMO IV HOME PMP EXT VNDR SUPPLIED,1028.0,351.58,123.87,1038.24,63
CDM,3305968,CHEMO IV HOME PMP EXT VNDR SUPPLIED,1028.0,351.58,123.87,1038.24,63
CDM,33068,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33076,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33142,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33217,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33290,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3330529,PLAN PORT TELETHRPY SPEC,1199.0,552.74,43.45,2724.0,63
CDM,3330537,PLAN PORT TELETHRPY SPEC TBI,1199.0,552.74,43.45,2724.0,63
CDM,3332061,RAD THER FIELD SIMULAT LVL 01 SMPL,1533.0,706.71,91.98,2724.0,63
CDM,3332079,RAD THER FIELD SIMULAT LVL 02 INTRM,2511.0,1157.57,245.54,2724.0,63
CDM,3332087,RAD THER FIELD SIMULAT LVL 03 CMPLX,2637.0,1215.66,245.54,2724.0,63
CDM,3332111,CALC DOSIMETRY RAD BASIC,563.0,259.54,32.74,2724.0,63
CDM,3332129,PLAN IMRT HISTOGRAMS DOSE-VOLUME,9504.0,4381.34,915.08,10291.24,63
CDM,3332228,CALC DOSIMETRY SPEC,600.0,276.6,18.78,2724.0,63
CDM,3332236,CALC DOSIMETRY SPEC DIODE,600.0,276.6,18.78,2724.0,63
CDM,3332244,CALC DOSIMETRY SPEC TLD,600.0,276.6,18.78,2724.0,63
CDM,3332251,DEVICE TX DESIGN&CONST LVL 01 SMPL,568.0,261.85,15.21,2724.0,63
CDM,3332269,DEVICE TX DESIGN&CONST LVL 02 INTRM,739.0,340.68,91.98,2724.0,63
CDM,3332277,DEVICE TX DESIGN&CONST LVL 03 CMPLX,1006.0,463.77,63.89,2724.0,63
CDM,3332285,CONSULT PHYSICS MEDICAL CONTINUING,692.0,319.01,86.33,2724.0,63
CDM,3332293,CONSULT PHYSICS RAD MEDICAL SPECIAL,995.0,458.7,91.98,2724.0,63
CDM,3332343,RAD THER IMG/S PORT,246.0,113.41,2.84,2724.0,40
CDM,3332376,PROCEDURE TX SPECIAL THRPY RAD,2188.0,1008.67,34.98,2724.0,63
CDM,3332392,APPL BRACHY INTRACAV LVL 01 SMPL,1629.0,750.97,214.9,2724.0,63
CDM,3332400,APPL BRACHY INTRACAV LVL 02 INTRM,2150.0,991.15,246.62,2724.0,63
CDM,3332418,APPL BRACHY INTRACAV LVL 03 CMPLX,3046.0,1404.21,322.08,3251.63,63
CDM,3332442,APPL SOURCE RAD INTERSTITIAL CMPLX,3363.0,1550.34,451.46,3825.05,63
CDM,3332491,SPVN/HANDLING/LOAD RADIOELEMENT,403.0,185.78,17.45,2724.0,40
CDM,3332756,INS TANDEM UTERI&/OVOID VAG BRACHY,2027.0,725.67,277.69,8807.75,63
CDM,3332764,PLC DEV/S RT GD PROSTATE,2071.0,741.42,99.66,5681.0,63
CDM,3332921,BRACHY N-STRND P-103/SRCE,251.0,71.79,50.39,291.96,65
CDM,3332988,HYPERTHERMIA EXTERNAL SUPERFICIAL,1494.0,688.73,175.22,3168.61,63
CDM,3332996,HYPERTHERMIA EXTERNAL DEEP,2718.0,1253.0,513.63,6175.38,63
CDM,3333002,HYPERTHERMIA INTERSTITIAL 1-5 APPL,2192.0,1010.51,393.35,4039.69,63
CDM,3333010,HYPERTHERMIA INTERSTITIAL 6+ APPL,3419.0,1576.16,393.35,6449.98,63
CDM,3333101,DEVICE MLC DESIGN&CONST PER IMRT,1654.0,762.49,238.18,2724.0,63
CDM,3333119,PLC DEV/S RT GD INTRABD/PLVC/RETRO,3018.0,1080.44,178.16,5681.0,63
CDM,3333127,PLC DEV/S INTRSTL RT GD INTRATH,1500.0,537.0,168.0,10059.0,63
CDM,3333135,SRS CRANIAL COURSE 1 SESSN,17370.0,8007.57,927.09,41139.0,63
CDM,3333143,SRS CRANIAL ROBOTIC COURSE 1 SESSN,17370.0,8007.57,927.09,41139.0,63
CDM,3333150,SRS/SBRT LINEAR COURSE MAX 5 SESSNS,11571.0,5334.23,967.78,13203.0,63
CDM,3333168,SRS/SBRT ROBOTIC COURSE 1 SESSN,11571.0,5334.23,967.78,13203.0,63
CDM,3333176,SRS/SBRT ROBOTIC COURSE 2-5 SESSNS,11571.0,5334.23,967.78,13203.0,63
CDM,3333234,INS DEV AFTERLOAD VAG BRACHY,990.0,354.42,148.05,6689.0,63
CDM,3333242,MEAS URINE&/CAPACITY BLADDER US,270.0,96.66,10.99,2481.0,63
CDM,3333358,PLAN RADTHRPY 3D W HISTGMS DOSE-VOL,5412.0,2494.93,250.27,4059.0,63
CDM,3333366,SIMULAT MGMT MOTION RESPIRATORY,1977.0,911.4,295.87,2724.0,40
CDM,3333382,GD LOC VOL TARGET DELIVERY TX RAD,349.0,160.89,64.91,2724.0,40
CDM,3333390,PLAN ISODOSE TELETHRPY LVL 01 SMPL,889.0,409.83,73.27,2724.0,63
CDM,3333408,PLAN ISODOSE TELETHRPY LVL 02 CMPLX,1202.0,554.12,132.58,2724.0,63
CDM,3333416,PLAN ISODOSE BRACHY LVL 01 SMPL,1158.0,533.84,168.57,2724.0,63
CDM,3333424,PLAN ISODOSE BRACHY LVL 02 INTRM,1697.0,782.32,222.07,2724.0,63
CDM,3333432,PLAN ISODOSE BRACHY LVL 03 CMPLX,2064.0,951.5,245.54,2724.0,63
CDM,3333515,BRACHY HDR ELEC ICAV/ISTL DOSI/FRAC,4403.0,2029.78,191.21,3302.25,63
CDM,3333523,BRACHY HDR RDNCL ICAV/ISTL 1 CH,2403.0,1107.78,239.93,2724.0,63
CDM,3333531,BRACHY HDR RDNCL ICAV/ISTL 2-12 CH,2925.0,1348.42,396.49,2724.0,63
CDM,3333549,BRACHY HDR RDNCL ICAV/ISTL 13+CH,5256.0,2423.02,513.63,4233.86,63
CDM,3333556,BRACHY HDR RDNCL SURF SKN DOSI 1 CH,2019.0,930.76,175.22,2724.0,63
CDM,3333564,BRACHY HDR RDNCL SURF SKN DOSI 2+CH,3031.0,1397.29,175.22,2724.0,63
CDM,3333606,APPL SURF SOURCE LDR RDNCL,488.0,224.97,71.65,2724.0,63
CDM,3333705,SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,39
CDM,3333713,SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CDM,3333721,SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,39
CDM,3333739,SED MOD DIFF 0-4Y INIT 15MN,525.0,166.95,80.25,752.08,39
CDM,3333747,SED MOD DIFF 5+Y INIT 15MN,580.0,184.44,72.74,614.45,39
CDM,3333754,SED MOD DIFF ADDL 15MN,265.0,84.27,49.29,465.97,39
CDM,3336864,TX RAD LVL 1 E-SGL/MULTI 2D IMG GD,900.0,414.9,87.39,2724.0,63
CDM,3336880,TX RAD LVL 2 ISOCNTR SGL IMG GD,2520.0,1161.72,169.01,2724.0,63
CDM,3336906,TX RAD LVL 3 ISOCNTRS MULTI IMG GD,2960.0,1364.56,175.22,2724.0,63
CDM,33415,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33423,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,33522,R&B NURSERY LEVEL 4,16754.0,5512.57,4809.0,12565.5,12
CDM,34025,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,34066,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3410008,RRX GA-68 GOZT/1MCI 50MCI/7.5ML MDV,292.6,104.75,95.68,4277.7,62
CDM,3411188,RRX GA-68 DOTATATE/0.1MCI 54MCI MDV,132.0,47.26,40.87,239.21,58
CDM,3411238,NM BONE&/JOINT PHASE 3,5105.0,2026.69,262.32,3828.75,63
CDM,3411246,NM BONE&/JOINT LTD,2452.0,973.44,173.19,1839.0,63
CDM,3411253,NM MARROW BONE LTD,1369.0,543.49,132.26,1554.07,63
CDM,3411261,NM MARROW BONE MULTIPLE,2885.0,1145.34,137.78,2163.75,63
CDM,3411279,NM MARROW BONE BODY WHOLE,3339.0,1325.58,188.36,2504.25,63
CDM,3411287,NM BONE&/JOINT MULTIPLE,2668.0,1059.2,205.6,2001.0,63
CDM,3411303,NM BONE&/JOINT BODY WHOLE,4375.0,1736.88,223.78,3281.25,63
CDM,3411345,NM FLOW VASCULAR BRAIN,1322.0,524.83,144.26,2016.76,63
CDM,3411360,NM POOL BLOOD CARDIAC 1ST PASS SGL,1298.0,515.31,117.04,2016.76,63
CDM,3411378,NM DETECTION SHUNT CARDIAC,1106.0,439.08,134.53,1554.07,63
CDM,3411394,NM FLOW CSF CISTERNOGRAM,2066.0,820.2,269.14,2088.2,63
CDM,3411410,NM DETECTION&LOC LEAK CSF,2073.0,822.98,217.53,5381.65,63
CDM,3411428,NM FLOW CSF EVAL SHUNT,2020.0,801.94,262.0,2054.14,63
CDM,3411436,NM REFLEX URETERAL,1395.0,553.82,179.32,1554.07,63
CDM,3411451,NM MOTILITY ESOPHAGEAL,1249.0,495.85,160.49,1554.07,63
CDM,3411469,NM EMPTYING GASTRIC,1984.0,787.65,258.43,2011.83,63
CDM,3411485,NM REFLUX GASTROESOPHAGEAL,1672.0,663.78,189.34,1554.07,63
CDM,3411493,NM LOSS BLOOD GI ACUTE,2040.0,809.88,265.56,2062.12,63
CDM,3411576,NM LIVER STATIC,1186.0,470.84,152.71,2016.76,63
CDM,3411584,NM LIVER W FLOW VASCULAR,1306.0,518.48,166.66,2016.76,63
CDM,3411592,NM LIVER&SPLEEN STATIC,1201.0,476.8,155.3,1554.07,63
CDM,3411600,NM LIVER&SPLEEN W FLOW VASCULAR,949.0,376.75,99.44,1554.07,63
CDM,3411626,NM PERF PULMONARY,1367.0,542.7,177.69,1554.07,63
CDM,3411683,NM LYMPH SYSTEM,2007.0,796.78,261.68,2043.63,63
CDM,3411691,NM INTESTINE,2017.0,800.75,262.0,2056.8,63
CDM,3411709,NM MUGA REST VENTRICLE RT,1260.0,500.22,18.46,945.0,37
CDM,3411717,NM MUGA REST/STRESS PLANAR SGL,3546.0,1407.76,160.82,2659.5,63
CDM,3411725,NM MUGA REST W SPECT,1528.0,606.62,153.35,1554.07,63
CDM,3411733,NM MUGA REST&STRESS MULTI,4227.0,1678.12,195.5,3170.25,63
CDM,3411741,NM MYOCARDIAL INFARCT PLANAR,1672.0,663.78,131.61,1554.07,63
CDM,3411758,NM MYOCARDIAL INFARCT SPECT,1886.0,748.74,158.87,2016.76,63
CDM,3411832,NM VOLUME CELL RED SAMPLING MULTI,1575.0,625.28,62.48,2016.76,63
CDM,3411840,NM VOLUME CELL RED SAMPLING SINGLE,1073.0,425.98,59.56,1554.07,63
CDM,3411857,NM SEQUESTRATION CELL RED LABELED,1777.0,705.47,82.88,1554.07,63
CDM,3411881,NM KIDNEY FUNCTION&FLOW,1497.0,594.31,166.98,2016.76,63
CDM,3411899,NM KIDNEY FUNCTION&FLOW PHARM MULTI,2045.0,811.86,266.21,2082.87,63
CDM,3411907,NM KIDNEY FUNCTION&FLOW PHARM SGL,1598.0,634.41,116.63,2016.76,63
CDM,3411915,NM KIDNEY FUNCTION NON IMG,1096.0,435.11,77.74,1554.07,63
CDM,3411931,NM KIDNEY,1096.0,435.11,134.21,1554.07,63
CDM,3411949,NM KIDNEY W FLOW VASCULAR,2705.0,1073.88,180.29,2028.75,63
CDM,3411980,NM GLAND SALIVARY W SERIAL,1259.0,499.82,80.94,1554.07,63
CDM,3411998,NM PATENCY SHUNT PERITONEAL VENOUS,1505.0,597.48,195.5,1554.07,63
CDM,3412004,NM SPLEEN W/WO FLOW VASCULAR,1255.0,498.24,135.17,1554.07,63
CDM,3412020,NM TESTICULAR W FLOW VASCULAR,1366.0,542.3,159.19,1554.07,63
CDM,3412046,NM UPTAKE METS CA THYROID,358.0,142.13,50.87,340.24,37
CDM,3412053,NM METS CA THYROID WHOLE BODY,3492.0,1386.32,239.32,2619.0,63
CDM,3412160,NM LOC RRX TMR PLNR WHL BODY 2D IMG,4713.0,1871.06,525.41,5381.65,63
CDM,3412178,NM LOC RRX TMR PLNR WHL BODY 1D IMG,1824.0,724.13,238.39,5381.65,63
CDM,3412186,NM TEST BREATH UREA C14 ACQ,347.0,137.76,11.06,260.25,63
CDM,3412194,NM TEST BREATH UREA C14 ANALYSIS,2884.0,1144.95,94.41,2163.0,63
CDM,3412202,NM THROMBOSIS VENOUS BI,1883.0,747.55,146.21,1554.07,63
CDM,3412210,NM THROMBOSIS VENOUS UNI,1721.0,683.24,116.03,2016.76,63
CDM,3412228,NM THROMBOSIS VENOUS ACUTE,2111.0,838.07,236.03,5381.65,63
CDM,3412244,THERAPY RRX PO HYPTHYROID INIT,1166.0,464.07,49.9,1028.66,63
CDM,3412269,THERAPY RRX INTRAARTICULAR,582.0,231.64,38.54,1028.66,63
CDM,3412277,THERAPY RRX INTRACAVITARY,1562.0,621.68,51.16,1171.5,63
CDM,3412285,THERAPY RRX INTRAARTERIAL PARTICUL,1625.0,646.75,83.45,1218.75,63
CDM,3412301,THERAPY RRX PO THYROID CA ABL,1166.0,464.07,49.9,1028.66,63
CDM,3412319,THERAPY RRX PO THYROID CA METS,1166.0,464.07,49.9,1028.66,63
CDM,3412400,RRX I-123 IOBENG DX/0-15MCI DOSE,10594.0,3792.65,1659.85,20144.05,62
CDM,3412434,RRX TC99 MEDRONATE/0-30MCI DOSE,354.3,126.84,13.0,265.73,34
CDM,3412467,RRX XENON 133 DX/10MCI,247.0,88.43,45.94,1036.12,34
CDM,3412483,SPVN/HANDLING/LOAD RADIOELEMENT,403.0,185.78,17.45,2724.0,40
CDM,3412525,NM VOLUME PLASMA SAMPLING MULTI,2599.0,1031.8,62.48,5381.65,63
CDM,3412582,RRX I-131 IOD NA DX/MCI SOLN,444.0,158.95,0.01,333.0,34
CDM,3412590,RRX I-131 IOD NA THR/MCI SOLN,109.0,44.36,9.66,81.75,61
CDM,3412608,RRX INDIUM 111 PENTETATE DX/0.5MCI,1585.0,567.43,572.23,3491.77,58
CDM,3412624,RRX INDIUM 111 OXYQ DX/0.5MCI,2816.0,1008.13,618.11,8300.57,58
CDM,3412632,RRX I-125 IOD NA THR/MCI SOLN,352.0,143.26,50.72,683.0,56
CDM,3412657,RRX TETROFOSMIN DX/DOSE,820.0,293.56,85.27,615.0,34
CDM,3412681,RRX NA PHOS 32 THR/MCI,2788.0,1134.72,143.3,2091.0,61
CDM,3412707,RRX TC-99 SESTAMIBI DX/DOSE,277.9,99.49,51.69,469.7,34
CDM,3412731,BRACHY N-STRND YTTR 90 SIRSP/SRCE,86508.0,24741.29,12613.29,79092.28,65
CDM,3412749,BRACHY N-STRND YTTR 90 THERASP/SRCE,86969.0,24873.13,12613.29,79092.28,65
CDM,3412780,RRX I-131 IOD NA DX/MCI CAP,373.0,133.53,0.01,279.75,34
CDM,3412798,RRX I-131 IOD NA THPY/MCI CAP,132.0,53.72,18.5,163.78,61
CDM,3412814,RRX PERTECHNETATE DX/MCI,3.0,1.07,0.558,6.79,34
CDM,3412863,RRX EXAMETAZIME DX/0-25MCI DOSE,7586.0,2715.79,641.87,6758.7,34
CDM,3412889,THERAPY RRX INF IV RMA,1640.0,652.72,98.17,1230.0,63
CDM,3412921,INJ EVAL SHUNT PERITONEAL-VENOUS,388.0,138.9,37.3,5681.0,40
CDM,3412962,NM FLOW VASCULAR NON-CARDIAC,1132.0,449.4,160.17,1554.07,63
CDM,3413085,RRX CHROMIUM 51 DX/0-250UCI DOSE,1411.0,505.14,352.62,3164.63,58
CDM,3413101,RRX MERTIATIDE DX/0-15MCI DOSE,1144.0,409.55,212.78,3055.13,32
CDM,3413143,RRX PYROPHOSPHATE DX/0-25MCI DOSE,463.2,165.83,64.05,347.4,34
CDM,3413168,RRX MEBROFENIN DX/0-15MCI DOSE,205.0,73.39,38.13,218.12,34
CDM,3413184,RRX PENTETATE DX/0-25MCI DOSE,228.0,81.62,35.72,171.0,28
CDM,3413200,RRX MAA DX/0-10MCI DOSE,127.0,45.47,23.62,118.27,34
CDM,3413218,RRX BICISATE DX/0-25MCI DOSE,2310.0,826.98,547.04,14891.17,58
CDM,3413226,RRX SULFUR COLLOID DX/0-20MCI DOSE,306.0,109.55,56.92,1054.34,34
CDM,3413234,RRX RBC LABELED DX/0-30MCI DOSE,626.0,224.11,106.48,469.5,34
CDM,3413259,RRX YTTR90 ZEV THR/0-40MCI DOSE,127245.0,51788.72,41609.11,267382.59,61
CDM,3413325,RRX TC-99 OXIDRONATE/0-30MCI DOSE,460.2,164.75,50.16,345.15,28
CDM,3413374,RRX ARCITUMOMAB DX/0-45MCI DOSE,6955.0,2489.89,647.61,5216.25,28
CDM,3413382,NM BRAIN 1-3 VW STATIC,1117.0,443.45,143.94,1554.07,63
CDM,3413390,NM BRAIN 1-3 VW STATIC W FLOW,1323.0,525.23,172.18,1554.07,63
CDM,3413408,NM BRAIN 4+ VW STATIC,1211.0,480.77,156.6,2016.76,63
CDM,3413416,NM BRAIN 4+ VW STATIC W FLOW,2030.0,805.91,264.6,2051.54,63
CDM,3413457,RRX I-123 IOD NA DX/100UCI <1MCI,207.0,74.11,38.5,467.44,34
CDM,3413465,RRX INDIUM-111 PENTET DX/0-6MCI,9723.0,3480.83,1531.69,15260.62,58
CDM,3413473,RRX EXAMETAZIME WBC LABELED DX/DOSE,6945.0,2486.31,832.26,8515.96,58
CDM,3413481,RRX INDIUM-111 WBC LABELED DX/DOSE,3442.0,1232.24,825.11,16601.13,58
CDM,3413499,APPL SOURCE RAD INTERSTITIAL CMPLX,3363.0,1550.34,451.46,3825.05,63
CDM,3413515,INJ RRX LOC STDY PROBE NON-IMG IV,664.0,263.61,38.69,1554.07,63
CDM,3413572,NM PERF MYOC SPECT WM/EF SGL,2315.0,919.06,243.21,5381.65,63
CDM,3413580,NM PERF MYOC SPEC WM/EF MULT,3591.0,1425.63,348.9,5381.65,63
CDM,3413598,NM PERF MYOC PLANAR WM/EF SGL,2315.0,919.06,215.63,5381.65,63
CDM,3413606,NM PERF MYOC PLANAR WM/EF MULT,3464.0,1375.21,326.55,5381.65,63
CDM,3413614,RRX SM153 LEXI THR/0-150MCI DOSE,20167.0,8207.97,3159.8,64208.36,61
CDM,3413721,INJ IVP DRUG INITIAL INCMP TEST,585.0,173.74,35.77,945.0,63
CDM,3413747,RRX I-123 IOFLUPANE DX/0-5MCI DOSE,5852.0,2095.02,1110.42,10221.06,58
CDM,3413762,INJ RRX NODE SENTINEL ID BI,1646.0,589.27,31.05,5681.0,40
CDM,3413770,INJ RRX NODE SENTINEL ID LT,1097.0,392.73,31.05,5681.0,40
CDM,3413788,INJ RRX NODE SENTINEL ID RT,1097.0,392.73,31.05,5681.0,40
CDM,3413796,NM HEPATOBILIARY W/WO GB,1956.0,776.53,255.23,1988.08,63
CDM,3413804,NM HEPATOBILIARY W PHARM W/WO GB,2435.0,966.7,346.99,2703.51,63
CDM,3413812,NM VENT PULMONARY,1120.0,444.64,145.93,1554.07,63
CDM,3413820,NM VENT&PERF PULMONARY,1892.0,751.12,247.43,2016.76,63
CDM,3413838,NM PERF PULM DIFF QN W/WO IMG,1132.0,449.4,146.58,1554.07,63
CDM,3413846,NM PERF&VENT PULM DIFF QN W/WO IMG,1765.0,700.7,230.88,2016.76,63
CDM,3413887,RRX I-131 ALBUMIN SERUM DX/5UCI,232.0,83.06,43.15,7369.09,34
CDM,3413895,NM VOLUME BLOOD PLASMA&CELL RED,1540.0,611.38,75.78,2016.76,63
CDM,3413960,NM THYROID UPTAKE MEAS QN SGL/MULT,640.0,254.08,70.3,1554.07,63
CDM,3413978,NM THYROID W/WO FLOW VASCULAR,1158.0,459.73,150.11,1554.07,63
CDM,3413986,NM THYROID UPTAKE MEAS W/WO FLW STM,1658.0,658.23,189.7,1554.07,63
CDM,3413994,NM PLANAR PARATHYROID,1943.0,771.37,226.01,1777.02,63
CDM,3414000,NM PLANAR PARATHYROID W SPECT,1982.0,786.85,258.14,2022.47,63
CDM,3414018,NM PLANAR PARATHYROID W SPECT/CT,2800.0,1111.6,316.53,2471.62,63
CDM,3414042,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,3414067,RRX DTPA AEROSOL DOSE 0-75MCI,279.0,99.88,24.23,209.25,34
CDM,3414075,RRX TC-99 TILMANOCEPT/0.5MCI INJ,2399.5,859.02,446.31,2608.78,34
CDM,3414083,RRX RADIUM RA223 DICHLORIDE/UCI,392.0,159.54,137.78,666.46,60
CDM,3414208,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,3414216,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,3414224,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,3414232,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,3414240,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,3414257,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,3414307,BRACHY STRND I-125/SRCE,445.0,127.27,27.12,333.75,65
CDM,3414356,NM LOC RRX TMR PLNR 1 AREA 1D IMG,1472.0,584.38,196.51,1589.69,63
CDM,3414372,NM LOC RRX TMR SPECT 1AREA 1ACQ 1D,2209.0,876.97,289.95,5381.65,63
CDM,3414380,NM LOC RRX TMR SPECT CT 1AREA 1ACQ,2744.0,1089.37,359.04,5381.65,63
CDM,3414398,NM LOC RRX TMR SPECT 2+AREA 2ACQ,4198.0,1666.61,552.03,5381.65,63
CDM,3414406,NM LOC RRX TMR SPECT CT 2+AREA 2ACQ,5398.0,2143.01,707.74,6100.33,63
CDM,3414422,RRX F18 PIFLUFOLASTAT/1MCI,1632.5,584.43,265.95,2498.09,62
CDM,3414463,THERAPY RRX IV,1220.0,485.56,52.17,1028.66,63
CDM,3414489,RRX F18 FLOTUFOLASTAT/1MCI,1978.7,708.37,536.98,1484.03,62
CDM,3414653,RRX F18 FLUOROESTRADIOL DX/1MCI,2.6,0.93,0.8502,3123.78,62
CDM,3502515,AUG SACRAL PERC INJ UNI,8646.0,3095.27,982.0,14124.0,59
CDM,3502523,AUG SACRAL PERC INJ BI,10799.0,3866.04,982.0,18194.0,59
CDM,3502531,ASP&/INJ JT/BUR SM WO US GD RT,663.0,237.35,34.91,5681.0,40
CDM,3502549,ASP&/INJ JT/BUR SM WO US GD BI,995.0,356.21,34.91,5681.0,40
CDM,3502556,ASP&/INJ JT/BUR SM WO US GD LT,663.0,237.35,34.91,5681.0,40
CDM,3502564,ASP&/INJ JT/BUR INTR WO US GD LT,689.0,246.66,35.9,5681.0,40
CDM,3502572,ASP&/INJ JT/BUR INTR WO US GD BI,1034.0,370.17,35.9,5681.0,40
CDM,3502580,ASP&/INJ JT/BUR INTR WO US GD RT,689.0,246.66,35.9,5681.0,40
CDM,3502598,ASP&/INJ JT/BUR MAJ WO US GD RT,840.0,300.72,44.27,5681.0,40
CDM,3502606,ASP&/INJ JT/BUR MAJ WO US GD BI,1260.0,451.08,44.27,5681.0,40
CDM,3502614,ASP&/INJ JT/BUR MAJ WO US GD LT,840.0,300.72,44.27,5681.0,40
CDM,3502622,ABL RF TUMOR/S BONE PERC IMG GD,11796.0,4222.97,352.66,30871.55,63
CDM,3502630,INJ MYELOGRAM&/CT LUMBAR,660.0,236.28,80.44,5681.0,40
CDM,3502655,VERTEBROPLASTY LUMBOSACRAL PERC,4992.0,1787.14,393.85,18194.0,63
CDM,3502663,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4389.0,1571.26,199.38,18194.0,38
CDM,3502671,AUG VERTEBRAL THORACIC PERC,13730.0,4915.34,494.28,13802.9,63
CDM,3502689,AUG VERTEBRAL LUMBAR PERC,7999.0,2863.64,460.82,13802.9,63
CDM,3502929,ABL CRYO TUMOR/S BONE PERC IMG GD,8646.0,3095.27,329.08,12775.92,63
CDM,3503042,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,1383.0,495.11,113.61,8022.0,63
CDM,3503059,INJ LUMB MYELOGRPHY 2+ S&I,2077.0,743.57,117.91,8022.0,63
CDM,3503067,ABL CRYO TUMOR/S LIVER PERC,13673.0,4894.93,429.13,18715.8,63
CDM,3503356,INS TUBE DUO/JEJUNOSTOMY PERC S&I,4103.0,1468.87,230.64,6689.0,63
CDM,3503364,PLC CATH NEPHROSTOMY PERC RT S&I,3433.0,1229.01,195.15,14124.0,40
CDM,3503372,PLC CATH NEPHROSTOMY PERC LT S&I,3433.0,1229.01,195.15,14124.0,40
CDM,3503380,PLC CATH NEPHROSTOMY PERC BI S&I,5150.0,1843.7,195.15,14124.0,40
CDM,3503695,INJ CHOLANGIOGRAM ACCESS EXIST S&I,1938.0,693.8,67.42,7697.0,63
CDM,3503778,ABL LYMPH NODE ALCOHOL,6519.0,2333.8,287.87,5681.0,62
CDM,3503786,ABL ETOH TUMOR/S LIVER,1545.0,553.11,450.93,10257.38,62
CDM,3503935,INJ EPID PATCH BLOOD/CLOT,1604.0,574.23,110.28,5681.0,63
CDM,3504008,PLC DEV/S MRKRS THRPY RAD NON-PROS,3220.0,1152.76,915.08,4664.0,59
CDM,3504032,DST NRV PLEXUS HYPOGASTRIC SUPERIOR,4511.0,1614.94,213.34,6689.0,63
CDM,3504065,THROMBOLYSIS INF CATH PERITONEAL,1253.0,448.57,563.85,5681.0,62
CDM,3504073,ASP CYST PERINEURAL,1386.0,496.19,189.35,5681.0,62
CDM,3504107,INJ/S EPID/SUB C/T W IMG,1867.0,668.39,104.71,5681.0,63
CDM,3504131,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,3504149,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,3504156,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,3504164,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,3504172,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,3504180,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,3521903,ABL RF TUMOR/S LIVER PERC,9095.0,3256.01,704.21,10644.28,63
CDM,3521911,ASP BLADDER NDL,742.0,265.64,37.89,5681.0,63
CDM,3521929,ASP BLADDER TROCAR/CATH,1374.0,491.89,49.33,5681.0,63
CDM,3521945,ASP PUNCT ABSCESS/CYST,651.0,233.06,94.84,5681.0,63
CDM,3521952,ASP&INJ CYST BONE,1183.0,423.51,159.68,5681.0,63
CDM,3521960,ASP&/INJ CYST THYROID,1291.0,462.18,46.82,5681.0,63
CDM,3521994,ASP&/INJ CYST/PELVIS RENAL LT,1376.0,492.61,90.4,5681.0,40
CDM,3522000,ASP&/INJ CYST/PELVIS RENAL RT,1376.0,492.61,90.4,5681.0,40
CDM,3522026,BX MASS ABD/RETRO NDL PERC,2983.0,1067.91,79.3,5681.0,63
CDM,3522034,BX BONE TROCAR/NDL DEEP,2957.0,1058.61,124.69,6689.0,63
CDM,3522042,BX BONE TROCAR/NDL SUPERFICIAL,2124.0,760.39,84.14,5681.0,63
CDM,3522059,BX BRAIN STEREOTACTIC W CT,8235.0,2948.13,982.0,13802.9,40
CDM,3522067,BX LIVER NDL PERC,3139.0,3104.87,84.42,5681.0,63
CDM,3522109,BX MUSCLE NDL PERC,2139.0,765.76,55.27,5681.0,63
CDM,3522125,BX PANCREAS NDL PERC,2435.0,871.73,226.28,5681.0,63
CDM,3522133,BX PLEURA NDL PERC,2408.0,862.06,80.58,5681.0,63
CDM,3522141,BX RENAL TROCAR/NDL PERC LT,3132.0,3245.64,121.75,5681.0,40
CDM,3522158,BX RENAL TROCAR/NDL PERC RT,3132.0,3245.64,121.75,5681.0,40
CDM,3522166,BX SPINAL CORD NDL PERC,3006.0,1076.15,250.68,5681.0,63
CDM,3522174,EXCHG CATH DRN ABSC/CYST,3433.0,1229.01,67.43,5681.0,63
CDM,3522182,CT LTD/FOLLOWUP,674.0,115.25,58.65,1218.0,63
CDM,3522208,CT GD ABLATION TISSUE,1791.0,306.26,333.13,1343.25,37
CDM,3522216,CT GD PLCMT NEEDLE S&I,1529.0,261.46,68.76,1218.0,37
CDM,3522224,CT GD LOC STEREOTACTIC,2020.0,345.42,156.4,1515.0,37
CDM,3522240,CT GD W PLC CATH DRN PERC S&I,962.0,164.5,55.46,1218.0,37
CDM,3522307,CTA AORTA ABD RUNOFF W CNT,1824.0,311.9,129.45,1832.84,63
CDM,3522323,CTA RECON AORTA,1715.0,293.27,42.15,1286.25,33
CDM,3522398,I&D HEMATOMA/SEROMA/FLUID,3139.0,1123.76,116.33,5681.0,63
CDM,3522448,INJ CNT ABSC/CYST VIA PREV CATH/TB,599.0,214.44,35.69,5681.0,40
CDM,3522547,INJ/INF NEUROLYTIC EPIDURAL C/T,1822.0,652.28,151.88,5681.0,63
CDM,3522554,INJ/INF NEUROLYTIC EPIDURAL L/S,1980.0,708.84,138.66,5681.0,63
CDM,3522687,CT HEAD W CNT,2033.0,339.51,96.35,1524.75,63
CDM,3522695,CT HEAD WO CNT,1626.0,271.54,67.14,1219.5,63
CDM,3522703,CT HEAD W&WO CNT,2439.0,407.31,115.14,1829.25,63
CDM,3522711,CT MAXFACIAL WO CNT,1083.0,180.86,79.0,1218.0,63
CDM,3522729,CT MAXFACIAL W CNT,1354.0,226.12,100.53,1218.0,63
CDM,3522737,CT MAXFACIAL W&WO CNT,1625.0,271.38,126.17,1218.75,63
CDM,3522745,CT NECK ST W CNT,1208.0,201.74,120.98,1218.0,63
CDM,3522752,CT NECK ST WO CNT,966.0,161.32,79.0,1218.0,63
CDM,3522760,CT NECK ST W&WO CNT,1449.0,241.98,129.45,1218.0,63
CDM,3522778,CT ORB/PF/SEL/IAC W CNT,1549.0,258.68,128.77,1218.0,63
CDM,3522786,CT ORB/PF/SEL/IAC WO CNT,1239.0,206.91,79.0,1218.0,63
CDM,3522794,CT ORB/PF/SEL/IAC W&WO CNT,1859.0,310.45,129.45,1394.25,63
CDM,3522810,CTA HEAD W CNT&PP,2561.0,427.69,129.45,1920.75,63
CDM,3522836,CTA NECK W CNT&PP,1522.0,254.17,129.45,1418.01,63
CDM,3522844,CT ABDOMEN W CNT,1447.0,240.2,129.45,1360.2,63
CDM,3522851,CT ABDOMEN WO CNT,1157.0,192.06,79.0,1218.0,63
CDM,3522869,CT ABDOMEN W&WO CNT,1736.0,288.18,129.45,1418.27,63
CDM,3522893,CT CHEST DX W CNT,1908.0,316.73,113.51,1431.0,63
CDM,3522901,CT CHEST DX WO CNT,1526.0,253.32,79.0,1218.0,63
CDM,3522919,CT CHEST DX W&WO CNT,2289.0,379.97,129.45,1716.75,63
CDM,3522927,CT SPINE CERVICAL W CNT,2148.0,356.57,112.87,1611.0,63
CDM,3522935,CT SPINE CERVICAL WO CNT,1718.0,285.19,79.0,1288.5,63
CDM,3522943,CT SPINE CERVICAL W&WO CNT,2577.0,427.78,129.45,1932.75,63
CDM,3522950,CT EXT LOWER W CNT LT,1327.0,220.28,113.51,1218.0,40
CDM,3522968,CT EXT LOWER W CNT RT,1327.0,220.28,113.51,1218.0,40
CDM,3522976,CT EXT LOWER WO CNT LT,1061.0,176.13,79.0,1218.0,40
CDM,3522984,CT EXT LOWER WO CNT RT,1061.0,176.13,79.0,1218.0,40
CDM,3523024,CT EXT LOWER W&WO CNT LT,1592.0,264.27,129.45,1218.0,40
CDM,3523032,CT EXT LOWER W&WO CNT RT,1592.0,264.27,129.45,1218.0,40
CDM,3523040,CT SPINE LUMBAR W CNT,2108.0,349.93,113.19,1581.0,63
CDM,3523057,CT SPINE LUMBAR WO CNT,1686.0,279.88,79.0,1264.5,63
CDM,3523065,CT SPINE LUMBAR W&WO CNT,2529.0,419.81,129.45,1896.75,63
CDM,3523073,CT PELVIS W CNT,1592.0,264.27,129.45,1362.8,63
CDM,3523081,CT PELVIS WO CNT,1273.0,211.32,79.0,1218.0,63
CDM,3523099,CT PELVIS W&WO CNT,1910.0,317.06,129.45,1432.5,63
CDM,3523107,CT SPINE THORACIC W CNT,2139.0,355.07,113.83,1604.25,63
CDM,3523115,CT SPINE THORACIC WO CNT,1711.0,284.03,79.0,1283.25,63
CDM,3523123,CT SPINE THORACIC W&WO CNT,2567.0,426.12,129.45,1925.25,63
CDM,3523156,CT EXT UPPER W CNT LT,1400.0,232.4,147.59,1516.98,40
CDM,3523164,CT EXT UPPER W CNT RT,1400.0,232.4,147.59,1516.98,40
CDM,3523180,CT EXT UPPER WO CNT LT,1120.0,185.92,79.0,1218.0,40
CDM,3523198,CT EXT UPPER WO CNT RT,1120.0,185.92,79.0,1218.0,40
CDM,3523206,CT EXT UPPER W&WO CNT LT,1680.0,278.88,129.45,1418.27,40
CDM,3523214,CT EXT UPPER W&WO CNT RT,1680.0,278.88,129.45,1418.27,40
CDM,3523230,CTA ABDOMEN W CNT&PP,1823.0,302.62,129.45,1415.68,63
CDM,3523255,CTA CHEST W CNT&PP,2404.0,399.06,129.45,1803.0,63
CDM,3523289,CTA EXT LOWER W CNT&PP LT,1672.0,277.55,129.45,1415.35,40
CDM,3523297,CTA EXT LOWER W CNT&PP RT,1672.0,277.55,129.45,1415.35,40
CDM,3523313,CTA PELVIS W CNT&PP,2006.0,333.0,129.45,1504.5,63
CDM,3523321,CTA EXT UPPER W CNT&PP LT,1764.0,292.82,129.45,1418.01,40
CDM,3523339,CTA EXT UPPER W CNT&PP RT,1764.0,292.82,129.45,1418.01,40
CDM,3523453,CT LTD/FOLLOWUP,674.0,115.25,58.65,1218.0,63
CDM,3523578,ABL RF TUMOR/S KIDNEY PERC RT,8971.0,3211.62,328.6,10257.38,40
CDM,3523586,ABL RF TUMOR/S KIDNEY PERC LT,8971.0,3211.62,328.6,10257.38,40
CDM,3523610,DISCOGRAM LUMBAR S&I,3093.0,872.23,70.39,7229.66,63
CDM,3523693,ASP BLADDER W INS CATH SUPRAPUBIC,3433.0,1229.01,137.96,6226.0,63
CDM,3523958,ABL CRYO TUMOR/S KIDNEY PERC LT,11961.0,4282.04,438.26,18194.0,40
CDM,3523966,ABL CRYO TUMOR/S KIDNEY PERC RT,11961.0,4282.04,438.26,18194.0,40
CDM,3524154,CT HEAD WO CNT,1626.0,271.54,67.14,1219.5,63
CDM,3524162,CT HEAD W CNT,2033.0,339.51,96.35,1524.75,63
CDM,3524170,CT HEAD W&WO CNT,2439.0,407.31,115.14,1829.25,63
CDM,3524204,CT ORB/PF/SEL/IAC W&WO CNT,1859.0,310.45,129.45,1394.25,63
CDM,3524212,CT MAXFACIAL WO CNT,1083.0,180.86,79.0,1218.0,63
CDM,3524220,CT MAXFACIAL W CNT,1354.0,226.12,100.53,1218.0,63
CDM,3524238,CT MAXFACIAL W&WO CNT,1625.0,271.38,126.17,1218.75,63
CDM,3524246,CT NECK ST WO CNT,966.0,161.32,79.0,1218.0,63
CDM,3524253,CT NECK ST W CNT,1208.0,201.74,120.98,1218.0,63
CDM,3524261,CT NECK ST W&WO CNT,1449.0,241.98,129.45,1218.0,63
CDM,3524279,CTA HEAD W CNT&PP,2561.0,427.69,129.45,1920.75,63
CDM,3524287,CTA NECK W CNT&PP,1522.0,254.17,129.45,1418.01,63
CDM,3524295,CT CHEST DX WO CNT,1526.0,253.32,79.0,1218.0,63
CDM,3524303,CT CHEST DX W CNT,1908.0,316.73,113.51,1431.0,63
CDM,3524311,CT CHEST DX W&WO CNT,2289.0,379.97,129.45,1716.75,63
CDM,3524329,CT SPINE CERVICAL WO CNT,1718.0,285.19,79.0,1288.5,63
CDM,3524337,CT SPINE CERVICAL W CNT,2148.0,356.57,112.87,1611.0,63
CDM,3524345,CT SPINE CERVICAL W&WO CNT,2577.0,427.78,129.45,1932.75,63
CDM,3524352,CT SPINE THORACIC WO CNT,1711.0,284.03,79.0,1283.25,63
CDM,3524360,CT SPINE THORACIC W CNT,2139.0,355.07,113.83,1604.25,63
CDM,3524378,CT SPINE THORACIC W&WO CNT,2567.0,426.12,129.45,1925.25,63
CDM,3524386,CT SPINE LUMBAR WO CNT,1686.0,279.88,79.0,1264.5,63
CDM,3524394,CT SPINE LUMBAR W CNT,2108.0,349.93,113.19,1581.0,63
CDM,3524402,CT SPINE LUMBAR W&WO CNT,2529.0,419.81,129.45,1896.75,63
CDM,3524410,CTA PELVIS W CNT&PP,2006.0,333.0,129.45,1504.5,63
CDM,3524428,CT PELVIS WO CNT,1273.0,211.32,79.0,1218.0,63
CDM,3524436,CT PELVIS W CNT,1592.0,264.27,129.45,1362.8,63
CDM,3524444,CT PELVIS W&WO CNT,1910.0,317.06,129.45,1432.5,63
CDM,3524469,CT EXT UPPER WO CNT LT,1120.0,185.92,79.0,1218.0,40
CDM,3524477,CT EXT UPPER WO CNT RT,1120.0,185.92,79.0,1218.0,40
CDM,3524493,CT EXT UPPER W CNT LT,1400.0,232.4,147.59,1516.98,40
CDM,3524501,CT EXT UPPER W CNT RT,1400.0,232.4,147.59,1516.98,40
CDM,3524527,CT EXT UPPER W&WO CNT LT,1680.0,278.88,129.45,1418.27,40
CDM,3524535,CT EXT UPPER W&WO CNT RT,1680.0,278.88,129.45,1418.27,40
CDM,3524543,CTA EXT UPPER W CNT&PP LT,1764.0,292.82,129.45,1418.01,40
CDM,3524550,CTA EXT UPPER W CNT&PP RT,1764.0,292.82,129.45,1418.01,40
CDM,3524576,CT EXT LOWER WO CNT LT,1061.0,176.13,79.0,1218.0,40
CDM,3524584,CT EXT LOWER WO CNT RT,1061.0,176.13,79.0,1218.0,40
CDM,3524600,CT EXT LOWER W CNT LT,1327.0,220.28,113.51,1218.0,40
CDM,3524618,CT EXT LOWER W CNT RT,1327.0,220.28,113.51,1218.0,40
CDM,3524634,CT EXT LOWER W&WO CNT LT,1592.0,264.27,129.45,1218.0,40
CDM,3524642,CT EXT LOWER W&WO CNT RT,1592.0,264.27,129.45,1218.0,40
CDM,3524659,CTA EXT LOWER W CNT&PP LT,1672.0,277.55,129.45,1415.35,40
CDM,3524667,CTA EXT LOWER W CNT&PP RT,1672.0,277.55,129.45,1415.35,40
CDM,3524675,CT ABDOMEN WO CNT,1157.0,192.06,79.0,1218.0,63
CDM,3524683,CT ABDOMEN W CNT,1447.0,240.2,129.45,1360.2,63
CDM,3524691,CT ABDOMEN W&WO CNT,1736.0,288.18,129.45,1418.27,63
CDM,3524709,CTA ABDOMEN W CNT&PP,1823.0,302.62,129.45,1415.68,63
CDM,3524816,CTA CHEST W CNT&PP,2404.0,399.06,129.45,1803.0,63
CDM,3524824,CHG TUBE CYSTO SIMPLE,529.0,189.38,50.29,5681.0,63
CDM,3524832,CHG CATH DRN/TUBE PERC S&I,797.0,224.75,56.43,597.75,37
CDM,3525367,XR ABSCESS/SINUS/FISTULA S&I,918.0,258.88,34.36,1989.95,63
CDM,3525599,INJ ANES PLEXUS CELIAC,1822.0,652.28,92.23,5681.0,63
CDM,3526365,BX RENAL TROCAR/NDL PERC BI,4698.0,3245.64,121.75,5681.0,40
CDM,3526381,BX THYROID NDL CORE PERC,1291.0,462.18,73.96,5681.0,63
CDM,3526605,CT EVAL QN CALCIUM HRT WO CNT,1683.0,287.79,58.65,1262.25,63
CDM,3526613,CT EVAL STRUC&MORPH HRT W CNT,1484.0,253.76,129.45,1218.0,63
CDM,3526621,CT EVAL STRUC&MORPH CONG HRT W CNT,1553.0,265.56,129.45,1512.8,63
CDM,3526639,CTA ART&GRAFTS HEART W CNT,1631.0,278.9,129.45,1700.38,63
CDM,3526647,INJ/S JT FCT C/T IMG 1 LVL BI,1427.0,510.87,102.7,5681.0,40
CDM,3526654,INJ/S JT FCT C/T IMG 1 LVL LT,951.0,340.46,102.7,5681.0,40
CDM,3526662,INJ/S JT FCT C/T IMG 1 LVL RT,951.0,340.46,102.7,5681.0,40
CDM,3526670,INJ/S JT FCT C/T IMG 2 LVL BI,1253.0,448.57,57.6,5681.0,40
CDM,3526688,INJ/S JT FCT C/T IMG 2 LVL LT,835.0,298.93,57.6,5681.0,40
CDM,3526696,INJ/S JT FCT C/T IMG 2 LVL RT,835.0,298.93,57.6,5681.0,40
CDM,3526704,INJ/S JT FCT C/T IMG 3+ LVL BI,1365.0,488.67,58.58,5681.0,40
CDM,3526712,INJ/S JT FCT C/T IMG 3+ LVL LT,910.0,325.78,58.58,5681.0,40
CDM,3526720,INJ/S JT FCT C/T IMG 3+ LVL RT,910.0,325.78,58.58,5681.0,40
CDM,3526738,INJ/S JT FCT L/S IMG 1 LVL BI,4019.0,1438.8,88.29,5681.0,40
CDM,3526746,INJ/S JT FCT L/S IMG 1 LVL LT,2679.0,959.08,88.29,5681.0,40
CDM,3526753,INJ/S JT FCT L/S IMG 1 LVL RT,2679.0,959.08,88.29,5681.0,40
CDM,3526761,INJ/S JT FCT L/S IMG 2 LVL BI,1421.0,508.72,49.44,5681.0,40
CDM,3526779,INJ/S JT FCT L/S IMG 2 LVL LT,947.0,339.03,49.44,5681.0,40
CDM,3526787,INJ/S JT FCT L/S IMG 2 LVL RT,947.0,339.03,49.44,5681.0,40
CDM,3526795,INJ/S JT FCT L/S IMG 3+ LVL BI,1445.0,517.31,50.41,5681.0,40
CDM,3526803,INJ/S JT FCT L/S IMG 3+ LVL LT,963.0,344.75,50.41,5681.0,40
CDM,3526811,INJ/S JT FCT L/S IMG 3+ LVL RT,963.0,344.75,50.41,5681.0,40
CDM,3526829,CT COLONOGRAPHY DX WO CNT,844.0,144.32,79.0,1901.53,63
CDM,3526837,CT COLONOGRAPHY DX W CNT,1055.0,180.4,129.45,2148.57,63
CDM,3527355,PLC DEV/S INTRSTL RT GD INTRATH,1500.0,537.0,168.0,10059.0,63
CDM,3527660,INJ TRACT SINOGRAM,369.0,132.1,35.08,5681.0,38
CDM,3527777,ABL RF TUMOR/S PULM PERC IMG GD LT,10258.0,3672.36,418.71,18194.0,40
CDM,3527785,ABL RF TUMOR/S PULM PERC IMG GD RT,10258.0,3672.36,418.71,18194.0,40
CDM,3527793,ABL RF TUMOR/S PULM PERC IMG GD BI,15387.0,5508.55,418.71,18194.0,40
CDM,3527801,ABL CRYO TUMOR/S PULM PERC IMG LT,10691.0,3827.38,418.06,10065.0,40
CDM,3527819,ABL CRYO TUMOR/S PULM PERC IMG RT,10691.0,3827.38,418.06,10065.0,40
CDM,3527827,ABL CRYO TUMOR/S PULM PERC IMG BI,16037.0,5741.25,418.06,12027.75,40
CDM,3527835,BX/EXCISE NODE NDL SUPERFICIAL BI,3543.0,1268.39,82.79,5681.0,40
CDM,3527843,BX/EXCISE NODE NDL SUPERFICIAL LT,2362.0,845.6,82.79,5681.0,40
CDM,3527850,BX/EXCISE NODE NDL SUPERFICIAL RT,2362.0,845.6,82.79,5681.0,40
CDM,3528577,ASP&/INJ CYST/PELVIS RENAL BI,2064.0,738.91,90.4,5681.0,40
CDM,3528767,BX GLAND SALIVARY NDL,2229.0,797.98,51.61,5681.0,63
CDM,3528775,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,3932.0,1407.66,127.31,5681.0,40
CDM,3528783,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2621.0,938.32,127.31,5681.0,40
CDM,3528791,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2621.0,938.32,127.31,5681.0,40
CDM,3528833,INJ/S EPID TRFR L/S FL/CT GD 1LV BI,3699.0,1324.24,108.61,5681.0,40
CDM,3528841,INJ/S EPID TRFR L/S FL/CT GD 1LV LT,2466.0,882.83,108.61,5681.0,40
CDM,3528858,INJ/S EPID TRFR L/S FL/CT GD 1LV RT,2466.0,882.83,108.61,5681.0,40
CDM,3528957,CT ABDOMEN&PELVIS WO CNT,2913.0,483.56,103.45,2184.75,63
CDM,3528965,CT ABDOMEN&PELVIS W CNT,3642.0,604.57,220.29,2731.5,63
CDM,3528973,CT ABDOMEN&PELVIS W&WO CNT,4370.0,725.42,241.82,3277.5,63
CDM,3528999,CHOLECYSTOSTOMY PERC W IMG GD S&I,6790.0,2430.82,319.81,10257.38,63
CDM,3529120,CT ABDOMEN&PELVIS WO CNT,2913.0,483.56,103.45,2184.75,63
CDM,3529138,CT ABDOMEN&PELVIS W CNT,3642.0,604.57,220.29,2731.5,63
CDM,3529146,CT ABDOMEN&PELVIS W&WO CNT,4370.0,725.42,241.82,3277.5,63
CDM,3529435,INJ JT SI ANES/STRD FL/CT GD BI,989.0,354.06,80.83,5681.0,40
CDM,3529443,INJ JT SI ANES/STRD FL/CT GD LT,659.0,235.92,80.83,5681.0,40
CDM,3529450,INJ JT SI ANES/STRD FL/CT GD RT,659.0,235.92,80.83,5681.0,40
CDM,3529500,PARACENTESIS ABDOMINAL W IMG,2449.0,1882.45,102.12,6689.0,63
CDM,3529542,CTA ABDOMEN&PELVIS W CNT&PP,4589.0,761.77,241.82,3441.75,63
CDM,3529633,CTA ABDOMEN&PELVIS W CNT&PP,4589.0,761.77,241.82,3441.75,63
CDM,3529708,INJ CNT/AIR PERITONEAL CAVITY,555.0,198.69,86.4,5681.0,40
CDM,3529864,CT ABDOMEN&PELVIS W CNT RDC,3642.0,604.57,220.29,2731.5,40
CDM,3529880,PLC DEV/S RT GD INTRABD/PLVC/RETRO,3018.0,1080.44,178.16,5681.0,63
CDM,3530060,DST NRV PLEXUS CELIAC,2603.0,931.87,156.64,6689.0,63
CDM,3530078,CT REND 3D W I&R W PP SAME WRKST,440.0,75.24,15.22,1218.0,37
CDM,3530086,CT REND 3D W I&R W PP DIFF WRKST,542.0,92.68,39.51,1218.0,37
CDM,3530128,THORACENTESIS ASP W IMG LT,3045.0,1034.68,104.86,5681.0,40
CDM,3530136,THORACENTESIS ASP W IMG RT,3045.0,1034.68,104.86,5681.0,40
CDM,3530144,THORACENTESIS ASP W IMG BI,4568.0,1034.68,104.86,5681.0,40
CDM,3530185,DRN PLEURA INS CATH INDWL W IMG LT,2781.0,995.6,143.18,6689.0,40
CDM,3530193,DRN PLEURA INS CATH INDWL W IMG RT,2781.0,995.6,143.18,6689.0,40
CDM,3530201,DRN PLEURA INS CATH INDWL W IMG BI,4172.0,1493.58,143.18,6689.0,40
CDM,3530474,CHEMO CNS REQ PUNCTURE SPINAL,747.0,249.5,117.45,950.0,63
CDM,3530573,DRN CATH FLUID VISCERAL IMG GD,3029.0,1084.38,185.74,18194.0,63
CDM,3530581,DRN CATH FLUID PERI PERC IMG GD,3139.0,1123.76,185.74,18194.0,63
CDM,3530631,DRN CATH FLUID TISSUE SOFT IMG GD,3433.0,1229.01,129.89,6689.0,63
CDM,3530649,DRN CATH FLUID TRNSVAG/REC IMG GD,4214.0,1508.61,196.66,7704.0,63
CDM,3530797,INJ ANES GANGLION SPHENO LT,810.0,289.98,102.52,5681.0,40
CDM,3530805,INJ ANES GANGLION SPHENO RT,810.0,289.98,102.52,5681.0,40
CDM,3530813,INJ ANES GANGLION SPHENO BI,1215.0,434.97,102.52,5681.0,40
CDM,3530839,ASP INTERDISCAL DX PERC,2769.0,991.3,148.96,13802.9,63
CDM,3530847,INS TUBE GASTRO PERC S&I,3442.0,1232.24,194.08,6689.0,63
CDM,3530862,INS CATH PLEURAL INDWL W CUFF,5104.0,1827.23,195.82,18194.0,63
CDM,3531027,COLL FLUID SCLEROTX W IMG GD S&I,3139.0,1123.76,114.14,14124.0,63
CDM,3531068,BX/S MARROW BONE DX NP/UNI,1386.0,496.19,68.17,5681.0,63
CDM,3531076,BX/S MARROW BONE DX BI,2079.0,744.28,68.17,5681.0,40
CDM,3531084,ASP/S&BX/S MARROW BONE DX BI,2219.0,3566.39,72.77,5681.0,40
CDM,3531092,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,3566.39,72.77,5681.0,63
CDM,3531118,INSTILL AGENT FIBRIN TB/CTH 1ST DAY,2883.0,1032.11,64.77,5681.0,63
CDM,3531191,DST NRV PERIPH/BRANCH BI,2733.0,978.41,116.34,5681.0,40
CDM,3531209,DST NRV PERIPH/BRANCH LT,1822.0,652.28,116.34,5681.0,40
CDM,3531217,DST NRV PERIPH/BRANCH RT,1822.0,652.28,116.34,5681.0,40
CDM,3531225,ASP NEEDLE FINE BX CT GD LSN 1ST,2502.0,895.72,104.85,5681.0,63
CDM,3531233,ASP NEEDLE FINE BX CT GD LSN ADDL,1966.0,703.83,69.66,5681.0,40
CDM,3531258,EMB/OCCL VASC ARTERIAL S&I,13748.0,4921.78,451.13,32276.26,63
CDM,3531266,ASP CYST SPINAL CORD PERC,1822.0,652.28,319.3,5681.0,63
CDM,3531274,INJ ANES PLEXUS HYPOGASTRIC,1626.0,582.11,123.1,6689.0,63
CDM,3531282,INJ URETHROCYSTOGRAM RETROGRADE,350.0,125.3,62.38,4664.0,40
CDM,3531332,ABL TUMOR/S ADRENAL MICROWAVE CT GD,7263.0,2600.15,1229.0,10644.28,62
CDM,3531340,CT BODY WHOLE,4073.0,676.12,58.65,3054.75,62
CDM,3531357,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,63
CDM,3531431,DST NRV BR GENICULAR INCL IMG GD BI,4728.0,1692.62,142.66,6226.0,40
CDM,3531449,ABL RF JOINT SI INCL IMG GD BI,4640.0,1661.12,191.07,14124.0,40
CDM,3531456,ABL RF JOINT SI INCL IMG GD LT,3093.0,1107.29,191.07,14124.0,40
CDM,3531464,ABL RF JOINT SI INCL IMG GD RT,3093.0,1107.29,191.07,14124.0,40
CDM,3531506,DST NRV BR GENICULAR INCL IMG GD LT,3152.0,1128.42,142.66,6226.0,40
CDM,3531514,DST NRV BR GENICULAR INCL IMG GD RT,3152.0,1128.42,142.66,6226.0,40
CDM,3531522,PUNCT C1-C2 W INJ,1365.0,488.67,113.61,5681.0,63
CDM,3531530,DST NRV INTERCOSTAL,2290.0,819.82,173.7,5681.0,63
CDM,3531639,RPLC G-TUBE WO GD/ENDO WO TRACT REV,1360.0,486.88,36.09,5681.0,63
CDM,3531662,EXCHG TUBE CHEST VIA WIRE,740.0,264.92,333.0,7390.37,62
CDM,3531738,ABL RF TUMOR/S KIDNEY PERC BI,13457.0,4817.61,328.6,10257.38,40
CDM,3531837,ABL CRYO TUMOR/S KIDNEY PERC BI,17942.0,6423.24,438.26,18194.0,40
CDM,3531886,INJ ANES GANGLION STELLA LT,2187.0,782.95,75.18,5681.0,40
CDM,3531894,INJ ANES GANGLION STELLA RT,2187.0,782.95,75.18,5681.0,40
CDM,3531902,INJ ANES GANGLION STELLA BI,3281.0,1174.6,75.18,5681.0,40
CDM,3531944,INJ PSEUDOANEURYSM EXT LT,1019.0,364.8,99.7,5681.0,40
CDM,3531951,INJ PSEUDOANEURYSM EXT RT,1019.0,364.8,99.7,5681.0,40
CDM,3531969,INJ PSEUDOANEURYSM EXT BI,1529.0,547.38,99.7,5681.0,40
CDM,3532009,DISRUPTION FIBRIN SHEATH BALLOON,4597.0,1645.73,392.67,6689.0,62
CDM,3532322,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3433.0,2599.15,146.11,14124.0,63
CDM,3532330,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3433.0,2599.15,146.11,14124.0,63
CDM,3532348,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3433.0,2599.15,146.11,14124.0,63
CDM,3532397,CT LOW DOSE SCRN CA LUNG WO CNT,538.0,89.31,79.0,1218.0,63
CDM,3532405,CT LOW DOSE SCRN CA LUNG WO CNT,538.0,89.31,79.0,1218.0,63
CDM,3532413,ECMO/ECLS ART INIT,3157.0,1038.75,325.57,13802.9,40
CDM,3532421,ECMO/ECLS INS CAN PERPH PERC 6+YRS,3254.0,1070.66,405.06,13802.9,40
CDM,3532439,THROMBECT MECH PRIM ART INIT BI,20705.0,7412.39,407.99,18194.0,40
CDM,3532454,THROMBECT MECH PRIM ART INIT LT,13803.0,4941.47,407.99,18194.0,40
CDM,3532462,THROMBECT MECH PRIM ART INIT RT,13803.0,4941.47,407.99,18194.0,40
CDM,3532520,THROMBECT MECH PRIM ART INIT NP/UNI,13803.0,4941.47,407.99,32276.26,63
CDM,3532538,DST NRV BV IO L/S IMG GD LVL 1-2,11313.0,4050.05,403.8,22604.88,63
CDM,3532546,DST NRV BV IO L/S IMG GD ADDL LVL,4376.0,1566.61,190.99,5681.0,38
CDM,3532553,ABL MASS MESENTERIC ALCOHOL PERC,7806.0,2794.55,586.96,5854.5,62
CDM,3532827,DST NRV PUDENDAL,1822.0,652.28,186.82,6689.0,63
CDM,3532892,DST NRV INTERCOSTAL,2290.0,819.82,173.7,5681.0,63
CDM,3533015,ANGIO ARTERY CAR EXT WO BASE PROC,3327.0,1191.07,392.67,6689.0,62
CDM,3533122,BX FAT PAD ABDOMINAL NDL PERC,1267.0,453.59,130.17,5681.0,62
CDM,3533163,INJ ANES GANGLION IMPAR CT GD,1305.0,467.19,189.35,5681.0,62
CDM,3533189,BX FAT PAD ABDOMINAL NDL PERC,1267.0,453.59,130.17,5681.0,62
CDM,3533197,ABL CRYO LYMPH NODE RETROPERIT PERC,11961.0,4282.04,586.96,8970.75,62
CDM,3533346,BX FAT PAD ABDOMINAL NDL PERC,1267.0,453.59,130.17,5681.0,62
CDM,3533379,REPOS CATH DRN PERTNL TUN W FL GD,4099.0,1467.44,586.96,5681.0,62
CDM,3533486,EMB PSEUDOANEURYSM CAROTID FL GD,13034.0,4666.17,392.67,9775.5,62
CDM,3533551,PLCMT MARKER SPINE THOR FLUORO GD,1500.0,537.0,149.49,5681.0,62
CDM,3533585,BRACHY N-STRND P-103/SRCE,251.0,71.79,50.39,291.96,65
CDM,3533635,FFR COR ANLY SW CTA W I&R PHYS/QHCP,4898.0,1435.11,666.87,4269.99,63
CDM,3533783,PLC STNT&GRF ART CAR OTH THN STENOS,9840.0,3522.72,392.67,7380.0,62
CDM,3533809,BX BLADDER NDL PERC,1856.0,664.45,192.95,5681.0,62
CDM,3533858,EMB/OCCL VASC TMRS/ORG W CTH PG S&I,13768.0,4928.94,3873.92,32276.26,62
CDM,3533874,REM STENT URETER CONDUIT ILEAL,2375.0,850.25,192.95,5681.0,62
CDM,3533999,CT ABDOMEN&PELVIS W CNT RDC,3642.0,604.57,220.29,2731.5,40
CDM,3534021,3D MODEL ANTMC PRINTED COMP 1ST,3080.0,526.68,14.72,2310.0,61
CDM,3534039,3D MODEL ANTMC PRINTED COMP EA ADD,770.0,131.67,3.92,1218.0,35
CDM,3534047,3D MODEL ANTMC PRINTED GUIDE 1ST,3300.0,564.3,31.25,2475.0,61
CDM,3534054,3D MODEL ANTMC PRINTED GUIDE EA ADD,990.0,169.29,3.92,1218.0,35
CDM,3534120,BX MASS CUFF VAGINAL NDL PERC,2983.0,1067.91,123.48,5681.0,62
CDM,3534195,QUAN&CHAR PLAQ ATHEROSCLEROTIC COR,1750.0,299.25,572.25,3916.93,62
CDM,3534211,CT PERFUSION CEREBRAL W CNT ADD-ON,1221.0,208.79,175.95,1218.0,34
CDM,3534229,CT PERFUSION CEREBRAL W CNT,1886.0,322.51,129.92,1414.5,62
CDM,3534237,GD LOC VOL TARGET DELIVERY TX RAD,349.0,160.89,64.91,2724.0,40
CDM,3534328,CTA HEAD&NECK W&WO CNT&PP,4083.0,698.19,258.41,3062.25,62
CDM,3534484,ABL ETOH NODULE NECK,1545.0,553.11,130.17,5681.0,62
CDM,3534583,DSRPT WIRE&INST AGNT FIBRIN CTH ABD,2135.0,764.33,586.96,5681.0,62
CDM,3534658,RPLC TUBE GASTRO/CECOSTOMY,1007.0,360.51,453.15,5681.0,62
CDM,3534666,CREATE 3D DIG MDL SMF INT 30MN,1540.0,263.34,137.3,1218.0,50
CDM,3534674,CREATE 3D DIG MDL SMF ADDL 30MN,330.0,56.43,47.55,1218.0,27
CDM,3534682,CREATE 3D DIG MDL SMF&SIM INT 60MN,1100.0,188.1,137.3,1218.0,50
CDM,3534690,CREATE 3D DIG MDL SMF&SIM ADDL 30MN,330.0,56.43,47.55,1218.0,27
CDM,3534708,CREATE 3D DIG MDL SMF&SIM&CA INT90M,1650.0,282.15,137.3,1237.5,50
CDM,3534716,CREATE 3D DIG MDL SMF&SIM&CA ADD30M,385.0,65.84,55.48,1218.0,27
CDM,3534724,GENERATE 3D PREDICT MDL CCTA&/MRI,1375.0,235.13,32.76,1511.98,60
CDM,3534732,CREATE 3D DIG MDL SMF INT 30MN,1540.0,295.68,137.3,1618.0,50
CDM,3534740,CREATE 3D DIG MDL SMF ADDL 30MN,330.0,63.36,47.55,1618.0,27
CDM,3534757,CREATE 3D DIG MDL SMF&SIM INT 60MN,1100.0,211.2,137.3,1618.0,50
CDM,3534765,CREATE 3D DIG MDL SMF&SIM ADDL 30MN,330.0,63.36,47.55,1618.0,27
CDM,3534773,CREATE 3D DIG MDL SMF&SIM&CA INT90M,1650.0,316.8,137.3,1618.0,50
CDM,3534781,CREATE 3D DIG MDL SMF&SIM&CA ADD30M,385.0,73.92,55.48,1618.0,27
CDM,3534799,GENERATE 3D PREDICT MDL CCTA&/MRI,1375.0,264.0,32.76,1618.0,60
CDM,3598950,CTA AORTA ABD RUNOFF W CNT,1824.0,311.9,129.45,1832.84,63
CDM,3602000,OR LEVEL 1 FIRST 30MIN,6435.0,1570.14,927.28,4826.25,27
CDM,3602018,OR LEVEL 1 ADDL 15MIN,2090.0,509.96,301.17,1567.5,27
CDM,3602026,OR LEVEL 2 FIRST 30MIN,7685.0,1875.14,1107.41,5763.75,27
CDM,3602034,OR LEVEL 2 ADDL 15MIN,2590.0,631.96,373.22,1942.5,27
CDM,3602042,OR LEVEL 3 FIRST 30MIN,8935.0,2180.14,1287.53,6701.25,27
CDM,3602059,OR LEVEL 3 ADDL 15MIN,3090.0,753.96,445.27,2317.5,27
CDM,3602067,OR LEVEL 4 FIRST 30MIN,10195.0,2487.58,1469.1,7646.25,27
CDM,3602075,OR LEVEL 4 ADDL 15MIN,3885.0,947.94,559.83,2913.75,27
CDM,3602083,OR LEVEL 5 FIRST 30MIN,12695.0,3097.58,1829.35,9521.25,27
CDM,3602091,OR LEVEL 5 ADDL 15MIN,4885.0,1191.94,703.93,3663.75,27
CDM,3602109,OR LEVEL 6 FIRST 30MIN,15195.0,3707.58,2189.6,11396.25,27
CDM,3602117,OR LEVEL 6 ADDL 15MIN,5885.0,1435.94,848.03,4413.75,27
CDM,3602208,CVOR LEVEL 1 FIRST 30MIN,6435.0,1570.14,927.28,4826.25,27
CDM,3602216,CVOR LEVEL 1 ADDL 15MIN,2090.0,509.96,301.17,1567.5,27
CDM,3602224,CVOR LEVEL 2 FIRST 30MIN,7685.0,1875.14,1107.41,5763.75,27
CDM,3602232,CVOR LEVEL 2 ADDL 15MIN,2590.0,631.96,373.22,1942.5,27
CDM,3602240,CVOR LEVEL 3 FIRST 30MIN,8935.0,2180.14,1287.53,6701.25,27
CDM,3602257,CVOR LEVEL 3 ADDL 15MIN,3090.0,753.96,445.27,2317.5,27
CDM,3602265,CVOR LEVEL 4 FIRST 30MIN,10195.0,2487.58,1469.1,7646.25,27
CDM,3602273,CVOR LEVEL 4 ADDL 15MIN,3885.0,947.94,559.83,2913.75,27
CDM,3602281,CVOR LEVEL 5 FIRST 30MIN,12695.0,3097.58,1829.35,9521.25,27
CDM,3602299,CVOR LEVEL 5 ADDL 15MIN,4885.0,1191.94,703.93,3663.75,27
CDM,3602307,CVOR LEVEL 6 FIRST 30MIN,15195.0,3707.58,2189.6,11396.25,27
CDM,3602315,CVOR LEVEL 6 ADDL 15MIN,5885.0,1435.94,848.03,4413.75,27
CDM,3602802,OR LEVEL 1 FIRST 30MIN,6435.0,1570.14,927.28,4826.25,27
CDM,3602810,OR LEVEL 1 ADDL 15MIN,2090.0,509.96,301.17,1567.5,27
CDM,3602828,OR LEVEL 2 FIRST 30MIN,7685.0,1875.14,1107.41,5763.75,27
CDM,3602836,OR LEVEL 2 ADDL 15MIN,2590.0,631.96,373.22,1942.5,27
CDM,3602844,OR LEVEL 3 FIRST 30MIN,8935.0,2180.14,1287.53,6701.25,27
CDM,3602851,OR LEVEL 3 ADDL 15MIN,3090.0,753.96,445.27,2317.5,27
CDM,3602869,OR LEVEL 4 FIRST 30MIN,10195.0,2487.58,1469.1,7646.25,27
CDM,3602877,OR LEVEL 4 ADDL 15MIN,3885.0,947.94,559.83,2913.75,27
CDM,3602885,OR LEVEL 5 FIRST 30MIN,12695.0,3097.58,1829.35,9521.25,27
CDM,3602893,OR LEVEL 5 ADDL 15MIN,4885.0,1191.94,703.93,3663.75,27
CDM,3602901,OR LEVEL 6 FIRST 30MIN,15195.0,3707.58,2189.6,11396.25,27
CDM,3602919,OR LEVEL 6 ADDL 15MIN,5885.0,1435.94,848.03,4413.75,27
CDM,3603321,LAVAGE BRONCH ALVEO WO SCOPE,1054.0,377.33,119.18,5681.0,62
CDM,3604048,ESWT/ESWL FIRST 30MIN,13065.0,5617.95,1882.67,18194.0,27
CDM,3604055,ESWT/ESWL ADDL 15MIN,5805.0,2496.15,836.5,18194.0,27
CDM,3604063,ESWT/ESWL FIRST 30MIN,13065.0,5617.95,1882.67,18194.0,27
CDM,3604071,ESWT/ESWL ADDL 15MIN,5805.0,2496.15,836.5,18194.0,27
CDM,3604659,MONITOR NEURO 1:1 IN OR 15MIN,254.0,226.82,31.17,711.0,39
CDM,3604758,ECMO/ECLS VENOUS INIT,2273.0,747.89,294.17,13802.9,40
CDM,3604766,ECMO/ECLS ART INIT,3157.0,1038.75,325.57,13802.9,40
CDM,3604774,ECMO/ECLS VENOUS MGMT SUBSQ DAY,2601.0,855.81,226.93,6904.78,40
CDM,3604782,ECMO/ECLS ART MGMT SUBSQ DAY,2525.0,830.8,221.59,6904.78,40
CDM,3604790,ECMO/ECLS VENOUS INIT,2273.0,747.89,294.17,13802.9,40
CDM,3604808,ECMO/ECLS ART INIT,3157.0,1038.75,325.57,13802.9,40
CDM,3604816,ECMO/ECLS VENOUS MGMT SUBSQ DAY,2601.0,855.81,226.93,6904.78,40
CDM,3604824,ECMO/ECLS ART MGMT SUBSQ DAY,2525.0,830.8,221.59,6904.78,40
CDM,3604832,ECMO/ECLS VENOUS INIT,2273.0,747.89,294.17,13802.9,40
CDM,3604840,ECMO/ECLS ART INIT,3157.0,1038.75,325.57,13802.9,40
CDM,3604857,ECMO/ECLS VENOUS MGMT SUBSQ DAY,2601.0,855.81,226.93,6904.78,40
CDM,3604865,ECMO/ECLS ART MGMT SUBSQ DAY,2525.0,830.8,221.59,6904.78,40
CDM,3690047,BRONCHOSCOPY DIAGNOSTIC,3433.0,1229.01,494.7,2574.75,27
CDM,3701075,SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,39
CDM,3701083,SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CDM,3701091,SED MOD ENDO SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CDM,3701109,SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,39
CDM,3701141,SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,39
CDM,3701158,SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CDM,3701166,SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,39
CDM,3701174,SED MOD DIFF 0-4Y INIT 15MN,525.0,166.95,80.25,752.08,39
CDM,3701182,SED MOD DIFF 5+Y INIT 15MN,580.0,184.44,72.74,614.45,39
CDM,3701190,SED MOD DIFF ADDL 15MN,265.0,84.27,49.29,465.97,39
CDM,3702107,ANESTHESIA LEVEL 1 FIRST 30MIN,1395.0,443.61,201.02,1046.25,29
CDM,3702115,ANESTHESIA LEVEL 2 FIRST 30MIN,1895.0,602.61,273.07,1421.25,29
CDM,3702123,ANESTHESIA LEVEL 3 FIRST 30MIN,2395.0,761.61,345.12,1796.25,29
CDM,3702131,ANESTHESIA LEVEL 4 FIRST 30MIN,2895.0,920.61,417.17,2171.25,29
CDM,3705100,ANESTHESIA LEVEL 1 ADDL 15MIN,555.0,176.49,79.98,416.25,29
CDM,3705118,ANESTHESIA LEVEL 2 ADDL 15MIN,655.0,208.29,94.39,491.25,29
CDM,3705126,ANESTHESIA LEVEL 3 ADDL 15MIN,755.0,240.09,108.8,566.25,29
CDM,3705134,ANESTHESIA LEVEL 4 ADDL 15MIN,955.0,303.69,137.62,716.25,29
CDM,38570,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,3900040,PLATELETS PATHOGEN RDC VOL RDC EA,1752.0,448.51,343.0,5243.11,62
CDM,3900230,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,3900248,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,3900255,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,3900297,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,3900305,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,3900313,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,3902020,LAB POOLING PLATELETS/BLOOD PROD,363.0,92.93,1.84,381.0,63
CDM,3902038,LAB COOMBS DIR ANTISERUM EA,126.0,23.94,5.39,94.5,63
CDM,3902046,LAB COOMBS INDIRECT REAGENT EA,363.0,68.97,5.72,272.25,63
CDM,3902053,CRYOPRECIPITATE EA UNIT,89.0,22.78,29.1,598.68,63
CDM,3902087,FFP FRZ WITHIN 8 HRS COLL EA UNIT,93.0,23.81,30.41,381.0,63
CDM,3902103,LAB HEMOLYSINS&AGGLUTININS INCUBATE,37.0,7.03,12.11,63.79,63
CDM,3902111,PLASMA CRYOPRECIPITATE RDC EA UNIT,442.0,113.15,47.63,738.97,63
CDM,3902129,FFP FRZ 8-24 HRS AFTER COLL EA UNIT,93.0,23.81,30.41,381.0,63
CDM,3902277,PLATELETS PHER LR EA UNIT,731.0,187.14,239.04,4456.84,63
CDM,3902285,PLATELETS PHER LR IRRD EA UNIT,787.0,201.47,257.35,4789.44,63
CDM,3902319,LAB BLOOD TYPE AG RBC EA,760.0,130.72,3.83,570.0,63
CDM,3902327,LAB PANEL AB RBC EA TECH SERUM,760.0,130.72,2.44,631.11,63
CDM,3902335,LAB SCR AB RBC SERUM EA,131.0,22.53,9.77,98.25,63
CDM,3902384,RBC LR AUTO EA UNIT,714.0,182.78,136.67,898.02,63
CDM,3902418,RBC LR IRRD EA UNIT,350.0,89.6,114.45,545.46,63
CDM,3902442,LAB PRETREAT RBC INCUB ENZYME,363.0,62.44,1.33,530.82,63
CDM,3902483,LAB SPLITTING BLOOD/BLOOD PROD EA,363.0,62.44,1.45,299.97,63
CDM,3902525,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,3902533,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,3902541,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,3902558,LAB BLOOD TYPE AG RBC EA NS,760.0,130.72,3.83,570.0,63
CDM,3902632,RBC LR EA UNIT,294.0,75.26,96.14,898.02,63
CDM,3902681,RBC WASHED EA UNIT,441.0,112.9,144.21,917.98,63
CDM,3902707,FFP FRZ WITHIN 8 HRS COLL PHER EA,93.0,23.81,30.41,381.0,63
CDM,3902715,BLOOD WHOLE LR EA UNIT,650.0,166.4,108.85,598.68,63
CDM,3902749,HLA MATCH,250.0,43.0,17.89,376.04,62
CDM,3902780,RBC WASHED IRRD LR EA UNIT,497.0,127.23,162.52,917.98,63
CDM,3902830,GRANULOCYTES PHER IRRD EA UNIT,5385.0,1378.56,343.0,4038.75,40
CDM,3902848,RBC DGLC LR EA UNIT,891.0,228.1,215.21,798.24,63
CDM,3902855,BLOOD WHOLE LR IRRD EA UNIT,706.0,180.74,88.31,798.24,63
CDM,3902871,RBC LR IRRD DGLC EA UNIT,700.0,179.2,188.93,798.24,63
CDM,3902913,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,3902921,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,3902939,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,3903234,BLOOD UNIT SPLIT RBC LR,135.0,34.56,44.15,381.0,63
CDM,3903242,BLOOD UNIT SPLIT PLASMA FROZEN,54.0,13.82,17.66,381.0,63
CDM,3903515,PLATELETS PHER LR IRRD WASHED EA,934.0,239.1,305.42,4789.44,63
CDM,3903572,PLATELETS PATHOGEN RDC EA UNIT,1875.0,480.0,343.0,5243.11,62
CDM,3903580,BLOOD UNIT SPLIT PLATELET ALIQUOTS,379.0,97.02,83.26,381.0,63
CDM,3903598,BLOOD UNIT SPLIT PLATELET PTHGN RDC,379.0,97.02,83.26,381.0,63
CDM,3903606,BLOOD UNIT SPLIT DEGLYCEROLIZED,404.0,103.42,83.26,381.0,63
CDM,3903614,PLATELETS PATHOGEN RDC WASHED EA,1752.0,448.51,343.0,5243.11,62
CDM,3903630,LAB DET IA RSV PRB AMP,211.0,46.63,70.2,329.47,63
CDM,3903663,LAB DET AB ONC SRM MRKL CLL QN,969.0,166.67,139.63,6612.09,59
CDM,3903689,LAB CHROMAT MS NON-DRUG QL/QN,75.0,12.0,24.09,113.08,63
CDM,3903697,LAB AQUAPORIN 4 AB FLOW CYTO MAYO,575.0,109.25,12.05,431.25,63
CDM,3903705,LAB AB CYTOM FLOW MOG MAYO,654.0,124.26,12.05,490.5,63
CDM,3903713,LAB STAIN SPECIAL 2 PROT AMYLOID,326.0,90.63,24.53,340.72,63
CDM,3903721,LAB MICRODISSECTION LASER PROT AMYL,202.0,56.16,37.57,539.47,39
CDM,3903739,LAB CHROMAT MS PROT AMYLOID QN,909.0,145.44,24.09,681.75,63
CDM,3903762,LAB DET AB ONC SRM MRKL CLL +/- NS,969.0,166.67,139.63,6612.09,59
CDM,3903788,LAB IMM MS ALPHA 2 MACROGLOBULIN,59.0,9.44,11.53,54.08,63
CDM,3903978,LAB DRG DF ETOH BIOMRK 1-2,130.0,20.8,13.47,97.5,37
CDM,3904000,LAB HEPCIDIN-25 SERUM/PLASMA ELISA,230.0,64.17,17.27,172.5,59
CDM,3904042,LAB DET AG IA IMM ENZ BLASTOMYCES,130.0,28.73,11.98,97.5,63
CDM,3904059,LAB IMM GANGLIOSIDE AB,67.0,10.72,11.53,54.08,63
CDM,3904067,LAB SUSCPT MICRODILUTION PLATE EA,60.0,13.26,8.65,45.0,63
CDM,3904109,LAB DET IA DENGUE TYPES 1-4 PRB AMP,290.0,64.09,35.09,217.5,63
CDM,3904117,LAB AB VIRUS DENGUE,70.0,13.3,12.88,60.47,63
CDM,3904166,LAB AB ID PLATELET IGG FLOW CYTO,236.0,44.84,18.37,177.0,63
CDM,3904174,LAB METFORMIN,189.0,30.24,18.64,141.75,63
CDM,3904216,LAB EOSINOPHILS URINE/OTHER,57.0,10.43,10.6,176.48,37
CDM,3904224,LAB IMM MATRIX METALLOPROTEINASE-7,377.0,60.32,17.27,282.75,63
CDM,3904240,LAB GENE SEQ THROMBOCYTOSIS PANEL,925.0,258.08,172.05,883.39,37
CDM,3904257,LAB DRG DF AMPH/METH DAY 1-2,156.0,24.96,23.37,117.0,37
CDM,3904265,LAB DRG DF METHYLENEDIOXYAMPH,156.0,24.96,23.37,117.0,37
CDM,3904273,LAB CHROMAT MS PESTICIDE,1823.0,291.68,24.09,1367.25,63
CDM,3904356,LAB LINEZOLID,155.0,24.8,18.64,116.25,63
CDM,3904364,LAB IMM MS NATALIZUMAB AB,337.0,53.92,11.53,252.75,63
CDM,3904372,LAB IMM MS DESMOGLEIN,143.0,22.88,11.53,107.25,63
CDM,3904398,LAB GENE NAT2 VARIES,908.0,253.33,168.89,883.39,37
CDM,3904406,LAB DIS INFCT CSF MNGS ANLYS,6379.0,1779.74,2085.93,4784.25,62
CDM,3904422,LAB CHOLESTEROL FLUID BODY,55.0,8.8,10.23,176.48,37
CDM,3904430,LAB IMM AB QN HAEMOPHILUS INFLU B,63.0,11.97,14.99,70.38,63
CDM,3904513,LAB ACTIVITY ENZYME L-ASPARAGNSE,325.0,52.0,22.17,243.75,63
CDM,3904521,LAB CHROMAT MS N-METHYLHIST URINE,115.0,18.4,24.09,113.08,63
CDM,3904612,LAB DET IA HEPATITIS D PCR PRB AMP,371.0,81.99,35.09,278.25,63
CDM,3904620,LAB GSAP DNA NPLSM SO IFSV MSI NGN,2691.0,750.79,879.96,3558.75,62
CDM,3904653,LAB AB TREPONEMA PALLIDUM CONF CSF,77.0,14.63,13.24,62.13,63
CDM,3904661,LAB AB ENA SCLERODERMA PANEL,161.0,30.59,17.93,120.75,63
CDM,3904679,LAB CHOLINESTERASE PLASMA,55.0,8.8,7.87,41.25,63
CDM,3904695,LAB IMM MS C1Q AB,156.0,24.96,11.53,117.0,63
CDM,3904729,PLATELETS PATHOGEN RDC LOW YIELD EA,1875.0,480.0,343.0,5243.11,62
CDM,3904737,PLATELETS PATHOGEN PHER LOW YIELDEA,1875.0,480.0,343.0,5243.11,62
CDM,3904745,PLATELETS PHER LR IRRD LOW YIELD EA,2042.0,522.75,343.0,4789.44,63
CDM,3904760,PLATELETS PHER LR LOW YIELD EA,1875.0,480.0,343.0,4456.84,63
CDM,3904786,LAB IMM MS ANTI GMCSF AB,197.0,31.52,11.53,147.75,63
CDM,39271,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,39347,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,39388,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,39461,R&B ICU,11728.0,3858.86,5277.6,8796.0,5
CDM,4002036,ASP&/INJ JT/BUR MAJ WO US GD BI,1260.0,451.08,44.27,5681.0,40
CDM,4002044,ASP&/INJ JT/BUR MAJ WO US GD LT,840.0,300.72,44.27,5681.0,40
CDM,4002051,ASP&/INJ JT/BUR MAJ WO US GD RT,840.0,300.72,44.27,5681.0,40
CDM,4002069,US BREAST CMP LT,409.0,142.74,66.49,449.06,40
CDM,4002077,US BREAST CMP RT,409.0,142.74,66.49,449.06,40
CDM,4002085,US BREAST LTD LT,323.0,112.73,51.57,333.39,40
CDM,4002093,US BREAST LTD RT,323.0,112.73,51.57,333.39,40
CDM,4002226,ASP&/INJ JT/BUR MAJ W US GD BI,2057.0,736.41,57.43,5681.0,40
CDM,4002234,ASP&/INJ JT/BUR MAJ W US GD LT,1371.0,490.82,57.43,5681.0,40
CDM,4002242,ASP&/INJ JT/BUR MAJ W US GD RT,1371.0,490.82,57.43,5681.0,40
CDM,4002267,ASP&/INJ JT/BUR INTR W US GD BI,1811.0,648.34,50.61,5681.0,40
CDM,4002275,ASP&/INJ JT/BUR INTR W US GD LT,1207.0,432.11,50.61,5681.0,40
CDM,4002283,ASP&/INJ JT/BUR INTR W US GD RT,1207.0,432.11,50.61,5681.0,40
CDM,4002291,ASP&/INJ JT/BUR SM W US GD BI,1577.0,564.57,44.48,5681.0,40
CDM,4002309,ASP&/INJ JT/BUR SM W US GD LT,1051.0,376.26,44.48,5681.0,40
CDM,4002317,ASP&/INJ JT/BUR SM W US GD RT,1051.0,376.26,44.48,5681.0,40
CDM,4002382,US BREAST LTD BI,485.0,169.26,51.57,363.75,40
CDM,4002416,US BREAST CMP BI,614.0,214.29,66.49,460.5,40
CDM,4002937,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,4002945,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,4002952,TEST NONSTRESS FETAL,626.0,559.02,19.76,711.0,63
CDM,4002960,INS DILATOR CERVICAL,1608.0,575.66,42.9,5681.0,63
CDM,4003034,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,4003042,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,4003059,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,4003067,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,4003075,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,4003083,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,40121,R&B OBSTETRICS SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,40162,R&B OBSTETRICS SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,40246,R&B OBSTETRICS SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4028,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4030011,ABL RF TUMOR/S LIVER PERC,9095.0,3256.01,704.21,10644.28,63
CDM,4030029,AMNIOCENTESIS DIAGNOSTIC,1473.0,527.33,78.34,5681.0,63
CDM,4030045,ASP BLADDER NDL,742.0,265.64,37.89,5681.0,63
CDM,4030052,ASP BLADDER TROCAR/CATH,1374.0,491.89,49.33,5681.0,63
CDM,4030128,ASP PUNCT ABSCESS/CYST,651.0,233.06,94.84,5681.0,63
CDM,4030136,ASP&/INJ CYST THYROID,1291.0,462.18,46.82,5681.0,63
CDM,4030169,ASP&/INJ CYST/PELVIS RENAL LT,1376.0,492.61,90.4,5681.0,40
CDM,4030177,ASP&/INJ CYST/PELVIS RENAL RT,1376.0,492.61,90.4,5681.0,40
CDM,4030268,BX MASS ABD/RETRO NDL PERC,2983.0,1067.91,79.3,5681.0,63
CDM,4030383,BX LIVER NDL PERC,3139.0,3104.87,84.42,5681.0,63
CDM,4030409,BX MUSCLE NDL PERC,2139.0,765.76,55.27,5681.0,63
CDM,4030425,BX PANCREAS NDL PERC,2435.0,871.73,226.28,5681.0,63
CDM,4030458,BX RENAL TROCAR/NDL PERC LT,3132.0,3245.64,121.75,5681.0,40
CDM,4030466,BX RENAL TROCAR/NDL PERC RT,3132.0,3245.64,121.75,5681.0,40
CDM,4030474,BX THYROID NDL CORE PERC,1291.0,462.18,73.96,5681.0,63
CDM,4030557,I&D HEMATOMA/SEROMA/FLUID,3139.0,1123.76,116.33,5681.0,63
CDM,4030649,INJ SIS/HYSTEROSALPINGOGRAPHY,501.0,179.36,56.32,5681.0,40
CDM,4030664,INJ PSEUDOANEURYSM EXT RT,1019.0,364.8,99.7,5681.0,40
CDM,4030680,ASP BLADDER W INS CATH SUPRAPUBIC,3433.0,1229.01,137.96,6226.0,63
CDM,4030847,US UTERUS PREG DETAIL GEST ADDL,920.0,321.08,62.26,835.67,37
CDM,4030854,US ABDOMEN CMP,640.0,223.36,76.51,508.37,63
CDM,4030862,US ABDOMEN LTD,532.0,214.99,58.06,449.06,63
CDM,4030870,US PROFILE BIO FETAL W NST ADDL,633.0,220.92,67.38,474.75,40
CDM,4030888,US PROFILE BIO FETAL WO NST,414.0,144.49,48.28,449.06,63
CDM,4030896,US PROFILE BIO FETAL WO NST ADDL,414.0,144.49,48.28,449.06,40
CDM,4030904,US PROFILE BIO FETAL W NST,633.0,220.92,67.38,494.34,63
CDM,4030953,US CHEST,424.0,147.98,29.5,449.06,63
CDM,4031027,ECHO DOPP FETAL CMP,500.0,174.5,41.5,449.06,63
CDM,4031092,US GD INTRAOPERATIVE,679.0,236.97,24.58,509.25,37
CDM,4031100,US GD AMNIOCENTESIS S&I,260.0,90.74,14.89,195.0,37
CDM,4031142,US GD PLCMT NEEDLE S&I,507.0,176.94,27.55,380.25,37
CDM,4031167,US GD ABLATION TISSUE,372.0,129.83,12.79,370.32,37
CDM,4031175,US HIPS INFANT DYNAMIC,522.0,182.18,58.65,594.69,63
CDM,4031183,US HIPS INFANT STATIC,401.0,139.95,58.65,435.74,63
CDM,4031191,SONOHYSTEROGRAPHY INF SALINE,461.0,160.89,80.13,948.33,63
CDM,4031225,US HEAD NEONATAL,506.0,176.59,79.0,498.37,63
CDM,4031241,US UTERUS PREG 0-13WK GEST ADDL,227.0,79.22,20.45,264.93,37
CDM,4031258,US UTERUS PREG 0-13WK GEST SGL,495.0,172.76,69.09,508.29,63
CDM,4031266,US UTERUS PREG 14+WK GEST ADDL,344.0,120.06,40.21,381.34,37
CDM,4031274,US UTERUS PREG 14+WK GEST SGL,569.0,198.58,79.0,583.82,63
CDM,4031282,US UTERUS PREG DETAIL GEST SGL,773.0,269.78,85.88,948.33,63
CDM,4031290,US UTERUS PREG RE-EVAL FETUS,421.0,146.93,68.12,474.46,63
CDM,4031308,US UTERUS PREG RE-EVAL FETUS ADDL,421.0,146.93,68.12,449.06,40
CDM,4031316,US UTERUS PREG LTD 1+ FETUS,329.0,114.82,49.3,449.06,63
CDM,4031324,US UTERUS PREG TRANSVAGINAL,437.0,152.51,55.78,449.06,63
CDM,4031332,US PELVIS NON OB CMP,504.0,175.9,71.36,459.04,63
CDM,4031340,US PELVIS NON OB LTD,426.0,148.67,25.6,449.06,63
CDM,4031357,US GD W PLC CATH DRN PERC S&I,962.0,335.74,55.46,721.5,37
CDM,4031399,US GD RPR PSEUDOAN ART/FISTULA AV,625.0,218.12,163.78,1128.44,63
CDM,4031407,US RETROPERITONEAL LTD,438.0,152.86,31.77,449.06,63
CDM,4031415,US RETROPERITONEAL CMP,608.0,212.19,71.68,470.82,63
CDM,4031423,US SCROTUM&CONTENTS,479.0,167.17,68.44,449.06,63
CDM,4031431,US TISSUE SOFT HEAD&NECK,498.0,173.8,79.0,483.77,63
CDM,4031449,US SPINAL CANAL&CONTENTS,632.0,220.57,79.0,630.07,63
CDM,4031464,US TRANSRECTAL,630.0,219.87,79.0,875.38,63
CDM,4031472,US TRANSVAGINAL,590.0,205.91,79.0,518.9,63
CDM,4031597,ASP PUNCT CYST BREAST ADDL LT,670.0,239.86,20.27,5681.0,40
CDM,4031605,ASP PUNCT CYST BREAST ADDL RT,670.0,239.86,20.27,5681.0,40
CDM,4031621,ASP PUNCT CYST BREAST INIT LT,1291.0,462.18,40.83,5681.0,40
CDM,4031639,ASP PUNCT CYST BREAST INIT RT,1291.0,462.18,40.83,5681.0,40
CDM,4031860,INJ DUCTO/GALACTOGRAM MAMMARY BI,1346.0,481.87,73.04,5681.0,40
CDM,4031878,INJ DUCTO/GALACTOGRAM MAMMARY LT,897.0,321.13,73.04,5681.0,40
CDM,4031886,INJ DUCTO/GALACTOGRAM MAMMARY RT,897.0,321.13,73.04,5681.0,40
CDM,4032116,DXA STUDY DENSITY 1+SKEL AX,442.0,124.64,28.85,449.06,63
CDM,4032124,DXA STUDY DENSITY 1+SKEL APPEND,176.0,49.63,21.71,333.39,63
CDM,4032132,DUCTO/GALACTOGRAM MAMMARY MULTI S&I,676.0,190.63,47.02,948.33,63
CDM,4032140,DUCTO/GALACTOGRAM MAMMARY SGL LTS&I,520.0,146.64,35.99,948.33,40
CDM,4032157,DUCTO/GALACTOGRAM MAMMARY SGL RTS&I,520.0,146.64,35.99,948.33,40
CDM,4032405,US DUPLEX ART EXT UPR UNI/LTD LT,1106.0,294.2,79.0,1105.36,40
CDM,4032413,US DUPLEX ART EXT LWR UNI/LTD RT,1240.0,329.84,79.0,1239.07,40
CDM,4032421,US DUPLEX ART EXT LWR UNI/LTD LT,1240.0,329.84,79.0,1239.07,40
CDM,4032439,US DUPLEX ART EXT UPR UNI/LTD RT,1106.0,294.2,79.0,1105.36,40
CDM,4032447,US DUPLEX ART EXT LWR BI,1950.0,518.7,166.84,1949.57,63
CDM,4032454,US DUPLEX ART EXT UPR CMP BI,1684.0,447.94,156.32,1683.55,63
CDM,4032488,US ART PHYS EXT LWR TREADMILL BI,1654.0,439.96,101.17,1830.83,63
CDM,4032496,US DUPLEX EXTRACRANIAL CMP BI,1672.0,444.75,148.53,1671.18,63
CDM,4032504,US DUPLEX EXTRACRANIAL UNI/LTD,1292.0,343.67,79.0,1291.29,63
CDM,4032520,US DUPLEX ABD/PEL/SCR&/RETRO CMP,1978.0,526.15,166.84,1977.97,63
CDM,4032538,US DUPLEX ABD/PEL/SCR&/RETRO LTD,1395.0,371.07,79.0,1394.39,63
CDM,4032546,US DUPLEX AO/IVC/ILIAC/GRFT LTD,855.0,227.43,79.0,1082.41,63
CDM,4032553,US DUPLEX AO/IVC/ILIAC/GRFT CMP,1615.0,429.59,139.12,1614.24,63
CDM,4032587,US DUPLEX VEIN EXT CMP BI,2080.0,553.28,150.47,1675.9,63
CDM,4032595,US DUPLEX VEIN EXT LTD/UNI,1093.0,290.74,79.0,1092.72,63
CDM,4032603,US DUPLEX HEMODIALYSIS,1094.0,291.0,79.0,1255.7,63
CDM,4032611,US TCD INTRACRANIAL CMP,1554.0,413.36,166.84,1821.25,63
CDM,4032629,US TCD INTRACRANIAL LTD,1051.0,279.57,79.0,1051.95,63
CDM,4032645,US TRANSRECTAL,630.0,219.87,79.0,875.38,63
CDM,4032652,US TRANSRECTAL STDY VOL PROSTATE,570.0,198.93,79.0,748.87,63
CDM,4032678,US GD APP RADIOELEMENT INTERSTITIAL,1162.0,405.54,26.9,871.5,37
CDM,4032702,ECHO DOPP FETAL CMP,500.0,174.5,41.5,449.06,63
CDM,4032710,ECHO DOPP FETAL FOLLOWUP/REPEAT,392.0,136.81,22.03,449.06,63
CDM,4032728,ECHO 2D CV FETAL W/WO M-MODE,1319.0,460.33,178.71,1989.95,63
CDM,4032736,ECHO 2D CV FETAL W/WO M-MODE FLWUP,662.0,231.04,114.81,948.33,63
CDM,4032751,US TRANSRECTAL,630.0,219.87,79.0,875.38,63
CDM,4032835,US UTERUS PREG LTD 1+ FETUS,329.0,114.82,49.3,449.06,63
CDM,4032991,US GD AMNIOCENTESIS S&I,260.0,90.74,14.89,195.0,37
CDM,4033197,US GD PLCMT NEEDLE ADDL S&I,507.0,176.94,27.55,380.25,37
CDM,4033254,US GD VA EVAL SITE W REC PERM,827.0,288.62,23.97,620.25,37
CDM,4033262,US GD PLCMT NEEDLE S&I,507.0,176.94,27.55,380.25,37
CDM,4033304,US GD VA EVAL SITE W REC PERM,827.0,288.62,23.97,620.25,37
CDM,4033445,VELOCIMETRY DOPPLER ART UMB FETAL,359.0,125.29,20.74,449.06,63
CDM,4033452,VELOCIMETRY DOPPLER ART CERE FETAL,384.0,134.02,54.49,449.06,63
CDM,4033486,VELOCIMETRY DOPPLER ART UMB FETAL,359.0,125.29,20.74,449.06,63
CDM,4033494,VELOCIMETRY DOPPLER ART CERE FETAL,384.0,134.02,54.49,449.06,63
CDM,4033536,US GD APP RADIOELEMENT INTERSTITIAL,1162.0,405.54,26.9,871.5,37
CDM,4033544,INJ PSEUDOANEURYSM EXT LT,1019.0,364.8,99.7,5681.0,40
CDM,4035002,US KIDNEY TRANSPLANTED W DOPPLER,635.0,221.61,79.0,644.71,63
CDM,4035010,US SCREEN AAA,668.0,233.13,78.82,501.0,63
CDM,4035184,BX BONE TROCAR/NDL SUPERFICIAL,2124.0,760.39,84.14,5681.0,63
CDM,4036091,BX GLAND SALIVARY NDL,2229.0,797.98,51.61,5681.0,63
CDM,4036547,US TCD INTRACRANIAL DET EMB WO INJ,1044.0,277.7,79.0,1475.35,63
CDM,4036604,XR SPECIMEN SURGICAL,694.0,195.71,26.9,1989.95,63
CDM,4036760,ASP PUNCT ABSCESS/CYST,651.0,233.06,94.84,5681.0,63
CDM,4037198,BX TIS SOFT PEL&HIP SUPER BI,4049.0,1449.54,194.98,5681.0,40
CDM,4037206,BX TIS SOFT PEL&HIP SUPER LT,2699.0,966.24,194.98,5681.0,40
CDM,4037214,BX TIS SOFT PEL&HIP SUPER RT,2699.0,966.24,194.98,5681.0,40
CDM,4037222,BX/EXCISE NODE NDL SUPERFICIAL BI,3543.0,1268.39,82.79,5681.0,40
CDM,4037230,BX/EXCISE NODE NDL SUPERFICIAL LT,2362.0,845.6,82.79,5681.0,40
CDM,4037248,BX/EXCISE NODE NDL SUPERFICIAL RT,2362.0,845.6,82.79,5681.0,40
CDM,4037412,US GD W PLC CATH DRN PERC S&I,962.0,335.74,55.46,721.5,37
CDM,4037438,US GD PLCMT NEEDLE S&I,507.0,176.94,27.55,380.25,37
CDM,4037446,US GD PLCMT NEEDLE ADDL S&I,507.0,176.94,27.55,380.25,37
CDM,4037586,BX/EXCISE NODE NDL SUPERFICIAL BI,3543.0,1268.39,82.79,5681.0,40
CDM,4037594,BX/EXCISE NODE NDL SUPERFICIAL LT,2362.0,845.6,82.79,5681.0,40
CDM,4037602,BX/EXCISE NODE NDL SUPERFICIAL RT,2362.0,845.6,82.79,5681.0,40
CDM,4037693,ASP&/INJ CYST/PELVIS RENAL BI,2064.0,738.91,90.4,5681.0,40
CDM,4037727,BX RENAL TROCAR/NDL PERC BI,4698.0,3245.64,121.75,5681.0,40
CDM,4037792,ART PHYS 1-2 LEVEL LTD BI,1463.0,389.16,68.72,1097.25,63
CDM,4037800,ART PHYS 3+ LEVEL CMP BI,1820.0,484.12,101.17,1471.62,63
CDM,4037982,US GD VA EVAL SITE W REC PERM,827.0,288.62,23.97,620.25,37
CDM,4037990,ART PHYS 1-2 LEVEL LTD UNI,975.0,259.35,68.72,974.25,40
CDM,4038006,ART PHYS 3+ LEVEL CMP UNI,1213.0,322.66,101.17,1471.62,40
CDM,4038055,ASP&/INJ CYST GANGLION,709.0,253.82,40.1,5681.0,63
CDM,4038618,PARACENTESIS ABDOMINAL W IMG,2449.0,1882.45,102.12,6689.0,63
CDM,4038634,INJ RRX NODE SENTINEL ID BI,1646.0,589.27,31.05,5681.0,40
CDM,4038642,INJ RRX NODE SENTINEL ID LT,1097.0,392.73,31.05,5681.0,40
CDM,4038659,INJ RRX NODE SENTINEL ID RT,1097.0,392.73,31.05,5681.0,40
CDM,4038733,INJ/S SHTH TNDN SGL/LIG/AP BI,891.0,318.98,37.87,5681.0,40
CDM,4038741,INJ/S SHTH TNDN SGL/LIG/AP LT,594.0,212.65,37.87,5681.0,40
CDM,4038758,INJ/S SHTH TNDN SGL/LIG/AP RT,594.0,212.65,37.87,5681.0,40
CDM,4038808,THORACENTESIS ASP WO IMG LT,2537.0,908.25,85.38,5681.0,40
CDM,4038816,THORACENTESIS ASP WO IMG RT,2537.0,908.25,85.38,5681.0,40
CDM,4038824,THORACENTESIS ASP WO IMG BI,3806.0,1362.55,85.38,5681.0,40
CDM,4038832,THORACENTESIS ASP W IMG LT,3045.0,1034.68,104.86,5681.0,40
CDM,4038840,THORACENTESIS ASP W IMG RT,3045.0,1034.68,104.86,5681.0,40
CDM,4038857,THORACENTESIS ASP W IMG BI,4568.0,1034.68,104.86,5681.0,40
CDM,4038915,DRN PLEURA INS CATH INDWL W IMG LT,2781.0,995.6,143.18,6689.0,40
CDM,4038923,DRN PLEURA INS CATH INDWL W IMG RT,2781.0,995.6,143.18,6689.0,40
CDM,4038931,DRN PLEURA INS CATH INDWL W IMG BI,4172.0,1493.58,143.18,6689.0,40
CDM,4039038,PLC DEV/S RT GD PROSTATE,2071.0,741.42,99.66,5681.0,63
CDM,4039236,CHEMODENERV GLANDS PAR&SUBMAND BI,974.0,348.69,110.57,5681.0,63
CDM,4039269,DRN CATH FLUID VISCERAL IMG GD,3029.0,1084.38,185.74,18194.0,63
CDM,4039277,DRN CATH FLUID PERI PERC IMG GD,3139.0,1123.76,185.74,18194.0,63
CDM,4039285,DRN CATH FLUID TRNSVAG/REC IMG GD,4214.0,1508.61,196.66,7704.0,63
CDM,4039319,BX BRST W/WO DEV/IMG US LSN ADD,1717.0,614.69,73.99,5681.0,40
CDM,4039368,DRN CATH FLUID TISSUE SOFT IMG GD,3433.0,1229.01,129.89,6689.0,63
CDM,4039459,BX BRST W/WO DEV/IMG SG LSN ADD,1717.0,614.69,78.58,5681.0,40
CDM,4039475,BX BRST W/WO DEV/IMG US LSN ADD,1717.0,614.69,73.99,5681.0,40
CDM,4039491,PLC DEV/S BRST MAMMO GD LSN ADD,1004.0,359.43,47.53,5681.0,40
CDM,4039517,PLC DEV/S BRST SG LSN ADD,1441.0,515.88,47.77,5681.0,40
CDM,4039533,PLC DEV/S BRST US GD LSN ADD,1518.0,543.44,40.59,5681.0,40
CDM,4039582,PLC DEV/S BRST MAMMO GD LSN 1ST LT,3139.0,1123.76,94.74,6689.0,40
CDM,4039590,PLC DEV/S BRST MAMMO GD LSN 1ST RT,3139.0,1123.76,94.74,6689.0,40
CDM,4039608,PLC DEV/S BRST SG LSN 1ST LT,3172.0,1135.58,95.59,6689.0,40
CDM,4039616,PLC DEV/S BRST SG LSN 1ST RT,3172.0,1135.58,95.59,6689.0,40
CDM,4039665,PLC DEV/S BRST US GD LSN 1ST LT,2300.0,823.4,80.89,6689.0,40
CDM,4039673,PLC DEV/S BRST US GD LSN 1ST RT,2300.0,823.4,80.89,6689.0,40
CDM,4039681,BX BRST W/WO DEV/IMG SG LSN 1ST LT,4370.0,1564.46,156.87,6689.0,40
CDM,4039699,BX BRST W/WO DEV/IMG SG LSN 1ST RT,4370.0,1564.46,156.87,6689.0,40
CDM,4039707,BX BRST W/WO DEV/IMG US LSN 1ST LT,4065.0,1455.27,148.27,6689.0,40
CDM,4039715,BX BRST W/WO DEV/IMG US LSN 1ST RT,4065.0,1455.27,148.27,6689.0,40
CDM,4039749,BX BRST W/WO DEV/IMG US LSN 1ST LT,4065.0,1455.27,148.27,6689.0,40
CDM,4039756,BX BRST W/WO DEV/IMG US LSN 1ST RT,4065.0,1455.27,148.27,6689.0,40
CDM,4040036,US JOINT CMP REALTIME,439.0,153.21,10.67,449.06,63
CDM,4040069,US JT/EVAL FOCAL EXT NONVASC LTD,306.0,106.79,30.15,449.06,63
CDM,4040135,ASP NEEDLE FINE BX US GD LSN 1ST,1966.0,1964.55,70.67,5681.0,63
CDM,4040143,ASP NEEDLE FINE BX US GD LSN ADDL,1757.0,629.01,48.46,5681.0,40
CDM,4040218,US ELASTOGRAPHY ORGAN,445.0,155.3,74.29,478.28,63
CDM,4040226,US ELASTOGRAPHY LSN TARGET 1ST,371.0,129.48,63.57,449.06,63
CDM,4040234,US ELASTOGRAPHY LSN TARGET ADDL,210.0,73.29,35.99,264.1,37
CDM,4040531,BX PUNCH SKIN LSN SGL,733.0,262.41,45.4,5681.0,63
CDM,4040549,BX PUNCH SKIN LSN ADDL,206.0,73.75,24.8,5681.0,40
CDM,4040556,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,63
CDM,4040598,ABL RF JOINT SI INCL IMG GD BI,4640.0,1661.12,191.07,14124.0,40
CDM,4040606,ABL RF JOINT SI INCL IMG GD LT,3093.0,1107.29,191.07,14124.0,40
CDM,4040614,ABL RF JOINT SI INCL IMG GD RT,3093.0,1107.29,191.07,14124.0,40
CDM,4040671,BX MUSCLE NDL PERC,1584.0,567.07,55.27,5681.0,63
CDM,4040697,US ELASTOGRAPHY LSN TARGET 1ST,371.0,129.48,63.57,449.06,63
CDM,4040705,US ELASTOGRAPHY LSN TARGET ADDL,210.0,73.29,35.99,264.1,37
CDM,4040804,DRN FLUID FETAL W US GD,1726.0,617.91,204.07,5681.0,63
CDM,4040812,TCD DETECT SHUNT VEN/ART W/INJ,1145.0,304.57,79.0,1470.49,63
CDM,4040820,STUDY VASOREACT TCD INTRACRNL COMP,1001.0,266.27,186.19,750.75,38
CDM,4040853,BX TESTIS NEEDLE RT,5108.0,1828.66,72.5,5681.0,40
CDM,4040861,BX TESTIS NEEDLE BI,7662.0,2743.0,72.5,5746.5,40
CDM,4040879,BX TESTIS NEEDLE LT,5108.0,1828.66,72.5,5681.0,40
CDM,4041026,PET EVL METAB BR DA NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CDM,4041075,PET EVL METAB TMR BR ONC FDG SUB1-3,6351.0,2305.41,1073.25,11557.05,40
CDM,4041612,RRX N13 AMMONIA DX/0-40MCI DOSE,1375.0,492.25,255.75,2858.5,34
CDM,4041687,RRX F18 SOD FLUOR DX/0-30MCI DOSE,733.0,262.41,136.34,1138.42,33
CDM,4041828,PET IMG LTD AREA NON ONC FDG,5785.0,2099.96,946.81,10463.13,63
CDM,4041836,PET IMG SKULL-THIGH NON ONC FDG,7282.0,2643.37,1073.25,11557.05,63
CDM,4041844,PET IMG WHOLE BODY NON ONC FDG,8422.0,3057.19,1073.25,11557.05,63
CDM,4041851,PET/CT LTD AREA NON ONC FDG,8631.0,3133.05,1073.25,11557.05,63
CDM,4041869,PET/CT SKULL-THIGH NON ONC FDG,10206.0,3704.78,1073.25,11895.84,63
CDM,4041877,PET/CT WHOLE BODY NON ONC FDG,9876.0,3584.99,1073.25,11557.05,63
CDM,4041919,PET EVL METAB BR NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CDM,4041935,PET EVL METAB TMR BR ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CDM,4041943,PET EVL METAB BR QN NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CDM,4041968,RRX F18 FDG DX/0-45MCI DOSE,2495.0,893.21,359.05,1871.25,32
CDM,4042156,RRX F18 FLORBETAPIR DX/0-10MCI DOSE,5790.0,2072.82,1755.7,6500.53,58
CDM,4042206,PET EVL METAB BR ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CDM,4042214,PET EVL METAB BR ONC FDG SUB 1-3,6351.0,2305.41,1073.25,11557.05,40
CDM,4042222,PET EVL METAB BR DA ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CDM,4042230,PET EVL METAB BR DA ONC FDG SUB 1-3,6351.0,2305.41,1073.25,11557.05,40
CDM,4042248,PET EVL METAB BR QN ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CDM,4042255,PET EVL METAB BR QN ONC FDG SUB 1-3,6351.0,2305.41,1073.25,11557.05,40
CDM,4042263,PET EVL METAB BR C11 ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CDM,4042271,PET EVL METAB BR C11 ONC FDG SUB1-3,6351.0,2305.41,1073.25,11557.05,40
CDM,4042321,PET IMG LTD AREA ONC FDG INIT,5785.0,2099.96,946.81,10463.13,40
CDM,4042339,PET IMG LTD AREA ONC FDG SUB 1-3,5785.0,2099.96,946.81,10463.13,40
CDM,4042347,PET IMG SKULL-THIGH ONC FDG INIT,7282.0,2643.37,1073.25,11557.05,40
CDM,4042354,PET IMG SKULL-THGH ONC FDG SUB 1-3,7282.0,2643.37,1073.25,11557.05,40
CDM,4042362,PET IMG WHOLE BODY ONC FDG INIT,8422.0,3057.19,1073.25,11557.05,40
CDM,4042370,PET IMG WHOLE BODY ONC FDG SUB 1-3,8422.0,3057.19,1073.25,11557.05,40
CDM,4042388,PET/CT LTD AREA ONC FDG INIT,8631.0,3133.05,1073.25,11557.05,40
CDM,4042396,PET/CT LTD AREA ONC FDG SUB 1-3,8631.0,3133.05,1073.25,11557.05,40
CDM,4042420,PET/CT SKULL-THIGH ONC FDG INIT,10206.0,3704.78,1073.25,11895.84,40
CDM,4042438,PET/CT SKULL-THIGH ONC FDG SUB 1-3,10206.0,3704.78,1073.25,11895.84,40
CDM,4042461,PET/CT WHOLE BODY ONC FDG INIT,9876.0,3584.99,1073.25,11557.05,40
CDM,4042479,PET/CT WHOLE BODY ONC FDG SUB 1-3,9876.0,3584.99,1073.25,11557.05,40
CDM,4042503,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,4042511,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,4042529,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,4042537,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,4042545,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,4042552,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,4042560,INJ RRX LOC STDY PROBE NON-IMG IV,664.0,263.61,38.69,1554.07,63
CDM,4042586,PET EVAL METAB MYOCARDIAL STUDY SGL,5380.0,1952.94,867.56,10463.13,63
CDM,4042594,PET EVAL METAB MYOC STUDY SGL W CT,5664.0,2056.03,1073.25,11557.05,63
CDM,4042602,PET EVAL METAB MYOC SGL R/S W CT,3956.0,1436.03,990.66,11557.05,63
CDM,4042610,PET EVAL METAB MYOC MULT R/S W CT,4983.0,1808.83,1629.44,17803.35,63
CDM,4042628,PET EVAL METAB MYOC TWO RDTRCR,4905.0,1780.52,1469.35,13055.22,63
CDM,4042636,PET EVAL METAB MYOC TWO RDTRCR W CT,5379.0,1952.58,1414.11,17803.35,63
CDM,4042644,PET QUAN ABSLT MYOC REST&RX STRESS,1001.0,363.36,100.41,5069.0,37
CDM,4042651,RRX COPPER CU64 DOTATATE/1MCI INJ,2868.5,1026.92,476.08,3795.43,62
CDM,4042669,PET EVL METAB BR ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CDM,4042677,PET EVL METAB BR DA ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CDM,4042685,PET EVL METAB BR QN ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CDM,4042693,PET IMG LTD AREA ONC FDG SUB 4+,5785.0,2099.96,946.81,10463.13,40
CDM,4042701,PET IMG SKULL-THIGH ONC FDG SUB 4+,7282.0,2643.37,1073.25,11557.05,40
CDM,4042719,PET IMG WHOLE BODY ONC FDG SUB 4+,8422.0,3057.19,1073.25,11557.05,40
CDM,4042727,PET/CT LTD AREA ONC FDG SUB 4+,8631.0,3133.05,1073.25,11557.05,40
CDM,4042735,PET/CT SKULL-THIGH ONC FDG SUB 4+,10206.0,3704.78,1073.25,11895.84,40
CDM,4042743,PET/CT WHOLE BODY ONC FDG SUB 4+,9876.0,3584.99,1073.25,11557.05,40
CDM,4042792,PET EVL METAB BR C11 NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CDM,4042800,PET EVL METAB BR C11 ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CDM,4042818,PET EVL METAB TMR BR NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CDM,4042826,PET EVL METAB TMR BR ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CDM,4042834,RRX RUBIDIUM RB82 DX/0-60MCI DOSE,1673.9,599.26,311.35,1801.3,34
CDM,4069,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4109096,RX NITRIC OXIDE 10 MIN,183.2,52.58,26.4,137.4,29
CDM,4109112,RX NITRIC OXIDE PER DAY,16207.8,4651.64,2335.54,12155.85,29
CDM,4109120,INTUBATION ENDOTRACHEAL EMERG,1063.0,206.22,136.1,1062.59,63
CDM,4109211,CATH/CANN ART SMP/MNTR/TRNS PERC,929.0,332.58,42.66,5681.0,40
CDM,4109237,CHG TUBE TRACH PRIOR TRACT FISTULA,491.0,175.78,33.93,5681.0,63
CDM,4109245,CPR,1318.0,255.69,177.3,1317.89,63
CDM,4109344,OXYGN UPTAKE REST CALORMTRY INDIRCT,734.0,259.1,40.35,550.5,63
CDM,4109351,DEMO&/EVAL PT AEROSOL/NEB/MDI/IPPB,473.0,91.76,17.45,385.56,63
CDM,4109385,BIPAP INITIAL DAY,1783.0,345.9,63.35,1337.25,63
CDM,4109393,BIPAP SUBSQ DAY,1783.0,345.9,63.35,1337.25,63
CDM,4109401,PHYSIOTHERAPY CHEST INITIAL,385.0,74.69,24.26,288.75,63
CDM,4109419,PHYSIOTHERAPY CHEST SUBSQ,405.0,78.57,38.18,303.75,63
CDM,4109435,CPAP INITIAL DAY,1783.0,345.9,63.35,1337.25,63
CDM,4109443,CPAP SUBSQ DAY,1783.0,345.9,63.35,1337.25,63
CDM,4109468,CLEARANCE AIRWAY INITIAL,385.0,74.69,24.26,288.75,63
CDM,4109476,CLEARANCE AIRWAY SUBSQ,405.0,78.57,38.18,303.75,63
CDM,4109583,VENT INITIAL DAY,3875.0,751.75,88.64,2906.25,63
CDM,4109591,VENT SUBSQ DAY,3193.0,619.44,62.36,2394.75,63
CDM,4109765,INHALATION AEROSOL PENTAMIDINE,400.0,77.6,35.35,385.56,63
CDM,4109823,PUNCT ARTERIAL FOR DIAGNOSIS,213.0,36.64,14.47,234.25,61
CDM,4109864,CPAP PER DAY,1783.0,345.9,63.35,1337.25,63
CDM,4109872,BIPAP PER DAY,1783.0,345.9,63.35,1337.25,63
CDM,4109880,CAPACITY VITAL TOTAL,232.0,81.9,21.05,226.54,63
CDM,4109914,INS&PLC CATH DIRECTED FLOW,5656.0,1657.21,84.35,16111.14,63
CDM,4109930,OXYGN UPTAKE REST&EXERCISE DIRECT,770.0,271.81,40.49,577.5,63
CDM,4109963,SPIROMETRY W VITAL CAP W/WO VENT,686.0,242.16,18.78,514.5,63
CDM,4109971,PHYSIOTHERAPY CHEST COMP INITIAL,385.0,74.69,24.26,288.75,63
CDM,4109989,PHYSIOTHERAPY CHEST COMP SUBSQ,405.0,78.57,38.18,303.75,63
CDM,4110086,INS CVC CENTRAL NONTUN 5+YRS,5317.0,1903.49,81.34,5681.0,63
CDM,4110094,BRONCHDLTN PRE&POST SPIROMETRY W VC,867.0,306.05,28.2,657.01,63
CDM,4110144,ADMIN SURFACTANT INTRAPULMONARY,230.0,81.19,54.84,540.08,63
CDM,4110151,EVAL BRONCHSPSM SPIRO W AGENTS,1085.0,383.0,34.97,813.75,63
CDM,4110169,CAPACITY BREATHING MAX VENT VOL MAX,226.0,79.78,11.97,169.5,63
CDM,4110193,LOOP VOLUME FLOW RESP,554.0,195.56,24.3,415.5,63
CDM,4110219,CHALLENGE BROCH INHAL W HISTAMINE,761.0,250.39,34.0,657.01,63
CDM,4110243,OXYGN UPTAKE GAS EXPIRD OUTPUT CO2,763.0,269.34,37.57,657.01,63
CDM,4110425,RPR CVC WO P/P,2333.0,835.21,32.08,6689.0,63
CDM,4110458,DECLOT CATH/VAD W AGENT THROMB,711.0,254.54,33.67,5681.0,63
CDM,4110615,PLETHYSMOGRAPHY VOLUMES LUNG,640.0,225.92,43.08,657.01,63
CDM,4110623,DILUT GAS/WASHOUT VOLUMES LUNG,519.0,183.21,32.09,389.25,63
CDM,4110649,CAPACITY DIFFUSING,870.0,307.11,46.69,652.5,40
CDM,4110664,HAST W REPORT,252.0,88.96,35.66,334.2,63
CDM,4110672,HAST W REPORT&TITRATE OXYGEN SUPP,345.0,121.78,47.63,450.81,63
CDM,4110698,OSCILLATION CHEST WALL MECH SESSN,522.0,101.27,20.04,391.5,63
CDM,4110805,COLLECT SPEC BLD CAPILLARY,38.0,6.54,0.5427,28.5,39
CDM,4110847,SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,39
CDM,4110854,SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CDM,4110862,SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,39
CDM,4110870,INS PICC WO P/P W IMG 0-4YRS,3433.0,1229.01,77.83,5988.0,63
CDM,4110888,INS PICC WO P/P W IMG 5+YRS,3433.0,1229.01,79.92,12090.0,63
CDM,4110896,INS PICC WO P/P WO IMG 0-4YRS,2862.0,1024.6,88.38,5681.0,63
CDM,4110904,INS PICC WO P/P WO IMG 5+YRS,3698.0,1323.88,90.96,5681.0,63
CDM,4110912,RPLC PICC WO P/P SA S&I,4273.0,1529.73,56.01,5681.0,63
CDM,4110961,RESIST AIRWAY OSCILLOMETRY,334.0,117.9,31.44,250.5,63
CDM,4110987,MEAS OUTPUT CARD DUR CATH CARD CHD,960.0,281.28,63.24,8055.57,39
CDM,41152,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,4130506,HBOT CHAMBER FULL BODY 30MIN,1267.0,486.53,86.48,2356.0,63
CDM,4130738,DEBRIDE TISSUE SUBQ 1ST 20CM,1506.0,780.11,59.06,1199.09,63
CDM,4130746,DEBRIDE TISSUE SUBQ ADDL 20CM,648.0,335.66,24.44,598.68,40
CDM,4130753,DEBRIDE MUSCLE&/FASCIA 1ST 20CM,3825.0,1981.35,149.28,4596.53,63
CDM,4130761,DEBRIDE MUSCLE&/FASCIA ADDL 20CM,1072.0,555.3,52.99,2301.59,40
CDM,4130779,DEBRIDE BONE 1ST 20CM,4597.0,2381.25,218.85,4596.53,63
CDM,4130787,DEBRIDE BONE ADDL 20CM,1892.0,980.06,93.56,2301.59,40
CDM,4130795,DEBRIDE SLCT WND OPEN 1ST 20CM,522.0,270.4,34.48,666.6,63
CDM,4130803,DEBRIDE SLCT WND OPEN ADDL 20CM,334.0,173.01,23.87,333.33,40
CDM,4130811,MEAS TENSION O2 TRANSQ 1-2 LEVEL BI,1463.0,389.16,68.72,1097.25,63
CDM,4130829,MEAS TENSION O2 TRANSQ 3+ LEVEL BI,1820.0,484.12,101.17,1471.62,63
CDM,41715,R&B NURSERY LEVEL 2 LOWER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,4200515,PT EVAL THERAPY LOW,424.0,73.78,78.86,531.03,39
CDM,4200564,PT EVAL THERAPY MOD,559.0,97.27,85.0,558.97,39
CDM,4200614,PT EVAL THERAPY HIGH,606.0,105.44,85.0,558.97,39
CDM,4200663,PT RE-EVAL THERAPY,368.0,64.03,68.45,379.96,39
CDM,4201430,PT EVAL THERAPY LOW,424.0,73.78,78.86,531.03,39
CDM,4201471,PT EVAL THERAPY MOD,559.0,97.27,85.0,558.97,39
CDM,4201513,PT EVAL THERAPY HIGH,606.0,105.44,85.0,558.97,39
CDM,4201554,PT RE-EVAL THERAPY,368.0,64.03,68.45,379.96,39
CDM,42028,R&B OBSTETRICS SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4203774,PT THER EXERCISE 15MN,168.0,17.47,28.89,283.0,39
CDM,4203782,PT THER NEUROMUS REEDUCATE 15MN,172.0,17.89,31.99,283.0,39
CDM,4203790,PT THER TRAIN GAIT 15MN,181.0,18.82,28.89,283.0,39
CDM,4203816,PT THER ACTIVITIES 15MN,218.0,22.67,36.03,283.0,39
CDM,4203824,PT MANAGEMENT SELF-CARE/HOME 15MN,241.0,25.06,32.14,283.0,39
CDM,4203832,PT MANAGEMENT WHEELCHAIR 15MN,162.0,16.85,30.13,283.0,39
CDM,4207304,PT CONF TEAM HCP W PT&/FM 30+MN,206.0,21.42,38.32,283.0,33
CDM,4207312,PT CONF TEAM HCP WO PT&/FM 30+MN,155.0,16.12,28.83,293.82,39
CDM,4207320,PT THERAPY MIST,322.0,33.49,46.4,416.69,36
CDM,4207379,PT THERAPY MANUAL 15MN,169.0,17.58,26.61,283.0,39
CDM,4209094,PT MODALITY APPL HOT/COLD,61.0,6.34,6.18,283.0,36
CDM,4209102,PT MODALITY APPL TRACTION MECHANIC,121.0,12.58,13.8,283.0,39
CDM,4209128,PT MODALITY APPL E-STIM UNATND OTH,106.0,11.02,12.12,283.0,39
CDM,4209136,PT MODALITY APPL E-STIM UNATND ULC,106.0,11.02,12.12,283.0,39
CDM,4209151,PT MODALITY APPL DEV VASOPNEUMATIC,107.0,11.13,11.47,283.0,39
CDM,4209169,PT MODALITY APPL BATH PARAFFIN,66.0,6.86,5.53,283.0,39
CDM,4209185,PT MODALITY APPL WHIRLPOOL,133.0,13.83,16.65,283.0,39
CDM,4209250,PT MODALITY APPL E-STIM MAN 15MN,139.0,14.46,14.12,283.0,39
CDM,4209268,PT MODALITY APPL IONTOPHORES 15MN,195.0,20.28,19.0,283.0,39
CDM,4209284,PT MODALITY APPL ULTRASOUND 15MN,122.0,12.69,13.77,283.0,39
CDM,4209318,PT THER EXERCISE 15MN,168.0,17.47,28.89,283.0,39
CDM,4209334,PT THER NEUROMUS REEDUCATE 15MN,172.0,17.89,31.99,283.0,39
CDM,4209359,PT THER TRAIN GAIT 15MN,181.0,18.82,28.89,283.0,39
CDM,4209375,PT THER MASSAGE 15MN,186.0,19.34,29.79,283.0,39
CDM,4209391,PT THERAPY MANUAL 15MN,169.0,17.58,26.61,283.0,39
CDM,4209409,PT THER GROUP,120.0,39.48,17.73,283.0,39
CDM,4209433,PT THER ACTIVITIES 15MN,218.0,22.67,36.03,283.0,39
CDM,4209466,PT TECHNIQUES SENSORY 15MN,155.0,16.12,28.83,283.0,39
CDM,4209474,PT MANAGEMENT SELF-CARE/HOME 15MN,241.0,25.06,32.14,283.0,39
CDM,4209482,PT REINTEGRATION COMM/WORK 15MN,156.0,16.22,29.02,283.0,39
CDM,4209490,PT MANAGEMENT WHEELCHAIR 15MN,162.0,16.85,30.13,283.0,39
CDM,4209524,PT DEBRIDE NONSELECT WO ANES SESSN,295.0,30.68,54.87,363.86,40
CDM,4209557,PT MEAS/TEST PERFORMANCE 15MIN,205.0,21.32,33.44,283.0,39
CDM,4209565,PT ASSESSMENT ASSIST TECH 15MN,177.0,18.41,32.92,283.0,39
CDM,4209698,PT THERAPY MIST,322.0,33.49,46.4,416.69,36
CDM,4212056,PT REPOSITIONING CANALITH PER DAY,243.0,25.27,34.91,283.0,39
CDM,4212122,PT MEAS/TEST PERFORMANCE 15MIN,205.0,21.32,33.44,283.0,39
CDM,4214144,PT TRAIN ORTHO UE/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CDM,4214177,PT TRAIN PROSTH UE&/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CDM,4214227,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,19.86,35.53,329.34,39
CDM,4214268,PT TRAIN ORTHO UE/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CDM,4214292,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,19.86,35.53,329.34,39
CDM,4214417,PT TEST DVLPMNTL W RPT 1ST HR,688.0,226.37,101.17,1015.76,63
CDM,4214425,PT TEST DVLPMNTL W RPT ADDL 30MIN,316.0,103.97,55.53,463.98,39
CDM,4214714,PTA REPOSITIONING CANALITH PER DAY,243.0,25.27,34.91,283.0,39
CDM,4214722,PTA MODALITY APPL HOT/COLD,61.0,6.34,6.18,283.0,36
CDM,4214730,PTA MODALITY APPL TRACTION MECHANIC,121.0,12.58,13.8,283.0,39
CDM,4214748,PTA MODALITY APPL DEV VASOPNEUMATIC,107.0,11.13,11.47,283.0,39
CDM,4214755,PTA MODALITY APPL BATH PARAFFIN,66.0,6.86,5.53,283.0,39
CDM,4214763,PTA MODALITY APPL WHIRLPOOL,133.0,13.83,16.65,283.0,39
CDM,4214789,PTA MODALITY APPL E-STIM MAN 15MN,139.0,14.46,14.12,283.0,39
CDM,4214797,PTA MODALITY APPL IONTOPHORES 15MN,195.0,20.28,19.0,283.0,39
CDM,4214813,PTA MODALITY APPL ULTRASOUND 15MN,122.0,12.69,13.77,283.0,39
CDM,4214821,PTA THER EXERCISE 15MN,168.0,17.47,28.89,283.0,39
CDM,4214839,PTA THER NEUROMUS REEDUCATE 15MN,172.0,17.89,31.99,283.0,39
CDM,4214854,PTA THER TRAIN GAIT 15MN,181.0,18.82,28.89,283.0,39
CDM,4214862,PTA THER MASSAGE 15MN,186.0,19.34,29.79,283.0,39
CDM,4214870,PTA THERAPY MANUAL 15MN,169.0,17.58,26.61,283.0,39
CDM,4214888,PTA THER GROUP,120.0,39.48,17.73,283.0,39
CDM,4214896,PTA THER ACTIVITIES 15MN,218.0,22.67,36.03,283.0,39
CDM,4214904,PTA TECHNIQUES SENSORY 15MN,155.0,16.12,28.83,283.0,39
CDM,4214912,PTA MANAGEMENT SELF-CARE/HOME 15MN,241.0,25.06,32.14,283.0,39
CDM,4214920,PTA REINTEGRATION COMM/WORK 15MN,156.0,16.22,29.02,283.0,39
CDM,4214938,PTA MANAGEMENT WHEELCHAIR 15MN,162.0,16.85,30.13,283.0,39
CDM,4214987,PTA DEBRIDE NONSELECT WO ANES SESSN,295.0,30.68,54.87,363.86,40
CDM,4215034,PTA THERAPY MIST,322.0,33.49,46.4,416.69,36
CDM,4215059,PTA MEAS/TEST PERFORMANCE 15MIN,205.0,21.32,33.44,283.0,39
CDM,4215067,PTA TRAIN ORTHO UE/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CDM,4215075,PTA TRAIN PROSTH UE&/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CDM,4215083,PTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,19.86,35.53,329.34,39
CDM,4219556,PTA MODALITY APPL E-STIM UNATND OTH,106.0,11.02,12.12,283.0,39
CDM,4219564,PTA MODALITY APPL E-STIM UNATND ULC,106.0,11.02,12.12,283.0,39
CDM,4219622,OTA MODALITY APPL E-STIM UNATND OTH,106.0,14.63,12.12,283.0,39
CDM,4219630,OTA MODALITY APPL E-STIM UNATND ULC,106.0,14.63,12.12,283.0,39
CDM,4280392,PT THER MASSAGE 15MN,186.0,19.34,29.79,283.0,39
CDM,430,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4300109,OT SCRN DVLPMNTL W S&D INST STD,265.0,36.57,11.32,283.0,40
CDM,43018,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,4303632,OT THER EXERCISE 15MN,168.0,23.18,28.89,283.0,39
CDM,4303640,OT THER NEUROMUS REEDUCATE 15MN,172.0,23.74,31.99,283.0,39
CDM,4303665,OT THER ACTIVITIES 15MN,218.0,30.08,36.03,283.0,39
CDM,4303673,OT TECHNIQUES SENSORY 15MN,155.0,21.39,28.83,283.0,39
CDM,4303681,OT MANAGEMENT SELF-CARE/HOME 15MN,241.0,33.26,32.14,283.0,39
CDM,4303699,OT MANAGEMENT WHEELCHAIR 15MN,162.0,22.36,30.13,283.0,39
CDM,43042,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,43059,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,4306056,OT CONF TEAM HCP W PT&/FM 30+MN,206.0,28.43,38.32,283.0,33
CDM,4306064,OT CONF TEAM HCP WO PT&/FM 30+MN,155.0,21.39,28.83,293.82,39
CDM,4306346,OT APPL SPLINT FINGER STATIC,222.0,30.64,28.29,476.55,40
CDM,4306353,OT APPL SPLINT FINGER DYNAMIC,206.0,28.43,33.85,476.55,40
CDM,43067,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,4307294,OT ASSESSMENT ASSIST TECH 15MN,177.0,24.43,32.92,283.0,39
CDM,43075,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,4307773,OT MODALITY APPL HOT/COLD,61.0,8.42,6.18,283.0,36
CDM,4307799,OT MODALITY APPL E-STIM UNATND OTH,106.0,14.63,12.12,283.0,39
CDM,4307815,OT MODALITY APPL E-STIM UNATND ULC,106.0,14.63,12.12,283.0,39
CDM,4307831,OT MODALITY APPL DEV VASOPNEUMATIC,107.0,14.77,11.47,283.0,39
CDM,4307849,OT MODALITY APPL BATH PARAFFIN,66.0,9.11,5.53,283.0,39
CDM,4307864,OT MODALITY APPL WHIRLPOOL,133.0,18.35,16.65,283.0,39
CDM,4307930,OT MODALITY APPL IONTOPHORES 15MN,195.0,26.91,19.0,283.0,39
CDM,4307955,OT MODALITY APPL ULTRASOUND 15MN,122.0,16.84,13.77,283.0,39
CDM,4307989,OT THER EXERCISE 15MN,168.0,23.18,28.89,283.0,39
CDM,4307997,OT THER NEUROMUS REEDUCATE 15MN,172.0,23.74,31.99,283.0,39
CDM,4308011,OT THER TRAIN GAIT 15MN,181.0,24.98,28.89,283.0,39
CDM,4308029,OT THER MASSAGE 15MN,186.0,25.67,29.79,283.0,39
CDM,4308045,OT THERAPY MANUAL 15MN,169.0,23.32,26.61,283.0,39
CDM,4308052,OT THER GROUP,120.0,39.48,17.73,283.0,39
CDM,4308086,OT THER ACTIVITIES 15MN,218.0,30.08,36.03,283.0,39
CDM,4308110,OT TECHNIQUES SENSORY 15MN,155.0,21.39,28.83,283.0,39
CDM,4308128,OT MANAGEMENT SELF-CARE/HOME 15MN,241.0,33.26,32.14,283.0,39
CDM,4308136,OT REINTEGRATION COMM/WORK 15MN,156.0,21.53,29.02,283.0,39
CDM,4308144,OT MANAGEMENT WHEELCHAIR 15MN,162.0,22.36,30.13,283.0,39
CDM,4308276,OT MODALITY APPL E-STIM MAN 15MN,139.0,19.18,14.12,283.0,39
CDM,4310454,OT REPOSITIONING CANALITH PER DAY,243.0,33.53,34.91,283.0,39
CDM,4310504,OT THERAPY MIST,322.0,44.44,46.4,416.69,36
CDM,4312120,OT TX DYSFNCT SWALLOW FNCT FEED,446.0,61.55,82.96,334.5,39
CDM,4312401,OT EVAL THERAPY LOW,424.0,67.42,78.86,541.74,39
CDM,4312427,OT EVAL THERAPY MOD,559.0,88.88,85.0,541.74,39
CDM,4312443,OT EVAL THERAPY HIGH,606.0,96.35,85.0,541.74,39
CDM,4312468,OT RE-EVAL THERAPY,368.0,58.51,68.45,358.08,39
CDM,4312799,OT EVAL THERAPY LOW,424.0,67.42,78.86,541.74,39
CDM,4312815,OT EVAL THERAPY MOD,559.0,88.88,85.0,541.74,39
CDM,4312831,OT EVAL THERAPY HIGH,606.0,96.35,85.0,541.74,39
CDM,4312856,OT RE-EVAL THERAPY,368.0,58.51,68.45,358.08,39
CDM,4313011,OT TRAIN ORTHO UE/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CDM,4313052,OT TRAIN PROSTH UE&/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CDM,4313086,OT TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,26.36,35.53,329.34,39
CDM,4313169,OT TRAIN ORTHO UE/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CDM,4313193,OT TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,26.36,35.53,329.34,39
CDM,4313300,OT TEST DVLPMNTL W RPT 1ST HR,688.0,226.37,101.17,1015.76,63
CDM,4313318,OT TEST DVLPMNTL W RPT ADDL 30MIN,316.0,103.97,55.53,463.98,39
CDM,4313326,OT SKILLS DEVLPMT COGNITIVE 15MN,142.0,19.6,21.8,283.0,39
CDM,4313334,OT SKILLS DEVLPMT COGNITIVE AD 15MN,131.0,18.08,20.81,283.0,39
CDM,4313425,OT SKILLS DEVLPMT COGNITIVE 15MN,142.0,19.6,21.8,283.0,39
CDM,4313433,OT SKILLS DEVLPMT COGNITIVE AD 15MN,131.0,18.08,20.81,283.0,39
CDM,4313680,OTA TX DYSFNCT SWALLOW FNCT FEED,446.0,61.55,82.96,334.5,39
CDM,4313706,OTA MODALITY APPL HOT/COLD,61.0,8.42,6.18,283.0,36
CDM,4313722,OTA MODALITY APPL DEV VASOPNEUMATIC,107.0,14.77,11.47,283.0,39
CDM,4313730,OTA MODALITY APPL BATH PARAFFIN,66.0,9.11,5.53,283.0,39
CDM,4313748,OTA MODALITY APPL WHIRLPOOL,133.0,18.35,16.65,283.0,39
CDM,4313763,OTA MODALITY APPL E-STIM MAN 15MN,139.0,19.18,14.12,283.0,39
CDM,4313771,OTA MODALITY APPL IONTOPHORES 15MN,195.0,26.91,19.0,283.0,39
CDM,4313797,OTA MODALITY APPL ULTRASOUND 15MN,122.0,16.84,13.77,283.0,39
CDM,4313805,OTA THER EXERCISE 15MN,168.0,23.18,28.89,283.0,39
CDM,4313813,OTA THER NEUROMUS REEDUCATE 15MN,172.0,23.74,31.99,283.0,39
CDM,4313839,OTA THER TRAIN GAIT 15MN,181.0,24.98,28.89,283.0,39
CDM,4313847,OTA THER MASSAGE 15MN,186.0,25.67,29.79,283.0,39
CDM,4313862,OTA THERAPY MANUAL 15MN,169.0,23.32,26.61,283.0,39
CDM,4313870,OTA THER GROUP,120.0,39.48,17.73,283.0,39
CDM,4313888,OTA THER ACTIVITIES 15MN,218.0,30.08,36.03,283.0,39
CDM,4313896,OTA TECHNIQUES SENSORY 15MN,155.0,21.39,28.83,283.0,39
CDM,4313904,OTA MANAGEMENT SELF-CARE/HOME 15MN,241.0,33.26,32.14,283.0,39
CDM,4313912,OTA REINTEGRATION COMM/WORK 15MN,156.0,21.53,29.02,283.0,39
CDM,4313920,OTA MANAGEMENT WHEELCHAIR 15MN,162.0,22.36,30.13,283.0,39
CDM,4314035,OTA TRAIN ORTHO UE/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CDM,4314043,OTA TRAIN PROSTH UE&/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CDM,4314050,OTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,26.36,35.53,329.34,39
CDM,43141,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,4315677,OTA SKILLS DEVLPMT COGNITIVE 15MN,142.0,19.6,21.8,283.0,39
CDM,4315685,OTA SKILL DEVLPMT COGNITIVE AD 15MN,131.0,18.08,20.81,283.0,39
CDM,4316543,OT APPL SPLINT ARM SHORT STATIC BI,704.0,97.15,39.65,528.0,40
CDM,4316550,OT APPL SPLINT ARM SHORT STATIC RT,469.0,64.72,39.65,476.55,40
CDM,4316568,OT APPL SPLINT ARM SHORT STATIC LT,469.0,64.72,39.65,476.55,40
CDM,4317954,OT APPL SPLINT ARM LONG BI,716.0,98.81,40.59,537.0,40
CDM,4317962,OT APPL SPLINT ARM LONG LT,477.0,65.83,40.59,476.55,40
CDM,4317970,OT APPL SPLINT ARM LONG RT,477.0,65.83,40.59,476.55,40
CDM,4317988,OT APPL SPLINT ARM SHORT DYN BI,716.0,98.81,48.52,537.0,40
CDM,4317996,OT APPL SPLINT ARM SHORT DYN LT,477.0,65.83,48.52,476.55,40
CDM,4318002,OT APPL SPLINT ARM SHORT DYN RT,477.0,65.83,48.52,476.55,40
CDM,43216,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,43299,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,43414,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,43422,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,43521,R&B NURSERY LEVEL 2 LOWER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,4381455,OT THER MASSAGE 15MN,186.0,25.67,29.79,283.0,39
CDM,4385803,OT THERAPY MANUAL 15MN,169.0,23.32,26.61,283.0,39
CDM,4400073,ST SCRN DVLPMNTL W S&D INST STD,265.0,43.72,11.32,283.0,40
CDM,4400370,ST EVAL SWALLOW ENDOSCOPIC FLEX,717.0,176.38,85.0,556.84,39
CDM,4400412,ST EVAL SWALLOW ENDOSCOPIC FLEX,717.0,176.38,85.0,556.84,39
CDM,4400438,ST EVAL TST SENSORY LARYNGEAL ENDO,794.0,195.32,85.0,595.5,39
CDM,44024,R&B OBSTETRICS SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4403283,ST LARYNGOSCOPY DIAGNOSTIC FLEX,626.0,224.11,67.08,6689.0,63
CDM,4403721,ST TX SPEECH/LANG/VOICE/COM IND,391.0,64.52,72.73,293.25,39
CDM,4403747,ST TX DYSFNCT SWALLOW FNCT FEED,446.0,73.59,82.96,334.5,39
CDM,4403762,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,572.0,140.71,69.08,642.78,39
CDM,4403788,ST EVAL FNCT SWALLOW FLUOROSCOPIC,720.0,177.12,85.0,699.59,39
CDM,4404935,ST TEST COGNITIVE HC PRO PER HR,687.0,113.36,85.0,686.15,39
CDM,4405122,ST CONF TEAM HCP W PT&/FM 30+MN,206.0,33.99,38.32,283.0,33
CDM,4405130,ST CONF TEAM HCP WO PT&/FM 30+MN,155.0,25.58,28.83,293.82,39
CDM,4405353,ST EVAL DEVICE VOICE PROSTHETIC,563.0,92.9,71.32,422.25,39
CDM,4405890,ST LARYNGOSCOPY W STROBOSCOPY,1411.0,505.14,116.75,6689.0,63
CDM,4405924,ST TX SPEECH/LANG/VOICE/COM IND,391.0,64.52,72.73,293.25,39
CDM,4405932,ST TX SPEECH/LANG/VOICE/COM GROUP,128.0,42.12,23.81,283.0,39
CDM,4405940,ST TX DYSFNCT SWALLOW FNCT FEED,446.0,73.59,82.96,334.5,39
CDM,4405957,ST EVAL DEVICE VOICE PROSTHETIC,563.0,92.9,71.32,422.25,39
CDM,4405973,ST THER DEVICE NON SP W PRG,383.0,63.2,66.4,287.25,33
CDM,4405981,ST EVAL DEVICE SP COMM W PT 1ST HR,1009.0,248.21,85.0,1245.32,39
CDM,4405999,ST EVAL DEVICE SP COMM W PT AD 30MN,405.0,99.63,47.89,622.69,39
CDM,4406005,ST THER DEVICE SP W PRG,540.0,89.1,85.0,662.41,39
CDM,4406013,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,572.0,140.71,69.08,642.78,39
CDM,4406021,ST EVAL FNCT SWALLOW FLUOROSCOPIC,720.0,177.12,85.0,699.59,39
CDM,4406062,ST EVAL/EXAM APHASIA W RPT PER HR,603.0,99.5,85.0,602.67,39
CDM,44065,R&B OBSTETRICS SEMI-PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4409132,ST EVAL FLUENCY SPEECH,582.0,96.03,85.0,875.34,39
CDM,4409140,ST EVAL PROD SOUND SP,638.0,105.27,85.0,710.57,39
CDM,4409157,ST EVAL PROD SOUND SP W LANG&EXPRSN,777.0,128.21,85.0,1476.15,39
CDM,4409165,ST ANALYSIS VOICE&RESON BEH&QUAL,741.0,122.26,85.0,740.3,39
CDM,4409413,ST MANAGEMENT SELF-CARE/HOME 15MN,241.0,39.76,32.14,283.0,39
CDM,4409603,ST TEST DVLPMNTL W RPT 1ST HR,688.0,226.37,101.17,1015.76,63
CDM,4409611,ST TEST DVLPMNTL W RPT ADDL 30MIN,316.0,103.97,55.53,463.98,39
CDM,4409645,ST SKILLS DEVLPMT COGNITIVE 15MN,142.0,23.43,21.8,283.0,39
CDM,4409652,ST SKILLS DEVLPMT COGNITIVE AD 15MN,131.0,21.62,20.81,283.0,39
CDM,4409785,ST TECHNIQUES SENSORY 15MN,155.0,25.58,28.83,283.0,39
CDM,448,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4500039,ED US CHEST,424.0,147.98,29.5,449.06,63
CDM,4500062,ED US ABDOMEN LTD,532.0,214.99,58.06,449.06,63
CDM,4500112,ED US PELVIS NON OB LTD,426.0,148.67,25.6,449.06,63
CDM,4500179,ED US GD PLCMT NEEDLE ADDL S&I,507.0,176.94,27.55,380.25,37
CDM,4500237,ED ECHO 2D LTD W CNT,1235.0,303.81,266.89,2497.0,62
CDM,4500245,ED ECHO 2D LTD WO CNT,988.0,243.05,72.3,2497.0,63
CDM,4500344,ED US JOINT CMP REALTIME,439.0,153.21,10.67,449.06,63
CDM,4500351,ED US JT/EVAL FOCAL EXT NONVASC LTD,306.0,106.79,30.15,449.06,63
CDM,4500369,ED TRAUMA ACT LVL1 EVAL/GREEN WO CC,5270.0,1227.91,759.41,7907.0,38
CDM,4500377,ED TRAUMA ACT LVL1 EVAL/GREEN W CC,7025.0,1636.82,1012.3,7907.0,61
CDM,45013,R&B NURSERY LEVEL 2 LOWER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,4504502,ED AMPUTATION DIGIT,5262.0,1299.71,758.25,3946.5,30
CDM,4504510,ED ANOSCOPY,717.0,177.1,103.32,2503.0,30
CDM,4504528,ED ASP/INJECT JOINT/BURSA,547.0,135.11,78.82,2503.0,30
CDM,4504544,ED TREATMENT BURN LVL 01 SMALL,563.0,139.06,81.13,2503.0,30
CDM,4504551,ED CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,64
CDM,4504569,ED CASTING EXTREMITY LOWER,627.0,154.87,90.35,2503.0,30
CDM,4504577,ED CASTING EXTREMITY UPPER,383.0,94.6,55.19,2503.0,30
CDM,4504585,ED ASP BLADDER CATH SUPRAPUB,3433.0,847.95,494.7,2574.75,30
CDM,4504593,ED INS CATH BLADDER INDWL CMPLX,459.0,113.37,66.14,2503.0,30
CDM,4504650,ED CPR,1318.0,325.55,177.3,2503.0,64
CDM,4504668,ED VISIT CRITICAL CARE ADDL 30MIN,4495.0,1110.27,104.15,3371.25,34
CDM,4504676,ED VISIT CRITICAL CARE 1ST 30-74MIN,10280.0,2539.16,206.85,7710.0,58
CDM,4504684,ED CHG TUBE CYSTO,739.0,182.53,106.49,2503.0,30
CDM,4504692,ED DEBRIDE TISSUE SKIN/SUBQ,1299.0,320.85,187.19,2503.0,30
CDM,4504700,ED DELIVERY PLACENTA,4275.0,1055.92,87.64,5699.56,64
CDM,4504718,ED DELIVERY VAGINAL ONLY,7090.0,1751.23,979.0,5317.5,30
CDM,4504726,ED INTUBATION ENDOTRACHEAL,1063.0,262.56,153.18,2503.0,30
CDM,4504734,ED INJ EPID PATCH BLOOD/CLOT,1604.0,396.19,110.28,2503.0,64
CDM,4504742,ED EXPLORATION WOUND/TRAUMA,364.0,89.91,52.45,2503.0,30
CDM,4504775,ED I&D HEMATOMA/SEROMA/FLUID,3139.0,775.33,452.33,2503.0,30
CDM,4504783,ED I&R FB SUBCUTANEOUS,1336.0,329.99,192.52,2503.0,30
CDM,4504809,ED IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CDM,4504817,ED IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,40
CDM,4504833,ED INJ SUBQ/IM,176.0,43.47,14.06,2503.0,64
CDM,4504841,ED INJ SHTH TNDN SGL/LIG/AP,594.0,146.72,85.6,2503.0,30
CDM,4504858,ED INJ TRIGGER PT/S MUSCLE,750.0,185.25,108.08,2503.0,30
CDM,4504866,ED PROCEDURE IRRG BLADDER,805.0,198.84,29.06,2503.0,64
CDM,4504890,ED LARYNGOSCOPY,361.0,89.17,52.02,2503.0,30
CDM,4504908,ED VISIT LEVEL 1,725.0,219.99,11.12,2503.0,58
CDM,4504916,ED VISIT LEVEL 2,1280.0,493.41,40.62,2503.0,58
CDM,4504924,ED VISIT LEVEL 3,1835.0,916.94,69.13,2503.0,58
CDM,4504932,ED VISIT LEVEL 4,2935.0,1461.69,117.63,2503.0,58
CDM,4504940,ED VISIT LEVEL 5,3610.0,1508.88,170.4,2707.5,58
CDM,4504965,ED PUNCT LUMBAR,1604.0,396.19,231.14,2503.0,30
CDM,4504973,ED MONITOR PRESS SYND COMPART MUSC,1022.0,252.43,86.49,2503.0,64
CDM,4504981,ED PROCEDURE NAIL,364.0,89.91,52.45,2503.0,30
CDM,4504999,ED PLC NEEDLE INF INTRAOSSEOUS,713.0,176.11,57.56,2503.0,64
CDM,4505038,ED LAVAGE PERITONEAL/PARACENTESIS,1877.0,463.62,270.48,2503.0,30
CDM,4505046,ED PLC CATHETER CENTRAL VENOUS,5317.0,1313.3,766.18,3987.75,30
CDM,4505053,ED REDUCTION FX/DISLOCATION OTHER,596.0,147.21,85.88,2503.0,30
CDM,4505061,ED REDUCTION FX/DISLOCATION DIGIT,475.0,117.32,68.45,2503.0,30
CDM,4505087,ED REM/BIVALVE CAST,412.0,101.76,59.37,2503.0,30
CDM,4505095,ED REM IUD,643.0,158.82,64.47,5261.73,64
CDM,4505103,ED REM FB NASAL,405.0,100.04,58.36,2503.0,30
CDM,4505129,ED REM FB EYE EMBEDDED,796.0,196.61,114.7,2503.0,30
CDM,4505137,ED REM FB EYE RUSTRING (METAL),1175.0,290.23,169.32,2503.0,30
CDM,4505145,ED REM FB EYE SUPERFICIAL,411.0,101.52,59.23,2503.0,30
CDM,4505152,ED REM FB PHARYNX,796.0,196.61,114.7,2503.0,30
CDM,4505194,ED SPLINT/STRAP EXTREMITY LOWER,324.0,80.03,46.69,2503.0,30
CDM,4505202,ED SPLINT/STRAP EXTREMITY UPPER,476.0,117.57,68.59,2503.0,30
CDM,4505210,ED PACING TRANSCUTANEOUS TEMP,1318.0,325.55,0.94,2503.0,64
CDM,4505228,ED THORACENT/TUBE CHEST/DRN PLEURAL,1876.0,463.37,270.33,2503.0,30
CDM,4505236,ED THORACOTOMY MASSAGE CARDIAC,2567.0,634.05,369.9,2503.0,30
CDM,4505244,ED TRACH/CRICOTHYROID,4269.0,1054.44,615.16,3201.75,30
CDM,4505335,ED TREATMENT INCOMPLETE ABORTION,5332.0,1317.0,768.34,3999.0,30
CDM,4505343,ED VENIPUNCTURE CUTDOWN,974.0,240.58,140.35,2503.0,30
CDM,4505350,ED CLOSURE WOUND W TISSUE ADHESIVE,492.0,121.52,70.9,2503.0,30
CDM,4505368,ED RPR WOUND LVL 03 COMPLEX,1019.0,251.69,146.84,2503.0,30
CDM,4505392,ED EKG TRACING ROUTINE 12+ LEADS,543.0,118.92,6.13,433.0,63
CDM,4505400,ED EKG TRACING RHYTHM 1-3 LEADS,130.0,28.47,6.13,433.0,63
CDM,4505491,ED INS CATH BLADDER INDWL SMPL,284.0,70.15,24.52,2503.0,64
CDM,4505590,ED INF IV HYDRATION 31-60MIN,469.0,115.84,31.58,2503.0,64
CDM,4505608,ED INF IV HYDRATION ADDL HR,138.0,34.09,12.04,2503.0,64
CDM,4505616,ED INF IV THRPY 1ST HR,882.0,217.85,61.03,2503.0,64
CDM,4505624,ED INF IV THRPY ADDL HR,184.0,45.45,19.91,2503.0,64
CDM,4505640,ED INF IV THRPY CONCURRENT,175.0,43.22,19.25,2503.0,40
CDM,4505657,ED INJ IVP DRUG INITIAL,585.0,144.5,35.77,2503.0,64
CDM,4505665,ED INJ IVP SEQ DRUG ADDL NEW,377.0,93.12,14.97,2503.0,64
CDM,4505871,ED INJ IVP SEQ DRUG ADDL SAME,198.0,48.91,9.45,2503.0,40
CDM,4505889,ED CHG TUBE GASTRO WO GD IMG/ENDO,1360.0,335.92,195.98,2503.0,30
CDM,4505913,ED PROCEDURE IRRG NOT BLADDER,565.0,139.56,81.42,2503.0,30
CDM,4505954,ED INJ/S ANES NRV BLOCK OTHER,1386.0,342.34,199.72,2503.0,30
CDM,4506135,ED PROCEDURE UNLIST LVL 01 SMPL,880.0,217.36,126.81,2503.0,30
CDM,4506143,ED PROCEDURE UNLIST LVL 02 INTRM,1409.0,348.02,203.04,2503.0,30
CDM,4506150,ED PROCEDURE UNLIST LVL 03 CMPLX,2946.0,727.66,424.52,2503.0,30
CDM,4506168,ED TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,4506176,ED TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,4506184,ED TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,4506192,ED I&D/ASP PUNCT LVL 01 SIMPLE,445.0,109.92,64.12,2503.0,30
CDM,4506200,ED I&D LVL 02 INTRM,532.0,131.4,76.66,2503.0,30
CDM,4506218,ED I&D LVL 03 COMPLEX,636.0,157.09,91.65,2503.0,30
CDM,4506226,ED REM FB CANL AUD EXT LVL 01 SMPL,284.0,70.15,40.92,2503.0,30
CDM,4506234,ED REM FB CANL AUD EXT LVL 02 CMPLX,681.0,168.21,98.13,2503.0,30
CDM,4506242,ED REM FB MUSCLE/TNDN LVL 01 SIMPLE,2094.0,517.22,301.75,2503.0,30
CDM,4506259,ED REM FB MUSCLE/TNDN LVL 02 CMPLX,3726.0,920.32,536.92,2794.5,30
CDM,4506267,ED RPR TENDON FOOT LVL 01 SIMPLE,2899.0,716.05,417.75,2503.0,30
CDM,4506275,ED RPR TENDON FOOT LVL 02 CMPLX,3612.0,892.16,520.49,2709.0,30
CDM,4506283,ED RPR TENDON HAND/FNG LVL 01 SMPL,1936.0,478.19,278.98,2503.0,30
CDM,4506291,ED RPR TENDON HAND/FNG LVL 02 CMPLX,2416.0,596.75,348.15,2503.0,30
CDM,4506317,ED INTUBATION/ASPIRATION GASTRIC,631.0,155.86,90.93,2503.0,30
CDM,4506325,ED CATH COLLECT SPEC URINE,49.0,8.43,3.0,49.22,63
CDM,4506333,ED INS CATH BLADDER NONINDWL,257.0,63.48,24.8,2503.0,64
CDM,4506341,ED PROCEDURE UNLIST ADD-ON,239.0,59.03,34.44,2503.0,30
CDM,4506408,ED INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,71.38,27.7,2503.0,64
CDM,4506416,ED COLLECT SPEC BLD CATH ARTERIAL,929.0,229.46,133.87,2503.0,30
CDM,4506424,ED TREATMENT BURN LVL 02 MEDIUM,667.0,164.75,96.11,2503.0,30
CDM,4506432,ED TREATMENT BURN LVL 03 LARGE,757.0,186.98,109.08,2503.0,30
CDM,4506440,ED RPR WOUND LVL 02 INTERMEDIATE,776.0,191.67,111.82,2503.0,30
CDM,4506457,ED RPR WOUND LVL 01 SIMPLE,621.0,153.39,89.49,2503.0,30
CDM,4506572,ED HEM NASAL CNTRL ANT LVL 02 BI,1142.0,282.07,164.56,2503.0,30
CDM,4506580,ED HEM NASAL CNTRL POST LVL 02 BI,1142.0,282.07,164.56,2503.0,30
CDM,4506598,ED HEM NASAL CNTRL ANT LVL 01 UNI,586.0,144.74,84.44,2503.0,30
CDM,4506606,ED HEM NASAL CNTRL POST LVL 01 UNI,586.0,144.74,84.44,2503.0,30
CDM,4506614,ED TRAUMA ACT LVL1 FULL/RED W CC,17610.0,4103.13,1422.32,13207.5,61
CDM,4506622,ED TRAUMA ACT LVL1 LTD/YELLOW W CC,11710.0,2728.43,1422.32,8782.5,61
CDM,4506697,ED REM CERUMEN IMPACTED W INST UNI,284.0,70.15,40.92,2503.0,30
CDM,4506705,ED REM CERUMEN IMPACTED W INST BI,426.0,105.22,61.39,2503.0,30
CDM,4506713,ED EXTRACTION TOOTH/TEETH,1224.0,302.33,176.38,2503.0,30
CDM,4506721,ED REM CERUMEN IMPACTED W IRRG UNI,221.0,54.59,31.85,2503.0,30
CDM,4506739,ED REM CERUMEN IMPACTED W IRRG BI,332.0,82.0,47.84,2503.0,30
CDM,4506788,ED TRAUMA ACT LVL1 FULL/RED WO CC,13210.0,3077.93,1903.56,9907.5,38
CDM,4506796,ED TRAUMA ACT LVL1 LTD/YELLOW WO CC,8785.0,2046.91,1265.92,7907.0,38
CDM,4506804,ED SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,39
CDM,4506812,ED SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CDM,4506820,ED SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,39
CDM,4506838,ED SED MOD DIFF 0-4Y INIT 15MN,525.0,166.95,80.25,752.08,39
CDM,4506846,ED SED MOD DIFF 5+Y INIT 15MN,580.0,184.44,72.74,614.45,39
CDM,4506853,ED SED MOD DIFF ADDL 15MN,265.0,84.27,49.29,465.97,39
CDM,4506929,ED PERICARDIOCENTESIS INCL IMG GD,3370.0,832.39,222.72,10257.38,64
CDM,4506960,ED INJ/S ANES NRV TRIGEMINAL BR BI,1977.0,488.32,50.08,2503.0,41
CDM,4506978,ED INJ/S ANES NRV TRIGEMINAL BR LT,1318.0,325.55,50.08,2503.0,41
CDM,4506986,ED INJ/S ANES NRV TRIGEMINAL BR RT,1318.0,325.55,50.08,2503.0,41
CDM,4507026,ED CATH/CANN ART SMP/MNTR/TRNS PERC,929.0,229.46,42.66,3432.43,41
CDM,4507034,ED REM SUTURE/STAPLE NO ANESTH,369.0,91.14,11.32,2503.0,41
CDM,4507042,ED REM SUTURE&STAPLE NO ANESTH,461.0,113.87,15.5,2503.0,41
CDM,45427,R&B NURSERY LEVEL 2 LOWER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,455,R&B OBSTETRICS PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,4601407,IMPRV RESP STRENGTH MUSC/S 15MIN,168.0,32.59,10.99,126.0,59
CDM,4601415,IMPRV RESP FNCT/STRENGTH MUSC/S GRP,270.0,52.38,12.62,202.5,59
CDM,4601423,IMPRV RESP FNCT 15MIN,213.0,41.32,10.02,159.75,59
CDM,4601704,TEST STRESS PULMONARY,542.0,191.33,11.97,406.5,63
CDM,4601712,TEST EXERCISE CARDIOPULMONARY,1714.0,605.04,85.88,1285.5,63
CDM,4601753,REHAB PULM OP WO CONT OX SESSN,199.0,61.09,29.58,149.25,63
CDM,4601761,REHAB PULM OP W CONT OX SESSN,242.0,74.29,40.35,181.5,63
CDM,4601779,REHAB PULM OP WO CONT OX 36+ SESSN,199.0,61.09,29.58,149.25,40
CDM,4601787,REHAB PULM OP W CONT OX 36+ SESSN,242.0,74.29,40.35,181.5,40
CDM,4703666,EVOK PTNTL AUD THRSHLD MULT I&R,1887.0,620.88,109.98,1415.25,63
CDM,4703674,EVOK PTNTL AUD NEURODX I&R,1548.0,509.34,81.45,1161.0,63
CDM,4800009,TX DEHISCENCE WOUND CLSR SMPL,1564.0,559.91,184.23,5681.0,63
CDM,4800488,PLC STNT/S VERT ART OPN/PERC INIT,12779.0,4574.88,776.16,10257.38,36
CDM,4800496,PLC STNT/S VERT ART OPN/PERC ADDL,9585.0,3431.43,460.98,7188.75,36
CDM,4800686,PLC STNT/S ART CRV CAR W EMB S&I,9840.0,3522.72,938.83,7704.0,40
CDM,4800694,PLC STNT/S ART CRV CAR WO EMB S&I,9326.0,3338.71,954.64,7704.0,40
CDM,4800702,EVAL DEV PROG ICD TV SGL IN PERSON,191.0,55.96,26.93,285.62,63
CDM,4800710,EVAL DEV PROG ICD TV SGL IN PERSON,191.0,55.96,26.93,285.62,63
CDM,4800728,EVAL DEV PROG ICD TV DUAL IN PERSON,219.0,64.17,26.93,348.21,63
CDM,4800736,EVAL DEV PROG ICD TV DUAL IN PERSON,219.0,64.17,26.93,348.21,63
CDM,4800744,EVAL DEV PROG ICD TV MULT IN PERSON,248.0,72.66,26.93,375.2,63
CDM,4800751,EVAL DEV PROG ICD TV MULT IN PERSON,248.0,72.66,26.93,375.2,63
CDM,4800769,EVAL DEV PERIPRO PROG ICD IN PERSON,145.0,42.48,26.97,190.53,39
CDM,4800777,EVAL DEV PERIPRO PROG ICD IN PERSON,145.0,42.48,26.97,190.53,39
CDM,4800785,EVAL DEV INTRGTN ICD TV IN PERSON,196.0,57.43,26.93,257.48,63
CDM,4800801,EVAL EP ICD TV CHAMBER SGL/DUAL,2097.0,614.42,79.4,44695.0,63
CDM,4800819,EVAL EP ICD TV CHAMBER SGL/DUAL,2097.0,614.42,79.4,44695.0,63
CDM,4800827,INS/RPL DEFIB SUBQ PERM W ELCTRD,15344.0,5493.15,534.79,66010.0,63
CDM,4800835,INS DEFIB SUBQ ELCTRD,13803.0,4941.47,435.19,22347.0,63
CDM,4800843,REM DEFIB SUBQ ELCTRD,6973.0,2496.33,332.51,66010.0,63
CDM,4800850,REPOS DEFIB SUBQ PREV ELCTRD,5953.0,2131.17,385.22,18194.0,63
CDM,4800868,EVAL DEV PROG DEV SUBQ IN PERSON,1386.0,406.1,26.93,1039.5,63
CDM,4800876,EVAL DEV INTRGTN DEV SUBQ IN PERSON,1386.0,406.1,26.93,1039.5,63
CDM,4800884,EVAL EP DEFIBRILLATOR SUBQ,1936.0,567.25,49.29,1452.0,39
CDM,4800892,INS/RPL DEFIB SUBQ PERM W ELCTRD,15344.0,5493.15,534.79,66010.0,63
CDM,4800900,INS DEFIB SUBQ ELCTRD,13803.0,4941.47,435.19,22347.0,63
CDM,4800918,REM DEFIB SUBQ ELCTRD,6973.0,2496.33,332.51,66010.0,63
CDM,4800926,REPOS DEFIB SUBQ PREV ELCTRD,5953.0,2131.17,385.22,18194.0,63
CDM,4800934,EVAL DEV PROG DEV SUBQ IN PERSON,1386.0,406.1,26.93,1039.5,63
CDM,4800942,EVAL DEV INTRGTN DEV SUBQ IN PERSON,1386.0,406.1,26.93,1039.5,63
CDM,4800959,EVAL EP DEFIBRILLATOR SUBQ,1936.0,567.25,49.29,1452.0,39
CDM,4800967,VERTEBROPLASTY CRVTHOR PERC,5456.0,1953.25,418.34,18194.0,63
CDM,4800975,VERTEBROPLASTY LUMBOSACRAL PERC,4992.0,1787.14,393.85,18194.0,63
CDM,4800983,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4389.0,1571.26,199.38,18194.0,38
CDM,4800991,AUG VERTEBRAL THORACIC PERC,13730.0,4915.34,494.28,13802.9,63
CDM,4801015,REM DEV IAB PERC,4277.0,1531.17,32.1,13802.9,41
CDM,4801064,PLC CATH SEL VENOUS BRANCH 1ST ORD,1465.0,524.47,148.19,5681.0,40
CDM,4801080,REPOSITION CVC PREVIOUS W FLUORO,2668.0,955.14,57.52,5681.0,63
CDM,4801098,CATH VENOUS SAMPLE BLOOD ORGAN,1438.0,514.8,173.21,5681.0,40
CDM,4801106,THROMBOLYSIS CEREBRAL INF IV,1692.0,605.74,225.29,13802.9,63
CDM,4801114,BX TRANSCATHETER,3930.0,1406.94,204.09,15325.0,63
CDM,4801122,BX TRANSCATHETER S&I,1787.0,503.93,26.45,1340.25,37
CDM,4801189,ANGIO ILIAC/FEMORAL DURING HRT CATH,1800.0,477.0,12.95,14891.0,38
CDM,4801205,RECORDING BUNDLE OF HIS,7186.0,2105.5,5.75,44695.0,63
CDM,4801213,EVAL EP COMP PACING&REC ATRIAL LT,4990.0,1462.07,928.14,44695.0,39
CDM,4801221,EVAL EP COMP PACING&REC VENT LT,7484.0,2192.81,1047.52,44695.0,39
CDM,4801239,EVAL EP LEADS W TEST ICD INITIAL,2641.0,773.81,18.52,11751.0,39
CDM,4801254,STUDY EP FLWUP PACING&REC,14856.0,4352.81,62.5,44695.0,63
CDM,4801270,RECORDING INTRA-ATRIAL,7186.0,2105.5,3.06,44695.0,63
CDM,4801288,MAP 3D EP INTRACARDIAC,9313.0,2728.71,276.0,44695.0,39
CDM,4801296,PACING INTRAVENTRICULAR,7186.0,2105.5,4.85,44695.0,63
CDM,4801304,STIMULATION&PACING INF IV DRUG,12537.0,3673.34,1047.52,44695.0,39
CDM,4801312,MAP TACHYCARDIA INTRAVENT&/ATRIAL,15507.0,4543.55,7.51,44695.0,39
CDM,4801320,RECORDING VENTRICULAR RT,5137.0,1505.14,4.85,44695.0,63
CDM,4801338,ABL CATH IC NODE A/V W/WO PM TEMP,12089.0,3542.08,550.92,44695.0,63
CDM,4801403,PLC DEVICE RAD BRACHY CORONARY,5714.0,1514.21,152.95,14891.0,40
CDM,4801452,INS ELCTRD LV PM/ICD ADD ON,10124.0,3624.39,437.79,55261.0,40
CDM,4801460,INS ELCTRD PM/ICD TRANSVENOUS DUAL,10258.0,3672.36,353.3,15325.0,63
CDM,4801478,INS ELCTRD PM/ICD TRANSVENOUS SGL,10258.0,3672.36,355.92,15325.0,63
CDM,4801528,INS/RPLC ELCTRD/CATH PM TEMP SGL,9672.0,3462.58,153.19,15325.0,63
CDM,4801536,INS DEV IAB PERC,8348.0,2988.58,245.24,13802.9,41
CDM,4801551,VEL&/FLW DOPP INTRAV VSL ADDL,2921.0,774.06,54.88,14891.0,39
CDM,4801569,VEL&/FLW DOPP INTRAV VSL INIT,5841.0,1547.86,201.01,14891.0,39
CDM,4801577,INTRO CATH SVC/IVC,1244.0,445.35,103.09,5681.0,40
CDM,4801593,INTRO NDL/CATH ARTERY EXTREMITY LT,867.0,310.39,84.4,5681.0,40
CDM,4801627,PLC DEV/S OCCLUSIVE,461.0,165.04,85.75,4664.0,33
CDM,4801668,REM ELCTRD ICD SGL/DUAL EXTRACT TV,8645.0,3094.91,824.37,10257.38,63
CDM,4801700,REPOSITION ELCTRD PM/ICD PREV A/V,6115.0,2189.17,297.16,10257.38,63
CDM,4801742,PLC CATH SEL ART ABD/EXT 1ST ORD,2083.0,745.71,223.82,6689.0,40
CDM,4801759,PLC CATH SEL ART ABD/EXT 2ND ORD,2024.0,724.59,239.51,6689.0,40
CDM,4801767,PLC CATH SEL ART ABD/EXT 3RD ORD,2547.0,911.83,282.91,6689.0,40
CDM,4801775,PLC CATH SEL ART ABD/EXT ADDL,1311.0,469.34,45.79,6689.0,40
CDM,4801783,PLC CATH SEL ART THOR/BRACH 1ST ORD,2107.0,754.31,202.6,6689.0,40
CDM,4801791,PLC CATH SEL ART THOR/BRACH 2ND ORD,2729.0,976.98,258.66,6689.0,40
CDM,4801809,PLC CATH SEL ART THOR/BRACH 3RD ORD,3380.0,1210.04,316.77,6689.0,40
CDM,4801817,PLC CATH SEL ART THOR/BRACH ADDL,796.0,284.97,49.98,6689.0,40
CDM,4801866,UPGRADE SYS PM IMP SGL TO DUAL,12779.0,4574.88,458.06,55261.0,63
CDM,4801940,ANGIO EXTREMITY BI S&I,6003.0,1266.63,70.02,11792.62,63
CDM,4801965,ANGIO PULMONARY SEL BI S&I,4220.0,890.42,70.02,11792.62,63
CDM,4802013,ANGIO VISCERAL SEL S&I,7413.0,1564.14,75.54,19658.22,63
CDM,4802021,AORTO ABD SERIAL S&I,4923.0,1038.75,58.38,11792.62,63
CDM,4802039,AORTO ABD ILIOFEM BI SERIAL S&I,5792.0,1222.11,62.88,11792.62,63
CDM,4802047,AORTO THORACIC SERIAL S&I,6871.0,1449.78,66.45,19658.22,63
CDM,4802112,CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,63
CDM,4802385,VENOGRAM EXTREMITY BI S&I,2282.0,643.52,63.9,5794.55,63
CDM,4802401,VENOGRAM IVC SERIAL S&I,4923.0,1388.29,60.0,11792.62,63
CDM,4802419,VENOGRAM SVC SERIAL S&I,1731.0,488.14,64.23,5794.55,63
CDM,4802427,EVAL EP COMP W ARRHYTHMIA,19066.0,5586.34,190.05,44695.0,63
CDM,4802435,EVAL EP COMP WO ARRHYTHMIA,14190.0,4157.67,20.74,44695.0,63
CDM,4802450,PACING INTRA-ATRIAL,7186.0,2105.5,4.41,44695.0,63
CDM,4802484,VENOGRAM SINUS VEN/JUG S&I,4220.0,1190.04,71.0,11792.62,63
CDM,4802492,VENOGRAM RENAL SEL BI S&I,4393.0,1238.83,77.17,11792.62,63
CDM,4802518,VALVOTOMY MITRAL HEART CLOSED,13803.0,4941.47,982.0,13802.9,40
CDM,4802526,ANGIO MAMMARY INTERNAL S&I,4017.0,847.59,108.28,11792.62,63
CDM,4802559,FLUORO GD PLCMT NEEDLE,582.0,164.12,87.26,623.23,37
CDM,4802567,PACING TRANSCUTANEOUS TEMP,1318.0,386.17,0.94,1317.89,63
CDM,4802575,VALVULOPLASTY BLN PULMONARY PERC,14774.0,5289.09,1042.29,26761.0,63
CDM,4802591,PTA BLN ART PULMONARY VSL SGL,14057.0,4118.7,601.98,26761.0,63
CDM,4802609,PTA BLN ART PULMONARY VSL ADDL,6283.0,1840.92,301.58,15325.0,40
CDM,4802807,ECHO ICRD INTRV THER/DX,5728.0,1678.3,21.59,44695.0,39
CDM,4802831,GD W PLC CATH DRN PERC S&I,962.0,271.28,55.46,721.5,37
CDM,4802898,INTRO CATH RT HEART/ART PULM MAIN,853.0,305.37,119.8,5681.0,40
CDM,4802971,ANGIO SEL VESSEL ADDL S&I,1487.0,313.76,49.61,1115.25,37
CDM,4802997,BX ENDOMYOCARDIAL,7560.0,6831.17,405.28,16111.14,63
CDM,4803003,EVAL EP LEADS ICD INITIAL,2635.0,772.06,18.52,44695.0,39
CDM,4803029,INDUCTION ARRTHYMIA BY PACING,5137.0,1505.14,10.59,44695.0,63
CDM,4803037,INS&PLC CATH DIRECTED FLOW,5656.0,1498.84,84.35,16111.14,63
CDM,4803094,CLOSE TRANSCATH PFO/ASD CONG W IMP,25279.0,9049.88,924.31,79657.7,63
CDM,4803110,THROMBECT GRAFT ARTERIAL/VENOUS,9241.0,3308.28,562.0,18194.0,63
CDM,4803144,FLUORO 0-1HR TIME PHYS/QHCP,475.0,133.95,27.22,948.33,63
CDM,4803177,I&D HEMATOMA/SEROMA/FLUID,3139.0,1123.76,116.33,5681.0,63
CDM,4803219,PLC CATH SEL VENOUS BRANCH 2+ ORD,1648.0,589.98,165.17,5681.0,40
CDM,4803227,THERAPY TRANSCATH EMB S&I,2708.0,763.66,56.0,2031.0,37
CDM,4803235,CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,63
CDM,4803243,ECHO 2D CMP WO CNT,1384.0,340.46,91.45,2497.0,63
CDM,4803250,ECHO 2D LTD WO CNT,988.0,243.05,72.3,2497.0,63
CDM,4803268,ECHO DOPP MAP VELOCITY COLOR FLOW,462.0,113.65,19.8,2497.0,39
CDM,4803276,ECHO CONG ANM CMP WO CNT,1707.0,419.92,155.02,2497.0,63
CDM,4803284,ECHO CONG ANM LTD WO CNT,875.0,215.25,117.08,2497.0,63
CDM,4803292,ECHO DOPP CMP,747.0,183.76,32.42,2497.0,39
CDM,4803300,ECHO DOPP LTD,374.0,92.0,17.53,2497.0,39
CDM,4803318,ECHO 2D REST&STRESS WO CNT W I&R,1432.0,352.27,114.81,2497.0,63
CDM,4803326,ECHO 2D TEE CMP WO CNT W I&R,2357.0,1045.7,128.08,2497.0,63
CDM,4803334,ECHO 2D TEE IMG I&R ONLY,1938.0,476.75,135.22,2497.0,39
CDM,4803342,COUNTERPULSATION EXTERNAL PER TX,1044.0,305.89,81.16,1043.3,63
CDM,4803359,TEST CV STRESS TREAD/BIKE&/RX TRACE,848.0,223.87,36.59,636.0,63
CDM,4803474,REM ELCTRD PM LEAD A/V DUAL,10086.0,3610.79,608.32,15325.0,63
CDM,4803482,REM ELCTRD PM LEAD A/V SGL,8069.0,2888.7,462.87,15325.0,63
CDM,4803490,VALVULOPLASTY BLN MITRAL PERC,14660.0,5248.28,1301.84,26761.0,63
CDM,4803508,CPR,1318.0,386.17,177.3,1317.89,63
CDM,4803516,INTRO CATH AORTA,1392.0,498.34,131.94,6689.0,40
CDM,4803524,VALVULOPLASTY BLN AORTA PERC,14532.0,5202.46,1263.13,26761.0,63
CDM,4803573,EVAL FNCT CARDIO W TILT TABLE/EKG,3891.0,1140.06,70.95,44695.0,63
CDM,4803748,EMB/THRMB ART AX/BR/IN/SUBC ARM BI,4964.0,1777.11,566.15,10065.0,40
CDM,4803763,EMB/THRMB ART FEMPP/AORILIAC LEG BI,14658.0,5247.56,968.14,10993.5,40
CDM,4803789,EMB/THRMB ART RADIAL/ULNAR ARM BI,14658.0,5247.56,565.5,10993.5,40
CDM,4803797,INJ VENOGRAPHY EXTREMITY BI,750.0,268.5,45.26,5681.0,40
CDM,4803862,EMB/THRMB ART RADIAL/ULNAR ARM LT,9772.0,3498.38,565.5,10257.38,40
CDM,4803870,EMB/THRMB ART RADIAL/ULNAR ARM RT,9772.0,3498.38,565.5,10257.38,40
CDM,4803888,EMB/THRMB ART FEMPP/AORILIAC LEG LT,9772.0,3498.38,968.14,10257.38,40
CDM,4803896,EMB/THRMB ART FEMPP/AORILIAC LEG RT,9772.0,3498.38,968.14,10257.38,40
CDM,4803904,EMB/THRMB ART AX/BR/IN/SUBC ARM LT,3309.0,1184.62,566.15,10065.0,40
CDM,4803912,EMB/THRMB ART AX/BR/IN/SUBC ARM RT,3309.0,1184.62,566.15,10065.0,40
CDM,4804076,AUG VERTEBRAL LUMBAR PERC,10799.0,3866.04,460.82,13802.9,63
CDM,4804084,AUG VERTEBRAL LUMBAR/THOR PERC ADDL,4724.0,1691.19,209.44,6904.78,38
CDM,4804142,INJ VENOGRAPHY EXTREMITY LT,500.0,179.0,45.26,5681.0,40
CDM,4804159,INJ VENOGRAPHY EXTREMITY RT,500.0,179.0,45.26,5681.0,40
CDM,4804167,VENOGRAM RENAL SEL LT S&I,4220.0,1190.04,66.78,11792.62,40
CDM,4804175,VENOGRAM RENAL SEL RT S&I,4220.0,1190.04,66.78,11792.62,40
CDM,4804209,VENOGRAM EXTREMITY LT S&I,2093.0,590.23,57.73,5794.55,40
CDM,4804217,VENOGRAM EXTREMITY RT S&I,2093.0,590.23,57.73,5794.55,40
CDM,4804266,ANGIO PULMONARY SEL LT S&I,4102.0,865.52,68.73,11792.62,40
CDM,4804274,ANGIO PULMONARY SEL RT S&I,4102.0,865.52,68.73,11792.62,40
CDM,4804282,ANGIO EXTREMITY LT S&I,5894.0,1243.63,67.1,11792.62,40
CDM,4804290,ANGIO EXTREMITY RT S&I,5894.0,1243.63,67.1,11792.62,40
CDM,4804365,CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,63
CDM,4804506,PLC CATH SEL ART PULM 2ND ORD RT,1315.0,470.77,163.1,5681.0,40
CDM,4804522,INTRO NDL/CATH ARTERY EXTREMITY RT,867.0,310.39,84.4,5681.0,40
CDM,4804621,INS CVC CENTRAL NONTUN 5+YRS,5317.0,1903.49,81.34,5681.0,63
CDM,4804829,PLC CATH SEL ART PULM 2ND ORD LT,1315.0,470.77,163.1,5681.0,40
CDM,4804837,PLC CATH SEL ART PULM BI,1088.0,389.5,143.71,5681.0,40
CDM,4804845,PLC CATH SEL ART PULM LT,725.0,259.55,134.85,5681.0,40
CDM,4804852,PLC CATH SEL ART PULM RT,725.0,259.55,134.85,5681.0,40
CDM,4804860,THROMBECT MECH SEC ART W FL,6905.0,2471.99,230.46,6904.78,40
CDM,4804910,FLUORO GD PLC/REPL/REM CVAD,526.0,148.33,78.82,537.02,37
CDM,4805412,CLOSE TRANSCATH VSD CONG W IMP,22297.0,5908.7,1253.6,79657.7,63
CDM,4805503,CATH/CANN ART SMP/MNTR/TRNS PERC,929.0,332.58,42.66,5681.0,40
CDM,4805545,THROMBECT MECH PRIM ART SUBSQ W FL,6905.0,2471.99,154.03,6904.78,40
CDM,4805867,I&D HEMATOMA/SEROMA/FLUID,3139.0,1123.76,116.33,5681.0,63
CDM,4805917,INS/RPLC ELCTRD/CATH PM TEMP SGL,9672.0,3462.58,153.19,15325.0,63
CDM,4805941,UPGRADE SYS PM IMP SGL TO DUAL,12779.0,4574.88,458.06,55261.0,63
CDM,4805958,REPOSITION ELCTRD PM/ICD PREV A/V,6115.0,2189.17,297.16,10257.38,63
CDM,4805966,INS ELCTRD PM/ICD TRANSVENOUS SGL,10258.0,3672.36,355.92,15325.0,63
CDM,4805974,INS ELCTRD PM/ICD TRANSVENOUS DUAL,10258.0,3672.36,353.3,15325.0,63
CDM,4806352,INS ELCTRD LV PREVIOUS PM/ICD,10258.0,3672.36,485.77,55261.0,63
CDM,4806360,INS ELCTRD LV PM/ICD ADD ON,10124.0,3624.39,437.79,55261.0,40
CDM,4806378,REPOSITION ELCTRD LV PREVIOUS,8111.0,2903.74,464.9,10257.38,63
CDM,4806394,REM ELCTRD PM LEAD A/V SGL,8069.0,2888.7,462.87,15325.0,63
CDM,4806402,REM ELCTRD PM LEAD A/V DUAL,10086.0,3610.79,608.32,15325.0,63
CDM,4806444,REM ELCTRD ICD SGL/DUAL EXTRACT TV,8645.0,3094.91,824.37,10257.38,63
CDM,4806493,INJ VENOGRAPHY EXTREMITY BI,750.0,268.5,45.26,5681.0,40
CDM,4806501,INJ VENOGRAPHY EXTREMITY LT,500.0,179.0,45.26,5681.0,40
CDM,4806519,INJ VENOGRAPHY EXTREMITY RT,500.0,179.0,45.26,5681.0,40
CDM,4806527,PLC CATH SEL VENOUS BRANCH 1ST ORD,1465.0,524.47,148.19,5681.0,40
CDM,4806535,CATH VENOUS SAMPLE BLOOD ORGAN,1438.0,514.8,173.21,5681.0,40
CDM,4806543,BX TRANSCATHETER,3930.0,1406.94,204.09,15325.0,63
CDM,4806576,ANGIO PULMONARY SEL BI S&I,4220.0,890.42,70.02,11792.62,63
CDM,4806584,VENOGRAM EXTREMITY LT S&I,2093.0,590.23,57.73,5794.55,40
CDM,4806592,VENOGRAM EXTREMITY RT S&I,2093.0,590.23,57.73,5794.55,40
CDM,4806600,VENOGRAM EXTREMITY BI S&I,2282.0,643.52,63.9,5794.55,63
CDM,4806626,BX TRANSCATHETER S&I,1787.0,503.93,26.45,1340.25,37
CDM,4806634,FLUORO 0-1HR TIME PHYS/QHCP,475.0,133.95,27.22,948.33,63
CDM,4806667,CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,63
CDM,4806683,INS&PLC CATH DIRECTED FLOW,5656.0,1498.84,84.35,16111.14,63
CDM,4806691,BX ENDOMYOCARDIAL,7560.0,6831.17,405.28,16111.14,63
CDM,4806790,RECORDING BUNDLE OF HIS,7186.0,2105.5,5.75,44695.0,63
CDM,4806808,RECORDING INTRA-ATRIAL,7186.0,2105.5,3.06,44695.0,63
CDM,4806816,RECORDING VENTRICULAR RT,5137.0,1505.14,4.85,44695.0,63
CDM,4806824,MAP TACHYCARDIA INTRAVENT&/ATRIAL,15507.0,4543.55,7.51,44695.0,39
CDM,4806832,PACING INTRA-ATRIAL,7186.0,2105.5,4.41,44695.0,63
CDM,4806840,PACING INTRAVENTRICULAR,7186.0,2105.5,4.85,44695.0,63
CDM,4806857,MAP 3D EP INTRACARDIAC,9313.0,2728.71,276.0,44695.0,39
CDM,4806865,INDUCTION ARRTHYMIA BY PACING,5137.0,1505.14,10.59,44695.0,63
CDM,4806873,EVAL EP COMP WO ARRHYTHMIA,14190.0,4157.67,20.74,44695.0,63
CDM,4806881,EVAL EP COMP W ARRHYTHMIA,19066.0,5586.34,190.05,44695.0,63
CDM,4806899,EVAL EP COMP PACING&REC ATRIAL LT,4990.0,1462.07,928.14,44695.0,39
CDM,4806907,EVAL EP COMP PACING&REC VENT LT,7484.0,2192.81,1047.52,44695.0,39
CDM,4806915,STIMULATION&PACING INF IV DRUG,12537.0,3673.34,1047.52,44695.0,39
CDM,4806923,STUDY EP FLWUP PACING&REC,14856.0,4352.81,62.5,44695.0,63
CDM,4806931,EVAL EP LEADS ICD INITIAL,2635.0,772.06,18.52,44695.0,39
CDM,4806949,EVAL EP LEADS W TEST ICD INITIAL,2641.0,773.81,18.52,11751.0,39
CDM,4806964,ABL CATH IC NODE A/V W/WO PM TEMP,12089.0,3542.08,550.92,44695.0,63
CDM,4806998,EVAL FNCT CARDIO W TILT TABLE/EKG,3891.0,1140.06,70.95,44695.0,63
CDM,4807004,ECHO ICRD INTRV THER/DX,5728.0,1678.3,21.59,44695.0,39
CDM,4807103,PLC DEV/S OCCLUSIVE,461.0,165.04,85.75,4664.0,33
CDM,4807434,CPR,1318.0,386.17,177.3,1317.89,63
CDM,4807640,ECHO 2D DOPP&CLR FLW CMP WO CNT,2678.0,658.79,125.48,2497.0,63
CDM,4807665,ECHO 2D REST&STRESS/EKG MNTR WO CNT,1875.0,461.25,147.18,2497.0,63
CDM,4807673,ECHO 2D DOPP&CLR FLW CMP W CNT,3348.0,823.61,518.51,3741.75,62
CDM,4807681,ECHO 2D REST&STRESS/EKG MNTR W CNT,2344.0,576.62,518.51,3741.75,62
CDM,4808085,EVAL DEV PROG CRM SUBQ IN PERSON,169.0,49.52,26.93,215.04,63
CDM,4808820,PLC EV DEV OCCL ART ILIAC,6905.0,2471.99,191.09,6904.78,40
CDM,4808838,ANLYS ELECT SYSTEM PM ANTITACHYCARD,512.0,150.02,45.08,44695.0,63
CDM,4809059,VENOGRAM HEPATIC W EVAL HEMO S&I,4501.0,1269.28,70.35,11792.62,63
CDM,4809109,INS VAD EXTRACORP VENTRICLE SGL,4323.0,1547.63,804.08,13802.9,40
CDM,4809117,REM VAD EXTRACORP VENTRICLE SGL,3598.0,1288.08,669.23,13802.9,40
CDM,4809315,PLC STNT/S ART INM/INTRATH CAR S&I,5978.0,2140.12,786.64,7704.0,40
CDM,4811030,INS VENT HEART LEFT THORACIC,7374.0,2639.89,731.35,13802.9,40
CDM,4811048,REM VENT HEART LEFT THORACIC,5531.0,1980.1,464.78,6904.78,40
CDM,4811055,ECHO TEE INTRACARDIAC TRANSCATH GD,2931.0,721.03,216.1,2497.0,39
CDM,4811170,RHC W IMP SENSOR PRESS WIRELESS,49131.0,13019.72,317.29,50502.38,63
CDM,4811204,US INTRAVASCULAR NONCORNRY INIT S&I,3525.0,1261.95,84.15,5681.0,40
CDM,4811212,US INTRAVASCULAR NONCORNRY ADDL S&I,2821.0,1009.92,66.97,5681.0,40
CDM,4811360,PLC CATH NEPHROSTOMY PERC BI S&I,5150.0,1843.7,195.15,14124.0,40
CDM,4811378,PLC CATH NEPHROSTOMY PERC LT S&I,3433.0,1229.01,195.15,14124.0,40
CDM,4811386,PLC CATH NEPHROSTOMY PERC RT S&I,3433.0,1229.01,195.15,14124.0,40
CDM,4811667,INS VAD LH ACC ART ONLY PERC S&I,3947.0,1413.03,341.82,13802.9,40
CDM,4811675,INS VAD LH ACC ART&VEN W PUNCT S&I,5762.0,2062.8,428.85,13802.9,40
CDM,4811683,REM VAD LH PERC ART/ART&VEN SEP,1896.0,678.77,178.2,13802.9,40
CDM,4811691,REM VAD RH PERC ART/ART&VEN SEP,1896.0,678.77,152.87,13802.9,40
CDM,4811709,TAS ANM CONG CARD IMG GD,7403.0,2650.27,712.33,5552.25,40
CDM,4811717,INS VAD RH ACC ART ONLY PERC S&I,3947.0,1413.03,336.58,13802.9,40
CDM,4811725,INS VAD LH ACC ART ONLY PERC S&I,3947.0,1413.03,341.82,13802.9,40
CDM,4811741,EXPOSE ART FEM GROIN W PROSTH EV LT,2616.0,936.53,194.34,5444.0,40
CDM,4811758,EXPOSE ART FEM GROIN W PROSTH EV RT,2616.0,936.53,194.34,5444.0,40
CDM,4811766,EXPOSE ART FEM GROIN W PROSTH EV BI,3924.0,1404.79,194.34,5444.0,40
CDM,4811790,PLC CATH SEL ART PULM 2ND ORD BI,1973.0,706.33,163.1,5681.0,40
CDM,4812327,ATHERECT PERIPH ART RENAL W S&I,14057.0,5032.41,2220.42,20325.69,63
CDM,4812335,ATHERECT PERIPH ART VISC W S&I,10258.0,3672.36,982.0,10257.38,40
CDM,4812343,ATHERECT PERIPH AORTA ABD W S&I,14057.0,5032.41,4299.0,20325.69,63
CDM,4812350,ATHERECT PERIPH TR&BR BRACH W S&I,14057.0,5032.41,588.29,20325.69,63
CDM,4812368,ATHERECT PERIPH ART ILIAC W S&I,16839.0,6028.36,743.03,32276.26,63
CDM,4812400,ADMIN DRUG&MEAS HEMODYNAMIC,2937.0,778.3,93.84,14891.0,33
CDM,4812988,RHC O2 SAT&CARDIAC OUTPUT,13154.0,5893.54,703.83,16111.14,63
CDM,4812996,LHC W INJ/S VENTRCLGRPHY LT S&I,14207.0,3764.86,636.89,16111.14,63
CDM,4813002,RHC&LHC W INJ/S VENTRCLGRPHY LT S&I,16112.0,4269.68,799.5,16111.14,63
CDM,4813010,PLC CATH&INJ/S CAG S&I,16112.0,4269.68,641.77,16111.14,63
CDM,4813028,PLC CATH&INJ/S CAG&GRF S&I,17682.0,4685.73,703.43,16111.14,63
CDM,4813036,PLC CATH&INJ/S CAG W RHC S&I,19761.0,5236.66,785.22,16111.14,63
CDM,4813044,PLC CATH&INJ/S CAG&GRF W RHC S&I,21305.0,5645.83,846.19,16111.14,63
CDM,4813051,PLC CATH&INJ/S CAG&LV W LHC S&I,18066.0,7091.32,719.33,16111.14,63
CDM,4813069,PLC CATH CAG&GRF&LV W LHC S&I,19034.0,5044.01,757.92,16111.14,63
CDM,4813077,PLC CATH CAG&LV W RHC&LHC S&I,21046.0,5577.19,838.07,16111.14,63
CDM,4813085,PLC CATH CAG&GRF&LV W RHC&LHC S&I,23175.0,6141.38,923.72,17381.25,63
CDM,4813093,LHC PUNCT TRANSSEPTAL/TRANSAPICAL,7006.0,1856.59,196.36,15325.0,40
CDM,4813101,INJ SEL CAG HRT CATH CONGENITAL S&I,1429.0,378.68,49.2,14891.0,39
CDM,4813119,INJ GRFT HRT CATH CONGENITAL S&I,1507.0,399.36,52.47,14891.0,39
CDM,4813127,INJ ANGIO LV/LA HRT CATH S&I,829.0,219.68,25.57,14891.0,39
CDM,4813135,INJ ANGIO RV/RA HRT CATH S&I,1040.0,275.6,24.72,14891.0,39
CDM,4813143,INJ AORTO SUPRVLV HRT CATH S&I,1086.0,287.79,35.64,14891.0,39
CDM,4813168,RHC O2 SAT&CARDIAC OUTPUT,13154.0,5893.54,703.83,16111.14,63
CDM,4813176,LHC W INJ/S VENTRCLGRPHY LT S&I,14207.0,3764.86,636.89,16111.14,63
CDM,4813184,RHC&LHC W INJ/S VENTRCLGRPHY LT S&I,16112.0,4269.68,799.5,16111.14,63
CDM,4813192,PLC CATH& INJ/S CAG S&I,16112.0,4269.68,641.77,16111.14,63
CDM,4813218,PLC CATH&INJ/S CAG W RHC S&I,19761.0,5236.66,785.22,16111.14,63
CDM,4813234,PLC CATH&INJ/S CAG&LV W LHC S&I,18066.0,7091.32,719.33,16111.14,63
CDM,4813259,PLC CATH CAG&LV W RHC&LHC S&I,21046.0,5577.19,838.07,16111.14,63
CDM,4813275,LHC PUNCT TRANSSEPTAL/TRANSAPICAL,7006.0,1856.59,196.36,15325.0,40
CDM,4813374,CHOLECYSTOSTOMY PERC W IMG GD S&I,6790.0,2430.82,319.81,10257.38,63
CDM,4813382,INS CATH INTRAPERIT TUN W PORT SQ,7413.0,2653.85,404.73,10065.0,63
CDM,4813390,REM CATH INTRAPERIT,5534.0,1981.17,213.06,7697.0,63
CDM,4813408,INS CATH INTRAPERIT TUN W IMG,5104.0,1827.23,191.43,18194.0,63
CDM,4813481,US GD VA EVAL SITE W REC PERM,827.0,288.62,23.97,620.25,37
CDM,4813697,INS NEW/RPLC PPM W ELCTRD ATRIAL,9772.0,3498.38,434.68,55261.0,63
CDM,4813705,INS NEW/RPLC PPM W ELCTRD ATRIAL,9772.0,3498.38,434.68,55261.0,63
CDM,4813713,INS NEW/RPLC PPM W ELCTRD VENT,10258.0,3672.36,456.66,55261.0,63
CDM,4813721,INS NEW/RPLC PPM W ELCTRD VENT,10258.0,3672.36,456.66,55261.0,63
CDM,4813739,INS NEW/RPLC PPM W ELCTRD A&V,28357.0,10151.81,494.26,55261.0,63
CDM,4813747,INS NEW/RPLC PPM W ELCTRD A&V,28357.0,10151.81,494.26,55261.0,63
CDM,4813762,INS GEN PPM ONLY W LD EXIST SGL,7000.0,2506.0,309.49,55261.0,63
CDM,4813788,INS GEN PPM ONLY W LD EXIST DUAL,7499.0,2684.64,324.07,55261.0,63
CDM,4813796,RPR ELCTRD PM/ICD TRANSVENOUS SGL,6248.0,2236.78,373.41,15325.0,63
CDM,4813804,RPR ELCTRD PM/ICD TRANSVENOUS SGL,6248.0,2236.78,373.41,15325.0,63
CDM,4813846,INS GEN PPM ONLY W LD EXIST MULTI,11790.0,4220.82,342.31,55261.0,63
CDM,4813853,REM&RPL GEN PPM SGL,11474.0,4107.69,325.02,55261.0,63
CDM,4813861,REM&RPL GEN PPM SGL,11474.0,4107.69,325.02,55261.0,63
CDM,4813879,REM&RPL GEN PPM DUAL,11952.0,4278.82,339.33,55261.0,63
CDM,4813887,REM&RPL GEN PPM DUAL,11952.0,4278.82,339.33,55261.0,63
CDM,4813895,REM&RPL GEN PPM MULTI,12669.0,4535.5,356.83,55261.0,63
CDM,4813903,REM&RPL GEN PPM MULTI,12669.0,4535.5,356.83,55261.0,63
CDM,4813937,REM GENERATOR PPM ONLY,4597.0,1645.73,224.3,15325.0,63
CDM,4813945,REM GENERATOR PPM ONLY,4597.0,1645.73,224.3,15325.0,63
CDM,4813952,INS GEN ICD ONLY W LD EXIST SGL,11632.0,4164.26,352.58,66010.0,63
CDM,4813978,REM GEN ICD ONLY,6125.0,2192.75,206.45,10257.38,63
CDM,4813986,REM GEN ICD ONLY,6125.0,2192.75,206.45,10257.38,63
CDM,4813994,INS/RPL ICD W LEAD SGL/DUAL,19993.0,7157.49,870.15,66010.0,63
CDM,4814000,INS/RPL ICD W LEAD SGL/DUAL,19993.0,7157.49,870.15,66010.0,63
CDM,4814018,REM&RPL GEN ICD SGL,16486.0,5901.99,356.2,66010.0,63
CDM,4814026,REM&RPL GEN ICD DUAL,18251.0,6533.86,370.1,66010.0,63
CDM,4814034,REM&RPL GEN ICD MULTI,19011.0,6805.94,385.95,66010.0,63
CDM,4814042,PLC CATH SEL 1ST ART RENAL UNI S&I,4220.0,1510.76,242.66,7697.0,63
CDM,4814067,PLC CATH SEL 1ST ART RENAL BI S&I,5138.0,1839.4,338.12,7697.0,63
CDM,4814083,PLC CATH SEL 2ND+ ART RENAL UNI S&I,7413.0,2653.85,336.5,10065.0,63
CDM,4814109,PLC CATH SEL 2ND+ ART RENAL BI S&I,8810.0,3153.98,394.3,7697.0,63
CDM,4814125,INS FILTER VENA CAVA ENDV S&I,9306.0,3331.55,209.54,10257.38,63
CDM,4814166,REM FILTER VENA CAVA ENDV S&I,10258.0,3672.36,329.11,10257.38,63
CDM,4814174,REM FILTER VENA CAVA ENDV S&I,10258.0,3672.36,329.11,10257.38,63
CDM,4814372,STUDY EXERCISE&MEAS HEMODYNAMIC,871.0,230.82,127.84,14891.0,39
CDM,4814380,INS GEN ICD ONLY W LD EXIST MULTI,15344.0,5493.15,383.79,66010.0,63
CDM,4814398,REM&RPL GEN ICD SGL,16486.0,5901.99,356.2,66010.0,63
CDM,4814406,REM&RPL GEN ICD DUAL,18251.0,6533.86,370.1,66010.0,63
CDM,4814414,REM&RPL GEN ICD MULTI,19011.0,6805.94,385.95,66010.0,63
CDM,4814422,INS GEN ICD ONLY W LD EXIST DUAL,11632.0,4164.26,358.04,66010.0,63
CDM,4814539,ECHO TEE CONG IMG I&R ONLY,1938.0,476.75,81.53,2497.0,39
CDM,4814646,ECHO REND 3D W I&R W PP SAME WRKST,440.0,153.56,15.22,330.0,37
CDM,4814653,ECHO REND 3D W I&R W PP DIFF WRKST,542.0,189.16,39.51,406.5,37
CDM,4814927,TAVR/TAVI VIA ARTERY FEMORAL PERC,13803.0,4941.47,982.0,13802.9,40
CDM,4814968,REPOS VAD PERC W IMG SESSN DIFF,1658.0,593.56,157.65,13802.9,40
CDM,4814976,REM FB INTRAVASC W IMG S&I,4597.0,1645.73,285.27,18194.0,63
CDM,4814984,THROMBOLYSIS INF ART INIT DAY S&I,7413.0,2653.85,366.62,15325.0,63
CDM,4814992,THROMBOLYSIS INF VEN INIT S&I,4597.0,1645.73,319.95,15325.0,63
CDM,4815007,THROMBOLYSIS INF ART/VEN SUBSQ S&I,3635.0,1301.33,218.79,18194.0,63
CDM,4815015,CESSAT THROMBOLYSIS&REM CATH S&I,3138.0,1123.4,115.48,18194.0,63
CDM,4815023,PLC CATH AORTA THOR ANG EC&/IC S&I,4220.0,1510.76,189.58,7697.0,63
CDM,4815031,TAVR/TAVI VIA ARTERY FEMORAL OPEN,15034.0,5382.17,982.0,13802.9,40
CDM,4815049,TAVR/TAVI VIA ARTERY AXILLA OPEN,15619.0,5591.6,982.0,13802.9,40
CDM,4815056,PLC CATH SEL CAR/INM ANG EC LT S&I,5176.0,1853.01,272.43,7697.0,40
CDM,4815064,PLC CATH SEL CAR/INM ANG EC RT S&I,5176.0,1853.01,272.43,7697.0,40
CDM,4815072,PLC CATH SEL CAR/INM ANG EC BI S&I,7764.0,2779.51,272.43,7697.0,40
CDM,4815080,PLC CATH SEL CAR/INM ANG IC LT S&I,7413.0,2653.85,313.97,10065.0,40
CDM,4815098,PLC CATH SEL CAR/INM ANG IC RT S&I,7413.0,2653.85,313.97,10065.0,40
CDM,4815106,PLC CATH SEL CAR/INM ANG IC BI S&I,11120.0,3980.96,313.97,10065.0,40
CDM,4815114,PLC CATH SEL ART CAR ANG IC LT S&I,7413.0,2653.85,352.24,10065.0,40
CDM,4815122,PLC CATH SEL ART CAR ANG IC RT S&I,7413.0,2653.85,352.24,10065.0,40
CDM,4815130,PLC CATH SEL ART CAR ANG IC BI S&I,11120.0,3980.96,352.24,10065.0,40
CDM,4815148,PLC CATH SEL ART SUB/INM ANG LT S&I,5205.0,1863.39,311.41,7697.0,40
CDM,4815155,PLC CATH SEL ART SUB/INM ANG RT S&I,5205.0,1863.39,311.41,7697.0,40
CDM,4815163,PLC CATH SEL ART SUB/INM ANG BI S&I,7808.0,2795.26,311.41,7697.0,40
CDM,4815171,PLC CATH SEL ART VERT ANG LT S&I,7413.0,2653.85,350.09,10065.0,40
CDM,4815189,PLC CATH SEL ART VERT ANG RT S&I,7413.0,2653.85,350.09,10065.0,40
CDM,4815197,PLC CATH SEL ART VERT ANG BI S&I,11120.0,3980.96,350.09,10065.0,40
CDM,4815205,PLC CATH SEL ART CAR EXT ANG LT S&I,2163.0,774.35,115.39,5681.0,40
CDM,4815213,PLC CATH SEL ART CAR EXT ANG RT S&I,2163.0,774.35,115.39,5681.0,40
CDM,4815221,PLC CATH SEL ART CAR EXT ANG BI S&I,3245.0,1161.71,115.39,5681.0,40
CDM,4815239,PLC CATH SEL BR INTRACRN ANG LT S&I,4017.0,1438.09,237.58,5681.0,40
CDM,4815247,PLC CATH SEL BR INTRACRN ANG RT S&I,4017.0,1438.09,237.58,5681.0,40
CDM,4815254,PLC CATH SEL BR INTRACRN ANG BI S&I,6026.0,2157.31,237.58,5681.0,40
CDM,4815262,PTCA ART COR MAJ SGL&/BR,11428.0,3028.42,500.65,39957.0,63
CDM,4815288,ATHER W ANGIO COR ART MAJ SGL&/BR,15821.0,4192.57,597.17,39957.0,63
CDM,4815320,ATHER W STENT ANGIO ART MAJ SGL&/BR,18490.0,4899.85,624.73,32670.0,63
CDM,4815395,EVAL EP&ABL ARRHYTHMIA SV,42001.0,38882.06,791.27,46020.56,63
CDM,4815403,EVAL EP&ABL ARRHYTHMIA VT,42851.0,39104.58,953.3,46020.56,63
CDM,4815411,ABL ARRHYTHMIA ADDL,21426.0,6277.82,290.02,44695.0,39
CDM,4815437,ABL FIB ATRIAL ADDL,20396.0,5976.03,290.34,44695.0,39
CDM,4815445,REM FB INTRAVASC W IMG S&I,4597.0,1645.73,285.27,18194.0,63
CDM,4815452,PLC STENT/S DE SGL COR ART/BR SGL,19347.0,5126.96,7281.13,52235.0,62
CDM,4815460,PLC STENT/S DE COR ART/BR ADDL,14511.0,3845.42,1229.0,14891.0,39
CDM,4815478,ATHERECT&STENT/PTCA DE ART COR SGL,23113.0,6124.95,8905.0,32276.26,62
CDM,4815486,ATHERECT&STENT/PTCA DE ART COR ADD,17335.0,4593.78,982.0,14891.0,39
CDM,4815494,REVASC DE GRFT BYPASS COR VSL SGL,21872.0,5796.08,7281.13,20325.69,62
CDM,4815502,REVASC DE GRFT BYPASS COR VSL ADDL,16405.0,4347.32,982.0,14891.0,39
CDM,4815510,REVASC DE OCC MI ACUTE COR VSL SGL,24619.0,6524.04,982.0,18464.25,39
CDM,4815528,REVASC DE OCC CHRONIC COR VSL SGL,26475.0,7015.88,8905.0,32276.26,62
CDM,4815536,REVASC DE OCC CHRONIC COR VSL ADDL,19858.0,5262.37,982.0,52235.0,39
CDM,4815577,PLC CATH AORTA THOR ANG EC&/IC S&I,4220.0,1510.76,189.58,7697.0,63
CDM,4815593,THROMBOLYSIS INF VEN INIT S&I,4597.0,1645.73,319.95,15325.0,63
CDM,4815601,THROMBOLYSIS INF ART/VEN SUBSQ S&I,3635.0,1301.33,218.79,18194.0,63
CDM,4815619,CESSAT THROMBOLYSIS&REM CATH S&I,3138.0,1123.4,115.48,18194.0,63
CDM,4815635,TAVR/TAVI VIA ARTERY ILIAC OPEN,16179.0,5792.08,982.0,13802.9,40
CDM,4815643,TAVR/TAVI VIA TRANSAORTIC,16298.0,5834.68,982.0,13802.9,40
CDM,4815817,RELOCATION POCKET SKIN PM,4597.0,1645.73,329.92,15325.0,63
CDM,4815833,RELOCATION POCKET SKIN ICD,4597.0,1645.73,391.79,6689.0,63
CDM,4815841,PLC STNT/S ART OPEN/PERC INIT S&I,14254.0,5102.93,416.31,20325.69,63
CDM,4815858,PLC STNT/S ART OPEN/PERC ADDL S&I,5733.0,2052.41,199.27,15325.0,40
CDM,4815890,EMB/OCCL VASC ARTERIAL S&I,13748.0,4921.78,451.13,32276.26,63
CDM,4815916,EMB/OCCL VASC HEMORRHAGE S&I,11612.0,4157.1,627.57,20325.69,63
CDM,4815940,THERAPY RDC SEPTAL TRANSCATH PERC,25374.0,7434.58,702.35,79657.7,39
CDM,4815957,RPR VALVE MITRAL PERC INIT PROSTH,26761.0,9580.44,982.0,26761.0,40
CDM,4815965,RPR VALVE MITRAL PERC ADDL PROSTH,13367.0,4785.39,401.11,13380.5,40
CDM,4815973,RPR VALVE MITRAL PERC COR SINUS,26761.0,9580.44,982.0,26761.0,36
CDM,4815981,PLC STNT/S ART OPEN/PERC INIT S&I,14254.0,5102.93,416.31,20325.69,63
CDM,4815999,PLC STNT/S ART OPEN/PERC ADDL S&I,5733.0,2052.41,199.27,15325.0,40
CDM,4816153,INTRO NDL/CATH ARTERY CAR/VERT LT,845.0,302.51,144.0,5681.0,40
CDM,4816161,INTRO NDL/CATH ARTERY CAR/VERT RT,845.0,302.51,144.0,5681.0,40
CDM,4816229,IMPLANT VALVE PULM TRNSCTH PERC,14128.0,5057.82,1248.67,10596.0,40
CDM,4816310,RPLC CICVC NONTUN WO P/P,3433.0,1229.01,62.4,5681.0,63
CDM,4816518,CLOSE LAA PERC W IMP ENDOCARD,5851.0,2094.66,740.08,10215.0,40
CDM,4816617,TBA OPN/PRC ART INT BI S&I,15387.0,5508.55,329.65,11751.0,40
CDM,4816641,TBA OPN/PRC ART ADL BI S&I,8099.0,2899.44,164.07,10528.0,40
CDM,4816757,TBA OPN/PRC VEIN INT BI S&I,15387.0,5508.55,282.07,11751.0,40
CDM,4816765,TBA OPN/PRC VEIN ADL BI S&I,7893.0,2825.69,137.95,10528.0,40
CDM,4816773,IMG ENDOLMNL IVUS/OCT COR VSL INIT,5379.0,1425.44,10.59,14891.0,39
CDM,4816781,IMG ENDOLMNL IVUS/OCT COR VSL ADDL,3115.0,825.48,5.75,14891.0,39
CDM,4816807,SED MOD SAME 5+Y INIT 15MN,580.0,143.26,11.77,435.0,39
CDM,4816815,SED MOD SAME ADDL 15MN,265.0,65.46,11.28,198.75,39
CDM,4816856,CLOSE LAA PERC W IMP ENDOCARD,5851.0,2094.66,740.08,10215.0,40
CDM,4817011,SED MOD SAME 5+Y INIT 15MN,580.0,143.26,11.77,435.0,39
CDM,4817029,SED MOD SAME ADDL 15MN,265.0,65.46,11.28,198.75,39
CDM,4817078,SED MOD SAME 0-4Y INIT 15MN,525.0,129.68,23.34,393.75,39
CDM,4817086,SED MOD SAME 5+Y INIT 15MN,580.0,143.26,11.77,435.0,39
CDM,4817094,SED MOD SAME ADDL 15MN,265.0,65.46,11.28,198.75,39
CDM,4817102,SED MOD DIFF 0-4Y INIT 15MN,525.0,129.68,80.25,752.08,39
CDM,4817110,SED MOD DIFF 5+Y INIT 15MN,580.0,143.26,72.74,614.45,39
CDM,4817128,SED MOD DIFF ADDL 15MN,265.0,65.46,49.29,465.97,39
CDM,4817136,CLOSE LEAK PARAVALVUL MITRAL INIT,68082.0,24373.36,1025.52,79657.7,63
CDM,4817144,CLOSE LEAK PARAVALVUL AORTIC INIT,55973.0,20038.33,843.66,79657.7,63
CDM,4817151,CLOSE LEAK PARAVALVUL ADDITIONAL,18475.0,6614.05,369.93,39745.7,39
CDM,4817250,TBA OPN/PRC ART INT NONPAIR/UNI S&I,10258.0,3672.36,329.65,11751.0,63
CDM,4817276,CREATE WINDOW PERICARDIAL RESC PART,2428.0,869.22,451.61,13802.9,40
CDM,4817383,TBA OPN/PRC ART ADL NONPAIR/UNI S&I,5399.0,1932.84,164.07,10528.0,40
CDM,4817409,TBA OPN/PRC VEIN INT NONPAIR/UNIS&I,10258.0,3672.36,282.07,11751.0,63
CDM,4817425,TBA OPN/PRC VEIN ADL NONPAIR/UNIS&I,5262.0,1883.8,137.95,10528.0,40
CDM,4817433,ANGIO PELVIC S&I,7413.0,1564.14,89.78,19658.22,63
CDM,4817805,RPR EV DPLMNT A UNILAC NDGFT NO RUP,15311.0,5481.34,1297.95,13802.9,40
CDM,4817813,RPR EV DPLMNT A BIILAC NDGFT NO RUP,17005.0,6087.79,1443.24,13802.9,40
CDM,4817854,PLC PROS DST EXT RPR EV/TX VES,6905.0,2471.99,303.84,6904.78,40
CDM,4817862,PLC PROS DLYD EXT RPR EV VES INIT,12488.0,4470.7,754.07,13802.9,40
CDM,4817870,PLC PROS DLYD EXT RPR EV VES ADD,6905.0,2471.99,277.54,6904.78,40
CDM,4817888,DEL DEV FIX NDGFT TRANSCATH S&I,4597.0,1645.73,621.61,7704.0,40
CDM,4817896,ACCS&CLSR ART FEM NDGFT PERC UNI,6499.0,2326.64,116.18,6499.0,38
CDM,4818498,INTERROGATION VAD IN PERSON,389.0,113.98,49.47,422.73,63
CDM,4818522,INS/RPL PM PERM LDLS RV W IMG GD,14554.0,5210.33,456.33,33913.79,63
CDM,4818589,TEST STRESS PULMONARY,542.0,191.33,11.97,406.5,63
CDM,4818605,TEST EXERCISE CARDIOPULMONARY,1714.0,605.04,85.88,1285.5,63
CDM,4818613,INS/RPL PM PERM LDLS RV W IMG GD,14554.0,5210.33,456.33,33913.79,63
CDM,4818621,REM PM PERM LDLS RV INCL IMG GD,15381.0,5506.4,482.07,18194.0,63
CDM,4818639,INS CRM SUBQ W PROGRAMMING,10258.0,3672.36,83.27,15325.0,63
CDM,4818647,REM CRM SUBQ,3542.0,1268.04,81.67,15325.0,63
CDM,4818654,EVAL DEV PROG PM SGL LD/LDLS,179.0,52.45,26.93,238.75,63
CDM,4818670,EVAL DEV PERIPRO PM/PM LDLS,145.0,42.48,26.97,164.52,39
CDM,4818688,EVAL DEV ANYLS PM/PM LDLS,174.0,50.98,26.93,200.75,63
CDM,4818704,EVAL DEV PM/IDS REM ACQ 0-90 DAY,196.0,57.43,20.73,10528.0,63
CDM,4818720,INS CRM SUBQ W PROGRAMMING,10258.0,3672.36,83.27,15325.0,63
CDM,4818738,REM CRM SUBQ,3542.0,1268.04,81.67,15325.0,63
CDM,4818746,EVAL DEV PERIPRO PM/PM LDLS,145.0,42.48,26.97,164.52,39
CDM,4818852,TMVI W PROS INCL PUNCT TRANSEP PERC,19793.0,7085.89,982.0,26761.0,40
CDM,4818860,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,63
CDM,4818878,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,63
CDM,4818886,DRN PERICARD PERC WO CONG CARD 6+Y,3504.0,1254.43,234.96,16111.14,40
CDM,4818894,DRN PERICARD PERC WO CONG CARD 0-5Y,3976.0,1423.41,274.4,5444.0,40
CDM,4818902,DRN PERICARD PERC INCL CT GD,3235.0,1158.13,201.08,5444.0,40
CDM,4818910,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,63
CDM,4818951,US DUPLEX ART&VEN B4 HEMO CMP BI,1581.0,420.55,166.84,1969.52,63
CDM,4818969,US DUPLEX ART&VEN B4 HEMO CMP UNI,953.0,253.5,79.0,952.43,63
CDM,4818977,INS ELCTRD DEFIB SUBSTRNL,10961.0,3211.57,136.0,14570.36,61
CDM,4818985,REM ELCTRD DEFIB SUBSTRNL,10258.0,3005.59,109.0,10257.38,61
CDM,4818993,REPOS ELCTR DEFIB-PAC SS IP,9247.0,2709.37,120.0,10257.38,61
CDM,4819009,EVAL DEV PRG ICD ELCTRD SS IN PER,210.0,61.53,30.26,247.32,59
CDM,4819017,EVAL DEV INTRG ICD ELCTRD SS IN PER,120.0,35.16,17.29,119.47,59
CDM,4819033,EVAL DEV INTRG RMT SS ICD QHP <90D,418.0,122.47,36.03,618.57,36
CDM,4819041,EVAL DEV INTRG RMT SS ICD TECH <90D,331.0,96.98,21.83,330.67,59
CDM,4819058,INS ELCTRD DEFIB SUBSTRNL,10961.0,3211.57,136.0,14570.36,61
CDM,4819066,REM ELCTRD DEFIB SUBSTRNL,10258.0,3005.59,109.0,10257.38,61
CDM,4819074,REPOS ELCTR DEFIB-PAC SS IP,9247.0,2709.37,120.0,10257.38,61
CDM,4819082,EVAL DEV PRG ICD ELCTRD SS IN PER,210.0,61.53,30.26,247.32,59
CDM,4819090,EVAL DEV INTRG ICD ELCTRD SS IN PER,120.0,35.16,17.29,119.47,59
CDM,4819140,DRN PERICARD PERC WO CONG CARD 6+Y,3504.0,1254.43,234.96,16111.14,40
CDM,4819181,ASSESS STRAIN MYOCARDIAL W IMG,279.0,68.63,36.14,2497.0,39
CDM,4819223,REVASC LITH INTRAV INCL ANGIOPLSTY,16112.0,5768.1,5221.0,20325.69,62
CDM,4819249,ADMIN DRUG&MEAS HEMODYNAMIC,2937.0,778.3,93.84,14891.0,33
CDM,4819256,STUDY EXERCISE&MEAS HEMODYNAMIC,871.0,230.82,127.84,14891.0,39
CDM,4819306,REVASC LITH INTRAV STNT ANGIOPLSTY,17769.0,6361.3,5221.0,32276.26,62
CDM,4819322,THROMBECT MECH PRIM ART INIT BI,20705.0,7412.39,407.99,18194.0,40
CDM,4819330,THROMBECT MECH PRIM ART INIT LT,13803.0,4941.47,407.99,18194.0,40
CDM,4819348,THROMBECT MECH PRIM ART INIT RT,13803.0,4941.47,407.99,18194.0,40
CDM,4819355,VEL&/FLW DOPP INTRAV VSL INIT RDC,5841.0,1547.86,201.01,14891.0,39
CDM,4819363,VEL&/FLW DOPP INTRAV VSL ADDL RDC,2921.0,774.06,54.88,14891.0,39
CDM,4819421,ASP&/INJ JT/BUR INTR WO US GD BI,1034.0,370.17,35.9,5681.0,40
CDM,4819439,ASP&/INJ JT/BUR INTR WO US GD LT,689.0,246.66,35.9,5681.0,40
CDM,4819447,ASP&/INJ JT/BUR INTR WO US GD RT,689.0,246.66,35.9,5681.0,40
CDM,4819454,ASP&/INJ JT/BUR MAJ WO US GD BI,1260.0,451.08,44.27,5681.0,40
CDM,4819462,ASP&/INJ JT/BUR MAJ WO US GD LT,840.0,300.72,44.27,5681.0,40
CDM,4819470,ASP&/INJ JT/BUR MAJ WO US GD RT,840.0,300.72,44.27,5681.0,40
CDM,4819488,ASP&/INJ JT/BUR SM WO US GD BI,995.0,356.21,34.91,5681.0,40
CDM,4819496,ASP&/INJ JT/BUR SM WO US GD LT,663.0,237.35,34.91,5681.0,40
CDM,4819504,ASP&/INJ JT/BUR SM WO US GD RT,663.0,237.35,34.91,5681.0,40
CDM,4819660,RPR VESSEL BLOOD INTRA-ABD DIR BI,5852.0,2095.02,982.0,13802.9,40
CDM,4819678,RPR VESSEL BLOOD INTRA-ABD DIR LT,3901.0,1396.56,725.59,13802.9,40
CDM,4819686,RPR VESSEL BLOOD INTRA-ABD DIR RT,3901.0,1396.56,725.59,13802.9,40
CDM,4819769,REVASC LITH INTRAV ATHR ANGIOPLSTY,19819.0,7095.2,6142.0,32276.26,62
CDM,4819777,THERAPY RDC SEPTAL TRANSCATH PERC,25374.0,7434.58,702.35,79657.7,39
CDM,4819819,REVASC LITH INTRAV STNT ATHR ANGIO,24644.0,8822.55,6142.0,32276.26,62
CDM,4819892,REVASC LITH INTRAV TIB/PER INCL ANG,11612.0,4157.1,5221.0,20325.69,62
CDM,4819975,RHC CHD CONN NTV NORM W IMG,8605.0,2280.33,178.62,16111.14,63
CDM,4819983,RHC CHD CONN NTV ABNRM W IMG,10757.0,2850.6,271.34,16111.14,63
CDM,4819991,LHC CHD CONN NTV NORM/ABNRM W IMG,10327.0,2736.66,246.14,16111.14,63
CDM,4820007,RHC&LHC CHD CONN NTV NORM W IMG,14742.0,3906.63,901.64,16111.14,63
CDM,4820015,RHC&LHC CHD CONN NTV ABNRM W IMG,16112.0,4269.68,1569.82,16111.14,63
CDM,4820114,RPR TTV PERC INTI PROSTH,26152.0,9362.42,934.42,19614.0,38
CDM,4820122,RPR TTV PERC SAME SESSN ADDL PROSTH,8378.0,2999.32,467.38,6901.45,38
CDM,4820148,INSR/RPLC SYS CCM GEN PULS&ELCRD TV,18627.0,6668.47,974.4,55265.94,59
CDM,4820155,IMP/RPL TTV W VALVE PROS PERC,19793.0,5245.14,982.0,21550.02,36
CDM,4820213,INJ ANGIO PULM NONSEL HRT CATH S&I,1069.0,283.29,44.15,14891.0,39
CDM,4820221,INJ ANGIO PULM SEL HRT CATH UNI S&I,877.0,232.4,36.43,14891.0,39
CDM,4820239,INJ ANGIO PULM SEL HRT CATH BI S&I,2351.0,623.02,60.44,14891.0,39
CDM,4820320,ECMO/ECLS REM CAN PERPH PERC 6+YRS,1836.0,604.1,224.8,6904.78,40
CDM,4820346,RPR EV DPLMNT ILIO ILAC NDGFT LT,12998.0,4653.28,1097.64,13802.9,40
CDM,4820353,RPR EV DPLMNT ILIO ILAC NDGFT RT,12998.0,4653.28,1097.64,13802.9,40
CDM,4820361,RPR EV DPLMNT ILIO ILAC NDGFT BI,19497.0,6979.93,1097.64,14622.75,40
CDM,4820395,RECORDING ESOPH EGM ATR W/WO VENT,2516.0,737.19,0.86,44695.0,63
CDM,4820510,PVC INDUCTION DRUG MNTR STAND ALONE,6753.0,1978.63,101.17,5064.75,62
CDM,4820593,INJ THROM PSDANSM ART FEM W BLN OCC,10258.0,3672.36,392.67,7693.5,62
CDM,4820643,VEL&/FLW DOPP IVAS VSL WO DRUG INT,4812.0,1275.18,101.17,14891.0,62
CDM,4820650,VEL&/FLW DOPP IVAS VSL WO DRUG MULT,8662.0,2295.43,101.17,14891.0,62
CDM,4820684,EVAL EP&ABL CARDIONEURAL,46799.0,13712.11,101.17,35099.25,62
CDM,4820734,EVAL EP&ABL FIB ATRIAL VEIN PULM,40792.0,38008.64,897.25,46020.56,63
CDM,4820767,THER RX TRNSCTH PERC BLN IC S&I,8686.0,2301.79,1251.65,20325.69,58
CDM,4820775,THER RX TRNSCTH PERC BLN IC SEP,3137.0,831.3,452.04,14891.0,35
CDM,4820809,INS SYS PPM SINGLE LDLS TRANSCTH,14554.0,3856.81,2097.23,33913.79,58
CDM,4820999,INS SYS PPM DUAL LDLS TRANSCTH,17650.0,6318.7,2543.36,33913.79,58
CDM,4821039,ECMO/ECLS INS CAN PERPH PERC 6+YRS,3254.0,1070.66,405.06,13802.9,40
CDM,4821062,INS/RPLC SYS ICD ELCTRD SUBSTRNL,20484.0,6001.81,887.69,55265.94,61
CDM,4821070,RECON TMV W IMP DEV ANNULUS PERC,34399.0,12314.84,982.0,25799.25,38
CDM,4821088,REPAIR WOUND CARDIAC WO BYPASS,13804.0,4941.83,982.0,13802.9,40
CDM,48397,R&B BEHAVIORAL PVT,4096.0,1347.71,816.39,3072.0,13
CDM,4850210,REM MASS ICRD W REINFSN BLD PERC,10433.0,3735.01,1381.25,11751.0,59
CDM,4850459,RECALIBRATION CARDIOMEMS,167.0,48.93,54.61,536.75,62
CDM,4850657,LITHOTRIPSY CORONARY PERC TRANSL,11282.0,2989.73,140.37,14891.0,37
CDM,4850707,BYPASS ART RETROG-ANT FEM-FEM PERC,3237.0,1158.85,392.67,6689.0,62
CDM,4850764,FFR COR W 3D MAPPING INTRAPROCEDR,5454.0,1445.31,81.74,14891.0,38
CDM,4850889,ECHO ICRD INTRV THER/DX STAND ALONE,5728.0,1678.3,101.17,4296.0,62
CDM,4850970,INS SYS STM NRV PHRENIC INCL IM GD,54466.0,19498.83,552.57,77552.01,63
CDM,4850988,REM&REPL STM NRV PHRENIC LD STM/SNS,16770.0,6003.66,488.61,19618.78,63
CDM,4850996,REM STM NRV PHRENIC SYS LD STM/SNS,5147.0,1842.63,332.14,7697.0,63
CDM,4851002,REM&REPL STM NRV PHRENIC GEN PULSE,14099.0,5047.44,370.72,54330.72,63
CDM,4851119,REPOS LEAD TV STM NRV PHRENIC,7165.0,2565.07,359.36,7697.0,63
CDM,4851283,INS SYS PPM DUAL LDLS TRANSCTH,17650.0,6318.7,2543.36,33913.79,58
CDM,4851309,ANLYS NEUROSTIM SMPL CRNL W PRG,466.0,416.14,26.93,711.0,63
CDM,4851341,RHC W IMP SENSOR PRESS WIRELESS,49131.0,13019.72,317.29,50502.38,63
CDM,4851432,REVSC IVT ANGIO SF VSL INIT BI,18749.0,6712.14,3487.31,14061.75,39
CDM,4851440,REVSC IVT ANGIO SF VSL INIT LT,12499.0,4474.64,2324.81,13802.9,39
CDM,4851457,REVSC IVT ANGIO SF VSL INIT RT,12499.0,4474.64,2324.81,13802.9,39
CDM,4851465,REVSC IVT ANGIO SF VSL ADD BI,7556.0,2705.05,1088.82,6904.78,37
CDM,4851473,REVSC IVT ANGIO SF VSL ADD LT,5037.0,1803.25,725.83,6904.78,37
CDM,4851481,REVSC IVT ANGIO SF VSL ADD RT,5037.0,1803.25,725.83,6904.78,37
CDM,4851499,REVSC IVT ANGIO CMPLX VSL INIT BI,27480.0,9837.84,4215.76,20610.0,39
CDM,4851507,REVSC IVT ANGIO CMPLX VSL INIT LT,18320.0,6558.56,3407.52,13802.9,39
CDM,4851515,REVSC IVT ANGIO CMPLX VSL INIT RT,18320.0,6558.56,3407.52,13802.9,39
CDM,4851523,REVSC IVT ANGIO CMPLX VSL ADD BI,9765.0,3495.87,1407.14,7323.75,37
CDM,4851531,REVSC IVT ANGIO CMPLX VSL ADD LT,6510.0,2330.58,938.09,6904.78,37
CDM,4851549,REVSC IVT ANGIO CMPLX VSL ADD RT,6510.0,2330.58,938.09,6904.78,37
CDM,4851556,REVSC IVT STNT SF VSL INIT BI,19512.0,6985.3,3629.23,14634.0,39
CDM,4851564,REVSC IVT STNT SF VSL INIT LT,13008.0,4656.86,2419.49,13802.9,39
CDM,4851572,REVSC IVT STNT SF VSL INIT RT,13008.0,4656.86,2419.49,13802.9,39
CDM,4851580,REVSC IVT STNT SF VSL ADD BI,10124.0,3624.39,1458.87,7593.0,37
CDM,4851598,REVSC IVT STNT SF VSL ADD LT,6749.0,2416.14,972.53,6904.78,37
CDM,4851606,REVSC IVT STNT SF VSL ADD RT,6749.0,2416.14,972.53,6904.78,37
CDM,4851614,REVSC IVT STNT CMPLX VSL INIT BI,28203.0,10096.67,5245.76,21152.25,39
CDM,4851622,REVSC IVT STNT CMPLX VSL INIT LT,18802.0,6731.12,3497.17,14101.5,39
CDM,4851630,REVSC IVT STNT CMPLX VSL INIT RT,18802.0,6731.12,3497.17,14101.5,39
CDM,4851648,REVSC IVT STNT CMPLX VSL ADD BI,10757.0,3851.01,1550.08,8067.75,37
CDM,4851655,REVSC IVT STNT CMPLX VSL ADD LT,7171.0,2567.22,1033.34,6904.78,37
CDM,4851663,REVSC IVT STNT CMPLX VSL ADD RT,7171.0,2567.22,1033.34,6904.78,37
CDM,4851671,REVSC F&P VT ANG SF VSL INIT BI,14973.0,5360.33,2784.98,13802.9,39
CDM,4851689,REVSC F&P VT ANG SF VSL INIT LT,9982.0,3573.56,1856.65,13802.9,39
CDM,4851697,REVSC F&P VT ANG SF VSL INIT RT,9982.0,3573.56,1856.65,13802.9,39
CDM,4851705,REVSC F&P VT ANG SF VSL ADD BI,5732.0,2052.06,825.98,6904.78,37
CDM,4851713,REVSC F&P VT ANG SF VSL ADD LT,3821.0,1367.92,550.61,6904.78,37
CDM,4851721,REVSC F&P VT ANG SF VSL ADD RT,3821.0,1367.92,550.61,6904.78,37
CDM,4851739,REVSC F&P VT ANG CMPLX VSL INIT BI,20241.0,7246.28,3764.83,15180.75,39
CDM,4851747,REVSC F&P VT ANG CMPLX VSL INIT LT,13494.0,4830.85,2509.88,13802.9,39
CDM,4851754,REVSC F&P VT ANG CMPLX VSL INIT RT,13494.0,4830.85,2509.88,13802.9,39
CDM,4851762,REVSC F&P VT ANG CMPLX VSL ADD BI,7628.0,2730.82,1099.19,6904.78,37
CDM,4851770,REVSC F&P VT ANG CMPLX VSL ADD LT,5085.0,1820.43,732.75,6904.78,37
CDM,4851788,REVSC F&P VT ANG CMPLX VSL ADD RT,5085.0,1820.43,732.75,6904.78,37
CDM,4851796,REVSC F&P VT STNT SF VSL INIT BI,21123.0,7562.03,3928.88,15842.25,39
CDM,4851804,REVSC F&P VT STNT SF VSL INIT LT,14082.0,5041.36,2619.25,13802.9,39
CDM,4851812,REVSC F&P VT STNT SF VSL INIT RT,14082.0,5041.36,2619.25,13802.9,39
CDM,4851820,REVSC F&P VT STNT SF VSL ADD BI,8928.0,3196.22,1286.52,6904.78,37
CDM,4851838,REVSC F&P VT STNT SF VSL ADD LT,5952.0,2130.82,857.68,6904.78,37
CDM,4851846,REVSC F&P VT STNT SF VSL ADD RT,5952.0,2130.82,857.68,6904.78,37
CDM,4851853,REVSC F&P VT STNT CMPLX VSL INIT BI,35481.0,12702.2,6599.47,26610.75,39
CDM,4851861,REVSC F&P VT STNT CMPLX VSL INIT LT,23654.0,8468.13,4399.64,17740.5,39
CDM,4851879,REVSC F&P VT STNT CMPLX VSL INIT RT,23654.0,8468.13,4399.64,17740.5,39
CDM,4851887,REVSC F&P VT STNT CMPLX VSL ADD BI,11985.0,4290.63,1727.04,8988.75,37
CDM,4851895,REVSC F&P VT STNT CMPLX VSL ADD LT,7990.0,2860.42,1151.36,6904.78,37
CDM,4851903,REVSC F&P VT STNT CMPLX VSL ADD RT,7990.0,2860.42,1151.36,6904.78,37
CDM,4851911,REVSC F&P VT ATHR SF VSL INIT BI,21905.0,7841.99,4074.33,16428.75,39
CDM,4851929,REVSC F&P VT ATHR SF VSL INIT LT,14603.0,5227.87,2716.16,13578.3,39
CDM,4851937,REVSC F&P VT ATHR SF VSL INIT RT,14603.0,5227.87,2716.16,13578.3,39
CDM,4851945,REVSC F&P VT ATHR SF VSL ADD BI,9654.0,3456.13,1391.14,7240.5,37
CDM,4851952,REVSC F&P VT ATHR SF VSL ADD LT,6436.0,2304.09,927.43,6904.78,37
CDM,4851960,REVSC F&P VT ATHR SF VSL ADD RT,6436.0,2304.09,927.43,6904.78,37
CDM,4851978,REVSC F&P VT ATHR CMPLX VSL INIT BI,30651.0,10973.06,5701.09,22988.25,39
CDM,4851986,REVSC F&P VT ATHR CMPLX VSL INIT LT,20434.0,7315.37,3800.72,15325.5,39
CDM,4851994,REVSC F&P VT ATHR CMPLX VSL INIT RT,20434.0,7315.37,3800.72,15325.5,39
CDM,4852000,REVSC F&P VT ATHR CMPLX VSL ADD BI,13281.0,4754.6,1913.79,9960.75,37
CDM,4852018,REVSC F&P VT ATHR CMPLX VSL ADD LT,8854.0,3169.73,1275.86,6904.78,37
CDM,4852026,REVSC F&P VT ATHR CMPLX VSL ADD RT,8854.0,3169.73,1275.86,6904.78,37
CDM,4852034,REVSC F&P VT ST&AT SF VSL INIT BI,26315.0,9420.77,4894.59,19736.25,39
CDM,4852042,REVSC F&P VT ST&AT SF VSL INIT LT,17543.0,6280.39,3263.0,13578.3,39
CDM,4852059,REVSC F&P VT ST&AT SF VSL INIT RT,17543.0,6280.39,3263.0,13578.3,39
CDM,4852067,REVSC F&P VT ST&AT SF VSL ADD BI,10098.0,3615.08,1455.12,7573.5,37
CDM,4852075,REVSC F&P VT ST&AT SF VSL ADD LT,6732.0,2410.06,970.08,6904.78,37
CDM,4852083,REVSC F&P VT ST&AT SF VSL ADD RT,6732.0,2410.06,970.08,6904.78,37
CDM,4852091,REVSC F&P VT ST&AT CMPLX VSL INITBI,35781.0,12809.6,6655.27,26835.75,39
CDM,4852109,REVSC F&P VT ST&AT CMPLX VSL INITLT,23854.0,8539.73,4436.84,17890.5,39
CDM,4852117,REVSC F&P VT ST&AT CMPLX VSL INITRT,23854.0,8539.73,4436.84,17890.5,39
CDM,4852125,REVSC F&P VT ST&AT CMPLX VSL ADD BI,14219.0,5090.4,2048.96,10664.25,37
CDM,4852133,REVSC F&P VT ST&AT CMPLX VSL ADD LT,9479.0,3393.48,1365.92,7109.25,37
CDM,4852141,REVSC F&P VT ST&AT CMPLX VSL ADD RT,9479.0,3393.48,1365.92,7109.25,37
CDM,4852158,REVSC T&P VT ANG SF VSL INIT BI,17418.0,6235.64,3239.75,13063.5,39
CDM,4852166,REVSC T&P VT ANG SF VSL INIT LT,11612.0,4157.1,2159.83,11278.0,39
CDM,4852174,REVSC T&P VT ANG SF VSL INIT RT,11612.0,4157.1,2159.83,11278.0,39
CDM,4852182,REVSC T&P VT ANG SF VSL ADD BI,6630.0,2373.54,955.38,5128.69,37
CDM,4852190,REVSC T&P VT ANG SF VSL ADD LT,4420.0,1582.36,636.92,5128.69,37
CDM,4852208,REVSC T&P VT ANG SF VSL ADD RT,4420.0,1582.36,636.92,5128.69,37
CDM,4852216,REVSC T&P VT ANG CMPLX VSL INIT BI,21266.0,7613.23,3955.48,15949.5,39
CDM,4852224,REVSC T&P VT ANG CMPLX VSL INIT LT,14177.0,5075.37,2636.92,11278.0,39
CDM,4852232,REVSC T&P VT ANG CMPLX VSL INIT RT,14177.0,5075.37,2636.92,11278.0,39
CDM,4852240,REVSC T&P VT ANG CMPLX VSL ADD BI,9426.0,3374.51,1358.29,7069.5,37
CDM,4852257,REVSC T&P VT ANG CMPLX VSL ADD LT,6284.0,2249.67,905.52,5128.69,37
CDM,4852265,REVSC T&P VT ANG CMPLX VSL ADD RT,6284.0,2249.67,905.52,5128.69,37
CDM,4852273,REVSC T&P VT STNT SF VSL INIT BI,21743.0,7783.99,4044.2,16307.25,39
CDM,4852281,REVSC T&P VT STNT SF VSL INIT LT,14495.0,5189.21,2696.07,13578.3,39
CDM,4852299,REVSC T&P VT STNT SF VSL INIT RT,14495.0,5189.21,2696.07,13578.3,39
CDM,4852307,REVSC T&P VT STNT SF VSL ADD BI,7592.0,2717.94,1094.01,5694.0,37
CDM,4852315,REVSC T&P VT STNT SF VSL ADD LT,5061.0,1811.84,729.29,5128.69,37
CDM,4852323,REVSC T&P VT STNT SF VSL ADD RT,5061.0,1811.84,729.29,5128.69,37
CDM,4852331,REVSC T&P VT STNT CMPLX VSL INIT BI,29175.0,10444.65,5426.55,21881.25,39
CDM,4852349,REVSC T&P VT STNT CMPLX VSL INIT LT,19450.0,6963.1,3617.7,14587.5,39
CDM,4852356,REVSC T&P VT STNT CMPLX VSL INIT RT,19450.0,6963.1,3617.7,14587.5,39
CDM,4852364,REVSC T&P VT STNT CMPLX VSL ADD BI,11421.0,4088.72,1645.77,8565.75,37
CDM,4852372,REVSC T&P VT STNT CMPLX VSL ADD LT,7614.0,2725.81,1097.18,5710.5,37
CDM,4852380,REVSC T&P VT STNT CMPLX VSL ADD RT,7614.0,2725.81,1097.18,5710.5,37
CDM,4852398,REVSC T&P VT ATH SF VSL INIT BI,30285.0,10842.03,5633.01,22713.75,39
CDM,4852406,REVSC T&P VT ATH SF VSL INIT LT,20190.0,7228.02,3755.34,15142.5,39
CDM,4852414,REVSC T&P VT ATH SF VSL INIT RT,20190.0,7228.02,3755.34,15142.5,39
CDM,4852422,REVSC T&P VT ATH SF VSL ADD BI,13244.0,4741.35,1908.46,9933.0,37
CDM,4852430,REVSC T&P VT ATH SF VSL ADD LT,8829.0,3160.78,1272.26,6621.75,37
CDM,4852448,REVSC T&P VT ATH SF VSL ADD RT,8829.0,3160.78,1272.26,6621.75,37
CDM,4852455,REVSC T&P VT ATH CMPLX VSL INIT BI,38123.0,13648.03,7090.88,28592.25,39
CDM,4852463,REVSC T&P VT ATH CMPLX VSL INIT LT,25415.0,9098.57,4727.19,19061.25,39
CDM,4852471,REVSC T&P VT ATH CMPLX VSL INIT RT,25415.0,9098.57,4727.19,19061.25,39
CDM,4852489,REVSC T&P VT ATH CMPLX VSL ADD BI,18044.0,6459.75,2233.0,13533.0,37
CDM,4852497,REVSC T&P VT ATH CMPLX VSL ADD LT,12029.0,4306.38,1733.38,9021.75,37
CDM,4852505,REVSC T&P VT ATH CMPLX VSL ADD RT,12029.0,4306.38,1733.38,9021.75,37
CDM,4852513,REVSC T&P VT ST&AT SF VSL INIT BI,33980.0,12164.84,6320.28,25485.0,39
CDM,4852521,REVSC T&P VT ST&AT SF VSL INIT LT,22653.0,8109.77,4213.46,16989.75,39
CDM,4852539,REVSC T&P VT ST&AT SF VSL INIT RT,22653.0,8109.77,4213.46,16989.75,39
CDM,4852547,REVSC T&P VT ST&AT SF VSL ADD BI,19583.0,7010.71,2233.0,14687.25,37
CDM,4852554,REVSC T&P VT ST&AT SF VSL ADD LT,13055.0,4673.69,1881.23,9791.25,37
CDM,4852562,REVSC T&P VT ST&AT SF VSL ADD RT,13055.0,4673.69,1881.23,9791.25,37
CDM,4852570,REVSC T&P VT ST&AT CMPLX VSL INITBI,40731.0,14581.7,7551.94,30548.25,39
CDM,4852588,REVSC T&P VT ST&AT CMPLX VSL INITLT,27154.0,9721.13,5050.64,20365.5,39
CDM,4852596,REVSC T&P VT ST&AT CMPLX VSL INITRT,27154.0,9721.13,5050.64,20365.5,39
CDM,4852604,REVSC T&P VT ST&AT CMPLX VSL ADD BI,24687.0,8837.95,2233.0,18515.25,37
CDM,4852612,REVSC T&P VT ST&AT CMPLX VSL ADD LT,16458.0,5891.96,2233.0,12343.5,37
CDM,4852620,REVSC T&P VT ST&AT CMPLX VSL ADD RT,16458.0,5891.96,2233.0,12343.5,37
CDM,4852679,PLC STNT/S W ANGIO SGL&/BR 1 LSN,15477.0,4101.41,557.04,32670.0,63
CDM,4852687,PLC STNT/S W ANGIO SGL&/BR 2+ LSN,16883.0,4474.0,3935.48,32276.26,62
CDM,4852695,REVASC GRFT BYPASS ART COR SGL&/BR,17497.0,4636.7,556.99,32670.0,63
CDM,4852711,REVASC OCC MI ACUTE ART COR SGL&/BR,19695.0,5219.18,625.43,32670.0,40
CDM,4852729,REVASC OCC CHRONIC ART/BR/GRFT COR,21180.0,5612.7,625.39,32670.0,63
CDM,4852737,THROMBECT ASP MECH COR PERC,6948.0,1841.22,166.89,14891.0,40
CDM,4852745,THROMBECT ASP MECH COR PERC,6948.0,1841.22,166.89,14891.0,40
CDM,4852752,REM&RPL PPM SGL LDLS RA TRNS IMG GD,15381.0,4075.96,2216.4,33913.79,58
CDM,4852760,REM&RPL PPM SGL LDLS RA TRNS IMG GD,15381.0,4075.96,2216.4,33913.79,58
CDM,4852778,REM CTH SWN GNZ KNOTTED&SHEATH INTR,1714.0,613.61,392.67,10257.38,62
CDM,4853032,REM PPM SGL LDLS RA TRANSCTH IMG GD,15381.0,4506.63,2216.4,11535.75,58
CDM,49270,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,49346,R&B ICU TRAUMA,14892.0,4899.91,6701.4,11169.0,5
CDM,51037,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,51045,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,51060,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,51342,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,5141692,THERAPY MIST PER DAY,322.0,166.8,46.4,416.69,59
CDM,5141981,THERAPY MIST PER DAY,322.0,166.8,46.4,416.69,59
CDM,51482,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,51714,R&B NURSERY LEVEL 1,4654.0,1531.31,1016.0,3490.5,12
CDM,52027,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,52712,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,53058,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,53066,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,53298,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,53421,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,53520,R&B NURSERY LEVEL 1,4654.0,1531.31,1016.0,3490.5,12
CDM,55012,R&B NURSERY LEVEL 1,4654.0,1531.31,1016.0,3490.5,12
CDM,55087,R&B NURSERY LEVEL 1,4654.0,1531.31,1016.0,3490.5,12
CDM,55152,R&B NURSERY LEVEL 1,4654.0,1531.31,1016.0,3490.5,12
CDM,55426,R&B NURSERY LEVEL 1,4654.0,1531.31,1016.0,3490.5,12
CDM,58230,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,59832,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,59857,R&B HOSPICE PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,6100010,SED MOD SAME 0-4Y INIT 15MN,525.0,168.0,23.34,393.75,39
CDM,6100028,SED MOD SAME 5+Y INIT 15MN,580.0,185.6,11.77,435.0,39
CDM,6100036,SED MOD SAME ADDL 15MN,265.0,84.8,11.28,198.75,39
CDM,6100044,SED MOD DIFF 0-4Y INIT 15MN,525.0,168.0,80.25,752.08,39
CDM,6100051,SED MOD DIFF 5+Y INIT 15MN,580.0,185.6,72.74,614.45,39
CDM,6100069,SED MOD DIFF ADDL 15MN,265.0,84.8,49.29,465.97,39
CDM,6100218,IMG 3D SEG ANAT PLAN&PREP&TRANS,275.0,52.8,33.89,1618.0,60
CDM,6104053,ABL RF TUMOR/S LIVER PERC,9095.0,3256.01,704.21,10644.28,63
CDM,6104061,ASP PUNCT ABSCESS/CYST,651.0,233.06,94.84,5681.0,63
CDM,6104087,MRI GD PLC NDL S&I,2301.0,441.79,346.22,2365.12,38
CDM,6104137,MRI ABDOMEN W CNT,2638.0,506.5,224.14,1978.5,61
CDM,6104145,MRI ABDOMEN WO CNT,2110.0,405.12,129.41,1618.0,61
CDM,6104152,MRI ABDOMEN W&WO CNT,3165.0,607.68,238.43,2373.75,61
CDM,6104160,MRI BONE MARROW,1629.0,312.77,166.84,1618.0,61
CDM,6104319,MRI CHEST W CNT,2385.0,457.92,295.23,2311.1,61
CDM,6104327,MRI CHEST WO CNT,1908.0,366.34,166.84,1927.95,61
CDM,6104335,MRI CHEST W&WO CNT,2862.0,549.5,266.89,2818.12,61
CDM,6104350,MRI GD ABLATION TISSUE,2215.0,425.28,411.99,1661.25,38
CDM,6104376,MRI EXT LOWER JT W CNT LT,1934.0,371.33,240.05,1898.88,38
CDM,6104384,MRI EXT LOWER JT W CNT RT,1934.0,371.33,240.05,1898.88,38
CDM,6104400,MRI EXT LOWER JT WO CNT LT,1547.0,297.02,140.78,1618.0,38
CDM,6104418,MRI EXT LOWER JT WO CNT RT,1547.0,297.02,140.78,1618.0,38
CDM,6104434,MRI EXT LOWER JT W&WO CNT LT,2321.0,445.63,266.89,2234.47,38
CDM,6104442,MRI EXT LOWER JT W&WO CNT RT,2321.0,445.63,266.89,2234.47,38
CDM,6104467,MRI EXT LOWER NONJT W CNT LT,2223.0,426.82,189.74,1667.25,38
CDM,6104475,MRI EXT LOWER NONJT W CNT RT,2223.0,426.82,189.74,1667.25,38
CDM,6104491,MRI EXT LOWER NONJT WO CNT LT,1778.0,341.38,162.2,1618.0,38
CDM,6104509,MRI EXT LOWER NONJT WO CNT RT,1778.0,341.38,162.2,1618.0,38
CDM,6104525,MRI EXT LOWER NONJT W&WO CNT LT,2667.0,512.06,239.72,2000.25,38
CDM,6104533,MRI EXT LOWER NONJT W&WO CNT RT,2667.0,512.06,239.72,2000.25,38
CDM,6104558,MRI SPECTROSCOPY,2395.0,459.84,58.65,2619.16,61
CDM,6104574,MRI JOINT TEMPOROMANDIBULAR BI,2258.0,433.54,166.84,1693.5,61
CDM,6104582,MRI JOINT TEMPOROMANDIBULAR LT,1505.0,288.96,166.84,1618.0,38
CDM,6104590,MRI JOINT TEMPOROMANDIBULAR RT,1505.0,288.96,166.84,1618.0,38
CDM,6104616,MRI EXT UPPER JT W CNT LT,2239.0,429.89,239.4,1877.73,38
CDM,6104624,MRI EXT UPPER JT W CNT RT,2239.0,429.89,239.4,1877.73,38
CDM,6104640,MRI EXT UPPER JT WO CNT LT,1791.0,343.87,141.1,1618.0,38
CDM,6104657,MRI EXT UPPER JT WO CNT RT,1791.0,343.87,141.1,1618.0,38
CDM,6104673,MRI EXT UPPER JT W&WO CNT LT,2687.0,515.9,266.89,2245.05,38
CDM,6104681,MRI EXT UPPER JT W&WO CNT RT,2687.0,515.9,266.89,2245.05,38
CDM,6104707,MRI EXT UPPER NONJT W&WO CNT LT,2774.0,532.61,266.89,2432.3,38
CDM,6104715,MRI EXT UPPER NONJT W&WO CNT RT,2774.0,532.61,266.89,2432.3,38
CDM,6104731,MRI EXT UPPER NONJT W CNT LT,2312.0,443.9,257.9,2017.82,38
CDM,6104749,MRI EXT UPPER NONJT W CNT RT,2312.0,443.9,257.9,2017.82,38
CDM,6104764,MRI EXT UPPER NONJT WO CNT LT,1849.0,355.01,166.84,1904.2,38
CDM,6104814,MRI BRAIN OPEN W CNT,4894.0,778.15,129.45,3670.5,61
CDM,6104822,MRI BRAIN OPEN WO CNT,3915.0,622.48,350.1,4414.93,61
CDM,6104830,MRI BRAIN OPEN W&WO CNT,5873.0,933.81,129.45,4404.75,61
CDM,6104848,MRI BRAIN W CNT,2505.0,398.3,189.42,1878.75,61
CDM,6104855,MRI BRAIN WO CNT,2004.0,318.64,128.76,1618.0,61
CDM,6104863,MRI BRAIN W&WO CNT,3006.0,477.95,214.41,2254.5,61
CDM,6104871,MRI ORBIT FACE&/NECK W&WO CNT,1994.0,317.05,241.34,1885.71,61
CDM,6104889,MRI ORBIT FACE&/NECK W CNT,1662.0,264.26,194.94,1618.0,61
CDM,6104897,MRI ORBIT FACE&/NECK WO CNT,1329.0,211.31,165.12,1618.0,61
CDM,6104905,MRI SPINE CERVICAL W CNT,2467.0,355.25,193.96,1850.25,61
CDM,6104913,MRI SPINE CERVICAL WO CNT,1973.0,284.11,123.25,1618.0,61
CDM,6104921,MRI SPINE CERVICAL W&WO CNT,2960.0,426.24,215.71,2220.0,61
CDM,6104939,MRI SPINE LUMBAR W CNT,2442.0,351.65,189.42,1831.5,61
CDM,6104947,MRI SPINE LUMBAR WO CNT,1953.0,281.23,123.58,1618.0,61
CDM,6104954,MRI SPINE LUMBAR W&WO CNT,2930.0,421.92,215.06,2197.5,61
CDM,6104962,MRI PELVIS W CNT,1897.0,364.22,190.07,1618.0,61
CDM,6104970,MRI PELVIS WO CNT,1517.0,291.26,162.52,1618.0,61
CDM,6104988,MRI PELVIS W&WO CNT,2276.0,436.99,237.13,1843.4,61
CDM,6104996,MRI SPINE THORACIC W CNT,2057.0,296.21,192.01,1618.0,61
CDM,6105001,MRI SPINE THORACIC WO CNT,1645.0,236.88,122.92,1618.0,61
CDM,6105019,MRI SPINE THORACIC W&WO CNT,2468.0,355.39,216.35,1851.0,61
CDM,6105555,MRI EXT UPPER NONJT WO CNT RT,1849.0,355.01,166.84,1904.2,38
CDM,6105654,MRI ELASTOGRAPHY,1153.0,221.38,150.84,1618.0,61
CDM,6105662,MRI BREAST WO CNT LT,1264.0,242.69,146.94,1618.0,38
CDM,6105670,MRI BREAST WO CNT RT,1264.0,242.69,146.94,1618.0,38
CDM,6105688,MRI BREAST WO CNT BI,1896.0,364.03,146.29,1618.0,61
CDM,6105696,MRI BREAST W&WO CNT LT,1896.0,364.03,240.37,1618.0,38
CDM,6105704,MRI BREAST W&WO CNT RT,1896.0,364.03,240.37,1618.0,38
CDM,6105712,MRI BREAST W&WO CNT BI,2844.0,546.05,238.1,2133.0,38
CDM,6105829,MRI BODY WHOLE,4073.0,782.02,58.65,3054.75,60
CDM,6105837,EVAL DEV PERIPRO PM/PM LDLS,145.0,42.48,26.97,164.52,39
CDM,6105845,EVAL DEV PERIPRO PROG ICD IN PERSON,145.0,42.48,26.97,190.53,39
CDM,6111538,MRI CAD BREAST,253.0,48.58,47.06,1618.0,37
CDM,6111546,MRI FUNCTIONAL BRAIN BY TECH,2221.0,426.43,166.84,2215.65,61
CDM,6111827,MRCP WO CNT,2110.0,405.12,129.41,1618.0,61
CDM,6111835,MRCP W CNT,2638.0,506.5,224.14,1978.5,61
CDM,6111843,MRCP W&WO CNT,3165.0,607.68,238.43,2373.75,61
CDM,6111918,MRI CARD MOR&FUNC WO CNT,1311.0,251.71,166.84,1618.0,61
CDM,6111934,MRI CARD MOR&FUNC W SI WO CNT,1891.0,363.07,243.01,1938.79,61
CDM,6111959,MRI CARD MOR&FUNC W&WO CNT,1967.0,377.66,246.54,1941.19,61
CDM,6111975,MRI CARD MOR&FUNC W SI W&WO CNT,2837.0,544.7,290.03,2308.44,61
CDM,6113476,MRI CAD BREAST,253.0,48.58,47.06,1618.0,37
CDM,6113500,MRI CARDIAC VELOCITY FLW MAP ADD-ON,860.0,118.68,34.08,1618.0,38
CDM,6113682,MR ASSESS IMP&/FB CLIN INIT 15MIN,46.0,12.97,14.5,100.91,62
CDM,6113690,MR ASSESS IMP&/FB CLIN EA ADD 30MIN,129.0,36.38,23.99,96.75,36
CDM,6113708,MR DETERMIN SAFETY PHYS/QHCP,143.0,40.33,46.76,362.84,62
CDM,6113716,MR CUST EXAM MED PHYSICS SAFETY PLN,562.0,158.48,166.84,996.1,62
CDM,6113724,MR PREP ELECT IMP SAFETY PHYS/QHCP,196.0,55.27,64.09,378.25,62
CDM,6113732,MR POS IMP SAFETY&/IMMOB PHYS/QHCP,305.0,86.01,40.35,244.78,62
CDM,6114029,MRI REND 3D W I&R W PP SAME WRKST,440.0,84.48,15.22,1618.0,38
CDM,6114037,MRI REND 3D W I&R W PP DIFF WRKST,542.0,104.06,39.51,1618.0,38
CDM,6114201,BX BRST W/WO DEV/IMG MR LSN ADD,1717.0,614.69,85.9,5681.0,40
CDM,6114227,PLC DEV/S BRST MR GD LSN ADD,1717.0,614.69,60.34,5681.0,40
CDM,6114359,PLC DEV/S BRST MR GD LSN 1ST LT,3238.0,1159.2,120.96,7704.0,40
CDM,6114367,PLC DEV/S BRST MR GD LSN 1ST RT,3238.0,1159.2,120.96,7704.0,40
CDM,6114433,BX BRST W/WO DEV/IMG MR LSN 1ST LT,4029.0,1442.38,172.41,7704.0,40
CDM,6114441,BX BRST W/WO DEV/IMG MR LSN 1ST RT,4029.0,1442.38,172.41,7704.0,40
CDM,6114573,MRI FUNCTIONAL BRAIN W PHYS,1489.0,285.89,166.84,1618.0,61
CDM,6114599,MRI FETAL W PELVIC SGL/1ST GEST,947.0,181.82,166.84,1927.95,61
CDM,6114631,ASP NEEDLE FINE BX US GD LSN 1ST,1966.0,1964.55,70.67,5681.0,63
CDM,6114649,ASP NEEDLE FINE BX US GD LSN ADDL,1757.0,629.01,48.46,5681.0,40
CDM,6114656,ASP NEEDLE FINE BX MR GD LSN 1ST,2574.0,921.49,98.92,5681.0,63
CDM,6114664,ASP NEEDLE FINE BX MR GD LSN ADDL,1880.0,673.04,64.5,5681.0,40
CDM,6114672,MRI BREAST WO CNT LT,1264.0,242.69,146.94,1618.0,38
CDM,6114680,MRI BREAST WO CNT RT,1264.0,242.69,146.94,1618.0,38
CDM,6114698,MRI BREAST WO CNT BI,1896.0,364.03,146.29,1618.0,61
CDM,6114706,MRI BREAST W&WO CNT LT,1896.0,364.03,240.37,1618.0,38
CDM,6114714,MRI BREAST W&WO CNT RT,1896.0,364.03,240.37,1618.0,38
CDM,6114722,MRI BREAST W&WO CNT BI,2844.0,546.05,238.1,2133.0,38
CDM,6114730,DRN CATH FLUID TISSUE SOFT IMG GD,3433.0,1229.01,129.89,6689.0,63
CDM,6114748,ABL RF JOINT SI INCL IMG GD BI,4640.0,1661.12,191.07,14124.0,40
CDM,6114755,ABL RF JOINT SI INCL IMG GD LT,3093.0,1107.29,191.07,14124.0,40
CDM,6114763,ABL RF JOINT SI INCL IMG GD RT,3093.0,1107.29,191.07,14124.0,40
CDM,6114797,BX BRST CORE W/WO DEV/SPEC TOMO GD,4370.0,1564.46,1229.0,6893.85,62
CDM,6152003,MRA HEAD W CNT,2584.0,519.38,172.87,1938.0,61
CDM,6152011,MRA HEAD WO CNT,2067.0,415.47,161.18,1618.0,61
CDM,6152029,MRA HEAD W&WO CNT,3101.0,623.3,262.72,2325.75,61
CDM,6152037,MRA EXT LOWER W CNT LT,2031.0,668.26,254.29,2012.16,38
CDM,6152045,MRA EXT LOWER W CNT RT,2031.0,668.26,254.29,2012.16,38
CDM,6152052,MRA EXT LOWER WO CNT LT,1625.0,534.67,254.29,2012.16,38
CDM,6152060,MRA EXT LOWER WO CNT RT,1625.0,534.67,254.29,2012.16,38
CDM,6152078,MRA EXT LOWER W/WO CNT LT,2438.0,802.18,254.29,2012.16,38
CDM,6152086,MRA EXT LOWER W/WO CNT RT,2438.0,802.18,254.29,2012.16,38
CDM,6152094,MRA ABDOMEN W CNT,2770.0,534.61,255.92,2077.5,38
CDM,6152102,MRA ABDOMEN WO CNT,2216.0,427.69,255.92,2004.25,38
CDM,6152110,MRA ABDOMEN W/WO CNT,3324.0,641.53,255.92,2493.0,38
CDM,6152128,MRA CHEST W CNT,2505.0,483.46,252.66,1993.67,38
CDM,6152136,MRA CHEST WO CNT,2004.0,386.77,252.66,1993.67,38
CDM,6152144,MRA CHEST W/WO CNT,3006.0,580.16,252.66,2254.5,38
CDM,6152151,MRA PELVIS W CNT,1992.0,384.46,257.21,2012.16,38
CDM,6152169,MRA PELVIS WO CNT,1593.0,307.45,257.21,2012.16,38
CDM,6152177,MRA PELVIS W/WO CNT,2390.0,461.27,257.21,2012.16,38
CDM,6152185,MRA SPINE W CNT,2591.0,500.06,263.7,2017.49,38
CDM,6152193,MRA SPINE WO CNT,2072.0,399.9,263.7,2017.49,38
CDM,6152201,MRA SPINE W/WO CNT,3108.0,599.84,263.7,2331.0,38
CDM,6152219,MRA EXT UPPER W CNT LT,2351.0,453.74,263.7,1943.51,38
CDM,6152227,MRA EXT UPPER W CNT RT,2351.0,453.74,263.7,1943.51,38
CDM,6152235,MRA EXT UPPER WO CNT LT,1881.0,363.03,263.7,1943.51,38
CDM,6152243,MRA EXT UPPER WO CNT RT,1881.0,363.03,263.7,1943.51,38
CDM,6152250,MRA EXT UPPER W/WO CNT LT,2822.0,544.65,263.7,2116.5,38
CDM,6152268,MRA EXT UPPER W/WO CNT RT,2822.0,544.65,263.7,2116.5,38
CDM,6152276,MRA NECK W CNT,2239.0,450.04,177.73,1679.25,61
CDM,6152284,MRA NECK WO CNT,1791.0,359.99,161.51,1618.0,61
CDM,6152292,MRA NECK W&WO CNT,2687.0,540.09,264.03,2062.39,61
CDM,6152300,QUAN MR ANLYS TISS COMP WO MRI SGL,2734.0,524.93,287.77,7519.62,57
CDM,6152318,QUAN MR ANLYS TISS COMP W MRI SGL,2734.0,524.93,257.16,2379.62,57
CDM,61713,R&B NURSERY LEVEL 2 HIGHER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,6271142,BIT LVL 07,3596.0,773.14,518.18,2697.0,29
CDM,6271159,BIT LVL 08,4880.0,1049.2,703.21,3660.0,29
CDM,6271167,IMP BOLT LVL 03,2157.0,616.9,401.2,1617.75,42
CDM,6271175,IMP BOLT LVL 04,3596.0,1028.46,668.86,2697.0,42
CDM,6271183,IMP BOLT LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,6271191,IMP BONE HUMAN/SYNTHETIC LVL 11,26284.0,7517.22,1312.53,19713.0,42
CDM,6271217,CANNULA LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,6271225,CANNULA LVL 07,3596.0,773.14,518.18,2697.0,29
CDM,6271233,CANNULA LVL 08,4397.0,945.36,633.61,3297.75,29
CDM,6271241,CATH ANGIO TRANSL NONLASER LVL 10,12969.0,2788.34,548.37,9726.75,39
CDM,6271258,CATH EP NON 3D 1-19 LVL 07,13895.0,2987.42,1202.73,10421.25,39
CDM,6271266,CATH EP NON 3D 1-19 LVL 08,17524.0,3767.66,1202.73,13143.0,39
CDM,6271274,CATH GUIDE LVL 08,3596.0,773.14,336.61,2697.0,39
CDM,6271282,CATH GUIDE LVL 09,4885.0,1050.28,336.61,3663.75,39
CDM,6271290,ELECTRODE ELECTROSURGICAL LVL 10,5861.0,1260.12,844.57,4395.75,29
CDM,6271308,ELECTRODE ELECTROSURGICAL LVL 11,9265.0,1991.98,1335.09,6948.75,29
CDM,6271316,ELECTRODE ELECTROSURGICAL LVL 12,12506.0,2688.79,1802.11,9379.5,29
CDM,6271324,ELECTRODE ELECTROSURGICAL LVL 09,3596.0,773.14,518.18,2697.0,29
CDM,6271332,CEMENT ACCESSORIES LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,6271340,CEMENT ACCESSORIES LVL 05,4885.0,1050.28,703.93,3663.75,29
CDM,6271357,CEMENT ACCESSORIES LVL 06,6950.0,1494.25,1001.5,5212.5,29
CDM,6271365,CLIP LVL 03,594.0,127.71,85.6,445.5,29
CDM,6271373,EMBOLIZATION SYS PROTECT LVL 02,6950.0,1987.7,1292.7,5212.5,42
CDM,6271381,IMP GENERATOR NEUROSTIM LVL 02,43800.0,12526.8,8146.8,86476.0,42
CDM,6271399,IMP GENERATOR NEUROSTIM LVL 03,65704.0,18791.34,12220.94,86476.0,42
CDM,6271407,IMP GENERATOR NEUROSTIM LVL 04,87604.0,25054.74,16294.34,86476.0,42
CDM,6271415,WIRE GUIDE LVL 09,9265.0,1991.98,1122.65,6948.75,39
CDM,6271423,IMP ICD CHAMBER DUAL LVL 04,109504.0,33179.71,20367.74,82128.0,42
CDM,6271431,IMP ICD CHAMBER DUAL LVL 05,131404.0,39815.41,24441.14,98553.0,42
CDM,6271449,INSTRUMENT DISP SINGLE LVL 07,3596.0,773.14,518.18,2697.0,29
CDM,6271456,INTRO LVL 06,3596.0,773.14,518.18,2697.0,29
CDM,6271464,INTRO LVL 07,5861.0,1260.12,844.57,4395.75,29
CDM,6271472,INTRO NON GD/EP/LASER LVL 02,313.0,67.3,58.22,248.85,39
CDM,6271480,INTRO NON GD/EP/LASER LVL 03,594.0,127.71,110.48,445.5,39
CDM,6271498,INTRO NON GD/EP/LASER LVL 04,1619.0,348.08,183.22,1214.25,39
CDM,6271506,INTRO NON GD/EP/LASER LVL 05,2695.0,579.42,183.22,2021.25,39
CDM,6271514,INTRO NON GD/EP/LASER LVL 06,3596.0,773.14,183.22,2697.0,39
CDM,6271522,INTRO NON GD/EP/LASER LVL 07,5861.0,1260.12,183.22,4395.75,39
CDM,6271530,INTRO NON GD/EP/LASER LVL 08,7876.0,1693.34,183.22,5907.0,39
CDM,6271548,KIT/SET NON ROUTINE SURG LVL 10,6950.0,1494.25,1001.5,5212.5,29
CDM,6271555,KIT/SET NON ROUTINE SURG LVL 11,9265.0,1991.98,1335.09,6948.75,29
CDM,6271563,KIT/SET NON ROUTINE SURG LVL 12,11580.0,2489.7,1668.68,8685.0,29
CDM,6271571,KIT/SET NON ROUTINE SURG LVL 13,13895.0,2987.42,2002.27,10421.25,29
CDM,6271589,MANIPULATOR LVL 01,313.0,67.3,45.1,234.75,29
CDM,6271597,MANIPULATOR LVL 02,594.0,127.71,85.6,445.5,29
CDM,6271605,IMP MESH LVL 11,19714.0,5638.2,3666.8,14785.5,42
CDM,6271613,IMP MESH LVL 12,24094.0,6890.88,4120.12,18070.5,42
CDM,6271621,IMP MESH LVL 13,28474.0,8143.56,4120.12,21355.5,42
CDM,6271639,NEEDLE SPECIALTY LVL 06,2157.0,463.76,310.82,1617.75,29
CDM,6271647,NEEDLE SPECIALTY LVL 07,2426.0,521.59,349.59,1819.5,29
CDM,6271662,IMP PCMKR SGL RR LVL 05,30664.0,9291.19,5703.5,41774.56,42
CDM,6271670,IMP PCMKR SGL RR LVL 06,35044.0,10618.33,6518.18,41774.56,42
CDM,6271688,SUPPLY PERFUSION/ECMO LVL 10,6105.0,1312.58,879.73,4578.75,29
CDM,6271696,SUPPLY PERFUSION/ECMO LVL 09,5129.0,1102.73,739.09,3846.75,29
CDM,6271704,IMP PIN/WIRE LVL 04,1132.0,323.75,210.55,1363.66,42
CDM,6271712,IMP PIN/WIRE LVL 05,1413.0,404.12,262.82,1363.66,42
CDM,6271720,IMP PIN/WIRE LVL 06,1619.0,463.03,301.13,1363.66,42
CDM,6271738,IMP PIN/WIRE LVL 07,1888.0,539.97,351.17,1416.0,42
CDM,6271746,IMP PLATE LVL 11,9265.0,2649.79,1003.99,6948.75,42
CDM,6271753,IMP PLATE LVL 12,11580.0,3311.88,1003.99,8685.0,42
CDM,6271761,IMP PLATE LVL 13,13895.0,3973.97,1003.99,10421.25,42
CDM,6271779,IMP PLATE LVL 14,15334.0,4385.52,1003.99,11500.5,42
CDM,6271787,POUCH LVL 01,166.0,35.69,23.92,124.5,29
CDM,6271795,POUCH LVL 02,447.0,96.1,64.41,335.25,29
CDM,6271803,POUCH LVL 03,850.0,182.75,122.48,637.5,29
CDM,6271811,PROBE LVL 10,13895.0,2987.42,2002.27,10421.25,29
CDM,6271829,PROBE LVL 08,5861.0,1260.12,844.57,4395.75,29
CDM,6271837,PROBE LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,6271845,IMP DEV JT KNEE TOTAL LVL 20,96364.0,27560.1,5497.98,72273.0,42
CDM,6271852,REAMER LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,6271860,REAMER LVL 05,3083.0,662.84,444.26,2312.25,29
CDM,6271878,IMP RING LVL 02,3596.0,1028.46,668.86,2697.0,42
CDM,6271886,IMP RING LVL 03,4397.0,1257.54,817.84,3297.75,42
CDM,6271894,IMP ROD/NAIL LVL 08,7876.0,2252.54,1003.99,5907.0,42
CDM,6271902,IMP ROD/NAIL LVL 09,9265.0,2649.79,1003.99,6948.75,42
CDM,6271910,IMP STAPLE BONE LVL 05,1490.0,426.14,277.14,1363.66,42
CDM,6271928,IMP STAPLE BONE LVL 06,2157.0,616.9,401.2,1617.75,42
CDM,6271936,IMP STAPLE BONE LVL 07,3083.0,881.74,573.44,2312.25,42
CDM,6271944,IMP STAPLE BONE LVL 08,3909.0,1117.97,727.07,2931.75,42
CDM,6271951,IMP STAPLE BONE LVL 09,4885.0,1397.11,908.61,3663.75,42
CDM,6271969,IMP STAPLE BONE LVL 10,5861.0,1676.25,1003.99,4395.75,42
CDM,6271977,IMP STAPLE BONE LVL 11,6487.0,1855.28,1003.99,4865.25,42
CDM,6271985,STAPLER LVL 07,5861.0,1260.12,844.57,4395.75,29
CDM,6271993,IMP STENT NOS LVL 10,21904.0,6264.54,1312.53,16428.0,42
CDM,6272009,IMP STENT NOS LVL 11,26284.0,7517.22,1312.53,19713.0,42
CDM,6272017,IMP STENT NOS LVL 12,30664.0,8769.9,1312.53,22998.0,42
CDM,6272025,IMP STENT NOS LVL 13,35044.0,10022.58,1312.53,26283.0,42
CDM,6272033,IMP STENT NOS LVL 14,39424.0,11275.26,1312.53,29568.0,42
CDM,6272041,IMP STENT NOS LVL 09,17524.0,5011.86,1312.53,13143.0,42
CDM,6272058,IMP STENT NONCOAT W DEL LVL 09,21904.0,6264.54,4074.14,16428.0,42
CDM,6272066,IMP STENT NONCOAT W DEL LVL 10,26284.0,7517.22,4888.82,19713.0,42
CDM,6272074,IMP STENT NONCOAT W DEL LVL 11,30664.0,8769.9,4897.5,22998.0,42
CDM,6272082,IMP STENT NONCOAT W DEL LVL 12,35044.0,10022.58,4897.5,26283.0,42
CDM,6272090,IMP STENT NONCOAT WO DEL LVL 10,17524.0,5011.86,979.5,13143.0,42
CDM,6272108,IMP STENT NONCOAT WO DEL LVL 11,21904.0,6264.54,979.5,16428.0,42
CDM,6272116,IMP STENT NONCOAT WO DEL LVL 12,26284.0,7517.22,979.5,19713.0,42
CDM,6272124,IMP STENT NONCOAT WO DEL LVL 13,30664.0,8769.9,979.5,22998.0,42
CDM,6272132,IMP STENT NONCOAT WO DEL LVL 14,35044.0,10022.58,979.5,26283.0,42
CDM,6272140,IMP STENT NONCOAT WO DEL LVL 09,13895.0,3973.97,979.5,10421.25,42
CDM,6272165,IMP TISSUE CONNECT HUMAN LVL 03,6950.0,1987.7,1292.7,8965.57,42
CDM,6272173,IMP TISSUE CONNECT HUMAN LVL 04,9265.0,2649.79,1723.29,8965.57,42
CDM,6272181,IMP TISSUE CONNECT HUMAN LVL 05,11580.0,3311.88,2153.88,8965.57,42
CDM,6272199,IMP TISSUE CONNECT HUMAN LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,6272207,IMP TISSUE CONNECT HUMAN LVL 07,15334.0,4385.52,2852.12,11500.5,42
CDM,6272215,IMP TISSUE CONNECT HUMAN LVL 08,17524.0,5011.86,3259.46,13143.0,42
CDM,6272231,WIRE PACING TEMP LVL 01,313.0,67.3,45.1,234.75,29
CDM,6272249,WIRE PACING TEMP LVL 02,594.0,127.71,85.6,445.5,29
CDM,6272256,PACER ACCESSORY LVL 02,1132.0,243.38,163.12,849.0,29
CDM,6272389,IMP CEMENT ACCESSORY LVL 03,1619.0,463.03,301.13,1363.66,42
CDM,6272397,IMP CEMENT ACCESSORY LVL 04,2695.0,770.77,501.27,2021.25,42
CDM,6272405,CATH BALLOON LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,6272413,CATH BALLOON LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,6272421,CATH BALLOON LVL 10,11580.0,2489.7,1668.68,8685.0,29
CDM,6272439,CATH BALLOON LVL 11,13895.0,2987.42,2002.27,10421.25,29
CDM,6272462,INSTRUMENT DISP SINGLE LVL 08,5861.0,1260.12,844.57,4395.75,29
CDM,6272470,INSTRUMENT DISP SINGLE LVL 09,6950.0,1494.25,1001.5,5212.5,29
CDM,6272488,IMP PROSTH ANKLE LVL 06,26284.0,7517.22,1312.53,19713.0,42
CDM,6272496,IMP PROSTH ANKLE LVL 07,30664.0,8769.9,1312.53,22998.0,42
CDM,6272504,IMP PROSTH ANKLE LVL 08,35044.0,10022.58,1312.53,26283.0,42
CDM,6272512,IMP CONNECTOR SPINAL LVL 01,313.0,89.52,58.22,1782.74,42
CDM,6272520,IMP CONNECTOR SPINAL LVL 02,594.0,169.88,110.48,1782.74,42
CDM,6272538,IMP CONNECTOR SPINAL LVL 03,2157.0,616.9,401.2,1782.74,42
CDM,6272546,IMP CONNECTOR SPINAL LVL 04,3596.0,1028.46,668.86,2697.0,42
CDM,6272553,IMP CONNECTOR SPINAL LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,6272561,IMP CONNECTOR SPINAL LVL 06,6950.0,1987.7,1292.7,5212.5,42
CDM,6272579,IMP CONNECTOR SPINAL LVL 07,9265.0,2649.79,1312.53,6948.75,42
CDM,6272587,IMP STENT COAT W DEL LVL 10,21904.0,6264.54,4074.14,18372.82,42
CDM,6272595,IMP STENT COAT W DEL LVL 11,26284.0,7517.22,4888.82,19713.0,42
CDM,6272603,IMP STENT COAT W DEL LVL 12,30664.0,8769.9,5703.5,22998.0,42
CDM,6272611,IMP STENT COAT W DEL LVL 13,35044.0,10022.58,6518.18,26283.0,42
CDM,6272629,PUNCH LVL 03,1619.0,348.08,233.3,1214.25,29
CDM,6272637,PUNCH LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,6272645,PROBE LVL 11,17524.0,3767.66,2525.21,13143.0,29
CDM,6272652,IMP BAND LVL 07,13895.0,3973.97,1312.53,10421.25,42
CDM,6272660,IMP BAND LVL 08,17524.0,5011.86,1312.53,13143.0,42
CDM,6272678,IMP MESH LVL 14,32854.0,9396.24,4120.12,24640.5,42
CDM,6272686,INSTRUMENT DISP SINGLE LVL 10,9265.0,1991.98,1335.09,6948.75,29
CDM,6272694,INSTRUMENT DISP SINGLE LVL 11,11580.0,2489.7,1668.68,8685.0,29
CDM,6272702,INSTRUMENT DISP SINGLE LVL 12,13895.0,2987.42,2002.27,10421.25,29
CDM,6272710,IMP DEV JT ELBOW TOTAL LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6272728,IMP DEV JT ELBOW TOTAL LVL 07,30664.0,8769.9,5497.98,22998.0,42
CDM,6272736,IMP DEV JT ELBOW TOTAL LVL 08,35044.0,10022.58,5497.98,26283.0,42
CDM,6272744,IMP DEV JT ELBOW TOTAL LVL 09,39424.0,11275.26,5497.98,29568.0,42
CDM,6272751,IMP DEV JT ELBOW TOTAL LVL 10,43804.0,12527.94,5497.98,32853.0,42
CDM,6272769,IMP DEV JT ELBOW TOTAL LVL 11,48184.0,13780.62,5497.98,36138.0,42
CDM,6272777,IMP DEV JT ELBOW TOTAL LVL 12,52564.0,15033.3,5497.98,39423.0,42
CDM,6272785,IMP DEV JT ELBOW TOTAL LVL 13,56944.0,16285.98,5497.98,42708.0,42
CDM,6272793,IMP DEV JT ELBOW TOTAL LVL 14,61324.0,17538.66,5497.98,45993.0,42
CDM,6272801,IMP DEV JT ELBOW TOTAL LVL 15,65704.0,18791.34,5497.98,49278.0,42
CDM,6272819,IMP TISSUE CONNECT HUMAN LVL 09,21904.0,6264.54,4074.14,16428.0,42
CDM,6272827,IMP TISSUE CONNECT HUMAN LVL 10,26284.0,7517.22,4888.82,19713.0,42
CDM,6272835,IMP TISSUE CONNECT HUMAN LVL 11,30664.0,8769.9,5703.5,22998.0,42
CDM,6272926,PAIN MGMT ACCESSORY LVL 01,313.0,67.3,45.1,234.75,29
CDM,6272934,PAIN MGMT ACCESSORY LVL 02,594.0,127.71,85.6,445.5,29
CDM,6272942,PAIN MGMT ACCESSORY LVL 03,1132.0,243.38,163.12,849.0,29
CDM,6273171,IMP ACCESS SYSTEM DIALYS LVL 04,3596.0,1028.46,668.86,5703.09,42
CDM,6273189,IMP ACCESS SYSTEM DIALYS LVL 05,5861.0,1676.25,1090.15,5703.09,42
CDM,6273197,IMP ACCESS SYSTEM DIALYS LVL 06,8107.0,2318.6,1507.9,6080.25,42
CDM,6273205,INTRO EP FIX CRV PEEL LVL 02,594.0,127.71,110.48,445.5,39
CDM,6273213,INTRO EP LASER LVL 01,313.0,67.3,58.22,234.75,39
CDM,6273221,INTRO EP LASER LVL 02,594.0,127.71,110.48,445.5,39
CDM,6273247,IMP DEV URINARY W SLING LVL 03,6950.0,1987.7,1292.7,15395.12,42
CDM,6273254,IMP DEV URINARY W SLING LVL 04,9265.0,2649.79,1723.29,15395.12,42
CDM,6273288,IMP ORTHOPEDIC CAGE LVL 02,4885.0,1397.11,908.61,3663.75,42
CDM,6273296,IMP ORTHOPEDIC CAGE LVL 03,9265.0,2649.79,1312.53,6948.75,42
CDM,6273304,IMP ORTHOPEDIC CAGE LVL 04,13895.0,3973.97,1312.53,10421.25,42
CDM,6273312,IMP ORTHOPEDIC CAGE LVL 05,17524.0,5011.86,1312.53,13143.0,42
CDM,6273320,IMP ORTHOPEDIC CAGE LVL 06,21904.0,6264.54,1312.53,16428.0,42
CDM,6273338,IMP ORTHOPEDIC CAGE LVL 07,26284.0,7517.22,1312.53,19713.0,42
CDM,6273346,IMP ORTHOPEDIC CAGE LVL 08,30664.0,8769.9,1312.53,22998.0,42
CDM,6273353,IMP ORTHOPEDIC CAGE LVL 09,35044.0,10022.58,1312.53,26283.0,42
CDM,6273361,IMP LD PCMKR NON VDD LVL 02,4885.0,1397.11,908.61,3663.75,42
CDM,6273379,IMP STENT NONCOR TEMP WO DEL LVL 06,2695.0,770.77,304.13,2021.25,42
CDM,6273387,IMP STENT NONCOR TEMP WO DEL LVL 07,4885.0,1397.11,304.13,3663.75,42
CDM,6273395,IMP STENT NONCOR TEMP WO DEL LVL 08,6950.0,1987.7,304.13,5212.5,42
CDM,6273403,IMP STENT NONCOR TEMP WO DEL LVL 09,9265.0,2649.79,304.13,6948.75,42
CDM,6273494,CEMENT ACCESSORIES LVL 07,9265.0,1991.98,1335.09,6948.75,29
CDM,6273502,CEMENT ACCESSORIES LVL 08,15334.0,3296.81,2209.63,11500.5,29
CDM,6273510,PROGRAMMER PT NEUROSTIM LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6273528,IMP PROSTH PENILE INFLT LVL 05,30664.0,8769.9,5703.5,62427.29,42
CDM,6273585,CLIP APPLIER LVL 04,3083.0,662.84,444.26,2312.25,29
CDM,6273627,IMP DEV JT KNEE TOTAL LVL 21,109504.0,31318.14,5497.98,82128.0,42
CDM,6273635,IMP DEV JT KNEE TOTAL LVL 22,122644.0,35076.18,5497.98,91983.0,42
CDM,6273643,IMP DEV JT KNEE TOTAL LVL 23,135784.0,38834.22,5497.98,101838.0,42
CDM,6273668,KIT/SET NON ROUTINE ORTH LVL 07,17524.0,3767.66,2525.21,13143.0,29
CDM,6273676,KIT/SET NON ROUTINE SURG LVL 14,17524.0,3767.66,2525.21,13143.0,29
CDM,6273684,KIT/SET NON ROUTINE SURG LVL 15,21904.0,4709.36,3156.37,16428.0,29
CDM,6273692,IMP CLIP ANEURYSM LVL 02,3596.0,1028.46,668.86,2697.0,42
CDM,6273700,IMP LD NEUROSTIM LVL 02,9265.0,2649.79,1723.29,7574.37,42
CDM,6273718,IMP LD NEUROSTIM LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6273726,IMP LD NEUROSTIM LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6273734,IMP RING CARDIAC LVL 03,17524.0,5011.86,1312.53,13143.0,42
CDM,6273742,IMP LD ICD COIL SGL LVL 02,4885.0,1397.11,908.61,10514.88,42
CDM,6273759,IMP LD ICD COIL SGL LVL 03,6950.0,1987.7,1292.7,10514.88,42
CDM,6273767,IMP LD ICD COIL SGL LVL 04,9265.0,2649.79,1723.29,10514.88,42
CDM,6273775,IMP LD ICD COIL SGL LVL 05,11580.0,3311.88,2153.88,10514.88,42
CDM,6273783,IMP LD ICD COIL SGL LVL 06,13895.0,3973.97,2584.47,10514.88,42
CDM,6273791,IMP LD ICD COIL SGL LVL 07,15334.0,4385.52,2852.12,11500.5,42
CDM,6273809,IMP LD ICD COIL SGL LVL 08,17524.0,5011.86,3259.46,13143.0,42
CDM,6273817,IMP LD ICD COIL SGL LVL 09,19714.0,5638.2,3666.8,14785.5,42
CDM,6273825,IMP LD ICD COIL DUAL LVL 02,4885.0,1397.11,908.61,60907.18,42
CDM,6273833,IMP LD ICD COIL DUAL LVL 03,6950.0,1987.7,1292.7,60907.18,42
CDM,6273841,IMP LD ICD COIL DUAL LVL 04,9265.0,2649.79,1723.29,60907.18,42
CDM,6273858,IMP LD ICD COIL DUAL LVL 05,11580.0,3311.88,2153.88,60907.18,42
CDM,6273866,IMP LD ICD COIL DUAL LVL 06,13895.0,3973.97,2584.47,60907.18,42
CDM,6273874,IMP LD ICD COIL DUAL LVL 07,15334.0,4385.52,2852.12,60907.18,42
CDM,6273882,IMP LD ICD COIL DUAL LVL 08,17524.0,5011.86,3259.46,60907.18,42
CDM,6273890,IMP LD ICD COIL DUAL LVL 09,19714.0,5638.2,3666.8,60907.18,42
CDM,6273908,INTRO EP FIX CRV PEEL LVL 03,1413.0,303.8,217.6,1059.75,39
CDM,6273916,INTRO EP FIX CRV PEEL LVL 04,2023.0,434.94,217.6,1517.25,39
CDM,6273924,IMP DEV JT SHDR TOTAL LVL 11,30664.0,8769.9,5497.98,22998.0,42
CDM,6273932,IMP DEV JT SHDR TOTAL LVL 12,35044.0,10022.58,5497.98,26283.0,42
CDM,6273940,IMP PROSTH ENT LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,6273957,IMP PROSTH ENT LVL 06,6950.0,1987.7,1292.7,5212.5,42
CDM,6273965,IMP PROSTH ENT LVL 07,9265.0,2649.79,1312.53,6948.75,42
CDM,6273973,IMP PROSTH ENT LVL 08,11580.0,3311.88,1312.53,8685.0,42
CDM,6274005,IMP PROSTH SPHINCTR ANAL LVL 02,11580.0,3311.88,1312.53,8685.0,42
CDM,6274013,CLIP LVL 04,850.0,182.75,122.48,637.5,29
CDM,6274021,IMP FIX SPINE LVL 09,27160.0,7767.76,1312.53,20370.0,42
CDM,6274039,CATH EP NON 3D 20+ LVL 03,9265.0,1991.98,1723.29,6948.75,39
CDM,6274047,CATH EP NON 3D 20+ LVL 04,13895.0,2987.42,2185.85,10421.25,39
CDM,6274054,CATH EP NON 3D 20+ LVL 05,17524.0,3767.66,2185.85,13143.0,39
CDM,6274062,IMP LD VENOUS COR LV LVL 04,9265.0,2649.79,1723.29,8750.91,42
CDM,6274070,IMP LD VENOUS COR LV LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6274088,IMP LD VENOUS COR LV LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6274096,IMP LD VENOUS COR LV LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6274104,IMP LD VENOUS COR LV LVL 08,26284.0,7517.22,4888.82,19713.0,42
CDM,6274112,IMP LD VENOUS COR LV LVL 09,30664.0,8769.9,5703.5,22998.0,42
CDM,6274260,IMP PCMKR DUAL RR LVL 05,65704.0,19908.31,12220.94,49278.0,42
CDM,6274278,IMP PCMKR DUAL RR LVL 06,87604.0,26544.01,16294.34,65703.0,42
CDM,6274286,IMP PCMKR DUAL RR LVL 07,109504.0,33179.71,20367.74,82128.0,42
CDM,6274294,IMP LD PCMKR NON VDD LVL 03,9265.0,2649.79,1490.99,6948.75,42
CDM,6274302,IMP LD PCMKR NON VDD LVL 04,13895.0,3973.97,1490.99,10421.25,42
CDM,6274310,IMP LD PCMKR NON VDD LVL 05,17524.0,5011.86,1490.99,13143.0,42
CDM,6274328,IMP LD PCMKR NON VDD LVL 06,21904.0,6264.54,1490.99,16428.0,42
CDM,6274336,IMP LD PCMKR NON VDD LVL 07,26284.0,7517.22,1490.99,19713.0,42
CDM,6274344,IMP LD PCMKR NON VDD LVL 08,30664.0,8769.9,1490.99,22998.0,42
CDM,6274351,IMP ICD CHAMBER NON SGL/DUAL LVL 05,109504.0,31318.14,20367.74,82128.0,42
CDM,6274369,IMP DEV CLOSURE VASCULAR LVL 07,4885.0,1397.11,908.61,3663.75,42
CDM,6274377,IMP PLATE LVL 15,18400.0,5262.4,1003.99,13800.0,42
CDM,6274393,TAPE MARKING RADIOPAQUE LVL 01,166.0,35.69,23.92,124.5,29
CDM,6274401,DEVICE INSERT RETRV LVL 02,2157.0,463.76,401.2,1773.49,39
CDM,6274419,DEVICE INSERT RETRV LVL 03,3596.0,773.14,668.86,2697.0,39
CDM,6274427,IMP LD ICD COIL DUAL LVL 10,24094.0,6890.88,4481.48,60907.18,42
CDM,6274435,IMP PCMKR NONSGL OR DUAL LVL 04,35040.0,10617.12,6517.44,26280.0,42
CDM,6274468,CATH ANGIO TRANSL LASER LVL 03,6950.0,1494.25,1292.7,8505.58,39
CDM,6274476,IMP PROSTH ENT LVL 09,13895.0,3973.97,1312.53,10421.25,42
CDM,6274484,IMP PROSTH ENT LVL 10,17524.0,5011.86,1312.53,13143.0,42
CDM,6274492,IMP PROSTH ENT LVL 11,21904.0,6264.54,1312.53,16428.0,42
CDM,6274500,IMP PROSTH ENT LVL 12,26284.0,7517.22,1312.53,19713.0,42
CDM,6274518,CATH ATHERECT TRANSL ROTAT LVL 03,13895.0,2987.42,2584.47,10952.52,39
CDM,6274526,IMP FILTER VENA CAVA LVL 02,2690.0,769.34,500.34,3310.63,42
CDM,6274575,DIALYSIS ACCESSORIES LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,6274617,IMP LD PCMKR VDD LVL 03,9265.0,2649.79,1490.99,6948.75,42
CDM,6274625,IMP LD PCMKR VDD LVL 04,11580.0,3311.88,1490.99,8685.0,42
CDM,6274633,IMP LD PCMKR VDD LVL 05,13895.0,3973.97,1490.99,10421.25,42
CDM,6274641,IMP LD PCMKR VDD LVL 06,15334.0,4385.52,1490.99,11500.5,42
CDM,6274658,IMP LD PCMKR VDD LVL 07,17524.0,5011.86,1490.99,13143.0,42
CDM,6274666,IMP LD PCMKR VDD LVL 08,19714.0,5638.2,1490.99,14785.5,42
CDM,6274682,CATH DIAGNOSTIC LVL 10,6950.0,1494.25,1001.5,5212.5,29
CDM,6274690,REAMER LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6274708,IMP PUMP INF PRG LVL 02,8112.0,2320.03,1508.83,58151.78,42
CDM,6274716,IMP PUMP INF PRG LVL 03,10431.0,2983.27,1940.17,58151.78,42
CDM,6274724,IMP PUMP INF PRG LVL 04,13895.0,3973.97,2584.47,58151.78,42
CDM,6274732,IMP PUMP INF PRG LVL 05,19714.0,5638.2,3666.8,58151.78,42
CDM,6274740,IMP PUMP INF PRG LVL 06,26284.0,7517.22,4888.82,58151.78,42
CDM,6274757,IMP PUMP INF PRG LVL 07,32854.0,9396.24,6110.84,58151.78,42
CDM,6274765,IMP PUMP INF PRG LVL 08,39424.0,11275.26,7332.86,58151.78,42
CDM,6274773,IMP PUMP INF PRG LVL 09,46870.0,13404.82,8717.82,58151.78,42
CDM,6274781,IMP PROSTH TESTICULAR LVL 04,17524.0,5011.86,1312.53,13143.0,42
CDM,6274799,IMP PROSTH TESTICULAR LVL 05,21904.0,6264.54,1312.53,16428.0,42
CDM,6274807,IMP PROSTH TESTICULAR LVL 06,26284.0,7517.22,1312.53,19713.0,42
CDM,6274815,IMP PROSTH TESTICULAR LVL 07,30664.0,8769.9,1312.53,22998.0,42
CDM,6274823,IMP PROSTH TESTICULAR LVL 08,35044.0,10022.58,1312.53,26283.0,42
CDM,6274864,IMP PLATE LVL 16,21904.0,6264.54,1003.99,16428.0,42
CDM,6274872,IMP PLATE LVL 17,24094.0,6890.88,1003.99,18070.5,42
CDM,6275028,CATH INTRASPINAL LVL 05,2695.0,579.42,501.27,2021.25,39
CDM,6275036,CATH INTRASPINAL LVL 06,3853.0,828.4,716.66,2889.75,39
CDM,6275044,IMP DEV URINARY WO SLNG LVL 03,6105.0,1746.03,1135.53,4578.75,42
CDM,6275051,IMP DEV URINARY WO SLNG LVL 04,9265.0,2649.79,1723.29,6948.75,42
CDM,6275077,IMP ICD CHAMBER NON SGL/DUAL LVL 06,122644.0,35076.18,22811.78,91983.0,42
CDM,6275085,CATH INTRAVASCULAR US LVL 04,4885.0,1050.28,908.61,3663.75,39
CDM,6275101,SUPPLY OSTOMY LVL 01,32.0,7.39,4.61,24.0,29
CDM,6275135,CANNULA LVL 09,6105.0,1312.58,879.73,4578.75,29
CDM,6275143,IMP PUMP VALVE BLOOD LVL 06,87604.0,25054.74,1312.53,65703.0,42
CDM,6275184,IMP BONE HUMAN/SYNTHETIC LVL 12,30664.0,8769.9,1312.53,22998.0,42
CDM,6275192,IMP BONE HUMAN/SYNTHETIC LVL 13,35482.0,10147.85,1312.53,26611.5,42
CDM,6275200,IMP PROSTH ORTHOPEDIC LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,6275218,IMP PROSTH ORTHOPEDIC LVL 03,4885.0,1397.11,908.61,3663.75,42
CDM,6275226,DILATOR LVL 06,3340.0,718.1,481.29,2505.0,29
CDM,6275259,INTRO EP FIX CRV NONPEEL LVL 02,1132.0,243.38,210.55,849.0,39
CDM,6275275,VEST AIRWAY DISPOSABLE LVL 01,594.0,137.21,85.6,445.5,29
CDM,6275291,PAIN MGMT ACCESSORY LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,6275309,PAIN MGMT ACCESSORY LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6275317,IMP FIX SPINE LVL 10,32854.0,9396.24,1312.53,24640.5,42
CDM,6275325,CATH ANGIO TRANSL LASER LVL 04,9265.0,1991.98,1723.29,8505.58,39
CDM,6275374,IMP DEV COCHLEAR INT&EXT CMP LVL 04,96364.0,27560.1,15261.64,72273.0,43
CDM,6275390,IMP PROSTH ANKLE LVL 09,39424.0,11275.26,1312.53,29568.0,42
CDM,6275408,KIT/SET NON ROUTINE CARDIAC LVL 07,6487.0,1394.7,934.78,4865.25,29
CDM,6275416,KIT/SET NON ROUTINE CARDIAC LVL 08,7876.0,1693.34,1134.93,5907.0,29
CDM,6275531,CATH INTRACARDIAC ECHO LVL 03,6487.0,1394.7,1206.58,4865.25,39
CDM,6275580,IMP DEV URINARY W SLING LVL 01,2690.0,769.34,500.34,15395.12,42
CDM,6275622,IMP STAPLE BONE LVL 12,7413.0,2120.12,1003.99,5559.75,42
CDM,6275671,IMP PROSTH MAXILLOFACIAL LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,6275689,IMP PROSTH MAXILLOFACIAL LVL 07,13895.0,3973.97,1312.53,10421.25,42
CDM,6275697,IMP PROSTH MAXILLOFACIAL LVL 08,17524.0,5011.86,1312.53,13143.0,42
CDM,6275705,IMP PROSTH MAXILLOFACIAL LVL 09,21904.0,6264.54,1312.53,16428.0,42
CDM,6275762,CATH ABL COOL-TIP LVL 06,6487.0,1394.7,1206.58,8015.46,39
CDM,6275770,CATH ABL COOL-TIP LVL 07,7413.0,1593.8,1378.82,8015.46,39
CDM,6275788,IMP NRSTM BAT RECHG SYS LVL 05,43800.0,12526.8,8146.8,111421.0,42
CDM,6275796,IMP NRSTM BAT RECHG SYS LVL 06,65704.0,18791.34,12220.94,111421.0,42
CDM,6275804,IMP NRSTM BAT RECHG SYS LVL 07,87604.0,25054.74,16294.34,111421.0,42
CDM,6275820,INTRO EP FIX CRV PEEL LVL 05,2695.0,579.42,217.6,2021.25,39
CDM,6275853,HEMOSTATIC AGENT LVL 05,3083.0,662.84,444.26,2312.25,29
CDM,6275861,IMP PUMP INF PRG LVL 10,51250.0,14657.5,9532.5,58151.78,42
CDM,6275879,IMP MATERIAL CORD VOCAL LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6275895,STYLET LVL 04,1888.0,405.92,272.06,1416.0,29
CDM,6275903,EMBOLIZATION SYS PROTECT LVL 03,8339.0,2384.95,1551.05,6254.25,42
CDM,6275911,CATH ABL NONCARDIAC LVL 01,1619.0,348.08,301.13,4307.3,39
CDM,6275929,CATH ABL NONCARDIAC LVL 02,3083.0,662.84,573.44,4307.3,39
CDM,6275937,IMP DEV JT KNEE TOTAL LVL 01,1132.0,323.75,210.55,7467.6,42
CDM,6275945,IMP DEV JT KNEE TOTAL LVL 02,2695.0,770.77,501.27,7467.6,42
CDM,6275952,IMP DEV JT KNEE TOTAL LVL 03,4880.0,1395.68,907.68,7467.6,42
CDM,6275986,IMP TISSUE CONNECT HUMAN LVL 12,35044.0,10022.58,6518.18,26283.0,42
CDM,6276034,BIT LVL 09,6024.0,1295.16,868.06,4518.0,29
CDM,6276042,IMP DEV URINARY WO SLNG LVL 01,2421.0,692.41,450.31,2669.58,42
CDM,6276083,CATH ATHERECT TRANSL DIRECT LVL 03,13895.0,2987.42,2584.47,10952.52,39
CDM,6276117,IMP EMBOLIZATION AGENT LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,6276125,IMP EMBOLIZATION AGENT LVL 03,3596.0,1028.46,668.86,2697.0,42
CDM,6276133,IMP EMBOLIZATION AGENT LVL 04,4885.0,1397.11,908.61,3663.75,42
CDM,6276141,IMP EMBOLIZATION AGENT LVL 05,6950.0,1987.7,1292.7,5212.5,42
CDM,6276158,IMP EMBOLIZATION AGENT LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,6276166,IMP EMBOLIZATION AGENT LVL 07,11580.0,3311.88,1312.53,8685.0,42
CDM,6276174,IMP EMBOLIZATION AGENT LVL 08,13895.0,3973.97,1312.53,10421.25,42
CDM,6276182,IMP EMBOLIZATION AGENT LVL 09,15334.0,4385.52,1312.53,11500.5,42
CDM,6276190,IMP PROSTH ORTHOPEDIC LVL 01,1614.0,461.6,300.2,1782.74,42
CDM,6276208,IMP PROSTH ORTHOPEDIC LVL 04,9265.0,2649.79,1312.53,6948.75,42
CDM,6276216,IMP TISSUE CONNECT HUMAN LVL 13,39424.0,11275.26,6600.85,29568.0,42
CDM,6276224,IMP TISSUE CONNECT HUMAN LVL 14,43804.0,12527.94,6600.85,32853.0,42
CDM,6276232,IMP BOLT LVL 06,6950.0,1987.7,1003.99,5212.5,42
CDM,6276240,IMP LD PCMKR VDD LVL 01,2690.0,769.34,500.34,2025.13,42
CDM,6276257,HYPO-HYPER THERMAL LVL 03,1413.0,326.4,203.61,1059.75,29
CDM,6276273,IMP DEV JT SHDR TOTAL LVL 13,39424.0,11275.26,5497.98,29568.0,42
CDM,6276281,IMP DEV JT SHDR TOTAL LVL 14,43804.0,12527.94,5497.98,32853.0,42
CDM,6276299,IMP DEV JT SHDR TOTAL LVL 15,48184.0,13780.62,5497.98,36138.0,42
CDM,6276315,PIN GUIDE LVL 04,1132.0,243.38,163.12,849.0,29
CDM,6276323,IMP LD NEUROSTIM LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,6276331,IMP LD NEUROSTIM LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6276356,RETRIEVER SUTURE LVL 03,2157.0,463.76,310.82,1617.75,29
CDM,6276364,RETRIEVER SUTURE LVL 04,3083.0,662.84,444.26,2312.25,29
CDM,6276372,RETRIEVER SUTURE LVL 05,3853.0,828.4,555.22,2889.75,29
CDM,6276398,INTRO EP LASER LVL 03,1888.0,405.92,162.55,1416.0,39
CDM,6276406,INTRO EP LASER LVL 04,3083.0,662.84,162.55,2312.25,39
CDM,6276414,INTRO EP LASER LVL 05,4885.0,1050.28,162.55,3663.75,39
CDM,6276422,INTRO EP LASER LVL 06,9265.0,1991.98,162.55,6948.75,39
CDM,6276430,INTRO EP LASER LVL 07,13895.0,2987.42,162.55,10421.25,39
CDM,6276455,IMP AGENT SYNTHETIC BULK 1ML LVL 02,447.0,127.84,83.14,602.41,43
CDM,6276463,IMP AGENT SYNTHETIC BULK 1ML LVL 03,709.0,202.77,131.87,602.41,43
CDM,6276471,IMP AGENT SYNTHETIC BULK 1ML LVL 04,1272.0,363.79,176.16,954.0,43
CDM,6276497,IMP SEPTAL DEFECT INTRACARD LVL 02,19714.0,5638.2,3666.8,52268.89,42
CDM,6276505,IMP SEPTAL DEFECT INTRACARD LVL 03,24094.0,6890.88,4481.48,52268.89,42
CDM,6276513,IMP DEV URINARY W SLING LVL 05,11580.0,3311.88,2153.88,15395.12,42
CDM,6276521,IMP DEV URINARY WO SLNG LVL 05,11580.0,3311.88,1965.46,8685.0,42
CDM,6276604,MORCELLATOR LVL 01,2690.0,578.35,500.34,3610.64,39
CDM,6276612,MORCELLATOR LVL 02,4880.0,1049.2,907.68,3660.0,39
CDM,6276620,MORCELLATOR LVL 03,9260.0,1990.9,1722.36,6945.0,39
CDM,6276638,CATH THROMBECTOMY/EMBOLECTMY LVL 08,9265.0,1991.98,575.51,6948.75,39
CDM,6276646,INTRO LVL 08,7876.0,1693.34,1134.93,5907.0,29
CDM,6276653,INTRO LVL 09,10191.0,2191.06,1468.52,7643.25,29
CDM,6276661,CATH INTRACARDIAC ECHO LVL 01,2690.0,578.35,500.34,2467.89,39
CDM,6276679,IMP TISSUE CONNECT NONHUMAN LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6276687,IMP LD ICD COIL DUAL LVL 11,32854.0,9396.24,6110.84,60907.18,42
CDM,6276711,PATCH EP REFSTAR LVL 03,2695.0,622.55,388.35,2021.25,29
CDM,6276729,IMP AGENT SYNTHETIC BULK 1ML LVL 05,2690.0,769.34,176.16,2017.5,43
CDM,6276737,IMP AGENT SYNTHETIC BULK 1ML LVL 06,3078.0,880.31,176.16,2308.5,43
CDM,6276794,IMP ROD/NAIL LVL 10,11580.0,3311.88,1003.99,8685.0,42
CDM,6276802,HANDPIECE LVL 07,17524.0,3767.66,2525.21,13143.0,29
CDM,6276810,HANDPIECE LVL 08,21904.0,4709.36,3156.37,16428.0,29
CDM,6276828,HANDPIECE LVL 09,26284.0,5651.06,3787.52,19713.0,29
CDM,6276836,HANDPIECE LVL 10,30664.0,6592.76,4418.68,22998.0,29
CDM,6276844,HANDPIECE LVL 11,35044.0,7534.46,5049.84,26283.0,29
CDM,6276851,HANDPIECE LVL 12,39424.0,8476.16,5681.0,29568.0,29
CDM,6276885,SUPPLY PERFUSION/ECMO LVL 11,7181.0,1543.92,1034.78,5385.75,29
CDM,6276893,INTRO NON GD/EP/LASER LVL 01,96.0,20.64,17.86,248.85,39
CDM,6276927,CATH INTRACARDIAC ECHO LVL 04,9265.0,1991.98,1723.29,6948.75,39
CDM,6276935,CATH INTRACARDIAC ECHO LVL 05,11580.0,2489.7,1816.97,8685.0,39
CDM,6276943,IMP PCMKR SGL RR LVL 02,17520.0,5308.56,3258.72,41774.56,42
CDM,6276968,IMP DEV CLOSURE VASCULAR LVL 08,9265.0,2649.79,1719.02,6948.75,42
CDM,6276976,IMP DEV CLOSURE VASCULAR LVL 09,13895.0,3973.97,1719.02,10421.25,42
CDM,6276984,IMP DEV CLOSURE VASCULAR LVL 10,17524.0,5011.86,1719.02,13143.0,42
CDM,6276992,IMP DEV CLOSURE VASCULAR LVL 11,21904.0,6264.54,1719.02,16428.0,42
CDM,6277008,DILATOR LVL 07,5861.0,1260.12,844.57,4395.75,29
CDM,6277016,IMP DEV JT HIP TOTAL LVL 17,109504.0,31318.14,5497.98,82128.0,42
CDM,6277024,IMP MEMBRANE AMNIO OCULAR LVL 01,2695.0,770.77,501.27,2268.33,42
CDM,6277032,IMP MEMBRANE AMNIO OCULAR LVL 02,3853.0,1101.96,716.66,2889.75,42
CDM,6277057,IMP CEMENT LVL 06,9265.0,2649.79,1003.99,6948.75,42
CDM,6277065,IMP CEMENT LVL 07,11580.0,3311.88,1003.99,8685.0,42
CDM,6277099,IMP PLATE CUST LVL 01,65704.0,18791.34,1003.99,49278.0,42
CDM,6277107,IMP PLATE CUST LVL 02,87604.0,25054.74,1003.99,65703.0,42
CDM,6277115,IMP PLATE CUST LVL 03,109504.0,31318.14,1003.99,82128.0,42
CDM,6277123,IMP PLATE CUST LVL 04,131404.0,37581.54,1003.99,98553.0,42
CDM,6277131,IMP BONE HUMAN/SYNTHETIC LVL 14,39862.0,11400.53,1312.53,29896.5,42
CDM,6277149,IMP BONE HUMAN/SYNTHETIC LVL 15,44242.0,12653.21,1312.53,33181.5,42
CDM,6277156,IMP BONE HUMAN/SYNTHETIC LVL 16,48622.0,13905.89,1312.53,36466.5,42
CDM,6277164,IMP BONE HUMAN/SYNTHETIC LVL 17,53002.0,15158.57,1312.53,39751.5,42
CDM,6277172,IMP SPINE KYPHX LVL 01,594.0,169.88,110.48,1782.74,42
CDM,6277180,IMP SPINE KYPHX LVL 02,1132.0,323.75,210.55,1782.74,42
CDM,6277198,IMP SPINE KYPHX LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6277206,IMP SPINE KYPHX LVL 04,4885.0,1397.11,908.61,3663.75,42
CDM,6277214,IMP SPINE KYPHX LVL 05,9265.0,2649.79,1312.53,6948.75,42
CDM,6277222,IMP SPINE KYPHX LVL 06,13895.0,3973.97,1312.53,10421.25,42
CDM,6277230,IMP SPINE KYPHX LVL 07,17524.0,5011.86,1312.53,13143.0,42
CDM,6277248,IMP SPINE KYPHX LVL 08,21904.0,6264.54,1312.53,16428.0,42
CDM,6277545,NEEDLE SPECIALTY LVL 08,2827.0,607.8,407.37,2120.25,29
CDM,6277552,NEEDLE SPECIALTY LVL 09,3340.0,718.1,481.29,2505.0,29
CDM,6277560,NEEDLE SPECIALTY LVL 10,3853.0,828.4,555.22,2889.75,29
CDM,6277578,LASER FIBER LVL 07,5861.0,1260.12,844.57,4395.75,29
CDM,6277669,IMP PROSTH SPHINCTR URIN LVL 02,14020.0,4009.72,2607.72,10515.0,42
CDM,6277818,IMP TISSUE CONNECT NONHUMAN LVL 08,30664.0,8769.9,5703.5,22998.0,42
CDM,6277842,IMP PROSTH SPHINCTR URIN LVL 03,19714.0,5638.2,3666.8,14785.5,42
CDM,6277859,IMP PROSTH SPHINCTR URIN LVL 04,25408.0,7266.69,4725.89,19056.0,42
CDM,6277875,SENSOR ENDOSURE AAA LVL 01,13895.0,2987.42,2002.27,10421.25,29
CDM,6277917,DRESSING SPECIALTY LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,6277925,IMP MARKER TISSUE LVL 03,1132.0,323.75,149.28,849.0,42
CDM,6277933,INTRO EP FIX CRV NONPEEL LVL 03,1888.0,405.92,351.17,1416.0,39
CDM,6277941,INTRO EP FIX CRV NONPEEL LVL 04,2695.0,579.42,489.85,2021.25,39
CDM,6277958,INTRO EP FIX CRV NONPEEL LVL 05,3853.0,828.4,489.85,2889.75,39
CDM,6277982,IMP PCMKR DUAL RR LVL 01,17520.0,5308.56,3258.72,41774.56,42
CDM,6278014,IMP DEV URINARY W SLING LVL 06,14020.0,4009.72,2607.72,15395.12,42
CDM,6278113,CATH INTRAVASCULAR US LVL 05,6950.0,1494.25,1292.7,5212.5,39
CDM,6278121,CATH INTRAVASCULAR US LVL 06,9265.0,1991.98,1723.29,6948.75,39
CDM,6278139,CATH INTRAVASCULAR US LVL 07,11580.0,2489.7,1816.97,8685.0,39
CDM,6278147,IMP PIN/WIRE LVL 08,2426.0,693.84,451.24,1819.5,42
CDM,6278154,IMP PIN/WIRE LVL 09,2827.0,808.52,525.82,2120.25,42
CDM,6278162,IMP PIN/WIRE LVL 10,3340.0,955.24,621.24,2505.0,42
CDM,6278170,IMP PIN/WIRE LVL 11,3853.0,1101.96,716.66,2889.75,42
CDM,6278188,CATH GUIDE LVL 10,6105.0,1312.58,336.61,4578.75,39
CDM,6278196,CATH GUIDE LVL 11,9265.0,1991.98,336.61,6948.75,39
CDM,6278204,CATH GUIDE LVL 12,11580.0,2489.7,336.61,8685.0,39
CDM,6278220,IMP SHUNT LVL 10,17524.0,5011.86,1312.53,13143.0,42
CDM,6278238,IMP ICD CHAMBER NON SGL/DUAL LVL 03,78840.0,22548.24,14664.24,63194.0,42
CDM,6278246,CATH INTRACARDIAC ECHO LVL 06,13895.0,2987.42,1816.97,10421.25,39
CDM,6278253,IMP ROD/NAIL LVL 11,15334.0,4385.52,1003.99,11500.5,42
CDM,6278261,IMP ROD/NAIL LVL 12,19714.0,5638.2,1003.99,14785.5,42
CDM,6278279,IMP ROD/NAIL LVL 13,24094.0,6890.88,1003.99,18070.5,42
CDM,6278329,IMP PIN/WIRE LVL 12,6105.0,1746.03,1003.99,4578.75,42
CDM,6278337,IMP CABLE LVL 07,6950.0,1987.7,1292.7,5212.5,42
CDM,6278345,IMP CABLE LVL 08,9265.0,2649.79,1312.53,6948.75,42
CDM,6278352,IMP CABLE LVL 09,11580.0,3311.88,1312.53,8685.0,42
CDM,6278360,IMP PCMKR DUAL NON RR LVL 01,19714.0,5973.34,3666.8,25942.8,42
CDM,6278378,IMP PCMKR DUAL NON RR LVL 02,24090.0,7299.27,4480.74,25942.8,42
CDM,6278386,IMP PCMKR SGL NON RR LVL 02,19714.0,5973.34,3666.8,25942.8,42
CDM,6278394,IMP PCMKR SGL NON RR LVL 03,22776.0,6901.13,4236.34,25942.8,42
CDM,6278410,IMP CARDIAC EVENT REC LVL 03,14892.0,4259.11,2769.91,41774.56,42
CDM,6278444,CANNULA LVL 10,7181.0,1543.92,1034.78,5385.75,29
CDM,6278451,CANNULA LVL 11,10654.0,2290.61,1535.24,7990.5,29
CDM,6278469,IMP PROSTH SPHINCTR ANAL LVL 01,5368.0,1535.25,998.45,4026.0,42
CDM,6278519,IMP CEMENT LVL 08,13895.0,3973.97,1003.99,10421.25,42
CDM,6278584,STAPLE RELOAD LVL 07,6105.0,1312.58,879.73,4578.75,29
CDM,6278600,STAPLE RELOAD LVL 08,8107.0,1743.0,1168.22,6080.25,29
CDM,6278634,IMP DEV COCHLEAR INT&EXT CMP LVL 06,131404.0,37581.54,15261.64,98553.0,43
CDM,6278642,IMP DEV COCHLEAR INT&EXT CMP LVL 07,153304.0,43844.94,15261.64,114978.0,43
CDM,6278659,IMP DEV COCHLEAR INT&EXT CMP LVL 08,175204.0,50108.34,15261.64,131403.0,43
CDM,6278667,IMP DEV COCHLEAR INT&EXT CMP LVL 09,197104.0,56371.74,15261.64,147828.0,43
CDM,6278675,IMP DEV COCHLEAR INT&EXT CMP LVL 10,219004.0,62635.14,15261.64,164253.0,43
CDM,6278683,DEVICE INSERT RETRV LVL 04,4397.0,945.36,817.84,3297.75,39
CDM,6278709,IMP DEV JT SHDR TOTAL LVL 16,55630.0,15910.18,5497.98,41722.5,42
CDM,6278717,CATH ABL EP NON 3D/VECTOR LVL 05,13895.0,2987.42,2584.47,10421.25,39
CDM,6278741,SUPPLY NEURO LVL 09,17524.0,3767.66,2525.21,13143.0,29
CDM,6278758,IMP MESH LVL 15,37234.0,10648.92,4120.12,27925.5,42
CDM,6278766,BAG DRAINAGE LVL 04,535.0,123.58,77.09,401.25,29
CDM,6278774,BAG DRAINAGE LVL 05,766.0,176.95,110.38,574.5,29
CDM,6278857,LENS INTRAOCULAR CHAM POST LVL 01,594.0,195.44,110.48,445.5,37
CDM,6278865,LENS INTRAOCULAR CHAM POST LVL 02,1132.0,372.46,139.52,849.0,37
CDM,6278873,LENS INTRAOCULAR CHAM POST LVL 03,2157.0,709.72,139.52,1617.75,37
CDM,6278881,LENS INTRAOCULAR CHAM ANT LVL 01,594.0,195.44,110.48,445.5,37
CDM,6278899,LENS INTRAOCULAR CHAM ANT LVL 02,1132.0,372.46,139.52,849.0,37
CDM,6278907,LENS INTRAOCULAR CHAM ANT LVL 03,2157.0,709.72,139.52,1617.75,37
CDM,6278915,INTRO EP FIX CRV PEEL LVL 06,3596.0,773.14,217.6,2697.0,39
CDM,6278931,IMP PIN/WIRE LVL 13,8107.0,2318.6,1003.99,6080.25,42
CDM,6278949,IMP LD ICD NON SGL/DUAL LVL 05,11580.0,3311.88,2153.88,8685.0,42
CDM,6278956,IMP STENT NOS LVL 15,43804.0,12527.94,1312.53,32853.0,42
CDM,6278972,IMP ADPT/EXT LD PACING/NEURO LVL 03,7413.0,2120.12,1378.82,11779.23,42
CDM,6278980,IMP NRSTM BAT RECHG SYS LVL 03,14892.0,4259.11,2769.91,111421.0,42
CDM,6278998,IMP NRSTM BAT RECHG SYS LVL 04,28470.0,8142.42,5295.42,111421.0,42
CDM,6279004,IMP LD NEUROSTIM LVL 07,30664.0,8769.9,5576.59,22998.0,42
CDM,6279020,IMP NRSTM BAT RECHG SYS LVL 01,4885.0,1397.11,908.61,111421.0,42
CDM,6279038,IMP NRSTM BAT RECHG SYS LVL 02,6945.0,1986.27,1291.77,111421.0,42
CDM,6279046,PAIN MGMT ACCESSORY LVL 06,3340.0,718.1,481.29,2505.0,29
CDM,6279111,REAMER LVL 02,588.0,126.42,84.73,441.0,29
CDM,6279152,IMP FIX SPINE LVL 11,39424.0,11275.26,1312.53,29568.0,42
CDM,6279160,RETRIEVER BASKET LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6279178,REAMER LVL 01,159.0,34.18,22.91,119.25,29
CDM,6279194,IMP ICD CHAMBER SGL LVL 01,43800.0,13271.4,8146.8,63194.0,42
CDM,6279202,CATH ABL COOL-TIP LVL 08,9265.0,1991.98,1723.29,8015.46,39
CDM,6279210,CATH ABL COOL-TIP LVL 09,11575.0,2488.62,2152.95,8681.25,39
CDM,6279228,CATH ABL COOL-TIP LVL 10,13432.0,2887.88,2498.35,10074.0,39
CDM,6279236,IMP PROSTH ORTHOPEDIC LVL 05,13895.0,3973.97,1312.53,10421.25,42
CDM,6279269,IMP DEV INTERSPINOUS LVL 01,4885.0,1397.11,908.61,3663.75,42
CDM,6279277,IMP DEV INTERSPINOUS LVL 02,9265.0,2649.79,1094.44,6948.75,42
CDM,6279285,IMP DEV INTERSPINOUS LVL 03,13895.0,3973.97,1094.44,10421.25,42
CDM,6279293,IMP DEV INTERSPINOUS LVL 04,17524.0,5011.86,1094.44,13143.0,42
CDM,6279301,IMP DEV INTERSPINOUS LVL 05,21904.0,6264.54,1094.44,16428.0,42
CDM,6279319,IMP DEV INTERSPINOUS LVL 06,26284.0,7517.22,1094.44,19713.0,42
CDM,6279327,IMP DEV INTERSPINOUS LVL 07,30664.0,8769.9,1094.44,22998.0,42
CDM,6279335,IMP DEV INTERSPINOUS LVL 08,35044.0,10022.58,1094.44,26283.0,42
CDM,6279343,HYPO-HYPER THERMAL LVL 04,3853.0,890.04,555.22,2889.75,29
CDM,6279376,IMP ORTHOPEDIC CAGE LVL 10,39424.0,11275.26,1312.53,29568.0,42
CDM,6279384,IMP STAPLE BONE LVL 13,8339.0,2384.95,1003.99,6254.25,42
CDM,6279392,IMP BONE HUMAN/SYNTHETIC LVL 18,61324.0,17538.66,1312.53,45993.0,42
CDM,6279400,IMP BONE HUMAN/SYNTHETIC LVL 19,70084.0,20044.02,1312.53,52563.0,42
CDM,6279418,IMP BONE HUMAN/SYNTHETIC LVL 20,78844.0,22549.38,1312.53,59133.0,42
CDM,6279426,IMP BONE HUMAN/SYNTHETIC LVL 21,87604.0,25054.74,1312.53,65703.0,42
CDM,6279434,IMP ORTHOPEDIC CAGE LVL 11,52564.0,15033.3,1312.53,39423.0,42
CDM,6279442,IMP ORTHOPEDIC CAGE LVL 12,65704.0,18791.34,1312.53,49278.0,42
CDM,6279459,IMP FIX SPINE LVL 12,52564.0,15033.3,1312.53,39423.0,42
CDM,6279467,IMP FIX SPINE LVL 13,65704.0,18791.34,1312.53,49278.0,42
CDM,6279475,IMP ORTHOPEDIC CAGE LVL 13,78844.0,22549.38,1312.53,59133.0,42
CDM,6279483,IMP FIX SPINE LVL 14,78844.0,22549.38,1312.53,59133.0,42
CDM,6279491,IMP BONE HUMAN/SYNTHETIC LVL 22,96364.0,27560.1,1312.53,72273.0,42
CDM,6279509,IMP GENERATOR NEUROSTIM LVL 05,109504.0,31318.14,20367.74,86476.0,42
CDM,6279525,IMP TUBE EAR LVL 02,447.0,127.84,83.14,1782.74,42
CDM,6279533,IMP TUBE EAR LVL 03,709.0,202.77,131.87,1782.74,42
CDM,6279541,IMP ORTHOTIC CAP END LVL 01,159.0,45.47,29.57,1782.74,42
CDM,6279558,IMP ORTHOTIC CAP END LVL 02,313.0,89.52,58.22,1782.74,42
CDM,6279566,IMP ORTHOTIC CAP END LVL 03,850.0,243.1,158.1,1782.74,42
CDM,6279574,IMP ORTHOTIC CAP END LVL 04,1413.0,404.12,262.82,1782.74,42
CDM,6279582,IMP ORTHOTIC CAP END LVL 05,1888.0,539.97,351.17,1782.74,42
CDM,6279590,IMP ORTHOTIC CAP END LVL 06,2695.0,770.77,501.27,2021.25,42
CDM,6279608,IMP STENT NONCOR TEMP W DEL LVL 02,1132.0,323.75,210.55,1345.83,42
CDM,6279624,INSERTS LVL 03,594.0,127.71,85.6,445.5,29
CDM,6279632,INSERTS LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6279640,IMP DEV URINARY W SLING LVL 07,17962.0,5137.13,3340.93,15395.12,42
CDM,6279665,CATH INTRAVASCULAR US LVL 08,13895.0,2987.42,1816.97,10421.25,39
CDM,6279673,CATH INTRAVASCULAR US LVL 09,15334.0,3296.81,1816.97,11500.5,39
CDM,6279699,DRESSING SPECIALTY LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,6279707,DRESSING SPECIALTY LVL 10,11580.0,2489.7,1668.68,8685.0,29
CDM,6279715,IMP SPINE FUSION LVL 03,7413.0,2120.12,1312.53,5559.75,42
CDM,6279723,IMP SPINE FUSION LVL 04,8339.0,2384.95,1312.53,6254.25,42
CDM,6279731,IMP SPINE FUSION LVL 05,9728.0,2782.21,1312.53,7296.0,42
CDM,6279749,IMP SPINE FUSION LVL 06,11117.0,3179.46,1312.53,8337.75,42
CDM,6279756,IMP SPINE FUSION LVL 07,13895.0,3973.97,1312.53,10421.25,42
CDM,6279764,IMP SPINE FUSION LVL 08,17524.0,5011.86,1312.53,13143.0,42
CDM,6279772,IMP SPINE FUSION LVL 09,21904.0,6264.54,1312.53,16428.0,42
CDM,6279780,IMP SPINE FUSION LVL 10,26284.0,7517.22,1312.53,19713.0,42
CDM,6279798,IMP SPINE FUSION LVL 11,30664.0,8769.9,1312.53,22998.0,42
CDM,6279806,IMP SPINE FUSION LVL 12,35044.0,10022.58,1312.53,26283.0,42
CDM,6279814,IMP SPINE FUSION LVL 13,39424.0,11275.26,1312.53,29568.0,42
CDM,6279830,IMP CEMENT ACCESSORY LVL 05,3853.0,1101.96,716.66,2889.75,42
CDM,6279848,IMP CEMENT ACCESSORY LVL 06,4880.0,1395.68,907.68,3660.0,42
CDM,6279855,IMP PLATE LVL 18,26284.0,7517.22,1003.99,19713.0,42
CDM,6279863,IMP PLATE LVL 19,28474.0,8143.56,1003.99,21355.5,42
CDM,6279871,IMP PLATE LVL 20,30664.0,8769.9,1003.99,22998.0,42
CDM,6279889,IMP PLATE LVL 21,32854.0,9396.24,1003.99,24640.5,42
CDM,6279897,IMP PLATE LVL 22,35044.0,10022.58,1003.99,26283.0,42
CDM,6279996,IMP SPINE FUSION LVL 14,43804.0,12527.94,1312.53,32853.0,42
CDM,6280002,IMP SPINE FUSION LVL 15,48184.0,13780.62,1312.53,36138.0,42
CDM,6280010,IMP SPINE FUSION LVL 16,52564.0,15033.3,1312.53,39423.0,42
CDM,6280028,IMP SPINE FUSION LVL 17,56944.0,16285.98,1312.53,42708.0,42
CDM,6280036,IMP SPINE FUSION LVL 18,61324.0,17538.66,1312.53,45993.0,42
CDM,6280044,IMP PROSTH ANKLE LVL 10,43804.0,12527.94,1312.53,32853.0,42
CDM,6280051,STAPLE RELOAD LVL 09,10422.0,2240.73,1501.81,7816.5,29
CDM,6280101,IMP TISSUE CONNECT NONHUMAN LVL 09,39424.0,11275.26,6198.23,29568.0,42
CDM,6280119,IMP TISSUE CONNECT NONHUMAN LVL 10,43804.0,12527.94,6198.23,32853.0,42
CDM,6280200,INSTRUMENT DISP SINGLE LVL 13,15334.0,3296.81,2209.63,11500.5,29
CDM,6280234,IMP SPINE FUSION LVL 19,65704.0,18791.34,1312.53,49278.0,42
CDM,6280242,IMP SPINE FUSION LVL 20,70084.0,20044.02,1312.53,52563.0,42
CDM,6280259,IMP SPINE FUSION LVL 21,74464.0,21296.7,1312.53,55848.0,42
CDM,6280267,IMP SPINE FUSION LVL 22,78844.0,22549.38,1312.53,59133.0,42
CDM,6280275,IMP SPINE FUSION LVL 23,83224.0,23802.06,1312.53,62418.0,42
CDM,6280283,CATH/WIRE/SUTURE PASSER LVL 03,850.0,182.75,122.48,637.5,29
CDM,6280291,BRA SURG POSTOP LVL 01,159.0,36.73,22.91,119.25,29
CDM,6280309,IMP SPINE FUSION LVL 24,111694.0,31944.48,1312.53,83770.5,42
CDM,6280317,SENSOR CEREBRAL OXIMETER LVL 02,1619.0,373.99,233.3,1214.25,29
CDM,6280325,IMP BOLT LVL 07,9265.0,2649.79,1003.99,6948.75,42
CDM,6280333,IMP BOLT LVL 08,12506.0,3576.72,1003.99,9379.5,42
CDM,6280341,CLIP LVL 05,1485.0,319.27,213.99,1113.75,29
CDM,6280358,CLIP LVL 06,2028.0,436.02,292.23,1521.0,29
CDM,6280366,NEEDLE BRACHYTHERAPY LVL 02,588.0,126.42,109.37,745.56,39
CDM,6280374,IMP PROSTH PENILE INFLT LVL 06,43804.0,12527.94,8147.54,62427.29,42
CDM,6280382,IMP PROSTH PENILE INFLT LVL 07,56944.0,16285.98,10591.58,62427.29,42
CDM,6280390,IMP PROSTH PENILE INFLT LVL 08,65704.0,18791.34,12220.94,62427.29,42
CDM,6280408,EMBOLIZATION SYS PROTECT LVL 04,11580.0,3311.88,2153.88,8685.0,42
CDM,6280416,TAPS LVL 04,3596.0,773.14,518.18,2697.0,29
CDM,6280424,THERAPY COLD LVL 04,2426.0,521.59,349.59,1819.5,29
CDM,6280432,THERAPY COLD LVL 05,3909.0,840.44,563.29,2931.75,29
CDM,6280440,IMP TISSUE CONNECT NONHUMAN LVL 11,48184.0,13780.62,6198.23,36138.0,42
CDM,6280523,IMP ADPT/EXT LD PACING/NEURO LVL 01,1126.0,322.04,209.44,11779.23,42
CDM,6280572,IMP STAPLE REINFORCEMENT LVL 01,313.0,89.52,58.22,1782.74,42
CDM,6280580,IMP STAPLE REINFORCEMENT LVL 02,594.0,169.88,110.48,1782.74,42
CDM,6280598,IMP STAPLE REINFORCEMENT LVL 03,1132.0,323.75,210.55,1782.74,42
CDM,6280606,IMP STAPLE REINFORCEMENT LVL 04,1619.0,463.03,301.13,1782.74,42
CDM,6280614,IMP STAPLE REINFORCEMENT LVL 05,2157.0,616.9,401.2,1782.74,42
CDM,6280655,IMP LD NEUROSTIM TEST KIT LVL 07,3909.0,1117.97,727.07,2931.75,42
CDM,6280671,IMP PROSTH SPHINCTR ANAL LVL 03,15334.0,4385.52,1312.53,11500.5,42
CDM,6280689,IMP PROSTH SPHINCTR ANAL LVL 04,19714.0,5638.2,1312.53,14785.5,42
CDM,6280721,IMP NEURO LVL 08,65704.0,18791.34,1312.53,49278.0,42
CDM,6280739,IMP STENT NONCOR TEMP W DEL LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6280747,IMP STENT NONCOR TEMP W DEL LVL 04,3909.0,1117.97,727.07,2931.75,42
CDM,6280754,IMP STENT NONCOR TEMP W DEL LVL 05,5373.0,1536.68,990.86,4029.75,42
CDM,6280762,WIRE PACING TEMP LVL 03,850.0,182.75,122.48,637.5,29
CDM,6280770,WIRE PACING TEMP LVL 04,1132.0,243.38,163.12,849.0,29
CDM,6280788,WIRE PACING TEMP LVL 05,1413.0,303.8,203.61,1059.75,29
CDM,6280796,MANIPULATOR LVL 03,850.0,182.75,122.48,637.5,29
CDM,6280804,IMP MATERIAL CORD VOCAL LVL 02,1614.0,461.6,300.2,1435.1,42
CDM,6280812,IMP LD NEUROSTIM TEST KIT LVL 08,6105.0,1746.03,1135.53,4578.75,42
CDM,6280820,IMP LD NEUROSTIM TEST KIT LVL 09,7644.0,2186.18,1421.78,5733.0,42
CDM,6280838,DEVICE CLOSURE TISSUE LVL 01,313.0,67.3,45.1,234.75,29
CDM,6280846,DEVICE CLOSURE TISSUE LVL 02,594.0,127.71,85.6,445.5,29
CDM,6280853,DEVICE CLOSURE TISSUE LVL 03,1132.0,243.38,163.12,849.0,29
CDM,6280861,DEVICE CLOSURE TISSUE LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,6280879,DEVICE CLOSURE TISSUE LVL 05,2157.0,463.76,310.82,1617.75,29
CDM,6280887,DEVICE CLOSURE TISSUE LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,6280895,DEVICE CLOSURE TISSUE LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,6280903,DEVICE CLOSURE TISSUE LVL 08,9265.0,1991.98,1335.09,6948.75,29
CDM,6280911,DEVICE CLOSURE TISSUE LVL 09,13895.0,2987.42,2002.27,10421.25,29
CDM,6280929,DEVICE CLOSURE TISSUE LVL 10,17524.0,3767.66,2525.21,13143.0,29
CDM,6280937,DEVICE CLOSURE TISSUE LVL 11,21904.0,4709.36,3156.37,16428.0,29
CDM,6280945,IMP HOOK LVL 01,2690.0,769.34,500.34,2017.5,42
CDM,6280952,IMP HOOK LVL 02,4885.0,1397.11,908.61,3663.75,42
CDM,6280960,IMP HOOK LVL 03,6950.0,1987.7,1292.7,5212.5,42
CDM,6280978,IMP HOOK LVL 04,9265.0,2649.79,1312.53,6948.75,42
CDM,6280986,WIRE GUIDE LVL 10,11580.0,2489.7,1122.65,8685.0,39
CDM,6280994,WIRE GUIDE LVL 11,13895.0,2987.42,1122.65,10421.25,39
CDM,6281000,IMP STENT COAT W DEL LVL 14,39424.0,11275.26,7332.86,29568.0,42
CDM,6281018,IMP STENT COAT W DEL LVL 15,43804.0,12527.94,8147.54,32853.0,42
CDM,6281026,IMP SPINAL BAR/RG/CLR LVL 01,594.0,169.88,110.48,1782.74,42
CDM,6281034,IMP SPINAL BAR/RG/CLR LVL 02,850.0,243.1,158.1,1782.74,42
CDM,6281042,IMP SPINAL BAR/RG/CLR LVL 03,1132.0,323.75,210.55,1782.74,42
CDM,6281059,IMP SPINAL BAR/RG/CLR LVL 04,1413.0,404.12,262.82,1782.74,42
CDM,6281067,IMP SPINAL BAR/RG/CLR LVL 05,1619.0,463.03,301.13,1782.74,42
CDM,6281075,IMP SPINAL BAR/RG/CLR LVL 06,1888.0,539.97,351.17,1782.74,42
CDM,6281083,IMP SPINAL BAR/RG/CLR LVL 07,2426.0,693.84,451.24,1819.5,42
CDM,6281091,IMP SPINAL BAR/RG/CLR LVL 08,2827.0,808.52,525.82,2120.25,42
CDM,6281109,IMP SPINAL BAR/RG/CLR LVL 09,3340.0,955.24,621.24,2505.0,42
CDM,6281117,DEVICE INFLATION DISP LVL 01,313.0,67.3,45.1,234.75,29
CDM,6281125,DEVICE INFLATION DISP LVL 02,594.0,127.71,85.6,445.5,29
CDM,6281133,DEVICE INFLATION DISP LVL 03,850.0,182.75,122.48,637.5,29
CDM,6281141,DEVICE INFLATION DISP LVL 04,1132.0,243.38,163.12,849.0,29
CDM,6281158,DEVICE INFLATION DISP LVL 05,1619.0,348.08,233.3,1214.25,29
CDM,6281166,DEVICE INFLATION DISP LVL 06,2157.0,463.76,310.82,1617.75,29
CDM,6281174,DEVICE INFLATION DISP LVL 07,2695.0,579.42,388.35,2021.25,29
CDM,6281182,IMP TISSUE CONNECT HUMAN LVL 15,48184.0,13780.62,6600.85,36138.0,42
CDM,6281208,DEVICE FIXATION DISP LVL 01,313.0,67.3,45.1,234.75,29
CDM,6281216,DEVICE FIXATION DISP LVL 02,594.0,127.71,85.6,445.5,29
CDM,6281224,DEVICE FIXATION DISP LVL 03,1132.0,243.38,163.12,849.0,29
CDM,6281232,DEVICE FIXATION DISP LVL 04,1619.0,348.08,233.3,1214.25,29
CDM,6281240,DEVICE FIXATION DISP LVL 05,2157.0,463.76,310.82,1617.75,29
CDM,6281257,DEVICE FIXATION DISP LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,6281265,DEVICE FIXATION DISP LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,6281273,IMP SPINAL BAR/RG/CLR LVL 10,3853.0,1101.96,716.66,2889.75,42
CDM,6281281,IMP SPINAL BAR/RG/CLR LVL 11,4153.0,1187.76,772.46,3114.75,42
CDM,6281299,IMP CATH PORT INDWELLING LVL 08,4153.0,1187.76,772.46,7147.71,42
CDM,6281307,IMP CATH PORT INDWELLING LVL 09,4641.0,1327.33,863.23,7147.71,42
CDM,6281323,DEVICE FIXATION DISP LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,6281349,IMP STENT NOS LVL 16,50374.0,14406.96,1312.53,37780.5,42
CDM,6281356,IMP SPINAL BAR/RG/CLR LVL 12,4885.0,1397.11,908.61,3663.75,42
CDM,6281364,IMP SPINAL BAR/RG/CLR LVL 13,6105.0,1746.03,1135.53,4578.75,42
CDM,6281372,EMBOLIZATION SYS PROTECT LVL 01,5861.0,1676.25,1090.15,4845.25,42
CDM,6281380,DEVICE ABLATION LVL 02,1132.0,243.38,163.12,849.0,29
CDM,6281398,DEVICE ABLATION LVL 03,3083.0,662.84,444.26,2312.25,29
CDM,6281406,DEVICE ABLATION LVL 04,4885.0,1050.28,703.93,3663.75,29
CDM,6281414,DEVICE ABLATION LVL 05,6950.0,1494.25,1001.5,5212.5,29
CDM,6281422,DEVICE ABLATION LVL 06,9265.0,1991.98,1335.09,6948.75,29
CDM,6281430,DEVICE ABLATION LVL 07,11580.0,2489.7,1668.68,8685.0,29
CDM,6281448,DEVICE ABLATION LVL 08,13895.0,2987.42,2002.27,10421.25,29
CDM,6281455,VEST AIRWAY DISPOSABLE LVL 02,850.0,196.35,122.48,637.5,29
CDM,6281463,VEST AIRWAY DISPOSABLE LVL 03,1132.0,261.49,163.12,849.0,29
CDM,6281471,SENSOR CEREBRAL OXIMETER LVL 01,588.0,135.83,84.73,441.0,29
CDM,6281489,DEVICE INSERT RETRV LVL 05,6105.0,1312.58,1135.53,4578.75,39
CDM,6281497,DEVICE INSERT RETRV LVL 06,8107.0,1743.0,1305.72,6080.25,39
CDM,6281505,DEVICE INSERT RETRV LVL 07,10422.0,2240.73,1305.72,7816.5,39
CDM,6281513,DEVICE INSERT RETRV LVL 08,12737.0,2738.46,1305.72,9552.75,39
CDM,6281521,DEVICE INSERT RETRV LVL 09,14239.0,3061.38,1305.72,10679.25,39
CDM,6281539,DEVICE INSERT RETRV LVL 10,16429.0,3532.24,1305.72,12321.75,39
CDM,6281547,DEVICE INSERT RETRV LVL 11,18619.0,4003.08,1305.72,13964.25,39
CDM,6281554,DEVICE INSERT RETRV LVL 12,20809.0,4473.93,1305.72,15606.75,39
CDM,6281562,DEVICE INSERT RETRV LVL 13,22999.0,4944.78,1305.72,17249.25,39
CDM,6281570,DEVICE INSERT RETRV LVL 14,25189.0,5415.64,1305.72,18891.75,39
CDM,6281588,DEVICE INSERT RETRV LVL 15,27379.0,5886.48,1305.72,20534.25,39
CDM,6281596,DEVICE INSERT RETRV LVL 16,29569.0,6357.34,1305.72,22176.75,39
CDM,6281604,DEVICE INSERT RETRV LVL 17,31759.0,6828.18,1305.72,23819.25,39
CDM,6281646,CATH/WIRE/SUTURE PASSER LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6281653,CATH/WIRE/SUTURE PASSER LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,6281661,CATH/WIRE/SUTURE PASSER LVL 06,2426.0,521.59,349.59,1819.5,29
CDM,6281679,INTRO EP FIX CRV PEEL LVL 07,4397.0,945.36,217.6,3297.75,39
CDM,6281745,TREPHINE LVL 03,1619.0,348.08,233.3,1214.25,29
CDM,6281752,TREPHINE LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,6281760,TREPHINE LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6281778,IMP TISSUE CONNECT NONHUMAN LVL 12,52564.0,15033.3,6198.23,39423.0,42
CDM,6281786,IMP TISSUE CONNECT NONHUMAN LVL 13,56944.0,16285.98,6198.23,42708.0,42
CDM,6281794,IMP DEV COCHLEAR INT&EXT CMP LVL 01,50370.0,14405.82,9368.82,56628.48,43
CDM,6281802,IMP DEV COCHLEAR INT&EXT CMP LVL 02,63510.0,18163.86,11812.86,56628.48,43
CDM,6281810,IMP DEV COCHLEAR INT&EXT CMP LVL 03,76650.0,21921.9,14256.9,57487.5,43
CDM,6281828,PACER ACCESSORY LVL 03,1619.0,348.08,233.3,1214.25,29
CDM,6281836,BOWL CELL SAVER LVL 02,2157.0,463.76,310.82,1617.75,29
CDM,6281844,BOWL CELL SAVER LVL 03,3083.0,662.84,444.26,2312.25,29
CDM,6281851,BOWL CELL SAVER LVL 04,3909.0,840.44,563.29,2931.75,29
CDM,6281869,IMP CEMENT ACCESSORY LVL 07,5861.0,1676.25,1003.99,4395.75,42
CDM,6281877,IMP CEMENT ACCESSORY LVL 08,6950.0,1987.7,1003.99,5212.5,42
CDM,6281885,IMP CEMENT ACCESSORY LVL 09,9265.0,2649.79,1003.99,6948.75,42
CDM,6281893,IMP CEMENT ACCESSORY LVL 10,11580.0,3311.88,1003.99,8685.0,42
CDM,6281901,IMP CEMENT ACCESSORY LVL 11,13895.0,3973.97,1003.99,10421.25,42
CDM,6282107,DEVICE INFLATION DISP LVL 08,3853.0,828.4,555.22,2889.75,29
CDM,6282115,DEVICE INFLATION DISP LVL 09,4641.0,997.82,668.77,3480.75,29
CDM,6282172,IMP NEURAWRAP NRV PROTEC/CM LVL 04,6718.0,1921.35,1107.13,6089.17,42
CDM,6282180,IMP COVER BURR HOLE LVL 03,1619.0,463.03,301.13,1782.74,42
CDM,6282198,IMP PUMP VALVE BLOOD LVL 05,78844.0,22549.38,1312.53,59133.0,42
CDM,6282206,IMP SEPTAL DEFECT INTRACARD LVL 04,28474.0,8143.56,5296.16,52268.89,42
CDM,6282230,PROBE LVL 12,24094.0,5180.21,3471.95,18070.5,29
CDM,6282248,IMP SPINE FUSION LVL 02,4880.0,1395.68,907.68,3660.0,42
CDM,6282255,IMP TISSUE CONNECT HUMAN LVL 16,54754.0,15659.64,6600.85,41065.5,42
CDM,6282263,IMP TISSUE CONNECT HUMAN LVL 17,61324.0,17538.66,6600.85,45993.0,42
CDM,6282271,IMP TISSUE CONNECT HUMAN LVL 18,67894.0,19417.68,6600.85,50920.5,42
CDM,6282289,IMP GENERATOR NEUROSTIM LVL 01,28470.0,8142.42,5295.42,86476.0,42
CDM,6282313,CATH HEM/PER SHORT TERM LVL 05,2157.0,463.76,361.24,1617.75,39
CDM,6282347,OBTURATOR DISPOSABLE LVL 03,1413.0,303.8,203.61,1059.75,29
CDM,6282354,OBTURATOR DISPOSABLE LVL 04,1888.0,405.92,272.06,1416.0,29
CDM,6282362,OBTURATOR DISPOSABLE LVL 05,2426.0,521.59,349.59,1819.5,29
CDM,6282370,OBTURATOR DISPOSABLE LVL 06,2827.0,607.8,407.37,2120.25,29
CDM,6282388,OBTURATOR DISPOSABLE LVL 07,3340.0,718.1,481.29,2505.0,29
CDM,6282396,CATH ANGIO TRANSL LASER LVL 05,11580.0,2489.7,2153.88,8685.0,39
CDM,6282438,IMP MATERIAL CORD VOCAL LVL 01,588.0,168.17,109.37,1435.1,42
CDM,6282446,ELECTRODE ELECTROSURGICAL LVL 13,15334.0,3296.81,2209.63,11500.5,29
CDM,6282453,ELECTRODE ELECTROSURGICAL LVL 14,19714.0,4238.51,2840.79,14785.5,29
CDM,6282461,IMP PROSTH ORTHOPEDIC LVL 06,17524.0,5011.86,1312.53,13143.0,42
CDM,6282479,IMP COVER BURR HOLE LVL 01,588.0,168.17,109.37,1782.74,42
CDM,6282685,DRAIN LVL 06,1619.0,348.08,233.3,1214.25,29
CDM,6282693,INTRO LVL 10,12506.0,2688.79,1802.11,9379.5,29
CDM,6282859,IMP RV/AD/RP HIP FEMORAL HD LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6282867,IMP RV/AD/RP HIP FEMORAL HD LVL 04,3596.0,1028.46,668.86,7467.6,42
CDM,6282875,IMP RV/AD/RP HIP FEMORAL HD LVL 05,4397.0,1257.54,817.84,7467.6,42
CDM,6282883,IMP RV/AD/RP HIP FEMORAL HD LVL 06,5373.0,1536.68,999.38,7467.6,42
CDM,6282891,IMP RV/AD/RP HIP STEM LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6282909,IMP RV/AD/RP HIP STEM LVL 04,21904.0,6264.54,4074.14,16428.0,42
CDM,6282917,IMP RV/AD/RP HIP STEM LVL 05,30664.0,8769.9,5497.98,22998.0,42
CDM,6282925,IMP RV/AD/RP HIP SHELL LVL 03,4397.0,1257.54,817.84,7467.6,42
CDM,6282933,IMP RV/AD/RP HIP SHELL LVL 04,5373.0,1536.68,999.38,7467.6,42
CDM,6282941,IMP RV/AD/RP HIP SHELL LVL 05,6487.0,1855.28,1206.58,7467.6,42
CDM,6282958,IMP RV/AD/RP HIP SHELL LVL 06,6950.0,1987.7,1292.7,7467.6,42
CDM,6282966,IMP RV/AD/RP HIP LINER LVL 04,5373.0,1536.68,999.38,7467.6,42
CDM,6282974,IMP RV/AD/RP HIP LINER LVL 05,6487.0,1855.28,1206.58,7467.6,42
CDM,6282982,IMP RV/AD/RP HIP LINER LVL 06,6950.0,1987.7,1292.7,7467.6,42
CDM,6282990,IMP RV/AD/RP HIP CUP LVL 05,9265.0,2649.79,1723.29,7467.6,42
CDM,6283006,IMP RV/AD/RP HIP CUP LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,6283014,IMP RV/AD/RP HIP CUP LVL 07,17524.0,5011.86,3259.46,13143.0,42
CDM,6283022,IMP RV/AD/RP HIP CUP LVL 08,21904.0,6264.54,4074.14,16428.0,42
CDM,6283030,IMP RV/AD/RP KN FEMORAL LVL 01,3596.0,1028.46,668.86,7467.6,42
CDM,6283048,IMP RV/AD/RP KN FEMORAL LVL 02,4885.0,1397.11,908.61,7467.6,42
CDM,6283055,IMP RV/AD/RP KN FEMORAL LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6283063,IMP RV/AD/RP KN FEMORAL LVL 04,26284.0,7517.22,4888.82,19713.0,42
CDM,6283071,IMP RV/AD/RP KN TIBIAL LVL 01,3596.0,1028.46,668.86,7467.6,42
CDM,6283089,IMP RV/AD/RP KN TIBIAL LVL 02,5373.0,1536.68,999.38,7467.6,42
CDM,6283097,IMP RV/AD/RP KN TIBIAL LVL 03,6950.0,1987.7,1292.7,7467.6,42
CDM,6283105,IMP RV/AD/RP KN TIBIAL LVL 04,8802.0,2517.37,1637.17,7467.6,42
CDM,6283113,IMP RV/AD/RP KN TIBIAL LVL 05,10654.0,3047.04,1981.64,7990.5,42
CDM,6283121,IMP RV/AD/RP KN TIBIAL LVL 06,12506.0,3576.72,2326.12,9379.5,42
CDM,6283139,IMP RV/AD/RP KN TIBIAL LVL 07,13582.0,3884.45,2526.25,10186.5,42
CDM,6283147,IMP RV/AD/RP KN TIBIAL LVL 08,15334.0,4385.52,2852.12,11500.5,42
CDM,6283154,IMP RV/AD/RP KN TIBIAL LVL 09,17086.0,4886.6,3178.0,12814.5,42
CDM,6283162,IMP RV/AD/RP KN STEM LVL 02,3596.0,1028.46,668.86,7467.6,42
CDM,6283170,IMP RV/AD/RP KN STEM LVL 03,4397.0,1257.54,817.84,7467.6,42
CDM,6283188,IMP RV/AD/RP KN STEM LVL 04,5373.0,1536.68,999.38,7467.6,42
CDM,6283196,IMP RV/AD/RP KN STEM LVL 05,6024.0,1722.86,1120.46,7467.6,42
CDM,6283204,IMP RV/AD/RP KN INSR/SLV/LN LVL 05,9265.0,2649.79,1723.29,7467.6,42
CDM,6283212,IMP RV/AD/RP KN INSR/SLV/LN LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,6283220,IMP RV/AD/RP KN INSR/SLV/LN LVL 07,17524.0,5011.86,3259.46,13143.0,42
CDM,6283238,IMP RV/AD/RP KN PATELLA LVL 03,3083.0,881.74,573.44,7467.6,42
CDM,6283246,IMP RV/AD/RP KN PATELLA LVL 04,3909.0,1117.97,727.07,7467.6,42
CDM,6283253,IMP RV/AD/RP KN PATELLA LVL 05,4885.0,1397.11,908.61,7467.6,42
CDM,6283261,IMP RV/AD/RP KN PATELLA LVL 06,5861.0,1676.25,1090.15,7467.6,42
CDM,6283279,IMP RV/AD/RP KN PATELLA LVL 07,6024.0,1722.86,1120.46,7467.6,42
CDM,6283287,IMP RV/AD/RP SHDR HEAD LVL 05,6487.0,1855.28,1206.58,7467.6,42
CDM,6283295,IMP RV/AD/RP SHDR HEAD LVL 06,7413.0,2120.12,1378.82,7467.6,42
CDM,6283303,IMP RV/AD/RP SHDR HEAD LVL 07,8339.0,2384.95,1551.05,7467.6,42
CDM,6283311,IMP RV/AD/RP SHDR STEM LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,6283329,IMP RV/AD/RP SHDR STEM LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6283337,IMP RV/AD/RP SHDR STEM LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6283345,IMP RV/AD/RP SHDR GLEN CMP LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,6283352,IMP RV/AD/RP SHDR GLEN CMP LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6283360,IMP RV/AD/RP SHDR GLEN CMP LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6283402,IMP RV/AD/RP SHDR SHELL LVL 01,9265.0,2649.79,1723.29,7467.6,42
CDM,6283410,IMP RV/AD/RP SHDR SHELL LVL 02,13895.0,3973.97,2584.47,10421.25,42
CDM,6283428,IMP RV/AD/RP SHDR SHELL LVL 03,17524.0,5011.86,3259.46,13143.0,42
CDM,6283436,IMP RV/AD/RP SHDR INSERT LVL 03,9265.0,2649.79,1723.29,7467.6,42
CDM,6283444,IMP RV/AD/RP SHDR INSERT LVL 04,13895.0,3973.97,2584.47,10421.25,42
CDM,6283451,IMP RV/AD/RP SHDR INSERT LVL 05,17524.0,5011.86,3259.46,13143.0,42
CDM,6283477,IMP MARKER TISSUE LVL 04,1894.0,541.68,149.28,1420.5,42
CDM,6283485,IMP MARKER TISSUE LVL 05,2580.0,737.88,149.28,1935.0,42
CDM,6283493,IMP MARKER TISSUE LVL 06,3355.0,959.53,149.28,2516.25,42
CDM,6283501,IMP RV/AD/RP HIP FEMORAL HD LVL 07,6024.0,1722.86,1120.46,7467.6,42
CDM,6283519,IMP RV/AD/RP HIP FEMORAL HD LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6283527,IMP RV/AD/RP HIP FEMORAL HD LVL 09,12506.0,3576.72,2326.12,9379.5,42
CDM,6283535,IMP RV/AD/RP HIP CN/CALC/SP LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6283543,IMP RV/AD/RP HIP CN/CALC/SP LVL 04,21904.0,6264.54,4074.14,16428.0,42
CDM,6283550,IMP RV/AD/RP HIP CN/CALC/SP LVL 05,30664.0,8769.9,5497.98,22998.0,42
CDM,6283568,IMP RV/AD/RP HIP LINER LVL 07,7876.0,2252.54,1464.94,7467.6,42
CDM,6283576,IMP RV/AD/RP HIP LINER LVL 08,8802.0,2517.37,1637.17,7467.6,42
CDM,6283584,IMP STENT NOS LVL 17,56944.0,16285.98,1312.53,42708.0,42
CDM,6283592,IMP STENT NOS LVL 18,63514.0,18165.0,1312.53,47635.5,42
CDM,6283626,IMP ROD/NAIL LVL 14,28474.0,8143.56,1003.99,21355.5,42
CDM,6283634,IMP ROD/NAIL LVL 15,32854.0,9396.24,1003.99,24640.5,42
CDM,6283642,IMP ROD/NAIL LVL 16,37234.0,10648.92,1003.99,27925.5,42
CDM,6283659,IMP ROD/NAIL LVL 17,41614.0,11901.6,1003.99,31210.5,42
CDM,6283667,IMP RV/AD/RP HIP SHELL LVL 07,9265.0,2649.79,1723.29,7467.6,42
CDM,6283675,IMP RV/AD/RP HIP SHELL LVL 08,11580.0,3311.88,2153.88,8685.0,42
CDM,6283683,IMP RV/AD/RP HIP SHELL LVL 09,13895.0,3973.97,2584.47,10421.25,42
CDM,6283709,CATH ATHERECT TRANSL ROTAT LVL 04,17524.0,3767.66,3259.46,13143.0,39
CDM,6283725,IMP RING FALLOPE LVL 01,166.0,47.48,30.88,1782.74,42
CDM,6283733,IMP RING FALLOPE LVL 02,588.0,168.17,109.37,1782.74,42
CDM,6283782,CATH ATHERECT TRANSL DIRECT LVL 04,17524.0,3767.66,3259.46,13143.0,39
CDM,6283790,IMP DEV URINARY W SLING LVL 08,21904.0,6264.54,4074.14,16428.0,42
CDM,6283808,IMP RV/AD/RP HIP FEMORAL HD LVL 10,14896.0,4260.26,2770.66,11172.0,42
CDM,6283816,IMP RV/AD/RP HIP FEMORAL HD LVL 11,17962.0,5137.13,3340.93,13471.5,42
CDM,6283840,IMP RV/AD/RP KN INSR/SLV/LN LVL 04,4880.0,1395.68,907.68,7467.6,42
CDM,6283857,IMP STENT COAT W DEL LVL 16,48184.0,13780.62,8962.22,36138.0,42
CDM,6283865,IMP STENT COAT W DEL LVL 17,52564.0,15033.3,9776.9,39423.0,42
CDM,6283881,THERAPY COLD LVL 06,4885.0,1050.28,703.93,3663.75,29
CDM,6283899,DEVICE INFLATION DISP LVL 10,5617.0,1207.66,809.41,4212.75,29
CDM,6283923,CATH THROMBECTOMY/EMBOLECTMY LVL 09,11580.0,2489.7,575.51,8685.0,39
CDM,6283949,BRUSH LVL 04,1132.0,243.38,163.12,849.0,29
CDM,6283956,IMP PLUG FISTULA LVL 01,2157.0,616.9,401.2,1782.74,42
CDM,6283964,IMP PLUG FISTULA LVL 02,3083.0,881.74,573.44,2312.25,42
CDM,6283972,IMP PLUG FISTULA LVL 03,4397.0,1257.54,817.84,3297.75,42
CDM,6283980,IMP VALVE LVL 12,61324.0,17538.66,1312.53,45993.0,42
CDM,6283998,IMP VALVE LVL 13,70084.0,20044.02,1312.53,52563.0,42
CDM,6284020,IMP PCMKR SGL NON RR LVL 01,15330.0,4644.99,2851.38,25942.8,42
CDM,6284038,IMP DEV OSSEO AUD INT&EXT LVL 01,594.0,169.88,110.48,12356.62,43
CDM,6284046,IMP DEV OSSEO AUD INT&EXT LVL 02,1132.0,323.75,210.55,12356.62,43
CDM,6284053,IMP DEV OSSEO AUD INT&EXT LVL 03,1619.0,463.03,301.13,12356.62,43
CDM,6284061,IMP DEV OSSEO AUD INT&EXT LVL 04,2695.0,770.77,501.27,12356.62,43
CDM,6284079,IMP DEV OSSEO AUD INT&EXT LVL 05,4885.0,1397.11,908.61,12356.62,43
CDM,6284087,IMP DEV OSSEO AUD INT&EXT LVL 06,6950.0,1987.7,1292.7,12356.62,43
CDM,6284095,IMP DEV OSSEO AUD INT&EXT LVL 07,9265.0,2649.79,1723.29,12356.62,43
CDM,6284103,IMP DEV OSSEO AUD INT&EXT LVL 08,11580.0,3311.88,2153.88,12356.62,43
CDM,6284111,IMP DEV OSSEO AUD INT&EXT LVL 09,13895.0,3973.97,2584.47,12356.62,43
CDM,6284129,IMP DEV OSSEO AUD INT&EXT LVL 10,17524.0,5011.86,3259.46,13143.0,43
CDM,6284137,IMP DEV OSSEO AUD INT&EXT LVL 11,21904.0,6264.54,3613.25,16428.0,43
CDM,6284145,IMP DEV OSSEO AUD INT&EXT LVL 12,26284.0,7517.22,3613.25,19713.0,43
CDM,6284228,IMP RV/AD/RP HIP INSR/EX/RNG LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6284236,IMP RV/AD/RP HIP INSR/EX/RNG LVL 04,3596.0,1028.46,668.86,7467.6,42
CDM,6284244,IMP RV/AD/RP HIP INSR/EX/RNG LVL 05,4397.0,1257.54,817.84,7467.6,42
CDM,6284251,IMP RV/AD/RP HIP INSR/EX/RNG LVL 06,5373.0,1536.68,999.38,7467.6,42
CDM,6284269,IMP RV/AD/RP HIP INSR/EX/RNG LVL 07,6024.0,1722.86,1120.46,7467.6,42
CDM,6284277,IMP RV/AD/RP HIP INSR/EX/RNG LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6284285,IMP RV/AD/RP HIP INSR/EX/RNG LVL 09,12506.0,3576.72,2326.12,9379.5,42
CDM,6284293,IMP RV/AD/RP HIP TR/CNT/SL LVL 04,2695.0,770.77,501.27,7467.6,42
CDM,6284301,IMP RV/AD/RP HIP TR/CNT/SL LVL 05,3596.0,1028.46,668.86,7467.6,42
CDM,6284319,IMP RV/AD/RP HIP TR/CNT/SL LVL 06,4397.0,1257.54,817.84,7467.6,42
CDM,6284327,IMP RV/AD/RP HIP TR/CNT/SL LVL 07,5373.0,1536.68,999.38,7467.6,42
CDM,6284335,IMP RV/AD/RP HIP TR/CNT/SL LVL 08,6024.0,1722.86,1120.46,7467.6,42
CDM,6284343,IMP RV/AD/RP HIP TR/CNT/SL LVL 09,9265.0,2649.79,1723.29,7467.6,42
CDM,6284350,IMP RV/AD/RP HIP TR/CNT/SL LVL 10,12506.0,3576.72,2326.12,9379.5,42
CDM,6284368,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 02,1132.0,323.75,210.55,7467.6,42
CDM,6284376,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 03,1619.0,463.03,301.13,7467.6,42
CDM,6284384,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 04,2157.0,616.9,401.2,7467.6,42
CDM,6284392,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 05,3596.0,1028.46,668.86,7467.6,42
CDM,6284400,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 06,4397.0,1257.54,817.84,7467.6,42
CDM,6284418,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 07,5373.0,1536.68,999.38,7467.6,42
CDM,6284426,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 08,6024.0,1722.86,1120.46,7467.6,42
CDM,6284434,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 09,9265.0,2649.79,1723.29,7467.6,42
CDM,6284442,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 10,12506.0,3576.72,2326.12,9379.5,42
CDM,6284459,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 11,13582.0,3884.45,2526.25,10186.5,42
CDM,6284467,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 12,15334.0,4385.52,2852.12,11500.5,42
CDM,6284475,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 13,17524.0,5011.86,3259.46,13143.0,42
CDM,6284483,IMP RV/AD/RP KN DIS/POS AUG LVL 02,1619.0,463.03,301.13,7467.6,42
CDM,6284491,IMP RV/AD/RP KN DIS/POS AUG LVL 03,2157.0,616.9,401.2,7467.6,42
CDM,6284509,IMP RV/AD/RP KN DIS/POS AUG LVL 04,3596.0,1028.46,668.86,7467.6,42
CDM,6284517,IMP RV/AD/RP KN DIS/POS AUG LVL 05,4397.0,1257.54,817.84,7467.6,42
CDM,6284525,IMP RV/AD/RP KN DIS/POS AUG LVL 06,5373.0,1536.68,999.38,7467.6,42
CDM,6284533,IMP RV/AD/RP KN DIS/POS AUG LVL 07,6024.0,1722.86,1120.46,7467.6,42
CDM,6284541,IMP RV/AD/RP KN DIS/POS AUG LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6284558,IMP RV/AD/RP KN DIS/POS AUG LVL 09,12506.0,3576.72,2326.12,9379.5,42
CDM,6284566,IMP RV/AD/RP KN DIS/POS AUG LVL 10,13582.0,3884.45,2526.25,10186.5,42
CDM,6284574,IMP RV/AD/RP KN DIS/POS AUG LVL 11,15334.0,4385.52,2852.12,11500.5,42
CDM,6284582,IMP RV/AD/RP KN DIS/POS AUG LVL 12,17524.0,5011.86,3259.46,13143.0,42
CDM,6284590,IMP RV/AD/RP KN DIS/POS AUG LVL 13,19714.0,5638.2,3666.8,14785.5,42
CDM,6284608,IMP RV/AD/RP KN TIB/FM TRIAL LVL 02,1619.0,463.03,301.13,7467.6,42
CDM,6284616,IMP RV/AD/RP KN TIB/FM TRIAL LVL 03,2157.0,616.9,401.2,7467.6,42
CDM,6284624,IMP RV/AD/RP KN TIB/FM TRIAL LVL 04,3596.0,1028.46,668.86,7467.6,42
CDM,6284632,IMP RV/AD/RP KN TIB/FM TRIAL LVL 05,4397.0,1257.54,817.84,7467.6,42
CDM,6284640,IMP RV/AD/RP KN TIB/FM TRIAL LVL 06,5373.0,1536.68,999.38,7467.6,42
CDM,6284657,IMP RV/AD/RP KN TIB/FM TRIAL LVL 07,6024.0,1722.86,1120.46,7467.6,42
CDM,6284665,IMP RV/AD/RP KN TIB/FM TRIAL LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6284673,IMP RV/AD/RP KN TIB/FM TRIAL LVL 09,12506.0,3576.72,2326.12,9379.5,42
CDM,6284681,IMP RV/AD/RP KN TIB/FM TRIAL LVL 10,13582.0,3884.45,2526.25,10186.5,42
CDM,6284699,IMP RV/AD/RP KN TIB/FM TRIAL LVL 11,15334.0,4385.52,2852.12,11500.5,42
CDM,6284707,IMP RV/AD/RP KN TIB/FM TRIAL LVL 12,17524.0,5011.86,3259.46,13143.0,42
CDM,6284715,IMP RV/AD/RP KN TIB/FM TRIAL LVL 13,19714.0,5638.2,3666.8,14785.5,42
CDM,6284723,IMP RV/AD/RP HIP NECK LVL 03,4397.0,1257.54,817.84,7467.6,42
CDM,6284731,IMP RV/AD/RP HIP NECK LVL 04,5373.0,1536.68,999.38,7467.6,42
CDM,6284749,IMP RV/AD/RP HIP NECK LVL 05,6024.0,1722.86,1120.46,7467.6,42
CDM,6284756,IMP RV/AD/RP HIP NECK LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,6284764,IMP RV/AD/RP HIP NECK LVL 07,12506.0,3576.72,2326.12,9379.5,42
CDM,6284772,IMP RV/AD/RP HIP NECK LVL 08,13582.0,3884.45,2526.25,10186.5,42
CDM,6284780,IMP RV/AD/RP HIP NECK LVL 09,15334.0,4385.52,2852.12,11500.5,42
CDM,6284798,IMP RV/AD/RP HIP NECK LVL 10,17524.0,5011.86,3259.46,13143.0,42
CDM,6284806,IMP RV/AD/RP HIP INSR/EX/RNG LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6284814,IMP RV/AD/RP HIP TR/CNT/SL LVL 03,1413.0,404.12,262.82,7467.6,42
CDM,6284822,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 01,588.0,168.17,109.37,7467.6,42
CDM,6284830,IMP RV/AD/RP KN DIS/POS AUG LVL 01,1126.0,322.04,209.44,7467.6,42
CDM,6284848,IMP RV/AD/RP KN TIB/FM TRIAL LVL 01,1126.0,322.04,209.44,7467.6,42
CDM,6284855,IMP RV/AD/RP HIP NECK LVL 02,3591.0,1027.03,667.93,7467.6,42
CDM,6284863,DRESSING SPECIALTY LVL 01,32.0,6.88,4.61,24.0,29
CDM,6284871,IMP RV/AD/RP HIP LINER LVL 09,13895.0,3973.97,2584.47,10421.25,42
CDM,6284889,IMP RV/AD/RP HIP LINER LVL 10,17524.0,5011.86,3259.46,13143.0,42
CDM,6284996,CATH URETHRAL LVL 01,32.0,6.88,4.61,24.0,29
CDM,6285001,DRAIN LVL 01,32.0,6.88,4.61,24.0,29
CDM,6285019,IMP TISSUE CONNECT HUMAN LVL 19,72274.0,20670.36,6600.85,54205.5,42
CDM,6285050,IMP LD NEUROSTIM TEST KIT LVL 10,9496.0,2715.86,1766.26,7122.0,42
CDM,6285068,SPACER/GUIDE LVL 01,1413.0,303.8,203.61,1059.75,29
CDM,6285076,SPACER/GUIDE LVL 02,2695.0,579.42,388.35,2021.25,29
CDM,6285084,SPACER/GUIDE LVL 03,3853.0,828.4,555.22,2889.75,29
CDM,6285092,SPACER/GUIDE LVL 04,6105.0,1312.58,879.73,4578.75,29
CDM,6285142,LASER FIBER LVL 08,9265.0,1991.98,1335.09,6948.75,29
CDM,6285159,IMP PROSTH PENILE INFLT LVL 01,844.0,241.38,156.98,62427.29,42
CDM,6285167,IMP DEV OSSEO AUD INT&EXT LVL 13,30664.0,8769.9,3613.25,22998.0,43
CDM,6285175,IMP DEV OSSEO AUD INT&EXT LVL 14,35044.0,10022.58,3613.25,26283.0,43
CDM,6285217,IMP RV/AD/RP SHDR HEAD LVL 03,3853.0,1101.96,716.66,7467.6,42
CDM,6285225,IMP RV/AD/RP SHDR HEAD LVL 04,5856.0,1674.82,1089.22,7467.6,42
CDM,6285233,IMP RV/AD/RP SHDR INSERT LVL 02,4880.0,1395.68,907.68,7467.6,42
CDM,6285290,IMP ACCESS SYSTEM DIALYS LVL 07,13895.0,3973.97,2584.47,10421.25,42
CDM,6285324,IMP PROSTH PENILE NONINF LVL 04,28474.0,8143.56,5296.16,21355.5,42
CDM,6285332,IMP RV/AD/RP HIP CN/CALC/SP LVL 06,35044.0,10022.58,5497.98,26283.0,42
CDM,6285373,IMP CATH HEM/PER LONG TERM LVL 09,7876.0,2252.54,705.48,5907.0,42
CDM,6285381,BLOCK CUST CUTTING LVL 03,3853.0,828.4,555.22,2889.75,29
CDM,6285399,IMP RV/AD/RP KN STEM LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,6285407,IMP RV/AD/RP KN STEM LVL 07,17524.0,5011.86,3259.46,13143.0,42
CDM,6285415,IMP RV/AD/RP HIP INSR/EX/RNG LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6285423,IMP RV/AD/RP HIP SYS MODULAR LVL 02,13895.0,3973.97,2584.47,10421.25,42
CDM,6285431,IMP RV/AD/RP HIP SYS MODULAR LVL 03,17524.0,5011.86,3259.46,13143.0,42
CDM,6285449,IMP RV/AD/RP HIP SYS MODULAR LVL 04,21904.0,6264.54,4074.14,16428.0,42
CDM,6285456,IMP RV/AD/RP HIP SYS MODULAR LVL 05,26284.0,7517.22,4888.82,19713.0,42
CDM,6285464,IMP RV/AD/RP HIP SYS MODULAR LVL 06,30664.0,8769.9,5497.98,22998.0,42
CDM,6285472,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6285480,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6285498,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6285506,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 04,3853.0,1101.96,716.66,7467.6,42
CDM,6285514,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 05,6105.0,1746.03,1135.53,7467.6,42
CDM,6285522,IMP RV/AD/RP KN ROTATING HNG LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6285530,IMP RV/AD/RP KN ROTATING HNG LVL 02,2695.0,770.77,501.27,7467.6,42
CDM,6285548,IMP RV/AD/RP KN ROTATING HNG LVL 03,3853.0,1101.96,716.66,7467.6,42
CDM,6285555,IMP RV/AD/RP KN ROTATING HNG LVL 04,6105.0,1746.03,1135.53,7467.6,42
CDM,6285563,IMP RV/AD/RP KN ROTATING HNG LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6285571,IMP RV/AD/RP KN ROTATING HNG LVL 06,19714.0,5638.2,3666.8,14785.5,42
CDM,6285589,IMP RV/AD/RP KN EX/CONNECT LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6285597,IMP RV/AD/RP KN EX/CONNECT LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6285605,IMP RV/AD/RP KN EX/CONNECT LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6285621,BLOCK CUST CUTTING LVL 04,6105.0,1312.58,879.73,4578.75,29
CDM,6285639,BLOCK CUST CUTTING LVL 05,13895.0,2987.42,2002.27,10421.25,29
CDM,6285647,IMP RV/AD/RP HIP SHELL LVL 10,17524.0,5011.86,3259.46,13143.0,42
CDM,6285654,IMP TISSUE CONNECT NONHUMAN LVL 14,65704.0,18791.34,6198.23,49278.0,42
CDM,6285662,IMP TISSUE CONNECT NONHUMAN LVL 15,74464.0,21296.7,6198.23,55848.0,42
CDM,6285670,IMP TISSUE CONNECT NONHUMAN LVL 16,83224.0,23802.06,6198.23,62418.0,42
CDM,6285696,IMP MARKER BONE LVL 01,594.0,169.88,110.48,1782.74,42
CDM,6285704,IMP MARKER BONE LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,6285712,IMP RV/AD/RP KN BR/AX/YK/BH LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6285720,IMP RV/AD/RP KN BR/AX/YK/BH LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6285738,IMP RV/AD/RP KN BR/AX/YK/BH LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6285746,IMP RV/AD/RP KN BR/AX/YK/BH LVL 04,3853.0,1101.96,716.66,7467.6,42
CDM,6285753,IMP RV/AD/RP KN BR/AX/YK/BH LVL 05,6105.0,1746.03,1135.53,7467.6,42
CDM,6285761,IMP RV/AD/RP SHDR HEAD LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6285811,IMP RV/AD/RP HIP SHELL LVL 11,21904.0,6264.54,4074.14,16428.0,42
CDM,6286017,HYPO-HYPER THERMAL LVL 05,6105.0,1410.26,879.73,4578.75,29
CDM,6286025,PATCH EP REFSTAR LVL 01,594.0,137.21,85.6,445.5,29
CDM,6286033,PATCH EP REFSTAR LVL 02,1407.0,325.02,202.75,1055.25,29
CDM,6286041,BLADE LVL 13,15334.0,3296.81,2209.63,11500.5,29
CDM,6286058,IMP AGENT COLLAGN BULK 2.5ML LVL 01,2695.0,770.77,339.25,2021.25,43
CDM,6286066,IMP AGENT COLLAGN BULK 2.5ML LVL 02,3853.0,1101.96,339.25,2889.75,43
CDM,6286074,IMP AGENT COLLAGN BULK 2.5ML LVL 03,6105.0,1746.03,339.25,4578.75,43
CDM,6286082,IMP AGENT COLLAGN BULK 2.5ML LVL 04,13895.0,3973.97,339.25,10421.25,43
CDM,6286090,IMP AGENT COLLAGN BULK 2.5ML LVL 05,19272.0,5511.79,339.25,14454.0,43
CDM,6286124,CATH ABL COOL-TIP LVL 01,1413.0,303.8,262.82,8015.46,39
CDM,6286132,CATH ABL COOL-TIP LVL 02,2695.0,579.42,501.27,8015.46,39
CDM,6286140,CATH ABL COOL-TIP LVL 03,3853.0,828.4,716.66,8015.46,39
CDM,6286157,CATH ABL COOL-TIP LVL 04,4880.0,1049.2,907.68,8015.46,39
CDM,6286165,IMP RV/AD/RP HIP INSR/EX/RNG LVL 10,15334.0,4385.52,2852.12,11500.5,42
CDM,6286173,IMP RV/AD/RP HIP SYS SOLN LVL 01,13895.0,3973.97,2584.47,10421.25,42
CDM,6286181,IMP RV/AD/RP HIP SYS SOLN LVL 02,19714.0,5638.2,3666.8,14785.5,42
CDM,6286199,IMP RV/AD/RP HIP SYS SOLN LVL 03,24094.0,6890.88,4481.48,18070.5,42
CDM,6286207,IMP RV/AD/RP HIP SYS SOLN LVL 04,28474.0,8143.56,5296.16,21355.5,42
CDM,6286215,IMP RV/AD/RP HIP SYS SOLN LVL 05,32854.0,9396.24,5497.98,24640.5,42
CDM,6286231,BLOCK CUST CUTTING LVL 06,17524.0,3767.66,2525.21,13143.0,29
CDM,6286264,IMP RV/AD/RP HIP FEMORAL HD LVL 12,21904.0,6264.54,4074.14,16428.0,42
CDM,6286272,IMP RV/AD/RP HIP FEMORAL HD LVL 13,28474.0,8143.56,5296.16,21355.5,42
CDM,6286280,IMP CLIP ANEURYSM LVL 03,6105.0,1746.03,1135.53,4578.75,42
CDM,6286298,IMP CLIP ANEURYSM LVL 04,9265.0,2649.79,1312.53,6948.75,42
CDM,6286306,IMP PLUG FISTULA LVL 04,6105.0,1746.03,1135.53,4578.75,42
CDM,6286322,IMP GENERATOR NEUROSTIM LVL 06,131404.0,37581.54,24441.14,98553.0,42
CDM,6286355,EMBOLIZATION SYS PROTECT LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6286363,EMBOLIZATION SYS PROTECT LVL 06,19714.0,5638.2,3567.29,14785.5,42
CDM,6286371,SUPPLY PERFUSION/ECMO LVL 12,13895.0,2987.42,2002.27,10421.25,29
CDM,6286397,CATH ABL COOL-TIP LVL 11,17086.0,3673.49,3178.0,12814.5,39
CDM,6286447,DEVICE FIXATION DISP LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,6286454,DEVICE FIXATION DISP LVL 10,13895.0,2987.42,2002.27,10421.25,29
CDM,6286538,IMP ICD CHAMBER NON SGL/DUAL LVL 02,70080.0,20042.88,13034.88,63194.0,42
CDM,6286546,IMP CEMENT ACCESSORY LVL 12,17524.0,5011.86,1003.99,13143.0,42
CDM,6286553,IMP SPACER ORTHOPEDIC LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6286561,IMP SPACER ORTHOPEDIC LVL 04,3853.0,1101.96,716.66,2889.75,42
CDM,6286579,IMP SPACER ORTHOPEDIC LVL 05,6024.0,1722.86,1120.46,4518.0,42
CDM,6286603,SUPPLY OSTOMY LVL 05,1413.0,326.4,203.61,1059.75,29
CDM,6286611,DEVICE FIXATION DISP LVL 11,17524.0,3767.66,2525.21,13143.0,29
CDM,6286637,CATH ERCP LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6286645,CATH INTRAUTERN/HYST LVL 06,6105.0,1312.58,879.73,4578.75,29
CDM,6286652,INTRO EP FIX CRV PEEL LVL 08,6105.0,1312.58,217.6,4578.75,39
CDM,6286660,RESERVOIR NEURO LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6286678,DEVICE INSERT RETRV LVL 18,36139.0,7769.88,1305.72,27104.25,39
CDM,6286686,IMP VALVE LVL 14,83224.0,23802.06,1312.53,62418.0,42
CDM,6286694,IMP VALVE LVL 15,96364.0,27560.1,1312.53,72273.0,42
CDM,6286702,IMP VALVE LVL 16,109504.0,31318.14,1312.53,82128.0,42
CDM,6286876,BURR LVL 08,9265.0,1991.98,1335.09,6948.75,29
CDM,6286884,BURR LVL 09,13895.0,2987.42,2002.27,10421.25,29
CDM,6286892,CATH GLANDULAR LVL 02,313.0,67.3,45.1,234.75,29
CDM,6286900,CATH SPINAL/NEURO LVL 05,4885.0,1050.28,703.93,3663.75,29
CDM,6286918,IMP RV/AD/RP ELBOW HEAD LVL 03,3853.0,1101.96,716.66,7467.6,42
CDM,6286926,IMP RV/AD/RP ELBOW HEAD LVL 04,5856.0,1674.82,1089.22,7467.6,42
CDM,6286934,IMP RV/AD/RP ELBOW HEAD LVL 05,6487.0,1855.28,1206.58,7467.6,42
CDM,6286942,IMP RV/AD/RP ELBOW HEAD LVL 06,7413.0,2120.12,1378.82,7467.6,42
CDM,6286959,IMP RV/AD/RP ELBOW HEAD LVL 07,8339.0,2384.95,1551.05,7467.6,42
CDM,6286967,IMP RV/AD/RP ELBOW HEAD LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6286975,IMP RV/AD/RP ELBOW INSERT LVL 01,4880.0,1395.68,907.68,7467.6,42
CDM,6286983,IMP RV/AD/RP ELBOW INSERT LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,6286991,IMP RV/AD/RP ELBOW INSERT LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6287007,IMP RV/AD/RP ELBOW INSERT LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6287015,IMP RV/AD/RP ELBOW STEM LVL 01,9265.0,2649.79,1723.29,7467.6,42
CDM,6287023,IMP RV/AD/RP ELBOW STEM LVL 02,13895.0,3973.97,2584.47,10421.25,42
CDM,6287031,IMP RV/AD/RP ELBOW STEM LVL 03,17524.0,5011.86,3259.46,13143.0,42
CDM,6287049,DEVICE ABLATION LVL 09,17524.0,3767.66,2525.21,13143.0,29
CDM,6287056,DRAIN LVL 07,2157.0,463.76,310.82,1617.75,29
CDM,6287064,PIN GUIDE LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,6287072,HARVESTER LVL 04,6105.0,1312.58,879.73,4578.75,29
CDM,6287080,HEMOSTATIC AGENT LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6287098,IMP RV/AD/RP HIP SHELL LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6287106,IMP RV/AD/RP HIP SHELL LVL 02,3591.0,1027.03,667.93,7467.6,42
CDM,6287114,IMP RV/AD/RP HIP CUP LVL 02,2695.0,770.77,501.27,7467.6,42
CDM,6287122,IMP RV/AD/RP HIP CUP LVL 03,3853.0,1101.96,716.66,7467.6,42
CDM,6287130,IMP RV/AD/RP HIP CUP LVL 04,4880.0,1395.68,907.68,7467.6,42
CDM,6287148,IMP RV/AD/RP KN EX/CONNECT LVL 02,3853.0,1101.96,716.66,7467.6,42
CDM,6287155,IMP RV/AD/RP KN EX/CONNECT LVL 03,6105.0,1746.03,1135.53,7467.6,42
CDM,6287163,IMP RV/AD/RP KN EX/CONNECT LVL 04,9260.0,2648.36,1722.36,7467.6,42
CDM,6287387,IMP PLATE LVL 23,37234.0,10648.92,1003.99,27925.5,42
CDM,6287437,IMP RV/AD/RP SHDR CUP LVL 04,6105.0,1746.03,1135.53,7467.6,42
CDM,6287445,IMP RV/AD/RP SHDR CUP LVL 05,9265.0,2649.79,1723.29,7467.6,42
CDM,6287452,IMP RV/AD/RP SHDR CUP LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,6287460,IMP RV/AD/RP SHDR CUP LVL 07,17524.0,5011.86,3259.46,13143.0,42
CDM,6287478,IMP RV/AD/RP SHDR HEAD LVL 09,13895.0,3973.97,2584.47,10421.25,42
CDM,6287486,IMP RV/AD/RP SHDR HEAD LVL 10,17524.0,5011.86,3259.46,13143.0,42
CDM,6287494,IMP RV/AD/RP SHDR STEM LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,6287502,CATH INF NON HEMODIALYSIS LVL 10,13895.0,2987.42,361.24,10421.25,39
CDM,6287510,TAPE MARKING RADIOPAQUE LVL 02,313.0,67.3,45.1,234.75,29
CDM,6287528,IMP CABLE LVL 10,13895.0,3973.97,1312.53,10421.25,42
CDM,6287536,IMP CABLE LVL 11,15772.0,4510.79,1312.53,11829.0,42
CDM,6287544,BRUSH LVL 05,1413.0,303.8,203.61,1059.75,29
CDM,6287551,IMP RV/AD/RP ELBOW HEAD LVL 09,11580.0,3311.88,2153.88,8685.0,42
CDM,6287569,IMP RV/AD/RP KN BR/AX/YK/BH LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,6287577,IMP RV/AD/RP HIP FEMORAL HD LVL 02,1619.0,463.03,301.13,7467.6,42
CDM,6287585,IMP SPACER ORTHOPEDIC LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,6287593,IMP DEV URINARY W SLING LVL 09,26284.0,7517.22,4888.82,19713.0,42
CDM,6287601,IMP NEURAWRAP NRV PROTEC/CM LVL 05,9265.0,2649.79,1107.13,6948.75,42
CDM,6287619,IMMOBILIZER LVL 05,1413.0,326.4,203.61,1059.75,29
CDM,6287627,IMMOBILIZER LVL 06,1888.0,436.13,272.06,1416.0,29
CDM,6287650,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,6287668,IMP RV/AD/RP HIP INSR/EX/RNG LVL 11,17524.0,5011.86,3259.46,13143.0,42
CDM,6287676,IMP HOOK LVL 05,13895.0,3973.97,1312.53,10421.25,42
CDM,6287692,IMP RV/AD/RP SHDR INSERT LVL 01,3853.0,1101.96,716.66,7467.6,42
CDM,6287700,IMP RV/AD/RP HIP DIS/POS AUG LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6287718,IMP RV/AD/RP HIP DIS/POS AUG LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6287726,IMP RV/AD/RP HIP DIS/POS AUG LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6287734,IMP RV/AD/RP HIP DIS/POS AUG LVL 04,3853.0,1101.96,716.66,7467.6,42
CDM,6287742,IMP RV/AD/RP HIP DIS/POS AUG LVL 05,4397.0,1257.54,817.84,7467.6,42
CDM,6287759,IMP RV/AD/RP HIP DIS/POS AUG LVL 06,5373.0,1536.68,999.38,7467.6,42
CDM,6287767,IMP RV/AD/RP HIP DIS/POS AUG LVL 07,6105.0,1746.03,1135.53,7467.6,42
CDM,6287775,IMP RV/AD/RP HIP DIS/POS AUG LVL 08,9265.0,2649.79,1723.29,7467.6,42
CDM,6287783,IMP RV/AD/RP HIP DIS/POS AUG LVL 09,11580.0,3311.88,2153.88,8685.0,42
CDM,6287791,IMP RV/AD/RP HIP DIS/POS AUG LVL 10,13895.0,3973.97,2584.47,10421.25,42
CDM,6287809,IMP RV/AD/RP HIP DIS/POS AUG LVL 11,16210.0,4636.06,3015.06,12157.5,42
CDM,6287817,IMP RV/AD/RP HIP DIS/POS AUG LVL 12,17524.0,5011.86,3259.46,13143.0,42
CDM,6287825,IMP RV/AD/RP HIP DIS/POS AUG LVL 13,19714.0,5638.2,3666.8,14785.5,42
CDM,6287833,REAMER LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,6287866,CLIP LVL 07,2695.0,579.42,388.35,2021.25,29
CDM,6287874,CLIP LVL 08,3853.0,828.4,555.22,2889.75,29
CDM,6287882,CLIP LVL 09,6105.0,1312.58,879.73,4578.75,29
CDM,6287932,IMP RV/AD/RP HIP LINER LVL 03,4392.0,1256.11,816.91,7467.6,42
CDM,6287940,IMP RV/AD/RP HIP STEM LVL 01,3853.0,1101.96,716.66,7467.6,42
CDM,6287957,IMP RV/AD/RP HIP STEM LVL 02,4880.0,1395.68,907.68,7467.6,42
CDM,6287965,IMP RV/AD/RP KN PATELLA LVL 08,6950.0,1987.7,1292.7,7467.6,42
CDM,6287981,IMP PROSTH ANKLE LVL 11,48184.0,13780.62,1312.53,36138.0,42
CDM,6288005,IMP RV/AD/RP SHDR STEM LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6288013,IMP RV/AD/RP SHDR STEM LVL 07,30664.0,8769.9,5497.98,22998.0,42
CDM,6288021,IMP ADPT/EXT LD PACING/NEURO LVL 04,10654.0,3047.04,1981.64,11779.23,42
CDM,6288047,IRRIGATOR/ACCESSORY LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6288054,DRAIN REINFUSION LVL 06,6105.0,1312.58,879.73,4578.75,29
CDM,6288062,DRAIN REINFUSION LVL 07,9265.0,1991.98,1335.09,6948.75,29
CDM,6288070,DRAIN REINFUSION LVL 08,13895.0,2987.42,2002.27,10421.25,29
CDM,6288088,IMP DEV JT SHDR TOTAL LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6288096,IMP DEV JT SHDR TOTAL LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6288104,IMP DEV JT SHDR TOTAL LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6288112,IMP DEV JT SHDR TOTAL LVL 04,3853.0,1101.96,716.66,7467.6,42
CDM,6288120,IMP RV/AD/RP KN TIBIAL LVL 10,21466.0,6139.28,3992.68,16099.5,42
CDM,6288138,IMP RV/AD/RP KN TIBIAL LVL 11,25846.0,7391.96,4807.36,19384.5,42
CDM,6288146,IMP FIX LW/UP/PELVIC LVL 02,6105.0,1746.03,1003.99,4578.75,42
CDM,6288153,IMP FIX LW/UP/PELVIC LVL 03,7413.0,2120.12,1003.99,5559.75,42
CDM,6288161,IMP FIX LW/UP/PELVIC LVL 04,9265.0,2649.79,1003.99,6948.75,42
CDM,6288187,IMP STENT NOS LVL 19,67894.0,19417.68,1312.53,50920.5,42
CDM,6288195,IMP STENT NOS LVL 20,72274.0,20670.36,1312.53,54205.5,42
CDM,6288203,IMP RV/AD/RP KN INSR/SLV/LN LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6288211,IMP RV/AD/RP KN INSR/SLV/LN LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6288229,IMP RV/AD/RP KN INSR/SLV/LN LVL 03,2152.0,615.47,400.27,7467.6,42
CDM,6288237,IMP STENT NOS LVL 21,76654.0,21923.04,1312.53,57490.5,42
CDM,6288260,IMP RV/AD/RP ELBOW HEAD LVL 10,13895.0,3973.97,2584.47,10421.25,42
CDM,6288278,IMP DEV OSSEO AUD INT&EXT LVL 15,39424.0,11275.26,3613.25,29568.0,43
CDM,6288286,IMP VALVE LVL 17,122644.0,35076.18,1312.53,91983.0,42
CDM,6288294,PIN GUIDE LVL 06,2157.0,463.76,310.82,1617.75,29
CDM,6288302,IMP PIN/WIRE LVL 14,10422.0,2980.69,1003.99,7816.5,42
CDM,6288310,IMP PIN/WIRE LVL 15,12737.0,3642.78,1003.99,9552.75,42
CDM,6288328,IMP PIN/WIRE LVL 16,13895.0,3973.97,1003.99,10421.25,42
CDM,6288336,IMP PIN/WIRE LVL 17,16210.0,4636.06,1003.99,12157.5,42
CDM,6288369,IMP DEV OSSEO AUD INT&EXT LVL 16,43804.0,12527.94,3613.25,32853.0,43
CDM,6288377,IMP DEV OSSEO AUD INT&EXT LVL 17,48184.0,13780.62,3613.25,36138.0,43
CDM,6288385,IMP DEV OSSEO AUD INT&EXT LVL 18,52564.0,15033.3,3613.25,39423.0,43
CDM,6288468,CATH INTRASPINAL LVL 01,166.0,35.69,30.88,1952.83,39
CDM,6288476,CATH INTRASPINAL LVL 02,313.0,67.3,58.22,1952.83,39
CDM,6288484,CATH INTRASPINAL LVL 03,594.0,127.71,110.48,1952.83,39
CDM,6288518,IMP RV/AD/RP KN FEMORAL LVL 05,30664.0,8769.9,5497.98,22998.0,42
CDM,6288559,IMP EXPANDER TISSUE LVL 04,9265.0,2649.79,1312.53,6948.75,42
CDM,6288583,IMP RV/AD/RP KN TIBIAL LVL 12,30226.0,8644.64,5497.98,22669.5,42
CDM,6288591,IMP RV/AD/RP KN TIBIAL LVL 13,34606.0,9897.32,5497.98,25954.5,42
CDM,6288609,IMP RV/AD/RP HIP LINER LVL 02,3853.0,1101.96,716.66,7467.6,42
CDM,6288658,DEVICE ABLATION LVL 10,21904.0,4709.36,3156.37,16428.0,29
CDM,6288666,DEVICE ABLATION LVL 11,26284.0,5651.06,3787.52,19713.0,29
CDM,6288674,DEVICE ABLATION LVL 12,30664.0,6592.76,4418.68,22998.0,29
CDM,6288690,DEVICE ABLATION LVL 01,594.0,127.71,85.6,445.5,29
CDM,6288708,IMP STENT COAT W DEL LVL 18,56944.0,16285.98,10591.58,42708.0,42
CDM,6288716,IMP EXPANDER TISSUE LVL 05,13895.0,3973.97,1312.53,10421.25,42
CDM,6288724,IMP RV/AD/RP KN ROTATING HNG LVL 07,24094.0,6890.88,4481.48,18070.5,42
CDM,6288740,IMP LD ICD NON SGL/DUAL LVL 06,13895.0,3973.97,2584.47,10421.25,42
CDM,6288757,IMP LD ICD NON SGL/DUAL LVL 07,15334.0,4385.52,2852.12,11500.5,42
CDM,6288765,IMP LD ICD NON SGL/DUAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
CDM,6288773,IMP LD ICD NON SGL/DUAL LVL 09,19714.0,5638.2,3666.8,14785.5,42
CDM,6288781,PACER ACCESSORY LVL 04,2157.0,463.76,310.82,1617.75,29
CDM,6288799,CATH BALLOON DILAT NONVASC LVL 06,13895.0,2987.42,2427.94,10421.25,39
CDM,6288807,IMP CATH HEM/PER LONG TERM LVL 10,9265.0,2649.79,705.48,6948.75,42
CDM,6288815,CATH SPINAL/NEURO LVL 06,6105.0,1312.58,879.73,4578.75,29
CDM,6288823,IMP PLATE LVL 24,39424.0,11275.26,1003.99,29568.0,42
CDM,6288831,IMP PLATE LVL 25,43804.0,12527.94,1003.99,32853.0,42
CDM,6288849,IMP PLATE LVL 26,48184.0,13780.62,1003.99,36138.0,42
CDM,6288856,IMP PLATE LVL 27,52564.0,15033.3,1003.99,39423.0,42
CDM,6288864,IMP PLATE LVL 28,56944.0,16285.98,1003.99,42708.0,42
CDM,6288898,HYPO-HYPER THERMAL LVL 06,8107.0,1872.72,1168.22,6080.25,29
CDM,6288906,IMP ICD CHAMBER DUAL LVL 01,43800.0,13271.4,8146.8,63194.0,42
CDM,6288914,IMP ICD CHAMBER SGL LVL 04,109504.0,33179.71,20367.74,82128.0,42
CDM,6288922,SUPPLY NEURO LVL 10,21904.0,4709.36,3156.37,16428.0,29
CDM,6288930,PACER ACCESSORY LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6288948,POUCH LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6288955,IMP PROSTH PENILE NONINF LVL 05,32854.0,9396.24,6110.84,24640.5,42
CDM,6288971,IMP SHUNT LVL 11,21904.0,6264.54,1312.53,16428.0,42
CDM,6288989,IMP STENT NOS LVL 22,81034.0,23175.72,1312.53,60775.5,42
CDM,6288997,TRANSDUCER LVL 04,2695.0,579.42,388.35,2021.25,29
CDM,6289003,IMP DEV JT WRIST TOTAL LVL 01,6105.0,1746.03,1135.53,7467.6,42
CDM,6289011,IMP DEV JT WRIST TOTAL LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,6289029,IMP DEV JT WRIST TOTAL LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6289037,IMP DEV JT WRIST TOTAL LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6289045,IMP DEV JT WRIST TOTAL LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,6289052,IMP DEV JT WRIST TOTAL LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6289060,IMP DEV JT WRIST TOTAL LVL 07,30664.0,8769.9,5497.98,22998.0,42
CDM,6289078,IMP DEV JT WRIST TOTAL LVL 08,35044.0,10022.58,5497.98,26283.0,42
CDM,6289086,IMP DEV JT WRIST TOTAL LVL 09,39424.0,11275.26,5497.98,29568.0,42
CDM,6289094,IMP DEV JT WRIST TOTAL LVL 10,43804.0,12527.94,5497.98,32853.0,42
CDM,6289110,IMP GRAFT VASCULAR LVL 16,61324.0,17538.66,3896.94,45993.0,42
CDM,6289201,IMP PROSTH OPHTHALMIC LVL 06,6105.0,1746.03,1135.53,4578.75,42
CDM,6289219,IMP PROSTH OPHTHALMIC LVL 07,9265.0,2649.79,1312.53,6948.75,42
CDM,6289227,INTRO EP STEER NONPEEL LVL 04,6105.0,1312.58,1135.53,4578.75,39
CDM,6289235,CATH ABL EP NON 3D/VECTOR LVL 06,21028.0,4521.02,3674.1,15771.0,39
CDM,6289243,IMP SPACER ORTHOPEDIC LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,6289250,IMP SPACER ORTHOPEDIC LVL 07,13895.0,3973.97,1312.53,10421.25,42
CDM,6289268,IMP SPACER ORTHOPEDIC LVL 08,17524.0,5011.86,1312.53,13143.0,42
CDM,6289276,IMP SPACER ORTHOPEDIC LVL 09,21904.0,6264.54,1312.53,16428.0,42
CDM,6289284,IMP RV/AD/RP HIP STEM LVL 06,32854.0,9396.24,5497.98,24640.5,42
CDM,6289292,RETRIEVER SUTURE LVL 06,6105.0,1312.58,879.73,4578.75,29
CDM,6289326,THERAPY COLD LVL 01,159.0,34.18,22.91,119.25,29
CDM,6289334,DEVICE OSSEO AUD ABUTMENT LVL 01,313.0,120.82,58.22,3938.58,43
CDM,6289342,DEVICE OSSEO AUD ABUTMENT LVL 02,594.0,229.28,110.48,3938.58,43
CDM,6289359,DEVICE OSSEO AUD ABUTMENT LVL 03,1413.0,545.42,262.82,3938.58,43
CDM,6289367,DEVICE OSSEO AUD ABUTMENT LVL 04,2695.0,1040.27,501.27,3938.58,43
CDM,6289375,DEVICE OSSEO AUD ABUTMENT LVL 05,3853.0,1487.26,716.66,3938.58,43
CDM,6289383,DEVICE OSSEO AUD ABUTMENT LVL 06,6105.0,2356.53,1135.53,4578.75,43
CDM,6289391,DEVICE OSSEO AUD ABUTMENT LVL 07,9265.0,3576.29,1151.7,6948.75,43
CDM,6289409,IMP VALVE LVL 18,140164.0,40086.9,1312.53,105123.0,42
CDM,6289417,NEEDLE BIOPSY MRW BONE PWR LVL 01,594.0,127.71,85.6,745.56,35
CDM,6289425,IMP NEURAGEN NRV GUIDE/CM LVL 01,1413.0,404.12,262.82,8367.75,42
CDM,6289433,IMP NEURAGEN NRV GUIDE/CM LVL 02,2695.0,770.77,501.27,8367.75,42
CDM,6289441,IMP NEURAGEN NRV GUIDE/CM LVL 03,3853.0,1101.96,716.66,8367.75,42
CDM,6289458,IMP NEURAGEN NRV GUIDE/CM LVL 04,6105.0,1746.03,1038.0,8367.75,42
CDM,6289466,IMP PROSTH ORTHOPEDIC LVL 07,21904.0,6264.54,1312.53,16428.0,42
CDM,6289508,TIPS LVL 05,6105.0,1312.58,879.73,4578.75,29
CDM,6289516,TIPS LVL 06,9265.0,1991.98,1335.09,6948.75,29
CDM,6289524,IMP RV/AD/RP ELBOW HEAD LVL 12,17524.0,5011.86,3259.46,13143.0,42
CDM,6289532,IMP RV/AD/RP ELBOW STEM LVL 04,21904.0,6264.54,4074.14,16428.0,42
CDM,6289540,SCALPEL HARMONIC LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6289581,CATH ABL EP NON 3D/VECTOR LVL 07,25408.0,5462.72,3674.1,19056.0,39
CDM,6289599,CATH ABL EP NON 3D/VECTOR LVL 08,29788.0,6404.42,3674.1,22341.0,39
CDM,6289607,EMBOLIZATION SYS PROTECT LVL 07,21904.0,6264.54,3567.29,16428.0,42
CDM,6289615,ADHESIVE LVL 01,166.0,35.69,23.92,124.5,29
CDM,6289623,ADHESIVE LVL 02,313.0,67.3,45.1,234.75,29
CDM,6289631,ADHESIVE LVL 03,594.0,127.71,85.6,445.5,29
CDM,6289649,ADHESIVE LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6289656,ADHESIVE LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6289664,ADHESIVE LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6289672,ADHESIVE LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,6289680,ADHESIVE LVL 08,6105.0,1312.58,879.73,4578.75,29
CDM,6289797,IMP MEMBRANE AMNIO OCULAR LVL 03,6105.0,1746.03,1135.53,4578.75,42
CDM,6289839,IMP VALVE LVL 19,157684.0,45097.62,1312.53,118263.0,42
CDM,6289847,IMP VALVE LVL 20,175204.0,50108.34,1312.53,131403.0,42
CDM,6289854,IMP VALVE LVL 21,197104.0,56371.74,1312.53,147828.0,42
CDM,6289938,IMP RV/AD/RP KN EX/CONNECT LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6289946,IMP EMBOLIZATION SPHERE LVL 05,9265.0,2649.79,1312.53,6948.75,42
CDM,6289953,IMP RV/AD/RP SHDR GLEN CMP LVL 01,4880.0,1395.68,907.68,7467.6,42
CDM,6289961,SCALPEL HARMONIC LVL 01,1413.0,303.8,203.61,1059.75,29
CDM,6289979,CATH URETHRAL LVL 07,2695.0,579.42,388.35,2021.25,29
CDM,6290217,IMP RV/AD/RP KN FEMORAL LVL 06,35044.0,10022.58,5497.98,26283.0,42
CDM,6290225,IMP RV/AD/RP HIP TR/CNT/SL LVL 01,313.0,89.52,58.22,7467.6,42
CDM,6290233,IMP RV/AD/RP HIP TR/CNT/SL LVL 02,594.0,169.88,110.48,7467.6,42
CDM,6290241,IMP SPACER ORTHOPEDIC LVL 01,594.0,169.88,110.48,1782.74,42
CDM,6290266,TENOGLIDE TENDON PROT 5X5/SC,351.4,100.5,50.64,743.56,38
CDM,6290274,IMP CABLE LVL 12,17524.0,5011.86,1312.53,13143.0,42
CDM,6290282,IMP CABLE LVL 13,19714.0,5638.2,1312.53,14785.5,42
CDM,6290290,NEEDLE SPECIALTY LVL 11,4153.0,892.9,598.45,3114.75,29
CDM,6290308,SCALPEL HARMONIC LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6290316,DEVICE INFLATION DISP LVL 11,6105.0,1312.58,879.73,4578.75,29
CDM,6290324,DEVICE INFLATION DISP LVL 12,6950.0,1494.25,1001.5,5212.5,29
CDM,6290449,SURGIMEND FETAL FIX INT 6X12/.5 SC,34.2,9.78,4.93,152.6,38
CDM,6290472,IMP ORTHOTIC CAP END LVL 07,3853.0,1101.96,716.66,2889.75,42
CDM,6290480,IMP ORTHOTIC CAP END LVL 08,6105.0,1746.03,1135.53,4578.75,42
CDM,6290514,IMP RV/AD/RP ANKLE BASE/TOP LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6290522,IMP RV/AD/RP ANKLE BASE/TOP LVL 02,3853.0,1101.96,716.66,7467.6,42
CDM,6290530,IMP RV/AD/RP ANKLE BASE/TOP LVL 03,6105.0,1746.03,1135.53,7467.6,42
CDM,6290548,IMP RV/AD/RP ANKLE BASE/TOP LVL 04,9265.0,2649.79,1723.29,7467.6,42
CDM,6290555,IMP RV/AD/RP ANKLE BASE/TOP LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6290563,IMP RV/AD/RP ANKLE BASE/TOP LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6290571,IMP RV/AD/RP ANKLE BASE/TOP LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6290589,IMP RV/AD/RP ANKLE BASE/TOP LVL 08,26284.0,7517.22,4888.82,19713.0,42
CDM,6290597,IMP RV/AD/RP ANKLE STEM LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6290605,IMP RV/AD/RP ANKLE STEM LVL 02,3853.0,1101.96,716.66,7467.6,42
CDM,6290613,IMP RV/AD/RP ANKLE STEM LVL 03,6105.0,1746.03,1135.53,7467.6,42
CDM,6290621,IMP RV/AD/RP ANKLE STEM LVL 04,9265.0,2649.79,1723.29,7467.6,42
CDM,6290639,IMP RV/AD/RP ANKLE STEM LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6290647,IMP RV/AD/RP ANKLE STEM LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6290654,IMP RV/AD/RP ANKLE DOME LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6290662,IMP RV/AD/RP ANKLE DOME LVL 02,3853.0,1101.96,716.66,7467.6,42
CDM,6290670,IMP RV/AD/RP ANKLE DOME LVL 03,6105.0,1746.03,1135.53,7467.6,42
CDM,6290688,IMP RV/AD/RP ANKLE DOME LVL 04,9265.0,2649.79,1723.29,7467.6,42
CDM,6290696,IMP RV/AD/RP ANKLE DOME LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6290704,IMP RV/AD/RP ANKLE DOME LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6290712,IMP RV/AD/RP ANKLE DOME LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6290720,IMP RV/AD/RP ANKLE DOME LVL 08,26284.0,7517.22,4888.82,19713.0,42
CDM,6290738,IMP RV/AD/RP ANKLE DOME LVL 09,30664.0,8769.9,5497.98,22998.0,42
CDM,6290746,IMP RV/AD/RP ANKLE DOME LVL 10,35044.0,10022.58,5497.98,26283.0,42
CDM,6290753,IMP RV/AD/RP ANKLE INSR/TRAY LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6290761,IMP RV/AD/RP ANKLE INSR/TRAY LVL 02,3853.0,1101.96,716.66,7467.6,42
CDM,6290779,IMP RV/AD/RP ANKLE INSR/TRAY LVL 03,6105.0,1746.03,1135.53,7467.6,42
CDM,6290787,IMP RV/AD/RP ANKLE INSR/TRAY LVL 04,9265.0,2649.79,1723.29,7467.6,42
CDM,6290795,IMP RV/AD/RP ANKLE INSR/TRAY LVL 05,13895.0,3973.97,2584.47,10421.25,42
CDM,6290803,IMP RV/AD/RP ANKLE INSR/TRAY LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6290811,IMP RV/AD/RP ANKLE INSR/TRAY LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6290829,IMP RV/AD/RP ANKLE INSR/TRAY LVL 08,26284.0,7517.22,4888.82,19713.0,42
CDM,6290837,IMP RV/AD/RP ANKLE INSR/TRAY LVL 09,30664.0,8769.9,5497.98,22998.0,42
CDM,6290845,IMP RV/AD/RP ANKLE INSR/TRAY LVL 10,35044.0,10022.58,5497.98,26283.0,42
CDM,6290886,IMP RV/AD/RP KN FEMORAL LVL 07,39424.0,11275.26,5497.98,29568.0,42
CDM,6290894,REAMER LVL 08,6105.0,1312.58,879.73,4578.75,29
CDM,6290902,REAMER LVL 09,6950.0,1494.25,1001.5,5212.5,29
CDM,6290910,TAPE MARKING RADIOPAQUE LVL 03,594.0,127.71,85.6,445.5,29
CDM,6291611,BLOCK CUST CUTTING LVL 02,2695.0,579.42,388.35,2021.25,29
CDM,6291629,IMP RV/AD/RP HIP CN/CALC/SP LVL 01,3853.0,1101.96,716.66,7467.6,42
CDM,6291637,IMP RV/AD/RP HIP CN/CALC/SP LVL 02,4880.0,1395.68,907.68,7467.6,42
CDM,6291678,IMP NRSTM BAT RECHG SYS LVL 08,109504.0,31318.14,20367.74,111421.0,42
CDM,6291686,IMP NRSTM BAT RECHG SYS LVL 09,131404.0,37581.54,24441.14,111421.0,42
CDM,6291819,CATH THROMBECTOMY/EMBOLECTMY LVL 10,13895.0,2987.42,575.51,10421.25,39
CDM,6291827,CATH THROMBECTOMY/EMBOLECTMY LVL 11,17524.0,3767.66,575.51,13143.0,39
CDM,6291835,CATH THROMBECTOMY/EMBOLECTMY LVL 12,21904.0,4709.36,575.51,16428.0,39
CDM,6291843,CATH THROMBECTOMY/EMBOLECTMY LVL 13,26284.0,5651.06,575.51,19713.0,39
CDM,6291850,CATH THROMBECTOMY/EMBOLECTMY LVL 14,32854.0,7063.61,575.51,24640.5,39
CDM,6291876,IMP PROSTH ANKLE LVL 12,52564.0,15033.3,1312.53,39423.0,42
CDM,6291884,IMP PROSTH ANKLE LVL 13,57820.0,16536.52,1312.53,43365.0,42
CDM,6291892,IMP RV/AD/RP KN BR/AX/YK/BH LVL 07,13895.0,3973.97,2584.47,10421.25,42
CDM,6291900,IMP RV/AD/RP KN STEM LVL 01,2690.0,769.34,500.34,7467.6,42
CDM,6291918,IMP RV/AD/RP HIP NECK LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6291926,IMP RV/AD/RP HIP SYS MODULAR LVL 01,9260.0,2648.36,1722.36,7467.6,42
CDM,6291934,IMP RV/AD/RP ELBOW HEAD LVL 13,21904.0,6264.54,4074.14,16428.0,42
CDM,6291942,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 14,19714.0,5638.2,3666.8,14785.5,42
CDM,6291959,IMP RV/AD/RP ELBOW HUM/ULNR LVL 01,6105.0,1746.03,1135.53,7467.6,42
CDM,6291967,IMP RV/AD/RP ELBOW HUM/ULNR LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,6291975,IMP RV/AD/RP ELBOW HUM/ULNR LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6291983,IMP RV/AD/RP ELBOW HUM/ULNR LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6291991,IMP RV/AD/RP ELBOW HUM/ULNR LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,6292007,IMP RV/AD/RP SHDR LN/SL LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6292015,IMP RV/AD/RP SHDR LN/SL LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6292023,IMP RV/AD/RP SHDR LN/SL LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6292031,IMP RV/AD/RP SHDR LN/SL LVL 04,3853.0,1101.96,716.66,7467.6,42
CDM,6292049,IMP RV/AD/RP SHDR LN/SL LVL 05,6105.0,1746.03,1135.53,7467.6,42
CDM,6292056,IMP RV/AD/RP SHDR PROX BODY LVL 01,6105.0,1746.03,1135.53,7467.6,42
CDM,6292064,IMP RV/AD/RP SHDR PROX BODY LVL 02,9265.0,2649.79,1723.29,7467.6,42
CDM,6292072,IMP RV/AD/RP SHDR PROX BODY LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6292080,IMP RV/AD/RP SHDR PROX BODY LVL 04,17524.0,5011.86,3259.46,13143.0,42
CDM,6292098,IMP RV/AD/RP SHDR PROX BODY LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,6292106,INTRO EP STEER NONPEEL LVL 05,9265.0,1991.98,1723.29,6948.75,39
CDM,6292312,IMP STAPLE REINFORCEMENT LVL 06,2695.0,770.77,501.27,2021.25,42
CDM,6292320,IMP RV/AD/RP HIP LINER LVL 01,2695.0,770.77,501.27,7467.6,42
CDM,6292338,IMP CONNECTOR NERVE LVL 01,3853.0,1101.96,716.66,2889.75,42
CDM,6292346,NEUROMATRIX 2.5CM LENGTH/0.5CM,430.5,123.12,62.04,1375.7,38
CDM,6292395,LENS INTRAOCULAR NEW TECH LVL 01,1413.0,464.92,262.82,2540.2,42
CDM,6292403,IMP STENT COAT W DEL LVL 19,63514.0,18165.0,11813.6,47635.5,42
CDM,6292411,IMP STENT COAT W DEL LVL 20,67894.0,19417.68,12628.28,50920.5,42
CDM,6292429,IMP STENT COAT W DEL LVL 21,72274.0,20670.36,13442.96,54205.5,42
CDM,6292437,IMP STENT COAT W DEL LVL 22,76654.0,21923.04,13526.9,57490.5,42
CDM,6292445,IMP STENT COAT W DEL LVL 23,81034.0,23175.72,13526.9,60775.5,42
CDM,6292460,IMP ICD CHAMBER NON SGL/DUAL LVL 01,61320.0,17537.52,11405.52,63194.0,42
CDM,6292494,IMP PCMKR SGL RR LVL 01,11575.0,3507.22,2152.95,41774.56,42
CDM,6292502,IMP CATH BRACHY SEED ADM LVL 01,1413.0,404.12,262.82,1059.75,42
CDM,6292510,IMP CATH BRACHY SEED ADM LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,6292528,IMP CATH BRACHY SEED ADM LVL 03,3853.0,1101.96,590.83,2889.75,42
CDM,6292536,IMP CATH BRACHY SEED ADM LVL 04,6105.0,1746.03,590.83,4578.75,42
CDM,6292544,IMP CATH BRACHY SEED ADM LVL 05,9265.0,2649.79,590.83,6948.75,42
CDM,6292551,IMP CONNECTOR NERVE LVL 02,6105.0,1746.03,1135.53,4578.75,42
CDM,6292569,IMP CONNECTOR NERVE LVL 03,9265.0,2649.79,1312.53,6948.75,42
CDM,6292577,IMP PUMP VALVE BLOOD LVL 07,100744.0,28812.78,1312.53,75558.0,42
CDM,6292585,IMP PUMP VALVE BLOOD LVL 08,109504.0,31318.14,1312.53,82128.0,42
CDM,6292593,CATH ABL TISSUE INSERT LVL 02,11580.0,2489.7,951.39,8685.0,39
CDM,6292601,IMP STENT NOS LVL 23,83224.0,23802.06,1312.53,62418.0,42
CDM,6292650,IMP LD ICD NON SGL/DUAL LVL 01,2695.0,770.77,501.27,5958.8,42
CDM,6292668,IMP LD ICD NON SGL/DUAL LVL 02,3853.0,1101.96,716.66,5958.8,42
CDM,6292676,IMP LD ICD NON SGL/DUAL LVL 03,4885.0,1397.11,908.61,5958.8,42
CDM,6292692,THERAPY COLD LVL 07,6105.0,1312.58,879.73,4578.75,29
CDM,6292700,THERAPY COLD LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,6292742,IMP RV/AD/RP ELBOW HUM/ULNR LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6292759,IMP RV/AD/RP SHDR HEAD LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6292767,IMP RV/AD/RP SHDR HEAD LVL 02,2695.0,770.77,501.27,7467.6,42
CDM,6292775,IMP RV/AD/RP HIP FEMORAL HD LVL 14,35044.0,10022.58,5497.98,26283.0,42
CDM,6292791,CATH FEEDING LVL 03,1132.0,243.38,163.12,849.0,29
CDM,6292809,IMP RV/AD/RP KN STEM LVL 08,21904.0,6264.54,4074.14,16428.0,42
CDM,6292817,IMP RV/AD/RP KN STEM LVL 09,26284.0,7517.22,4888.82,19713.0,42
CDM,6292825,IMP RV/AD/RP KN STEM LVL 10,30664.0,8769.9,5497.98,22998.0,42
CDM,6292833,IMP RV/AD/RP HIP CUP LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6292841,BIT LVL 10,6718.0,1444.37,968.06,5038.5,29
CDM,6292858,IMP RV/AD/RP SHDR GLEN CMP LVL 05,21904.0,6264.54,4074.14,16428.0,42
CDM,6292866,TAPS LVL 05,3909.0,840.44,563.29,2931.75,29
CDM,6292908,IMP SPINE FUSION LVL 01,2690.0,769.34,500.34,2017.5,42
CDM,6292916,IMP NEURAGEN NRV GUIDE/CM LVL 05,9265.0,2649.79,1038.0,8367.75,42
CDM,6292999,IMP PROSTH MAXILLOFACIAL LVL 10,28474.0,8143.56,1312.53,21355.5,42
CDM,6293005,IMP PROSTH MAXILLOFACIAL LVL 11,35044.0,10022.58,1312.53,26283.0,42
CDM,6293013,IMP PROSTH MAXILLOFACIAL LVL 12,41614.0,11901.6,1312.53,31210.5,42
CDM,6293021,IMP PROSTH MAXILLOFACIAL LVL 13,48184.0,13780.62,1312.53,36138.0,42
CDM,6293039,MANIPULATOR LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6293047,MANIPULATOR LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,6293062,DEVICE INSERT RETRV LVL 19,43366.0,9323.69,1305.72,32524.5,39
CDM,6293070,DEVICE INSERT RETRV LVL 20,47746.0,10265.39,1305.72,35809.5,39
CDM,6293088,DEVICE INSERT RETRV LVL 21,52126.0,11207.09,1305.72,39094.5,39
CDM,6293096,DEVICE INSERT RETRV LVL 22,56506.0,12148.79,1305.72,42379.5,39
CDM,6293112,IMP RV/AD/RP HIP FEMORAL HD LVL 15,39424.0,11275.26,5497.98,29568.0,42
CDM,6293120,CATH/WIRE/SUTURE PASSER LVL 07,2695.0,579.42,388.35,2021.25,29
CDM,6293138,IMP ORTHOPEDIC CAGE LVL 01,2690.0,769.34,500.34,2017.5,42
CDM,6293146,IMP CONNECTOR SPINAL LVL 08,13895.0,3973.97,1312.53,10421.25,42
CDM,6293153,HEMOSTATIC AGENT LVL 07,6105.0,1312.58,879.73,4578.75,29
CDM,6293161,LASER FIBER LVL 09,13895.0,2987.42,2002.27,10421.25,29
CDM,6293179,IMP CATH PORT INDWELLING LVL 10,6105.0,1746.03,1135.53,7147.71,42
CDM,6293336,IMP NEURAWRAP NRV PROTEC/CM LVL 01,2695.0,770.77,501.27,6089.17,42
CDM,6293344,IMP NEURAWRAP NRV PROTEC/CM LVL 02,3853.0,1101.96,716.66,6089.17,42
CDM,6293351,IMP NEURAWRAP NRV PROTEC/CM LVL 03,6100.0,1744.6,1107.13,6089.17,42
CDM,6293377,IMP STIMULATOR BONE LVL 01,13890.0,3972.54,1312.53,10417.5,42
CDM,6293385,IMP STIMULATOR BONE LVL 02,19714.0,5638.2,1312.53,14785.5,42
CDM,6293393,IMP STIMULATOR BONE LVL 03,24094.0,6890.88,1312.53,18070.5,42
CDM,6293401,IMP STIMULATOR BONE LVL 04,28474.0,8143.56,1312.53,21355.5,42
CDM,6293435,IMP FILTER VENA CAVA LVL 01,1407.0,402.4,261.7,3310.63,42
CDM,6293450,KIT/SET SURG SPLINT CAD/CAM LVL 01,6487.0,1394.7,934.78,4865.25,29
CDM,6293484,IMP RV/AD/RP KN TIBIAL LVL 14,38986.0,11150.0,5497.98,29239.5,42
CDM,6293492,CLIP APPLIER LVL 05,3853.0,828.4,555.22,2889.75,29
CDM,6293526,IMP MESH LVL 16,41614.0,11901.6,4120.12,31210.5,42
CDM,6293534,IMP MESH LVL 17,45994.0,13154.28,4120.12,34495.5,42
CDM,6293542,IMP MESH LVL 18,50374.0,14406.96,4120.12,37780.5,42
CDM,6293559,IMP MESH LVL 19,54754.0,15659.64,4120.12,41065.5,42
CDM,6293567,IMP MESH LVL 20,59134.0,16912.32,4120.12,44350.5,42
CDM,6293575,IMP MESH LVL 21,63514.0,18165.0,4120.12,47635.5,42
CDM,6293583,IMP MESH LVL 22,67894.0,19417.68,4120.12,50920.5,42
CDM,6293591,IMP MESH LVL 23,72362.0,20695.53,4120.12,54271.5,42
CDM,6293633,IMP EMBOLIZATION SPHERE LVL 06,13895.0,3973.97,1312.53,10421.25,42
CDM,6293641,IMP DEV TISS LOCAL/EXCISION LVL 01,594.0,169.88,110.48,788.86,42
CDM,6293658,IMP DEV TISS LOCAL/EXCISION LVL 02,1413.0,404.12,262.82,1059.75,42
CDM,6293666,IMP DEV TISS LOCAL/EXCISION LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6293674,IMP DEV TISS LOCAL/EXCISION LVL 04,3853.0,1101.96,580.79,2889.75,42
CDM,6293682,IMP DEV TISS LOCAL/EXCISION LVL 05,6105.0,1746.03,580.79,4578.75,42
CDM,6293690,IMP DEV TISS LOCAL/EXCISION LVL 06,9265.0,2649.79,580.79,6948.75,42
CDM,6293708,IMP DEV TISS LOCAL/EXCISION LVL 07,11580.0,3311.88,580.79,8685.0,42
CDM,6293716,IMP DEV TISS LOCAL/EXCISION LVL 08,13895.0,3973.97,580.79,10421.25,42
CDM,6293724,IMP DEV TISS LOCAL/EXCISION LVL 09,15334.0,4385.52,580.79,11500.5,42
CDM,6293732,IMP DEV TISS LOCAL/EXCISION LVL 10,17524.0,5011.86,580.79,13143.0,42
CDM,6293823,IMP RV/AD/RP SHDR GLEN CMP LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6293831,IMP RV/AD/RP SHDR HEAD LVL 11,21904.0,6264.54,4074.14,16428.0,42
CDM,6293849,VAD RPL ELC MICROPROC CU SYS 0-12,15363.0,5930.12,2857.52,37743.31,43
CDM,6293914,VAD RPL E/P BATTERY CLIPS 0-12,4694.0,1811.88,355.57,3520.5,43
CDM,6293922,VAD RPL E-E/P HOLSTER 0-12,2214.0,854.6,390.15,1660.5,43
CDM,6293930,VAD RPL ANY BAG CONSOLIDATED 0-12,1664.0,642.3,126.76,1248.0,43
CDM,6293963,VAD RPL ANY SHOWER COVER 0-12,2304.0,889.34,387.89,1728.0,43
CDM,6294144,CATH ANGIO TRANSL LASER LVL 06,13895.0,2987.42,2584.47,10421.25,39
CDM,6294177,VAD RPL BATTERY CHGR 12+,24580.0,9487.88,3172.62,18435.0,43
CDM,6294193,VAD RPL ELC MICROPROC CU SYS 12+,15363.0,5930.12,2857.52,37743.31,43
CDM,6294219,VAD RPL E-E/P BATTERY NONLITH 6+,2934.0,1132.52,545.72,3894.15,43
CDM,6294227,VAD RPL E/P BATTERY CLIPS 12+,4694.0,1811.88,355.57,3520.5,43
CDM,6294235,VAD RPL E-E/P HOLSTER 12+,2214.0,854.6,390.15,1660.5,43
CDM,6294284,VAD RPL ANY SHOWER COVER 12+,2304.0,889.34,387.89,1728.0,43
CDM,6294359,VAD RPL ANY BAG CONSOLIDATED 12+,1664.0,642.3,126.76,1248.0,43
CDM,6294367,SUPPLY PERFUSION/ECMO LVL 13,19714.0,4238.51,2840.79,14785.5,29
CDM,6294375,SUPPLY PERFUSION/ECMO LVL 14,26284.0,5651.06,3787.52,19713.0,29
CDM,6294383,SUPPLY PERFUSION/ECMO LVL 15,32854.0,7063.61,4734.26,24640.5,29
CDM,6294391,SUPPLY PERFUSION/ECMO LVL 16,39424.0,8476.16,5681.0,29568.0,29
CDM,6294409,SUPPLY PERFUSION/ECMO LVL 17,43804.0,9417.86,6312.16,32853.0,29
CDM,6294417,SUPPLY PERFUSION/ECMO LVL 18,48184.0,10359.56,6943.31,36138.0,29
CDM,6294425,IMP PUMP VALVE BLOOD LVL 09,118264.0,33823.5,1312.53,88698.0,42
CDM,6294433,IMP PUMP VALVE BLOOD LVL 10,127024.0,36328.86,1312.53,95268.0,42
CDM,6294441,IMP PUMP VALVE BLOOD LVL 11,135784.0,38834.22,1312.53,101838.0,42
CDM,6294458,IMP PUMP VALVE BLOOD LVL 12,144544.0,41339.58,1312.53,108408.0,42
CDM,6294466,IMP PUMP VALVE BLOOD LVL 13,153304.0,43844.94,1312.53,114978.0,42
CDM,6294540,TENOGLIDE TENDON PROT 10X12.5/SC,106.8,30.54,15.39,743.56,38
CDM,6294557,CATH GUIDE LVL 13,13895.0,2987.42,336.61,10421.25,39
CDM,6294565,CATH INTRASPINAL LVL 07,4885.0,1050.28,908.61,3663.75,39
CDM,6294573,IMP PROSTH SPHINCTR URIN LVL 05,30664.0,8769.9,5694.62,22998.0,42
CDM,6294581,IMP PROSTH SPHINCTR URIN LVL 06,35044.0,10022.58,5694.62,26283.0,42
CDM,6294599,IMP PROSTH SPHINCTR URIN LVL 07,39424.0,11275.26,5694.62,29568.0,42
CDM,6294607,IMP PROSTH SPHINCTR URIN LVL 08,43804.0,12527.94,5694.62,32853.0,42
CDM,6294615,IMP PROSTH SPHINCTR URIN LVL 09,48184.0,13780.62,5694.62,36138.0,42
CDM,6294623,IMP PROSTH SPHINCTR URIN LVL 10,52564.0,15033.3,5694.62,39423.0,42
CDM,6294631,IMP PROSTH SPHINCTR URIN LVL 11,56944.0,16285.98,5694.62,42708.0,42
CDM,6294649,IMP PROSTH SPHINCTR URIN LVL 12,61324.0,17538.66,5694.62,45993.0,42
CDM,6294656,IMP PROSTH SPHINCTR URIN LVL 13,67894.0,19417.68,5694.62,50920.5,42
CDM,6294664,IMP STENT NOS LVL 24,85414.0,24428.4,1312.53,64060.5,42
CDM,6294854,VAD RPL CABLE PWR AUTO DC 0-12,1176.0,453.94,139.58,882.0,43
CDM,6294896,VAD RPL BATTERY LI-ION 11V 0-6,2416.0,932.58,449.38,2218.58,43
CDM,6294904,VAD RPL BATTERY LI-ION 11V 6+,2416.0,932.58,449.38,2218.58,43
CDM,6295034,IMP MEMBRANE AMNIO OCULAR LVL 04,9265.0,2649.79,1670.05,6948.75,42
CDM,6295042,IMP MEMBRANE AMNIO OCULAR LVL 05,13895.0,3973.97,1670.05,10421.25,42
CDM,6295075,PROBE/NEEDLE CRYOABLATION LVL 01,588.0,126.42,109.37,2309.84,39
CDM,6295083,PROBE/NEEDLE CRYOABLATION LVL 02,2690.0,578.35,500.34,2309.84,39
CDM,6295091,PROBE/NEEDLE CRYOABLATION LVL 03,4885.0,1050.28,908.61,3663.75,39
CDM,6295109,PROBE/NEEDLE CRYOABLATION LVL 04,9265.0,1991.98,1700.61,6948.75,39
CDM,6295117,PROBE/NEEDLE CRYOABLATION LVL 05,13895.0,2987.42,1700.61,10421.25,39
CDM,6295125,PROBE/NEEDLE CRYOABLATION LVL 06,17524.0,3767.66,1700.61,13143.0,39
CDM,6295133,PROBE/NEEDLE CRYOABLATION LVL 07,21904.0,4709.36,1700.61,16428.0,39
CDM,6295141,PROBE/NEEDLE CRYOABLATION LVL 08,26284.0,5651.06,1700.61,19713.0,39
CDM,6295158,PROBE/NEEDLE CRYOABLATION LVL 09,30664.0,6592.76,1700.61,22998.0,39
CDM,6295166,PROBE/NEEDLE CRYOABLATION LVL 10,35044.0,7534.46,1700.61,26283.0,39
CDM,6295174,PROBE/NEEDLE CRYOABLATION LVL 11,39424.0,8476.16,1700.61,29568.0,39
CDM,6295182,PROBE/NEEDLE CRYOABLATION LVL 12,43804.0,9417.86,1700.61,32853.0,39
CDM,6295190,PROBE/NEEDLE CRYOABLATION LVL 13,48184.0,10359.56,1700.61,36138.0,39
CDM,6295208,PROBE/NEEDLE CRYOABLATION LVL 14,52564.0,11301.26,1700.61,39423.0,39
CDM,6295224,IMP DEV EMBOLIZATION PIPELIN LVL 01,56506.0,16160.72,1312.53,42379.5,42
CDM,6295232,IMP DEV EMBOLIZATION PIPELIN LVL 02,60886.0,17413.4,1312.53,45664.5,42
CDM,6295240,IMP FIX LW/UP/PELVIC LVL 05,13895.0,3973.97,1003.99,10421.25,42
CDM,6295257,IMP FIX LW/UP/PELVIC LVL 01,3853.0,1101.96,716.66,2889.75,42
CDM,6295265,IMP FIX LW/UP/PELVIC LVL 06,17524.0,5011.86,1003.99,13143.0,42
CDM,6295273,IMP FIX LW/UP/PELVIC LVL 07,21904.0,6264.54,1003.99,16428.0,42
CDM,6295281,IMP BLADE LVL 01,1413.0,404.12,262.82,1363.66,42
CDM,6295299,IMP BLADE LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,6295307,IMP BLADE LVL 03,3853.0,1101.96,716.66,2889.75,42
CDM,6295315,WIRE PACING TEMP LVL 06,2695.0,579.42,388.35,2021.25,29
CDM,6295323,CATH FEEDING LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6295331,CATH FEEDING LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6295539,IMP RV/AD/RP KN ROTATING HNG LVL 08,28474.0,8143.56,5296.16,21355.5,42
CDM,6295547,IMP RV/AD/RP KN ROTATING HNG LVL 09,32854.0,9396.24,5497.98,24640.5,42
CDM,6295661,DRAIN W ACCESSORIES LVL 05,1888.0,405.92,272.06,1416.0,29
CDM,6295679,BLOCK CUST CUTTING LVL 01,1413.0,303.8,203.61,1059.75,29
CDM,6295703,IMP TISSUE CONNECT HUMAN LVL 20,78844.0,22549.38,6600.85,59133.0,42
CDM,6295711,IMP TISSUE CONNECT HUMAN LVL 21,87604.0,25054.74,6600.85,65703.0,42
CDM,6295729,IMP TISSUE CONNECT HUMAN LVL 22,96364.0,27560.1,6600.85,72273.0,42
CDM,6295737,IMP PROSTH MAXILLOFACIAL LVL 14,54754.0,15659.64,1312.53,41065.5,42
CDM,6295745,IMP PROSTH MAXILLOFACIAL LVL 15,59134.0,16912.32,1312.53,44350.5,42
CDM,6295752,IMP PROSTH MAXILLOFACIAL LVL 16,63514.0,18165.0,1312.53,47635.5,42
CDM,6295760,IMP PROSTH MAXILLOFACIAL LVL 17,67894.0,19417.68,1312.53,50920.5,42
CDM,6295778,IMP PROSTH MAXILLOFACIAL LVL 18,72274.0,20670.36,1312.53,54205.5,42
CDM,6295786,IMP PROSTH MAXILLOFACIAL LVL 19,76654.0,21923.04,1312.53,57490.5,42
CDM,6295836,IMP PROSTH SPHINCTR URIN LVL 14,74464.0,21296.7,5694.62,55848.0,42
CDM,6295844,CATH ABL TISSUE INSERT LVL 01,6105.0,1312.58,951.39,4578.75,39
CDM,6295869,CATH SPINAL/NEURO LVL 07,6950.0,1494.25,1001.5,5212.5,29
CDM,6295893,IMP CLIP/S 1-4 REPAIR MITRAL KIT,109800.0,31402.8,1312.53,82350.0,42
CDM,6295919,INSTRUMENT DISP SINGLE LVL 14,17524.0,3767.66,2525.21,13143.0,29
CDM,6295935,IMP LD VENOUS COR LV LVL 01,2695.0,770.77,501.27,8750.91,42
CDM,6295943,IMP LD VENOUS COR LV LVL 02,3853.0,1101.96,716.66,8750.91,42
CDM,6295950,IMP LD VENOUS COR LV LVL 03,4880.0,1395.68,907.68,8750.91,42
CDM,6296016,IMP CATH HEM/PER LONG TERM LVL 11,11580.0,3311.88,705.48,8685.0,42
CDM,6296032,IMP MEMBRANE AMNIO OCULAR LVL 06,17524.0,5011.86,1670.05,13143.0,42
CDM,6296081,IMP SEPTAL DEFECT INTRACARD LVL 05,32854.0,9396.24,6110.84,52268.89,42
CDM,6296149,IMP CATH PORT INDWELLING LVL 11,6950.0,1987.7,1292.7,7147.71,42
CDM,6296776,INTRO NON GD/EP/LASER LVL 09,10191.0,2191.06,183.22,7643.25,39
CDM,6296784,INTRO NON GD/EP/LASER LVL 10,13895.0,2987.42,183.22,10421.25,39
CDM,6296792,IMP ADPT/EXT LD PACING/NEURO LVL 05,13895.0,3973.97,2584.47,11779.23,42
CDM,6296800,IMP ADPT/EXT LD PACING/NEURO LVL 06,17524.0,5011.86,3259.46,13143.0,42
CDM,6296818,IMP ADPT/EXT LD PACING/NEURO LVL 07,21904.0,6264.54,4074.14,16428.0,42
CDM,6296958,IMP PROSTH SPHINCTR URIN LVL 15,76654.0,21923.04,5694.62,57490.5,42
CDM,6297006,IMP RV/AD/RP SHDR STEM LVL 01,4880.0,1395.68,907.68,7467.6,42
CDM,6297030,IMP COVER BURR HOLE LVL 04,2695.0,770.77,501.27,2021.25,42
CDM,6297303,CATH TLA NONLASER DRUG COAT LVL 01,166.0,35.69,30.88,6399.56,39
CDM,6297311,CATH TLA NONLASER DRUG COAT LVL 02,313.0,67.3,58.22,6399.56,39
CDM,6297329,CATH TLA NONLASER DRUG COAT LVL 03,594.0,127.71,110.48,6399.56,39
CDM,6297337,CATH TLA NONLASER DRUG COAT LVL 04,1413.0,303.8,262.82,6399.56,39
CDM,6297345,CATH TLA NONLASER DRUG COAT LVL 05,1888.0,405.92,351.17,6399.56,39
CDM,6297352,CATH TLA NONLASER DRUG COAT LVL 06,2695.0,579.42,501.27,6399.56,39
CDM,6297360,CATH TLA NONLASER DRUG COAT LVL 07,3853.0,828.4,716.66,6399.56,39
CDM,6297378,CATH TLA NONLASER DRUG COAT LVL 08,4397.0,945.36,817.84,6399.56,39
CDM,6297386,CATH TLA NONLASER DRUG COAT LVL 09,6105.0,1312.58,1135.53,6399.56,39
CDM,6297394,CATH TLA NONLASER DRUG COAT LVL 10,7413.0,1593.8,1378.82,6399.56,39
CDM,6297402,CATH TLA NONLASER DRUG COAT LVL 11,9265.0,1991.98,1723.29,6948.75,39
CDM,6297410,CATH TLA NONLASER DRUG COAT LVL 12,11580.0,2489.7,2153.88,8685.0,39
CDM,6297428,CATH BALLOON PACING LVL 05,6105.0,1312.58,879.73,4578.75,29
CDM,6297642,IMP PROSTH ANKLE LVL 14,67894.0,19417.68,1312.53,50920.5,42
CDM,6297857,DEVICE CLOSURE TISSUE LVL 12,26284.0,5651.06,3787.52,19713.0,29
CDM,6297865,DEVICE CLOSURE TISSUE LVL 13,30664.0,6592.76,4418.68,22998.0,29
CDM,6297873,IMP RV/AD/RP KN PATELLA LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6297881,IMP RV/AD/RP KN PATELLA LVL 02,2152.0,615.47,400.27,7467.6,42
CDM,6298012,RETRIEVER VASCULAR LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6298020,RETRIEVER VASCULAR LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6298038,RETRIEVER VASCULAR LVL 05,6105.0,1312.58,879.73,4578.75,29
CDM,6298046,RETRIEVER VASCULAR LVL 06,8107.0,1743.0,1168.22,6080.25,29
CDM,6298053,RETRIEVER VASCULAR LVL 07,10422.0,2240.73,1501.81,7816.5,29
CDM,6298061,RETRIEVER VASCULAR LVL 08,13895.0,2987.42,2002.27,10421.25,29
CDM,6298079,RETRIEVER VASCULAR LVL 09,17524.0,3767.66,2525.21,13143.0,29
CDM,6298087,RETRIEVER VASCULAR LVL 10,21904.0,4709.36,3156.37,16428.0,29
CDM,6298095,RETRIEVER VASCULAR LVL 11,26284.0,5651.06,3787.52,19713.0,29
CDM,6298103,RETRIEVER VASCULAR LVL 12,30664.0,6592.76,4418.68,22998.0,29
CDM,6298111,RETRIEVER VASCULAR LVL 13,35044.0,7534.46,5049.84,26283.0,29
CDM,6298160,IMP FIX LW/UP/PELVIC LVL 08,26284.0,7517.22,1003.99,19713.0,42
CDM,6298327,MILK HUMAN PROLACT+4 H2MF 10ML,230.0,49.45,33.14,172.5,29
CDM,6298335,MILK HUMAN PROLACT+4 H2MF 20ML,460.0,98.9,66.29,345.0,29
CDM,6298343,MILK HUMAN PROLACT+6 H2MF 30ML,987.0,212.2,142.23,740.25,29
CDM,6298350,MILK HUMAN PROLACT+8 H2MF 40ML,920.0,197.8,132.57,690.0,29
CDM,6298368,IMP RV/AD/RP HIP FEMORAL HD LVL 16,65704.0,18791.34,5497.98,49278.0,42
CDM,6298475,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 01,594.0,169.88,110.48,1782.74,42
CDM,6298483,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,6298491,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 03,2157.0,616.9,401.2,1782.74,42
CDM,6298509,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 04,3083.0,881.74,573.44,2312.25,42
CDM,6298517,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 05,4885.0,1397.11,908.61,3663.75,42
CDM,6298525,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 06,6950.0,1987.7,1292.7,5212.5,42
CDM,6298533,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 07,9265.0,2649.79,1312.53,6948.75,42
CDM,6298541,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 08,13895.0,3973.97,1312.53,10421.25,42
CDM,6298558,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 09,17524.0,5011.86,1312.53,13143.0,42
CDM,6298566,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 10,21904.0,6264.54,1312.53,16428.0,42
CDM,6298574,OCCLUDER LVL 05,30664.0,6592.76,4418.68,22998.0,29
CDM,6298582,IMP SENSOR PRESS PA ALL LVL 01,43804.0,12527.94,2614.58,32853.0,38
CDM,6298590,IMP SENSOR PRESS PA ALL LVL 02,65704.0,18791.34,2614.58,49278.0,38
CDM,6298608,IMP SENSOR PRESS PA ALL LVL 03,87604.0,25054.74,2614.58,65703.0,38
CDM,6298657,IMP DEV CLOSURE ATRIAL APNDG LVL 01,6105.0,1746.03,1135.53,4578.75,42
CDM,6298665,IMP DEV CLOSURE ATRIAL APNDG LVL 02,13895.0,3973.97,1312.53,10421.25,42
CDM,6298673,IMP DEV CLOSURE ATRIAL APNDG LVL 03,26284.0,7517.22,1312.53,19713.0,42
CDM,6298681,IMP DEV CLOSURE ATRIAL APNDG LVL 04,43804.0,12527.94,1312.53,32853.0,42
CDM,6298699,IMP DEV CLOSURE ATRIAL APNDG LVL 05,61324.0,17538.66,1312.53,45993.0,42
CDM,6298707,IMP DEV CLOSURE ATRIAL APNDG LVL 06,78844.0,22549.38,1312.53,59133.0,42
CDM,6298723,IMP DEV JT SHDR TOTAL LVL 17,61324.0,17538.66,5497.98,45993.0,42
CDM,6298731,IMP DEV JT SHDR TOTAL LVL 18,70084.0,20044.02,5497.98,52563.0,42
CDM,6298772,IMP RV/AD/RP HIP SHELL LVL 12,26284.0,7517.22,4888.82,19713.0,42
CDM,6298780,IMP RV/AD/RP HIP SHELL LVL 13,30664.0,8769.9,5497.98,22998.0,42
CDM,6298798,IMP RV/AD/RP HIP SHELL LVL 14,35044.0,10022.58,5497.98,26283.0,42
CDM,6298814,IMP RV/AD/RP HIP SYS TRIFLNG LVL 01,3853.0,1101.96,716.66,7467.6,42
CDM,6298822,IMP RV/AD/RP HIP SYS TRIFLNG LVL 02,6105.0,1746.03,1135.53,7467.6,42
CDM,6298830,IMP RV/AD/RP HIP SYS TRIFLNG LVL 03,13895.0,3973.97,2584.47,10421.25,42
CDM,6298848,IMP RV/AD/RP HIP SYS TRIFLNG LVL 04,21904.0,6264.54,4074.14,16428.0,42
CDM,6298855,IMP RV/AD/RP HIP SYS TRIFLNG LVL 05,32854.0,9396.24,5497.98,24640.5,42
CDM,6298939,IMP CARDIAC EVENT REC LVL 01,6105.0,1746.03,1135.53,41774.56,42
CDM,6298947,IMP CARDIAC EVENT REC LVL 02,11575.0,3310.45,2152.95,41774.56,42
CDM,6298954,IMP PCMKR NONSGL OR DUAL LVL 01,6105.0,1849.82,1135.53,25942.8,42
CDM,6298962,IMP PCMKR NONSGL OR DUAL LVL 02,13895.0,4210.18,2584.47,25942.8,42
CDM,6298970,IMP PCMKR NONSGL OR DUAL LVL 03,21900.0,6635.7,4073.4,25942.8,42
CDM,6299036,IMP RETRACTOR SYS TISS LVL 01,594.0,169.88,110.48,1782.74,42
CDM,6299044,IMP RETRACTOR SYS TISS LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,6299051,IMP RETRACTOR SYS TISS LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6299069,IMP RETRACTOR SYS TISS LVL 04,3853.0,1101.96,716.66,2889.75,42
CDM,6299077,IMP RETRACTOR SYS TISS LVL 05,6105.0,1746.03,1135.53,4578.75,42
CDM,6299085,IMP DEV JT ANKLE TOTAL LVL 01,594.0,169.88,110.48,7467.6,42
CDM,6299093,IMP DEV JT ANKLE TOTAL LVL 02,1413.0,404.12,262.82,7467.6,42
CDM,6299101,IMP DEV JT ANKLE TOTAL LVL 03,2695.0,770.77,501.27,7467.6,42
CDM,6299119,IMP DEV JT ANKLE TOTAL LVL 04,3853.0,1101.96,716.66,7467.6,42
CDM,6299127,IMP DEV JT ANKLE TOTAL LVL 05,6105.0,1746.03,1135.53,7467.6,42
CDM,6299135,IMP DEV JT ANKLE TOTAL LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,6299143,IMP DEV JT ANKLE TOTAL LVL 07,13895.0,3973.97,2584.47,10421.25,42
CDM,6299150,IMP DEV JT ANKLE TOTAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
CDM,6299168,IMP DEV JT ANKLE TOTAL LVL 09,21904.0,6264.54,4074.14,16428.0,42
CDM,6299176,IMP DEV JT ANKLE TOTAL LVL 10,26284.0,7517.22,4888.82,19713.0,42
CDM,6299184,IMP DEV JT ANKLE TOTAL LVL 11,30664.0,8769.9,5497.98,22998.0,42
CDM,6299192,IMP DEV JT ANKLE TOTAL LVL 12,35044.0,10022.58,5497.98,26283.0,42
CDM,6299200,IMP DEV JT ANKLE TOTAL LVL 13,39424.0,11275.26,5497.98,29568.0,42
CDM,6299218,IMP DEV JT ANKLE TOTAL LVL 14,43804.0,12527.94,5497.98,32853.0,42
CDM,6299226,IMP DEV JT FNGR MCP LVL 01,1413.0,404.12,260.66,1059.75,43
CDM,6299234,IMP DEV JT FNGR MCP LVL 02,2695.0,770.77,260.66,2021.25,43
CDM,6299242,IMP DEV JT FNGR MCP LVL 03,3853.0,1101.96,260.66,2889.75,43
CDM,6299259,IMP DEV JT FNGR MCP LVL 04,6105.0,1746.03,260.66,4578.75,43
CDM,6299267,IMP DEV JT FNGR MCP LVL 05,9265.0,2649.79,260.66,6948.75,43
CDM,6299465,IMP ANCHOR FIX NON BONE LVL 01,313.0,89.52,58.22,1782.74,42
CDM,6299473,IMP ANCHOR FIX NON BONE LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,6299481,IMP ANCHOR FIX NON BONE LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6299499,IMP ANCHOR FIX NON BONE LVL 04,3853.0,1101.96,716.66,2889.75,42
CDM,6299507,IMP ANCHOR FIX NON BONE LVL 05,6105.0,1746.03,1135.53,4578.75,42
CDM,6299515,IMP ANCHOR FIX NON BONE LVL 06,9265.0,2649.79,1312.53,6948.75,42
CDM,6299523,IMP ANCHOR FIX NON BONE LVL 07,13895.0,3973.97,1312.53,10421.25,42
CDM,6299549,IMP ANCHOR FIX NON BONE LVL 08,17524.0,5011.86,1312.53,13143.0,42
CDM,6299556,ANCHOR APPLIER SYS LVL 01,313.0,67.3,45.1,234.75,29
CDM,6299564,ANCHOR APPLIER SYS LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6299572,ANCHOR APPLIER SYS LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6299580,ANCHOR APPLIER SYS LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6299598,ANCHOR APPLIER SYS LVL 05,6105.0,1312.58,879.73,4578.75,29
CDM,6299606,ANCHOR APPLIER SYS LVL 06,9265.0,1991.98,1335.09,6948.75,29
CDM,6299614,ANCHOR APPLIER SYS LVL 07,13895.0,2987.42,2002.27,10421.25,29
CDM,6299622,ANCHOR APPLIER SYS LVL 08,17524.0,3767.66,2525.21,13143.0,29
CDM,6299630,ANCHOR APPLIER SYS LVL 09,21904.0,4709.36,3156.37,16428.0,29
CDM,6299747,IMP DEV JT ANKLE TOTAL LVL 15,48184.0,13780.62,5497.98,36138.0,42
CDM,6299754,SIZER PRE-IMP BREAST DISP LVL 01,166.0,35.69,23.92,124.5,29
CDM,6299762,SIZER PRE-IMP BREAST DISP LVL 02,313.0,67.3,45.1,234.75,29
CDM,6299770,SIZER PRE-IMP BREAST DISP LVL 03,594.0,127.71,85.6,445.5,29
CDM,6299838,IMP RV/AD/RP HIP STEM LVL 07,43804.0,12527.94,5497.98,32853.0,42
CDM,6299861,IMP PROSTH PENILE NONINF LVL 06,37234.0,10648.92,6925.52,27925.5,42
CDM,6299887,DEVICE SYS DELIVERY DISP LVL 01,166.0,35.69,23.92,124.5,29
CDM,6299895,DEVICE SYS DELIVERY DISP LVL 02,313.0,67.3,45.1,234.75,29
CDM,6299903,DEVICE SYS DELIVERY DISP LVL 03,594.0,127.71,85.6,445.5,29
CDM,6299911,DEVICE SYS DELIVERY DISP LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6299929,DEVICE SYS DELIVERY DISP LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6299937,DEVICE SYS DELIVERY DISP LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6299945,IMP NEURAGEN NRV GUIDE/CM LVL 06,11580.0,3311.88,1038.0,8685.0,42
CDM,6299952,SYS RECHG EXT BTRY INT RPLC ONLY,6080.0,2346.88,1130.88,4560.0,43
CDM,6299960,MILK HUMAN PROLACT+10 H2MF 50ML,1150.0,247.25,165.72,862.5,29
CDM,6299978,IMP DEV URINARY W SLING LVL 10,30664.0,8769.9,5703.5,22998.0,42
CDM,6299994,IMP SEPTAL DEFECT INTRACARD LVL 06,37234.0,10648.92,6925.52,52268.89,42
CDM,6300974,PLUG BIOPSY LUNG W DELIVERY LVL 01,594.0,169.88,110.48,445.5,42
CDM,6300982,PLUG BIOPSY LUNG W DELIVERY LVL 02,1413.0,404.12,244.88,1059.75,42
CDM,6300990,PLUG BIOPSY LUNG W DELIVERY LVL 03,2695.0,770.77,244.88,2021.25,42
CDM,6301006,PLUG BIOPSY LUNG W DELIVERY LVL 04,3853.0,1101.96,244.88,2889.75,42
CDM,6301014,PLUG BIOPSY LUNG W DELIVERY LVL 05,6105.0,1746.03,244.88,4578.75,42
CDM,6301022,PLUG BIOPSY LUNG W DELIVERY LVL 06,13895.0,3973.97,244.88,10421.25,42
CDM,6301030,DEVICE ABLATION LVL 13,39424.0,8476.16,5681.0,29568.0,29
CDM,6301048,DEVICE ABLATION LVL 14,48184.0,10359.56,6943.31,36138.0,29
CDM,6301055,DEVICE ABLATION LVL 15,56944.0,12242.96,8205.63,42708.0,29
CDM,6301063,IMP SEPTAL DEFECT INTRACARD LVL 07,43804.0,12527.94,8147.54,52268.89,42
CDM,6301071,IMP RV/AD/RP HIP FEMORAL HD LVL 01,1132.0,323.75,210.55,7467.6,42
CDM,6301089,IMP PCMKR SGL RR LVL 07,39424.0,11945.47,7332.86,41774.56,42
CDM,6301097,IMP PCMKR SGL RR LVL 08,43804.0,13272.61,8147.54,41774.56,42
CDM,6301105,IMP PCMKR SGL RR LVL 09,48184.0,14599.75,8962.22,41774.56,42
CDM,6301113,IMP RV/AD/RP SHDR PROX BODY LVL 06,26284.0,7517.22,4888.82,19713.0,42
CDM,6301295,CATH THROMBECTOMY/EMBOLECTMY LVL 15,35044.0,7534.46,575.51,26283.0,39
CDM,6301303,IMP NEURAWRAP NRV PROTEC/CM LVL 06,11580.0,3311.88,1107.13,8685.0,42
CDM,6301311,IMP ORTHOTIC CAP END LVL 09,8107.0,2318.6,1312.53,6080.25,42
CDM,6301337,INTRO EP STEER NONPEEL LVL 01,1413.0,303.8,262.82,2935.13,39
CDM,6301345,INTRO EP STEER NONPEEL LVL 02,2695.0,579.42,501.27,2935.13,39
CDM,6301352,IMP SPACER ORTHOPEDIC LVL 10,26284.0,7517.22,1312.53,19713.0,42
CDM,6301402,IMP CEMENT LVL 09,17524.0,5011.86,1003.99,13143.0,42
CDM,6301493,IMP LD NEUROSTIM TEST KIT LVL 01,166.0,47.48,30.88,2624.81,42
CDM,6301501,IMP LD NEUROSTIM TEST KIT LVL 02,313.0,89.52,58.22,2624.81,42
CDM,6301519,IMP LD NEUROSTIM TEST KIT LVL 03,594.0,169.88,110.48,2624.81,42
CDM,6301527,IMP LD NEUROSTIM TEST KIT LVL 04,1413.0,404.12,262.82,2624.81,42
CDM,6301535,IMP LD NEUROSTIM TEST KIT LVL 05,1883.0,538.54,350.24,2624.81,42
CDM,6301568,IMP DEV EMBOLIZATION PIPELIN LVL 03,65266.0,18666.08,1312.53,48949.5,42
CDM,6301576,IMP DEV EMBOLIZATION PIPELIN LVL 04,69646.0,19918.76,1312.53,52234.5,42
CDM,6301584,IMP SHUNT LVL 12,26284.0,7517.22,1312.53,19713.0,42
CDM,6301592,IMP SHUNT LVL 13,30664.0,8769.9,1312.53,22998.0,42
CDM,6301618,IMP RV/AD/RP SHDR GLEN CMP LVL 07,30664.0,8769.9,5497.98,22998.0,42
CDM,6301626,IMP RV/AD/RP SHDR GLEN CMP LVL 08,35044.0,10022.58,5497.98,26283.0,42
CDM,6301634,IMP RV/AD/RP SHDR GLEN CMP LVL 09,39424.0,11275.26,5497.98,29568.0,42
CDM,6301642,IMP RV/AD/RP SHDR GLEN CMP LVL 10,43804.0,12527.94,5497.98,32853.0,42
CDM,6301659,IMP RV/AD/RP SHDR GLEN CMP LVL 11,48184.0,13780.62,5497.98,36138.0,42
CDM,6301667,IMP RV/AD/RP SHDR GLEN CMP LVL 12,52564.0,15033.3,5497.98,39423.0,42
CDM,6301675,IMP RV/AD/RP SHDR GLEN CMP LVL 13,56944.0,16285.98,5497.98,42708.0,42
CDM,6301881,IMP SPACER ORTHOPEDIC LVL 11,30664.0,8769.9,1312.53,22998.0,42
CDM,6302038,VAD RPL E-E/P BTRY LI-ION EA 6+,2401.0,926.79,446.59,2218.58,43
CDM,6302269,STAPLE RELOAD LVL 10,12737.0,2738.46,1835.4,9552.75,29
CDM,6302277,STAPLE RELOAD LVL 11,13895.0,2987.42,2002.27,10421.25,29
CDM,6302285,STAPLER LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,6302293,STAPLER LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,6302301,STAPLER LVL 10,13895.0,2987.42,2002.27,10421.25,29
CDM,6302319,STAPLER LVL 11,17524.0,3767.66,2525.21,13143.0,29
CDM,6302327,MILK HUMAN PROLACT+6 H2MF 15ML,516.0,110.94,74.36,387.0,29
CDM,6302335,IDE G160223 DEV SYS MITRAL CONTOUR,57240.0,18833.68,1312.53,42930.0,36
CDM,6302376,VAD RPL CABLE PWR MOD PT 0-12,3975.0,1534.35,739.35,2981.25,43
CDM,6302384,VAD RPL CABLE PWR MOD PT 12+,3975.0,1534.35,739.35,2981.25,43
CDM,6302426,IMP PROSTH SPHINCTR URIN LVL 16,87604.0,25054.74,5694.62,65703.0,42
CDM,6302442,CANNULA LVL 12,13895.0,2987.42,2002.27,10421.25,29
CDM,6302459,CANNULA LVL 13,19714.0,4238.51,2840.79,14785.5,29
CDM,6302467,CANNULA LVL 14,26284.0,5651.06,3787.52,19713.0,29
CDM,6302475,CANNULA LVL 15,32854.0,7063.61,4734.26,24640.5,29
CDM,6302483,CANNULA LVL 16,39424.0,8476.16,5681.0,29568.0,29
CDM,6302491,CANNULA LVL 17,45994.0,9888.71,6627.74,34495.5,29
CDM,6302509,CANNULA LVL 18,52564.0,11301.26,7574.47,39423.0,29
CDM,6302590,IMP PROSTH PENILE NONINF LVL 08,45994.0,13154.28,8554.88,34495.5,42
CDM,6302616,CATH THROMBECTOMY/EMBOLECTMY LVL 16,39424.0,8476.16,575.51,29568.0,39
CDM,6302756,IMP RING GERD LVL 01,2695.0,770.77,501.27,2021.25,42
CDM,6302764,IMP RING GERD LVL 02,6105.0,1746.03,1135.53,4578.75,42
CDM,6302772,IMP RING GERD LVL 03,9265.0,2649.79,1312.53,6948.75,42
CDM,6302780,IMP RING GERD LVL 04,13895.0,3973.97,1312.53,10421.25,42
CDM,6302798,IMP RING GERD LVL 05,17524.0,5011.86,1312.53,13143.0,42
CDM,6302806,IMP RING GERD LVL 06,21904.0,6264.54,1312.53,16428.0,42
CDM,6302814,IMP RING GERD LVL 07,26284.0,7517.22,1312.53,19713.0,42
CDM,6302822,IMP GENERATOR NEUROSTIM LVL 07,153304.0,43844.94,28514.54,114978.0,42
CDM,6302897,IMP SPACER ORTHOPEDIC LVL 13,39424.0,11275.26,1312.53,29568.0,42
CDM,6302905,IMP SPACER ORTHOPEDIC LVL 14,43804.0,12527.94,1312.53,32853.0,42
CDM,6302913,IMP SPACER ORTHOPEDIC LVL 15,54754.0,15659.64,1312.53,41065.5,42
CDM,6302939,CANNULA LVL 19,56944.0,12242.96,8205.63,42708.0,29
CDM,6303002,IMP RV/AD/RP ANKLE INSR/TRAY LVL 11,39424.0,11275.26,5497.98,29568.0,42
CDM,6303010,IMP RV/AD/RP ANKLE INSR/TRAY LVL 12,43804.0,12527.94,5497.98,32853.0,42
CDM,6303135,ALLDRM FIX INT 2X4/SC,211.0,60.35,30.41,222.5,62
CDM,6303143,ALLDRM FIX INT 11.8X23.7 CNTR/SC,108.5,31.03,15.63,222.5,62
CDM,6303150,ALLDRM FIX INT 16X20/SC,114.9,32.86,16.56,222.5,62
CDM,6303192,ALLDRM FIX INT 8X16/SC,108.5,31.03,15.63,222.5,62
CDM,6303200,ALLDRM FIX INT 3X7/SC,136.5,39.04,19.67,222.5,62
CDM,6303226,ALLDRM FIX INT 4X12/SC,102.7,29.37,14.8,222.5,62
CDM,6303259,ALLDRM FIX INT 9.6X19.3 CNTR/SC,111.8,31.97,16.11,222.5,62
CDM,6303267,ALLDRM FIX INT 4X7/SC,106.0,30.32,15.27,222.5,62
CDM,6303275,ALLDRM FIX INT 10.7X21.5 CNTR/SC,108.5,31.03,15.63,222.5,62
CDM,6303291,ALLDRM FIX INT 7.3X14.7 CNTR/SC,108.6,31.06,15.65,222.5,62
CDM,6303440,ALLPTCH HD FIX INT 2X5 THCK/SC,163.0,46.62,29.91,222.5,66
CDM,6303457,ALLPTCH HD FIX INT 4X8 THCK/SC,126.1,36.06,29.91,222.5,66
CDM,6303465,ALLPTCH HD FIX INT 5X5 THCK/SC,147.7,42.24,29.91,222.5,66
CDM,6303481,ALLPTCH HD FIX INT 5X5 THCK ULT/SC,141.6,40.5,29.91,222.5,66
CDM,6303499,ALLPTCH HD FIX INT 2X5 THIN/SC,104.1,29.77,29.91,222.5,66
CDM,6303507,ALLPTCH HD FIX INT 5X5 THIN/SC,122.6,35.06,29.91,222.5,66
CDM,6303515,FLEX HD FIX INT 1X4 THCK ULT/SC,136.0,38.9,29.91,222.5,66
CDM,6303523,FLEX HD FIX INT 2X12 THCK ULT/SC,90.2,25.8,29.5,222.5,66
CDM,6303531,FLEX HD FIX INT 2X7 THCK ULT/SC,121.9,34.86,29.91,222.5,66
CDM,6303549,FLEX HD FIX INT 3X12 THCK ULT/SC,77.4,22.14,25.31,222.5,66
CDM,6303556,FLEX HD FIX INT 3X7 THCK ULT/SC,95.2,27.23,29.91,222.5,66
CDM,6303564,FLEX HD FIX INT 4X12 THCK ULT/SC,71.0,20.31,23.22,222.5,66
CDM,6303572,FLEX HD FIX INT 4X16 THCK ULT/SC,68.9,19.71,22.53,222.5,66
CDM,6303580,FLEX HD FIX INT 4X7 THCK ULT/SC,80.2,22.94,26.23,222.5,66
CDM,6303598,FLEX HD FIX INT 5X10 THCK ULT/SC,68.5,19.59,22.4,222.5,66
CDM,6303606,FLEX HD FIX INT 5X12 THCK ULT/SC,70.7,20.22,23.12,222.5,66
CDM,6303614,FLEX HD FIX INT 6X12 THCK ULT/SC,80.1,22.91,26.19,222.5,66
CDM,6303648,FLEX HD FIX INT 8X12 THCK ULT/SC,73.8,21.11,24.13,222.5,66
CDM,6303655,FLEX HD FIX INT 8X16 THCK ULT/SC,82.1,23.48,26.85,222.5,66
CDM,6303671,FLEX HD FIX INT 12X16 THCK ULT/SC,65.1,18.62,21.29,222.5,66
CDM,6303697,FLEX HD FIX INT 12X24 THCK ULT/SC,64.3,18.39,21.03,222.5,66
CDM,6303705,FLEX HD FIX INT 16X20 THCK ULT/SC,63.0,18.02,20.6,222.5,66
CDM,6303713,FLEX HD FIX INT 1X2 THIN/SC,196.6,56.23,29.91,222.5,66
CDM,6303721,FLEX HD FIX INT 2X4 THIN/SC,83.2,23.8,27.21,222.5,66
CDM,6303739,FLEX HD FIX INT 3X7 THIN/SC,77.7,22.22,25.41,222.5,66
CDM,6303747,FLEX HD FIX INT 4X12 THIN/SC,48.3,13.81,15.79,222.5,66
CDM,6303754,FLEX HD FIX INT 4X7 THIN/SC,61.6,17.62,20.14,222.5,66
CDM,6303804,FLEX HD FIX INT 15X24 THCK ULT/SC,51.3,14.67,16.78,222.5,66
CDM,6303820,ALLPTCH HD FIX INT 8X12 THIN/SC,145.2,41.53,29.91,222.5,66
CDM,6303861,FLEX HD FIX INT 20X25 THCK/SC,85.6,24.48,27.99,222.5,66
CDM,6303895,ALLPTCH HD FIX INT 6X8 THIN/SC,154.8,44.27,29.91,222.5,66
CDM,6303911,STRAT TM FIX INT 10X10 FIRM/SC,89.3,25.54,12.87,410.16,61
CDM,6303929,STRAT TM FIX INT 10X16 FIRM/SC,89.3,25.54,12.87,410.16,61
CDM,6303978,STRAT TM FIX INT 16X20 FIRM/SC,89.3,25.54,12.87,410.16,61
CDM,6303986,STRAT TM FIX INT 20X20 FIRM/SC,89.3,25.54,12.87,410.16,61
CDM,6303994,STRAT TM FIX INT 20X25 FIRM/SC,89.3,25.54,12.87,410.16,61
CDM,6304083,STRAT TM FIX INT 6X8/SC,86.7,24.8,12.49,410.16,61
CDM,6304141,STRAT TM FIX INT 20X40 FIRM/SC,66.8,19.1,9.63,410.16,61
CDM,6305213,PALGN/PALGN X+ FIX INT 4X8/SC,226.4,64.75,32.62,410.16,62
CDM,6305262,PALGN/PM FIX INT 0.36MG/0.25CC 1CC,1253.1,358.39,180.57,2222.32,39
CDM,6305270,PALGN/PM FIX INT 0.36MG/0.25CC 2CC,1081.7,309.37,155.87,2222.32,39
CDM,6305429,IMP STENT NOS LVL 25,87604.0,25054.74,1312.53,65703.0,42
CDM,6305437,IMP STENT NOS LVL 26,89794.0,25681.08,1312.53,67345.5,42
CDM,6305445,IMP PROSTH PENILE INFLT LVL 09,74464.0,21296.7,13850.3,62427.29,42
CDM,6305452,IMP PROSTH PENILE INFLT LVL 10,83224.0,23802.06,15479.66,62427.29,42
CDM,6305460,PROGRAMMER PT NEUROSTIM LVL 04,17524.0,5011.86,2813.08,13143.0,42
CDM,6305478,PROGRAMMER PT NEUROSTIM LVL 05,21904.0,6264.54,2813.08,16428.0,42
CDM,6305486,PROGRAMMER PT NEUROSTIM LVL 06,26284.0,7517.22,2813.08,19713.0,42
CDM,6305494,PROGRAMMER PT NEUROSTIM LVL 07,30664.0,8769.9,2813.08,22998.0,42
CDM,6305601,GRAFIX/GPL PRIM FIX INT 1.5X2/SC,819.8,234.46,118.13,614.85,62
CDM,6305627,GRAFIX/GPL PRIM FIX INT 2X3/SC,512.2,146.49,73.81,410.16,62
CDM,6305635,GRAFIX/GPL PRIM FIX INT 3X4/SC,314.3,89.89,45.29,410.16,62
CDM,6305650,GRAFIX/GPL PRIM FIX INT 5X5/SC,310.2,88.72,44.7,410.16,62
CDM,6305668,GRAFIX/GPL PRIM FIX INT 7.5X15/SC,205.8,58.86,29.66,410.16,62
CDM,6305676,STRAVIX/STRAVPL PRIM FIX INT 2X2/SC,2093.5,598.74,132.79,1570.12,62
CDM,6305684,STRAVIX/STRAVPL PRIM FIX INT 2X4/SC,663.2,189.68,95.57,497.4,62
CDM,6305692,STRAVIX/STRAVPL PRIM FIX INT 3X6/SC,465.3,133.08,67.05,410.16,62
CDM,6305718,IMP DEV EMBOLIZATION ANEUR LVL 01,48184.0,13780.62,1312.53,36138.0,42
CDM,6305726,IMP DEV EMBOLIZATION ANEUR LVL 02,52564.0,15033.3,1312.53,39423.0,42
CDM,6305734,IMP DEV EMBOLIZATION ANEUR LVL 03,56944.0,16285.98,1312.53,42708.0,42
CDM,6305742,IMP DEV EMBOLIZATION ANEUR LVL 04,61324.0,17538.66,1312.53,45993.0,42
CDM,6305759,IMP DEV EMBOLIZATION ANEUR LVL 05,65704.0,18791.34,1312.53,49278.0,42
CDM,6305767,IMP DEV EMBOLIZATION ANEUR LVL 06,70084.0,20044.02,1312.53,52563.0,42
CDM,6305775,IMP DEV JT ANKLE TOTAL LVL 16,52564.0,15033.3,5497.98,39423.0,42
CDM,6305783,IMP DEV JT ANKLE TOTAL LVL 17,56944.0,16285.98,5497.98,42708.0,42
CDM,6305957,CYTAL MTRX 3LYR FIX INT 10X15/SC,66.2,18.93,9.54,410.16,62
CDM,6305973,CYTAL MTRX 3LYR FIX INT 7X10/SC,87.9,25.14,12.67,410.16,62
CDM,6305981,CYTAL MTRX 6LYR FIX INT 10X15/SC,93.7,26.8,13.5,410.16,62
CDM,6306005,CYTAL MTRX 6LYR FIX INT 7X10/SC,110.1,31.49,15.87,410.16,62
CDM,6306013,CYTAL MTRX BURN MSH FIX INT10X15/SC,40.6,11.61,5.85,410.16,62
CDM,6306039,CYTAL MTRX BURN MSH FIX INT 7X10/SC,15.8,4.52,2.28,410.16,62
CDM,6306153,EPIFIX MESH FIX EXT 3.5X3.5/SC,523.6,149.23,75.45,410.16,63
CDM,6306179,EPIFIX FIX INT 14MM DISK/SC,526.7,150.64,75.9,410.16,62
CDM,6306187,EPIFIX FIX INT 18MM DISK/SC,809.4,231.49,116.63,607.05,62
CDM,6306195,EPIFIX FIX INT 2X2/SC,867.5,248.1,125.01,650.62,62
CDM,6306203,EPIFIX FIX INT 2X3/SC,668.9,191.31,96.39,501.68,62
CDM,6306211,EPIFIX FIX INT 2X4/SC,563.4,161.13,81.19,422.55,62
CDM,6306229,EPIFIX FIX INT 3X4/SC,668.6,191.22,96.35,501.45,62
CDM,6306245,EPIFIX FIX INT 4X4/SC,656.1,187.64,94.54,492.07,62
CDM,6306252,EPIFIX FIX INT 5X6/SC,665.2,190.25,95.86,498.9,62
CDM,6306286,EPIFIX MESH FIX INT 3.5X3.5/SC,523.6,149.75,75.45,410.16,62
CDM,6306294,EPIFIX MESH FIX INT 4X4.5/SC,413.1,118.15,59.53,410.16,62
CDM,6306369,CATH GUIDE LVL 14,15334.0,3296.81,336.61,11500.5,39
CDM,6306401,INTGR BM FIX INT 10X12.5/SC,133.8,38.27,19.28,333.86,62
CDM,6306419,IMP LD NEUROSTIM LVL 09,39424.0,11275.26,5576.59,29568.0,42
CDM,6306427,INTGR BM FIX INT 10X25/SC,118.6,33.92,17.09,333.86,62
CDM,6306443,INTGR BM FIX INT 10X8/SC,297.7,85.14,42.9,333.86,62
CDM,6306450,INTGR BM FIX INT 20X25/SC,93.9,26.86,13.53,333.86,62
CDM,6306484,INTGR BM FIX INT 5X5/SC,422.0,120.69,49.53,333.86,62
CDM,6306625,IMP GEN NRSTM HF W BAT RECHG LVL 01,6105.0,1746.03,1135.53,111421.0,42
CDM,6306633,IMP GEN NRSTM HF W BAT RECHG LVL 02,9265.0,2649.79,1723.29,111421.0,42
CDM,6306641,IMP GEN NRSTM HF W BAT RECHG LVL 03,13895.0,3973.97,2584.47,111421.0,42
CDM,6306658,IMP GEN NRSTM HF W BAT RECHG LVL 04,17524.0,5011.86,3259.46,111421.0,42
CDM,6306666,IMP GEN NRSTM HF W BAT RECHG LVL 05,21904.0,6264.54,4074.14,111421.0,42
CDM,6306674,IMP GEN NRSTM HF W BAT RECHG LVL 06,26284.0,7517.22,4888.82,111421.0,42
CDM,6306682,IMP GEN NRSTM HF W BAT RECHG LVL 07,30664.0,8769.9,5703.5,111421.0,42
CDM,6306872,IMP NRSTM SEN TV&LD STIM LVL 01,21904.0,6264.54,4074.14,111421.0,42
CDM,6306880,IMP NRSTM SEN TV&LD STIM LVL 02,43804.0,12527.94,8147.54,111421.0,42
CDM,6306898,IMP NRSTM SEN TV&LD STIM LVL 03,65704.0,18791.34,12220.94,111421.0,42
CDM,6306906,IMP NRSTM SEN TV&LD STIM LVL 04,87604.0,25054.74,16294.34,111421.0,42
CDM,6306914,IMP NRSTM SEN TV&LD STIM LVL 05,109504.0,31318.14,20367.74,111421.0,42
CDM,6306922,IMP NRSTM SEN TV&LD STIM LVL 06,131404.0,37581.54,24441.14,111421.0,42
CDM,6306930,IMP NRSTM SEN TV&LD STIM LVL 07,153304.0,43844.94,28514.54,114978.0,42
CDM,6306948,IMP ANCHOR/SCREW/WASHER/NUT LVL 01,70.0,20.02,13.02,1363.66,42
CDM,6306955,IMP ANCHOR/SCREW/WASHER/NUT LVL 02,102.0,29.17,18.97,1363.66,42
CDM,6306963,IMP ANCHOR/SCREW/WASHER/NUT LVL 03,166.0,47.48,30.88,1363.66,42
CDM,6306971,IMP ANCHOR/SCREW/WASHER/NUT LVL 04,221.0,63.21,41.11,1363.66,42
CDM,6306989,IMP ANCHOR/SCREW/WASHER/NUT LVL 05,313.0,89.52,58.22,1363.66,42
CDM,6306997,IMP ANCHOR/SCREW/WASHER/NUT LVL 06,447.0,127.84,83.14,1363.66,42
CDM,6307003,IMP ANCHOR/SCREW/WASHER/NUT LVL 07,594.0,169.88,110.48,1363.66,42
CDM,6307011,IMP ANCHOR/SCREW/WASHER/NUT LVL 08,850.0,243.1,158.1,1363.66,42
CDM,6307029,IMP ANCHOR/SCREW/WASHER/NUT LVL 09,1132.0,323.75,210.55,1363.66,42
CDM,6307037,IMP ANCHOR/SCREW/WASHER/NUT LVL 10,1413.0,404.12,262.82,1363.66,42
CDM,6307045,IMP ANCHOR/SCREW/WASHER/NUT LVL 11,1619.0,463.03,301.13,1363.66,42
CDM,6307052,IMP ANCHOR/SCREW/WASHER/NUT LVL 12,2695.0,770.77,501.27,2021.25,42
CDM,6307060,IMP ANCHOR/SCREW/WASHER/NUT LVL 13,3853.0,1101.96,716.66,2889.75,42
CDM,6307078,IMP ANCHOR/SCREW/WASHER/NUT LVL 14,4885.0,1397.11,908.61,3663.75,42
CDM,6307086,IMP ANCHOR/SCREW/WASHER/NUT LVL 15,6105.0,1746.03,1003.99,4578.75,42
CDM,6307094,IMP ANCHOR/SCREW/WASHER/NUT LVL 16,6950.0,1987.7,1003.99,5212.5,42
CDM,6307102,IMP ANCHOR/SCREW/WASHER/NUT LVL 17,9265.0,2649.79,1003.99,6948.75,42
CDM,6307110,IMP ANCHOR/SCREW/WASHER/NUT LVL 18,11580.0,3311.88,1003.99,8685.0,42
CDM,6307128,IMP ANCHOR/SCREW/WASHER/NUT LVL 19,13895.0,3973.97,1003.99,10421.25,42
CDM,6307136,IMP ANCHOR/SCREW/WASHER/NUT LVL 20,17524.0,5011.86,1003.99,13143.0,42
CDM,6307144,IMP ANCHOR/SCREW/WASHER/NUT LVL 21,21904.0,6264.54,1003.99,16428.0,42
CDM,6307151,IMP RV/AD/RP SHDR CUP LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6307169,IMP RV/AD/RP SHDR CUP LVL 02,2695.0,770.77,501.27,7467.6,42
CDM,6307177,IMP RV/AD/RP SHDR CUP LVL 03,3853.0,1101.96,716.66,7467.6,42
CDM,6307219,IMP CABLE LVL 14,21904.0,6264.54,1312.53,16428.0,42
CDM,6307227,IMP ANCHOR/SCREW/WASHER/NUT LVL 22,26284.0,7517.22,1003.99,19713.0,42
CDM,6307235,IMP ANCHOR/SCREW/WASHER/NUT LVL 23,30664.0,8769.9,1003.99,22998.0,42
CDM,6307284,SUPPLY PERFUSION/ECMO LVL 19,52564.0,11301.26,7574.47,39423.0,29
CDM,6307292,SUPPLY PERFUSION/ECMO LVL 20,61324.0,13184.66,8836.79,45993.0,29
CDM,6307300,SUPPLY PERFUSION/ECMO LVL 21,70084.0,15068.06,10099.1,52563.0,29
CDM,6307318,SUPPLY PERFUSION/ECMO LVL 22,83224.0,17893.16,11992.58,62418.0,29
CDM,6307326,SUPPLY PERFUSION/ECMO LVL 23,96364.0,20718.26,13886.05,72273.0,29
CDM,6307342,IMP ROD/NAIL LVL 23,98554.0,28186.44,1003.99,73915.5,42
CDM,6307367,GRAFIX PL PRIME FIX INT 16MMDISK/SC,692.6,198.08,99.8,519.45,62
CDM,6307383,GRAFIX PRIME FIX INT 16MMDISK/SC,692.6,198.08,99.8,519.45,62
CDM,6307391,IMP PCMKR SGL RR LVL 10,52564.0,15926.89,9776.9,41774.56,42
CDM,6307409,CYTAL MTRX 2LYR FIX INT 10X15/SC,39.6,11.33,5.71,410.16,62
CDM,6307425,DURAL SLNT ADHERUS AUTOSPRAY,4621.8,1321.83,859.65,3466.35,42
CDM,6307433,DURAL SLNT ADHERUS AUTOSPRAY ET,1756.0,502.22,326.62,1782.74,42
CDM,6307565,SURGICAL SLNT COSEAL ADH VASC 4ML,1273.7,364.28,236.91,1782.74,42
CDM,6307581,SURGICAL SLNT COSEAL PREMIX 8ML,1970.2,563.48,366.46,1782.74,42
CDM,6307821,SEALANT SYS DURASEAL 5ML,2180.2,623.54,405.52,1782.74,42
CDM,6307839,SPINE SLNT DURASEAL SYS 3ML 5U,1867.0,533.96,347.26,1782.74,42
CDM,6307847,SPINE SLNT DURASEAL SYS 5ML 5U,4246.5,1214.5,789.85,3184.88,42
CDM,6307953,FBR SLNT TISSEEL W DPLJECT SYS 10ML,2404.8,517.03,346.53,1803.6,29
CDM,6307979,FBR SLNT TISSEEL W DPLJECT SYS 4ML,969.0,208.34,139.63,726.75,29
CDM,6307987,FBR SLNT TISSEEL W PRIMA 10ML SYR,2256.9,485.23,325.22,1692.67,29
CDM,6307995,FBR SLNT TISSEEL W PRIMA 4ML SYR,644.3,138.52,92.84,483.23,29
CDM,6308001,FBR SLNT TISSEEL THROMBIN FRZ 4ML,909.6,195.56,131.07,682.2,29
CDM,6308019,FBR SLNT TISSEEL VALUE PACK 2ML,432.5,92.99,62.32,324.38,29
CDM,6308035,GRAFIX PRIME FIX EXT 3X4/SC,314.3,89.58,45.29,410.16,63
CDM,6308282,FLEXHD PLIABLE FIX INT 10X17 THN/SC,88.9,25.43,29.07,222.5,66
CDM,6308399,CANNULA LVL 20,61324.0,13184.66,8836.79,45993.0,29
CDM,6308423,IMP FIBROCARTILAGE HMN/SYNTH LVL 01,1413.0,404.12,262.82,1782.74,42
CDM,6308431,IMP FIBROCARTILAGE HMN/SYNTH LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,6308449,IMP FIBROCARTILAGE HMN/SYNTH LVL 03,3853.0,1101.96,716.66,2889.75,42
CDM,6308456,IMP FIBROCARTILAGE HMN/SYNTH LVL 04,6105.0,1746.03,1135.53,4578.75,42
CDM,6308464,IMP FIBROCARTILAGE HMN/SYNTH LVL 05,9265.0,2649.79,1312.53,6948.75,42
CDM,6308472,IMP FIBROCARTILAGE HMN/SYNTH LVL 06,13895.0,3973.97,1312.53,10421.25,42
CDM,6308480,IMP FIBROCARTILAGE HMN/SYNTH LVL 07,17524.0,5011.86,1312.53,13143.0,42
CDM,6308498,IMP FIBROCARTILAGE HMN/SYNTH LVL 08,21904.0,6264.54,1312.53,16428.0,42
CDM,6308639,AMNIOBAND FIX INT 2X2/SC,436.6,124.87,132.79,410.16,66
CDM,6308647,AMNIOBAND FIX INT 2X3/SC,304.7,87.14,99.64,410.16,66
CDM,6308654,AMNIOBAND FIX INT 2X4/SC,359.8,102.9,117.65,410.16,66
CDM,6308662,AMNIOBAND FIX INT 3X4/SC,247.9,70.9,81.06,410.16,66
CDM,6308753,AMNIOBAND FIX INT 16MM DISK/SC,488.0,139.57,132.79,410.16,66
CDM,6308787,IMP COIL EMBOLIZATION LVL 11,17524.0,5011.86,1312.53,13143.0,42
CDM,6308795,IMP COIL EMBOLIZATION LVL 12,19714.0,5638.2,1312.53,14785.5,42
CDM,6308803,HEMOSTATIC AGENT GI TOP LVL 01,313.0,67.3,58.22,234.75,39
CDM,6308811,HEMOSTATIC AGENT GI TOP LVL 02,1413.0,303.8,135.66,1059.75,39
CDM,6308829,HEMOSTATIC AGENT GI TOP LVL 03,2695.0,579.42,135.66,2021.25,39
CDM,6308837,HEMOSTATIC AGENT GI TOP LVL 04,3853.0,828.4,135.66,2889.75,39
CDM,6308845,HEMOSTATIC AGENT GI TOP LVL 05,6105.0,1312.58,135.66,4578.75,39
CDM,6308852,HEMOSTATIC AGENT GI TOP LVL 06,9265.0,1991.98,135.66,6948.75,39
CDM,6308860,HEMOSTATIC AGENT GI TOP LVL 07,13895.0,2987.42,135.66,10421.25,39
CDM,6308878,IMP GEN CCM OPTIMIZER SMART,176923.0,50599.98,32907.68,132692.25,42
CDM,6308894,VAD RPL CABLE PWR MOD DL 0-12,18117.0,6993.16,95.5,13587.75,42
CDM,6308902,VAD RPL CABLE PWR MOD DL 12+,18117.0,6993.16,95.5,13587.75,42
CDM,6308910,IMP GEN NRSTM HF W BAT RECHG LVL 08,43804.0,12527.94,8147.54,111421.0,42
CDM,6308928,IMP GEN NRSTM HF W BAT RECHG LVL 09,65704.0,18791.34,12220.94,111421.0,42
CDM,6308936,IMP GEN NRSTM HF W BAT RECHG LVL 10,87604.0,25054.74,16294.34,111421.0,42
CDM,6308944,IMP GEN NRSTM HF W BAT RECHG LVL 11,109504.0,31318.14,20367.74,111421.0,42
CDM,6308951,IMP SYS VERTEBRAL AUG SPINEJACK,13720.0,3923.92,2551.92,13802.9,42
CDM,6308977,IMP PROSTH PENILE NONINF LVL 09,50374.0,14406.96,9369.56,37780.5,42
CDM,6308985,IMP PROSTH PENILE NONINF LVL 10,54754.0,15659.64,10184.24,41065.5,42
CDM,6309165,LASER PROBE LVL 06,19714.0,4238.51,2840.79,14785.5,29
CDM,6309173,LASER PROBE LVL 07,26284.0,5651.06,3787.52,19713.0,29
CDM,6309181,LASER PROBE LVL 08,32854.0,7063.61,4734.26,24640.5,29
CDM,6309199,LASER PROBE LVL 09,39424.0,8476.16,5681.0,29568.0,29
CDM,6309215,CATH ANGIO TRANSL NONLASER LVL 11,15772.0,3390.98,548.37,11829.0,39
CDM,6309223,CATH ANGIO TRANSL NONLASER LVL 12,19276.0,4144.34,548.37,14457.0,39
CDM,6309231,CATH ANGIO TRANSL NONLASER LVL 13,22780.0,4897.7,548.37,17085.0,39
CDM,6309256,IMP SEALANT PULMONARY LIQUID LVL 02,3596.0,1028.46,668.86,3552.17,42
CDM,6309264,IMP SEALANT PULMONARY LIQUID LVL 03,4397.0,1257.54,817.84,3552.17,42
CDM,6309272,IMP SEALANT PULMONARY LIQUID LVL 04,6105.0,1746.03,1135.53,4578.75,42
CDM,6309298,IMP RV/AD/RP ANKLE DOME LVL 11,39424.0,11275.26,5497.98,29568.0,42
CDM,6309306,IMP RV/AD/RP ANKLE DOME LVL 12,43804.0,12527.94,5497.98,32853.0,42
CDM,6309314,IMP RV/AD/RP ANKLE DOME LVL 13,48184.0,13780.62,5497.98,36138.0,42
CDM,6309322,IMP RV/AD/RP ANKLE DOME LVL 14,52564.0,15033.3,5497.98,39423.0,42
CDM,6309330,CATH TLA NONLASER DRUG COAT LVL 13,13895.0,2987.42,2584.47,10421.25,39
CDM,6309355,IMP DEV ASSIST VENTRICULR LVL 01,240904.0,68898.54,1312.53,180678.0,42
CDM,6309363,IMP DEV ASSIST VENTRICULR LVL 02,262804.0,75161.94,1312.53,197103.0,42
CDM,6309371,IMP DEV ASSIST VENTRICULR LVL 03,284704.0,81425.34,1312.53,213528.0,42
CDM,6309389,IMP DEV ASSIST VENTRICULR LVL 04,306604.0,87688.74,1312.53,229953.0,42
CDM,6309397,IMP DEV ASSIST VENTRICULR LVL 05,328504.0,93952.14,1312.53,246378.0,42
CDM,6309405,IMP DEV ASSIST VENTRICULR LVL 06,350404.0,100215.54,1312.53,262803.0,42
CDM,6309413,IMP DEV ASSIST VENTRICULR LVL 07,372304.0,106478.94,1312.53,279228.0,42
CDM,6309421,IMP DEV ASSIST VENTRICULR LVL 08,394204.0,112742.34,1312.53,295653.0,42
CDM,6309439,IMP DEV ASSIST VENTRICULR LVL 09,416104.0,119005.74,1312.53,312078.0,42
CDM,6309447,IMP DEV ASSIST VENTRICULR LVL 10,438004.0,125269.14,1312.53,328503.0,42
CDM,6309454,IMP LD NEUROSTIM LVL 10,43804.0,12527.94,5576.59,32853.0,42
CDM,6309504,CATH LITHO TRANSL INTRAVASC LVL 01,4885.0,1050.28,908.61,10952.52,39
CDM,6309512,CATH LITHO TRANSL INTRAVASC LVL 02,6950.0,1494.25,1292.7,10952.52,39
CDM,6309520,CATH LITHO TRANSL INTRAVASC LVL 03,9265.0,1991.98,1723.29,10952.52,39
CDM,6309538,CATH LITHO TRANSL INTRAVASC LVL 04,11580.0,2489.7,2153.88,10952.52,39
CDM,6309546,CATH LITHO TRANSL INTRAVASC LVL 05,13895.0,2987.42,2584.47,10952.52,39
CDM,6309553,CATH LITHO TRANSL INTRAVASC LVL 06,15334.0,3296.81,2852.12,11500.5,39
CDM,6309561,CATH LITHO TRANSL INTRAVASC LVL 07,17524.0,3767.66,3259.46,13143.0,39
CDM,6309579,CATH LITHO TRANSL INTRAVASC LVL 08,19714.0,4238.51,3666.8,14785.5,39
CDM,6309587,CATH LITHO TRANSL INTRAVASC LVL 09,21904.0,4709.36,4074.14,16428.0,39
CDM,6309611,PMA P140026 DEV SYS CAS ENROUTE,11676.0,3841.75,2171.74,8757.0,36
CDM,6309629,CATH OCC VALV 1WAY PRESS GEN LVL 01,4885.0,1397.11,908.61,3663.75,42
CDM,6309637,CATH OCC VALV 1WAY PRESS GEN LVL 02,6950.0,1987.7,1292.7,5212.5,42
CDM,6309645,CATH OCC VALV 1WAY PRESS GEN LVL 03,9265.0,2649.79,1441.19,6948.75,42
CDM,6309652,CATH OCC VALV 1WAY PRESS GEN LVL 04,11580.0,3311.88,1441.19,8685.0,42
CDM,6309660,CATH OCC VALV 1WAY PRESS GEN LVL 05,13895.0,3973.97,1441.19,10421.25,42
CDM,6309678,CATH OCC VALV 1WAY PRESS GEN LVL 06,17524.0,5011.86,1441.19,13143.0,42
CDM,6309686,CATH OCC VALV 1WAY PRESS GEN LVL 07,21904.0,6264.54,1441.19,16428.0,42
CDM,6309694,CATH OCC VALV 1WAY PRESS GEN LVL 08,26284.0,7517.22,1441.19,19713.0,42
CDM,6309702,CATH OCC VALV 1WAY PRESS GEN LVL 09,30664.0,8769.9,1441.19,22998.0,42
CDM,6309710,CATH OCC VALV 1WAY PRESS GEN LVL 10,35044.0,10022.58,1441.19,26283.0,42
CDM,6309728,SEALANT SURG PREVELEAK 4ML,2181.2,468.96,314.31,1635.9,29
CDM,6309769,IMP MTRX DEV/DRUG BN/TIS-BN LVL 01,313.0,89.52,58.22,1629.74,42
CDM,6309777,IMP MTRX DEV/DRUG BN/TIS-BN LVL 02,1413.0,404.12,262.82,1629.74,42
CDM,6309785,IMP MTRX DEV/DRUG BN/TIS-BN LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6309793,IMP MTRX DEV/DRUG BN/TIS-BN LVL 04,3853.0,1101.96,716.66,2889.75,42
CDM,6309801,IMP MTRX DEV/DRUG BN/TIS-BN LVL 05,6105.0,1746.03,1135.53,4578.75,42
CDM,6309819,IMP MTRX DEV/DRUG BN/TIS-BN LVL 06,9265.0,2649.79,1199.89,6948.75,42
CDM,6309827,IMP MTRX DEV/DRUG BN/TIS-BN LVL 07,13895.0,3973.97,1199.89,10421.25,42
CDM,6309835,IMP MTRX DEV/DRUG BN/TIS-BN LVL 08,17524.0,5011.86,1199.89,13143.0,42
CDM,6309843,CATH THROMBECTOMY/EMBOLECTMY LVL 17,43804.0,9417.86,575.51,32853.0,39
CDM,6309850,CATH THROMBECTOMY/EMBOLECTMY LVL 18,48184.0,10359.56,575.51,36138.0,39
CDM,6309868,ENDOSCOPE SINGLE USE UGI LVL 01,313.0,67.3,58.22,2301.59,39
CDM,6309876,ENDOSCOPE SINGLE USE UGI LVL 02,1413.0,303.8,262.82,2301.59,39
CDM,6309884,ENDOSCOPE SINGLE USE UGI LVL 03,2695.0,579.42,501.27,2301.59,39
CDM,6309892,ENDOSCOPE SINGLE USE UGI LVL 04,3853.0,828.4,716.66,2889.75,39
CDM,6309900,ENDOSCOPE SINGLE USE UGI LVL 05,6105.0,1312.58,1135.53,4578.75,39
CDM,6309918,ENDOSCOPE SINGLE USE UGI LVL 06,9265.0,1991.98,1694.54,6948.75,39
CDM,6309926,ENDOSCOPE SINGLE USE UGI LVL 07,13895.0,2987.42,1694.54,10421.25,39
CDM,6309934,IMP PUMP VALVE BLOOD LVL 14,162064.0,46350.3,1312.53,121548.0,42
CDM,6309942,IMP PUMP VALVE BLOOD LVL 15,170824.0,48855.66,1312.53,128118.0,42
CDM,6309959,IMP PUMP VALVE BLOOD LVL 16,179584.0,51361.02,1312.53,134688.0,42
CDM,6309967,INTRO EP FIX CRV NONPEEL LVL 06,4885.0,1050.28,489.85,3663.75,39
CDM,6309975,INTRO EP FIX CRV NONPEEL LVL 07,6105.0,1312.58,489.85,4578.75,39
CDM,6309983,INTRO EP FIX CRV NONPEEL LVL 08,6950.0,1494.25,489.85,5212.5,39
CDM,6309991,INTRO EP FIX CRV NONPEEL LVL 09,8107.0,1743.0,489.85,6080.25,39
CDM,6310031,CLIP LVL 10,8107.0,1743.0,1168.22,6080.25,29
CDM,6310056,IMP PUMP VALVE BLOOD LVL 01,30664.0,8769.9,1312.53,22998.0,42
CDM,6310064,IMP PUMP VALVE BLOOD LVL 02,39424.0,11275.26,1312.53,29568.0,42
CDM,6310072,IMP PUMP VALVE BLOOD LVL 03,52564.0,15033.3,1312.53,39423.0,42
CDM,6310080,IMP PUMP VALVE BLOOD LVL 04,65704.0,18791.34,1312.53,49278.0,42
CDM,6310098,FIX EXTRNL LW/UP/PELVIC LVL 29,157684.0,33902.06,22722.26,118263.0,29
CDM,6310106,FIX EXTRNL LW/UP/PELVIC LVL 30,175204.0,37668.86,25246.9,131403.0,29
CDM,6310114,FIX EXTRNL LW/UP/PELVIC LVL 31,192724.0,41435.66,27771.53,144543.0,29
CDM,6310122,FIX EXTRNL LW/UP/PELVIC LVL 32,210244.0,45202.46,30296.16,157683.0,29
CDM,6310130,OCCLUDER LVL 06,39424.0,8476.16,5681.0,29568.0,29
CDM,6310148,OCCLUDER LVL 07,48184.0,10359.56,6943.31,36138.0,29
CDM,6310155,OCCLUDER LVL 08,56944.0,12242.96,8205.63,42708.0,29
CDM,6310163,OCCLUDER LVL 09,65704.0,14126.36,9467.95,49278.0,29
CDM,6310171,OCCLUDER LVL 10,74464.0,16009.76,10730.26,55848.0,29
CDM,6310189,OCCLUDER LVL 11,83224.0,17893.16,11992.58,62418.0,29
CDM,6310205,IDE G180266 IMP SYS TVRS PASCAL,128100.0,42148.74,1312.53,96075.0,36
CDM,6310213,SENSOR IMAGING EP LVL 01,594.0,127.71,85.6,445.5,29
CDM,6310221,SENSOR IMAGING EP LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6310239,SENSOR IMAGING EP LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6310247,SENSOR IMAGING EP LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6310254,SENSOR IMAGING EP LVL 05,6105.0,1312.58,879.73,4578.75,29
CDM,6310262,SENSOR IMAGING EP LVL 06,9265.0,1991.98,1335.09,6948.75,29
CDM,6310270,CATH KEY EP LVL 01,594.0,127.71,85.6,445.5,29
CDM,6310288,CATH KEY EP LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6310296,CATH KEY EP LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6310304,CATH KEY EP LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6310312,CATH KEY EP LVL 05,6105.0,1312.58,879.73,4578.75,29
CDM,6310320,CATH KEY EP LVL 06,9265.0,1991.98,1335.09,6948.75,29
CDM,6310353,IMP RV/AD/RP ELBOW STEM LVL 05,26284.0,7517.22,4888.82,19713.0,42
CDM,6310361,IMP RV/AD/RP ELBOW STEM LVL 06,30664.0,8769.9,5497.98,22998.0,42
CDM,6310379,IMP RV/AD/RP ELBOW STEM LVL 07,35044.0,10022.58,5497.98,26283.0,42
CDM,6310403,IMP DEV EMBOLIZATION ANEUR LVL 07,74464.0,21296.7,1312.53,55848.0,42
CDM,6310429,CATH BALLOON DILAT NONVASC LVL 07,17524.0,3767.66,2427.94,13143.0,39
CDM,6310437,IMP FIX LW/UP/PELVIC LVL 10,35044.0,10022.58,1003.99,26283.0,42
CDM,6310445,IMP FIX LW/UP/PELVIC LVL 11,43804.0,12527.94,1003.99,32853.0,42
CDM,6310452,IMP FIX LW/UP/PELVIC LVL 12,52564.0,15033.3,1003.99,39423.0,42
CDM,6310460,IMP FIX LW/UP/PELVIC LVL 13,61324.0,17538.66,1003.99,45993.0,42
CDM,6310478,IMP FIX LW/UP/PELVIC LVL 14,70084.0,20044.02,1003.99,52563.0,42
CDM,6310486,IMP FIX LW/UP/PELVIC LVL 15,78844.0,22549.38,1003.99,59133.0,42
CDM,6310502,IMP ANCHOR FIX NON BONE LVL 09,30664.0,8769.9,1312.53,22998.0,42
CDM,6310510,IMP ANCHOR FIX NON BONE LVL 10,39424.0,11275.26,1312.53,29568.0,42
CDM,6310528,IMP ANCHOR FIX NON BONE LVL 11,52564.0,15033.3,1312.53,39423.0,42
CDM,6310536,IMP ANCHOR FIX NON BONE LVL 12,65704.0,18791.34,1312.53,49278.0,42
CDM,6310544,IMP ANCHOR FIX NON BONE LVL 13,78844.0,22549.38,1312.53,59133.0,42
CDM,6310551,IMP ANCHOR FIX NON BONE LVL 14,87604.0,25054.74,1312.53,65703.0,42
CDM,6310569,IMP ANCHOR FIX NON BONE LVL 15,100744.0,28812.78,1312.53,75558.0,42
CDM,6310577,IMP ANCHOR FIX NON BONE LVL 16,109504.0,31318.14,1312.53,82128.0,42
CDM,6310585,FLEX HD FIX INT 20X30 THCK ULT/SC,71.4,20.42,23.35,222.5,66
CDM,6310742,IMP RV/AD/RP ANKLE INSR/TRAY LVL 13,48184.0,13780.62,5497.98,36138.0,42
CDM,6310759,IMP RV/AD/RP ANKLE INSR/TRAY LVL 14,52564.0,15033.3,5497.98,39423.0,42
CDM,6310767,IMP RV/AD/RP ANKLE INSR/TRAY LVL 15,56944.0,16285.98,5497.98,42708.0,42
CDM,6310809,IMP RV/AD/RP ANKLE DOME LVL 15,56944.0,16285.98,5497.98,42708.0,42
CDM,6310817,IMP RV/AD/RP ANKLE DOME LVL 16,61324.0,17538.66,5497.98,45993.0,42
CDM,6310825,IMP RV/AD/RP ANKLE DOME LVL 17,65704.0,18791.34,5497.98,49278.0,42
CDM,6310833,IMP RV/AD/RP ANKLE DOME LVL 18,70084.0,20044.02,5497.98,52563.0,42
CDM,6310841,IMP STENT NOS LVL 27,109504.0,31318.14,1312.53,82128.0,42
CDM,6310858,IMP STENT NOS LVL 28,131404.0,37581.54,1312.53,98553.0,42
CDM,6310866,IMP STENT NOS LVL 29,153304.0,43844.94,1312.53,114978.0,42
CDM,6310890,IMP STENT COAT WO DEL LVL 01,1413.0,404.12,262.82,3671.9,42
CDM,6310908,IMP STENT COAT WO DEL LVL 02,2695.0,770.77,501.27,3671.9,42
CDM,6310916,IMP STENT COAT WO DEL LVL 03,3853.0,1101.96,716.66,3671.9,42
CDM,6310924,IMP STENT COAT WO DEL LVL 04,4885.0,1397.11,908.61,3671.9,42
CDM,6310932,IMP STENT COAT WO DEL LVL 05,6945.0,1986.27,1291.77,5208.75,42
CDM,6310981,IMP RV/AD/RP ELBOW HEAD LVL 01,1413.0,404.12,262.82,7467.6,42
CDM,6310999,IMP RV/AD/RP ELBOW HEAD LVL 02,2695.0,770.77,501.27,7467.6,42
CDM,6311005,CATH ABL CRYO BALLOON LVL 01,594.0,127.71,85.6,445.5,29
CDM,6311013,CATH ABL CRYO BALLOON LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6311021,CATH ABL CRYO BALLOON LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6311039,CATH ABL CRYO BALLOON LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6311047,CATH ABL CRYO BALLOON LVL 05,4880.0,1049.2,703.21,3660.0,29
CDM,6311054,CATH ABL CRYO BALLOON LVL 06,5861.0,1260.12,844.57,4395.75,29
CDM,6311062,CATH ABL CRYO BALLOON LVL 07,6487.0,1394.7,934.78,4865.25,29
CDM,6311070,CATH ABL CRYO BALLOON LVL 08,7413.0,1593.8,1068.21,5559.75,29
CDM,6311112,IDE G200042 IMP GEN CCM OPTIM SMART,66144.0,21763.36,12302.78,55710.5,36
CDM,6311187,IDE G140240 DEV SYS VALVE MITRAL,109800.0,36127.49,1312.53,82350.0,36
CDM,6311211,PILLOW FETAL LVL 01,594.0,127.71,85.6,445.5,29
CDM,6311229,PILLOW FETAL LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6311237,PILLOW FETAL LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6311245,PILLOW FETAL LVL 04,3853.0,828.4,555.22,2889.75,29
CDM,6311286,IDE G220079 DEV SYS PFA FP PVI,22260.0,7324.21,1312.53,16695.0,36
CDM,6311294,IDE G220079 DEV SYS PFA FP PVI+CTI,28865.0,9497.45,1312.53,21648.75,36
CDM,6311484,IMP RV/AD/RP ANKLE INSR/TRAY LVL 16,65704.0,18791.34,5497.98,49278.0,42
CDM,6311567,IMP DEV SYS BAROSTIM,152211.0,43532.35,28311.25,114158.25,42
CDM,6311583,INTRO NON GD/EP/LASER LVL 11,15334.0,3296.81,183.22,11500.5,39
CDM,6311591,INTRO NON GD/EP/LASER LVL 12,17524.0,3767.66,183.22,13143.0,39
CDM,6311609,INTRO NON GD/EP/LASER LVL 13,19714.0,4238.51,183.22,14785.5,39
CDM,6311633,ENDOSCOPE SINGLE USE UT LVL 01,313.0,67.3,58.22,1537.74,39
CDM,6311641,ENDOSCOPE SINGLE USE UT LVL 02,1413.0,303.8,262.82,1537.74,39
CDM,6311658,ENDOSCOPE SINGLE USE UT LVL 03,2695.0,579.42,501.27,2021.25,39
CDM,6311666,ENDOSCOPE SINGLE USE UT LVL 04,3853.0,828.4,716.66,2889.75,39
CDM,6311674,ENDOSCOPE SINGLE USE UT LVL 05,6105.0,1312.58,1132.16,4578.75,39
CDM,6311682,ENDOSCOPE SINGLE USE UT LVL 06,9265.0,1991.98,1132.16,6948.75,39
CDM,6311690,ENDOSCOPE SINGLE USE UT LVL 07,13895.0,2987.42,1132.16,10421.25,39
CDM,6311740,IMP SLEEVE SMIT INTRAUTERINE LVL 01,166.0,47.48,30.88,1782.74,42
CDM,6311757,IMP SLEEVE SMIT INTRAUTERINE LVL 02,313.0,89.52,58.22,1782.74,42
CDM,6311765,IMP SLEEVE SMIT INTRAUTERINE LVL 03,594.0,169.88,110.48,1782.74,42
CDM,6311781,CATH ABL TISSUE INSERT LVL 03,13895.0,2987.42,951.39,10421.25,39
CDM,6311799,CATH ABL TISSUE INSERT LVL 04,17524.0,3767.66,951.39,13143.0,39
CDM,6311807,CATH ABL TISSUE INSERT LVL 05,21904.0,4709.36,951.39,16428.0,39
CDM,6311815,IMP OCULAR LVL 01,166.0,47.48,30.88,1548.72,43
CDM,6311823,IMP OCULAR LVL 02,313.0,89.52,58.22,1548.72,43
CDM,6311831,IMP OCULAR LVL 03,594.0,169.88,110.48,1548.72,43
CDM,6311849,IMP OCULAR LVL 04,1413.0,404.12,262.82,1548.72,43
CDM,6311856,IMP OCULAR LVL 05,2695.0,770.77,452.85,2021.25,43
CDM,6311898,IDE G220229 DEV SYS CRYOABLATION VT,26280.0,8646.91,1700.61,19710.0,36
CDM,6311906,ELECTRODE ELECTROSURGICAL LVL 15,24094.0,5180.21,3471.95,18070.5,29
CDM,6311914,IMP DEV JT SHDR TOTAL LVL 19,78844.0,22549.38,5497.98,59133.0,42
CDM,6311922,IMP DEV JT SHDR TOTAL LVL 20,87604.0,25054.74,5497.98,65703.0,42
CDM,6311948,IMP AGENT SYNTHETIC BULK 1ML LVL 07,3591.0,1027.03,176.16,2693.25,43
CDM,6311955,IMP AGENT SYNTHETIC BULK 1ML LVL 08,6105.0,1746.03,176.16,4578.75,43
CDM,6312102,DEVICE SYS DELIVERY DISP LVL 07,6105.0,1312.58,879.73,4578.75,29
CDM,6312110,DEVICE SYS DELIVERY DISP LVL 08,9265.0,1991.98,1335.09,6948.75,29
CDM,6312151,HANDPIECE LVL 13,43804.0,9417.86,6312.16,32853.0,29
CDM,6312185,FIX EXTRNL LW/UP/PELVIC LVL 33,227764.0,48969.26,32820.79,170823.0,29
CDM,6312193,FIX EXTRNL LW/UP/PELVIC LVL 34,245284.0,52736.06,35345.42,183963.0,29
CDM,6312201,FIX EXTRNL LW/UP/PELVIC LVL 35,262804.0,56502.86,37870.06,197103.0,29
CDM,6312219,FIX EXTRNL LW/UP/PELVIC LVL 36,280324.0,60269.66,40394.69,210243.0,29
CDM,6312227,CATH THROMBECTOMY/EMBO DVT PPP,27531.0,5919.16,575.51,20648.25,39
CDM,6312235,INTRO NON GD/EP/LASER DVT PPP,7509.0,2147.57,183.22,5631.75,42
CDM,6312243,CATH THROMBECTOMY/EMBO VTE PPP,37856.0,8139.04,575.51,28392.0,39
CDM,6312250,INTRO NON GD/EP/LASER VTE PPP,10324.0,2952.66,183.22,7743.0,42
CDM,6312268,IMP DEV JT ANKLE TOTAL LVL 18,61324.0,17538.66,5497.98,45993.0,42
CDM,6312276,IMP DEV JT ANKLE TOTAL LVL 19,65704.0,18791.34,5497.98,49278.0,42
CDM,6312292,IMP GEN NRSTM W LD&CNTRL EP LVL 01,30664.0,8769.9,5703.5,55710.5,42
CDM,6312300,IMP GEN NRSTM W LD&CNTRL EP LVL 02,43804.0,12527.94,8147.54,55710.5,42
CDM,6312318,IMP GEN NRSTM W LD&CNTRL EP LVL 03,65704.0,18791.34,12220.94,55710.5,42
CDM,6312326,IMP GEN NRSTM W LD&CNTRL EP LVL 04,87604.0,25054.74,16294.34,65703.0,42
CDM,6312334,IMP GEN NRSTM W LD&CNTRL EP LVL 05,109504.0,31318.14,20367.74,82128.0,42
CDM,6312342,IMP GEN NRSTM W LD&CNTRL EP LVL 06,131404.0,37581.54,24441.14,98553.0,42
CDM,6312359,IMP ADHSN BARRIER 30+ DAYS LVL 01,850.0,243.1,158.1,1201.48,42
CDM,6312367,IMP ADHSN BARRIER 30+ DAYS LVL 02,2695.0,770.77,501.27,2021.25,42
CDM,6312375,IMP ADHSN BARRIER 30+ DAYS LVL 03,4885.0,1397.11,884.59,3663.75,42
CDM,6312383,IMP ADHSN BARRIER 30+ DAYS LVL 04,9265.0,2649.79,884.59,6948.75,42
CDM,6312417,IMP CATH DRAINAGE 30+ DAYS LVL 01,594.0,169.88,110.48,445.5,42
CDM,6312425,IMP CATH DRAINAGE 30+ DAYS LVL 02,1888.0,539.97,236.01,1416.0,42
CDM,6312433,IMP CATH DRAINAGE 30+ DAYS LVL 03,2695.0,770.77,236.01,2021.25,42
CDM,6312441,IMP CATH DRAINAGE 30+ DAYS LVL 04,3853.0,1101.96,236.01,2889.75,42
CDM,6312458,IMP CATH DRAINAGE 30+ DAYS LVL 05,6105.0,1746.03,236.01,4578.75,42
CDM,6312466,IMP TUBE TRACH 30+ DAYS LVL 01,313.0,89.52,58.22,1782.74,42
CDM,6312474,IMP TUBE TRACH 30+ DAYS LVL 02,594.0,169.88,110.48,1782.74,42
CDM,6312482,IMP TUBE TRACH 30+ DAYS LVL 03,850.0,243.1,158.1,1782.74,42
CDM,6312490,IMP TUBE TRACH 30+ DAYS LVL 04,1132.0,323.75,210.55,1782.74,42
CDM,6312508,IMP TUBE TRACH 30+ DAYS LVL 05,1413.0,404.12,262.82,1782.74,42
CDM,6312516,IMP TUBE TRACH 30+ DAYS LVL 06,1619.0,463.03,301.13,1782.74,42
CDM,6312524,IMP TUBE TRACH 30+ DAYS LVL 07,2157.0,616.9,401.2,1782.74,42
CDM,6312532,IMP TUBE TRACH 30+ DAYS LVL 08,2695.0,770.77,501.27,2021.25,42
CDM,6312540,ADHSN BARRIER IMP <30DAYS LVL 01,850.0,182.75,158.1,1201.48,39
CDM,6312557,ADHSN BARRIER IMP <30DAYS LVL 02,2695.0,579.42,501.27,2021.25,39
CDM,6312565,ADHSN BARRIER IMP <30DAYS LVL 03,4885.0,1050.28,884.59,3663.75,39
CDM,6312573,ADHSN BARRIER IMP <30DAYS LVL 04,9265.0,1991.98,884.59,6948.75,39
CDM,6312607,CATH DRAINAGE IMP <30DAYS LVL 01,594.0,127.71,110.48,445.5,39
CDM,6312615,CATH DRAINAGE IMP <30DAYS LVL 02,1888.0,405.92,236.01,1416.0,39
CDM,6312623,CATH DRAINAGE IMP <30DAYS LVL 03,2695.0,579.42,236.01,2021.25,39
CDM,6312631,CATH DRAINAGE IMP <30DAYS LVL 04,3853.0,828.4,236.01,2889.75,39
CDM,6312656,TUBE TRACH IMP <30DAYS LVL 01,313.0,67.3,45.1,234.75,29
CDM,6312664,TUBE TRACH IMP <30DAYS LVL 02,594.0,127.71,85.6,445.5,29
CDM,6312672,TUBE TRACH IMP <30DAYS LVL 03,850.0,182.75,122.48,637.5,29
CDM,6312680,TUBE TRACH IMP <30DAYS LVL 04,1132.0,243.38,163.12,849.0,29
CDM,6312698,TUBE TRACH IMP <30DAYS LVL 05,1413.0,303.8,203.61,1059.75,29
CDM,6312706,TUBE TRACH IMP <30DAYS LVL 06,1619.0,348.08,233.3,1214.25,29
CDM,6312714,TUBE TRACH IMP <30DAYS LVL 07,2157.0,463.76,310.82,1617.75,29
CDM,6312722,TUBE TRACH IMP <30DAYS LVL 08,2695.0,579.42,388.35,2021.25,29
CDM,6312730,CYTAL MTRX 3LYR FIX INT 16X35/SC,45.0,12.87,6.48,410.16,62
CDM,6312755,HANDPIECE LVL 14,48184.0,10359.56,6943.31,36138.0,29
CDM,6312896,IMP ROD/NAIL LVL 24,109504.0,31318.14,1003.99,82128.0,42
CDM,6312904,IMP CUFF APICAL HEART LVL 01,166.0,47.48,30.88,1782.74,42
CDM,6312912,IMP CUFF APICAL HEART LVL 02,313.0,89.52,58.22,1782.74,42
CDM,6312920,IMP CUFF APICAL HEART LVL 03,594.0,169.88,110.48,1782.74,42
CDM,6312938,IMP CUFF APICAL HEART LVL 04,1413.0,404.12,262.82,1782.74,42
CDM,6312946,IMP CUFF APICAL HEART LVL 05,2695.0,770.77,501.27,2021.25,42
CDM,6312953,IMP CUFF APICAL HEART LVL 06,3853.0,1101.96,716.66,2889.75,42
CDM,6312961,IMP CUFF APICAL HEART LVL 07,4885.0,1397.11,908.61,3663.75,42
CDM,6312979,IMP CUFF APICAL HEART LVL 08,6105.0,1746.03,1135.53,4578.75,42
CDM,6312987,IMP CUFF APICAL HEART LVL 09,9265.0,2649.79,1312.53,6948.75,42
CDM,6313001,DEVICE SYS HEM CNTRL UTR VAC LVL 01,166.0,35.69,23.92,124.5,29
CDM,6313019,DEVICE SYS HEM CNTRL UTR VAC LVL 02,313.0,67.3,45.1,234.75,29
CDM,6313027,DEVICE SYS HEM CNTRL UTR VAC LVL 03,594.0,127.71,85.6,445.5,29
CDM,6313035,DEVICE SYS HEM CNTRL UTR VAC LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6313043,DEVICE SYS HEM CNTRL UTR VAC LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6313050,DEVICE SYS HEM CNTRL UTR VAC LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6313068,DEVICE SYS HEM CNTRL UTR VAC LVL 07,4885.0,1050.28,703.93,3663.75,29
CDM,6313076,DEVICE SYS HEM CNTRL UTR VAC LVL 08,6105.0,1312.58,879.73,4578.75,29
CDM,6313084,DEVICE SYS HEM CNTRL UTR VAC LVL 09,9265.0,1991.98,1335.09,6948.75,29
CDM,6313100,TUBE TRACH IMP <30DAYS LVL 09,3853.0,828.4,555.22,2889.75,29
CDM,6313118,IMP TUBE TRACH 30+ DAYS LVL 09,3853.0,1101.96,716.66,2889.75,42
CDM,6313142,CATH ABL EP NON 3D/VECTOR LVL 09,34168.0,7346.12,3674.1,25626.0,39
CDM,6313159,CATH ABL EP NON 3D/VECTOR LVL 10,38548.0,8287.82,3674.1,28911.0,39
CDM,6313175,IMP GEN NRSTM W LD&CNTRL EP LVL 07,153304.0,43844.94,28514.54,114978.0,42
CDM,6313183,IMP GEN NRSTM W LD&CNTRL EP LVL 08,175204.0,50108.34,32587.94,131403.0,42
CDM,6313191,LASER PROBE LVL 10,45994.0,9888.71,6627.74,34495.5,29
CDM,6313209,LASER PROBE LVL 11,52564.0,11301.26,7574.47,39423.0,29
CDM,6313258,IDE G230249 DEV SYS PFA FARAPULSE,77088.0,25364.26,1312.53,57816.0,36
CDM,6313290,IMP TUBE TRACH 30+ DAYS LVL 10,6105.0,1746.03,1135.53,4578.75,42
CDM,6313308,IMP TUBE TRACH 30+ DAYS LVL 11,13895.0,3973.97,1312.53,10421.25,42
CDM,6313365,PROGRAMMER PT NEUROSTIM LVL 08,35044.0,10022.58,2813.08,26283.0,42
CDM,6313373,PROGRAMMER PT NEUROSTIM LVL 09,39424.0,11275.26,2813.08,29568.0,42
CDM,6313423,BRACHY STRND C-131/SRCE,7118.0,2035.75,52.1,5338.5,65
CDM,6313456,IMP RV/AD/RP SHDR LN/SL LVL 06,9265.0,2649.79,1723.29,7467.6,42
CDM,6313464,IMP RV/AD/RP SHDR LN/SL LVL 07,13895.0,3973.97,2584.47,10421.25,42
CDM,6313498,IMP CONNECTOR NERVE LVL 04,13895.0,3973.97,1312.53,10421.25,42
CDM,6313522,FIX EXTRNL LW/UP/PELVIC LVL 37,297844.0,64036.46,42919.32,223383.0,29
CDM,6313530,FIX EXTRNL LW/UP/PELVIC LVL 38,315364.0,67803.26,45443.95,236523.0,29
CDM,6313548,FIX EXTRNL LW/UP/PELVIC LVL 39,332884.0,71570.06,47968.58,249663.0,29
CDM,6313555,FIX EXTRNL LW/UP/PELVIC LVL 40,350404.0,75336.86,50493.22,262803.0,29
CDM,6313563,FIX EXTRNL LW/UP/PELVIC LVL 41,367924.0,79103.66,53017.85,275943.0,29
CDM,6313571,FIX EXTRNL LW/UP/PELVIC LVL 42,385444.0,82870.46,55542.48,289083.0,29
CDM,6313589,ALLDRM FIX INT 20.1X23.6RSTR PRF/SC,129.0,36.89,18.59,222.5,62
CDM,6313597,DRESSING SPECIALTY LVL 11,13895.0,2987.42,2002.27,10421.25,29
CDM,6313613,CLIP LVL 11,10422.0,2240.73,1501.81,7816.5,29
CDM,6313639,IMP CEMENT LVL 10,21904.0,6264.54,1003.99,16428.0,42
CDM,6313704,IMP GENERATOR NEUROSTIM LVL 08,175204.0,50108.34,32587.94,131403.0,42
CDM,6313712,IMP LD ICD NON SGL/DUAL LVL 10,21904.0,6264.54,4074.14,16428.0,42
CDM,6313720,IMP LD ICD NON SGL/DUAL LVL 11,24094.0,6890.88,4387.13,18070.5,42
CDM,6313746,IMP PCMKR SGL RR LVL 11,56944.0,17254.03,10591.58,42708.0,42
CDM,6313753,IMP EMBOLIZATION AGENT LVL 11,19714.0,5638.2,1312.53,14785.5,42
CDM,6313761,IMP EMBOLIZATION AGENT LVL 10,17524.0,5011.86,1312.53,13143.0,42
CDM,6313787,DRESSING SPECIALTY LVL 12,17524.0,3767.66,2525.21,13143.0,29
CDM,6313811,IMP SLEEVE SMIT INTRAUTERINE LVL 04,1413.0,404.12,262.82,1782.74,42
CDM,6313829,IMP SLEEVE SMIT INTRAUTERINE LVL 05,2695.0,770.77,501.27,2021.25,42
CDM,6313837,IMP CLIP/S 1-3 REPAIR TRICUSPID KIT,170820.0,48854.52,1312.53,128115.0,42
CDM,6313928,CATH TLA NONLASER DRUG COAT LVL 14,17524.0,3767.66,3259.46,13143.0,39
CDM,6313936,CATH TLA NONLASER DRUG COAT LVL 15,21904.0,4709.36,4074.14,16428.0,39
CDM,6313944,CATH TLA NONLASER DRUG COAT LVL 16,26284.0,5651.06,4711.64,19713.0,39
CDM,6313993,IMP PROSTH MAXILLOFACIAL LVL 20,81034.0,23175.72,1312.53,60775.5,42
CDM,6314009,IMP PROSTH MAXILLOFACIAL LVL 21,85414.0,24428.4,1312.53,64060.5,42
CDM,6314017,IMP PROSTH MAXILLOFACIAL LVL 22,89794.0,25681.08,1312.53,67345.5,42
CDM,6314025,ELECTRODE ELECTROSURGICAL LVL 16,28474.0,6121.91,4103.1,21355.5,29
CDM,6314033,ELECTRODE ELECTROSURGICAL LVL 17,32854.0,7063.61,4734.26,24640.5,29
CDM,6314124,IMP PCMKR DUAL LEADLESS RR LVL 01,17520.0,5308.56,3258.72,41774.56,42
CDM,6314132,IMP PCMKR DUAL LEADLESS RR LVL 02,21904.0,6636.91,4074.14,41774.56,42
CDM,6314140,IMP PCMKR DUAL LEADLESS RR LVL 03,26284.0,7964.05,4888.82,41774.56,42
CDM,6314157,IMP PCMKR DUAL LEADLESS RR LVL 04,43804.0,13272.61,8147.54,41774.56,42
CDM,6314165,IMP PCMKR DUAL LEADLESS RR LVL 05,65704.0,19908.31,12220.94,49278.0,42
CDM,6314249,CATH FEEDING LVL 06,3853.0,828.4,555.22,2889.75,29
CDM,6314256,CATH FEEDING LVL 07,5373.0,1155.2,774.25,4029.75,29
CDM,6314264,CATH FEEDING LVL 08,6950.0,1494.25,1001.5,5212.5,29
CDM,6314272,IMP PCMKR DUAL LEADLESS RR LVL 06,87604.0,26544.01,16294.34,65703.0,42
CDM,6314280,IMP PCMKR DUAL LEADLESS RR LVL 07,109504.0,33179.71,20367.74,82128.0,42
CDM,6314298,CATH APPL LVL 01,166.0,35.69,23.92,124.5,29
CDM,6314306,CATH APPL LVL 02,313.0,67.3,45.1,234.75,29
CDM,6314314,CATH APPL LVL 03,594.0,127.71,85.6,445.5,29
CDM,6314322,FLEX HD FIX INT 10X16 THCK ULT/SC,74.8,21.39,24.46,222.5,66
CDM,6314355,AMNIOFIX FIX INT 4X6/SHEET 24SC,6991.4,1999.54,132.79,5243.55,61
CDM,6314421,IMP RV/AD/RP KN FEMORAL LVL 08,43804.0,12527.94,5497.98,32853.0,42
CDM,6314652,IMP COVER BURR HOLE LVL 05,3853.0,1101.96,716.66,2889.75,42
CDM,6314728,CATH COR TRANSL NONLASER DRUG LVL01,313.0,67.3,58.22,917.98,39
CDM,6314736,CATH COR TRANSL NONLASER DRUG LVL02,1413.0,303.8,262.82,1059.75,39
CDM,6314744,CATH COR TRANSL NONLASER DRUG LVL03,3853.0,828.4,675.86,2889.75,39
CDM,6314751,CATH COR TRANSL NONLASER DRUG LVL04,6105.0,1312.58,675.86,4578.75,39
CDM,6314769,CATH COR TRANSL NONLASER DRUG LVL05,9265.0,1991.98,675.86,6948.75,39
CDM,6314777,CATH COR TRANSL NONLASER DRUG LVL06,13895.0,2987.42,675.86,10421.25,39
CDM,6314785,CATH COR TRANSL NONLASER DRUG LVL07,17524.0,3767.66,675.86,13143.0,39
CDM,6314793,CATH COR TRANSL NONLASER DRUG LVL08,21904.0,4709.36,675.86,16428.0,39
CDM,6314801,CATH COR TRANSL NONLASER DRUG LVL09,26284.0,5651.06,675.86,19713.0,39
CDM,6314876,CATH ATHERECT TRANSL ROTAT LVL 05,21904.0,4709.36,4074.14,16428.0,39
CDM,6314884,CATH ATHERECT TRANSL ROTAT LVL 06,26284.0,5651.06,4888.82,19713.0,39
CDM,6314918,CHOLEDOCHOSCOPE SINGLE USE LVL 01,313.0,67.3,45.1,234.75,29
CDM,6314926,CHOLEDOCHOSCOPE SINGLE USE LVL 02,1413.0,303.8,203.61,1059.75,29
CDM,6314934,CHOLEDOCHOSCOPE SINGLE USE LVL 03,2695.0,579.42,388.35,2021.25,29
CDM,6314942,CHOLEDOCHOSCOPE SINGLE USE LVL 04,6105.0,1312.58,879.73,4578.75,29
CDM,6314959,CHOLEDOCHOSCOPE SINGLE USE LVL 05,9265.0,1991.98,1335.09,6948.75,29
CDM,6314967,CHOLEDOCHOSCOPE SINGLE USE LVL 06,13895.0,2987.42,2002.27,10421.25,29
CDM,6314975,NEUROSTIM EXTERNAL WIRELESS LVL 01,166.0,35.69,23.92,124.5,29
CDM,6314983,NEUROSTIM EXTERNAL WIRELESS LVL 02,313.0,67.3,45.1,234.75,29
CDM,6314991,NEUROSTIM EXTERNAL WIRELESS LVL 03,594.0,127.71,85.6,445.5,29
CDM,6315006,NEUROSTIM EXTERNAL WIRELESS LVL 04,1413.0,303.8,203.61,1059.75,29
CDM,6315014,NEUROSTIM EXTERNAL WIRELESS LVL 05,2695.0,579.42,388.35,2021.25,29
CDM,6315063,IMP GEN NRSTM LD W BAT RECHG LVL 01,313.0,89.52,58.22,55710.5,42
CDM,6315071,IMP GEN NRSTM LD W BAT RECHG LVL 02,1413.0,404.12,262.82,55710.5,42
CDM,6315089,IMP GEN NRSTM LD W BAT RECHG LVL 03,3853.0,1101.96,716.66,55710.5,42
CDM,6315097,IMP GEN NRSTM LD W BAT RECHG LVL 04,13895.0,3973.97,2584.47,55710.5,42
CDM,6315105,IMP GEN NRSTM LD W BAT RECHG LVL 05,21904.0,6264.54,4074.14,55710.5,42
CDM,6315113,IMP GEN NRSTM LD W BAT RECHG LVL 06,30664.0,8769.9,5703.5,55710.5,42
CDM,6315121,IMP GEN NRSTM LD W BAT RECHG LVL 07,43804.0,12527.94,8147.54,55710.5,42
CDM,6315139,IMP GEN NRSTM LD W BAT RECHG LVL 08,65704.0,18791.34,12220.94,55710.5,42
CDM,6315147,IMP GEN NRSTM LD W BAT RECHG LVL 09,87604.0,25054.74,16294.34,65703.0,42
CDM,6315154,IMP GEN NRSTM LD W BAT RECHG LVL 10,109504.0,31318.14,20367.74,82128.0,42
CDM,6315170,SUSPNSN AUTOGRFT SYS W APPL LVL 01,313.0,67.3,58.22,4596.53,39
CDM,6315188,SUSPNSN AUTOGRFT SYS W APPL LVL 02,1413.0,303.8,262.82,4596.53,39
CDM,6315196,SUSPNSN AUTOGRFT SYS W APPL LVL 03,3853.0,828.4,716.66,4596.53,39
CDM,6315204,SUSPNSN AUTOGRFT SYS W APPL LVL 04,6105.0,1312.58,1135.53,4596.53,39
CDM,6315212,SUSPNSN AUTOGRFT SYS W APPL LVL 05,13895.0,2987.42,2584.47,10421.25,39
CDM,6315220,SUSPNSN AUTOGRFT SYS W APPL LVL 06,17524.0,3767.66,3259.46,13143.0,39
CDM,6315238,SUSPNSN AUTOGRFT SYS W APPL LVL 07,21904.0,4709.36,3384.17,16428.0,39
CDM,6315246,SUSPNSN AUTOGRFT SYS W APPL LVL 08,26284.0,5651.06,3384.17,19713.0,39
CDM,6315253,SUSPNSN AUTOGRFT SYS W APPL LVL 09,30664.0,6592.76,3384.17,22998.0,39
CDM,6315295,IMP MTRX FILLER BONE DE LVL 01,313.0,89.52,58.22,978.38,42
CDM,6315303,IMP MTRX FILLER BONE DE LVL 02,1413.0,404.12,262.82,1059.75,42
CDM,6315311,IMP MTRX FILLER BONE DE LVL 03,2695.0,770.77,501.27,2021.25,42
CDM,6315329,IMP MTRX FILLER BONE DE LVL 04,3853.0,1101.96,716.66,2889.75,42
CDM,6315337,IMP MTRX FILLER BONE DE LVL 05,6105.0,1746.03,720.32,4578.75,42
CDM,6315345,IMP MTRX FILLER BONE DE LVL 06,9265.0,2649.79,720.32,6948.75,42
CDM,6315352,IMP MTRX FILLER BONE DE LVL 07,13895.0,3973.97,720.32,10421.25,42
CDM,6315360,IMP MTRX FILLER BONE DE LVL 08,17524.0,5011.86,720.32,13143.0,42
CDM,6315378,IMP MTRX FILLER BONE DE LVL 09,21904.0,6264.54,720.32,16428.0,42
CDM,6315493,IMP PATCH PERICARDIAL LVL 01,166.0,47.48,30.88,1782.74,42
CDM,6315501,IMP PATCH PERICARDIAL LVL 02,313.0,89.52,58.22,1782.74,42
CDM,6315519,IMP PATCH PERICARDIAL LVL 03,594.0,169.88,110.48,1782.74,42
CDM,6315527,IMP PATCH PERICARDIAL LVL 04,1413.0,404.12,262.82,1782.74,42
CDM,6315535,IMP PATCH PERICARDIAL LVL 05,2695.0,770.77,501.27,2021.25,42
CDM,6315568,MYRIAD MATRIX FIX INT 10X10 THIN/SC,27.4,7.84,3.95,219.1,61
CDM,6315576,MYRIAD MATRIX FIX INT 10X20 THIN/SC,28.0,8.01,4.03,219.1,61
CDM,6315584,MYRIAD MATRIX FIX INT 20X20 THIN/SC,27.4,7.84,3.95,219.1,61
CDM,6315675,IDE G210349 SYS LD PM SOLIA CSP S,1835.0,603.77,341.31,2025.13,36
CDM,6315683,IMP MTRX FILLER BONE DE LVL 10,26284.0,7517.22,720.32,19713.0,42
CDM,6315691,IMP MTRX FILLER BONE DE LVL 11,30664.0,8769.9,720.32,22998.0,42
CDM,6315709,IMP MTRX FILLER BONE DE LVL 12,35044.0,10022.58,720.32,26283.0,42
CDM,6315824,CATH GUIDE LVL 15,17524.0,3767.66,336.61,13143.0,39
CDM,6315832,CATH GUIDE LVL 16,21904.0,4709.36,336.61,16428.0,39
CDM,6315881,IMP POUCH ECM LVL 01,313.0,89.52,58.22,1782.74,42
CDM,6315899,IMP POUCH ECM LVL 02,1413.0,404.12,262.82,1782.74,42
CDM,6315907,IMP POUCH ECM LVL 03,3853.0,1101.96,716.66,2889.75,42
CDM,6315915,IMP POUCH ECM LVL 04,6105.0,1746.03,1135.53,4578.75,42
CDM,6316392,IMP GEN NRSTM LD W BAT RECHG LVL 11,118264.0,33823.5,21997.1,88698.0,42
CDM,6316400,IMP GEN NRSTM LD W BAT RECHG LVL 12,124834.0,35702.52,23219.12,93625.5,42
CDM,6316418,IMP GEN NRSTM LD W BAT RECHG LVL 13,131404.0,37581.54,24441.14,98553.0,42
CDM,6316434,DURAGEN PL 2.5X2.5/SH,841.0,240.53,121.19,630.75,61
CDM,6316517,ARTHROFLEX INT 1.0MM 2.5X3/SC,451.1,129.01,65.0,410.16,61
CDM,6316533,IMP RV/AD/RP KN FEMORAL LVL 09,48184.0,13780.62,5497.98,36138.0,42
CDM,6316541,IMP RV/AD/RP KN FEMORAL LVL 10,52564.0,15033.3,5497.98,39423.0,42
CDM,6316558,IMP RV/AD/RP KN FEMORAL LVL 11,56944.0,16285.98,5497.98,42708.0,42
CDM,6316566,IMP RV/AD/RP KN FEMORAL LVL 12,61324.0,17538.66,5497.98,45993.0,42
CDM,6316574,IMP RV/AD/RP KN FEMORAL LVL 13,65704.0,18791.34,5497.98,49278.0,42
CDM,6316582,IMP RV/AD/RP KN FEMORAL LVL 14,72274.0,20670.36,5497.98,54205.5,42
CDM,6316590,IMP RV/AD/RP KN FEMORAL LVL 15,78844.0,22549.38,5497.98,59133.0,42
CDM,6316608,IMP RV/AD/RP KN FEMORAL LVL 16,85414.0,24428.4,5497.98,64060.5,42
CDM,6316616,IMP RV/AD/RP KN FEMORAL LVL 17,91984.0,26307.42,5497.98,68988.0,42
CDM,6316624,IMP RV/AD/RP KN FEMORAL LVL 18,98554.0,28186.44,5497.98,73915.5,42
CDM,6316632,IMP RV/AD/RP KN FEMORAL LVL 19,105124.0,30065.46,5497.98,78843.0,42
CDM,6316640,IMP RV/AD/RP KN TIBIAL LVL 15,43804.0,12527.94,5497.98,32853.0,42
CDM,6316657,IMP RV/AD/RP KN TIBIAL LVL 16,48184.0,13780.62,5497.98,36138.0,42
CDM,6316665,IMP RV/AD/RP KN TIBIAL LVL 17,52564.0,15033.3,5497.98,39423.0,42
CDM,6316772,DURAGEN PL 2.5X7.5/SH,1366.2,390.73,132.79,1024.65,61
CDM,6316780,DURAGEN PL 5X5/SH,1384.0,395.82,132.79,1038.0,61
CDM,6316798,DURAGEN PL 7.5X7.5/SH,2458.7,703.19,132.79,1844.03,61
CDM,6316806,DURAGEN PL 7.5X7.5/SH 5/PKG,2393.5,684.54,132.79,1795.12,61
CDM,6316814,DURAGEN SU 2.5X7.5/SH,1369.5,391.68,132.79,1027.12,61
CDM,6316822,DURAGEN SU 7.5X7.5/SH,2697.4,771.46,132.79,2023.05,61
CDM,6316830,IMP NRSTM BAT RECHG SYS LVL 10,153304.0,43844.94,28514.54,114978.0,42
CDM,6316889,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 11,26284.0,7517.22,1312.53,19713.0,42
CDM,6316897,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 12,30664.0,8769.9,1312.53,22998.0,42
CDM,6316921,ARTHROFLEX INT 2.0MM 2.5X3/SC,602.9,172.43,86.88,452.18,61
CDM,6316962,ARTHROFLEX INT 3.0MM 4X7/SC,421.5,120.55,60.74,410.16,61
CDM,6317010,DURAGEN CL 10X12.5/SH,3229.8,923.72,132.79,2422.35,61
CDM,6317028,DURAGEN CL 2.5X2.5/SH 5/PKG,854.4,244.36,123.12,640.8,61
CDM,6317036,DURAGEN CL 2.5X7.5/SH,1200.5,343.34,132.79,900.38,61
CDM,6317044,DURAGEN CL 2.5X7.5/SH 5/PKG,1079.1,308.62,132.79,809.33,61
CDM,6317051,DURAGEN CL 5X5/SH,1011.0,289.15,132.79,758.25,61
CDM,6317077,DURAGEN CL 7.5X7.5/SH,1823.8,521.61,132.79,1367.85,61
CDM,6317085,DURAGEN CL 7.5X7.5/SH 5/PKG,2028.5,580.15,132.79,1521.38,61
CDM,6317093,DURAGEN PL 10X12.5/SH,4170.5,1192.76,132.79,3127.88,61
CDM,6317101,DURAGEN PL 12.5X17.5/SH,5207.8,1489.43,132.79,3905.85,61
CDM,6317119,FLEX HD DIAMOND XL 24X35 THCK/SC,58.5,16.73,19.13,222.5,66
CDM,6317499,CATH THROMBECTOMY/EMBO ARTIX PPP,25952.0,5579.68,575.51,19464.0,39
CDM,6317507,INTRO NON GD/EP/LASER ARTIX PPP,6899.0,1973.11,183.22,5174.25,42
CDM,6317937,IDE G230187 DEV SYS HRT ARTF TOTAL,1110768.0,365476.0,1312.53,833076.0,36
CDM,6318026,TACHOSIL 9.5X4.8CM PATCH,50.4,10.84,7.26,37.8,29
CDM,6318034,TACHOSIL 4.8X4.8CM PATCH,35.6,7.65,5.13,26.7,29
CDM,6318182,IDE G160013 DEV SYS REVIVENT TC,109500.0,36028.78,1312.53,82125.0,36
CDM,6318240,FLEX HD FIX INT 23X26 THIN/SC,74.9,21.42,24.49,222.5,66
CDM,6318257,IMP SYS MNTR PRESS IM CMPRT LVL 01,166.0,47.48,23.92,887.84,40
CDM,6318265,IMP SYS MNTR PRESS IM CMPRT LVL 02,313.0,89.52,45.1,887.84,40
CDM,6318273,IMP SYS MNTR PRESS IM CMPRT LVL 03,594.0,169.88,85.6,887.84,40
CDM,6318281,IMP SYS MNTR PRESS IM CMPRT LVL 04,1413.0,404.12,203.61,1059.75,40
CDM,6318299,IMP SYS MNTR PRESS IM CMPRT LVL 05,2695.0,770.77,388.35,2021.25,40
CDM,6318307,IMP SYS MNTR PRESS IM CMPRT LVL 06,3853.0,1101.96,555.22,2889.75,40
CDM,6318315,IMP SYS MNTR PRESS IM CMPRT LVL 07,6105.0,1746.03,653.67,4578.75,40
CDM,6318323,IMP SYS MNTR PRESS IM CMPRT LVL 08,6950.0,1987.7,653.67,5212.5,40
CDM,6318331,IMP SYS MNTR PRESS IM CMPRT LVL 09,9265.0,2649.79,653.67,6948.75,40
CDM,6318349,IMP SYS MNTR PRESS IM CMPRT LVL 10,11580.0,3311.88,653.67,8685.0,40
CDM,6318810,CATH ABL EP 3D/VECTOR LVL 07,26284.0,5651.06,4453.64,19713.0,39
CDM,6318828,CATH ABL EP 3D/VECTOR LVL 08,30664.0,6592.76,4453.64,22998.0,39
CDM,6318836,CATH ABL EP 3D/VECTOR LVL 09,35044.0,7534.46,4453.64,26283.0,39
CDM,6318844,CATH ABL EP 3D/VECTOR LVL 10,39424.0,8476.16,4453.64,29568.0,39
CDM,6318976,ENDOSCOPE SINGLE USE UT LVL 08,17524.0,3767.66,1132.16,13143.0,39
CDM,6319024,PROBE CRYOABLATION NON OPIOID LVL01,166.0,47.48,30.88,259.76,42
CDM,6319032,PROBE CRYOABLATION NON OPIOID LVL02,313.0,89.52,58.22,259.76,42
CDM,6319040,PROBE CRYOABLATION NON OPIOID LVL03,594.0,169.88,110.48,445.5,42
CDM,6319057,PROBE CRYOABLATION NON OPIOID LVL04,1413.0,404.12,191.25,1059.75,42
CDM,6319065,PROBE CRYOABLATION NON OPIOID LVL05,2695.0,770.77,191.25,2021.25,42
CDM,6319073,PROBE CRYOABLATION NON OPIOID LVL06,3853.0,1101.96,191.25,2889.75,42
CDM,6319081,PROBE CRYOABLATION NON OPIOID LVL07,6105.0,1746.03,191.25,4578.75,42
CDM,6319099,PROBE CRYOABLATION NON OPIOID LVL08,6950.0,1987.7,191.25,5212.5,42
CDM,6319107,PROBE CRYOABLATION NON OPIOID LVL09,9265.0,2649.79,191.25,6948.75,42
CDM,6319115,PROBE CRYOABLATION NON OPIOID LVL10,11580.0,3311.88,191.25,8685.0,42
CDM,6319123,PROBE CRYOABLATION NON OPIOID LVL11,13895.0,3973.97,191.25,10421.25,42
CDM,6319131,PROBE CRYOABLATION NON OPIOID LVL12,17524.0,5011.86,191.25,13143.0,42
CDM,6319214,IMP VALVE LVL 22,208054.0,59503.44,1312.53,156040.5,42
CDM,6319222,IMP VALVE LVL 23,219004.0,62635.14,1312.53,164253.0,42
CDM,6319230,IMP VALVE LVL 24,240904.0,68898.54,1312.53,180678.0,42
CDM,6319271,IMP VALVE LVL 25,262804.0,75161.94,1312.53,197103.0,42
CDM,6319305,CLIP LVL 12,11580.0,2489.7,1668.68,8685.0,29
CDM,6319313,CLIP LVL 13,13895.0,2987.42,2002.27,10421.25,29
CDM,6319321,CLIP LVL 14,17524.0,3767.66,2525.21,13143.0,29
CDM,6319339,CLIP LVL 15,21904.0,4709.36,3156.37,16428.0,29
CDM,6319347,CLIP LVL 16,26284.0,5651.06,3787.52,19713.0,29
CDM,6319537,IDE G190128 IMP DEV SYS ALTAVALVE,219000.0,72057.57,1312.53,164250.0,36
CDM,6319578,AMNIOEXCEL FIX INT 5X8/SC,225.7,64.55,73.8,410.16,66
CDM,6319925,IMP PROSTH MAXILLOFACIAL LVL 23,91984.0,26307.42,1312.53,68988.0,42
CDM,6319933,IMP PROSTH MAXILLOFACIAL LVL 24,98554.0,28186.44,1312.53,73915.5,42
CDM,6319958,IDE G250226 CATH PFA FARAPOINT,4832.0,1589.87,898.75,4990.33,36
CDM,63529,R&B NURSERY LEVEL 2 HIGHER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,65011,R&B NURSERY LEVEL 2 HIGHER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,65425,R&B NURSERY LEVEL 2 HIGHER ACUITY,9308.0,3062.61,2166.0,6981.0,12
CDM,6771810,DOBUTAMN/250MG 250MG/20ML SNIV,85.0,4.08,7.58,63.75,40
CDM,6783336,METOLAZONE/2.5MG 2.5MG TB,6.9,2.27,0.99429,13.3,35
CDM,6788152,PEN V POT/250MG 5GM/100ML PWPO,34.6,11.38,4.99,25.95,35
CDM,6789754,TRIMETHOPRIM-POLYB/10ML 10ML SNOP,23.2,7.63,3.34,17.4,29
CDM,6794523,SULFASALAZINE/500MG 500MG TB,4.9,1.61,0.70609,13.3,35
CDM,6796833,TRAZODONE/150MG 150MG TB,4.4,1.45,0.63404,13.3,35
CDM,6797781,TUBERCULIN PPD/1ML 5U/0.1ML SNIJ,37.1,12.21,5.35,27.82,29
CDM,6805253,ESTRADL/0.5MG 0.5MG TB,4.5,1.48,0.64845,13.3,35
CDM,6810469,LORATA-PSEUDOE/10-240MG TBER 24H,4.0,1.32,0.5764,3.0,29
CDM,6812614,LEECH EACH,73.7,15.85,10.62,55.27,29
CDM,6812796,BUMETANIDE/2MG 2MG TB,7.0,2.3,1.01,13.3,35
CDM,6814743,HIB-PRP-OMP 3DOSE/0.5ML 0.5ML IM,122.0,5.86,22.69,218.78,40
CDM,6819205,POLYCARBOPHIL/625MG 625MG TB,2.3,0.76,0.33143,1.73,29
CDM,6819700,MIRTAZAPINE/15MG 15MG TBDS,6.0,1.97,0.8646,13.3,35
CDM,6824361,ADMIN FEE PNEUMOCOCCAL,116.0,21.58,29.0,139.0,63
CDM,6824379,ADMIN FEE INFLUENZA,116.0,21.58,29.0,139.0,63
CDM,6824478,ADMIN FEE HEPATITIS B,116.0,21.58,29.0,139.0,63
CDM,6828693,SMOG COMP/300ML 300ML EN,95.4,31.39,17.74,71.55,31
CDM,6843155,CETIRIZINE/5ML 5MG/5ML SNPO,4.8,1.58,0.69168,13.3,35
CDM,6861033,EYE LUB 1% REFRSH/0.4ML 0.4ML GL,3.6,1.18,0.51876,2.7,29
CDM,6863245,ZINC OXIDE 40%/57GM 57GM PS,6.9,2.27,0.99429,5.17,29
CDM,6866461,MENTHL-METHYL SALC 10-15%/85GM CR,5.7,1.88,0.82137,4.28,29
CDM,6867527,FAT EMULSN CLIN 20%/250ML 250ML EM,50.3,2.41,7.25,37.73,29
CDM,6868491,KCL-NACL 0.90%/2MEQ 40MEQ/1L SNIV,3.7,0.18,0.11,2.77,40
CDM,6869291,EPO ALFA ESRD/100U 2KU SNIJ,4.9,1.61,0.69,5.12,40
CDM,6869317,EPO ALFA ESRD/100U 3KU SNIJ,7.9,2.6,0.69,5.92,40
CDM,6869325,EPO ALFA ESRD/100U 4KU SNIJ,4.9,1.61,0.69,5.12,40
CDM,6871768,DARBEPO/1MCG 300MCG/.6ML SNIJ,22.4,6.38,2.34,21.15,67
CDM,6872626,EPO ALFA EPBX ESRD/100U 2KU SNIJ,3.4,1.12,0.63,5.12,40
CDM,6872634,EPO ALFA EPBX ESRD/100U 3KU SNIJ,3.4,1.12,0.63,5.12,40
CDM,6872642,EPO ALFA EPBX ESRD/100U 4KU SNIJ,3.4,1.12,0.63,5.12,40
CDM,6873111,FENTNYL CITR/0.1MG 1MG/100ML EP,8.9,0.43,0.84,6.67,40
CDM,6876270,PHENOBRB SOD/<=120MG 130MG/1ML SNIJ,120.8,5.8,22.47,213.26,40
CDM,6877187,TREPROSTINIL/1MG 50MG/20ML SN MDV,58.6,16.7,24.44,122.52,67
CDM,6877476,BORTEZOMIB HOS/0.1MG 2.5MG PWIJ,13.2,3.76,1.71,9.9,41
CDM,6877591,AMPHO B LIPID/10MG 10MG/10ML SPIJ,43.4,12.37,8.07,74.57,41
CDM,6877625,EFGARTIGIMOD-AL/2MG 400MG/20ML SNIV,92.6,26.39,25.72,130.31,67
CDM,6877963,MINOCYCLINE HCL/1MG 100MG/5ML PWIJ,9.3,2.65,2.09,18.56,67
CDM,6880694,PHENYLEPH/20MCG 40MG/250ML SNIV,0.2,0.01,0.01,0.15,40
CDM,6882104,GADOTERIDOL/1ML 7.5MMOL/15ML SNIV,7.0,0.34,1.3,5.25,36
CDM,6883060,LIFILEUCEL TIL/DOSE 7.5B-72B SNIJ,3141500.0,1033647.74,4.9,2356125.0,32
CDM,7140080,THERAPY ELECTROCONVULSIVE W MNTR,1896.0,623.84,102.94,3006.3,69
CDM,7140817,RECOVERY LEVEL 1 FIRST 1MIN,620.0,200.26,89.34,465.0,29
CDM,7140825,RECOVERY LEVEL 1 ADDL 1MIN,28.0,9.04,4.03,21.0,29
CDM,7140833,RECOVERY LEVEL 2 FIRST 1MIN,720.0,232.56,103.75,540.0,29
CDM,7140841,RECOVERY LEVEL 2 ADDL 1MIN,32.0,10.34,4.61,24.0,29
CDM,7140858,RECOVERY LEVEL 3 FIRST 1MIN,820.0,264.86,118.16,615.0,29
CDM,7140866,RECOVERY LEVEL 3 ADDL 1MIN,39.0,12.6,5.62,29.25,29
CDM,7140874,RECOVERY LEVEL 4 FIRST 1MIN,920.0,297.16,132.57,690.0,29
CDM,7140882,RECOVERY LEVEL 4 ADDL 1MIN,45.0,14.54,6.48,33.75,29
CDM,7141138,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,7141146,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,7141153,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,7141252,RECOVERY LEVEL 1 FIRST 1MIN,620.0,200.26,89.34,465.0,29
CDM,7141260,RECOVERY LEVEL 1 ADDL 1MIN,28.0,9.04,4.03,21.0,29
CDM,7141278,RECOVERY LEVEL 2 FIRST 1MIN,720.0,232.56,103.75,540.0,29
CDM,7141286,RECOVERY LEVEL 2 ADDL 1MIN,32.0,10.34,4.61,24.0,29
CDM,7141294,RECOVERY LEVEL 3 FIRST 1MIN,820.0,264.86,118.16,615.0,29
CDM,7141302,RECOVERY LEVEL 3 ADDL 1MIN,39.0,12.6,5.62,29.25,29
CDM,7141310,RECOVERY LEVEL 4 FIRST 1MIN,920.0,297.16,132.57,690.0,29
CDM,7141328,RECOVERY LEVEL 4 ADDL 1MIN,45.0,14.54,6.48,33.75,29
CDM,7141567,INJ/S EPID/SUB C/T WO IMG,1308.0,468.26,97.21,5681.0,63
CDM,7141583,INJ/S EPID/SUB L/S WO IMG,1412.0,505.5,77.2,5681.0,63
CDM,7141740,PROCEDURE UNLIST ADD-ON,239.0,85.56,34.44,179.25,27
CDM,7141757,PROCEDURE UNLIST LVL 01 SMPL,880.0,315.04,126.81,660.0,27
CDM,7141765,PROCEDURE UNLIST LVL 02 INTRM,1409.0,504.42,203.04,1056.75,27
CDM,7141773,PROCEDURE UNLIST LVL 03 CMPLX,2946.0,1054.67,424.52,2209.5,27
CDM,7201056,AMNIOCENTESIS DIAGNOSTIC,1473.0,527.33,78.34,5681.0,63
CDM,7201064,AMNIOCENTESIS THER US GD,2837.0,1015.65,172.43,5681.0,63
CDM,7201072,INS DILATOR CERVICAL,1608.0,1432.73,42.9,1318.83,63
CDM,7201080,VERSION CEPHALIC EXTERNAL,2430.0,2165.13,99.62,5699.56,63
CDM,7201098,INJ EPID PATCH BLOOD/CLOT,1604.0,574.23,110.28,5681.0,63
CDM,7201106,OR LEVEL 1 FIRST 30MIN,6435.0,1570.14,927.28,4826.25,27
CDM,7201114,OR LEVEL 2 FIRST 30MIN,7685.0,1875.14,1107.41,5763.75,27
CDM,7201122,OR LEVEL 3 FIRST 30MIN,8935.0,2180.14,1287.53,6701.25,27
CDM,7201130,OR LEVEL 4 FIRST 30MIN,10195.0,2487.58,1469.1,7646.25,27
CDM,7201148,OR LEVEL 5 FIRST 30MIN,12695.0,3097.58,1829.35,9521.25,27
CDM,7201155,OR LEVEL 6 FIRST 30MIN,15195.0,3707.58,2189.6,11396.25,27
CDM,7201163,OR LEVEL 1 ADDL 15MIN,2090.0,509.96,301.17,1567.5,27
CDM,7201171,OR LEVEL 2 ADDL 15MIN,2590.0,631.96,373.22,1942.5,27
CDM,7201189,OR LEVEL 3 ADDL 15MIN,3090.0,753.96,445.27,2317.5,27
CDM,7201197,OR LEVEL 4 ADDL 15MIN,3885.0,947.94,559.83,2913.75,27
CDM,7201205,OR LEVEL 5 ADDL 15MIN,4885.0,1191.94,703.93,3663.75,27
CDM,7201213,OR LEVEL 6 ADDL 15MIN,5885.0,1435.94,848.03,4413.75,27
CDM,7201221,EPIDURAL LABOR,1345.0,427.71,193.81,1008.75,29
CDM,7201239,ANESTHESIA LEVEL 1 FIRST 30MIN,1395.0,443.61,201.02,1046.25,29
CDM,7201247,ANESTHESIA LEVEL 2 FIRST 30MIN,1895.0,602.61,273.07,1421.25,29
CDM,7201254,ANESTHESIA LEVEL 3 FIRST 30MIN,2395.0,761.61,345.12,1796.25,29
CDM,7201262,ANESTHESIA LEVEL 4 FIRST 30MIN,2895.0,920.61,417.17,2171.25,29
CDM,7201270,ANESTHESIA LEVEL 1 ADDL 15MIN,555.0,176.49,79.98,416.25,29
CDM,7201288,ANESTHESIA LEVEL 2 ADDL 15MIN,655.0,208.29,94.39,491.25,29
CDM,7201296,ANESTHESIA LEVEL 3 ADDL 15MIN,755.0,240.09,108.8,566.25,29
CDM,7201304,ANESTHESIA LEVEL 4 ADDL 15MIN,955.0,303.69,137.62,716.25,29
CDM,7201429,LABOR LEVEL 1 0-12HRS,3545.0,2697.74,510.83,2658.75,29
CDM,7201437,LABOR LEVEL 2 12+HRS,5315.0,4044.72,765.89,3986.25,29
CDM,7201445,DELIVERY VAGINAL SINGLE,7090.0,2332.82,1021.67,5317.5,29
CDM,7201452,DELIVERY VAGINAL MULTI,10485.0,3449.88,1186.0,7863.75,29
CDM,7201460,CIRCUMCISION W BLOCK REGIONAL,762.0,250.72,93.11,5681.0,59
CDM,7201528,TEST STRESS CONTRACTION FETAL,914.0,816.2,34.03,711.0,63
CDM,7201536,TEST NONSTRESS FETAL,626.0,559.02,19.76,711.0,63
CDM,7201544,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,7201601,RECOVERY WO DELIVERY VAGINAL,2625.0,2338.88,378.26,1968.75,29
CDM,7201742,CIRCUMCISION W BLOCK REGIONAL,762.0,250.72,93.11,5681.0,59
CDM,7202328,DELIVERY OF PLACENTA,4275.0,3809.02,87.64,5699.56,63
CDM,7202336,RECOVERY LEVEL 1 FIRST 1MIN,620.0,200.26,89.34,465.0,29
CDM,7202344,RECOVERY LEVEL 1 ADDL 1MIN,28.0,9.04,4.03,21.0,29
CDM,7202351,RECOVERY LEVEL 2 FIRST 1MIN,720.0,232.56,103.75,540.0,29
CDM,7202369,RECOVERY LEVEL 2 ADDL 1MIN,32.0,10.34,4.61,24.0,29
CDM,7202377,RECOVERY LEVEL 3 FIRST 1MIN,820.0,264.86,118.16,615.0,29
CDM,7202385,RECOVERY LEVEL 3 ADDL 1MIN,39.0,12.6,5.62,29.25,29
CDM,7202393,RECOVERY LEVEL 4 FIRST 1MIN,920.0,297.16,132.57,690.0,29
CDM,7202401,RECOVERY LEVEL 4 ADDL 1MIN,45.0,14.54,6.48,33.75,29
CDM,7202427,VISIT OB TRIAGE NEW LEVEL 1,845.0,643.04,46.21,1318.0,34
CDM,7202435,VISIT OB TRIAGE NEW LEVEL 2,1625.0,1236.62,46.21,1318.0,34
CDM,7202443,VISIT OB TRIAGE NEW LEVEL 3,2430.0,1849.23,54.54,1822.5,34
CDM,7202450,VISIT OB TRIAGE NEW LEVEL 4,2925.0,2225.93,54.54,2193.75,34
CDM,7202468,VISIT OB TRIAGE NEW LEVEL 5,3915.0,2979.32,54.54,2936.25,34
CDM,7202476,VISIT OB TRIAGE ESTABLISHED LEVEL 1,320.0,243.52,8.55,1318.0,34
CDM,7202484,VISIT OB TRIAGE ESTABLISHED LEVEL 2,810.0,616.41,34.42,1318.0,34
CDM,7202492,VISIT OB TRIAGE ESTABLISHED LEVEL 3,1625.0,1236.62,54.54,1318.0,34
CDM,7202500,VISIT OB TRIAGE ESTABLISHED LEVEL 4,2505.0,1906.3,54.54,1878.75,34
CDM,7202518,VISIT OB TRIAGE ESTABLISHED LEVEL 5,3525.0,2682.52,54.54,2643.75,34
CDM,7202526,INF IV HYDRATION 31-60MIN,469.0,178.69,31.58,478.0,63
CDM,7202534,INF IV HYDRATION ADDL HR,138.0,52.58,12.04,478.0,63
CDM,7202542,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,7202559,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,7202567,INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,110.11,27.7,478.0,63
CDM,7202575,INF IV THRPY CONCURRENT,175.0,66.68,19.25,478.0,39
CDM,7202583,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,63
CDM,7202591,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,63
CDM,7202609,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,39
CDM,7202781,IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CDM,7202799,IMMUNIZATION VACCINE ADDL,47.0,8.74,8.74,139.0,40
CDM,7203037,INJ ANES GANGLION SPHENO BI,1215.0,434.97,102.52,5681.0,40
CDM,7203045,INJ ANES GANGLION SPHENO LT,810.0,289.98,102.52,5681.0,40
CDM,7203052,INJ ANES GANGLION SPHENO RT,810.0,289.98,102.52,5681.0,40
CDM,7203060,I&D/ASP PUNCT LVL 01 SIMPLE,445.0,159.31,64.12,333.75,27
CDM,7203078,I&D LVL 02 INTRM,532.0,190.46,76.66,399.0,27
CDM,7203086,I&D LVL 03 COMPLEX,636.0,227.69,91.65,477.0,27
CDM,7203110,REM SUTURE/STAPLE NO ANESTH,369.0,132.1,11.32,5681.0,40
CDM,7203128,RPR WOUND LVL 01 SIMPLE,621.0,222.32,89.49,465.75,27
CDM,7203136,RPR WOUND LVL 02 INTERMEDIATE,776.0,277.81,111.82,582.0,27
CDM,7203144,RPR WOUND LVL 03 COMPLEX,1019.0,364.8,146.84,764.25,27
CDM,7301005,EKG TRACING RHYTHM 1-3 LEADS,130.0,28.47,6.13,433.0,63
CDM,7301013,EKG TRACING RHYTHM 1-3 LEADS,130.0,28.47,6.13,433.0,63
CDM,7301021,EKG TRACING ROUTINE 12+ LEADS,543.0,118.92,6.13,433.0,63
CDM,7301039,EKG SIGNAL AVERAGED,586.0,128.33,18.78,439.5,63
CDM,7301245,ECHO 2D CMP W CNT,1730.0,425.58,518.51,2497.0,62
CDM,7301278,ECHO TEE CONG ANM WO CNT W I&R,3340.0,821.64,219.84,4956.07,63
CDM,7301294,EVAL FNCT CARDIO W TILT TABLE/EKG,3891.0,1140.06,70.95,44695.0,63
CDM,7301302,ECHO CONG ANM CMP W CNT,2134.0,524.96,518.51,2497.0,62
CDM,7301310,ECHO CONG ANM LTD W CNT,1094.0,269.12,357.74,2497.0,62
CDM,7301328,ECHO 2D LTD W CNT,1235.0,303.81,266.89,2497.0,62
CDM,7301336,ECHO 2D TEE CMP W CNT W I&R,2947.0,724.96,518.51,4552.1,62
CDM,7301344,ECHO 2D REST&STRESS W CNT W I&R,1790.0,440.34,518.51,5498.74,62
CDM,7301385,EKG RECORD EXTERNAL 0-48HR,494.0,313.2,17.81,370.5,63
CDM,7301393,EKG ANALYSIS EXTERNAL 0-48HR,583.0,369.62,34.69,495.11,63
CDM,7400450,TEST LATENCY SLEEP MULT PEDS,5887.0,5257.09,353.64,4415.25,63
CDM,7400518,TEST LATENCY SLEEP MULT,4709.0,4205.14,353.64,3531.75,63
CDM,7400575,MAPPING CORTICAL&SUBCORTICAL 1ST HR,1202.0,508.45,165.12,1511.98,63
CDM,7400583,MAPPING CORTICAL&SUBCORTICAL ADD HR,754.0,318.94,106.38,934.0,40
CDM,7400609,EEG AWAKE&ASLEEP,1471.0,622.23,191.73,1470.56,63
CDM,7400617,EEG AWAKE&DROWSY RDC,1339.0,566.4,191.73,1338.91,40
CDM,7400625,EEG AWAKE&ASLEEP RDC,1471.0,622.23,191.73,1470.56,40
CDM,7400633,EEG AWAKE&DROWSY,1339.0,566.4,191.73,1338.91,63
CDM,7400641,EEG EVAL DEATH CEREBRAL,1128.0,477.14,56.47,1463.31,63
CDM,7400658,EEG COMA/SLEEP ONLY,1464.0,619.27,191.73,1463.31,63
CDM,7400666,EEG ANALYSIS DIGITAL,1086.0,459.38,188.4,1302.2,39
CDM,7400674,EEG EXTENDED 61-119MIN,1677.0,709.37,191.73,1676.57,63
CDM,7400682,EEG EXTENDED 41-60MIN,1501.0,634.92,191.73,1500.03,63
CDM,7400690,EEG DURING SURGERY NONINTRACRANIAL,1364.0,576.97,134.65,1023.0,39
CDM,7400708,EEG ACTIVATION PHARM/PHYSICAL,1116.0,472.07,275.87,1077.36,63
CDM,7400740,ELECTROCORTICOGRAM AT SURGERY,2628.0,1111.64,488.81,7331.17,39
CDM,7400765,TEST ACTIVATION WADA W EEG MONITOR,1377.0,582.47,450.28,1511.98,63
CDM,7400989,EMG NEEDLE CHEMODENERVATION GD,350.0,115.16,55.5,262.5,39
CDM,7401003,PSG W 4+ PARAM 6+YRS,6000.0,2538.0,494.34,4945.1,63
CDM,7401011,PSG W 4+ PARAM 6+YRS W CPAP,6917.0,2925.89,517.35,5486.04,63
CDM,7401029,PSG W 4+ PARAM 6+YRS PEDS,7500.0,3172.5,494.34,5625.0,63
CDM,7401037,PSG W 4+PARAM 6+YR RDC<6HRS,6000.0,2538.0,494.34,4945.1,40
CDM,7401045,PSG W 4+ PARAM 6+YRS W CPAP PED,8647.0,3657.68,517.35,6485.25,63
CDM,7401052,PSG W 4+ PARAM 0-5YRS,8391.0,3549.39,666.87,7531.93,63
CDM,7401060,PSG W 4+ PARAM 0-5YRS W CPAP,8855.0,7907.52,640.0,7843.17,63
CDM,7401078,PSG W 4+ PARAM 6+YR W CPAP RDC<6HR,6917.0,2925.89,517.35,5486.04,40
CDM,7401086,PSG W 4+PARAM 0-5YR RDC<7HRS,8391.0,3549.39,666.87,7531.93,40
CDM,7401094,PSG W 4+ PARAM 0-5YR W CPAP RDC<7HR,8855.0,7907.52,640.0,7843.17,40
CDM,7401102,TEST LATENCY SLEEP MULT PEDS<4 NAPS,5887.0,5257.09,353.64,4415.25,40
CDM,7401110,TEST LATENCY SLEEP MULT RDC<4 NAPS,4709.0,4205.14,353.64,3531.75,40
CDM,7401144,STUDY SLEEP ATTENDED PEDS RDC<6HR,3662.0,1549.03,342.28,3410.41,40
CDM,7401169,PSG W 4+PARAM 6+YR PEDS RDC<6HRS,7500.0,3172.5,494.34,5625.0,40
CDM,7401177,PSG W 4+ PARAM 6+YR W CPAP PED<6HR,8647.0,3657.68,517.35,6485.25,40
CDM,7401185,SLP UNATND HOM RT/SAT/FLW&EFF,785.0,701.0,49.9,1051.88,63
CDM,7401318,EEG CONT SETUP ED TECH MIN CHAN 8,808.0,341.78,101.17,1328.01,63
CDM,7401326,EEG CONT WO VID 2-12HR UNMNTR,1010.0,427.23,191.73,3000.05,63
CDM,7401334,EEG CONT WO VID 2-12HR W INT MNTR,1162.0,491.53,191.73,3000.05,63
CDM,7401342,EEG CONT WO VID 2-12HR W CONT MNTR,1263.0,534.25,191.73,3000.05,63
CDM,7401359,EEG CONT WO VID 12-26HR UNMNTR,1515.0,640.84,283.13,3000.05,63
CDM,7401367,EEG CONT WO VID 12-26HR W INT MNTR,1667.0,705.14,353.64,3000.05,63
CDM,7401375,EEG CONT WO VID 12-26HR W CONT MNTR,1768.0,747.86,353.64,3000.05,63
CDM,7401383,EEG CONT W VID 2-12HR UNMNTR,1263.0,534.25,191.73,3000.05,63
CDM,7401391,EEG CONT W VID 2-12HR W INT MNTR,1453.0,614.62,191.73,3000.05,63
CDM,7401409,EEG CONT W VID 2-12HR W CONT MNTR,1579.0,667.92,353.64,3000.05,63
CDM,7401417,EEG CONT W VID 12-26HR UNMNTR,1894.0,801.16,283.13,2700.05,63
CDM,7401425,EEG CONT W VID 12-26HR W INT MNTR,2084.0,881.53,353.64,3000.05,63
CDM,7401433,EEG CONT W VID 12-26HR W CONT MNTR,2210.0,934.83,666.87,3000.05,63
CDM,7401508,SLP UNATND HOM RT/SAT/ANLY&TIME,844.0,753.69,94.69,946.71,63
CDM,7401516,SLP UNATND HOM RT/SAT/ANLY&TIME<6HR,844.0,753.69,94.69,946.71,40
CDM,7501794,MOTILITY ESOPHAGEAL,979.0,983.11,153.43,5681.0,63
CDM,7501984,TEST ESOPHAGUS PH CAP,2648.0,1125.4,353.64,4664.0,63
CDM,7502289,TEST ESOPHAGUS PH CATH NASAL,1074.0,1245.83,138.83,4664.0,63
CDM,7502685,IMG GI ESOPH-ILEUM INTRALUM W I&R,3739.0,1589.08,586.96,5662.85,63
CDM,7502784,ENDO GI LEVEL 1 FIRST 15MIN,275.0,116.88,39.63,206.25,27
CDM,7502792,ENDO GI LEVEL 1 ADDL 15MIN,140.0,59.5,20.17,105.0,27
CDM,7502800,ENDO GI LEVEL 2 FIRST 15MIN,590.0,250.75,85.02,442.5,27
CDM,7502818,ENDO GI LEVEL 2 ADDL 15MIN,295.0,125.38,42.51,221.25,27
CDM,7502826,ENDO GI LEVEL 3 FIRST 15MIN,1375.0,584.38,198.14,1031.25,27
CDM,7502834,ENDO GI LEVEL 3 ADDL 15MIN,690.0,293.25,99.43,517.5,27
CDM,7502842,ENDO GI LEVEL 4 FIRST 15MIN,1900.0,807.5,273.79,1425.0,27
CDM,7502859,ENDO GI LEVEL 4 ADDL 15MIN,950.0,403.75,136.9,712.5,27
CDM,7502867,ENDO ED LEVEL 1 FIRST 15MIN,275.0,67.92,39.63,2503.0,30
CDM,7502875,ENDO ED LEVEL 1 ADDL 15MIN,140.0,34.58,20.17,2503.0,30
CDM,7502883,ENDO ED LEVEL 2 FIRST 15MIN,590.0,145.73,85.02,2503.0,30
CDM,7502891,ENDO ED LEVEL 2 ADDL 15MIN,295.0,72.86,42.51,2503.0,30
CDM,7502909,ENDO ED LEVEL 3 FIRST 15MIN,1375.0,339.62,198.14,2503.0,30
CDM,7502917,ENDO ED LEVEL 3 ADDL 15MIN,690.0,170.43,99.43,2503.0,30
CDM,7502925,ENDO ED LEVEL 4 FIRST 15MIN,1900.0,469.3,273.79,2503.0,30
CDM,7502933,ENDO ED LEVEL 4 ADDL 15MIN,950.0,234.65,136.9,2503.0,30
CDM,7502941,ENDO OTHER LEVEL 1 FIRST 15MIN,275.0,98.45,39.63,206.25,27
CDM,7502958,ENDO OTHER LEVEL 1 ADDL 15MIN,140.0,50.12,20.17,105.0,27
CDM,7502966,ENDO OTHER LEVEL 2 FIRST 15MIN,590.0,211.22,85.02,442.5,27
CDM,7502974,ENDO OTHER LEVEL 2 ADDL 15MIN,295.0,105.61,42.51,221.25,27
CDM,7502982,ENDO OTHER LEVEL 3 FIRST 15MIN,1375.0,492.25,198.14,1031.25,27
CDM,7502990,ENDO OTHER LEVEL 3 ADDL 15MIN,690.0,247.02,99.43,517.5,27
CDM,7503006,ENDO OTHER LEVEL 4 FIRST 15MIN,1900.0,680.2,273.79,1425.0,27
CDM,7503014,ENDO OTHER LEVEL 4 ADDL 15MIN,950.0,340.1,136.9,712.5,27
CDM,7503030,ENDO ANES MAC/GEN FIRST 15MIN,1395.0,443.61,201.02,1046.25,29
CDM,7503048,ENDO ANES MAC/GEN ADDL 15MIN,555.0,176.49,79.98,416.25,29
CDM,7503055,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,7503063,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,7503071,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,7503279,TEST ESOPHAGEAL PH CATH NASAL IMPED,1147.0,487.48,117.73,4664.0,63
CDM,7503287,THERAPY ELECTROCONVULSIVE W MNTR,1896.0,623.84,102.94,3006.3,69
CDM,7503303,STUDY CAPSULE PATENCY,323.0,137.28,101.17,2481.0,62
CDM,7503360,INSTILL FECAL MICROB LGI EN RECT SP,746.0,317.05,107.5,13802.9,58
CDM,7503378,SENSATION RECTAL&TONE&STUDY COMPLNC,535.0,227.38,159.94,2726.46,62
CDM,7503386,MANOMETRY ANORECTAL SENS&BLN EXPLSN,1133.0,481.52,276.4,2481.0,62
CDM,7610454,FLAP DELAY/SECT F/N/H/F/G,6499.0,3366.48,321.08,6499.0,63
CDM,7610462,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7610470,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7610488,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7610496,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7610504,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7610512,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7610520,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7610538,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7610546,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7610553,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7610827,RPR WND INTRM SC/TR 0-2.5CM,1490.0,771.82,148.0,3432.43,63
CDM,7611437,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7611668,PUNCT LUMBAR DIAGNOSTIC,1604.0,830.87,61.59,1603.86,63
CDM,7611734,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7611742,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7611759,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7611767,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7611775,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7611783,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7611791,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7611809,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7611817,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7611825,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7611841,BX TISS SOFT LEG/ANKLE SUPERFICIAL,3433.0,1778.29,159.27,3432.43,63
CDM,7611858,PAR/CUT LSN HYPERKERATOTIC BGN SGL,284.0,147.11,15.1,363.86,63
CDM,7612435,IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CDM,7612559,TRANSFER TISS S/A&/L 10.1-30.0CM,5262.0,2725.72,692.94,5261.73,63
CDM,7612575,RPR WND INTRM N/H/F 0-2.5CM,1465.0,758.87,141.88,3432.43,63
CDM,7612609,REM TAGS SKIN LSN 1-15,443.0,229.47,75.29,3432.43,63
CDM,7612617,RPR WND INTRM SC/TR 2.6-7.5CM,1666.0,862.99,185.92,3432.43,63
CDM,7612658,TRANSFER TISS TRUNK 0-10.0CM,3681.0,1906.76,494.03,4596.53,63
CDM,7612666,TRANSFER TISS TRUNK 10.1-30.0CM,4678.0,2423.2,638.73,5261.73,63
CDM,7612674,TRANSFER TISS S/A&/L 0-10.0CM,4131.0,2139.86,555.47,5261.73,63
CDM,7612815,DEBRIDE FX&/DSL OPEN SKIN&TISS SUBQ,1299.0,672.88,268.59,4596.53,63
CDM,7612823,DEBRIDE FX&/DSL OPEN SKIN/MUSC,4017.0,2080.81,288.41,4596.53,63
CDM,7612831,DEBRIDE FX&/DSL OPEN SKIN/MUSC/BONE,2452.0,1270.14,402.77,5114.29,63
CDM,7612856,GRAFT PINCH SGL/MULT 0-2CM,1512.0,783.22,380.02,4596.53,63
CDM,7612955,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7612963,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7612971,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7612989,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7612997,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7613029,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7613037,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7613045,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7613052,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7613060,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7613110,CAUT CHEMICAL TISSUE GRANULATION,383.0,198.39,36.77,3432.43,63
CDM,7613243,MONITOR PRESS SYND COMPART MUSC,1022.0,529.4,86.49,1246.81,63
CDM,7613433,APPL CMPRSS MULT BELOW KNEE LT,353.0,182.85,26.1,476.55,40
CDM,7613441,APPL CMPRSS MULT BELOW KNEE RT,353.0,182.85,26.1,476.55,40
CDM,7613458,APPL CMPRSS MULT BELOW KNEE BI,530.0,274.54,26.1,476.55,40
CDM,7613466,TRANSFER TISS ANY AREA 30.1-60.0CM,6499.0,3366.48,847.73,6499.0,63
CDM,7613474,TRANSFER TISS ANY AREA ADDL 30.0CM,3147.0,1630.15,208.08,3252.83,40
CDM,7613789,REFILL&MAINT PUMP IMPLANTABLE,653.0,193.94,114.46,945.0,63
CDM,7613813,REM FB PELVIS/HIP DEEP,5262.0,2725.72,605.4,5760.96,63
CDM,7613847,RPR WND SMPL TR&/EXT 7.6-12.5CM,801.0,414.92,71.43,600.75,63
CDM,7613854,RPR WND SMPL F/E/E/N 0-2.5CM,577.0,298.89,53.92,576.73,63
CDM,7613904,DEBRIDE TISSUE SUBQ 1ST 20CM,1506.0,780.11,59.06,1199.09,63
CDM,7613912,DEBRIDE TISSUE SUBQ ADDL 20CM,648.0,335.66,24.44,598.68,40
CDM,7613920,DEBRIDE MUSCLE&/FASCIA 1ST 20CM,3825.0,1981.35,149.28,4596.53,63
CDM,7613938,DEBRIDE MUSCLE&/FASCIA ADDL 20CM,1072.0,555.3,52.99,2301.59,40
CDM,7613946,DEBRIDE BONE 1ST 20CM,4597.0,2381.25,218.85,4596.53,63
CDM,7613953,DEBRIDE BONE ADDL 20CM,1892.0,980.06,93.56,2301.59,40
CDM,7613961,DEBRIDE SLCT WND OPEN 1ST 20CM,522.0,270.4,34.48,666.6,63
CDM,7613979,DEBRIDE SLCT WND OPEN ADDL 20CM,334.0,173.01,23.87,333.33,40
CDM,7614399,PAR/CUT LSN HYPERKERATOTIC BGN 2-4,411.0,212.9,21.35,363.86,63
CDM,7614407,PAR/CUT LSN HYPERKERATOTIC BGN 4+,527.0,272.99,27.93,395.25,63
CDM,7614415,PAR/CUT LSN HYPERKERATOTIC BGN SGL,284.0,147.11,15.1,363.86,63
CDM,7614423,PAR/CUT LSN HYPERKERATOTIC BGN 2-4,411.0,212.9,21.35,363.86,63
CDM,7614431,PAR/CUT LSN HYPERKERATOTIC BGN 4+,527.0,272.99,27.93,395.25,63
CDM,7614449,EXC TUMOR PELVIS&HIP SUBQ 0-2CM,4597.0,2381.25,356.93,5114.29,63
CDM,7614506,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7614522,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7614548,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7614563,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7614589,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7614605,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7614621,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7614647,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7614662,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7614696,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7615602,I&R FB TISSUE SUBQ SIMPLE,801.0,414.92,103.94,3432.43,63
CDM,7615610,I&R FB TISSUE SUBQ COMPLICATED,2247.0,1163.95,179.82,4596.53,63
CDM,7615628,ASP PUNCT ABSCESS/CYST,651.0,337.22,94.84,715.75,63
CDM,7615636,I&D WOUND POSTOP COMPLEX,4597.0,2381.25,174.79,5114.29,63
CDM,7615719,EXC SKIN&TISSUE HIDRADEN AXILLARY,4597.0,2381.25,257.39,5114.29,63
CDM,7615727,EXC SKIN&TISSUE HIDRADEN INGUINAL,4534.0,2348.61,245.12,5114.29,63
CDM,7615735,EXC SKIN&TISSUE HIDRADEN PERIANAL,4534.0,2348.61,281.68,5114.29,63
CDM,7615743,TRIM NAILS NONDYSTROPHIC,237.0,122.77,7.24,363.86,63
CDM,7615750,DEBRIDE NAIL/S 1-5,280.0,145.04,13.78,363.86,63
CDM,7615768,DEBRIDE NAIL/S 6+,364.0,188.55,23.01,363.86,63
CDM,7615776,AVULSION PLATE NAIL SMPL SGL,701.0,363.12,52.44,525.75,63
CDM,7615784,AVULSION PLATE NAIL SMPL ADDL,180.0,93.24,16.42,179.6,40
CDM,7615792,EXC NAIL&MATRIX REM PERM,1287.0,666.67,100.1,3432.43,63
CDM,7615800,INJ INTRALESIONAL LSN 1-7,283.0,146.59,29.08,363.86,63
CDM,7615818,INJ INTRALESIONAL LSN 8+,364.0,188.55,44.16,363.86,63
CDM,7615826,RPR WND SMPL TR&/EXT 0-2.5CM,577.0,298.89,43.54,576.73,63
CDM,7615834,RPR WND SMPL TR&/EXT 2.6-7.5CM,731.0,378.66,57.18,576.73,63
CDM,7615875,GRAFT SPLIT T/A/L 1ST 0-100CM,4597.0,2381.25,698.58,4596.53,63
CDM,7615883,GRAFT SPLIT T/A/L ADDL 100CM,2302.0,1192.44,107.0,2301.59,40
CDM,7615891,GRAFT SPLIT F/N/H/F/G 1ST 0-100CM,5603.0,2902.35,674.52,6239.39,63
CDM,7615909,GRAFT SPLIT F/N/H/F/G ADDL 100CM,2302.0,1192.44,127.28,2301.59,40
CDM,7615933,CAUT CHEMICAL TISSUE GRANULATION,383.0,198.39,36.77,3432.43,63
CDM,7615941,BX MUSCLE SUPERFICIAL,2977.0,1542.09,92.55,4596.53,63
CDM,7615966,APPL SPLINT ARM SHORT STATIC,469.0,242.94,39.65,476.55,63
CDM,7615974,APPL CAST LEG CONTACT RIGID,684.0,354.31,96.42,1068.05,63
CDM,7615982,APPL SPLINT LEG SHORT,424.0,219.63,48.85,476.55,63
CDM,7615990,STRAPPING BOOT UNNA BI,567.0,293.71,25.49,476.55,40
CDM,7616006,STRAPPING BOOT UNNA LT,378.0,195.8,25.49,476.55,40
CDM,7616014,STRAPPING BOOT UNNA RT,378.0,195.8,25.49,476.55,40
CDM,7616030,COLLECT SPEC BLD VAD IMPLNT,413.0,213.93,26.9,309.75,63
CDM,7616048,INS CATH BLADDER NONINDWL,257.0,133.13,24.8,283.97,63
CDM,7616055,INS CATH BLADDER INDWL SMPL,284.0,147.11,24.52,283.97,63
CDM,7616063,PUNCT LUMBAR DIAGNOSTIC,1604.0,830.87,61.59,1603.86,63
CDM,7616089,INJ ANES GANGLION STELLA,2187.0,1132.87,75.18,3151.58,63
CDM,7616105,DEBRIDE NONSELECT WO ANES SESSN,295.0,152.81,83.39,363.86,63
CDM,7616121,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7616147,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7616162,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7616188,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7616212,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7616220,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7616246,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7616261,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7616287,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7616303,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7616329,DECLOT CATH/VAD W AGENT THROMB,711.0,368.3,33.67,1077.69,63
CDM,7616337,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7616345,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7616352,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7616360,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7616378,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7616386,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7616394,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7616402,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7616410,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7616428,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7616634,BX BONE OPEN SUPERFICIAL,4597.0,2381.25,136.63,5114.29,63
CDM,7616642,I&D ABSCESS SIMPLE,741.0,383.84,105.0,620.83,63
CDM,7616659,I&D ABSCESS CMP/MULT,1071.0,554.78,181.2,3432.43,63
CDM,7616667,I&D HEMATOMA/SEROMA/FLUID,3139.0,1626.0,116.33,3432.43,63
CDM,7616675,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7616683,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7616691,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7616709,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7616717,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7616725,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7616733,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7616741,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7616758,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7616766,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7616881,PHLEBOTOMY THERAPEUTIC,897.0,266.41,81.16,945.0,63
CDM,7616899,IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CDM,7617020,FLAP DELAY/SECT SCALP/ARM/LEG,5262.0,2725.72,240.45,5261.73,63
CDM,7617046,INJ EPID PATCH BLOOD/CLOT,1604.0,830.87,110.28,1603.86,63
CDM,7617095,AMP TOE JT METATARSOPHALANGEAL,4759.0,2465.16,173.28,5760.96,63
CDM,7617103,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7617129,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7617145,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7617160,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7617194,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7617202,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7617228,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7617244,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7617269,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7617285,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7617608,INS CATH BLADDER NONINDWL,257.0,133.13,24.8,283.97,63
CDM,7618010,COLLECT SPEC BLD VAD IMPLNT,413.0,213.93,26.9,309.75,63
CDM,7618515,IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,40
CDM,7618606,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7619091,DECLOT CATH/VAD W AGENT THROMB,711.0,368.3,33.67,1077.69,63
CDM,7619133,REFILL&MAINT PUMP PORTABLE,662.0,196.61,120.63,1053.28,63
CDM,7619224,PREP WND T/A/L 1ST 100CM,4597.0,2381.25,212.31,4596.53,63
CDM,7619232,PREP WND T/A/L ADDL 100CM,975.0,505.05,43.43,2301.59,40
CDM,7619240,PREP WND F/N/H/F/G 1ST 100CM,4990.0,2584.82,251.54,4596.53,63
CDM,7619257,PREP WND F/N/H/F/G ADDL 100CM,1949.0,1009.58,86.33,2301.59,40
CDM,7619398,FLAP DELAY/SECT TRUNK,5603.0,2902.35,208.87,6239.39,63
CDM,7619463,AMP TOE METATARSAL SGL,4055.0,2100.49,415.02,5760.96,63
CDM,7619471,AMP TOE JT INTERPHALANGEAL,4910.0,2543.38,169.02,5760.96,63
CDM,7619505,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7619513,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7619521,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7619539,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7619547,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7619554,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7619562,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7619570,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7619588,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7619760,DECOMPRESS LEG COMPART ANT&/LAT,5262.0,2725.72,391.43,5760.96,63
CDM,7619786,EXC LESION 0-0.5 CM,1257.0,651.13,181.13,942.75,29
CDM,7619794,EXC LESION 0.6-1.0 CM,1371.0,710.18,197.56,1028.25,29
CDM,7619802,EXC LESION 1.1-2.0 CM,1358.0,703.44,195.69,1018.5,29
CDM,7619810,EXC LESION 2.1-3.0 CM,2261.0,1171.2,325.81,1695.75,29
CDM,7619828,EXC LESION 3.1-4.0 CM,5012.0,2596.22,722.23,3759.0,29
CDM,7619836,EXC LESION 4+ CM,6029.0,3123.02,868.78,4521.75,29
CDM,7619885,DECOMPRESS LEG COMPART POST W DEBR,8646.0,4478.63,608.55,12775.92,63
CDM,7619893,APPL CAST LEG LONG,384.0,198.91,96.83,1068.05,63
CDM,7619984,COLLECT SPEC BLD PICC NOS,468.0,242.42,29.17,351.0,63
CDM,7619992,COLLECT SPEC BLD PICC NOS,468.0,242.42,29.17,351.0,63
CDM,7620487,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7620537,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620545,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7620560,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7620586,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7620594,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620610,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620636,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620669,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620677,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620685,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620693,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620735,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620750,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620768,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620818,OBSRV OB PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620826,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620834,OBSRV OB PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620859,OBSRV OB PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620867,OBSRV OB PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620875,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620883,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620891,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620909,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7620958,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621113,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621121,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7621196,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621238,OBSRV OB PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621881,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621899,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621931,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7621972,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7622020,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7622327,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7622400,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7622434,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7622467,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,42
CDM,7622616,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7622731,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7622913,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7623077,INJ/S ANES NRV INTRCST LVL SGL BI,2348.0,840.58,56.64,5681.0,40
CDM,7623085,INJ/S ANES NRV INTRCST LVL SGL RT,1565.0,560.27,56.64,5681.0,40
CDM,7623093,INJ/S ANES NRV INTRCST LVL SGL LT,1565.0,560.27,56.64,5681.0,40
CDM,7623101,INJ/S ANES NRV INTRCST LVL ADD BI,2937.0,1051.45,24.23,5681.0,40
CDM,7623119,INJ/S ANES NRV INTRCST LVL ADD RT,1958.0,700.96,24.23,5681.0,40
CDM,7623127,INJ/S ANES NRV INTRCST LVL ADD LT,1958.0,700.96,24.23,5681.0,40
CDM,7623200,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,42
CDM,7630148,INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,110.11,27.7,478.0,63
CDM,7630197,INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,110.11,27.7,478.0,63
CDM,7630262,APPL CMPRSS MULT ARM&HAND BI,312.0,161.62,15.18,476.55,40
CDM,7630270,APPL CMPRSS MULT ARM&HAND LT,208.0,107.74,15.18,476.55,40
CDM,7630288,APPL CMPRSS MULT ARM&HAND RT,208.0,107.74,15.18,476.55,40
CDM,7630296,APP SKN T/A/L 0-100CM 1ST 25CM,660.0,341.88,81.5,4596.53,63
CDM,7630304,APP SKN T/A/L 0-100CM ADDL 25CM,82.0,42.48,15.25,2301.59,40
CDM,7630312,APP SKN T/A/L 100+CM/1%PEDS,1162.0,601.92,188.58,4596.53,63
CDM,7630320,APP SKN T/A/L 100+CM/1%PEDS AD,332.0,171.98,42.82,2301.59,40
CDM,7630338,APP SKN F/N/H/F 0-100CM 1ST 25CM,624.0,323.23,90.66,4596.53,63
CDM,7630346,APP SKN F/N/H/F 0-100CM ADDL 25,91.0,47.14,16.93,2301.59,40
CDM,7630353,APP SKN F/N/H/F 100+CM/1%PEDS,1248.0,646.46,214.96,4596.53,63
CDM,7630361,APP SKN F/N/H/F 100+CM/1%PEDS AD,372.0,192.7,53.58,2301.59,40
CDM,7630809,TENOTOMY TNDN FLEX TOE OPEN SGL,3218.0,1666.92,239.2,5261.73,63
CDM,7630833,APPL CAST LEG SHORT WALKING,362.0,187.52,53.17,1068.05,63
CDM,7631286,WOUND NEG PRESS NONDME 0-50 SC,792.0,410.26,250.73,715.75,63
CDM,7631294,WOUND NEG PRESS NONDME 51+ SC,914.0,473.45,250.73,715.75,63
CDM,7631369,EVACUATION HEMATOMA SUBUNGUAL,127.0,65.79,31.67,234.25,63
CDM,7632011,REM CERUMEN IMPACTED W INST UNI,284.0,147.11,31.67,283.97,63
CDM,7632029,REM CERUMEN IMPACTED W INST BI,426.0,220.67,31.67,319.5,63
CDM,7632359,TRANSFER TISS E/N/E&/L 0-10.0CM,4798.0,2485.36,650.57,5261.73,63
CDM,7632367,WOUND NEG PRESS W DME 0-50 SC,318.0,164.72,23.79,363.86,63
CDM,7632375,WOUND NEG PRESS W DME 51+ SC,581.0,300.96,26.1,715.75,63
CDM,7632383,WOUND NEG PRESS W DME 0-50 SC,318.0,164.72,23.79,363.86,63
CDM,7632391,WOUND NEG PRESS W DME 51+ SC,581.0,300.96,26.1,715.75,63
CDM,7632904,INF IV HYDRATION 31-60MIN,469.0,178.69,31.58,478.0,63
CDM,7632912,INF IV HYDRATION ADDL HR,138.0,52.58,12.04,478.0,63
CDM,7632920,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,7632938,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,7632946,INF IV THRPY CONCURRENT,175.0,66.68,19.25,478.0,39
CDM,7632961,CHEMO SUBQ/IM NONHORMONAL,562.0,187.71,44.93,950.0,63
CDM,7632979,CHEMO SUBQ/IM HORMONAL,308.0,102.87,34.48,950.0,63
CDM,7632987,CHEMO IVP DRUG INITIAL,900.0,300.6,97.32,950.0,63
CDM,7632995,CHEMO IVP DRUG ADDL,512.0,171.01,44.93,950.0,63
CDM,7633001,CHEMO INF IV 1ST HR,979.0,334.82,125.88,1221.24,63
CDM,7633019,CHEMO INF IV ADDL HR,225.0,76.95,27.02,950.0,63
CDM,7633027,CHEMO INF IV SEQ 1ST HR,461.0,157.66,44.93,950.0,63
CDM,7633043,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,7633050,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,7633068,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,7633092,PUNCT LUMBAR DIAGNOSTIC,1604.0,830.87,61.59,1603.86,63
CDM,7633118,COLLECT SPEC BLD VAD IMPLNT,413.0,213.93,26.9,309.75,63
CDM,7633126,DECLOT CATH/VAD W AGENT THROMB,711.0,368.3,33.67,1077.69,63
CDM,7633134,REFILL&MAINT PUMP PORTABLE,662.0,196.61,120.63,1053.28,63
CDM,7633142,COLLECT SPEC BLD PICC NOS,468.0,242.42,29.17,351.0,63
CDM,7633159,INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,110.11,27.7,478.0,63
CDM,7633167,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,7633175,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,63
CDM,7633183,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,63
CDM,7633191,IRRG VAD IMP DELIVERY DRUG,257.0,76.33,24.33,945.0,63
CDM,7633209,PHLEBOTOMY THERAPEUTIC,897.0,266.41,81.16,945.0,63
CDM,7633217,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,39
CDM,7633233,VISIT SMK&TOB INTRM 3-10MIN,56.0,18.43,8.07,98.05,59
CDM,7633241,RPR CMPLX TRUNK 2.6-7.5CM,1260.0,652.68,240.09,5261.73,63
CDM,7633258,RPR CMPLX F/H&/F ADDL 5.0CM,584.0,302.51,108.62,2634.19,40
CDM,7633266,REM IMP SUPERFICIAL,3433.0,1778.29,142.56,3432.43,63
CDM,7633274,RPR WND INTRM N/H/F 2.6-7.5CM,1635.0,846.93,191.18,3432.43,63
CDM,7633282,VISIT SMK&TOB INTRM 3-10MIN,56.0,18.43,8.07,98.05,59
CDM,7633290,RPR CMPLX TRUNK 2.6-7.5CM,1260.0,652.68,240.09,5261.73,63
CDM,7633308,RPR CMPLX F/H&/F ADDL 5.0CM,584.0,302.51,108.62,2634.19,40
CDM,7633316,REM IMP SUPERFICIAL,3433.0,1778.29,142.56,3432.43,63
CDM,7633324,EXC WEDGE SKIN NAIL FOLD,513.0,265.73,91.49,715.75,63
CDM,7633555,REM IMP DEEP,5035.0,2608.13,413.2,5261.73,63
CDM,7633589,EXC CYST FIBROADENOMA OPN LSN 1+,6059.0,3138.56,409.89,6893.85,63
CDM,7633597,REM FB PELVIS/HIP SUBQ,3477.0,1801.09,167.13,5114.29,63
CDM,7633654,EXC BONE PARTIAL TOE PHALANX,3427.0,1775.19,331.45,5760.96,63
CDM,7633662,INJ THERAPEUTIC CARPAL TUNNEL,761.0,394.2,55.27,1092.92,63
CDM,7633670,ANGIO FLUORESCENT VASC NON-OPTH,1187.0,334.73,241.82,1516.98,62
CDM,7633696,INJ TEST FLOW VASCULAR FLAP/GRAFT,465.0,240.87,102.69,876.4,63
CDM,7633704,ANGIO EXTREMITY LT S&I,5894.0,1243.63,67.1,11792.62,40
CDM,7633712,ANGIO EXTREMITY RT S&I,5894.0,1243.63,67.1,11792.62,40
CDM,7633720,ANGIO EXTREMITY BI S&I,6003.0,1266.63,70.02,11792.62,63
CDM,7633746,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,28
CDM,7633753,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,28
CDM,7633761,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,28
CDM,7633779,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,28
CDM,7633787,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,28
CDM,7633795,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,28
CDM,7633803,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,28
CDM,7633811,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,28
CDM,7633829,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,28
CDM,7633837,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,28
CDM,7633845,BX MUSCLE DEEP,5262.0,2725.72,150.54,5261.73,63
CDM,7633951,RPR CMPLX F/H&/F 1.1-2.5CM,1163.0,602.43,235.25,4596.53,63
CDM,7633969,RPR CMPLX F/H&/F 2.6-7.5CM,1454.0,753.17,293.86,5261.73,63
CDM,7634058,REM FB FOOT SUBQ,1538.0,796.68,130.69,3432.43,63
CDM,7634066,I&D FOOT BELOW FASCIA SGL,5262.0,2725.72,137.3,5261.73,63
CDM,7634090,EXC BONE PARTIAL FINGER PHALANX DST,3218.0,1666.92,440.69,5261.73,63
CDM,7634108,EXC JOINT HEMIPHAL/INTERPHAL TOE,4138.0,2143.48,264.63,5760.96,63
CDM,7635063,EXC ULCR COCC PRESS W COCC&FLP CLSR,6499.0,3366.48,780.52,6499.0,63
CDM,7635071,EXC ULCR COCC PRESS W COCC&FLP CLSR,6499.0,3366.48,780.52,6499.0,63
CDM,7635097,AMP FINGER/THUMB SGL W DIR CLSR,4910.0,2543.38,694.74,5760.96,63
CDM,7635105,AMP FINGER/THUMB SGL W DIR CLSR,4910.0,2543.38,694.74,5760.96,63
CDM,7635139,INJ/S TRIGGER PT/S MUSC/S 1-2,491.0,254.34,35.93,540.44,63
CDM,7635147,INJ/S TRIGGER PT/S MUSC/S 1-2,491.0,254.34,35.93,540.44,63
CDM,7635196,RPR CMPLX TRUNK 1.1-2.5CM,1105.0,572.39,195.05,4596.53,63
CDM,7636251,BX/S MARROW BONE DX NP/UNI,1386.0,717.95,68.17,3432.43,63
CDM,7636269,BX/S MARROW BONE DX BI,2079.0,1076.92,68.17,3432.43,40
CDM,7636301,ASP/S&BX/S MARROW BONE DX BI,2219.0,3566.39,72.77,3432.43,40
CDM,7636434,EXC ULCR SACRAL PRESS W SUTURE PRM,5262.0,2725.72,688.47,5261.73,63
CDM,7636442,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,3566.39,72.77,5114.29,63
CDM,7636475,APPL SPLINT LEG LONG,477.0,247.09,51.37,476.55,63
CDM,7636483,REM FB FOOT DEEP,3494.0,1809.89,306.6,4596.53,63
CDM,7636491,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,63
CDM,7636509,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,63
CDM,7636517,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,39
CDM,7636657,ASP NEEDLE FINE BX WO IMG LSN ADDL,734.0,380.21,42.01,629.41,40
CDM,7636665,BX SKIN TANGENTIAL LSN SGL,535.0,277.13,36.62,715.75,63
CDM,7636673,BX SKIN TANGENTIAL LSN ADDL,174.0,90.13,21.25,173.62,40
CDM,7636681,BX PUNCH SKIN LSN SGL,733.0,379.69,45.4,715.75,63
CDM,7636699,BX PUNCH SKIN LSN ADDL,206.0,106.71,24.8,205.15,40
CDM,7636707,BX INCISIONAL SKIN LSN SGL,1183.0,612.79,54.84,1301.27,63
CDM,7636715,BX INCISIONAL SKIN LSN ADDL,245.0,126.91,29.7,244.66,40
CDM,7636723,ASP NEEDLE FINE BX WO IMG LSN 1ST,927.0,480.19,53.2,715.75,63
CDM,7636731,WOUND NEG PRESS NONDME 0-50 SC,792.0,410.26,250.73,715.75,63
CDM,7636749,WOUND NEG PRESS NONDME 51+ SC,914.0,473.45,250.73,715.75,63
CDM,7636772,EXC ULCR COCC PRESS W COCC&SUT PRM,5262.0,2725.72,617.56,5261.73,63
CDM,7636780,I&D ABSC/BUR/HEMAT THIGH/KNEE BI,7893.0,4088.57,502.53,5919.75,40
CDM,7636798,I&D ABSC/BUR/HEMAT THIGH/KNEE LT,5262.0,2725.72,502.53,5261.73,40
CDM,7636806,I&D ABSC/BUR/HEMAT THIGH/KNEE RT,5262.0,2725.72,502.53,5261.73,40
CDM,7636814,CLOSURE WOUND SECONDARY EXTN/CMP,5603.0,2902.35,777.04,6239.39,63
CDM,7636822,REM FB MUSCLE/SHTH TNDN SMPL,2094.0,1084.69,145.49,3432.43,63
CDM,7636830,RPR CMPLX E/N/E&/L 1.1-2.5CM,1441.0,746.44,270.17,5261.73,63
CDM,7636863,INJ/S ANES NRV/BR PERPH OTHER,1386.0,717.95,40.83,1603.86,63
CDM,7636962,IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,40
CDM,7637002,IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CDM,7637010,IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,40
CDM,7637036,CHEMO PUSH INTRAARTERIAL,613.0,204.74,99.21,950.0,63
CDM,7637051,RPR WND INTRM SC/TR 7.6-12.5CM,1764.0,913.75,200.46,4596.53,63
CDM,7637069,RPR WND INTRM SC/TR 12.6-20.0CM,1996.0,1033.93,235.35,4596.53,63
CDM,7637077,RPR WND INTRM SC/TR 20.1-30.0CM,2089.0,1082.1,274.87,4596.53,63
CDM,7637085,RPR WND INTRM SC/TR 30.1+CM,3651.0,1891.22,319.25,4596.53,63
CDM,7637093,RPR CMPLX F/H&/F 1.1-2.5CM,1163.0,602.43,235.25,4596.53,63
CDM,7637101,RPR CMPLX F/H&/F 2.6-7.5CM,1454.0,753.17,293.86,5261.73,63
CDM,7637531,BX TISS SOFT LEG/ANKLE SUPER BI,5150.0,2667.7,159.27,3862.5,40
CDM,7637549,BX TISS SOFT LEG/ANKLE SUPER LT,3433.0,1778.29,159.27,3432.43,40
CDM,7637556,BX TISS SOFT LEG/ANKLE SUPER RT,3433.0,1778.29,159.27,3432.43,40
CDM,7637598,APPL CAST ARM SHORT BI,809.0,419.06,61.38,1068.05,40
CDM,7637606,APPL CAST ARM SHORT LT,539.0,279.2,61.38,1068.05,40
CDM,7637614,APPL CAST ARM SHORT RT,539.0,279.2,61.38,1068.05,40
CDM,7639446,REM SUTURE/STAPLE NO ANESTH,369.0,191.14,11.32,1716.22,40
CDM,7639453,REM SUTURE&STAPLE NO ANESTH,461.0,238.8,15.5,1716.22,40
CDM,7639487,REM SUTURE/STAPLE NO ANESTH,369.0,191.14,11.32,1716.22,40
CDM,7639495,REM SUTURE&STAPLE NO ANESTH,461.0,238.8,15.5,1716.22,40
CDM,7639677,RPR WND SMPL TR&/EXT 12.5-20.0CM,1031.0,534.06,91.88,773.25,63
CDM,7639685,RPR WND SMPL TR&/EXT 20.1-30.0CM,1260.0,652.68,112.39,945.0,63
CDM,7639693,RPR WND SMPL TR&/EXT 30.1+CM,1565.0,810.67,130.17,1173.75,63
CDM,7639701,RPR WND SMPL F/E/E/N 2.6-5.0CM,592.0,306.66,56.2,576.73,63
CDM,7639719,RPR WND SMPL F/E/E/N 5.1-7.5CM,765.0,396.27,72.72,576.73,63
CDM,7639727,RPR WND SMPL F/E/E/N 7.6-12.5CM,956.0,495.21,91.24,717.0,63
CDM,7639735,RPR WND SMPL F/E/E/N 12.6-20.0CM,1296.0,671.33,123.71,972.0,63
CDM,7639743,RPR WND SMPL F/E/E/N 20.1-30.0CM,1636.0,847.45,149.16,1227.0,63
CDM,7639750,RPR WND SMPL F/E/E/N 30.1+CM,1845.0,955.71,130.17,1383.75,63
CDM,7639768,RPR WND INTRM N/H/F 7.6-12.5CM,1792.0,928.26,209.21,4596.53,63
CDM,7639776,RPR WND INTRM N/H/F 12.6-20.0CM,2294.0,1188.29,267.12,4596.53,63
CDM,7639784,RPR WND INTRM N/H/F 20.1-30.0CM,2673.0,1384.61,309.99,4596.53,63
CDM,7639792,RPR WND INTRM N/H/F 30.1+CM,2964.0,1535.35,343.68,4596.53,63
CDM,7639818,I&D ABSC/HEMAT LEG/ANKLE BI,6896.0,3572.13,384.15,5172.0,40
CDM,7639826,I&D ABSC/HEMAT LEG/ANKLE LT,4597.0,2381.25,384.15,4596.53,40
CDM,7639834,I&D ABSC/HEMAT LEG/ANKLE RT,4597.0,2381.25,384.15,4596.53,40
CDM,7639842,TENOTOMY TNDN TOE PERC SINGLE,5262.0,2725.72,206.58,5261.73,63
CDM,7639859,CAPSULOT JOINT INTERPHAL TOE BI,5171.0,2678.58,248.96,5261.73,40
CDM,7639867,CAPSULOT JOINT INTERPHAL TOE LT,3447.0,1785.55,248.96,5261.73,40
CDM,7639875,CAPSULOT JOINT INTERPHAL TOE RT,3447.0,1785.55,248.96,5261.73,40
CDM,7690001,CHEMO INF IV 1ST HR,979.0,334.82,125.88,1221.24,63
CDM,7690019,CHEMO INF IV ADDL HR,225.0,76.95,27.02,950.0,63
CDM,7690027,CHEMO INF IV SEQ 1ST HR,461.0,157.66,44.93,950.0,63
CDM,7690035,CHEMO IVP DRUG INITIAL,900.0,300.6,97.32,950.0,63
CDM,7690043,CHEMO IVP DRUG ADDL,512.0,171.01,44.93,950.0,63
CDM,7690050,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,63
CDM,7690068,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,63
CDM,7690076,INF IV THRPY CONCURRENT,175.0,66.68,19.25,478.0,39
CDM,7690084,INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,110.11,27.7,478.0,63
CDM,7690092,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,63
CDM,7690100,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,39
CDM,7690118,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,63
CDM,7690126,INF IV HYDRATION 31-60MIN,469.0,178.69,31.58,478.0,63
CDM,7690134,INF IV HYDRATION ADDL HR,138.0,52.58,12.04,478.0,63
CDM,7690142,ASP BLADDER CATH SUPRAPUB,3433.0,1229.01,494.7,2574.75,27
CDM,7690159,INS CATH BLADDER INDWL SMPL,284.0,101.67,24.52,5681.0,63
CDM,7690167,INS CATH BLADDER INDWL CMP,459.0,164.32,73.85,5681.0,63
CDM,7690175,INS CATH BLADDER NONINDWL,257.0,92.01,24.8,5681.0,63
CDM,7690183,CATH COLLECT SPEC URINE,49.0,8.43,3.0,49.22,63
CDM,7690217,INJ EPID PATCH BLOOD/CLOT,1604.0,574.23,110.28,5681.0,63
CDM,7690225,IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CDM,7690233,IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,40
CDM,7690258,CHEMO SUBQ/IM NONHORMONAL,562.0,187.71,44.93,950.0,63
CDM,7690274,INJ/S ANES NRV BLOCK OTHER,1386.0,496.19,199.72,1039.5,27
CDM,7690282,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,7690290,INJ/S SHTH TNDN SGL/LIG/AP,594.0,212.65,85.6,445.5,27
CDM,7690308,INJ/S TRIGGER PT/S MUSC/S,750.0,268.5,108.08,562.5,27
CDM,7690316,PROCEDURE IRRG BLADDER,805.0,288.19,29.06,5681.0,63
CDM,7690324,PUNCT LUMBAR,1604.0,574.23,231.14,1203.0,27
CDM,7690340,LAVAGE PERITONEAL/PARACENTESIS,1877.0,671.97,270.48,1407.75,27
CDM,7690357,SPLINT/STRAP EXTREMITY LOWER,324.0,115.99,46.69,243.0,27
CDM,7690365,SPLINT/STRAP EXTREMITY UPPER,476.0,170.41,68.59,357.0,27
CDM,7690373,THORACENT/TUBE CHEST/DRN PLEURAL,1876.0,671.61,270.33,1407.0,27
CDM,7690381,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CDM,7690399,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CDM,7690407,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CDM,7690415,ADMISSION DIRECT OBSERVATION HOSP,668.0,273.88,30.0,9768.0,62
CDM,7690423,PROCEDURE UNLIST LVL 01 SMPL,880.0,315.04,126.81,660.0,27
CDM,7690431,PROCEDURE UNLIST LVL 02 INTRM,1409.0,504.42,203.04,1056.75,27
CDM,7690449,PROCEDURE UNLIST LVL 03 CMPLX,2946.0,1054.67,424.52,2209.5,27
CDM,7690456,PROCEDURE UNLIST ADD-ON,239.0,85.56,34.44,179.25,27
CDM,7690464,I&D/ASP PUNCT LVL 01 SIMPLE,445.0,159.31,64.12,333.75,27
CDM,7690472,I&D LVL 02 INTRM,532.0,190.46,76.66,399.0,27
CDM,7690480,I&D LVL 03 COMPLEX,636.0,227.69,91.65,477.0,27
CDM,7690555,INJ/S ANES NRV TRIGEMINAL BR EA,1318.0,471.84,50.08,5681.0,63
CDM,7690621,CHG TUBE CYSTO SIMPLE,715.0,255.97,50.29,5681.0,63
CDM,7690647,DEBRIDE TISSUE SKIN/SUBQ,1299.0,465.04,187.19,974.25,27
CDM,7690654,RPR WOUND LVL 01 SIMPLE,621.0,222.32,89.49,465.75,27
CDM,7690662,RPR WOUND LVL 02 INTERMEDIATE,776.0,277.81,111.82,582.0,27
CDM,7690670,RPR WOUND LVL 03 COMPLEX,1019.0,364.8,146.84,764.25,27
CDM,78394,R&B DETOXIFICATION PVT,4096.0,1347.71,739.87,3072.0,13
CDM,8011009,HARVEST CELL STEM COLL AUTOLOGOUS,4708.0,1549.07,80.04,3531.0,60
CDM,8011017,HARVEST CELL STEM COLL ALLOGENEIC,5760.0,1895.21,81.66,5760.0,38
CDM,8011025,APHERESIS WBC,5336.0,1584.79,107.59,4002.0,63
CDM,8011033,APHERESIS RBC,5174.0,1536.68,102.44,3880.5,63
CDM,8011041,APHERESIS PLATELETS,5917.0,1757.35,102.48,4437.75,63
CDM,8011058,APHERESIS PHERESIS PLASMA,5244.0,1557.47,90.15,3933.0,63
CDM,8011074,PHOTOPHERESIS EXTRACORPOREAL,6972.0,2495.98,92.5,8755.0,63
CDM,8011082,HEMODIALYSIS IP DIALYSIS UNIT,2680.0,485.08,69.03,2010.0,63
CDM,8011090,HEMODIALYSIS IP BEDSIDE,2680.0,485.08,69.03,2010.0,63
CDM,8011108,HEMODIALYSIS IP SLED,3620.0,655.22,521.64,2715.0,29
CDM,8011132,DIALYSIS OP UNSCH/ER ESRD PT,2395.0,457.44,474.4,3504.34,62
CDM,8011223,THERAPY RENAL REPLACEMENT CRRT/SLED,2685.0,883.45,386.91,2013.75,29
CDM,8011231,THERAPY RENAL REPLACEMENT CRRT/SLED,2685.0,883.45,386.91,2013.75,29
CDM,8011249,THERAPY RENAL REPLACEMENT CRRT/SLED,2685.0,883.45,386.91,2013.75,29
CDM,8011256,THERAPY RENAL REPLACEMENT CRRT/SLED,2685.0,883.45,386.91,2013.75,29
CDM,8011538,THERAPY RENAL REPLACEMENT CRRT/SLED,2685.0,883.45,386.91,2013.75,29
CDM,8011660,DIALYSIS OP UNSCH/ER NON ESRD PT,2680.0,511.88,69.03,2010.0,63
CDM,8011694,APHERESIS IMMUNOADSRP EXTRACORP SEL,4844.0,1438.67,82.49,7668.67,63
CDM,8011728,ULTRAFILTRATION THERAPEUTIC,2493.0,820.27,489.75,2742.14,61
CDM,8100034,ACQ/STORE KIDNEY LIVING,118654.0,39040.73,17098.04,118654.0,28
CDM,8100042,ACQ/STORE LIVER LIVING,158394.0,52116.38,22824.58,158394.0,28
CDM,8101750,THERAPY CAR T-CELL ADMIN AUTOLOG,1187.0,390.56,193.45,890.25,59
CDM,8101842,ACQ/STORE KIDNEY CADAVER,118654.0,39040.73,17098.04,118654.0,28
CDM,8101859,ACQ/STORE LIVER CADAVER,150286.0,49448.6,21656.21,150286.0,28
CDM,8101867,ACQ/STORE PANC CADAVER,137163.0,45130.74,19765.19,137163.0,28
CDM,8101875,ACQ/STORE HEART CADAVER,207405.0,68242.47,29887.06,207405.0,28
CDM,8101909,ACQ/STORE PANC 2NDRY2 KIDNEY CAD,54544.0,17946.61,7859.79,54544.0,28
CDM,8101933,ACQ/STORE KIDNEY 2NDRY HEART CAD,59328.0,19520.69,8549.16,59328.0,28
CDM,8101941,ACQ/STORE KIDNEY 2NDRY LIVER CAD,59328.0,19520.69,8549.16,59328.0,28
CDM,8391,R&B DETOXIFICATION SEMI-PVT,4096.0,1347.71,739.87,3072.0,14
CDM,8403818,METOCLOPRAMIDE/<=10MG 10MG/2ML SNIJ,0.35,0.02,0.0651,8.18,40
CDM,8404022,DIPHENOXYLT-ATROP/2.5-0.025MG TB,0.05,0.02,0.0072,13.3,35
CDM,8404188,NITROGLYCERIN/0.4MG 10MG FLER,0.82,0.27,0.11816,0.615,29
CDM,8407058,D5-NACL 0.2%/500ML SNIV,5.13,0.25,0.73923,3.85,29
CDM,8407223,TUBERCULIN PPD/1ML 5U/0.1ML SNIJ,8.37,2.75,1.21,6.28,29
CDM,8412769,ACETAZOLAMIDE/250MG 250MG TB,1.67,0.55,0.24065,13.3,35
CDM,8413106,MICROFIB COLL/70X35 SNTP,190.0,9.12,27.38,142.5,29
CDM,8415341,ISOSORBIDE DINITRATE/30MG 30MG TB,1.05,0.35,0.1513,13.3,35
CDM,8420804,MOXIFLOXACIN/400MG 400MG TB,2.94,0.97,0.42365,13.3,35
CDM,8421786,OPIUM TINCTURE/1ML 1ML TN,5.23,1.72,0.75364,13.3,35
CDM,8450850,CARDIOPLEGIA/1000ML 1000ML SNIJ,53.24,2.56,7.67,39.93,29
CDM,8451106,CYCLOPENTOLATE-PHENYL/2ML 2ML SNOP,35.26,11.6,5.08,26.45,29
CDM,8456360,DOXYCYCLINE MONOHYD/100MG 100MG CP,0.09,0.03,0.01297,13.3,35
CDM,8467854,PAROMOMYCIN/250MG 250MG CP,4.05,1.33,0.58361,13.3,35
CDM,8471609,PLEGISOL/1000ML 1000ML SNIJ,85.27,4.09,12.29,63.95,29
CDM,8477762,EPO ALFA EPBX/1000U 20KU SNIJ MDV,4.53,1.29,0.84258,51.22,44
CDM,8480139,EPO ALFA ESRD/100U 2KU SNIJ,0.22,0.07,0.04092,5.12,40
CDM,8480154,EPO ALFA ESRD/100U 3KU SNIJ,0.85,0.28,0.1581,5.12,40
CDM,8480162,EPO ALFA ESRD/100U 4KU SNIJ,0.22,0.07,0.04092,5.12,40
CDM,8483315,EPO ALFA EPBX ESRD/100U 2KU SNIJ,0.22,0.07,0.04092,5.12,40
CDM,8483323,EPO ALFA EPBX ESRD/100U 3KU SNIJ,0.52,0.17,0.09672,5.12,40
CDM,8483331,EPO ALFA EPBX ESRD/100U 4KU SNIJ,0.56,0.18,0.10416,5.12,40
CDM,8483877,FOSPHENYTOIN/50MG 100MG/2ML PE SN,0.82,0.23,0.15252,5.12,44
CDM,8483968,GEMCITABN NOS/200MG 2GM/52.6ML SNIV,1.78,0.09,0.33108,21.62,40
CDM,8488850,RITUXIM-HYAL/10MG 1.4GM-23400U SNIJ,23.5,6.7,4.37,271.87,44
CDM,88393,R&B BEHAVIORAL SEMI-PVT,4096.0,1347.71,816.39,3072.0,14
CDM,9009952,BEHAVIORAL SITTER 1:1 PER HOUR,40.0,13.16,5.76,30.0,26
CDM,91017,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91025,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91033,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91041,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91066,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91124,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91132,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91157,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91348,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,91488,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92023,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92080,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,9210006,SSEP STIM NERVE LIMBS UPR&LW,2007.0,660.36,321.76,2006.24,63
CDM,9210196,ANLYS NEUROSTIM WO REPROGRAMMING,341.0,304.51,18.35,711.0,63
CDM,9210238,EMG NEEDLE 1 EXTREMITY,331.0,108.91,60.97,259.43,63
CDM,9210246,EMG NEEDLE 2 EXTREMITIES,474.0,155.96,77.86,355.5,63
CDM,9210253,EMG NEEDLE 3 EXTREMITIES,587.0,193.14,101.17,440.25,63
CDM,9210261,EMG NEEDLE 4 EXTREMITIES,686.0,225.71,101.17,514.5,63
CDM,9210279,EMG NEEDLE MUSC/S NRV CRANIAL BI,353.0,116.15,75.26,380.18,63
CDM,9210287,EMG NEEDLE MUSC/S NRV CRANIAL UNI,346.0,113.84,63.9,380.18,63
CDM,9210295,TEST LIMB ISCHEMIC W ACQ SPECIMEN,587.0,193.14,62.92,440.25,63
CDM,9210303,EMG NEEDLE MUSC/S LTD,213.0,70.08,61.95,234.25,63
CDM,9210329,EMG NEEDLE MUSC/S THOR PARASPINAL,346.0,113.84,73.63,380.18,63
CDM,9210386,TEST NEUROMUS JUNCTION EA NERVE,249.0,81.93,68.44,226.54,63
CDM,9210394,SSEP STIM NERVE LIMBS LOWER,773.0,254.34,127.43,718.42,63
CDM,9210402,SSEP STIM NERVE LIMBS UPPER,804.0,264.54,144.63,733.38,63
CDM,9210949,ANLYS NEUROSTIM CMPLX W PROGRAMMING,646.0,576.88,55.52,711.0,63
CDM,9211087,CMEP STIM TRANSCRANIAL LIMBS UPPER,1374.0,1226.98,158.95,1511.98,63
CDM,9211095,CMEP STIM TRANSCRANIAL LIMBS LOWER,1029.0,918.9,161.87,1000.86,63
CDM,9211269,EMG NEEDLE LARYNX,267.0,87.85,66.17,255.97,63
CDM,9211459,ART PHYS 1-2 LEVEL LTD BI,1463.0,389.16,68.72,1097.25,63
CDM,9211467,ART PHYS 3+ LEVEL CMP BI,1820.0,484.12,101.17,1471.62,63
CDM,9211582,INTERROGATION VAD IN PERSON,389.0,113.98,49.47,422.73,63
CDM,9211624,EMG NEEDLE EXT DONE W STUDY LTD,237.0,77.98,42.51,303.26,40
CDM,9211632,EMG NEEDLE EXT DONE W STUDY CMP,280.0,92.13,50.63,210.0,40
CDM,9211640,EMG NEEDLE NON-EXT DONE W STUDY,173.0,56.92,32.18,172.02,40
CDM,9211657,CMEP STIM TRANSCRANIAL LIMBS UPR&LW,2770.0,911.41,430.44,2769.76,63
CDM,9211715,STUDIES CONDUCTION NERVE 1-2,346.0,113.84,37.28,380.18,63
CDM,9211723,STUDIES CONDUCTION NERVE 3-4,416.0,136.88,45.72,415.02,63
CDM,9211731,STUDIES CONDUCTION NERVE 5-6,500.0,164.52,55.14,499.76,63
CDM,9211749,STUDIES CONDUCTION NERVE 7-8,645.0,212.22,70.06,657.01,63
CDM,9211756,STUDIES CONDUCTION NERVE 9-10,749.0,246.44,80.12,748.35,63
CDM,9211764,STUDIES CONDUCTION NERVE 11-12,847.0,278.69,90.47,846.67,63
CDM,9211772,STUDIES CONDUCTION NERVE 13+,948.0,311.92,100.21,947.84,63
CDM,9211780,MONITOR NEURO 1:1 IN OR 15MIN,254.0,226.82,31.17,711.0,39
CDM,9211798,MONITOR NEURO OUT OR/MULTI IN OR HR,881.0,786.73,163.87,711.0,38
CDM,9211921,EVOK POTENT VIS CNS NO GLAUC W I&R,1399.0,460.31,47.99,1049.25,63
CDM,9211939,CDP-SOT 6 CONDITIONS W MCT&ADT,1609.0,1436.84,19.76,1206.75,63
CDM,92122,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92130,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92148,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92155,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92189,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92197,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92213,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92221,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92254,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92262,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92288,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92320,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92437,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92643,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,92718,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93013,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93047,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93054,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93062,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93070,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93146,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93211,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93294,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93419,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,93427,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,9400029,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,9400599,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,9400771,REFILL&MAINT PUMP PORTABLE,662.0,196.61,120.63,1053.28,63
CDM,9400987,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,63
CDM,9400995,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,63
CDM,9401001,REFILL&MAINT PUMP IMPLANTABLE,653.0,193.94,114.46,945.0,63
CDM,9401019,IRRG VAD IMP DELIVERY DRUG,257.0,76.33,24.33,945.0,63
CDM,9401159,INJ INTRA-ARTERIAL,532.0,158.0,18.28,945.0,63
CDM,9401373,INJ SUBQ/IM,176.0,52.27,14.06,945.0,63
CDM,9401381,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,63
CDM,9401399,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,63
CDM,9401555,IRRG VAD IMP DELIVERY DRUG,257.0,76.33,24.33,945.0,63
CDM,9401571,PHLEBOTOMY THERAPEUTIC,897.0,266.41,81.16,945.0,63
CDM,9401662,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,39
CDM,9401670,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,39
CDM,9402710,APPL INJECTOR ON-BODY,417.0,123.85,17.95,945.0,63
CDM,9402736,APPL INJECTOR ON-BODY,417.0,123.85,17.95,945.0,63
CDM,9431149,CR II W EKG PER SESSION,842.0,521.2,13.13,631.5,63
CDM,9431354,CR II WO EKG PER SESSION,408.0,252.55,8.55,400.0,63
CDM,9431495,CR II W EKG 36+ SESSIONS,842.0,521.2,13.13,631.5,40
CDM,9431503,CR II WO EKG 36+ SESSIONS,408.0,252.55,8.55,400.0,40
CDM,9431578,CR II WO EKG PER SESSION TELEHLTH,408.0,252.55,8.55,400.0,63
CDM,9431586,CR II WO EKG 36+ SESSIONS TELEHLTH,408.0,252.55,8.55,400.0,40
CDM,95018,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,95158,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,95422,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,98236,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,98574,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99101,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99275,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99341,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99382,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99465,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99838,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CDM,99853,R&B MEDICAL/SURGICAL PVT,3723.0,1224.98,1675.35,2792.25,5
CPT,0001U,LAB RBC DNA HEA 35 AG 11 BLD GRP NS,2160.0,410.4,311.26,3793.97,59
CPT,0023U,LAB ONC AML DNA DET/NONDET,746.0,208.13,243.94,1076.3,63
CPT,0029U,LAB DRG METAB ADVRS TGT SEQ ANLYS,2227.0,621.33,414.22,3214.77,40
CPT,0035U,LAB NEURO CSF PRION PROT QUAL,1623.0,452.82,33.01,2343.03,63
CPT,0037U,LAB GENE SO NEOPLSM DNA TGT SEQ 324,10500.0,2929.5,3500.0,18442.87,63
CPT,0046U,LAB GENE FLT3 VAR ITD QN,2340.0,652.86,407.43,1764.58,63
CPT,0049U,LAB NPM1 GENE ANALYSIS QUAN,2275.0,634.72,407.43,2146.87,63
CPT,0054T,"COMPUTER-ASSISTED MUSCULOSKELETAL SURGICAL NAVIGATIONAL ORTHOPEDIC PROCEDURE, WITH IMAGE-GUIDANCE BASED ON FLUOROSCOPIC IMAGES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,109.01,5681.0,14
CPT,0055T,"COMPUTER-ASSISTED MUSCULOSKELETAL SURGICAL NAVIGATIONAL ORTHOPEDIC PROCEDURE, WITH IMAGE-GUIDANCE BASED ON CT/MRI IMAGES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,219.52,5681.0,14
CPT,0058U,LAB DET AB ONC SRM MRKL CLL QN,969.0,166.67,139.63,6612.09,59
CPT,0059U,LAB DET AB ONC SRM MRKL CLL +/- NS,969.0,166.67,139.63,6612.09,59
CPT,0075T,PLC STNT/S VERT ART OPN/PERC INIT,12779.0,4574.88,776.16,10257.38,72
CPT,0076T,PLC STNT/S VERT ART OPN/PERC ADDL,9585.0,3431.43,460.98,7188.75,72
CPT,0077U,LAB IG PARAPROT IMPRC&MS BLD/UR QL,211.0,58.87,30.41,203.88,59
CPT,0088U,LAB TRNSPL REJECT ALLOGRAFT KIDNEY,9479.0,2644.64,1365.92,16648.23,59
CPT,0112U,LAB DET IA 16S&18S RRNA GENE NGS,1069.0,298.25,154.04,1671.51,59
CPT,0115U,LAB DET IA RESP NA 18 VIRAL&2 BACT,827.0,230.73,270.43,1292.35,63
CPT,0118U,LAB TRNSPL DNA DNR DRV CELL-FREE QN,8260.0,2304.54,2701.02,11924.33,63
CPT,0140U,LAB DIS INFCT ID FUNGAL DNA TGT 15,471.0,131.41,154.02,735.71,63
CPT,0141U,LAB DIS INFCT ID BAC&FNG GRM+ RXRST,471.0,131.41,154.02,735.71,63
CPT,0142U,LAB DIS INFCT ID BAC&FNG GRM- RXRST,471.0,131.41,154.02,735.71,63
CPT,0152U,LAB DIS INFCT DNA PLASMA NGS UNTGT,6379.0,1779.74,919.21,9979.33,59
CPT,0169U,LAB GENE NUDT15&TPMT VAR COMMON,1399.0,390.32,457.47,2456.45,63
CPT,0172U,LAB ONC BRCA1&2 ANLYS MUT SOMATIC,9090.0,2536.11,2972.43,15966.26,63
CPT,0174T,CAD CHEST CONCURRENT,161.0,45.4,23.2,120.75,33
CPT,0175T,CAD CHEST REMOTE,161.0,45.4,15.37,120.75,27
CPT,0200T,AUG SACRAL PERC INJ UNI,8646.0,3095.27,982.0,14124.0,118
CPT,0201T,AUG SACRAL PERC INJ BI,10799.0,3866.04,982.0,18194.0,118
CPT,0211U,LAB ONC SEQ NEXT GEN DNA&RNA FFPE,25365.0,7076.84,8294.35,36618.61,63
CPT,0225U,LAB DIS INFCT SARS-COV-2 TGT 21,1926.0,537.35,66.17,1805.07,63
CPT,0234T,ATHERECT PERIPH ART RENAL W S&I,14057.0,5032.41,2220.42,20325.69,126
CPT,0235T,ATHERECT PERIPH ART VISC W S&I,10258.0,3672.36,982.0,10257.38,80
CPT,0236T,ATHERECT PERIPH AORTA ABD W S&I,14057.0,5032.41,4299.0,20325.69,126
CPT,0237T,ATHERECT PERIPH TR&BR BRACH W S&I,14057.0,5032.41,588.29,20325.69,126
CPT,0238T,ATHERECT PERIPH ART ILIAC W S&I,16839.0,6028.36,743.03,32276.26,126
CPT,0244U,LAB GENE ONC SO DNA PROFILE 257,10500.0,2929.5,3433.5,15158.5,63
CPT,0251U,LAB HEPCIDIN-25 SERUM/PLASMA ELISA,230.0,64.17,17.27,172.5,59
CPT,0275T,"PERCUTANEOUS LAMINOTOMY/LAMINECTOMY (INTERLAMINAR APPROACH) FOR DECOMPRESSION OF NEURAL ELEMENTS, (WITH OR WITHOUT LIGAMENTOUS RESECTION, DISCECTOMY, FACETECTOMY AND/OR FORAMINOTOMY), ANY METHOD, UNDE",,,982.0,18194.0,6
CPT,0313U,LAB ONC SEQ NEXT GEN DNA&MRNA 74,10800.0,3013.2,1556.28,12609.4,59
CPT,0345T,RPR VALVE MITRAL PERC COR SINUS,26761.0,9580.44,982.0,26761.0,36
CPT,0358U,LAB IMM NEURO AMYLD 1-42&1-40 CSF,785.0,219.02,113.12,1222.64,59
CPT,0364U,LAB ONC GSA&NGS SEQ DOM CLONAL QN,6022.0,1680.14,867.77,9421.03,58
CPT,0393U,LAB NEURO CSF PROTEIN ASYN MSFLD QN,1623.0,452.82,233.87,1894.89,59
CPT,0395T,BRACHY HDR ELEC ICAV/ISTL DOSI/FRAC,4403.0,2029.78,191.21,3302.25,63
CPT,0408T,INSR/RPLC SYS CCM GEN PULS&ELCRD TV,18627.0,6668.47,974.4,55265.94,59
CPT,0432U,LAB AB KLHL11 SERUM/CSF QL,156.0,43.52,22.48,128.12,58
CPT,0480U,LAB DIS INFCT CSF MNGS ANLYS,6379.0,1779.74,2085.93,4784.25,62
CPT,0483T,TMVI W PROS INCL PUNCT TRANSEP PERC,19793.0,7085.89,982.0,26761.0,40
CPT,0523T,FFR COR W 3D MAPPING INTRAPROCEDR,5454.0,1445.31,81.74,14891.0,38
CPT,0544T,RECON TMV W IMP DEV ANNULUS PERC,34399.0,12314.84,982.0,25799.25,38
CPT,0559T,3D MODEL ANTMC PRINTED COMP 1ST,3080.0,526.68,14.72,2310.0,61
CPT,0560T,3D MODEL ANTMC PRINTED COMP EA ADD,770.0,131.67,3.92,1218.0,35
CPT,0561T,3D MODEL ANTMC PRINTED GUIDE 1ST,3300.0,564.3,31.25,2475.0,61
CPT,0562T,3D MODEL ANTMC PRINTED GUIDE EA ADD,990.0,169.29,3.92,1218.0,35
CPT,0569T,RPR TTV PERC INTI PROSTH,26152.0,9362.42,934.42,19614.0,38
CPT,0570T,RPR TTV PERC SAME SESSN ADDL PROSTH,8378.0,2999.32,467.38,6901.45,38
CPT,0571T,INS/RPLC SYS ICD ELCTRD SUBSTRNL,20484.0,6001.81,887.69,55265.94,61
CPT,0572T,INS ELCTRD DEFIB SUBSTRNL,10961.0,3211.57,136.0,14570.36,122
CPT,0573T,REM ELCTRD DEFIB SUBSTRNL,10258.0,3005.59,109.0,10257.38,122
CPT,0574T,REPOS ELCTR DEFIB-PAC SS IP,9247.0,2709.37,120.0,10257.38,122
CPT,0575T,EVAL DEV PRG ICD ELCTRD SS IN PER,210.0,61.53,30.26,247.32,118
CPT,0576T,EVAL DEV INTRG ICD ELCTRD SS IN PER,120.0,35.16,17.29,119.47,118
CPT,0578T,EVAL DEV INTRG RMT SS ICD QHP <90D,418.0,122.47,36.03,618.57,36
CPT,0579T,EVAL DEV INTRG RMT SS ICD TECH <90D,331.0,96.98,21.83,330.67,59
CPT,0644T,REM MASS ICRD W REINFSN BLD PERC,10433.0,3735.01,1381.25,11751.0,118
CPT,0646T,IMP/RPL TTV W VALVE PROS PERC,19793.0,5245.14,982.0,21550.02,36
CPT,0648T,QUAN MR ANLYS TISS COMP WO MRI SGL,2734.0,524.93,287.77,7519.62,57
CPT,0649T,QUAN MR ANLYS TISS COMP W MRI SGL,2734.0,524.93,257.16,2379.62,57
CPT,0692T,ULTRAFILTRATION THERAPEUTIC,2493.0,820.27,489.75,2742.14,61
CPT,0751T,LAB DGTZ SLIDE PTH LVL 2,54.0,15.07,0.04897,40.5,33
CPT,0752T,LAB DGTZ SLIDE PTH LVL 3,54.0,15.07,0.04897,40.5,33
CPT,0753T,LAB DGTZ SLIDE PTH LVL 4,54.0,15.07,0.04897,40.5,33
CPT,0754T,LAB DGTZ SLIDE PTH LVL 5,54.0,15.07,0.04897,40.5,33
CPT,0755T,LAB DGTZ SLIDE PTH LVL 6,54.0,15.07,0.04897,40.5,33
CPT,0756T,LAB DGTZ SLIDE STN ORG GRP 1,54.0,15.07,0.04897,40.5,33
CPT,0757T,LAB DGTZ SLIDE STN OTH GRP 2,54.0,15.07,0.04897,40.5,33
CPT,0758T,LAB DGTZ SLIDE STN HIS W BLOCK FRZ,54.0,15.07,0.04897,40.5,33
CPT,0759T,LAB DGTZ SLIDE STN CONSTI ENZ GRP3,54.0,15.07,0.04897,40.5,33
CPT,0760T,LAB DGTZ SLIDE STN IHC/ICC AB 1ST,54.0,15.07,0.04897,40.5,33
CPT,0761T,LAB DGTZ SLIDE STN IHC/ICC AB ADD,54.0,15.07,0.04897,40.5,33
CPT,0762T,LAB DGTZ SLIDE STN IHC/ICC AB MULT,54.0,15.07,0.04897,40.5,33
CPT,0763T,LAB DGTZ SLIDE STN MORPHO ANLYS AB,54.0,15.07,0.04897,40.5,33
CPT,0780T,INSTILL FECAL MICROB LGI EN RECT SP,746.0,317.05,107.5,13802.9,58
CPT,0795T,INS SYS PPM DUAL LDLS TRANSCTH,17650.0,6318.7,2543.36,33913.79,116
CPT,0823T,INS SYS PPM SINGLE LDLS TRANSCTH,14554.0,3856.81,2097.23,33913.79,58
CPT,0824T,REM PPM SGL LDLS RA TRANSCTH IMG GD,15381.0,4506.63,2216.4,11535.75,58
CPT,0825T,REM&RPL PPM SGL LDLS RA TRNS IMG GD,15381.0,4075.96,2216.4,33913.79,116
CPT,0827T,LAB DGTZ SLD CYTOP SMEAR NONGYN,54.0,15.07,0.04897,40.5,33
CPT,0828T,LAB DGTZ SLD CYTOP FLTR SMPL NONGYN,54.0,15.07,0.04897,40.5,33
CPT,0829T,LAB DGTZ SLD CYTOP CONCEN&SMR&INTRP,54.0,15.07,0.04897,40.5,33
CPT,0830T,LAB DGTZ SLD CYTOP SC ENHCMT NONGYN,54.0,15.07,0.04897,40.5,33
CPT,0831T,LAB DGTZ SLD CYTOP CRV/VAG W INTRP,54.0,15.07,0.04897,40.5,33
CPT,0832T,LAB DGTZ SLD CYTOP SMR/OTH SC&IN,54.0,15.07,0.04897,40.5,33
CPT,0833T,LAB DGTZ SLD CYTOP SMR/OTH PREP SCN,54.0,15.07,0.04897,40.5,33
CPT,0834T,LAB DGTZ SLD CYTOP SMR/OTH STDY EXT,54.0,15.07,0.04897,40.5,33
CPT,0835T,LAB DGTZ SLD CYTOP EVL FNA IMM 1ST,54.0,15.07,0.04897,40.5,33
CPT,0836T,LAB DGTZ SLD CYTOP EVL FNA IMM ADDL,54.0,15.07,0.04897,40.5,33
CPT,0837T,LAB DGTZ SLD CYTOP EVL FNA I&R,54.0,15.07,0.04897,40.5,33
CPT,0838T,LAB DGTZ SLD CNST&RPT REF SLD ELSWR,54.0,15.07,0.04897,40.5,33
CPT,0841T,LAB DGTZ SLD CNSLT PTH SRG BLK 1ST,54.0,15.07,0.04897,40.5,33
CPT,0842T,LAB DGTZ SLD CNSLT PTH SRG EA ADDL,54.0,15.07,0.04897,40.5,33
CPT,0843T,LAB DGTZ SLD CNSLT PTH SRG CYTO INT,54.0,15.07,0.04897,40.5,33
CPT,0844T,LAB DGTZ SLD CNSLT PTH SRG CYTO ADD,54.0,15.07,0.04897,40.5,33
CPT,0845T,LAB DGTZ SLD IF AB STN INT EA SPEC,54.0,15.07,0.04897,40.5,33
CPT,0846T,LAB DGTZ SLD IF AB STN ADDL EA SPEC,54.0,15.07,0.04897,40.5,33
CPT,0847T,LAB DGTZ SLD TISS ARCHVL ANLY MOLEC,54.0,15.07,0.04897,40.5,33
CPT,0848T,LAB DGTZ SLD ISH STN SGL PRB EA INT,54.0,15.07,0.04897,40.5,33
CPT,0849T,LAB DGTZ SLD ISH STN SGL PRB EA ADD,54.0,15.07,0.04897,40.5,33
CPT,0850T,LAB DGTZ SLD ISH STN MP EA,54.0,15.07,0.04897,40.5,33
CPT,0851T,LAB DGTZ SLD MORPHO ISH MAN SGL INT,54.0,15.07,0.04897,40.5,33
CPT,0852T,LAB DGTZ SLD MORPHO ISH MAN SGL ADD,54.0,15.07,0.04897,40.5,33
CPT,0853T,LAB DGTZ SLD MORPHO ISH MAN MP EA,54.0,15.07,0.04897,40.5,33
CPT,0854T,LAB DGTZ SLD SMEAR BLD PERIPH INTRP,54.0,15.07,0.04897,40.5,33
CPT,0855T,LAB DGTZ SLD SMEAR MARROW BN INTRP,54.0,15.07,0.04897,40.5,33
CPT,0856T,LAB DGTZ SLD MICROSCOPY ELECTRON DX,54.0,15.07,0.04897,40.5,33
CPT,0913T,THER RX TRNSCTH PERC BLN IC S&I,8686.0,2301.79,1251.65,20325.69,58
CPT,0914T,THER RX TRNSCTH PERC BLN IC SEP,3137.0,831.3,452.04,14891.0,35
CPT,10004,ASP NEEDLE FINE BX WO IMG LSN ADDL,734.0,380.21,42.01,629.41,40
CPT,10005,ASP NEEDLE FINE BX US GD LSN 1ST,1966.0,1964.55,70.67,5681.0,252
CPT,10006,ASP NEEDLE FINE BX US GD LSN ADDL,1757.0,629.01,48.46,5681.0,160
CPT,10007,ASP NEEDLE FINE BX FL GD LSN 1ST,2450.0,877.1,86.63,5681.0,126
CPT,10008,ASP NEEDLE FINE BX FL GD LSN ADDL,1475.0,528.05,49.71,5681.0,80
CPT,10009,ASP NEEDLE FINE BX CT GD LSN 1ST,2502.0,895.72,104.85,5681.0,126
CPT,10010,ASP NEEDLE FINE BX CT GD LSN ADDL,1966.0,703.83,69.66,5681.0,80
CPT,10011,ASP NEEDLE FINE BX MR GD LSN 1ST,2574.0,921.49,98.92,5681.0,63
CPT,10012,ASP NEEDLE FINE BX MR GD LSN ADDL,1880.0,673.04,64.5,5681.0,40
CPT,10021,ASP NEEDLE FINE BX WO IMG LSN 1ST,927.0,406.03,53.2,5681.0,126
CPT,10030,DRN CATH FLUID TISSUE SOFT IMG GD,3433.0,1229.01,129.89,6689.0,252
CPT,10035,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,1920.0,687.36,80.89,6689.0,63
CPT,10036,PLC DEV/S LOC TIS SOFT PERC LSN ADD,979.0,350.48,40.87,5681.0,38
CPT,10060,I&D ABSCESS SIMPLE,741.0,383.84,105.0,620.83,63
CPT,10060,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",,,105.0,5681.0,104
CPT,10061,I&D ABSCESS CMP/MULT,1071.0,554.78,181.2,3432.43,63
CPT,10061,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",,,181.2,5681.0,104
CPT,10080,Incision and drainage of pilonidal cyst; simple,,,103.42,5681.0,52
CPT,10120,I&R FB TISSUE SUBQ SIMPLE,801.0,350.84000000000003,103.94,5681.0,126
CPT,10120,"Incision and removal of foreign body, subcutaneous tissues; simple",,,103.94,5681.0,52
CPT,10121,I&R FB TISSUE SUBQ COMPLICATED,2247.0,1163.95,179.82,4596.53,63
CPT,10121,"INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED",,,179.82,6689.0,52
CPT,10140,I&D HEMATOMA/SEROMA/FLUID,3139.0,1374.88,116.33,5681.0,378
CPT,10140,"Incision and drainage of hematoma, seroma or fluid collection",,,116.33,5681.0,52
CPT,10160,ASP PUNCT ABSCESS/CYST,651.0,285.14,94.84,5681.0,378
CPT,10180,I&D WOUND POSTOP COMPLEX,4597.0,2381.25,174.79,5114.29,63
CPT,10180,"Incision and drainage, complex, postoperative wound infection",,,174.79,6689.0,52
CPT,1030T,CREATE 3D DIG MDL SMF INT 30MN,1540.0,279.51,137.3,1618.0,100
CPT,1031T,CREATE 3D DIG MDL SMF ADDL 30MN,330.0,59.894999999999996,47.55,1618.0,54
CPT,1032T,CREATE 3D DIG MDL SMF&SIM INT 60MN,1100.0,199.64999999999998,137.3,1618.0,100
CPT,1033T,CREATE 3D DIG MDL SMF&SIM ADDL 30MN,330.0,59.894999999999996,47.55,1618.0,54
CPT,1034T,CREATE 3D DIG MDL SMF&SIM&CA INT90M,1650.0,299.475,137.3,1618.0,100
CPT,1035T,CREATE 3D DIG MDL SMF&SIM&CA ADD30M,385.0,69.88,55.48,1618.0,54
CPT,11010,DEBRIDE FX&/DSL OPEN SKIN&TISS SUBQ,1299.0,672.88,268.59,4596.53,63
CPT,11010,"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN AND SUBCUTANEOUS TISSUES",,,268.59,6689.0,52
CPT,11011,DEBRIDE FX&/DSL OPEN SKIN/MUSC,4017.0,2080.81,288.41,4596.53,63
CPT,11011,"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, AND MUSCLE",,,288.41,6689.0,52
CPT,11012,DEBRIDE FX&/DSL OPEN SKIN/MUSC/BONE,2452.0,1270.14,402.77,5114.29,63
CPT,11012,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone",,,402.77,6689.0,52
CPT,11042,DEBRIDE TISSUE SUBQ 1ST 20CM,1506.0,780.11,59.06,1199.09,126
CPT,11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",,,59.06,6689.0,104
CPT,11043,DEBRIDE MUSCLE&/FASCIA 1ST 20CM,3825.0,1981.35,149.28,4596.53,126
CPT,11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",,,149.28,6689.0,52
CPT,11044,DEBRIDE BONE 1ST 20CM,4597.0,2381.25,218.85,4596.53,126
CPT,11044,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",,,218.85,6689.0,52
CPT,11045,DEBRIDE TISSUE SUBQ ADDL 20CM,648.0,335.66,24.44,598.68,80
CPT,11045,"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,24.44,5681.0,19
CPT,11046,DEBRIDE MUSCLE&/FASCIA ADDL 20CM,1072.0,555.3,52.99,2301.59,80
CPT,11046,"DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCED",,,52.99,5681.0,19
CPT,11047,DEBRIDE BONE ADDL 20CM,1892.0,980.06,93.56,2301.59,80
CPT,11055,PAR/CUT LSN HYPERKERATOTIC BGN SGL,284.0,147.11,15.1,363.86,126
CPT,11056,PAR/CUT LSN HYPERKERATOTIC BGN 2-4,411.0,212.9,21.35,363.86,126
CPT,11057,PAR/CUT LSN HYPERKERATOTIC BGN 4+,527.0,272.99,27.93,395.25,126
CPT,11102,BX SKIN TANGENTIAL LSN SGL,535.0,277.13,36.62,715.75,63
CPT,11103,BX SKIN TANGENTIAL LSN ADDL,174.0,90.13,21.25,173.62,40
CPT,11104,BX PUNCH SKIN LSN SGL,733.0,321.05,45.4,5681.0,126
CPT,11105,BX PUNCH SKIN LSN ADDL,206.0,90.22999999999999,24.8,5681.0,80
CPT,11106,BX INCISIONAL SKIN LSN SGL,1183.0,612.79,54.84,1301.27,63
CPT,11107,BX INCISIONAL SKIN LSN ADDL,245.0,126.91,29.7,244.66,40
CPT,11200,REM TAGS SKIN LSN 1-15,443.0,229.47,75.29,3432.43,63
CPT,11200,"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions",,,75.29,5681.0,52
CPT,11401,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm",,,103.95,5681.0,52
CPT,11402,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm",,,113.71,5681.0,52
CPT,11404,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm",,,161.65,5681.0,52
CPT,11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",,,243.36,6689.0,52
CPT,11420,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less",,,80.94,6689.0,52
CPT,11421,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm",,,107.32,6689.0,52
CPT,11422,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm",,,133.62,5681.0,52
CPT,11423,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",,,154.46,5681.0,52
CPT,11426,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",,,262.46,6689.0,52
CPT,11440,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less",,,105.59,6689.0,52
CPT,11441,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm",,,131.26,6689.0,52
CPT,11442,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm",,,144.61,5681.0,52
CPT,11443,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm",,,175.92,5681.0,52
CPT,11444,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm",,,221.25,5681.0,52
CPT,11450,EXC SKIN&TISSUE HIDRADEN AXILLARY,4597.0,2381.25,257.39,5114.29,63
CPT,11462,EXC SKIN&TISSUE HIDRADEN INGUINAL,4534.0,2348.61,245.12,5114.29,63
CPT,11470,EXC SKIN&TISSUE HIDRADEN PERIANAL,4534.0,2348.61,281.68,5114.29,63
CPT,11602,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm",,,157.64,5681.0,52
CPT,11603,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm",,,188.24,5681.0,52
CPT,11604,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm",,,207.04,6689.0,52
CPT,11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",,,307.7,6689.0,52
CPT,11623,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",,,203.82,5681.0,52
CPT,11626,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",,,282.77,6689.0,52
CPT,11641,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm",,,151.96,6689.0,52
CPT,11642,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm",,,177.69,6689.0,52
CPT,11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",,,221.36,6689.0,52
CPT,11646,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm",,,378.03,6689.0,52
CPT,11719,TRIM NAILS NONDYSTROPHIC,237.0,122.77,7.24,363.86,63
CPT,11720,DEBRIDE NAIL/S 1-5,280.0,145.04,13.78,363.86,63
CPT,11720,DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5,,,13.78,5681.0,52
CPT,11721,DEBRIDE NAIL/S 6+,364.0,188.55,23.01,363.86,63
CPT,11730,AVULSION PLATE NAIL SMPL SGL,701.0,363.12,52.44,525.75,63
CPT,11730,"Avulsion of nail plate, partial or complete, simple; single",,,52.44,5681.0,104
CPT,11732,AVULSION PLATE NAIL SMPL ADDL,180.0,93.24,16.42,179.6,40
CPT,11740,EVACUATION HEMATOMA SUBUNGUAL,127.0,65.79,31.67,234.25,63
CPT,11750,EXC NAIL&MATRIX REM PERM,1287.0,666.67,100.1,3432.43,63
CPT,11760,REPAIR OF NAIL BED,,,107.37,5681.0,52
CPT,11765,EXC WEDGE SKIN NAIL FOLD,513.0,265.73,91.49,715.75,63
CPT,11770,Excision of pilonidal cyst or sinus; simple,,,181.55,7704.0,52
CPT,11771,Excision of pilonidal cyst or sinus; extensive,,,441.47,7704.0,52
CPT,11772,Excision of pilonidal cyst or sinus; complicated,,,567.72,7704.0,52
CPT,11900,INJ INTRALESIONAL LSN 1-7,283.0,123.95,29.08,5681.0,126
CPT,11901,INJ INTRALESIONAL LSN 8+,364.0,159.43,44.16,5681.0,126
CPT,11952,"SUBCUTANEOUS INJECTION OF FILLING MATERIAL (EG, COLLAGEN); 5.1 TO 10.0 CC",,,99.15,4664.0,47
CPT,11970,Replacement of tissue expander with permanent implant,,,550.75,12775.92,52
CPT,11971,REMOVAL OF TISSUE EXPANDER WITHOUT INSERTION OF IMPLANT,,,542.28,6226.0,52
CPT,11976,"REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSULES",,,90.17,5681.0,52
CPT,11981,"INSERTION, DRUG-DELIVERY IMPLANT (IE, BIORESORBABLE, BIODEGRADABLE, NON-BIODEGRADABLE)",,,60.79,5681.0,52
CPT,11982,REM IMP DRUG DELIVERY,713.0,255.25,70.9,5681.0,63
CPT,11982,"Removal, non-biodegradable drug delivery implant",,,70.9,5681.0,52
CPT,11983,"REMOVAL WITH REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT",,,100.18,5681.0,52
CPT,12001,RPR WND SMPL TR&/EXT 0-2.5CM,577.0,298.89,43.54,576.73,63
CPT,12001,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less",,,43.54,5681.0,104
CPT,12002,RPR WND SMPL TR&/EXT 2.6-7.5CM,731.0,378.66,57.18,576.73,63
CPT,12002,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm",,,57.18,4664.0,104
CPT,12004,RPR WND SMPL TR&/EXT 7.6-12.5CM,801.0,414.92,71.43,600.75,63
CPT,12004,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm",,,71.43,5681.0,52
CPT,12005,RPR WND SMPL TR&/EXT 12.5-20.0CM,1031.0,534.06,91.88,773.25,63
CPT,12006,RPR WND SMPL TR&/EXT 20.1-30.0CM,1260.0,652.68,112.39,945.0,63
CPT,12006,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm",,,112.39,6689.0,52
CPT,12007,RPR WND SMPL TR&/EXT 30.1+CM,1565.0,810.67,130.17,1173.75,63
CPT,12011,RPR WND SMPL F/E/E/N 0-2.5CM,577.0,298.89,53.92,576.73,63
CPT,12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,53.92,4664.0,104
CPT,12013,RPR WND SMPL F/E/E/N 2.6-5.0CM,592.0,306.66,56.2,576.73,63
CPT,12013,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,56.2,4664.0,104
CPT,12014,RPR WND SMPL F/E/E/N 5.1-7.5CM,765.0,396.27,72.72,576.73,63
CPT,12014,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm",,,72.72,5681.0,52
CPT,12015,RPR WND SMPL F/E/E/N 7.6-12.5CM,956.0,495.21,91.24,717.0,63
CPT,12015,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",,,91.24,5681.0,52
CPT,12016,RPR WND SMPL F/E/E/N 12.6-20.0CM,1296.0,671.33,123.71,972.0,63
CPT,12017,RPR WND SMPL F/E/E/N 20.1-30.0CM,1636.0,847.45,149.16,1227.0,63
CPT,12018,RPR WND SMPL F/E/E/N 30.1+CM,1845.0,955.71,130.17,1383.75,63
CPT,12020,TX DEHISCENCE WOUND CLSR SMPL,1564.0,559.91,184.23,5681.0,63
CPT,12020,Treatment of superficial wound dehiscence; simple closure,,,184.23,5681.0,52
CPT,12031,RPR WND INTRM SC/TR 0-2.5CM,1490.0,771.82,148.0,3432.43,63
CPT,12031,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less",,,148.0,5681.0,52
CPT,12032,RPR WND INTRM SC/TR 2.6-7.5CM,1666.0,862.99,185.92,3432.43,63
CPT,12032,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",,,185.92,5681.0,104
CPT,12034,RPR WND INTRM SC/TR 7.6-12.5CM,1764.0,913.75,200.46,4596.53,63
CPT,12034,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm",,,200.46,6689.0,104
CPT,12035,RPR WND INTRM SC/TR 12.6-20.0CM,1996.0,1033.93,235.35,4596.53,63
CPT,12035,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm",,,235.35,6689.0,104
CPT,12036,RPR WND INTRM SC/TR 20.1-30.0CM,2089.0,1082.1,274.87,4596.53,63
CPT,12036,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm",,,274.87,6689.0,52
CPT,12037,RPR WND INTRM SC/TR 30.1+CM,3651.0,1891.22,319.25,4596.53,63
CPT,12037,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm",,,319.25,6689.0,52
CPT,12041,RPR WND INTRM N/H/F 0-2.5CM,1465.0,758.87,141.88,3432.43,63
CPT,12041,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less",,,141.88,5681.0,52
CPT,12042,RPR WND INTRM N/H/F 2.6-7.5CM,1635.0,846.93,191.18,3432.43,63
CPT,12042,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",,,191.18,5681.0,104
CPT,12044,RPR WND INTRM N/H/F 7.6-12.5CM,1792.0,928.26,209.21,4596.53,63
CPT,12045,RPR WND INTRM N/H/F 12.6-20.0CM,2294.0,1188.29,267.12,4596.53,63
CPT,12046,RPR WND INTRM N/H/F 20.1-30.0CM,2673.0,1384.61,309.99,4596.53,63
CPT,12047,RPR WND INTRM N/H/F 30.1+CM,2964.0,1535.35,343.68,4596.53,63
CPT,12051,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,165.56,5681.0,104
CPT,12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,194.74,5681.0,104
CPT,12054,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",,,214.7,6689.0,104
CPT,12055,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm",,,250.73,6689.0,52
CPT,13100,RPR CMPLX TRUNK 1.1-2.5CM,1105.0,572.39,195.05,4596.53,63
CPT,13101,RPR CMPLX TRUNK 2.6-7.5CM,1260.0,652.68,240.09,5261.73,126
CPT,13101,"Repair, complex, trunk; 2.6 cm to 7.5 cm",,,240.09,7704.0,52
CPT,13102,"REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,69.36,5681.0,19
CPT,13121,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",,,250.69,7704.0,104
CPT,13122,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)",,,79.83,5681.0,19
CPT,13131,RPR CMPLX F/H&/F 1.1-2.5CM,1163.0,602.43,235.25,4596.53,126
CPT,13131,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm",,,235.25,6689.0,52
CPT,13132,RPR CMPLX F/H&/F 2.6-7.5CM,1454.0,753.17,293.86,5261.73,126
CPT,13132,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",,,293.86,7704.0,104
CPT,13133,"REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,121.39,5681.0,38
CPT,13133,RPR CMPLX F/H&/F ADDL 5.0CM,584.0,302.51,108.62,2634.19,80
CPT,13151,RPR CMPLX E/N/E&/L 1.1-2.5CM,1441.0,746.44,270.17,5261.73,63
CPT,13151,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm",,,270.17,7704.0,52
CPT,13152,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm",,,325.69,7704.0,52
CPT,13153,"REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,131.93,7704.0,19
CPT,13160,CLOSURE WOUND SECONDARY EXTN/CMP,5603.0,2902.35,777.04,6239.39,63
CPT,13160,"SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED",,,777.04,6689.0,52
CPT,14000,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS",,,494.03,6689.0,52
CPT,14000,TRANSFER TISS TRUNK 0-10.0CM,3681.0,1906.76,494.03,4596.53,63
CPT,14001,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM",,,638.73,7704.0,52
CPT,14001,TRANSFER TISS TRUNK 10.1-30.0CM,4678.0,2423.2,638.73,5261.73,63
CPT,14020,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10 SQ CM OR LESS",,,555.47,7704.0,52
CPT,14020,TRANSFER TISS S/A&/L 0-10.0CM,4131.0,2139.86,555.47,5261.73,63
CPT,14021,"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm",,,692.94,7704.0,52
CPT,14021,TRANSFER TISS S/A&/L 10.1-30.0CM,5262.0,2725.72,692.94,5261.73,63
CPT,14040,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS",,,610.53,6689.0,52
CPT,14041,"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm",,,744.89,7704.0,52
CPT,14060,"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less",,,650.57,7704.0,52
CPT,14060,TRANSFER TISS E/N/E&/L 0-10.0CM,4798.0,2485.36,650.57,5261.73,63
CPT,14061,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM",,,799.88,7704.0,52
CPT,14301,"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm",,,847.73,18194.0,52
CPT,14301,TRANSFER TISS ANY AREA 30.1-60.0CM,6499.0,3366.48,847.73,6499.0,63
CPT,14302,"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)",,,208.08,5681.0,19
CPT,14302,TRANSFER TISS ANY AREA ADDL 30.0CM,3147.0,1630.15,208.08,3252.83,40
CPT,15002,PREP WND T/A/L 1ST 100CM,4597.0,2381.25,212.31,4596.53,63
CPT,15002,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; firs",,,212.31,6689.0,52
CPT,15003,PREP WND T/A/L ADDL 100CM,975.0,505.05,43.43,2301.59,40
CPT,15003,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each",,,43.43,5681.0,19
CPT,15004,PREP WND F/N/H/F/G 1ST 100CM,4990.0,2584.82,251.54,4596.53,63
CPT,15004,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, m",,,251.54,6689.0,52
CPT,15005,PREP WND F/N/H/F/G ADDL 100CM,1949.0,1009.58,86.33,2301.59,40
CPT,15050,GRAFT PINCH SGL/MULT 0-2CM,1512.0,783.22,380.02,4596.53,63
CPT,15100,GRAFT SPLIT T/A/L 1ST 0-100CM,4597.0,2381.25,698.58,4596.53,63
CPT,15100,"SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT 15050)",,,698.58,6689.0,52
CPT,15101,GRAFT SPLIT T/A/L ADDL 100CM,2302.0,1192.44,107.0,2301.59,40
CPT,15101,"SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND CHILDREN, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PR",,,107.0,7704.0,19
CPT,15120,GRAFT SPLIT F/N/H/F/G 1ST 0-100CM,5603.0,2902.35,674.52,6239.39,63
CPT,15120,"SPLIT-THICKNESS AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT ",,,674.52,7697.0,52
CPT,15121,GRAFT SPLIT F/N/H/F/G ADDL 100CM,2302.0,1192.44,127.28,2301.59,40
CPT,15121,"SPLIT-THICKNESS AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND",,,127.28,7704.0,19
CPT,15240,"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less",,,779.19,7704.0,52
CPT,15241,"FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARAT",,,103.51,7704.0,19
CPT,15271,APP SKN T/A/L 0-100CM 1ST 25CM,660.0,341.88,81.5,4596.53,63
CPT,15271,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA",,,81.5,6689.0,104
CPT,15272,APP SKN T/A/L 0-100CM ADDL 25CM,82.0,42.48,15.25,2301.59,40
CPT,15272,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIONAL 25 SQ CM WOUND SURFACE AREA, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE F",,,16.3,5681.0,19
CPT,15273,APP SKN T/A/L 100+CM/1%PEDS,1162.0,601.92,188.58,4596.53,63
CPT,15273,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; FIRST 100 SQ CM WOUND SURFACE AREA, OR 1% OF BODY AREA OF INFANTS AND CHILDREN",,,188.58,7697.0,52
CPT,15274,APP SKN T/A/L 100+CM/1%PEDS AD,332.0,171.98,42.82,2301.59,40
CPT,15275,APP SKN F/N/H/F 0-100CM 1ST 25CM,624.0,323.23,90.66,4596.53,63
CPT,15275,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LES",,,90.66,6689.0,104
CPT,15276,APP SKN F/N/H/F 0-100CM ADDL 25,91.0,47.14,16.93,2301.59,40
CPT,15276,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIONAL 25 SQ",,,24.15,5681.0,38
CPT,15277,APP SKN F/N/H/F 100+CM/1%PEDS,1248.0,646.46,214.96,4596.53,63
CPT,15277,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; FI",,,214.96,6689.0,52
CPT,15278,APP SKN F/N/H/F 100+CM/1%PEDS AD,372.0,192.7,53.58,2301.59,40
CPT,15278,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; EA",,,53.58,5681.0,19
CPT,15572,"FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; SCALP, ARMS, OR LEGS",,,720.1,7704.0,52
CPT,15600,FLAP DELAY/SECT TRUNK,5603.0,2902.35,208.87,6239.39,63
CPT,15610,FLAP DELAY/SECT SCALP/ARM/LEG,5262.0,2725.72,240.45,5261.73,63
CPT,15620,FLAP DELAY/SECT F/N/H/F/G,6499.0,3366.48,321.08,6499.0,63
CPT,15630,"DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT EYELIDS, NOSE, EARS, OR LIPS",,,338.03,7704.0,52
CPT,15733,"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (i.e., buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)",,,1003.98,18194.0,52
CPT,15734,"Muscle, myocutaneous, or fasciocutaneous flap; trunk",,,1459.9,7704.0,52
CPT,15736,"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPER EXTREMITY",,,1187.62,7704.0,52
CPT,15738,"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY",,,1234.0,7704.0,52
CPT,15769,"Grafting of autologous soft tissue, other, harvested by direct excision (e.g., fat, dermis, fascia)",,,470.44,18194.0,52
CPT,15770,Graft; derma-fat-fascia,,,660.78,7704.0,52
CPT,15771,"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate",,,501.68,18194.0,52
CPT,15772,"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (list separately in addition to code for pri",,,143.36,5681.0,14
CPT,15773,"GRAFTING OF AUTOLOGOUS FAT HARVESTED BY LIPOSUCTION TECHNIQUE TO FACE, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, AND/OR FEET; 25 CC OR LESS INJECTATE",,,491.37,18194.0,52
CPT,15777,"Implantation of biologic implant (e.g., acellular dermal matrix) for soft tissue reinforcement (i.e., breast, trunk) (list separately in addition to code for primary procedure)",,,206.92,5681.0,19
CPT,15820,"BLEPHAROPLASTY, LOWER EYELID;",,,505.65,7704.0,47
CPT,15822,"BLEPHAROPLASTY, UPPER EYELID;",,,390.89,7704.0,47
CPT,15830,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy",,,1142.73,11691.26,52
CPT,15832,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); THIGH",,,900.85,7704.0,47
CPT,15836,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); ARM",,,779.86,7704.0,47
CPT,15838,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); SUBMENTAL FAT PAD",,,636.22,7390.37,45
CPT,15839,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); OTHER AREA",,,723.42,7704.0,47
CPT,15851,"REMOVAL OF SUTURES OR STAPLES REQUIRING ANESTHESIA (IE, GENERAL ANESTHESIA, MODERATE SEDATION)",,,63.72,5681.0,52
CPT,15853,ED REM SUTURE/STAPLE NO ANESTH,369.0,91.14,11.32,2503.0,41
CPT,15853,REM SUTURE/STAPLE NO ANESTH,369.0,161.62,11.32,5681.0,120
CPT,15854,ED REM SUTURE&STAPLE NO ANESTH,461.0,113.87,15.5,2503.0,41
CPT,15854,REM SUTURE&STAPLE NO ANESTH,461.0,238.8,15.5,1716.22,80
CPT,15860,INJ TEST FLOW VASCULAR FLAP/GRAFT,465.0,240.87,102.69,876.4,63
CPT,15860,"Intravenous injection of agent (e.g., fluorescein) to test vascular flow in flap or graft",,,102.69,5681.0,52
CPT,15877,SUCTION ASSISTED LIPECTOMY; TRUNK,,,3781.45,7704.0,46
CPT,15878,SUCTION ASSISTED LIPECTOMY; UPPER EXTREMITY,,,2201.69,7704.0,46
CPT,15879,SUCTION ASSISTED LIPECTOMY; LOWER EXTREMITY,,,3781.45,7704.0,46
CPT,15920,EXC ULCR COCC PRESS W COCC&SUT PRM,5262.0,2725.72,617.56,5261.73,63
CPT,15922,EXC ULCR COCC PRESS W COCC&FLP CLSR,6499.0,3366.48,780.52,6499.0,126
CPT,15931,EXC ULCR SACRAL PRESS W SUTURE PRM,5262.0,2725.72,688.47,5261.73,63
CPT,17250,CAUT CHEMICAL TISSUE GRANULATION,383.0,167.75,36.77,5681.0,189
CPT,17999,ABL ETOH NODULE NECK,1545.0,553.11,130.17,5681.0,62
CPT,17999,BX FAT PAD ABDOMINAL NDL PERC,1267.0,453.59,130.17,5681.0,186
CPT,17999,THROMBOLYSIS INF CATH TISSUE SUBQ,1253.0,448.57,130.17,5681.0,62
CPT,17999,"UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE",,,130.17,5681.0,49
CPT,19000,ASP PUNCT CYST BREAST INIT LT,1291.0,462.18,40.83,5681.0,40
CPT,19000,ASP PUNCT CYST BREAST INIT RT,1291.0,462.18,40.83,5681.0,40
CPT,19001,ASP PUNCT CYST BREAST ADDL LT,670.0,239.86,20.27,5681.0,40
CPT,19001,ASP PUNCT CYST BREAST ADDL RT,670.0,239.86,20.27,5681.0,40
CPT,19030,INJ DUCTO/GALACTOGRAM MAMMARY BI,1346.0,481.87,73.04,5681.0,40
CPT,19030,INJ DUCTO/GALACTOGRAM MAMMARY LT,897.0,321.13,73.04,5681.0,40
CPT,19030,INJ DUCTO/GALACTOGRAM MAMMARY RT,897.0,321.13,73.04,5681.0,40
CPT,19081,BX BRST W/WO DEV/IMG SG LSN 1ST LT,4370.0,1564.46,156.87,6689.0,40
CPT,19081,BX BRST W/WO DEV/IMG SG LSN 1ST RT,4370.0,1564.46,156.87,6689.0,40
CPT,19082,BX BRST W/WO DEV/IMG SG LSN ADD,1717.0,614.69,78.58,5681.0,40
CPT,19083,BX BRST W/WO DEV/IMG US LSN 1ST LT,4065.0,1455.27,148.27,6689.0,80
CPT,19083,BX BRST W/WO DEV/IMG US LSN 1ST RT,4065.0,1455.27,148.27,6689.0,80
CPT,19084,BX BRST W/WO DEV/IMG US LSN ADD,1717.0,614.69,73.99,5681.0,80
CPT,19085,BX BRST W/WO DEV/IMG MR LSN 1ST LT,4029.0,1442.38,172.41,7704.0,40
CPT,19085,BX BRST W/WO DEV/IMG MR LSN 1ST RT,4029.0,1442.38,172.41,7704.0,40
CPT,19086,BX BRST W/WO DEV/IMG MR LSN ADD,1717.0,614.69,85.9,5681.0,40
CPT,19101,"Biopsy of breast; open, incisional",,,218.25,6893.85,52
CPT,19120,EXC CYST FIBROADENOMA OPN LSN 1+,6059.0,3138.56,409.89,6893.85,63
CPT,19120,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions",,,409.89,7704.0,52
CPT,19125,"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion",,,453.13,7704.0,52
CPT,19281,PLC DEV/S BRST MAMMO GD LSN 1ST LT,3139.0,1123.76,94.74,6689.0,40
CPT,19281,PLC DEV/S BRST MAMMO GD LSN 1ST RT,3139.0,1123.76,94.74,6689.0,40
CPT,19282,PLC DEV/S BRST MAMMO GD LSN ADD,1004.0,359.43,47.53,5681.0,40
CPT,19283,PLC DEV/S BRST SG LSN 1ST LT,3172.0,1135.58,95.59,6689.0,40
CPT,19283,PLC DEV/S BRST SG LSN 1ST RT,3172.0,1135.58,95.59,6689.0,40
CPT,19284,PLC DEV/S BRST SG LSN ADD,1441.0,515.88,47.77,5681.0,40
CPT,19285,PLC DEV/S BRST US GD LSN 1ST LT,2300.0,823.4,80.89,6689.0,40
CPT,19285,PLC DEV/S BRST US GD LSN 1ST RT,2300.0,823.4,80.89,6689.0,40
CPT,19286,PLC DEV/S BRST US GD LSN ADD,1518.0,543.44,40.59,5681.0,40
CPT,19287,PLC DEV/S BRST MR GD LSN 1ST LT,3238.0,1159.2,120.96,7704.0,40
CPT,19287,PLC DEV/S BRST MR GD LSN 1ST RT,3238.0,1159.2,120.96,7704.0,40
CPT,19288,PLC DEV/S BRST MR GD LSN ADD,1717.0,614.69,60.34,5681.0,40
CPT,19300,MASTECTOMY FOR GYNECOMASTIA,,,423.62,8715.0,52
CPT,19301,"Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy);",,,644.95,7704.0,52
CPT,19303,"Mastectomy, simple, complete",,,934.61,11691.26,52
CPT,19307,"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle",,,1150.43,18194.0,52
CPT,19316,Mastopexy,,,774.83,11691.26,52
CPT,19318,Breast reduction,,,1066.76,11691.26,52
CPT,19325,BREAST AUGMENTATION WITH IMPLANT,,,603.05,18194.0,52
CPT,19328,Removal of intact breast implant,,,542.8,7697.0,52
CPT,19330,"Removal of ruptured breast implant, including implant contents (e.g., saline, silicone gel)",,,632.18,7697.0,52
CPT,19340,"Insertion of breast implant on same day of mastectomy (i.e., immediate)",,,742.68,14390.77,52
CPT,19342,Insertion or replacement of breast implant on separate day from mastectomy,,,745.07,14390.77,52
CPT,19350,Nipple/areola reconstruction,,,659.25,8715.0,52
CPT,19357,"Tissue expander placement in breast reconstruction, including subsequent expansion(s)",,,1134.13,24263.93,52
CPT,19361,BREAST RECONSTRUCTION; WITH LATISSIMUS DORSI FLAP,,,982.0,13802.9,14
CPT,19370,"REVISION OF PERI-IMPLANT CAPSULE, BREAST, INCLUDING CAPSULOTOMY, CAPSULORRHAPHY, AND/OR PARTIAL CAPSULECTOMY",,,657.96,8715.0,52
CPT,19371,"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents",,,696.33,8715.0,52
CPT,19380,"Revision of reconstructed breast (e.g., significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue e",,,789.91,11691.26,52
CPT,19499,BX BRST CORE W/WO DEV/SPEC TOMO GD,4370.0,1564.46,1229.0,6893.85,62
CPT,19499,INJ STEROID BREAST,176.0,63.01,79.2,6893.85,62
CPT,20103,EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY,,,337.18,6499.0,52
CPT,20200,BX MUSCLE SUPERFICIAL,2977.0,1542.09,92.55,4596.53,63
CPT,20205,"BIOPSY, MUSCLE; DEEP",,,150.54,7704.0,52
CPT,20205,BX MUSCLE DEEP,5262.0,2725.72,150.54,5261.73,63
CPT,20206,BX MUSCLE NDL PERC,1861.5,666.415,55.27,5681.0,252
CPT,20220,"BIOPSY, BONE, TROCAR, OR NEEDLE; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS)",,,84.14,5681.0,52
CPT,20220,BX BONE TROCAR/NDL SUPERFICIAL,2124.0,760.39,84.14,5681.0,189
CPT,20225,BX BONE TROCAR/NDL DEEP,2957.0,1058.61,124.69,6689.0,126
CPT,20240,BX BONE OPEN SUPERFICIAL,4597.0,2381.25,136.63,5114.29,63
CPT,20240,"Biopsy, bone, open; superficial (e.g., sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)",,,136.63,6689.0,52
CPT,20245,"BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT)",,,333.43,7704.0,52
CPT,20500,INJ TRACT SINUS THERAPEUTIC,3433.0,1229.01,87.77,5681.0,63
CPT,20501,INJ TRACT SINOGRAM,369.0,132.1,35.08,5681.0,114
CPT,20520,REM FB MUSCLE/SHTH TNDN SMPL,2094.0,1084.69,145.49,3432.43,63
CPT,20520,REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE,,,145.49,6689.0,52
CPT,20526,INJ THERAPEUTIC CARPAL TUNNEL,761.0,394.2,55.27,1092.92,63
CPT,20550,INJ/S SHTH TNDN SGL/LIG/AP BI,891.0,318.98,37.87,5681.0,80
CPT,20550,INJ/S SHTH TNDN SGL/LIG/AP LT,594.0,212.65,37.87,5681.0,80
CPT,20550,INJ/S SHTH TNDN SGL/LIG/AP RT,594.0,212.65,37.87,5681.0,80
CPT,20552,INJ/S TRIGGER PT/S MUSC/S 1-2,491.0,215.06,35.93,5681.0,189
CPT,20552,"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)",,,35.93,5681.0,52
CPT,20553,INJ/S TRIGGER PT/S MUSC/S 3+,560.0,200.48,40.83,5681.0,63
CPT,20553,"Injection(s); single or multiple trigger point(s), 3 or more muscles",,,40.83,5681.0,52
CPT,20600,ASP&/INJ JT/BUR SM WO US GD BI,995.0,356.21,34.91,5681.0,160
CPT,20600,ASP&/INJ JT/BUR SM WO US GD LT,663.0,237.35,34.91,5681.0,160
CPT,20600,ASP&/INJ JT/BUR SM WO US GD RT,663.0,237.35,34.91,5681.0,160
CPT,20604,ASP&/INJ JT/BUR SM W US GD BI,1577.0,564.57,44.48,5681.0,80
CPT,20604,ASP&/INJ JT/BUR SM W US GD LT,1051.0,376.26,44.48,5681.0,80
CPT,20604,ASP&/INJ JT/BUR SM W US GD RT,1051.0,376.26,44.48,5681.0,80
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD BI,1034.0,370.17,35.9,5681.0,120
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD LT,689.0,246.66,35.9,5681.0,120
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD RT,689.0,246.66,35.9,5681.0,120
CPT,20605,"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance",,,35.9,5681.0,52
CPT,20606,ASP&/INJ JT/BUR INTR W US GD BI,1811.0,648.34,50.61,5681.0,120
CPT,20606,ASP&/INJ JT/BUR INTR W US GD LT,1207.0,432.11,50.61,5681.0,120
CPT,20606,ASP&/INJ JT/BUR INTR W US GD RT,1207.0,432.11,50.61,5681.0,120
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD BI,1260.0,451.08,44.27,5681.0,200
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD LT,840.0,300.72,44.27,5681.0,200
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD RT,840.0,300.72,44.27,5681.0,200
CPT,20610,"Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance",,,44.27,5681.0,52
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD BI,2057.0,736.41,57.43,5681.0,120
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD LT,1371.0,490.82,57.43,5681.0,120
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD RT,1371.0,490.82,57.43,5681.0,120
CPT,20612,ASP&/INJ CYST GANGLION,709.0,253.82,40.1,5681.0,63
CPT,20615,ASP&INJ CYST BONE,1183.0,423.51,159.68,5681.0,189
CPT,20670,REM IMP SUPERFICIAL,3433.0,1778.29,142.56,3432.43,126
CPT,20670,"REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)",,,142.56,5681.0,52
CPT,20680,REM IMP DEEP,5035.0,2608.13,413.2,5261.73,63
CPT,20680,"Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)",,,413.2,7704.0,52
CPT,20690,"APPLICATION OF A UNIPLANE (PINS OR WIRES IN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM",,,585.87,12775.92,52
CPT,20692,"APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM (EG, ILIZAROV, MONTICELLI TYPE)",,,1108.34,22604.88,52
CPT,20694,"REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM",,,338.6,5681.0,52
CPT,20704,"MANUAL PREPARATION AND INSERTION OF DRUG-DELIVERY DEVICE(S), INTRA-ARTICULAR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,144.82,5681.0,14
CPT,20900,"BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)",,,175.42,12775.92,52
CPT,20902,"BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE",,,267.17,12775.92,52
CPT,20912,CARTILAGE GRAFT; NASAL SEPTUM,,,475.79,7704.0,52
CPT,20930,"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)",,,113.52,6904.78,14
CPT,20931,"ALLOGRAFT, STRUCTURAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,106.23,6904.78,14
CPT,20936,"Autograft for spine surgery only (includes harvesting the graft); local (e.g., ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary",,,121.28,7697.0,14
CPT,20937,AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); MORSELIZED (THROUGH SEPARATE SKIN OR FASCIAL INCISION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,160.73,7697.0,14
CPT,20950,ED MONITOR PRESS SYND COMPART MUSC,1022.0,252.43,86.49,2503.0,64
CPT,20950,MONITOR PRESS SYND COMPART MUSC,1022.0,529.4,86.49,1246.81,63
CPT,20982,ABL RF TUMOR/S BONE PERC IMG GD,11796.0,4222.97,352.66,30871.55,126
CPT,20983,ABL CRYO TUMOR/S BONE PERC IMG GD,8646.0,3095.27,329.08,12775.92,63
CPT,20999,"UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL",,,149.49,5681.0,49
CPT,21011,"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm",,,257.16,5681.0,52
CPT,21012,"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater",,,334.0,5681.0,52
CPT,21025,"EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); MANDIBLE",,,649.49,10422.97,52
CPT,21026,"EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); FACIAL BONE(S)",,,421.37,10422.97,52
CPT,21030,EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA OR ZYGOMA BY ENUCLEATION AND CURETTAGE,,,353.97,10422.97,50
CPT,21031,EXCISION OF TORUS MANDIBULARIS,,,267.51,6226.0,50
CPT,21032,EXCISION OF MAXILLARY TORUS PALATINUS,,,256.14,6226.0,50
CPT,21040,"EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE, BY ENUCLEATION AND/OR CURETTAGE",,,355.27,6689.0,52
CPT,21046,"EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE; REQUIRING INTRA-ORAL OSTEOTOMY (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION[S])",,,965.57,10422.97,52
CPT,21047,"EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE; REQUIRING EXTRA-ORAL OSTEOTOMY AND PARTIAL MANDIBULECTOMY (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION[S])",,,1182.93,10422.97,52
CPT,21048,"EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA; REQUIRING INTRA-ORAL OSTEOTOMY (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION[S])",,,974.26,10422.97,52
CPT,21050,"CONDYLECTOMY, TEMPOROMANDIBULAR JOINT (SEPARATE PROCEDURE)",,,844.17,10422.97,52
CPT,21070,CORONOIDECTOMY (SEPARATE PROCEDURE),,,601.26,10422.97,52
CPT,21073,"MANIPULATION OF TEMPOROMANDIBULAR JOINT(S) (TMJ), THERAPEUTIC, REQUIRING AN ANESTHESIA SERVICE (IE, GENERAL OR MONITORED ANESTHESIA CARE)",,,235.3,5681.0,52
CPT,21085,IMPRESSION AND CUSTOM PREPARATION; ORAL SURGICAL SPLINT,,,153.41,4664.0,50
CPT,21100,"APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACIAL FIXATION, INCLUDES REMOVAL (SEPARATE PROCEDURE)",,,350.04,10422.97,52
CPT,21116,INJECTION PROCEDURE FOR TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,,,43.19,5681.0,14
CPT,21120,"GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, PROSTHETIC MATERIAL)",,,497.31,14124.0,52
CPT,21141,"RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION (EG, FOR LONG FACE SYNDROME), WITHOUT BONE GRAFT",,,1298.29,13802.9,50
CPT,21145,"RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)",,,1508.52,13802.9,50
CPT,21146,"RECONSTRUCTION MIDFACE, LEFORT I; 2 PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (EG, UNGRAFTED UNILATERAL ALVEOLAR CLEFT)",,,1575.38,13802.9,50
CPT,21147,"RECONSTRUCTION MIDFACE, LEFORT I; 3 OR MORE PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (EG, UNGRAFTED BILATERAL ALVEOLAR CLEFT OR MULTIPLE OSTEOTO",,,1657.21,13802.9,50
CPT,21193,"RECONSTRUCTION OF MANDIBULAR RAMI, HORIZONTAL, VERTICAL, C, OR L OSTEOTOMY; WITHOUT BONE GRAFT",,,1199.06,13802.9,50
CPT,21196,"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation",,,1393.26,13802.9,50
CPT,21198,"OSTEOTOMY, MANDIBLE, SEGMENTAL;",,,985.61,10422.97,50
CPT,21210,"GRAFT, BONE; NASAL, MAXILLARY OR MALAR AREAS (INCLUDES OBTAINING GRAFT)",,,743.09,14124.0,52
CPT,21215,"GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)",,,772.22,14124.0,52
CPT,21235,"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)",,,561.5,14124.0,52
CPT,21240,"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUT AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1022.29,10422.97,52
CPT,21243,"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH PROSTHETIC JOINT REPLACEMENT",,,1634.69,47774.5,52
CPT,21244,"RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSOSTEAL BONE PLATE (EG, MANDIBULAR STAPLE BONE PLATE)",,,984.84,14124.0,52
CPT,21245,"RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; PARTIAL",,,923.32,14124.0,52
CPT,21246,"RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; COMPLETE",,,828.46,14124.0,52
CPT,21248,"RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL IMPLANT (EG, BLADE, CYLINDER); PARTIAL",,,776.06,14124.0,52
CPT,21282,LATERAL CANTHOPEXY,,,392.83,10059.0,52
CPT,21299,UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE,,,153.41,6499.0,49
CPT,21315,Closed treatment of nasal bone fracture with manipulation; without stabilization,,,58.25,6689.0,52
CPT,21320,Closed treatment of nasal bone fracture with manipulation; with stabilization,,,92.85,6689.0,52
CPT,21325,OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED,,,437.59,8715.0,52
CPT,21336,"OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT STABILIZATION",,,625.76,8715.0,52
CPT,21346,OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); WITH WIRING AND/OR LOCAL FIXATION,,,1000.15,13802.9,50
CPT,21360,"OPEN TREATMENT OF DEPRESSED MALAR FRACTURE, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD",,,518.73,14124.0,52
CPT,21365,"OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA) FRACTURE(S) OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD; WITH INTERNAL FIXATION AND MULTIPLE SURGICAL AP",,,1055.52,14124.0,52
CPT,21386,OPEN TREATMENT OF ORBITAL FLOOR BLOWOUT FRACTURE; PERIORBITAL APPROACH,,,677.57,13802.9,50
CPT,21390,"OPEN TREATMENT OF ORBITAL FLOOR BLOWOUT FRACTURE; PERIORBITAL APPROACH, WITH ALLOPLASTIC OR OTHER IMPLANT",,,786.69,14124.0,52
CPT,21407,"Open treatment of fracture of orbit, except blowout; with implant",,,629.87,10422.97,52
CPT,21422,OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE);,,,610.93,13802.9,50
CPT,21451,CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITH MANIPULATION,,,626.32,8715.0,52
CPT,21453,Closed treatment of mandibular fracture with interdental fixation,,,908.34,10422.97,52
CPT,21462,OPEN TREATMENT OF MANDIBULAR FRACTURE; WITH INTERDENTAL FIXATION,,,1132.81,10422.97,52
CPT,21465,OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE,,,782.5,10422.97,52
CPT,21470,"OPEN TREATMENT OF COMPLICATED MANDIBULAR FRACTURE BY MULTIPLE SURGICAL APPROACHES INCLUDING INTERNAL FIXATION, INTERDENTAL FIXATION, AND/OR WIRING OF DENTURES OR SPLINTS",,,1140.3,10422.97,52
CPT,21480,CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT,,,30.21,5681.0,52
CPT,21501,"INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX;",,,332.68,6689.0,52
CPT,21552,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; 3 CM OR GREATER",,,439.41,18194.0,52
CPT,21554,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); 5 cm or greater",,,716.9,18194.0,52
CPT,21555,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; LESS THAN 3 CM",,,303.17,6689.0,52
CPT,21556,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM",,,520.92,6689.0,52
CPT,21558,"Radical resection of tumor (e.g., sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater",,,1305.6,18194.0,52
CPT,21931,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",,,461.28,18194.0,52
CPT,21932,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); less than 5 cm",,,649.63,14124.0,52
CPT,21933,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); 5 cm or greater",,,722.14,18194.0,52
CPT,22015,"INCISION AND DRAINAGE, OPEN, OF DEEP ABSCESS (SUBFASCIAL), POSTERIOR SPINE; LUMBAR, SACRAL, OR LUMBOSACRAL",,,931.79,13802.9,50
CPT,22100,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; CERVICAL",,,931.02,18194.0,52
CPT,22102,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; LUMBAR",,,758.44,18194.0,52
CPT,22103,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CO",,,129.76,18194.0,21
CPT,22212,"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic",,,1482.52,13802.9,50
CPT,22214,"OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, 1 VERTEBRAL SEGMENT; LUMBAR",,,1482.67,13802.9,50
CPT,22510,VERTEBROPLASTY CRVTHOR PERC,5456.0,1953.25,418.34,18194.0,126
CPT,22511,VERTEBROPLASTY LUMBOSACRAL PERC,4992.0,1787.14,393.85,18194.0,189
CPT,22512,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4389.0,1571.26,199.38,18194.0,114
CPT,22513,AUG VERTEBRAL THORACIC PERC,13730.0,4915.34,494.28,13802.9,189
CPT,22514,AUG VERTEBRAL LUMBAR PERC,9399.0,3364.84,460.82,13802.9,189
CPT,22514,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or",,,460.82,13802.9,50
CPT,22515,AUG VERTEBRAL LUMBAR/THOR PERC ADDL,4724.0,1691.19,209.44,6904.78,76
CPT,22551,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2",,,1658.7,22604.88,50
CPT,22552,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (list ",,,381.43,8755.0,14
CPT,22554,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2",,,1235.41,22604.88,50
CPT,22558,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar",,,1487.89,47774.5,50
CPT,22585,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primar",,,312.56,10065.0,14
CPT,22595,"ARTHRODESIS, POSTERIOR TECHNIQUE, ATLAS-AXIS (C1-C2)",,,1488.88,22604.88,50
CPT,22600,"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment",,,1278.31,30871.55,50
CPT,22610,"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; THORACIC (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)",,,1256.94,30871.55,50
CPT,22612,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)",,,1543.47,30871.55,50
CPT,22614,"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)",,,376.7,6904.78,19
CPT,22630,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;",,,1524.58,47774.5,50
CPT,22632,"ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, INCLUDING LAMINECTOMY AND/OR DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE, LUMBAR; EACH ADDITIONAL INTERSPACE (LIST SE",,,309.15,6904.78,14
CPT,22633,"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), ",,,1763.25,47774.5,50
CPT,22800,"ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; UP TO 6 VERTEBRAL SEGMENTS",,,1337.44,30871.55,50
CPT,22802,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments",,,2064.45,30871.55,50
CPT,22808,"ARTHRODESIS, ANTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 2 TO 3 VERTEBRAL SEGMENTS",,,1783.19,30871.55,50
CPT,22840,"Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation",,,728.4,6904.78,14
CPT,22842,"Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)",,,734.61,6904.78,14
CPT,22843,"Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)",,,786.71,6904.78,14
CPT,22845,Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure),,,699.24,10065.0,14
CPT,22846,ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,727.74,10065.0,14
CPT,22848,PELVIC FIXATION (ATTACHMENT OF CAUDAL END OF INSTRUMENTATION TO PELVIC BONY STRUCTURES) OTHER THAN SACRUM (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,346.55,6904.78,14
CPT,22850,"REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD)",,,722.56,13802.9,50
CPT,22852,Removal of posterior segmental instrumentation,,,696.74,13802.9,50
CPT,22853,"Insertion of interbody biomechanical device(s) (e.g., synthetic cage, mesh) with integral anterior instrumentation for device anchoring (e.g., screws, flanges), when performed, to intervertebral disc ",,,248.05,6904.78,14
CPT,22855,REMOVAL OF ANTERIOR INSTRUMENTATION,,,1084.37,13802.9,50
CPT,22856,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection)",,,1583.93,30871.55,50
CPT,22899,PLCMT MARKER SPINE THOR FLUORO GD,1500.0,537.0,149.49,5681.0,124
CPT,22900,"Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); less than 5 cm",,,555.68,8715.0,52
CPT,22901,"Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); 5 cm or greater",,,652.68,18194.0,52
CPT,22902,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm",,,329.15,14124.0,52
CPT,22903,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater",,,432.31,18194.0,52
CPT,22905,"Radical resection of tumor (e.g., sarcoma), soft tissue of abdominal wall; 5 cm or greater",,,1294.49,18194.0,52
CPT,23030,"INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR HEMATOMA",,,250.95,6226.0,52
CPT,23035,"INCISION, BONE CORTEX (EG, OSTEOMYELITIS OR BONE ABSCESS), SHOULDER AREA",,,669.04,7704.0,52
CPT,23071,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater",,,413.49,18194.0,52
CPT,23073,"Excision, tumor, soft tissue of shoulder area, subfascial (e.g., intramuscular); 5 cm or greater",,,684.09,18194.0,52
CPT,23076,"Excision, tumor, soft tissue of shoulder area, subfascial (e.g., intramuscular); less than 5 cm",,,535.4,6689.0,52
CPT,23101,"ARTHROTOMY, ACROMIOCLAVICULAR JOINT OR STERNOCLAVICULAR JOINT, INCLUDING BIOPSY AND/OR EXCISION OF TORN CARTILAGE",,,455.92,14124.0,52
CPT,23107,"ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY",,,658.0,12775.92,52
CPT,23120,CLAVICULECTOMY; PARTIAL,,,584.26,10059.0,52
CPT,23140,EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA;,,,551.7,8715.0,52
CPT,23150,EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS;,,,660.51,8715.0,52
CPT,23190,"OSTECTOMY OF SCAPULA, PARTIAL (EG, SUPERIOR MEDIAL ANGLE)",,,570.9,8715.0,52
CPT,23335,"REMOVAL OF PROSTHESIS, INCLUDES DEBRIDEMENT AND SYNOVECTOMY WHEN PERFORMED; HUMERAL AND GLENOID COMPONENTS (EG, TOTAL SHOULDER)",,,1239.49,13802.9,50
CPT,23350,INJ ARTHRO SHOULDER BI,941.0,336.88,48.14,5681.0,40
CPT,23350,INJ ARTHRO SHOULDER LT,627.0,224.47,48.14,5681.0,40
CPT,23350,INJ ARTHRO SHOULDER RT,627.0,224.47,48.14,5681.0,40
CPT,23395,"MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM; SINGLE",,,1258.41,12775.92,52
CPT,23405,"TENOTOMY, SHOULDER AREA; SINGLE TENDON",,,608.1,12775.92,52
CPT,23410,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE",,,807.13,12775.92,52
CPT,23412,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; CHRONIC",,,838.91,14124.0,52
CPT,23415,"CORACOACROMIAL LIGAMENT RELEASE, WITH OR WITHOUT ACROMIOPLASTY",,,690.15,12775.92,52
CPT,23420,"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)",,,958.56,14124.0,52
CPT,23430,Tenodesis of long tendon of biceps,,,734.83,12775.92,52
CPT,23440,RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS,,,746.87,12775.92,52
CPT,23455,"CAPSULORRHAPHY, ANTERIOR; WITH LABRAL REPAIR (EG, BANKART PROCEDURE)",,,967.74,14124.0,52
CPT,23460,"CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH BONE BLOCK",,,1069.4,12775.92,52
CPT,23462,"CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH CORACOID PROCESS TRANSFER",,,1046.35,14124.0,52
CPT,23470,"Arthroplasty, glenohumeral joint; hemiarthroplasty",,,1172.23,22604.88,50
CPT,23472,"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (e.g., total shoulder))",,,1410.31,30871.55,50
CPT,23473,"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component",,,1568.26,22604.88,50
CPT,23474,"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component",,,1692.55,22604.88,50
CPT,23485,"OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION; WITH BONE GRAFT FOR NONUNION OR MALUNION (INCLUDES OBTAINING GRAFT AND/OR NECESSARY FIXATION)",,,936.59,22604.88,52
CPT,23505,Closed treatment of clavicular fracture; with manipulation,,,338.59,5681.0,52
CPT,23515,"OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,712.04,12775.92,52
CPT,23530,"OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;",,,571.24,12775.92,52
CPT,23532,"OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)",,,621.21,12775.92,52
CPT,23550,"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;",,,567.23,12775.92,52
CPT,23552,"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)",,,642.74,12775.92,52
CPT,23585,"OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR ACROMION) INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,958.0,12775.92,52
CPT,23615,"OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, INCLUDES REPAIR OF TUBEROSITY(S), WHEN PERFORMED;",,,869.77,22604.88,52
CPT,23650,"Closed treatment of shoulder dislocation, with manipulation; without anesthesia",,,149.49,5681.0,52
CPT,23655,"CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA",,,408.99,5681.0,52
CPT,23660,OPEN TREATMENT OF ACUTE SHOULDER DISLOCATION,,,580.47,12775.92,52
CPT,23670,"OPEN TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,859.28,12775.92,52
CPT,23700,"MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPARATUS (DISLOCATION EXCLUDED)",,,193.56,5681.0,52
CPT,23929,"UNLISTED PROCEDURE, SHOULDER",,,149.49,5681.0,49
CPT,23930,"INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESS OR HEMATOMA",,,211.88,6226.0,52
CPT,24071,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER",,,399.4,18194.0,52
CPT,24073,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER",,,680.32,18194.0,52
CPT,24075,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; LESS THAN 3 CM",,,326.08,6689.0,52
CPT,24076,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM",,,539.98,6689.0,52
CPT,24077,"Radical resection of tumor (e.g., sarcoma), soft tissue of upper arm or elbow area; less than 5 cm",,,1004.25,7704.0,52
CPT,24102,"ARTHROTOMY, ELBOW; WITH SYNOVECTOMY",,,611.89,8715.0,52
CPT,24105,"EXCISION, OLECRANON BURSA",,,361.03,7704.0,52
CPT,24125,EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON PROCESS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT),,,617.96,7704.0,52
CPT,24130,"EXCISION, RADIAL HEAD",,,508.31,7704.0,52
CPT,24149,"RADICAL RESECTION OF CAPSULE, SOFT TISSUE, AND HETEROTOPIC BONE, ELBOW, WITH CONTRACTURE RELEASE (SEPARATE PROCEDURE)",,,1161.9,13802.9,50
CPT,24220,INJ ARTHRO ELBOW BI,989.0,354.06,64.18,5681.0,40
CPT,24220,INJ ARTHRO ELBOW LT,659.0,235.92,64.18,5681.0,40
CPT,24220,INJ ARTHRO ELBOW RT,659.0,235.92,64.18,5681.0,40
CPT,24301,"MUSCLE OR TENDON TRANSFER, ANY TYPE, UPPER ARM OR ELBOW, SINGLE (EXCLUDING 24320-24331)",,,740.81,12775.92,52
CPT,24305,"TENDON LENGTHENING, UPPER ARM OR ELBOW, EACH TENDON",,,575.61,8715.0,52
CPT,24341,"REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECONDARY (EXCLUDES ROTATOR CUFF)",,,743.02,12775.92,52
CPT,24342,"REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT",,,763.52,12775.92,52
CPT,24343,"REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE",,,708.26,8715.0,52
CPT,24344,"RECONSTRUCTION LATERAL COLLATERAL LIGAMENT, ELBOW, WITH TENDON GRAFT (INCLUDES HARVESTING OF GRAFT)",,,1086.9,12775.92,52
CPT,24345,"REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE",,,704.98,12775.92,52
CPT,24363,"ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (EG, TOTAL ELBOW)",,,1416.16,30871.55,50
CPT,24366,"ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT",,,672.32,22604.88,50
CPT,24370,"REVISION OF TOTAL ELBOW ARTHROPLASTY, INCLUDING ALLOGRAFT WHEN PERFORMED; HUMERAL OR ULNAR COMPONENT",,,1500.22,22604.88,50
CPT,24371,"REVISION OF TOTAL ELBOW ARTHROPLASTY, INCLUDING ALLOGRAFT WHEN PERFORMED; HUMERAL AND ULNAR COMPONENT",,,1723.38,30871.55,50
CPT,24430,"REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)",,,1036.01,22604.88,52
CPT,24435,"REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1062.82,22604.88,52
CPT,24515,"OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,867.46,22604.88,52
CPT,24516,"TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS",,,845.01,22604.88,52
CPT,24545,"OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED; WITHOUT INTERCONDYLAR EXTENSION",,,913.56,22604.88,52
CPT,24546,"OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED; WITH INTERCONDYLAR EXTENSION",,,1018.53,22604.88,52
CPT,24579,"OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,823.77,22604.88,52
CPT,24586,OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS);,,,1065.91,22604.88,52
CPT,24587,OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS); WITH IMPLANT ARTHROPLASTY,,,1067.75,22604.88,52
CPT,24605,TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA,,,478.41,6689.0,52
CPT,24635,"OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF ULNA WITH DISLOCATION OF RADIAL HEAD), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,669.22,12775.92,52
CPT,24655,Closed treatment of radial head or neck fracture; with manipulation,,,410.9,5681.0,52
CPT,24665,"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL HEAD EXCISION, WHEN PERFORMED;",,,652.05,12775.92,52
CPT,24666,"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL HEAD EXCISION, WHEN PERFORMED; WITH RADIAL HEAD PROSTHETIC REPLACEMENT",,,723.74,22604.88,52
CPT,24685,"OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,648.37,12775.92,52
CPT,24800,"ARTHRODESIS, ELBOW JOINT; LOCAL",,,822.45,12775.92,52
CPT,24802,"ARTHRODESIS, ELBOW JOINT; WITH AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)",,,984.44,22604.88,52
CPT,24999,"UNLISTED PROCEDURE, HUMERUS OR ELBOW",,,149.49,5681.0,49
CPT,25020,"DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR COMPARTMENT; WITHOUT DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE",,,727.61,7704.0,52
CPT,25028,"INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA",,,681.66,6226.0,52
CPT,25040,"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body",,,554.05,10059.0,52
CPT,25075,"EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; LESS THAN 3 CM",,,313.31,6689.0,52
CPT,25076,"EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 3 CM",,,514.42,7704.0,52
CPT,25118,"Synovectomy, extensor tendon sheath, wrist, single compartment;",,,383.3,6689.0,52
CPT,25215,Carpectomy; all bones of proximal row,,,614.95,8715.0,52
CPT,25240,"EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPE OR MATCHED RESECTION)",,,429.69,8715.0,52
CPT,25246,INJ ARTHRO WRIST BI,969.0,346.9,70.71,5681.0,40
CPT,25246,INJ ARTHRO WRIST LT,646.0,231.27,70.71,5681.0,40
CPT,25246,INJ ARTHRO WRIST RT,646.0,231.27,70.71,5681.0,40
CPT,25260,"REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE",,,630.12,8715.0,52
CPT,25270,"REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE",,,492.32,8715.0,52
CPT,25280,"LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON",,,562.64,8715.0,52
CPT,25295,"TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON",,,524.31,7704.0,52
CPT,25310,"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon",,,616.93,7704.0,52
CPT,25312,"TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; WITH TENDON GRAFT(S) (INCLUDES OBTAINING GRAFT), EACH TENDON",,,709.46,8755.0,52
CPT,25320,"CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, OPEN (EG, CAPSULODESIS, LIGAMENT REPAIR, TENDON TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR CARPAL INSTABILITY",,,978.74,12775.92,52
CPT,25337,"RECONSTRUCTION FOR STABILIZATION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT, SECONDARY BY SOFT TISSUE STABILIZATION (EG, TENDON TRANSFER, TENDON GRAFT OR WEAVE, OR TENODESIS) WITH OR WITHOUT O",,,877.84,12775.92,52
CPT,25392,"OSTEOPLASTY, RADIUS AND ULNA; SHORTENING (EXCLUDING 64876)",,,995.17,12775.92,52
CPT,25400,"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)",,,790.89,12775.92,52
CPT,25405,"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1018.0,12775.92,52
CPT,25447,"Arthroplasty, intercarpal or carpometacarpal joints; interposition (e.g., tendon)",,,822.54,10059.0,52
CPT,25515,"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,665.32,12775.92,52
CPT,25525,"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, AND CLOSED TREATMENT OF DISTAL RADIOULNAR JOINT DISLOCATION (GALEAZZI FRACTURE/ DISLOCATION), INCLUDES PERCUTANEOUS",,,781.85,12775.92,52
CPT,25545,"OPEN TREATMENT OF ULNAR SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,620.87,12775.92,52
CPT,25575,"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna",,,892.19,12775.92,52
CPT,25605,"Closed treatment of distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation",,,513.49,7704.0,104
CPT,25606,PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION,,,664.83,7704.0,52
CPT,25607,"OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIXATION",,,733.91,12775.92,52
CPT,25608,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 2 FRAGMENTS,,,819.28,12775.92,52
CPT,25609,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 3 OR MORE FRAGMENTS,,,1037.39,12775.92,52
CPT,25671,PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR DISLOCATION,,,534.23,6226.0,52
CPT,25676,"OPEN TREATMENT OF DISTAL RADIOULNAR DISLOCATION, ACUTE OR CHRONIC",,,626.27,12775.92,52
CPT,26010,DRAINAGE OF FINGER ABSCESS; SIMPLE,,,130.17,4664.0,52
CPT,26020,"DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH",,,552.48,6689.0,104
CPT,26055,"Tendon sheath incision (e.g., for trigger finger)",,,291.66,6689.0,52
CPT,26075,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each",,,338.78,8715.0,52
CPT,26080,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each",,,399.17,8715.0,104
CPT,26135,"SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING INTRINSIC RELEASE AND EXTENSOR HOOD RECONSTRUCTION, EACH DIGIT",,,550.33,8715.0,52
CPT,26180,"EXCISION OF TENDON, FINGER, FLEXOR OR EXTENSOR, EACH TENDON",,,449.57,7704.0,52
CPT,26235,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER",,,490.83,7704.0,52
CPT,26236,EXC BONE PARTIAL FINGER PHALANX DST,3218.0,1666.92,440.69,5261.73,63
CPT,26236,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); DISTAL PHALANX OF FINGER",,,440.69,7704.0,52
CPT,26340,"MANIPULATION, FINGER JOINT, UNDER ANESTHESIA, EACH JOINT",,,358.87,5681.0,52
CPT,26350,"REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); PRIMARY OR SECONDARY WITHOUT FREE GRAFT, EACH TENDON",,,737.72,7697.0,52
CPT,26356,"REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); PRIMARY, WITHOUT FREE GRAFT, EACH TENDON",,,787.79,8715.0,52
CPT,26370,"REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; PRIMARY, EACH TENDON",,,772.65,8715.0,52
CPT,26418,"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon",,,618.21,8715.0,52
CPT,26437,"REALIGNMENT OF EXTENSOR TENDON, HAND, EACH TENDON",,,659.24,7704.0,52
CPT,26442,"TENOLYSIS, FLEXOR TENDON; PALM AND FINGER, EACH TENDON",,,976.67,7704.0,52
CPT,26445,"TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER, EACH TENDON",,,596.89,7704.0,52
CPT,26474,"TENODESIS; OF DISTAL JOINT, EACH JOINT",,,644.82,6689.0,52
CPT,26480,"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon",,,775.25,7704.0,52
CPT,26540,"REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT",,,691.11,8715.0,52
CPT,26591,"REPAIR, INTRINSIC MUSCLES OF HAND, EACH MUSCLE",,,484.22,7704.0,52
CPT,26615,"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone",,,572.63,10065.0,52
CPT,26685,"OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH JOINT",,,573.81,7704.0,52
CPT,26735,"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each",,,591.75,8715.0,52
CPT,26746,"OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,733.91,10059.0,52
CPT,26765,"OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,502.73,8715.0,52
CPT,26785,"OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, SINGLE",,,545.34,6689.0,52
CPT,26860,"ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;",,,606.26,7704.0,52
CPT,26951,AMP FINGER/THUMB SGL W DIR CLSR,4910.0,2543.38,694.74,5760.96,126
CPT,26951,"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; WITH DIRECT CLOSURE",,,694.74,6689.0,52
CPT,26952,"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; WITH LOCAL ADVANCEMENT FLAPS (V-Y, HOOD)",,,675.51,8715.0,52
CPT,26989,"UNLISTED PROCEDURE, HANDS OR FINGERS",,,149.49,5681.0,49
CPT,27040,BX TIS SOFT PEL&HIP SUPER BI,4049.0,1449.54,194.98,5681.0,40
CPT,27040,BX TIS SOFT PEL&HIP SUPER LT,2699.0,966.24,194.98,5681.0,40
CPT,27040,BX TIS SOFT PEL&HIP SUPER RT,2699.0,966.24,194.98,5681.0,40
CPT,27043,"EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; 3 CM OR GREATER",,,460.92,18194.0,52
CPT,27047,EXC TUMOR PELVIS&HIP SUBQ 0-2CM,4597.0,2381.25,356.93,5114.29,63
CPT,27047,"EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM",,,356.93,6689.0,52
CPT,27076,"RADICAL RESECTION OF TUMOR; ILIUM, INCLUDING ACETABULUM, BOTH PUBIC RAMI, OR ISCHIUM AND ACETABULUM",,,2443.88,13802.9,50
CPT,27080,"COCCYGECTOMY, PRIMARY",,,501.42,7697.0,52
CPT,27086,REM FB PELVIS/HIP SUBQ,3477.0,1801.09,167.13,5114.29,63
CPT,27087,REM FB PELVIS/HIP DEEP,5262.0,2725.72,605.4,5760.96,63
CPT,27087,"REMOVAL OF FOREIGN BODY, PELVIS OR HIP; DEEP (SUBFASCIAL OR INTRAMUSCULAR)",,,605.4,7704.0,52
CPT,27093,INJ ARTHRO HIP WO ANES BI,864.0,309.31,65.71,5681.0,80
CPT,27093,INJ ARTHRO HIP WO ANES LT,576.0,206.21,65.71,5681.0,80
CPT,27093,INJ ARTHRO HIP WO ANES RT,576.0,206.21,65.71,5681.0,80
CPT,27095,INJ ARTHRO HIP W ANES BI,989.0,354.06,79.23,5681.0,80
CPT,27095,INJ ARTHRO HIP W ANES LT,659.0,235.92,79.23,5681.0,80
CPT,27095,INJ ARTHRO HIP W ANES RT,659.0,235.92,79.23,5681.0,80
CPT,27096,INJ JT SI ANES/STRD FL/CT GD BI,989.0,354.06,80.83,5681.0,80
CPT,27096,INJ JT SI ANES/STRD FL/CT GD LT,659.0,235.92,80.83,5681.0,80
CPT,27096,INJ JT SI ANES/STRD FL/CT GD RT,659.0,235.92,80.83,5681.0,80
CPT,27130,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft",,,1253.83,27605.8,50
CPT,27132,"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft",,,1628.07,27605.8,50
CPT,27134,"Revision of total hip arthroplasty; both components, with or without autograft or allograft",,,1851.32,22604.88,50
CPT,27138,"Revision of total hip arthroplasty; femoral component only, with or without allograft",,,1482.67,22604.88,50
CPT,27216,"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL (INCLUDES IPSILATERAL ILIUM, SACROILIAC JOINT AND/OR",,,877.71,7697.0,14
CPT,27217,"OPEN TREATMENT OF ANTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES PUBIC SYMPHYSIS ",,,825.28,13802.9,14
CPT,27218,"OPEN TREATMENT OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES IPSILATERAL IL",,,982.0,13802.9,14
CPT,27235,"PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, PROXIMAL END, NECK",,,890.43,12775.92,50
CPT,27236,"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement",,,1168.22,13802.9,50
CPT,27245,"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage",,,1199.45,13802.9,50
CPT,27266,CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; REQUIRING REGIONAL OR GENERAL ANESTHESIA,,,577.45,6689.0,52
CPT,27279,"ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE, WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, UNILATERAL; PLACEMENT OF TRANSARTICULAR DEVICE(S) AND/OR INTRA-ART",,,784.43,30871.55,50
CPT,27280,"ARTHRODESIS, SACROILIAC JOINT, OPEN, INCLUDES OBTAINING BONE GRAFT, INCLUDING INSTRUMENTATION, WHEN PERFORMED",,,1327.77,30871.55,50
CPT,27301,I&D ABSC/BUR/HEMAT THIGH/KNEE BI,7893.0,4088.57,502.53,5919.75,40
CPT,27301,I&D ABSC/BUR/HEMAT THIGH/KNEE LT,5262.0,2725.72,502.53,5261.73,40
CPT,27301,I&D ABSC/BUR/HEMAT THIGH/KNEE RT,5262.0,2725.72,502.53,5261.73,40
CPT,27301,"INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA, THIGH OR KNEE REGION",,,502.53,7704.0,52
CPT,27310,"ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTION)",,,723.53,8715.0,52
CPT,27327,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm",,,312.01,6689.0,52
CPT,27328,"Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); less than 5 cm",,,614.09,7704.0,52
CPT,27332,"ARTHROTOMY, WITH EXCISION OF SEMILUNAR CARTILAGE (MENISCECTOMY) KNEE; MEDIAL OR LATERAL",,,639.77,8715.0,52
CPT,27334,"ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR",,,678.76,8715.0,52
CPT,27335,"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area",,,756.25,12775.92,52
CPT,27337,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater",,,412.84,18194.0,52
CPT,27339,"Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); 5 cm or greater",,,741.41,18194.0,52
CPT,27340,"EXCISION, PREPATELLAR BURSA",,,374.91,7704.0,52
CPT,27369,INJ ARTHRO KNEE CNT/CNT ENHANCE BI,629.0,225.18,38.9,5681.0,40
CPT,27369,INJ ARTHRO KNEE CNT/CNT ENHANCE LT,419.0,150.0,38.9,5681.0,40
CPT,27369,INJ ARTHRO KNEE CNT/CNT ENHANCE RT,419.0,150.0,38.9,5681.0,40
CPT,27372,"REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA",,,395.5,14124.0,52
CPT,27380,SUTURE OF INFRAPATELLAR TENDON; PRIMARY,,,616.44,12775.92,52
CPT,27385,Suture of quadriceps or hamstring muscle rupture; primary,,,601.61,12775.92,52
CPT,27386,"SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON GRAFT",,,844.12,12775.92,52
CPT,27390,"TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE TENDON",,,449.11,6226.0,52
CPT,27403,"ARTHROTOMY WITH MENISCUS REPAIR, KNEE",,,638.81,12775.92,52
CPT,27405,"REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL",,,669.13,12775.92,52
CPT,27409,"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments",,,950.38,12775.92,52
CPT,27415,"OSTEOCHONDRAL ALLOGRAFT, KNEE, OPEN",,,1343.66,22604.88,50
CPT,27418,"ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE)",,,809.98,12775.92,52
CPT,27422,"RECONSTRUCTION OF DISLOCATING PATELLA; WITH EXTENSOR REALIGNMENT AND/OR MUSCLE ADVANCEMENT OR RELEASE (EG, CAMPBELL, GOLDWAITE TYPE PROCEDURE)",,,732.39,14124.0,52
CPT,27425,"LATERAL RETINACULAR RELEASE, OPEN",,,453.09,14124.0,52
CPT,27427,"Ligamentous reconstruction (augmentation), knee; extra-articular",,,699.87,12775.92,52
CPT,27428,"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)",,,1098.32,22604.88,52
CPT,27430,"QUADRICEPSPLASTY (EG, BENNETT OR THOMPSON TYPE)",,,733.24,12775.92,52
CPT,27446,"Arthroplasty, knee, condyle and plateau; medial or lateral compartment",,,1122.75,22604.88,50
CPT,27447,"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)",,,1251.96,27605.8,50
CPT,27450,"OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITH FIXATION",,,990.65,13802.9,50
CPT,27466,"OSTEOPLASTY, FEMUR; LENGTHENING",,,1160.6,13802.9,50
CPT,27470,"Repair, nonunion or malunion, femur, distal to head and neck; without graft (e.g., compression technique)",,,1157.4,13802.9,50
CPT,27472,"REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITH ILIAC OR OTHER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT)",,,1237.59,13802.9,50
CPT,27486,"Revision of total knee arthroplasty, with or without allograft; 1 component",,,1371.05,22604.88,50
CPT,27487,"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component",,,1707.56,30871.55,50
CPT,27495,"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING, OR WIRING) WITH OR WITHOUT METHYLMETHACRYLATE, FEMUR",,,1106.8,13802.9,50
CPT,27506,"OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, WITH OR WITHOUT EXTERNAL FIXATION, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS",,,1309.41,13802.9,50
CPT,27524,"OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR",,,743.03,12775.92,52
CPT,27535,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,877.72,13802.9,50
CPT,27536,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR WITHOUT INTERNAL FIXATION",,,1163.29,13802.9,50
CPT,27552,CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA,,,630.04,5681.0,52
CPT,27566,"OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUT PARTIAL OR TOTAL PATELLECTOMY",,,878.22,12775.92,52
CPT,27570,Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices),,,152.54,5681.0,52
CPT,27596,"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; RE-AMPUTATION",,,690.99,13802.9,50
CPT,27599,"UNLISTED PROCEDURE, FEMUR OR KNEE",,,149.49,5681.0,49
CPT,27600,DECOMPRESS LEG COMPART ANT&/LAT,5262.0,2725.72,391.43,5760.96,63
CPT,27603,I&D ABSC/HEMAT LEG/ANKLE BI,6896.0,3572.13,384.15,5172.0,40
CPT,27603,I&D ABSC/HEMAT LEG/ANKLE LT,4597.0,2381.25,384.15,4596.53,40
CPT,27603,I&D ABSC/HEMAT LEG/ANKLE RT,4597.0,2381.25,384.15,4596.53,40
CPT,27612,"ARTHROTOMY, POSTERIOR CAPSULAR RELEASE, ANKLE, WITH OR WITHOUT ACHILLES TENDON LENGTHENING",,,565.5,7704.0,52
CPT,27613,BX TISS SOFT LEG/ANKLE SUPER BI,5150.0,2667.7,159.27,3862.5,40
CPT,27613,BX TISS SOFT LEG/ANKLE SUPER LT,3433.0,1778.29,159.27,3432.43,40
CPT,27613,BX TISS SOFT LEG/ANKLE SUPER RT,3433.0,1778.29,159.27,3432.43,40
CPT,27613,BX TISS SOFT LEG/ANKLE SUPERFICIAL,3433.0,1778.29,159.27,3432.43,63
CPT,27618,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm",,,302.72,6689.0,52
CPT,27620,"ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY",,,444.02,8715.0,52
CPT,27632,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater",,,402.09,18194.0,52
CPT,27638,"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; WITH ALLOGRAFT",,,731.41,12775.92,52
CPT,27640,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY), BONE (EG, OSTEOMYELITIS); TIBIA",,,817.82,7697.0,52
CPT,27648,INJ ARTHRO ANKLE BI,930.0,332.94,49.89,5681.0,40
CPT,27648,INJ ARTHRO ANKLE LT,620.0,221.96,49.89,5681.0,40
CPT,27648,INJ ARTHRO ANKLE RT,620.0,221.96,49.89,5681.0,40
CPT,27650,"REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;",,,649.06,12775.92,52
CPT,27656,"REPAIR, FASCIAL DEFECT OF LEG",,,338.27,6689.0,52
CPT,27664,"REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON",,,359.26,12775.92,52
CPT,27680,"TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; SINGLE, EACH TENDON",,,416.78,7704.0,52
CPT,27685,"LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SINGLE TENDON (SEPARATE PROCEDURE)",,,461.71,7704.0,52
CPT,27686,"LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; MULTIPLE TENDONS (THROUGH SAME INCISION), EACH",,,526.09,7704.0,52
CPT,27691,"TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); DEEP (EG, ANTERIOR TIBIAL OR POSTERIOR TIBIAL THROUGH INTEROSSEOUS SPACE, FLEXOR DIGITORUM LONGUS, FLEXOR HALLUCIS LONGU",,,732.57,12775.92,52
CPT,27695,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",,,481.32,12775.92,52
CPT,27702,"Arthroplasty, ankle; with implant (total ankle)",,,943.87,47774.5,50
CPT,27705,OSTEOTOMY; TIBIA,,,737.8,12775.92,52
CPT,27707,OSTEOTOMY; FIBULA,,,402.88,7697.0,52
CPT,27709,OSTEOTOMY; TIBIA AND FIBULA,,,1121.78,22604.88,52
CPT,27715,"OSTEOPLASTY, TIBIA AND FIBULA, LENGTHENING OR SHORTENING",,,1051.52,22604.88,50
CPT,27720,"REPAIR OF NONUNION OR MALUNION, TIBIA; WITHOUT GRAFT, (EG, COMPRESSION TECHNIQUE)",,,858.09,18194.0,52
CPT,27724,"REPAIR OF NONUNION OR MALUNION, TIBIA; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1225.06,13802.9,50
CPT,27752,"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction",,,490.1,5681.0,52
CPT,27756,"PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG, PINS OR SCREWS)",,,573.24,12775.92,52
CPT,27758,"OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,881.94,22604.88,52
CPT,27759,"TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE",,,978.06,22604.88,52
CPT,27766,"OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,598.39,12775.92,52
CPT,27769,"OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,716.1,18194.0,52
CPT,27788,Closed treatment of distal fibular fracture (lateral malleolus); with manipulation,,,149.49,5681.0,52
CPT,27792,"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,637.53,12775.92,52
CPT,27810,"Closed treatment of bimalleolar ankle fracture (e.g., lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation",,,430.68,5681.0,52
CPT,27814,"OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LATERAL AND POSTERIOR MALLEOLI, OR MEDIAL AND POSTERIOR MALLEOLI), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,753.26,12775.92,52
CPT,27822,"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITHOUT FIXATION OF POSTERIOR LIP",,,860.13,12775.92,52
CPT,27823,"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITH FIXATION OF POSTERIOR LIP",,,968.21,12775.92,52
CPT,27824,"Closed treatment of fracture of weight bearing articular portion of distal tibia (e.g., pilon or tibial plafond), with or without anesthesia; without manipulation",,,149.49,5681.0,52
CPT,27827,"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILON OR TIBIAL PLAFOND), WITH INTERNAL FIXATION, WHEN PERFORMED; OF TIBIA ONLY",,,1100.54,22604.88,52
CPT,27828,"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILON OR TIBIAL PLAFOND), WITH INTERNAL FIXATION, WHEN PERFORMED; OF BOTH TIBIA AND FIBULA",,,1300.59,22604.88,52
CPT,27829,"OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,697.86,12775.92,52
CPT,27840,Closed treatment of ankle dislocation; without anesthesia,,,149.49,5681.0,52
CPT,27842,"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation",,,490.78,5681.0,52
CPT,27880,"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA;",,,869.15,13802.9,50
CPT,27886,"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; RE-AMPUTATION",,,630.86,13802.9,50
CPT,27893,DECOMPRESS LEG COMPART POST W DEBR,8646.0,4478.63,608.55,12775.92,63
CPT,27899,"UNLISTED PROCEDURE, LEG OR ANKLE",,,149.49,5681.0,49
CPT,28002,I&D FOOT BELOW FASCIA SGL,5262.0,2725.72,137.3,5261.73,63
CPT,28005,"Incision, bone cortex (e.g., osteomyelitis or bone abscess), foot",,,563.4,7704.0,52
CPT,28010,TENOTOMY TNDN TOE PERC SINGLE,5262.0,2725.72,206.58,5261.73,63
CPT,28011,"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS",,,276.89,7704.0,52
CPT,28022,"ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METATARSOPHALANGEAL JOINT",,,324.11,6689.0,52
CPT,28035,"RELEASE, TARSAL TUNNEL (POSTERIOR TIBIAL NERVE DECOMPRESSION)",,,354.56,8715.0,52
CPT,28118,"OSTECTOMY, CALCANEUS;",,,417.88,8715.0,52
CPT,28122,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TARSAL OR METATARSAL BONE, EXCEPT TALUS OR CALCANEUS",,,434.34,7704.0,52
CPT,28124,EXC BONE PARTIAL TOE PHALANX,3427.0,1775.19,331.45,5760.96,63
CPT,28140,METATARSECTOMY,,,418.92,7704.0,52
CPT,28160,EXC JOINT HEMIPHAL/INTERPHAL TOE,4138.0,2143.48,264.63,5760.96,63
CPT,28160,"HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, PROXIMAL END OF PHALANX, EACH",,,264.63,7704.0,52
CPT,28190,REM FB FOOT SUBQ,1538.0,796.68,130.69,3432.43,63
CPT,28190,"Removal of foreign body, foot; subcutaneous",,,130.69,6689.0,52
CPT,28192,REM FB FOOT DEEP,3494.0,1809.89,306.6,4596.53,63
CPT,28208,"REPAIR, TENDON, EXTENSOR, FOOT; PRIMARY OR SECONDARY, EACH TENDON",,,318.02,7704.0,52
CPT,28232,TENOTOMY TNDN FLEX TOE OPEN SGL,3218.0,1666.92,239.2,5261.73,63
CPT,28232,"TENOTOMY, OPEN, TENDON FLEXOR; TOE, SINGLE TENDON (SEPARATE PROCEDURE)",,,239.2,6689.0,50
CPT,28272,CAPSULOT JOINT INTERPHAL TOE BI,5171.0,2678.58,248.96,5261.73,40
CPT,28272,CAPSULOT JOINT INTERPHAL TOE LT,3447.0,1785.55,248.96,5261.73,40
CPT,28272,CAPSULOT JOINT INTERPHAL TOE RT,3447.0,1785.55,248.96,5261.73,40
CPT,28285,"Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)",,,383.0,7704.0,52
CPT,28296,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method",,,507.8,7704.0,52
CPT,28297,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method",,,593.54,22604.88,52
CPT,28298,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method",,,501.83,12775.92,52
CPT,28300,"OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATION",,,641.18,12775.92,52
CPT,28304,"OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS;",,,605.29,12775.92,52
CPT,28415,"OPEN TREATMENT OF CALCANEAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED;",,,1101.94,12775.92,52
CPT,28465,"OPEN TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,634.32,12775.92,52
CPT,28475,"CLOSED TREATMENT OF METATARSAL FRACTURE; WITH MANIPULATION, EACH",,,149.49,5681.0,52
CPT,28476,"PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH MANIPULATION, EACH",,,385.38,6689.0,52
CPT,28485,"OPEN TREATMENT OF METATARSAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,558.53,12775.92,52
CPT,28615,"OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,817.7,12775.92,52
CPT,28725,ARTHRODESIS; SUBTALAR,,,766.57,22604.88,52
CPT,28730,"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE;",,,714.2,22604.88,52
CPT,28740,"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT",,,607.91,12775.92,52
CPT,28750,"ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT",,,568.16,12775.92,52
CPT,28805,"AMPUTATION, FOOT; TRANSMETATARSAL",,,691.25,13802.9,50
CPT,28810,AMP TOE METATARSAL SGL,4055.0,2100.49,415.02,5760.96,63
CPT,28810,"AMPUTATION, METATARSAL, WITH TOE, SINGLE",,,415.02,6689.0,52
CPT,28820,AMP TOE JT METATARSOPHALANGEAL,4759.0,2465.16,173.28,5760.96,63
CPT,28820,"AMPUTATION, TOE; METATARSOPHALANGEAL JOINT",,,173.28,6689.0,52
CPT,28825,AMP TOE JT INTERPHALANGEAL,4910.0,2543.38,169.02,5760.96,63
CPT,28825,"Amputation, toe; interphalangeal joint",,,169.02,6689.0,52
CPT,28899,"Unlisted procedure, foot or toes",,,149.49,5681.0,49
CPT,29075,APPL CAST ARM SHORT BI,809.0,419.06,61.38,1068.05,40
CPT,29075,APPL CAST ARM SHORT LT,539.0,279.2,61.38,1068.05,40
CPT,29075,APPL CAST ARM SHORT RT,539.0,279.2,61.38,1068.05,40
CPT,29105,APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND),,,40.59,2481.0,48
CPT,29105,OT APPL SPLINT ARM LONG BI,716.0,98.81,40.59,537.0,40
CPT,29105,OT APPL SPLINT ARM LONG LT,477.0,65.83,40.59,476.55,40
CPT,29105,OT APPL SPLINT ARM LONG RT,477.0,65.83,40.59,476.55,40
CPT,29125,APPL SPLINT ARM SHORT STATIC,469.0,242.94,39.65,476.55,63
CPT,29125,OT APPL SPLINT ARM SHORT STATIC BI,704.0,97.15,39.65,528.0,40
CPT,29125,OT APPL SPLINT ARM SHORT STATIC LT,469.0,64.72,39.65,476.55,40
CPT,29125,OT APPL SPLINT ARM SHORT STATIC RT,469.0,64.72,39.65,476.55,40
CPT,29126,OT APPL SPLINT ARM SHORT DYN BI,716.0,98.81,48.52,537.0,40
CPT,29126,OT APPL SPLINT ARM SHORT DYN LT,477.0,65.83,48.52,476.55,40
CPT,29126,OT APPL SPLINT ARM SHORT DYN RT,477.0,65.83,48.52,476.55,40
CPT,29130,OT APPL SPLINT FINGER STATIC,222.0,30.64,28.29,476.55,40
CPT,29131,OT APPL SPLINT FINGER DYNAMIC,206.0,28.43,33.85,476.55,40
CPT,29345,APPL CAST LEG LONG,384.0,198.91,96.83,1068.05,63
CPT,29425,APPL CAST LEG SHORT WALKING,362.0,187.52,53.17,1068.05,63
CPT,29445,APPL CAST LEG CONTACT RIGID,684.0,354.31,96.42,1068.05,63
CPT,29445,Application of rigid total contact leg cast,,,96.42,2481.0,48
CPT,29505,APPL SPLINT LEG LONG,477.0,247.09,51.37,476.55,63
CPT,29515,APPL SPLINT LEG SHORT,424.0,219.63,48.85,476.55,63
CPT,29580,STRAPPING BOOT UNNA BI,567.0,293.71,25.49,476.55,40
CPT,29580,STRAPPING BOOT UNNA LT,378.0,195.8,25.49,476.55,40
CPT,29580,STRAPPING BOOT UNNA RT,378.0,195.8,25.49,476.55,40
CPT,29581,APPL CMPRSS MULT BELOW KNEE BI,530.0,274.54,26.1,476.55,40
CPT,29581,APPL CMPRSS MULT BELOW KNEE LT,353.0,182.85,26.1,476.55,40
CPT,29581,APPL CMPRSS MULT BELOW KNEE RT,353.0,182.85,26.1,476.55,40
CPT,29581,"APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; LEG (BELOW KNEE), INCLUDING ANKLE AND FOOT",,,26.1,2481.0,48
CPT,29584,APPL CMPRSS MULT ARM&HAND BI,312.0,161.62,15.18,476.55,40
CPT,29584,APPL CMPRSS MULT ARM&HAND LT,208.0,107.74,15.18,476.55,40
CPT,29584,APPL CMPRSS MULT ARM&HAND RT,208.0,107.74,15.18,476.55,40
CPT,29806,"Arthroscopy, shoulder, surgical; capsulorrhaphy",,,1039.65,12775.92,52
CPT,29819,"ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY",,,580.26,10065.0,52
CPT,29821,"ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE",,,585.45,10065.0,52
CPT,29822,"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anc",,,535.72,7704.0,52
CPT,29823,"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, bicep",,,585.81,10065.0,52
CPT,29824,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)",,,668.6,10065.0,52
CPT,29826,"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, when performed (list separately in addition to code f",,,165.68,7704.0,21
CPT,29827,"Arthroscopy, shoulder, surgical; with rotator cuff repair",,,1047.62,12775.92,52
CPT,29828,"Arthroscopy, shoulder, surgical; biceps tenodesis",,,899.86,18194.0,52
CPT,29846,"ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT DEBRIDEMENT",,,517.84,7704.0,52
CPT,29867,"ARTHROSCOPY, KNEE, SURGICAL; OSTEOCHONDRAL ALLOGRAFT (EG, MOSAICPLASTY)",,,1253.46,22604.88,50
CPT,29870,"ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)",,,407.16,7704.0,52
CPT,29875,"Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection) (separate procedure)",,,491.83,8715.0,52
CPT,29877,"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)",,,613.3,8715.0,52
CPT,29879,"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture",,,653.19,7704.0,52
CPT,29880,"Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s",,,555.82,8715.0,52
CPT,29881,"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s)",,,535.72,8715.0,52
CPT,29882,"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)",,,678.81,7704.0,52
CPT,29883,"ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL AND LATERAL)",,,829.65,7704.0,52
CPT,29884,"ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITH OR WITHOUT MANIPULATION (SEPARATE PROCEDURE)",,,612.31,7704.0,52
CPT,29888,Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction,,,955.58,12775.92,52
CPT,29889,Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction,,,1202.13,22604.88,52
CPT,29907,"ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; WITH SUBTALAR ARTHRODESIS",,,863.66,22604.88,52
CPT,29915,"Arthroscopy, hip, surgical; with acetabuloplasty (i.e., treatment of pincer lesion)",,,998.03,18194.0,52
CPT,29999,"UNLISTED PROCEDURE, ARTHROSCOPY",,,149.49,5681.0,49
CPT,30020,"DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM",,,121.08,5681.0,52
CPT,30100,"BIOPSY, INTRANASAL",,,67.12,5681.0,52
CPT,30110,"EXCISION, NASAL POLYP(S), SIMPLE",,,131.23,5681.0,50
CPT,30117,"EXCISION OR DESTRUCTION (EG, LASER), INTRANASAL LESION; INTERNAL APPROACH",,,406.69,7704.0,52
CPT,30118,"EXCISION OR DESTRUCTION (EG, LASER), INTRANASAL LESION; EXTERNAL APPROACH (LATERAL RHINOTOMY)",,,697.66,7704.0,52
CPT,30130,"EXCISION INFERIOR TURBINATE, PARTIAL OR COMPLETE, ANY METHOD",,,409.85,7704.0,52
CPT,30140,"Submucous resection inferior turbinate, partial or complete, any method",,,173.75,6689.0,52
CPT,30150,RHINECTOMY; PARTIAL,,,785.99,10422.97,52
CPT,30220,"INSERTION, NASAL SEPTAL PROSTHESIS (BUTTON)",,,126.65,7704.0,52
CPT,30400,"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip",,,1203.09,10422.97,52
CPT,30420,"Rhinoplasty, primary; including major septal repair",,,1425.54,10422.97,52
CPT,30450,"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)",,,1709.54,14124.0,52
CPT,30465,"Repair of nasal vestibular stenosis (e.g., spreader grafting, lateral nasal wall reconstruction)",,,1009.07,18194.0,52
CPT,30468,Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s),,,164.94,18194.0,52
CPT,30520,"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft",,,664.71,8715.0,52
CPT,30560,Lysis intranasal synechia,,,148.93,6689.0,52
CPT,30580,REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED),,,451.97,10422.97,52
CPT,30600,Repair fistula; oronasal,,,377.93,10422.97,52
CPT,30620,Septal or other intranasal dermatoplasty (does not include obtaining graft),,,664.24,14124.0,52
CPT,30630,REPAIR NASAL SEPTAL PERFORATIONS,,,658.57,14124.0,52
CPT,30801,"ABLATION, SOFT TISSUE OF INFERIOR TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD (EG, ELECTROCAUTERY, RADIOFREQUENCY ABLATION, OR TISSUE VOLUME REDUCTION); SUPERFICIAL",,,149.56,5681.0,52
CPT,30901,"CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD",,,55.0,5681.0,52
CPT,30930,"FRACTURE NASAL INFERIOR TURBINATE(S), THERAPEUTIC",,,116.84,8715.0,52
CPT,30999,"Unlisted procedure, nose",,,153.41,5681.0,49
CPT,31051,"SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY; WITH MUCOSAL STRIPPING OR REMOVAL OF POLYP(S)",,,682.64,10422.97,52
CPT,31200,"ETHMOIDECTOMY; INTRANASAL, ANTERIOR",,,615.87,10422.97,52
CPT,31201,"Ethmoidectomy; intranasal, total",,,766.44,10059.0,52
CPT,31225,Maxillectomy; without orbital exenteration,,,982.0,13802.9,14
CPT,31237,"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)",,,156.09,6689.0,52
CPT,31238,"NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF NASAL HEMORRHAGE",,,163.27,6689.0,52
CPT,31240,"NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSA RESECTION",,,155.13,6689.0,52
CPT,31241,"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery",,,432.51,7704.0,50
CPT,31253,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed",,,485.15,18194.0,52
CPT,31254,"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)",,,236.4,12425.97,52
CPT,31255,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)",,,313.99,12425.97,52
CPT,31256,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;",,,175.1,7704.0,52
CPT,31257,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy",,,432.91,18194.0,52
CPT,31259,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus",,,457.45,18194.0,52
CPT,31267,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus",,,258.16,12425.97,52
CPT,31276,"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed",,,367.4,12425.97,52
CPT,31287,"Nasal/sinus endoscopy, surgical, with sphenoidotomy;",,,195.63,12425.97,52
CPT,31288,"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus",,,227.53,12425.97,52
CPT,31299,"UNLISTED PROCEDURE, ACCESSORY SINUSES",,,153.41,4664.0,49
CPT,31300,"LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE), WITH REMOVAL OF TUMOR OR LARYNGOCELE, CORDECTOMY",,,1224.9,10059.0,52
CPT,31400,"ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROACH",,,992.41,10422.97,52
CPT,31500,INTUBATION ENDOTRACHEAL EMERG,1063.0,206.22,136.1,1062.59,63
CPT,31502,CHG TUBE TRACH PRIOR TRACT FISTULA,491.0,175.78,33.93,5681.0,63
CPT,31525,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn",,,156.08,6689.0,52
CPT,31526,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope",,,152.82,6689.0,52
CPT,31528,"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial",,,140.44,6689.0,52
CPT,31529,"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent",,,156.77,6689.0,52
CPT,31530,"Laryngoscopy, direct, operative, with foreign body removal;",,,193.22,6689.0,52
CPT,31535,"Laryngoscopy, direct, operative, with biopsy;",,,183.82,6689.0,52
CPT,31536,"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope",,,204.07,7704.0,52
CPT,31540,"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;",,,234.04,7704.0,52
CPT,31541,"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope",,,255.23,8715.0,52
CPT,31545,"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)",,,350.76,8715.0,52
CPT,31546,"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)",,,531.36,12425.97,52
CPT,31552,"LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT, WITHOUT INDWELLING STENT PLACEMENT, AGE 12 YEARS OR OLDER",,,1459.42,10422.97,50
CPT,31560,"Laryngoscopy, direct, operative, with arytenoidectomy;",,,302.54,12425.97,52
CPT,31561,"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope",,,330.9,12425.97,52
CPT,31570,"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;",,,222.43,6689.0,52
CPT,31571,"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope",,,241.54,6689.0,52
CPT,31572,"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral",,,175.71,14124.0,52
CPT,31573,"Laryngoscopy, flexible; with therapeutic injection(s) (e.g., chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral",,,145.04,14124.0,52
CPT,31575,ST LARYNGOSCOPY DIAGNOSTIC FLEX,626.0,224.11,67.08,6689.0,63
CPT,31579,ST LARYNGOSCOPY W STROBOSCOPY,1411.0,505.14,116.75,6689.0,63
CPT,31591,"LARYNGOPLASTY, MEDIALIZATION, UNILATERAL",,,1080.42,10422.97,50
CPT,31599,"UNLISTED PROCEDURE, LARYNX",,,153.41,5681.0,49
CPT,31613,"TRACHEOSTOMA REVISION; SIMPLE, WITHOUT FLAP ROTATION",,,416.25,6689.0,52
CPT,31614,"TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION",,,699.01,10422.97,52
CPT,31615,Tracheobronchoscopy through established tracheostomy incision,,,112.82,5681.0,52
CPT,31622,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)",,,127.43,6689.0,104
CPT,31623,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings",,,126.86,6689.0,52
CPT,31624,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage",,,128.45,6689.0,104
CPT,31625,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,150.03,6689.0,104
CPT,31627,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (list separately in addition to code for primary procedure[s])",,,92.34,5681.0,14
CPT,31628,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe",,,168.85,6689.0,52
CPT,31629,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)",,,179.2,7697.0,104
CPT,31630,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture",,,190.21,7697.0,104
CPT,31631,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF TRACHEAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED)",,,216.71,12425.97,52
CPT,31632,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL LUNG BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,46.91,6689.0,21
CPT,31633,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY",,,60.29,6689.0,21
CPT,31634,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BALLOON OCCLUSION, WITH ASSESSMENT OF AIR LEAK, WITH ADMINISTRATION OF OCCLUSIVE SUBSTANCE (EG, FIBRIN GLUE), IF ",,,180.46,12425.97,52
CPT,31635,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body",,,168.46,6689.0,104
CPT,31636,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF BRONCHIAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED), INITIAL BRONCHUS",,,207.49,12425.97,104
CPT,31640,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor",,,237.07,7697.0,104
CPT,31641,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy, cryotherapy)",,,243.51,7697.0,104
CPT,31645,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial",,,141.44,6689.0,104
CPT,31647,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BALLOON OCCLUSION, WHEN PERFORMED, ASSESSMENT OF AIR LEAK, AIRWAY SIZING, AND INSERTION OF BRONCHIAL VALVE(S), IN",,,196.98,14124.0,52
CPT,31648,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH REMOVAL OF BRONCHIAL VALVE(S), INITIAL LOBE",,,190.0,14124.0,52
CPT,31652,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[i",,,211.36,18194.0,52
CPT,31653,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[i",,,234.25,18194.0,104
CPT,31825,SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTIC REPAIR,,,478.71,6689.0,52
CPT,31899,LAVAGE BRONCH ALVEO WO SCOPE,1054.0,377.33,119.18,5681.0,62
CPT,31899,"UNLISTED PROCEDURE, TRACHEA, BRONCHI",,,119.18,5681.0,49
CPT,32400,BX PLEURA NDL PERC,2408.0,862.06,80.58,5681.0,126
CPT,32408,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3433.0,2599.15,146.11,14124.0,189
CPT,32550,INS CATH PLEURAL INDWL W CUFF,5104.0,1827.23,195.82,18194.0,126
CPT,32552,REM CATH PLEURAL INDWL W CUFF,2250.0,805.5,151.86,5681.0,63
CPT,32553,PLC DEV/S INTRSTL RT GD INTRATH,1500.0,537.0,168.0,10059.0,189
CPT,32554,THORACENTESIS ASP WO IMG BI,3806.0,1362.55,85.38,5681.0,80
CPT,32554,THORACENTESIS ASP WO IMG LT,2537.0,908.25,85.38,5681.0,80
CPT,32554,THORACENTESIS ASP WO IMG RT,2537.0,908.25,85.38,5681.0,80
CPT,32555,THORACENTESIS ASP W IMG BI,4568.0,1034.68,104.86,5681.0,120
CPT,32555,THORACENTESIS ASP W IMG LT,3045.0,1034.68,104.86,5681.0,120
CPT,32555,THORACENTESIS ASP W IMG RT,3045.0,1034.68,104.86,5681.0,120
CPT,32556,DRN PLEURA INS CATH INDWL WO IMG BI,3494.0,1250.85,119.38,6689.0,40
CPT,32556,DRN PLEURA INS CATH INDWL WO IMG LT,2329.0,833.78,119.38,6689.0,40
CPT,32556,DRN PLEURA INS CATH INDWL WO IMG RT,2329.0,833.78,119.38,6689.0,40
CPT,32557,DRN PLEURA INS CATH INDWL W IMG BI,4172.0,1493.58,143.18,6689.0,120
CPT,32557,DRN PLEURA INS CATH INDWL W IMG LT,2781.0,995.6,143.18,6689.0,120
CPT,32557,DRN PLEURA INS CATH INDWL W IMG RT,2781.0,995.6,143.18,6689.0,120
CPT,32560,INSTILL AGENT PLEURODESIS W TB/CATH,1301.0,465.76,73.01,6689.0,63
CPT,32561,INSTILL AGENT FIBRIN TB/CTH 1ST DAY,2883.0,1032.11,64.77,5681.0,126
CPT,32994,ABL CRYO TUMOR/S PULM PERC IMG BI,16037.0,5741.25,418.06,12027.75,40
CPT,32994,ABL CRYO TUMOR/S PULM PERC IMG LT,10691.0,3827.38,418.06,10065.0,40
CPT,32994,ABL CRYO TUMOR/S PULM PERC IMG RT,10691.0,3827.38,418.06,10065.0,40
CPT,32998,ABL RF TUMOR/S PULM PERC IMG GD BI,15387.0,5508.55,418.71,18194.0,40
CPT,32998,ABL RF TUMOR/S PULM PERC IMG GD LT,10258.0,3672.36,418.71,18194.0,40
CPT,32998,ABL RF TUMOR/S PULM PERC IMG GD RT,10258.0,3672.36,418.71,18194.0,40
CPT,32999,CONVERSION TB CHEST CATH TUN PLRL,2614.0,935.81,392.67,7390.37,62
CPT,32999,EXCHG TUBE CHEST VIA WIRE,740.0,264.92,333.0,7390.37,124
CPT,32999,REPOS TUBE CHEST W IMG,1912.0,684.5,392.67,7390.37,62
CPT,33016,ED PERICARDIOCENTESIS INCL IMG GD,3370.0,832.39,222.72,10257.38,64
CPT,33016,PERICARDIOCENTESIS INCL IMG GD,3370.0,1206.46,222.72,14124.0,378
CPT,33017,DRN PERICARD PERC WO CONG CARD 6+Y,3504.0,1254.43,234.96,16111.14,80
CPT,33018,DRN PERICARD PERC WO CONG CARD 0-5Y,3976.0,1423.41,274.4,5444.0,40
CPT,33019,DRN PERICARD PERC INCL CT GD,3235.0,1158.13,201.08,5444.0,40
CPT,33025,CREATE WINDOW PERICARDIAL RESC PART,2428.0,869.22,451.61,13802.9,40
CPT,33206,INS NEW/RPLC PPM W ELCTRD ATRIAL,9772.0,3498.38,434.68,55261.0,126
CPT,33207,INS NEW/RPLC PPM W ELCTRD VENT,10258.0,3672.36,456.66,55261.0,126
CPT,33208,INS NEW/RPLC PPM W ELCTRD A&V,28357.0,10151.81,494.26,55261.0,126
CPT,33210,INS/RPLC ELCTRD/CATH PM TEMP SGL,9672.0,3462.58,153.19,15325.0,126
CPT,33212,INS GEN PPM ONLY W LD EXIST SGL,7000.0,2506.0,309.49,55261.0,63
CPT,33213,INS GEN PPM ONLY W LD EXIST DUAL,7499.0,2684.64,324.07,55261.0,63
CPT,33214,UPGRADE SYS PM IMP SGL TO DUAL,12779.0,4574.88,458.06,55261.0,126
CPT,33215,REPOSITION ELCTRD PM/ICD PREV A/V,6115.0,2189.17,297.16,10257.38,126
CPT,33216,INS ELCTRD PM/ICD TRANSVENOUS SGL,10258.0,3672.36,355.92,15325.0,126
CPT,33216,"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator",,,355.92,15325.0,50
CPT,33217,INS ELCTRD PM/ICD TRANSVENOUS DUAL,10258.0,3672.36,353.3,15325.0,126
CPT,33218,RPR ELCTRD PM/ICD TRANSVENOUS SGL,6248.0,2236.78,373.41,15325.0,126
CPT,33221,INS GEN PPM ONLY W LD EXIST MULTI,11790.0,4220.82,342.31,55261.0,63
CPT,33222,RELOCATION POCKET SKIN PM,4597.0,1645.73,329.92,15325.0,63
CPT,33223,RELOCATION POCKET SKIN ICD,4597.0,1645.73,391.79,6689.0,63
CPT,33224,INS ELCTRD LV PREVIOUS PM/ICD,10258.0,3672.36,485.77,55261.0,63
CPT,33225,INS ELCTRD LV PM/ICD ADD ON,10124.0,3624.39,437.79,55261.0,80
CPT,33226,REPOSITION ELCTRD LV PREVIOUS,8111.0,2903.74,464.9,10257.38,63
CPT,33227,REM&RPL GEN PPM SGL,11474.0,4107.69,325.02,55261.0,126
CPT,33228,REM&RPL GEN PPM DUAL,11952.0,4278.82,339.33,55261.0,126
CPT,33229,REM&RPL GEN PPM MULTI,12669.0,4535.5,356.83,55261.0,126
CPT,33230,INS GEN ICD ONLY W LD EXIST DUAL,11632.0,4164.26,358.04,66010.0,63
CPT,33231,INS GEN ICD ONLY W LD EXIST MULTI,15344.0,5493.15,383.79,66010.0,63
CPT,33233,REM GENERATOR PPM ONLY,4597.0,1645.73,224.3,15325.0,126
CPT,33233,Removal of permanent pacemaker pulse generator only,,,224.3,15325.0,52
CPT,33234,REM ELCTRD PM LEAD A/V SGL,8069.0,2888.7,462.87,15325.0,126
CPT,33235,REM ELCTRD PM LEAD A/V DUAL,10086.0,3610.79,608.32,15325.0,126
CPT,33235,Removal of transvenous pacemaker electrode(s); dual lead system,,,608.32,15325.0,50
CPT,33240,INS GEN ICD ONLY W LD EXIST SGL,11632.0,4164.26,352.58,66010.0,63
CPT,33241,REM GEN ICD ONLY,6125.0,2192.75,206.45,10257.38,126
CPT,33244,REM ELCTRD ICD SGL/DUAL EXTRACT TV,8645.0,3094.91,824.37,10257.38,189
CPT,33249,INS/RPL ICD W LEAD SGL/DUAL,19993.0,7157.49,870.15,66010.0,126
CPT,33262,REM&RPL GEN ICD SGL,16486.0,5901.99,356.2,66010.0,126
CPT,33263,REM&RPL GEN ICD DUAL,18251.0,6533.86,370.1,66010.0,126
CPT,33264,REM&RPL GEN ICD MULTI,19011.0,6805.94,385.95,66010.0,126
CPT,33264,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system,,,385.95,66010.0,50
CPT,33270,INS/RPL DEFIB SUBQ PERM W ELCTRD,15344.0,5493.15,534.79,66010.0,126
CPT,33271,INS DEFIB SUBQ ELCTRD,13803.0,4941.47,435.19,22347.0,126
CPT,33272,REM DEFIB SUBQ ELCTRD,6973.0,2496.33,332.51,66010.0,126
CPT,33273,REPOS DEFIB SUBQ PREV ELCTRD,5953.0,2131.17,385.22,18194.0,126
CPT,33274,INS/RPL PM PERM LDLS RV W IMG GD,14554.0,5210.33,456.33,33913.79,126
CPT,33275,REM PM PERM LDLS RV INCL IMG GD,15381.0,5506.4,482.07,18194.0,63
CPT,33276,INS SYS STM NRV PHRENIC INCL IM GD,54466.0,19498.83,552.57,77552.01,63
CPT,33279,REM STM NRV PHRENIC SYS LD STM/SNS,5147.0,1842.63,332.14,7697.0,63
CPT,33281,REPOS LEAD TV STM NRV PHRENIC,7165.0,2565.07,359.36,7697.0,63
CPT,33285,INS CRM SUBQ W PROGRAMMING,10258.0,3672.36,83.27,15325.0,126
CPT,33286,REM CRM SUBQ,3542.0,1268.04,81.67,15325.0,126
CPT,33287,REM&REPL STM NRV PHRENIC GEN PULSE,14099.0,5047.44,370.72,54330.72,63
CPT,33288,REM&REPL STM NRV PHRENIC LD STM/SNS,16770.0,6003.66,488.61,19618.78,63
CPT,33289,RHC W IMP SENSOR PRESS WIRELESS,49131.0,13019.72,317.29,50502.38,126
CPT,33300,REPAIR WOUND CARDIAC WO BYPASS,13804.0,4941.83,982.0,13802.9,40
CPT,33340,CLOSE LAA PERC W IMP ENDOCARD,5851.0,2094.66,740.08,10215.0,80
CPT,33361,TAVR/TAVI VIA ARTERY FEMORAL PERC,13803.0,4941.47,982.0,13802.9,40
CPT,33362,TAVR/TAVI VIA ARTERY FEMORAL OPEN,15034.0,5382.17,982.0,13802.9,40
CPT,33363,TAVR/TAVI VIA ARTERY AXILLA OPEN,15619.0,5591.6,982.0,13802.9,40
CPT,33364,TAVR/TAVI VIA ARTERY ILIAC OPEN,16179.0,5792.08,982.0,13802.9,40
CPT,33365,TAVR/TAVI VIA TRANSAORTIC,16298.0,5834.68,982.0,13802.9,40
CPT,33418,RPR VALVE MITRAL PERC INIT PROSTH,26761.0,9580.44,982.0,26761.0,40
CPT,33419,RPR VALVE MITRAL PERC ADDL PROSTH,13367.0,4785.39,401.11,13380.5,40
CPT,33420,VALVOTOMY MITRAL HEART CLOSED,13803.0,4941.47,982.0,13802.9,40
CPT,33477,IMPLANT VALVE PULM TRNSCTH PERC,14128.0,5057.82,1248.67,10596.0,40
CPT,33741,TAS ANM CONG CARD IMG GD,7403.0,2650.27,712.33,5552.25,40
CPT,33946,ECMO/ECLS VENOUS INIT,2273.0,747.89,294.17,13802.9,120
CPT,33947,ECMO/ECLS ART INIT,3157.0,1038.75,325.57,13802.9,160
CPT,33948,ECMO/ECLS VENOUS MGMT SUBSQ DAY,2601.0,855.81,226.93,6904.78,120
CPT,33949,ECMO/ECLS ART MGMT SUBSQ DAY,2525.0,830.8,221.59,6904.78,120
CPT,33952,ECMO/ECLS INS CAN PERPH PERC 6+YRS,3254.0,1070.66,405.06,13802.9,80
CPT,33966,ECMO/ECLS REM CAN PERPH PERC 6+YRS,1836.0,604.1,224.8,6904.78,80
CPT,33967,INS DEV IAB PERC,8348.0,2988.58,245.24,13802.9,41
CPT,33968,REM DEV IAB PERC,4277.0,1531.17,32.1,13802.9,41
CPT,33975,INS VAD EXTRACORP VENTRICLE SGL,4323.0,1547.63,804.08,13802.9,40
CPT,33977,REM VAD EXTRACORP VENTRICLE SGL,3598.0,1288.08,669.23,13802.9,40
CPT,33988,INS VENT HEART LEFT THORACIC,7374.0,2639.89,731.35,13802.9,40
CPT,33989,REM VENT HEART LEFT THORACIC,5531.0,1980.1,464.78,6904.78,40
CPT,33990,INS VAD LH ACC ART ONLY PERC S&I,3947.0,1413.03,341.82,13802.9,80
CPT,33991,INS VAD LH ACC ART&VEN W PUNCT S&I,5762.0,2062.8,428.85,13802.9,40
CPT,33992,REM VAD LH PERC ART/ART&VEN SEP,1896.0,678.77,178.2,13802.9,40
CPT,33993,REPOS VAD PERC W IMG SESSN DIFF,1658.0,593.56,157.65,13802.9,40
CPT,33995,INS VAD RH ACC ART ONLY PERC S&I,3947.0,1413.03,336.58,13802.9,40
CPT,33997,REM VAD RH PERC ART/ART&VEN SEP,1896.0,678.77,152.87,13802.9,40
CPT,33999,REM CTH SWN GNZ KNOTTED&SHEATH INTR,1714.0,613.61,392.67,10257.38,62
CPT,34101,EMB/THRMB ART AX/BR/IN/SUBC ARM BI,4964.0,1777.11,566.15,10065.0,40
CPT,34101,EMB/THRMB ART AX/BR/IN/SUBC ARM LT,3309.0,1184.62,566.15,10065.0,40
CPT,34101,EMB/THRMB ART AX/BR/IN/SUBC ARM RT,3309.0,1184.62,566.15,10065.0,40
CPT,34111,EMB/THRMB ART RADIAL/ULNAR ARM BI,14658.0,5247.56,565.5,10993.5,40
CPT,34111,EMB/THRMB ART RADIAL/ULNAR ARM LT,9772.0,3498.38,565.5,10257.38,40
CPT,34111,EMB/THRMB ART RADIAL/ULNAR ARM RT,9772.0,3498.38,565.5,10257.38,40
CPT,34201,EMB/THRMB ART FEMPP/AORILIAC LEG BI,14658.0,5247.56,968.14,10993.5,40
CPT,34201,EMB/THRMB ART FEMPP/AORILIAC LEG LT,9772.0,3498.38,968.14,10257.38,40
CPT,34201,EMB/THRMB ART FEMPP/AORILIAC LEG RT,9772.0,3498.38,968.14,10257.38,40
CPT,34703,RPR EV DPLMNT A UNILAC NDGFT NO RUP,15311.0,5481.34,1297.95,13802.9,40
CPT,34705,RPR EV DPLMNT A BIILAC NDGFT NO RUP,17005.0,6087.79,1443.24,13802.9,40
CPT,34707,RPR EV DPLMNT ILIO ILAC NDGFT BI,19497.0,6979.93,1097.64,14622.75,40
CPT,34707,RPR EV DPLMNT ILIO ILAC NDGFT LT,12998.0,4653.28,1097.64,13802.9,40
CPT,34707,RPR EV DPLMNT ILIO ILAC NDGFT RT,12998.0,4653.28,1097.64,13802.9,40
CPT,34709,PLC PROS DST EXT RPR EV/TX VES,6905.0,2471.99,303.84,6904.78,40
CPT,34710,PLC PROS DLYD EXT RPR EV VES INIT,12488.0,4470.7,754.07,13802.9,40
CPT,34711,PLC PROS DLYD EXT RPR EV VES ADD,6905.0,2471.99,277.54,6904.78,40
CPT,34712,DEL DEV FIX NDGFT TRANSCATH S&I,4597.0,1645.73,621.61,7704.0,40
CPT,34713,ACCS&CLSR ART FEM NDGFT PERC UNI,6499.0,2326.64,116.18,6499.0,38
CPT,34808,PLC EV DEV OCCL ART ILIAC,6905.0,2471.99,191.09,6904.78,40
CPT,34812,EXPOSE ART FEM GROIN W PROSTH EV BI,3924.0,1404.79,194.34,5444.0,40
CPT,34812,EXPOSE ART FEM GROIN W PROSTH EV LT,2616.0,936.53,194.34,5444.0,40
CPT,34812,EXPOSE ART FEM GROIN W PROSTH EV RT,2616.0,936.53,194.34,5444.0,40
CPT,35206,"REPAIR BLOOD VESSEL, DIRECT; UPPER EXTREMITY",,,757.35,10257.38,50
CPT,35207,"REPAIR BLOOD VESSEL, DIRECT; HAND, FINGER",,,739.08,8715.0,52
CPT,35221,RPR VESSEL BLOOD INTRA-ABD DIR BI,5852.0,2095.02,982.0,13802.9,40
CPT,35221,RPR VESSEL BLOOD INTRA-ABD DIR LT,3901.0,1396.56,725.59,13802.9,40
CPT,35221,RPR VESSEL BLOOD INTRA-ABD DIR RT,3901.0,1396.56,725.59,13802.9,40
CPT,35301,"THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; CAROTID, VERTEBRAL, SUBCLAVIAN, BY NECK INCISION",,,982.0,10257.38,14
CPT,35702,"EXPLORATION NOT FOLLOWED BY SURGICAL REPAIR, ARTERY; UPPER EXTREMITY (EG, AXILLARY, BRACHIAL, RADIAL, ULNAR)",,,391.91,10257.38,14
CPT,35875,THROMBECT GRAFT ARTERIAL/VENOUS,9241.0,3308.28,562.0,18194.0,126
CPT,36000,INTRO NDL/INTRACATHETER VEIN,88.0,31.5,8.83,2481.0,80
CPT,36002,INJ PSEUDOANEURYSM EXT BI,1529.0,547.38,99.7,5681.0,80
CPT,36002,INJ PSEUDOANEURYSM EXT LT,1019.0,364.8,99.7,5681.0,120
CPT,36002,INJ PSEUDOANEURYSM EXT RT,1019.0,364.8,99.7,5681.0,120
CPT,36005,INJ VENOGRAPHY EXTREMITY BI,750.0,268.5,45.26,5681.0,160
CPT,36005,INJ VENOGRAPHY EXTREMITY LT,500.0,179.0,45.26,5681.0,160
CPT,36005,INJ VENOGRAPHY EXTREMITY RT,500.0,179.0,45.26,5681.0,160
CPT,36010,INTRO CATH SVC/IVC,1244.0,445.35,103.09,5681.0,80
CPT,36011,PLC CATH SEL VENOUS BRANCH 1ST ORD,1465.0,524.47,148.19,5681.0,120
CPT,36012,PLC CATH SEL VENOUS BRANCH 2+ ORD,1648.0,589.98,165.17,5681.0,80
CPT,36013,INTRO CATH RT HEART/ART PULM MAIN,853.0,305.37,119.8,5681.0,80
CPT,36014,PLC CATH SEL ART PULM BI,1088.0,389.5,143.71,5681.0,80
CPT,36014,PLC CATH SEL ART PULM LT,725.0,259.55,134.85,5681.0,80
CPT,36014,PLC CATH SEL ART PULM RT,725.0,259.55,134.85,5681.0,80
CPT,36015,PLC CATH SEL ART PULM 2ND ORD BI,1973.0,706.33,163.1,5681.0,80
CPT,36015,PLC CATH SEL ART PULM 2ND ORD LT,1315.0,470.77,163.1,5681.0,80
CPT,36015,PLC CATH SEL ART PULM 2ND ORD RT,1315.0,470.77,163.1,5681.0,80
CPT,36100,INTRO NDL/CATH ARTERY CAR/VERT LT,845.0,302.51,144.0,5681.0,40
CPT,36100,INTRO NDL/CATH ARTERY CAR/VERT RT,845.0,302.51,144.0,5681.0,40
CPT,36140,INTRO NDL/CATH ARTERY EXTREMITY LT,867.0,310.39,84.4,5681.0,80
CPT,36140,INTRO NDL/CATH ARTERY EXTREMITY RT,867.0,310.39,84.4,5681.0,80
CPT,36160,INTRO NDL AORTA TRANSLUMBAR,809.0,289.62,117.2,6689.0,40
CPT,36200,INTRO CATH AORTA,1392.0,498.34,131.94,6689.0,80
CPT,36215,PLC CATH SEL ART THOR/BRACH 1ST ORD,2107.0,754.31,202.6,6689.0,80
CPT,36216,PLC CATH SEL ART THOR/BRACH 2ND ORD,2729.0,976.98,258.66,6689.0,80
CPT,36217,PLC CATH SEL ART THOR/BRACH 3RD ORD,3380.0,1210.04,316.77,6689.0,80
CPT,36218,PLC CATH SEL ART THOR/BRACH ADDL,796.0,284.97,49.98,6689.0,80
CPT,36221,PLC CATH AORTA THOR ANG EC&/IC S&I,4220.0,1510.76,189.58,7697.0,189
CPT,36222,PLC CATH SEL CAR/INM ANG EC BI S&I,7764.0,2779.51,272.43,7697.0,80
CPT,36222,PLC CATH SEL CAR/INM ANG EC LT S&I,5176.0,1853.01,272.43,7697.0,80
CPT,36222,PLC CATH SEL CAR/INM ANG EC RT S&I,5176.0,1853.01,272.43,7697.0,80
CPT,36223,PLC CATH SEL CAR/INM ANG IC BI S&I,11120.0,3980.96,313.97,10065.0,80
CPT,36223,PLC CATH SEL CAR/INM ANG IC LT S&I,7413.0,2653.85,313.97,10065.0,80
CPT,36223,PLC CATH SEL CAR/INM ANG IC RT S&I,7413.0,2653.85,313.97,10065.0,80
CPT,36224,PLC CATH SEL ART CAR ANG IC BI S&I,11120.0,3980.96,352.24,10065.0,80
CPT,36224,PLC CATH SEL ART CAR ANG IC LT S&I,7413.0,2653.85,352.24,10065.0,80
CPT,36224,PLC CATH SEL ART CAR ANG IC RT S&I,7413.0,2653.85,352.24,10065.0,80
CPT,36225,PLC CATH SEL ART SUB/INM ANG BI S&I,7808.0,2795.26,311.41,7697.0,80
CPT,36225,PLC CATH SEL ART SUB/INM ANG LT S&I,5205.0,1863.39,311.41,7697.0,80
CPT,36225,PLC CATH SEL ART SUB/INM ANG RT S&I,5205.0,1863.39,311.41,7697.0,80
CPT,36226,PLC CATH SEL ART VERT ANG BI S&I,11120.0,3980.96,350.09,10065.0,80
CPT,36226,PLC CATH SEL ART VERT ANG LT S&I,7413.0,2653.85,350.09,10065.0,80
CPT,36226,PLC CATH SEL ART VERT ANG RT S&I,7413.0,2653.85,350.09,10065.0,80
CPT,36227,PLC CATH SEL ART CAR EXT ANG BI S&I,3245.0,1161.71,115.39,5681.0,80
CPT,36227,PLC CATH SEL ART CAR EXT ANG LT S&I,2163.0,774.35,115.39,5681.0,80
CPT,36227,PLC CATH SEL ART CAR EXT ANG RT S&I,2163.0,774.35,115.39,5681.0,80
CPT,36228,PLC CATH SEL BR INTRACRN ANG BI S&I,6026.0,2157.31,237.58,5681.0,80
CPT,36228,PLC CATH SEL BR INTRACRN ANG LT S&I,4017.0,1438.09,237.58,5681.0,80
CPT,36228,PLC CATH SEL BR INTRACRN ANG RT S&I,4017.0,1438.09,237.58,5681.0,80
CPT,36245,PLC CATH SEL ART ABD/EXT 1ST ORD,2083.0,745.71,223.82,6689.0,80
CPT,36246,PLC CATH SEL ART ABD/EXT 2ND ORD,2024.0,724.59,239.51,6689.0,80
CPT,36247,PLC CATH SEL ART ABD/EXT 3RD ORD,2547.0,911.83,282.91,6689.0,80
CPT,36248,PLC CATH SEL ART ABD/EXT ADDL,1311.0,469.34,45.79,6689.0,80
CPT,36251,PLC CATH SEL 1ST ART RENAL UNI S&I,4220.0,1510.76,242.66,7697.0,126
CPT,36252,PLC CATH SEL 1ST ART RENAL BI S&I,5138.0,1839.4,338.12,7697.0,126
CPT,36253,PLC CATH SEL 2ND+ ART RENAL UNI S&I,7413.0,2653.85,336.5,10065.0,126
CPT,36254,PLC CATH SEL 2ND+ ART RENAL BI S&I,8810.0,3153.98,394.3,7697.0,126
CPT,36299,ACCESS DIRECT JUGULAR VEIN,1467.0,525.19,272.86,4664.0,39
CPT,36299,INJ VENOGRAM NON EXTREMITY,446.0,159.67,82.96,4664.0,39
CPT,36400,VENIPUNCTURE FEM/JUG HCP 0-2YRS,59.0,21.12,10.97,165.5,37
CPT,36406,VENIPUNCTURE VEIN OTH HCP 0-2YRS,58.0,20.76,8.55,84.48,37
CPT,36416,COLLECT SPEC BLD CAPILLARY,38.0,6.54,0.5427,28.5,78
CPT,36430,ED TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,63
CPT,36430,ED TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,63
CPT,36430,ED TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,63
CPT,36430,TRANSFUSION BLOOD/COMP 1 UNIT,1435.0,444.85,41.1,1474.02,504
CPT,36430,TRANSFUSION BLOOD/COMP 2 UNITS,1794.0,556.14,41.1,1474.02,504
CPT,36430,TRANSFUSION BLOOD/COMP 3+ UNITS,2153.0,667.43,41.1,1614.75,504
CPT,36470,INJ SCLEROSANT VEIN INCMPT SGL BI,345.0,123.51,36.37,5681.0,40
CPT,36470,INJ SCLEROSANT VEIN INCMPT SGL LT,230.0,82.34,36.37,5681.0,40
CPT,36470,INJ SCLEROSANT VEIN INCMPT SGL RT,230.0,82.34,36.37,5681.0,40
CPT,36471,INJ SCLEROSANT VEIN INCMPT MULTI BI,689.0,246.66,72.42,5681.0,40
CPT,36471,INJ SCLEROSANT VEIN INCMPT MULTI LT,459.0,164.32,72.42,5681.0,40
CPT,36471,INJ SCLEROSANT VEIN INCMPT MULTI RT,459.0,164.32,72.42,5681.0,40
CPT,36475,ABL EV RF VEIN EXT 1ST LT S&I,6851.0,2452.66,264.29,18194.0,40
CPT,36475,ABL EV RF VEIN EXT 1ST RT S&I,6851.0,2452.66,264.29,18194.0,40
CPT,36476,ABL EV RF VEIN EXT SUBSQ LT S&I,3310.0,1184.98,126.53,5681.0,40
CPT,36476,ABL EV RF VEIN EXT SUBSQ RT S&I,3310.0,1184.98,126.53,5681.0,40
CPT,36478,ABL EV LASER VEIN EXT 1ST LT S&I,6818.0,2440.84,264.53,18194.0,40
CPT,36478,ABL EV LASER VEIN EXT 1ST RT S&I,6818.0,2440.84,264.53,18194.0,40
CPT,36479,ABL EV LASER VEIN EXT SUBSQ LT S&I,3330.0,1192.14,129.16,5681.0,40
CPT,36479,ABL EV LASER VEIN EXT SUBSQ RT S&I,3330.0,1192.14,129.16,5681.0,40
CPT,36481,CATH VEIN PORTAL PERC ANY METHOD,1108.0,396.66,206.09,5681.0,40
CPT,36482,ABL EV ADH CHEM EXT VEIN 1ST BI,12515.0,4480.37,170.73,10065.0,40
CPT,36482,ABL EV ADH CHEM EXT VEIN 1ST LT,8343.0,2986.79,170.73,10065.0,40
CPT,36482,ABL EV ADH CHEM EXT VEIN 1ST RT,8343.0,2986.79,170.73,10065.0,40
CPT,36500,CATH VENOUS SAMPLE BLOOD ORGAN,1438.0,514.8,173.21,5681.0,120
CPT,36500,Venous catheterization for selective organ blood sampling,,,173.21,5681.0,14
CPT,36511,APHERESIS WBC,5336.0,1584.79,107.59,4002.0,63
CPT,36512,APHERESIS RBC,5174.0,1536.68,102.44,3880.5,63
CPT,36513,APHERESIS PLATELETS,5917.0,1757.35,102.48,4437.75,63
CPT,36514,APHERESIS PHERESIS PLASMA,5244.0,1557.47,90.15,3933.0,63
CPT,36516,APHERESIS IMMUNOADSRP EXTRACORP SEL,4844.0,1438.67,82.49,7668.67,63
CPT,36522,PHOTOPHERESIS EXTRACORPOREAL,6972.0,2495.98,92.5,8755.0,63
CPT,36555,INS CVC CENTRAL NONTUN 0-4YRS,4220.0,1510.76,81.45,5681.0,63
CPT,36556,INS CVC CENTRAL NONTUN 5+YRS,5317.0,1903.49,81.34,5681.0,189
CPT,36557,INS CVC CENTRAL TUN WO P/P 0-4YRS,7413.0,2653.85,310.61,10065.0,63
CPT,36558,INS CVC CENTRAL TUN WO P/P 5+YRS,6385.0,2285.83,248.88,7697.0,63
CPT,36560,INS CVD CENTRAL TUN W PORT 0-4YRS,5425.0,1942.15,371.05,7704.0,63
CPT,36561,INS CVD CENTRAL TUN W PORT 5+YRS,5262.0,5014.03,319.34,7704.0,63
CPT,36563,INS CAD CENTRAL TUN W PORT,8217.0,2941.69,347.95,10065.0,63
CPT,36565,INS CAD CENTRAL TUN 2 CATH WO P/P,5262.0,1883.8,323.69,7704.0,63
CPT,36566,INS CAD CENTRAL TUN 2 CATH W PORT,8343.0,2986.79,343.13,14124.0,63
CPT,36568,INS PICC WO P/P WO IMG 0-4YRS,2862.0,1024.6,88.38,5681.0,126
CPT,36569,INS PICC WO P/P WO IMG 5+YRS,3698.0,1323.88,90.96,5681.0,126
CPT,36569,"INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), WITHOUT SUBCUTANEOUS PORT OR PUMP, WITHOUT IMAGING GUIDANCE; AGE 5 YEARS OR OLDER",,,90.96,5681.0,52
CPT,36570,INS PICD WO P/P 0-4YRS,6541.0,2341.68,322.23,7704.0,63
CPT,36571,INS PICD WO P/P 5+YRS,5867.0,2100.39,301.48,7704.0,63
CPT,36572,INS PICC WO P/P W IMG 0-4YRS,3433.0,1229.01,77.83,5988.0,126
CPT,36573,INS PICC WO P/P W IMG 5+YRS,3433.0,1229.01,79.92,12090.0,126
CPT,36575,RPR CVC WO P/P,2333.0,835.21,32.08,6689.0,126
CPT,36576,RPR CVD W P/P,4597.0,1645.73,176.42,6689.0,63
CPT,36578,RPLC CATH CVD W P/P,4597.0,1645.73,196.11,7697.0,63
CPT,36580,RPLC CICVC NONTUN WO P/P,3433.0,1229.01,62.4,5681.0,126
CPT,36581,RPLC CICVC TUN WO P/P,4597.0,1645.73,175.61,7697.0,63
CPT,36582,RPLC CICVC TUN W PORT,5262.0,1883.8,275.91,7704.0,63
CPT,36583,RPLC CICVC TUN W PUMP,7413.0,2653.85,318.36,10065.0,63
CPT,36584,RPLC PICC WO P/P SA S&I,4273.0,1529.73,56.01,5681.0,126
CPT,36585,RPLC PICVD W PORT,5262.0,1883.8,268.8,7704.0,63
CPT,36589,REM CVC TUN WO P/P,2314.0,828.41,131.32,5681.0,63
CPT,36590,REM CVD TUN W P/P,3193.0,2905.77,182.8,5681.0,63
CPT,36590,"REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION",,,182.8,5681.0,52
CPT,36591,COLLECT SPEC BLD VAD IMPLNT,413.0,213.93,26.9,309.75,189
CPT,36592,COLLECT SPEC BLD PICC NOS,468.0,242.42,29.17,351.0,189
CPT,36593,DECLOT CATH/VAD W AGENT THROMB,711.0,311.42,33.67,5681.0,315
CPT,36595,REM OBSTRUCT MECH CVD PERICATHETER,4597.0,1645.73,172.98,8715.0,63
CPT,36596,REM OBSTRUCT MECH CVD INTRALUMINAL,3165.0,1133.07,43.35,5681.0,63
CPT,36597,REPOSITION CVC PREVIOUS W FLUORO,2668.0,955.14,57.52,5681.0,126
CPT,36598,INJ/S CNT EVAL CVD FLUORO S&I,937.0,335.45,34.09,6689.0,63
CPT,36600,PUNCT ARTERIAL FOR DIAGNOSIS,213.0,36.64,14.47,234.25,61
CPT,36620,CATH/CANN ART SMP/MNTR/TRNS PERC,929.0,332.58,42.66,5681.0,120
CPT,36620,ED CATH/CANN ART SMP/MNTR/TRNS PERC,929.0,229.46,42.66,3432.43,41
CPT,36680,ED PLC NEEDLE INF INTRAOSSEOUS,713.0,176.11,57.56,2503.0,64
CPT,36818,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION",,,655.57,10065.0,52
CPT,36819,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION",,,693.89,10065.0,52
CPT,36821,"Arteriovenous anastomosis, open; direct, any site (e.g., Cimino type) (separate procedure)",,,627.41,7704.0,52
CPT,36830,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (e.g., biological collagen, thermoplastic graft)",,,633.52,10065.0,52
CPT,36832,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)",,,719.26,10065.0,52
CPT,36833,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)",,,767.08,10065.0,52
CPT,36860,DECLOT CANNULA EXTERNAL WO BLN,4597.0,1645.73,105.42,6689.0,63
CPT,36861,DECLOT CANNULA EXTERNAL W BLN,5580.0,1997.64,132.26,10065.0,63
CPT,36901,INTRO NDL&/CTH DIAL W DX ANG S&I,5262.0,1883.8,159.77,5681.0,63
CPT,36902,INTRO NDL&/CTH DIAL W TBA S&I,8378.0,2999.32,227.98,11751.0,63
CPT,36903,INTRO NDL&/CTH DIAL W PLC STNT/S IV,16356.0,5855.45,299.43,20325.69,63
CPT,36904,THROMBECT&/INF PERC IMG ANG S&I,13803.0,4941.47,349.65,10352.25,63
CPT,36905,THROMBECT&/INF PERC MECH W TBA S&I,16356.0,5855.45,420.2,20325.69,63
CPT,36906,THROMBECT&/INF PERC W PLC STNT/S IV,26334.0,9427.57,484.88,32276.26,63
CPT,36907,TBA DIAL CENTRAL SEG W IMG SI,6076.0,2175.21,138.62,10528.0,40
CPT,36908,PLC TRANSCTH STNT/S IVASC CDS S&I,9412.0,3369.5,196.38,7059.0,40
CPT,36909,EMB/OCCL PERM CIRCUIT DIALYSIS S&I,6612.0,2367.1,190.59,5681.0,40
CPT,37182,INS TIPS,11303.0,4046.47,773.95,32276.26,63
CPT,37182,"INSERTION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS) (INCLUDES VENOUS ACCESS, HEPATIC AND PORTAL VEIN CATHETERIZATION, PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, INTRAHEPATIC TRACT FORMAT",,,773.95,32276.26,50
CPT,37183,REV TIPS,13803.0,4941.47,355.36,13802.9,63
CPT,37184,THROMBECT MECH PRIM ART INIT BI,20705.0,7412.39,407.99,18194.0,80
CPT,37184,THROMBECT MECH PRIM ART INIT LT,13803.0,4941.47,407.99,18194.0,80
CPT,37184,THROMBECT MECH PRIM ART INIT NP/UNI,13803.0,4941.47,407.99,32276.26,63
CPT,37184,THROMBECT MECH PRIM ART INIT RT,13803.0,4941.47,407.99,18194.0,80
CPT,37185,THROMBECT MECH PRIM ART SUBSQ W FL,6905.0,2471.99,154.03,6904.78,80
CPT,37186,THROMBECT MECH SEC ART W FL,6905.0,2471.99,230.46,6904.78,80
CPT,37187,THROMBECT MECH VEIN W FL,13803.0,4941.47,372.97,20325.69,63
CPT,37188,THROMBECT MECH VEIN SUBSQ W FL,11588.0,4148.5,266.45,18194.0,63
CPT,37191,INS FILTER VENA CAVA ENDV S&I,9306.0,3331.55,209.54,10257.38,126
CPT,37192,REPOS FILTER VENA CAVA ENDV S&I,10258.0,3672.36,325.04,10257.38,63
CPT,37193,REM FILTER VENA CAVA ENDV S&I,10258.0,3672.36,329.11,10257.38,189
CPT,37195,THROMBOLYSIS CEREBRAL INF IV,1692.0,605.74,225.29,13802.9,126
CPT,37197,REM FB INTRAVASC W IMG S&I,4597.0,1645.73,285.27,18194.0,189
CPT,37200,BX TRANSCATHETER,3930.0,1406.94,204.09,15325.0,189
CPT,37211,THROMBOLYSIS INF ART INIT DAY S&I,7413.0,2653.85,366.62,15325.0,126
CPT,37212,THROMBOLYSIS INF VEN INIT S&I,4597.0,1645.73,319.95,15325.0,189
CPT,37213,THROMBOLYSIS INF ART/VEN SUBSQ S&I,3635.0,1301.33,218.79,18194.0,189
CPT,37214,CESSAT THROMBOLYSIS&REM CATH S&I,3138.0,1123.4,115.48,18194.0,189
CPT,37215,PLC STNT/S ART CRV CAR W EMB S&I,9840.0,3522.72,938.83,7704.0,80
CPT,37216,PLC STNT/S ART CRV CAR WO EMB S&I,9326.0,3338.71,954.64,7704.0,80
CPT,37218,PLC STNT/S ART INM/INTRATH CAR S&I,5978.0,2140.12,786.64,7704.0,80
CPT,37220,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL ANGIOPLASTY",,,377.35,8715.0,5
CPT,37221,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL, WHEN PERFORMED",,,464.62,8715.0,5
CPT,37224,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty",,,419.24,8715.0,5
CPT,37236,PLC STNT/S ART OPEN/PERC INIT S&I,14254.0,5102.93,416.31,20325.69,189
CPT,37236,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,416.31,20325.69,50
CPT,37237,PLC STNT/S ART OPEN/PERC ADDL S&I,5733.0,2052.41,199.27,15325.0,120
CPT,37238,PLC STNT/S VEIN OPEN/PERC INIT S&I,11612.0,4157.1,290.34,20325.69,63
CPT,37239,PLC STNT/S VEIN OPEN/PERC ADDL S&I,4777.0,1710.17,142.25,15325.0,40
CPT,37241,EMB/OCCL VASC VENOUS S&I,11612.0,4157.1,405.51,20325.69,63
CPT,37242,EMB/OCCL VASC ARTERIAL S&I,13748.0,4921.78,451.13,32276.26,189
CPT,37243,EMB/OCCL VASC TMRS/ORG S&I,15098.0,5405.08,532.54,20325.69,63
CPT,37244,EMB/OCCL VASC HEMORRHAGE S&I,11612.0,4157.1,627.57,20325.69,126
CPT,37246,TBA OPN/PRC ART INT BI S&I,15387.0,5508.55,329.65,11751.0,80
CPT,37246,TBA OPN/PRC ART INT NONPAIR/UNI S&I,10258.0,3672.36,329.65,11751.0,126
CPT,37247,TBA OPN/PRC ART ADL BI S&I,8099.0,2899.44,164.07,10528.0,80
CPT,37247,TBA OPN/PRC ART ADL NONPAIR/UNI S&I,5399.0,1932.84,164.07,10528.0,80
CPT,37248,TBA OPN/PRC VEIN INT BI S&I,15387.0,5508.55,282.07,11751.0,80
CPT,37248,TBA OPN/PRC VEIN INT NONPAIR/UNIS&I,10258.0,3672.36,282.07,11751.0,126
CPT,37249,TBA OPN/PRC VEIN ADL BI S&I,7893.0,2825.69,137.95,10528.0,80
CPT,37249,TBA OPN/PRC VEIN ADL NONPAIR/UNIS&I,5262.0,1883.8,137.95,10528.0,80
CPT,37252,US INTRAVASCULAR NONCORNRY INIT S&I,3525.0,1261.95,84.15,5681.0,80
CPT,37253,US INTRAVASCULAR NONCORNRY ADDL S&I,2821.0,1009.92,66.97,5681.0,80
CPT,37254,REVSC IVT ANGIO SF VSL INIT BI,18749.0,6712.14,3487.31,14061.75,78
CPT,37254,REVSC IVT ANGIO SF VSL INIT LT,12499.0,4474.64,2324.81,13802.9,78
CPT,37254,REVSC IVT ANGIO SF VSL INIT RT,12499.0,4474.64,2324.81,13802.9,78
CPT,37255,REVSC IVT ANGIO SF VSL ADD BI,7556.0,2705.05,1088.82,6904.78,74
CPT,37255,REVSC IVT ANGIO SF VSL ADD LT,5037.0,1803.25,725.83,6904.78,74
CPT,37255,REVSC IVT ANGIO SF VSL ADD RT,5037.0,1803.25,725.83,6904.78,74
CPT,37256,REVSC IVT ANGIO CMPLX VSL INIT BI,27480.0,9837.84,4215.76,20610.0,78
CPT,37256,REVSC IVT ANGIO CMPLX VSL INIT LT,18320.0,6558.56,3407.52,13802.9,78
CPT,37256,REVSC IVT ANGIO CMPLX VSL INIT RT,18320.0,6558.56,3407.52,13802.9,78
CPT,37257,REVSC IVT ANGIO CMPLX VSL ADD BI,9765.0,3495.87,1407.14,7323.75,74
CPT,37257,REVSC IVT ANGIO CMPLX VSL ADD LT,6510.0,2330.58,938.09,6904.78,74
CPT,37257,REVSC IVT ANGIO CMPLX VSL ADD RT,6510.0,2330.58,938.09,6904.78,74
CPT,37258,REVSC IVT STNT SF VSL INIT BI,19512.0,6985.3,3629.23,14634.0,78
CPT,37258,REVSC IVT STNT SF VSL INIT LT,13008.0,4656.86,2419.49,13802.9,78
CPT,37258,REVSC IVT STNT SF VSL INIT RT,13008.0,4656.86,2419.49,13802.9,78
CPT,37259,REVSC IVT STNT SF VSL ADD BI,10124.0,3624.39,1458.87,7593.0,74
CPT,37259,REVSC IVT STNT SF VSL ADD LT,6749.0,2416.14,972.53,6904.78,74
CPT,37259,REVSC IVT STNT SF VSL ADD RT,6749.0,2416.14,972.53,6904.78,74
CPT,37260,REVSC IVT STNT CMPLX VSL INIT BI,28203.0,10096.67,5245.76,21152.25,78
CPT,37260,REVSC IVT STNT CMPLX VSL INIT LT,18802.0,6731.12,3497.17,14101.5,78
CPT,37260,REVSC IVT STNT CMPLX VSL INIT RT,18802.0,6731.12,3497.17,14101.5,78
CPT,37261,REVSC IVT STNT CMPLX VSL ADD BI,10757.0,3851.01,1550.08,8067.75,74
CPT,37261,REVSC IVT STNT CMPLX VSL ADD LT,7171.0,2567.22,1033.34,6904.78,74
CPT,37261,REVSC IVT STNT CMPLX VSL ADD RT,7171.0,2567.22,1033.34,6904.78,74
CPT,37263,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",,,4215.76,13802.9,45
CPT,37263,REVSC F&P VT ANG SF VSL INIT BI,14973.0,5360.33,2784.98,13802.9,78
CPT,37263,REVSC F&P VT ANG SF VSL INIT LT,9982.0,3573.56,1856.65,13802.9,78
CPT,37263,REVSC F&P VT ANG SF VSL INIT RT,9982.0,3573.56,1856.65,13802.9,78
CPT,37264,REVSC F&P VT ANG SF VSL ADD BI,5732.0,2052.06,825.98,6904.78,74
CPT,37264,REVSC F&P VT ANG SF VSL ADD LT,3821.0,1367.92,550.61,6904.78,74
CPT,37264,REVSC F&P VT ANG SF VSL ADD RT,3821.0,1367.92,550.61,6904.78,74
CPT,37265,REVSC F&P VT ANG CMPLX VSL INIT BI,20241.0,7246.28,3764.83,15180.75,78
CPT,37265,REVSC F&P VT ANG CMPLX VSL INIT LT,13494.0,4830.85,2509.88,13802.9,78
CPT,37265,REVSC F&P VT ANG CMPLX VSL INIT RT,13494.0,4830.85,2509.88,13802.9,78
CPT,37266,REVSC F&P VT ANG CMPLX VSL ADD BI,7628.0,2730.82,1099.19,6904.78,74
CPT,37266,REVSC F&P VT ANG CMPLX VSL ADD LT,5085.0,1820.43,732.75,6904.78,74
CPT,37266,REVSC F&P VT ANG CMPLX VSL ADD RT,5085.0,1820.43,732.75,6904.78,74
CPT,37267,REVSC F&P VT STNT SF VSL INIT BI,21123.0,7562.03,3928.88,15842.25,78
CPT,37267,REVSC F&P VT STNT SF VSL INIT LT,14082.0,5041.36,2619.25,13802.9,78
CPT,37267,REVSC F&P VT STNT SF VSL INIT RT,14082.0,5041.36,2619.25,13802.9,78
CPT,37268,REVSC F&P VT STNT SF VSL ADD BI,8928.0,3196.22,1286.52,6904.78,74
CPT,37268,REVSC F&P VT STNT SF VSL ADD LT,5952.0,2130.82,857.68,6904.78,74
CPT,37268,REVSC F&P VT STNT SF VSL ADD RT,5952.0,2130.82,857.68,6904.78,74
CPT,37269,REVSC F&P VT STNT CMPLX VSL INIT BI,35481.0,12702.2,6599.47,26610.75,78
CPT,37269,REVSC F&P VT STNT CMPLX VSL INIT LT,23654.0,8468.13,4399.64,17740.5,78
CPT,37269,REVSC F&P VT STNT CMPLX VSL INIT RT,23654.0,8468.13,4399.64,17740.5,78
CPT,37270,REVSC F&P VT STNT CMPLX VSL ADD BI,11985.0,4290.63,1727.04,8988.75,74
CPT,37270,REVSC F&P VT STNT CMPLX VSL ADD LT,7990.0,2860.42,1151.36,6904.78,74
CPT,37270,REVSC F&P VT STNT CMPLX VSL ADD RT,7990.0,2860.42,1151.36,6904.78,74
CPT,37271,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",,,7551.94,32276.26,45
CPT,37271,REVSC F&P VT ATHR SF VSL INIT BI,21905.0,7841.99,4074.33,16428.75,78
CPT,37271,REVSC F&P VT ATHR SF VSL INIT LT,14603.0,5227.87,2716.16,13578.3,78
CPT,37271,REVSC F&P VT ATHR SF VSL INIT RT,14603.0,5227.87,2716.16,13578.3,78
CPT,37272,REVSC F&P VT ATHR SF VSL ADD BI,9654.0,3456.13,1391.14,7240.5,74
CPT,37272,REVSC F&P VT ATHR SF VSL ADD LT,6436.0,2304.09,927.43,6904.78,74
CPT,37272,REVSC F&P VT ATHR SF VSL ADD RT,6436.0,2304.09,927.43,6904.78,74
CPT,37273,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",,,7551.94,32276.26,45
CPT,37273,REVSC F&P VT ATHR CMPLX VSL INIT BI,30651.0,10973.06,5701.09,22988.25,78
CPT,37273,REVSC F&P VT ATHR CMPLX VSL INIT LT,20434.0,7315.37,3800.72,15325.5,78
CPT,37273,REVSC F&P VT ATHR CMPLX VSL INIT RT,20434.0,7315.37,3800.72,15325.5,78
CPT,37274,REVSC F&P VT ATHR CMPLX VSL ADD BI,13281.0,4754.6,1913.79,9960.75,74
CPT,37274,REVSC F&P VT ATHR CMPLX VSL ADD LT,8854.0,3169.73,1275.86,6904.78,74
CPT,37274,REVSC F&P VT ATHR CMPLX VSL ADD RT,8854.0,3169.73,1275.86,6904.78,74
CPT,37275,REVSC F&P VT ST&AT SF VSL INIT BI,26315.0,9420.77,4894.59,19736.25,78
CPT,37275,REVSC F&P VT ST&AT SF VSL INIT LT,17543.0,6280.39,3263.0,13578.3,78
CPT,37275,REVSC F&P VT ST&AT SF VSL INIT RT,17543.0,6280.39,3263.0,13578.3,78
CPT,37276,REVSC F&P VT ST&AT SF VSL ADD BI,10098.0,3615.08,1455.12,7573.5,74
CPT,37276,REVSC F&P VT ST&AT SF VSL ADD LT,6732.0,2410.06,970.08,6904.78,74
CPT,37276,REVSC F&P VT ST&AT SF VSL ADD RT,6732.0,2410.06,970.08,6904.78,74
CPT,37277,REVSC F&P VT ST&AT CMPLX VSL INITBI,35781.0,12809.6,6655.27,26835.75,78
CPT,37277,REVSC F&P VT ST&AT CMPLX VSL INITLT,23854.0,8539.73,4436.84,17890.5,78
CPT,37277,REVSC F&P VT ST&AT CMPLX VSL INITRT,23854.0,8539.73,4436.84,17890.5,78
CPT,37278,REVSC F&P VT ST&AT CMPLX VSL ADD BI,14219.0,5090.4,2048.96,10664.25,74
CPT,37278,REVSC F&P VT ST&AT CMPLX VSL ADD LT,9479.0,3393.48,1365.92,7109.25,74
CPT,37278,REVSC F&P VT ST&AT CMPLX VSL ADD RT,9479.0,3393.48,1365.92,7109.25,74
CPT,37280,REVSC T&P VT ANG SF VSL INIT BI,17418.0,6235.64,3239.75,13063.5,78
CPT,37280,REVSC T&P VT ANG SF VSL INIT LT,11612.0,4157.1,2159.83,11278.0,78
CPT,37280,REVSC T&P VT ANG SF VSL INIT RT,11612.0,4157.1,2159.83,11278.0,78
CPT,37281,REVSC T&P VT ANG SF VSL ADD BI,6630.0,2373.54,955.38,5128.69,74
CPT,37281,REVSC T&P VT ANG SF VSL ADD LT,4420.0,1582.36,636.92,5128.69,74
CPT,37281,REVSC T&P VT ANG SF VSL ADD RT,4420.0,1582.36,636.92,5128.69,74
CPT,37282,REVSC T&P VT ANG CMPLX VSL INIT BI,21266.0,7613.23,3955.48,15949.5,78
CPT,37282,REVSC T&P VT ANG CMPLX VSL INIT LT,14177.0,5075.37,2636.92,11278.0,78
CPT,37282,REVSC T&P VT ANG CMPLX VSL INIT RT,14177.0,5075.37,2636.92,11278.0,78
CPT,37283,REVSC T&P VT ANG CMPLX VSL ADD BI,9426.0,3374.51,1358.29,7069.5,74
CPT,37283,REVSC T&P VT ANG CMPLX VSL ADD LT,6284.0,2249.67,905.52,5128.69,74
CPT,37283,REVSC T&P VT ANG CMPLX VSL ADD RT,6284.0,2249.67,905.52,5128.69,74
CPT,37284,REVSC T&P VT STNT SF VSL INIT BI,21743.0,7783.99,4044.2,16307.25,78
CPT,37284,REVSC T&P VT STNT SF VSL INIT LT,14495.0,5189.21,2696.07,13578.3,78
CPT,37284,REVSC T&P VT STNT SF VSL INIT RT,14495.0,5189.21,2696.07,13578.3,78
CPT,37285,REVSC T&P VT STNT SF VSL ADD BI,7592.0,2717.94,1094.01,5694.0,74
CPT,37285,REVSC T&P VT STNT SF VSL ADD LT,5061.0,1811.84,729.29,5128.69,74
CPT,37285,REVSC T&P VT STNT SF VSL ADD RT,5061.0,1811.84,729.29,5128.69,74
CPT,37286,REVSC T&P VT STNT CMPLX VSL INIT BI,29175.0,10444.65,5426.55,21881.25,78
CPT,37286,REVSC T&P VT STNT CMPLX VSL INIT LT,19450.0,6963.1,3617.7,14587.5,78
CPT,37286,REVSC T&P VT STNT CMPLX VSL INIT RT,19450.0,6963.1,3617.7,14587.5,78
CPT,37287,REVSC T&P VT STNT CMPLX VSL ADD BI,11421.0,4088.72,1645.77,8565.75,74
CPT,37287,REVSC T&P VT STNT CMPLX VSL ADD LT,7614.0,2725.81,1097.18,5710.5,74
CPT,37287,REVSC T&P VT STNT CMPLX VSL ADD RT,7614.0,2725.81,1097.18,5710.5,74
CPT,37288,REVSC T&P VT ATH SF VSL INIT BI,30285.0,10842.03,5633.01,22713.75,78
CPT,37288,REVSC T&P VT ATH SF VSL INIT LT,20190.0,7228.02,3755.34,15142.5,78
CPT,37288,REVSC T&P VT ATH SF VSL INIT RT,20190.0,7228.02,3755.34,15142.5,78
CPT,37289,REVSC T&P VT ATH SF VSL ADD BI,13244.0,4741.35,1908.46,9933.0,74
CPT,37289,REVSC T&P VT ATH SF VSL ADD LT,8829.0,3160.78,1272.26,6621.75,74
CPT,37289,REVSC T&P VT ATH SF VSL ADD RT,8829.0,3160.78,1272.26,6621.75,74
CPT,37290,REVSC T&P VT ATH CMPLX VSL INIT BI,38123.0,13648.03,7090.88,28592.25,78
CPT,37290,REVSC T&P VT ATH CMPLX VSL INIT LT,25415.0,9098.57,4727.19,19061.25,78
CPT,37290,REVSC T&P VT ATH CMPLX VSL INIT RT,25415.0,9098.57,4727.19,19061.25,78
CPT,37291,REVSC T&P VT ATH CMPLX VSL ADD BI,18044.0,6459.75,2233.0,13533.0,74
CPT,37291,REVSC T&P VT ATH CMPLX VSL ADD LT,12029.0,4306.38,1733.38,9021.75,74
CPT,37291,REVSC T&P VT ATH CMPLX VSL ADD RT,12029.0,4306.38,1733.38,9021.75,74
CPT,37292,REVSC T&P VT ST&AT SF VSL INIT BI,33980.0,12164.84,6320.28,25485.0,78
CPT,37292,REVSC T&P VT ST&AT SF VSL INIT LT,22653.0,8109.77,4213.46,16989.75,78
CPT,37292,REVSC T&P VT ST&AT SF VSL INIT RT,22653.0,8109.77,4213.46,16989.75,78
CPT,37293,REVSC T&P VT ST&AT SF VSL ADD BI,19583.0,7010.71,2233.0,14687.25,74
CPT,37293,REVSC T&P VT ST&AT SF VSL ADD LT,13055.0,4673.69,1881.23,9791.25,74
CPT,37293,REVSC T&P VT ST&AT SF VSL ADD RT,13055.0,4673.69,1881.23,9791.25,74
CPT,37294,REVSC T&P VT ST&AT CMPLX VSL INITBI,40731.0,14581.7,7551.94,30548.25,78
CPT,37294,REVSC T&P VT ST&AT CMPLX VSL INITLT,27154.0,9721.13,5050.64,20365.5,78
CPT,37294,REVSC T&P VT ST&AT CMPLX VSL INITRT,27154.0,9721.13,5050.64,20365.5,78
CPT,37295,REVSC T&P VT ST&AT CMPLX VSL ADD BI,24687.0,8837.95,2233.0,18515.25,74
CPT,37295,REVSC T&P VT ST&AT CMPLX VSL ADD LT,16458.0,5891.96,2233.0,12343.5,74
CPT,37295,REVSC T&P VT ST&AT CMPLX VSL ADD RT,16458.0,5891.96,2233.0,12343.5,74
CPT,37607,LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA,,,358.44,7704.0,52
CPT,37609,"LIGATION OR BIOPSY, TEMPORAL ARTERY",,,198.26,6689.0,52
CPT,37618,"LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE); EXTREMITY",,,379.92,13802.9,14
CPT,37722,"LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS FROM SAPHENOFEMORAL JUNCTION TO KNEE OR BELOW",,,440.98,7704.0,52
CPT,37765,PHLEBECTOMY VEIN EXT 10-20 BI,7893.0,2825.69,258.6,7704.0,40
CPT,37765,PHLEBECTOMY VEIN EXT 10-20 LT,5262.0,1883.8,258.6,7704.0,40
CPT,37765,PHLEBECTOMY VEIN EXT 10-20 RT,5262.0,1883.8,258.6,7704.0,40
CPT,37766,PHLEBECTOMY VEIN EXT 21+ BI,9698.0,3471.88,316.97,7704.0,40
CPT,37766,PHLEBECTOMY VEIN EXT 21+ LT,6465.0,2314.47,316.97,7704.0,40
CPT,37766,PHLEBECTOMY VEIN EXT 21+ RT,6465.0,2314.47,316.97,7704.0,40
CPT,37766,"STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; MORE THAN 20 INCISIONS",,,316.97,7704.0,52
CPT,37799,ANGIO ARTERY CAR EXT WO BASE PROC,3327.0,1191.07,392.67,6689.0,62
CPT,37799,BYPASS ART RETROG-ANT FEM-FEM PERC,3237.0,1158.85,392.67,6689.0,62
CPT,37799,DISRUPTION FIBRIN SHEATH BALLOON,4597.0,1645.73,392.67,6689.0,62
CPT,37799,EMB PSEUDOANEURYSM CAROTID FL GD,13034.0,4666.17,392.67,9775.5,62
CPT,37799,INJ THROM PSDANSM ART FEM W BLN OCC,10258.0,3672.36,392.67,7693.5,62
CPT,37799,PLC STNT&GRF ART CAR OTH THN STENOS,9840.0,3522.72,392.67,7380.0,62
CPT,37799,REPOSITION CVC PREVIOUS PORT ONLY,2365.0,846.67,392.67,6689.0,62
CPT,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY",,,392.67,6689.0,49
CPT,38200,INJ SPLENOPORTOGRAM,659.0,235.92,122.57,5681.0,40
CPT,38205,HARVEST CELL STEM COLL ALLOGENEIC,5760.0,1895.21,81.66,5760.0,38
CPT,38206,HARVEST CELL STEM COLL AUTOLOGOUS,4708.0,1549.07,80.04,3531.0,60
CPT,38221,BX/S MARROW BONE DX BI,2079.0,910.6,68.17,5681.0,120
CPT,38221,BX/S MARROW BONE DX NP/UNI,1386.0,607.07,68.17,5681.0,189
CPT,38222,ASP/S&BX/S MARROW BONE DX BI,2219.0,3566.39,72.77,5681.0,120
CPT,38222,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,3566.39,72.77,5681.0,189
CPT,38228,THERAPY CAR T-CELL ADMIN AUTOLOG,1187.0,390.56,193.45,890.25,59
CPT,38300,DRN ABSCESS LYMPH NODE SIMPLE,4543.0,1626.39,205.96,5681.0,63
CPT,38308,LYMPHANGIOTOMY OR OTHER OPERATIONS ON LYMPHATIC CHANNELS,,,460.01,6893.85,52
CPT,38380,SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL APPROACH,,,567.5,13802.9,14
CPT,38500,"Biopsy or excision of lymph node(s); open, superficial",,,249.43,6893.85,52
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL BI,3543.0,1268.39,82.79,5681.0,160
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL LT,2362.0,845.6,82.79,5681.0,160
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL RT,2362.0,845.6,82.79,5681.0,160
CPT,38510,"Biopsy or excision of lymph node(s); open, deep cervical node(s)",,,408.7,6893.85,52
CPT,38525,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",,,431.82,6893.85,52
CPT,38542,"Dissection, deep jugular node(s)",,,514.14,10644.28,52
CPT,38570,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple",,,505.09,18194.0,52
CPT,38571,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy",,,645.34,18715.8,52
CPT,38572,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple",,,876.77,18715.8,52
CPT,38589,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM",,,3668.82,10644.28,49
CPT,38720,Cervical lymphadenectomy (complete),,,1314.12,11691.26,50
CPT,38724,Cervical lymphadenectomy (modified radical neck dissection),,,1419.96,13802.9,15
CPT,38745,Axillary lymphadenectomy; complete,,,861.49,10644.28,52
CPT,38790,INJ LYMPHANGIOGRAPHY BI,1157.0,414.21,79.46,5681.0,40
CPT,38790,INJ LYMPHANGIOGRAPHY LT,771.0,276.02,79.46,5681.0,40
CPT,38790,INJ LYMPHANGIOGRAPHY RT,771.0,276.02,79.46,5681.0,40
CPT,38792,INJ RRX NODE SENTINEL ID BI,1646.0,589.27,31.05,5681.0,80
CPT,38792,INJ RRX NODE SENTINEL ID LT,1097.0,392.73,31.05,5681.0,80
CPT,38792,INJ RRX NODE SENTINEL ID RT,1097.0,392.73,31.05,5681.0,80
CPT,38792,Injection procedure; radioactive tracer for identification of sentinel node,,,31.05,5681.0,52
CPT,38794,CANNULATION DUCT THORACIC,1785.0,639.03,273.16,4664.0,40
CPT,38900,"Intraoperative identification (e.g., mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)",,,132.45,5681.0,14
CPT,38999,ABL LYMPH NODE ALCOHOL,6519.0,2333.8,287.87,5681.0,62
CPT,38999,DISRUPT CHYLI CISTERN/THOR DUCT NDL,13803.0,4941.47,287.87,10352.25,62
CPT,38999,"UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM",,,287.87,5681.0,49
CPT,39402,"MEDIASTINOSCOPY; WITH LYMPH NODE BIOPSY(IES) (EG, LUNG CANCER STAGING)",,,384.84,10644.28,50
CPT,40490,BIOPSY OF LIP,,,67.35,4664.0,52
CPT,40650,"REPAIR LIP, FULL THICKNESS; VERMILION ONLY",,,312.39,7704.0,52
CPT,40799,"UNLISTED PROCEDURE, LIPS",,,153.41,4929.13,49
CPT,40800,"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; SIMPLE",,,116.69,4664.0,104
CPT,40801,"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; COMPLICATED",,,195.18,6689.0,104
CPT,40808,"BIOPSY, VESTIBULE OF MOUTH",,,87.65,5681.0,104
CPT,40810,"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITHOUT REPAIR",,,120.53,5837.49,50
CPT,40812,"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH SIMPLE REPAIR",,,178.78,5681.0,50
CPT,40814,"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH COMPLEX REPAIR",,,277.84,6689.0,52
CPT,40820,"DESTRUCTION OF LESION OR SCAR OF VESTIBULE OF MOUTH BY PHYSICAL METHODS (EG, LASER, THERMAL, CRYO, CHEMICAL)",,,163.15,5837.49,52
CPT,40830,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS",,,142.5,4664.0,52
CPT,40831,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX",,,196.68,5681.0,104
CPT,40840,VESTIBULOPLASTY; ANTERIOR,,,621.22,10422.97,52
CPT,40842,"VESTIBULOPLASTY; POSTERIOR, UNILATERAL",,,663.55,10422.97,52
CPT,41000,"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; LINGUAL",,,102.43,5681.0,52
CPT,41005,"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBLINGUAL, SUPERFICIAL",,,114.12,5681.0,52
CPT,41008,"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBMANDIBULAR SPACE",,,253.37,5837.49,52
CPT,41017,"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBMANDIBULAR",,,335.96,5837.49,52
CPT,41018,"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; MASTICATOR SPACE",,,391.76,5681.0,52
CPT,41100,BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS,,,105.57,5681.0,52
CPT,41112,EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIOR TWO-THIRDS,,,238.8,6689.0,104
CPT,41115,Excision of lingual frenum (frenectomy),,,143.94,5681.0,52
CPT,41120,Glossectomy; less than one-half tongue,,,1031.54,10422.97,52
CPT,41250,REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO-THIRDS OF TONGUE,,,150.69,6689.0,52
CPT,41252,"REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX",,,153.41,6689.0,52
CPT,41530,"SUBMUCOSAL ABLATION OF THE TONGUE BASE, RADIOFREQUENCY, 1 OR MORE SITES, PER SESSION",,,369.02,14124.0,52
CPT,41599,"UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH",,,153.41,4664.0,49
CPT,41800,"DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES",,,81.16,5681.0,104
CPT,41826,"EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH SIMPLE REPAIR",,,191.23,6226.0,50
CPT,41827,"EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH COMPLEX REPAIR",,,283.21,10422.97,52
CPT,41828,"EXCISION OF HYPERPLASTIC ALVEOLAR MUCOSA, EACH QUADRANT (SPECIFY)",,,217.12,5681.0,50
CPT,41850,"DESTRUCTION OF LESION (EXCEPT EXCISION), DENTOALVEOLAR STRUCTURES",,,117.73,5681.0,50
CPT,41874,"ALVEOLOPLASTY, EACH QUADRANT (SPECIFY)",,,239.47,5837.49,50
CPT,41899,"UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES",,,153.41,5681.0,98
CPT,42104,"EXCISION, LESION OF PALATE, UVULA; WITHOUT CLOSURE",,,132.9,6689.0,52
CPT,42145,"Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty)",,,677.08,10422.97,52
CPT,42210,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)",,,1049.98,10422.97,52
CPT,42226,"LENGTHENING OF PALATE, AND PHARYNGEAL FLAP",,,887.55,10422.97,52
CPT,42235,"REPAIR OF ANTERIOR PALATE, INCLUDING VOMER FLAP",,,727.94,10422.97,52
CPT,42330,"SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL",,,163.19,5837.49,50
CPT,42400,BX GLAND SALIVARY NDL,2229.0,797.98,51.61,5681.0,189
CPT,42410,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection",,,620.12,10422.97,52
CPT,42415,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve",,,1039.25,14124.0,52
CPT,42420,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve",,,1162.29,14124.0,52
CPT,42440,EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND,,,410.67,10422.97,52
CPT,42500,"PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; PRIMARY OR SIMPLE",,,341.03,10422.97,52
CPT,42550,INJ PROC SIALOGRAM LT,643.0,230.19,59.02,5681.0,40
CPT,42550,INJ PROC SIALOGRAM RT,643.0,230.19,59.02,5681.0,40
CPT,42650,DILATION SALIVARY DUCT,,,57.97,5681.0,52
CPT,42699,"UNLISTED PROCEDURE, SALIVARY GLANDS OR DUCTS",,,153.41,5681.0,49
CPT,42700,INCISION AND DRAINAGE ABSCESS; PERITONSILLAR,,,134.1,5681.0,104
CPT,42800,BIOPSY; OROPHARYNX,,,115.57,5681.0,50
CPT,42804,"BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE",,,121.69,5837.49,52
CPT,42808,"EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY METHOD",,,163.84,6689.0,52
CPT,42826,"Tonsillectomy, primary or secondary; age 12 or over",,,253.36,8715.0,52
CPT,42960,"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); SIMPLE",,,158.59,5681.0,52
CPT,42975,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic",,,94.83,6689.0,52
CPT,42999,"UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS",,,153.41,6499.0,98
CPT,43180,"ESOPHAGOSCOPY, RIGID, TRANSORAL WITH DIVERTICULECTOMY OF HYPOPHARYNX OR CERVICAL ESOPHAGUS (EG, ZENKER'S DIVERTICULUM), WITH CRICOPHARYNGEAL MYOTOMY, INCLUDES USE OF TELESCOPE OR OPERATING MICROSCOPE ",,,536.05,18194.0,52
CPT,43191,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)",,,151.78,5988.0,104
CPT,43195,"ESOPHAGOSCOPY, RIGID, TRANSORAL; WITH BALLOON DILATION (LESS THAN 30 MM DIAMETER)",,,180.54,10059.0,52
CPT,43200,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,85.33,5681.0,52
CPT,43201,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE",,,100.43,5681.0,104
CPT,43202,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE",,,99.82,5681.0,52
CPT,43205,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF ESOPHAGEAL VARICES",,,136.2,5681.0,52
CPT,43212,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,181.71,18194.0,52
CPT,43215,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN BODY(S)",,,136.49,5681.0,104
CPT,43220,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH TRANSENDOSCOPIC BALLOON DILATION (LESS THAN 30 MM DIAMETER)",,,114.17,6689.0,52
CPT,43229,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,189.7,18194.0,52
CPT,43235,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,118.5,5444.0,104
CPT,43236,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance",,,133.85,5444.0,52
CPT,43237,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures",,,188.54,5444.0,52
CPT,43238,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,223.52,5444.0,52
CPT,43239,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,133.85,5444.0,104
CPT,43240,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when",,,377.06,10688.95,52
CPT,43241,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH INSERTION OF INTRALUMINAL TUBE OR CATHETER",,,137.38,5444.0,52
CPT,43242,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,252.93,6499.0,104
CPT,43244,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices",,,235.93,5444.0,52
CPT,43245,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (e.g., balloon, bougie)",,,169.23,5444.0,52
CPT,43246,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube",,,192.88,6689.0,104
CPT,43247,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)",,,170.39,5444.0,52
CPT,43248,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire",,,160.33,5444.0,52
CPT,43249,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)",,,148.2,5444.0,52
CPT,43251,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,188.79,5444.0,104
CPT,43253,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (e.g., anesthetic, neurolytic agent) or fiducial ",,,252.6,10059.0,104
CPT,43254,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection",,,259.78,5988.0,52
CPT,43255,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method",,,192.8,5444.0,52
CPT,43259,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,217.34,7704.0,52
CPT,43260,ERCP DX W/WO SPEC,5103.0,1826.87,310.37,6788.28,63
CPT,43260,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,310.37,6788.28,52
CPT,43261,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple",,,325.72,6788.28,52
CPT,43262,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy,,,343.13,6788.28,52
CPT,43264,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s),,,349.97,6788.28,104
CPT,43265,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH DESTRUCTION OF CALCULI, ANY METHOD (EG, MECHANICAL, ELECTROHYDRAULIC, LITHOTRIPSY)",,,416.29,10688.95,52
CPT,43266,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,209.53,18194.0,104
CPT,43270,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)",,,215.97,10059.0,52
CPT,43273,ENDOSCOPIC CANNULATION OF PAPILLA WITH DIRECT VISUALIZATION OF PANCREATIC/COMMON BILE DUCT(S) (LIST SEPARATELY IN ADDITION TO CODE(S) FOR PRIMARY PROCEDURE),,,114.41,18194.0,21
CPT,43274,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,444.67,18194.0,104
CPT,43275,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s),,,361.73,18194.0,52
CPT,43276,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,462.98,18194.0,104
CPT,43277,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH TRANS-ENDOSCOPIC BALLOON DILATION OF BILIARY/PANCREATIC DUCT(S) OR OF AMPULLA (SPHINCTEROPLASTY), INCLUDING SPHINCTEROTOMY, WHEN PERFORMED, ",,,363.71,18194.0,52
CPT,43278,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S), INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED",,,416.25,18194.0,52
CPT,43279,"LAPAROSCOPY, SURGICAL, ESOPHAGOMYOTOMY (HELLER TYPE), WITH FUNDOPLASTY, WHEN PERFORMED",,,982.0,10065.0,15
CPT,43280,"LAPAROSCOPY, SURGICAL, ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, TOUPET PROCEDURES)",,,1045.69,18715.8,52
CPT,43281,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh",,,1486.07,18715.8,50
CPT,43282,"LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITH IMPLANTATION OF MESH",,,1673.59,18715.8,50
CPT,43284,"LAPAROSCOPY, SURGICAL, ESOPHAGEAL SPHINCTER AUGMENTATION PROCEDURE, PLACEMENT OF SPHINCTER AUGMENTATION DEVICE (IE, MAGNETIC BAND), INCLUDING CRUROPLASTY WHEN PERFORMED",,,636.64,18715.8,50
CPT,43285,REMOVAL OF ESOPHAGEAL SPHINCTER AUGMENTATION DEVICE,,,654.41,10644.28,50
CPT,43289,"UNLISTED LAPAROSCOPY PROCEDURE, ESOPHAGUS",,,3668.82,10644.28,49
CPT,43450,"DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES",,,77.34,5444.0,104
CPT,43453,DIL ESOPHAGUS GD WIRE NO SCOPE,1737.0,621.85,84.14,5681.0,63
CPT,43497,"LOWER ESOPHAGEAL MYOTOMY, TRANSORAL (IE, PERORAL ENDOSCOPIC MYOTOMY [POEM])",,,765.78,18194.0,52
CPT,43499,"UNLISTED PROCEDURE, ESOPHAGUS",,,586.96,13802.9,49
CPT,43644,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (Roux limb 150 cm or less)",,,982.0,17878.0,15
CPT,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",,,3668.82,10644.28,49
CPT,43752,PLC G-TUBE NASO/ORO PHYS W FL GD,1211.0,433.54,38.57,6689.0,126
CPT,43761,REPOS G-TUBE NASO/ORO,1811.0,648.34,100.51,5681.0,126
CPT,43762,"REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT",,,36.09,5681.0,52
CPT,43762,RPLC G-TUBE WO GD/ENDO WO TRACT REV,1360.0,486.88,36.09,5681.0,63
CPT,43772,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only",,,924.16,10769.59,50
CPT,43774,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components",,,934.88,11278.0,50
CPT,43775,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (i.e., sleeve gastrectomy)",,,982.0,17878.0,15
CPT,43999,"UNLISTED PROCEDURE, STOMACH",,,586.96,5681.0,49
CPT,44120,"ENTERECTOMY, RESECTION OF SMALL INTESTINE; SINGLE RESECTION AND ANASTOMOSIS",,,982.0,13802.9,14
CPT,44180,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)",,,894.06,13802.9,52
CPT,44202,"LAPAROSCOPY, SURGICAL; ENTERECTOMY, RESECTION OF SMALL INTESTINE, SINGLE RESECTION AND ANASTOMOSIS",,,1344.05,13802.9,15
CPT,44207,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)",,,982.0,10257.38,19
CPT,44208,"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS) WITH COLOSTOMY",,,982.0,10257.38,19
CPT,44227,"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis",,,1600.96,13802.9,14
CPT,44238,"UNLISTED LAPAROSCOPY PROCEDURE, INTESTINE (EXCEPT RECTUM)",,,982.0,10644.28,49
CPT,44340,REVISION OF COLOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE),,,615.96,7704.0,52
CPT,44360,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDU",,,138.8,6689.0,52
CPT,44361,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE",,,152.87,6689.0,52
CPT,44363,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH REMOVAL OF FOREIGN BODY(S)",,,184.58,6689.0,52
CPT,44364,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE",,,196.71,6689.0,52
CPT,44366,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTERY, LASER, HEATER PROBE, STAPLER",,,230.74,6689.0,52
CPT,44369,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, B",,,236.27,6689.0,52
CPT,44370,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION)",,,257.11,18194.0,52
CPT,44376,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,272.95,6689.0,52
CPT,44378,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTERY, LASER, HEATER PROBE, STAPLER, PL",,,369.61,6689.0,52
CPT,44380,"ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,55.78,5681.0,52
CPT,44385,"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL POUCH (EG, KOCK POUCH, ILEAL RESERVOIR [S OR J]); DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,70.74,5681.0,52
CPT,44386,"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL POUCH (EG, KOCK POUCH, ILEAL RESERVOIR [S OR J]); WITH BIOPSY, SINGLE OR MULTIPLE",,,86.49,5681.0,52
CPT,44388,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,150.56,5444.0,52
CPT,44389,"Colonoscopy through stoma; with biopsy, single or multiple",,,165.45,5444.0,52
CPT,44394,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,217.01,5444.0,52
CPT,44500,INTRO TUBE GI LONG,675.0,241.65,18.34,5444.0,126
CPT,44500,"INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT) (SEPARATE PROCEDURE)",,,18.34,5444.0,104
CPT,44625,"CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE; WITH RESECTION AND ANASTOMOSIS OTHER THAN COLORECTAL",,,979.86,13802.9,14
CPT,44799,"UNLISTED PROCEDURE, SMALL INTESTINE",,,586.96,7390.37,49
CPT,44970,"Laparoscopy, surgical, appendectomy",,,588.48,10644.28,52
CPT,45100,"BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)",,,298.28,5681.0,52
CPT,45112,"PROCTECTOMY, COMBINED ABDOMINOPERINEAL, PULL-THROUGH PROCEDURE (EG, COLO-ANAL ANASTOMOSIS)",,,982.0,13802.9,14
CPT,45130,"EXCISION OF RECTAL PROCIDENTIA, WITH ANASTOMOSIS; PERINEAL APPROACH",,,982.0,13802.9,14
CPT,45171,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA (IE, PARTIAL THICKNESS)",,,603.87,10059.0,52
CPT,45172,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)",,,804.7,18194.0,52
CPT,45305,"PROCTOSIGMOIDOSCOPY, RIGID; WITH BIOPSY, SINGLE OR MULTIPLE",,,70.9,5681.0,52
CPT,45330,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,55.07,3698.0,104
CPT,45331,"Sigmoidoscopy, flexible; with biopsy, single or multiple",,,70.12,3698.0,104
CPT,45332,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S)",,,102.08,5681.0,52
CPT,45333,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS",,,91.2,5681.0,52
CPT,45335,"SIGMOIDOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE",,,64.89,5681.0,52
CPT,45338,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE",,,116.2,5681.0,104
CPT,45340,"SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATION",,,75.94,5681.0,104
CPT,45341,"SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION",,,119.87,5681.0,52
CPT,45342,"SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S)",,,164.44,5681.0,52
CPT,45346,"SIGMOIDOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,154.77,8022.0,52
CPT,45349,"SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION",,,190.82,8022.0,52
CPT,45350,"SIGMOIDOSCOPY, FLEXIBLE; WITH BAND LIGATION(S) (EG, HEMORRHOIDS)",,,97.84,8022.0,104
CPT,45378,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,177.9,5444.0,104
CPT,45379,"Colonoscopy, flexible; with removal of foreign body(s)",,,229.63,5444.0,52
CPT,45380,"Colonoscopy, flexible; with biopsy, single or multiple",,,193.33,5444.0,104
CPT,45381,"Colonoscopy, flexible; with directed submucosal injection(s), any substance",,,193.0,5444.0,52
CPT,45382,"Colonoscopy, flexible; with control of bleeding, any method",,,248.97,5444.0,52
CPT,45384,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps",,,219.64,6689.0,52
CPT,45385,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,244.64,5444.0,104
CPT,45386,"Colonoscopy, flexible; with transendoscopic balloon dilation",,,204.05,5444.0,52
CPT,45388,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)",,,260.19,8022.0,52
CPT,45390,"Colonoscopy, flexible; with endoscopic mucosal resection",,,319.86,8022.0,52
CPT,45391,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures",,,248.02,5444.0,52
CPT,45398,"Colonoscopy, flexible; with band ligation(s) (e.g., hemorrhoids)",,,226.52,8022.0,52
CPT,45400,"LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE)",,,1098.98,13802.9,14
CPT,45499,"UNLISTED LAPAROSCOPY PROCEDURE, RECTUM",,,3668.82,10644.28,49
CPT,45560,REPAIR OF RECTOCELE (SEPARATE PROCEDURE),,,676.22,7697.0,52
CPT,45910,DILATION OF RECTAL STRICTURE (SEPARATE PROCEDURE) UNDER ANESTHESIA OTHER THAN LOCAL,,,189.33,5681.0,52
CPT,45915,REMOVAL OF FECAL IMPACTION OR FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA,,,223.86,5681.0,52
CPT,46020,PLACEMENT OF SETON,,,113.73,7704.0,52
CPT,46040,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure),,,418.43,7704.0,52
CPT,46045,"INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULAR, OR SUBMUCOSAL ABSCESS, TRANSANAL, UNDER ANESTHESIA",,,432.03,6689.0,52
CPT,46050,"INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL",,,99.7,5681.0,104
CPT,46083,"INCISION OF THROMBOSED HEMORRHOID, EXTERNAL",,,108.2,5681.0,52
CPT,46255,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP;",,,348.3,7704.0,52
CPT,46260,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;",,,472.79,7704.0,52
CPT,46280,"SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED",,,472.34,8715.0,52
CPT,46600,"ANOSCOPY; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,40.34,5681.0,52
CPT,46607,"ANOSCOPY; WITH HIGH-RESOLUTION MAGNIFICATION (HRA) (EG, COLPOSCOPE, OPERATING MICROSCOPE) AND CHEMICAL AGENT ENHANCEMENT, WITH BIOPSY, SINGLE OR MULTIPLE",,,121.28,8022.0,52
CPT,46706,REPAIR OF ANAL FISTULA WITH FIBRIN GLUE,,,176.41,6226.0,52
CPT,46750,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE; ADULT",,,731.98,7704.0,52
CPT,46761,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; LEVATOR MUSCLE IMBRICATION (PARK POSTERIOR ANAL REPAIR)",,,890.84,7704.0,52
CPT,46922,"DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION",,,135.48,6226.0,52
CPT,46945,"HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; SINGLE HEMORRHOID COLUMN/GROUP, WITHOUT IMAGING GUIDANCE",,,334.21,6689.0,50
CPT,46946,"HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; 2 OR MORE HEMORRHOID COLUMNS/GROUPS, WITHOUT IMAGING GUIDANCE",,,373.47,6689.0,52
CPT,47000,BX LIVER NDL PERC,3139.0,3104.87,84.42,5681.0,252
CPT,47300,MARSUPIALIZATION OF CYST OR ABSCESS OF LIVER,,,982.0,10257.38,14
CPT,47370,"LAPAROSCOPY, SURGICAL, ABLATION OF 1 OR MORE LIVER TUMOR(S); RADIOFREQUENCY",,,1218.51,18715.8,50
CPT,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER",,,3668.82,10644.28,49
CPT,47382,ABL RF TUMOR/S LIVER PERC,9095.0,3256.01,704.21,10644.28,252
CPT,47383,ABL CRYO TUMOR/S LIVER PERC,13673.0,4894.93,429.13,18715.8,126
CPT,47399,ABL ETOH TUMOR/S LIVER,1545.0,553.11,450.93,10257.38,62
CPT,47490,CHOLECYSTOSTOMY PERC W IMG GD S&I,6790.0,2430.82,319.81,10257.38,189
CPT,47531,INJ CHOLANGIOGRAM ACCESS EXIST S&I,1938.0,693.8,67.42,7697.0,189
CPT,47532,INJ CHOLANGIOGRAM ACCESS NEW S&I,3926.0,1405.51,200.92,18194.0,126
CPT,47533,PLC CATH DRN BILIARY PERC EXT S&I,5104.0,1827.23,250.22,18194.0,126
CPT,47534,PLC CATH DRN BILIARY INT-EXT S&I,5360.0,1918.88,350.17,18194.0,126
CPT,47535,CONVERSION CATH DRN BILIARY EXT S&I,5331.0,1908.5,186.02,18194.0,126
CPT,47536,EXCHG CATH DRN BILIARY PERC S&I,4865.0,1741.67,125.39,18194.0,126
CPT,47537,REM CATH DRN BILIARY PERC S&I,2841.0,1017.08,91.97,5681.0,63
CPT,47537,"REMOVAL OF BILIARY DRAINAGE CATHETER, PERCUTANEOUS, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING BILIARY STENTS), INCLUDING DIAGNOSTIC CHOLANGIOGRAPHY WHEN PERFORMED, IMAGING GUIDAN",,,91.97,5681.0,52
CPT,47538,PLC STNT/S DUCT BILE EXIST S&I,9650.0,3454.7,222.68,18194.0,63
CPT,47539,PLC STNT/S DUCT BILE NEW S&I,10956.0,3922.25,404.32,18194.0,63
CPT,47540,PLC STNT/S DUCT BILE NEW W DRN S&I,13803.0,4941.47,416.48,18194.0,63
CPT,47541,PLC ACCS BILI TREE SM BOWEL NEW S&I,6749.0,2416.14,318.83,18194.0,63
CPT,47542,"BALLOON DILATION OF BILIARY DUCT(S) OR OF AMPULLA (SPHINCTEROPLASTY), PERCUTANEOUS, INCLUDING IMAGING GUIDANCE (EG, FLUOROSCOPY), AND ALL ASSOCIATED RADIOLOGICAL SUPERVISION AND INTERPRETATION, EACH D",,,128.71,5681.0,14
CPT,47542,DIL BLN DUCT BILIARY PERC EA S&I,4597.0,1645.73,128.71,5681.0,40
CPT,47543,BX/S ENDOLMNL BILI TREE PERC S&I,4802.0,1719.12,135.94,5681.0,40
CPT,47544,REM CALCULI BILI DUCT&/GALLBLDR S&I,5262.0,1883.8,148.34,5681.0,80
CPT,47554,REM CALCULI BILI ENDO PERC T-TUBE,14985.0,5364.63,428.88,18715.8,63
CPT,47555,ENDO BILI W DIL DCT WO STNT PERC,4844.0,1734.15,317.64,11398.36,126
CPT,47556,ENDO BILI W DIL DCT&STNT PERC,5503.0,1970.07,359.81,18715.8,126
CPT,47562,"Laparoscopy, surgical; cholecystectomy",,,644.59,18194.0,52
CPT,47563,"Laparoscopy, surgical; cholecystectomy with cholangiography",,,700.56,18194.0,52
CPT,47564,"Laparoscopy, surgical; cholecystectomy with exploration of common duct",,,1088.73,18715.8,52
CPT,47579,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT",,,3668.82,10644.28,49
CPT,47999,"UNLISTED PROCEDURE, BILIARY TRACT",,,586.96,5444.0,49
CPT,48102,BX PANCREAS NDL PERC,2435.0,871.73,226.28,5681.0,189
CPT,48102,"Biopsy of pancreas, percutaneous needle",,,226.28,5681.0,52
CPT,48999,"UNLISTED PROCEDURE, PANCREAS",,,450.93,4664.0,98
CPT,49000,"EXPLORATORY LAPAROTOMY, EXPLORATORY CELIOTOMY WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDURE)",,,748.27,13802.9,15
CPT,49082,ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITHOUT IMAGING GUIDANCE,,,71.02,6689.0,104
CPT,49083,PARACENTESIS ABDOMINAL W IMG,2449.0,1882.45,102.12,6689.0,189
CPT,49084,LAVAGE PERITONEAL W/WO IMG,1770.0,633.66,102.74,6689.0,63
CPT,49180,BX MASS ABD/RETRO NDL PERC,2983.0,1067.91,79.3,5681.0,189
CPT,49180,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle",,,79.3,5681.0,52
CPT,49185,COLL FLUID SCLEROTX W IMG GD S&I,3139.0,1123.76,114.14,14124.0,126
CPT,49320,"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,321.97,10644.28,52
CPT,49321,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,336.82,10644.28,104
CPT,49322,"Laparoscopy, surgical; with aspiration of cavity or cyst (e.g., ovarian cyst) (single or multiple)",,,366.15,10644.28,52
CPT,49324,"LAPAROSCOPY, SURGICAL; WITH INSERTION OF TUNNELED INTRAPERITONEAL CATHETER",,,376.31,18194.0,52
CPT,49325,"LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED",,,401.19,18194.0,52
CPT,49326,"LAPAROSCOPY, SURGICAL; WITH OMENTOPEXY (OMENTAL TACKING PROCEDURE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,180.75,18194.0,21
CPT,49329,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,1229.0,10644.28,49
CPT,49400,INJ CNT/AIR PERITONEAL CAVITY,555.0,198.69,86.4,5681.0,80
CPT,49402,REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY,,,831.36,7697.0,52
CPT,49405,DRN CATH FLUID VISCERAL IMG GD,3029.0,1084.38,185.74,18194.0,189
CPT,49406,DRN CATH FLUID PERI PERC IMG GD,3139.0,1123.76,185.74,18194.0,189
CPT,49407,DRN CATH FLUID TRNSVAG/REC IMG GD,4214.0,1508.61,196.66,7704.0,189
CPT,49411,PLC DEV/S RT GD INTRABD/PLVC/RETRO,3018.0,1080.44,178.16,5681.0,189
CPT,49418,INS CATH INTRAPERIT TUN W IMG,5104.0,1827.23,191.43,18194.0,126
CPT,49418,"INSERTION OF TUNNELED INTRAPERITONEAL CATHETER (EG, DIALYSIS, INTRAPERITONEAL CHEMOTHERAPY INSTILLATION, MANAGEMENT OF ASCITES), COMPLETE PROCEDURE, INCLUDING IMAGING GUIDANCE, CATHETER PLACEMENT, CON",,,191.43,18194.0,52
CPT,49419,INS CATH INTRAPERIT TUN W PORT SQ,7413.0,2653.85,404.73,10065.0,126
CPT,49422,REM CATH INTRAPERIT,5534.0,1981.17,213.06,7697.0,126
CPT,49422,REMOVAL OF TUNNELED INTRAPERITONEAL CATHETER,,,213.06,7697.0,52
CPT,49423,EXCHG CATH DRN ABSC/CYST,3433.0,1229.01,67.43,5681.0,189
CPT,49424,INJ CNT ABSC/CYST VIA PREV CATH/TB,599.0,214.44,35.69,5681.0,120
CPT,49425,INS SHUNT PERITONEAL-VENOUS,10845.0,3882.51,715.3,13802.9,41
CPT,49426,REV SHUNT PERITONEAL-VENOUS,8033.0,2875.81,654.44,7697.0,63
CPT,49427,INJ EVAL SHUNT PERITONEAL-VENOUS,388.0,138.9,37.3,5681.0,80
CPT,49429,REM SHUNT PERITONEAL-VENOUS,6143.0,2199.19,444.8,7697.0,63
CPT,49429,REMOVAL OF PERITONEAL-VENOUS SHUNT,,,444.8,7697.0,50
CPT,49440,INS TUBE GASTRO PERC S&I,3442.0,1232.24,194.08,6689.0,126
CPT,49441,INS TUBE DUO/JEJUNOSTOMY PERC S&I,4103.0,1468.87,230.64,6689.0,126
CPT,49442,INS TUBE CECOSTOMY PERC S&I,3879.0,1388.68,198.47,10059.0,63
CPT,49446,CHG G-TUBE TO G-J TUBE PERC S&I,2767.0,990.59,139.48,5681.0,63
CPT,49450,RPLC TUBE GASTRO/CECOSTOMY PERC S&I,1242.0,444.64,62.52,5681.0,63
CPT,49451,RPLC TUBE DUO/JEJUNOSTOMY PERC S&I,1681.0,601.8,84.46,5681.0,63
CPT,49452,"REPLACEMENT OF GASTRO-JEJUNOSTOMY TUBE, PERCUTANEOUS, UNDER FLUOROSCOPIC GUIDANCE INCLUDING CONTRAST INJECTION(S), IMAGE DOCUMENTATION AND REPORT",,,130.02,5681.0,52
CPT,49452,RPLC TUBE G-J PERC S&I,2069.0,740.7,130.02,5681.0,63
CPT,49460,REM OBSTRUCT MECH TUBE G/COLON S&I,906.0,324.35,48.63,5681.0,63
CPT,49465,INJ CNT TUBE G/COLON PERC S&I,492.0,176.14,29.16,5681.0,126
CPT,49505,"Repair initial inguinal hernia, age 5 years or older; reducible",,,511.97,8715.0,52
CPT,49507,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated",,,575.11,18194.0,52
CPT,49520,"Repair recurrent inguinal hernia, any age; reducible",,,619.32,14124.0,52
CPT,49591,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,331.63,8715.0,50
CPT,49592,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,460.62,13802.9,50
CPT,49593,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,554.84,11398.36,50
CPT,49594,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,721.99,13802.9,50
CPT,49595,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,746.45,11398.36,50
CPT,49596,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,990.34,13802.9,14
CPT,49613,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,408.75,8715.0,50
CPT,49614,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,553.29,13802.9,50
CPT,49615,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,618.68,11398.36,50
CPT,49616,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,831.09,13802.9,14
CPT,49617,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,856.76,10065.0,14
CPT,49618,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,1199.99,13802.9,14
CPT,49621,"REPAIR OF PARASTOMAL HERNIA, ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL OR RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS, WHEN PERFORMED; REDUCIBLE",,,719.34,10065.0,14
CPT,49623,"REMOVAL OF TOTAL OR NEAR TOTAL NON-INFECTED MESH OR OTHER PROSTHESIS AT THE TIME OF INITIAL OR RECURRENT ANTERIOR ABDOMINAL HERNIA REPAIR OR PARASTOMAL HERNIA REPAIR, ANY APPROACH (IE, OPEN, LAPAROSCO",,,190.78,5681.0,14
CPT,49650,"Laparoscopy, surgical; repair initial inguinal hernia",,,424.62,10644.28,52
CPT,49651,"Laparoscopy, surgical; repair recurrent inguinal hernia",,,554.03,14124.0,52
CPT,49659,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY",,,3668.82,10644.28,49
CPT,49999,ABL CRYO LYMPH NODE RETROPERIT PERC,11961.0,4282.04,586.96,8970.75,62
CPT,49999,ABL MASS MESENTERIC ALCOHOL PERC,7806.0,2794.55,586.96,5854.5,62
CPT,49999,DSRPT WIRE&INST AGNT FIBRIN CTH ABD,2135.0,764.33,586.96,5681.0,62
CPT,49999,EXCHG CATH PERITONEAL TUNNELED,2614.0,935.81,586.96,5681.0,62
CPT,49999,REPOS CATH DRN PERTNL TUN W FL GD,4099.0,1467.44,586.96,5681.0,62
CPT,49999,REPOS TUBE JEJUNOSTOMY,1245.0,445.71,560.25,5681.0,62
CPT,49999,RPLC TUBE GASTRO/CECOSTOMY,1007.0,360.51,453.15,5681.0,62
CPT,49999,THROMBOLYSIS INF CATH PERITONEAL,1253.0,448.57,563.85,5681.0,124
CPT,49999,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,586.96,5681.0,49
CPT,50080,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,678.95,16667.46,50
CPT,50080,REM STONE KIDNEY LITHO <=2CM BI,11130.0,3984.54,678.95,8755.0,40
CPT,50080,REM STONE KIDNEY LITHO <=2CM LT,7420.0,2656.36,678.95,8755.0,40
CPT,50080,REM STONE KIDNEY LITHO <=2CM RT,7420.0,2656.36,678.95,8755.0,40
CPT,50081,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,1092.44,16667.46,50
CPT,50200,BX RENAL TROCAR/NDL PERC BI,4698.0,3245.64,121.75,5681.0,120
CPT,50200,BX RENAL TROCAR/NDL PERC LT,3132.0,3245.64,121.75,5681.0,120
CPT,50200,BX RENAL TROCAR/NDL PERC RT,3132.0,3245.64,121.75,5681.0,120
CPT,50382,RPLC STENT URETER INT PERC BI S&I,5685.0,2035.23,239.69,6226.0,40
CPT,50382,RPLC STENT URETER INT PERC LT S&I,3790.0,1356.82,239.69,6226.0,40
CPT,50382,RPLC STENT URETER INT PERC RT S&I,3790.0,1356.82,239.69,6226.0,40
CPT,50384,REM STENT URETER INT PERC BI S&I,5150.0,1843.7,216.43,6226.0,40
CPT,50384,REM STENT URETER INT PERC LT S&I,3433.0,1229.01,216.43,6226.0,40
CPT,50384,REM STENT URETER INT PERC RT S&I,3433.0,1229.01,216.43,6226.0,40
CPT,50384,"REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLING URETERAL STENT VIA PERCUTANEOUS APPROACH, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,216.43,6226.0,52
CPT,50385,"REMOVAL (VIA SNARE/CAPTURE) AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT VIA TRANSURETHRAL APPROACH, WITHOUT USE OF CYSTOSCOPY, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,206.35,10059.0,52
CPT,50386,REM STENT URETER TRANSURETH BI S&I,3563.0,1275.55,156.51,6226.0,40
CPT,50386,REM STENT URETER TRANSURETH LT S&I,2375.0,850.25,156.51,6226.0,40
CPT,50386,REM STENT URETER TRANSURETH RT S&I,2375.0,850.25,156.51,6226.0,40
CPT,50387,RPLC CATH NEPHROURETER FL GD BI S&I,4686.0,1677.59,79.27,5681.0,40
CPT,50387,RPLC CATH NEPHROURETER FL GD LT S&I,3124.0,1118.39,79.27,5681.0,40
CPT,50387,RPLC CATH NEPHROURETER FL GD RT S&I,3124.0,1118.39,79.27,5681.0,40
CPT,50389,REM TUBE NEPHRO W FLUORO BI S&I,2151.0,770.06,51.06,5681.0,40
CPT,50389,REM TUBE NEPHRO W FLUORO LT S&I,1434.0,513.37,51.06,5681.0,40
CPT,50389,REM TUBE NEPHRO W FLUORO RT S&I,1434.0,513.37,51.06,5681.0,40
CPT,50389,"REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING URETERAL STENT)",,,51.06,18194.0,104
CPT,50390,ASP&/INJ CYST/PELVIS RENAL BI,2064.0,738.91,90.4,5681.0,120
CPT,50390,ASP&/INJ CYST/PELVIS RENAL LT,1376.0,492.61,90.4,5681.0,120
CPT,50390,ASP&/INJ CYST/PELVIS RENAL RT,1376.0,492.61,90.4,5681.0,120
CPT,50396,STUDY MANOMETRIC RENAL TB/CATH BI,1671.0,598.22,111.65,5681.0,40
CPT,50396,STUDY MANOMETRIC RENAL TB/CATH LT,1114.0,398.81,111.65,5681.0,40
CPT,50396,STUDY MANOMETRIC RENAL TB/CATH RT,1114.0,398.81,111.65,5681.0,40
CPT,50430,INJ NEPH&/URETERGRM ACC NEW BI S&I,2547.0,911.83,147.21,5988.0,40
CPT,50430,INJ NEPH&/URETERGRM ACC NEW LT S&I,1698.0,607.88,147.21,5988.0,40
CPT,50430,INJ NEPH&/URETERGRM ACC NEW RT S&I,1698.0,607.88,147.21,5988.0,40
CPT,50431,INJ NEPH&/URETERGRM ACC EXST BI S&I,1971.0,705.62,63.72,5988.0,40
CPT,50431,INJ NEPH&/URETERGRM ACC EXST LT S&I,1314.0,470.41,63.72,5988.0,40
CPT,50431,INJ NEPH&/URETERGRM ACC EXST RT S&I,1314.0,470.41,63.72,5988.0,40
CPT,50432,"PLACEMENT OF NEPHROSTOMY CATHETER, PERCUTANEOUS, INCLUDING DIAGNOSTIC NEPHROSTOGRAM AND/OR URETEROGRAM WHEN PERFORMED, IMAGING GUIDANCE (EG, ULTRASOUND AND/OR FLUOROSCOPY) AND ALL ASSOCIATED RADIOLOGI",,,195.15,14124.0,52
CPT,50432,PLC CATH NEPHROSTOMY PERC BI S&I,5150.0,1843.7,195.15,14124.0,120
CPT,50432,PLC CATH NEPHROSTOMY PERC LT S&I,3433.0,1229.01,195.15,14124.0,120
CPT,50432,PLC CATH NEPHROSTOMY PERC RT S&I,3433.0,1229.01,195.15,14124.0,120
CPT,50433,PLC CATH NEPHROURET PERC NEW BI S&I,7725.0,2765.55,242.28,14124.0,40
CPT,50433,PLC CATH NEPHROURET PERC NEW LT S&I,5150.0,1843.7,242.28,14124.0,40
CPT,50433,PLC CATH NEPHROURET PERC NEW RT S&I,5150.0,1843.7,242.28,14124.0,40
CPT,50434,CNV CATH NEPH PERC PRE EXIST BI S&I,4694.0,1680.45,181.96,5988.0,40
CPT,50434,CNV CATH NEPH PERC PRE EXIST LT S&I,3129.0,1120.18,181.96,5988.0,40
CPT,50434,CNV CATH NEPH PERC PRE EXIST RT S&I,3129.0,1120.18,181.96,5988.0,40
CPT,50435,"EXCHANGE NEPHROSTOMY CATHETER, PERCUTANEOUS, INCLUDING DIAGNOSTIC NEPHROSTOGRAM AND/OR URETEROGRAM WHEN PERFORMED, IMAGING GUIDANCE (EG, ULTRASOUND AND/OR FLUOROSCOPY) AND ALL ASSOCIATED RADIOLOGICAL ",,,95.52,5988.0,52
CPT,50435,EXCHG CATH NEPH PERC BI S&I,5150.0,1843.7,95.52,5988.0,40
CPT,50435,EXCHG CATH NEPH PERC LT S&I,3433.0,1229.01,95.52,5988.0,40
CPT,50435,EXCHG CATH NEPH PERC RT S&I,3433.0,1229.01,95.52,5988.0,40
CPT,50436,DIL TRACT EXIST PERC BI S&I,4727.0,1692.27,143.3,18194.0,40
CPT,50436,DIL TRACT EXIST PERC LT S&I,3151.0,1128.06,143.3,18194.0,40
CPT,50436,DIL TRACT EXIST PERC RT S&I,3151.0,1128.06,143.3,18194.0,40
CPT,50437,DIL TRACT EXIST PERC NEW ACC BI S&I,8012.0,2868.3,237.44,7697.0,40
CPT,50437,DIL TRACT EXIST PERC NEW ACC LT S&I,5341.0,1912.08,237.44,7697.0,40
CPT,50437,DIL TRACT EXIST PERC NEW ACC RT S&I,5341.0,1912.08,237.44,7697.0,40
CPT,50543,"Laparoscopy, surgical; partial nephrectomy",,,1445.99,18715.8,50
CPT,50544,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",,,1202.65,18715.8,52
CPT,50545,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)",,,982.0,13802.9,14
CPT,50546,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy",,,1168.7,13802.9,14
CPT,50548,"LAPAROSCOPY, SURGICAL; NEPHRECTOMY WITH TOTAL URETERECTOMY",,,1300.79,13802.9,14
CPT,50557,"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH FULGURATION AND/OR INCISION, WITH ",,,332.67,16667.46,52
CPT,50590,"Lithotripsy, extracorporeal shock wave",,,559.87,22523.67,52
CPT,50592,ABL RF TUMOR/S KIDNEY PERC BI,13457.0,4817.61,328.6,10257.38,40
CPT,50592,ABL RF TUMOR/S KIDNEY PERC LT,8971.0,3211.62,328.6,10257.38,40
CPT,50592,ABL RF TUMOR/S KIDNEY PERC RT,8971.0,3211.62,328.6,10257.38,40
CPT,50593,ABL CRYO TUMOR/S KIDNEY PERC BI,17942.0,6423.24,438.26,18194.0,40
CPT,50593,ABL CRYO TUMOR/S KIDNEY PERC LT,11961.0,4282.04,438.26,18194.0,40
CPT,50593,ABL CRYO TUMOR/S KIDNEY PERC RT,11961.0,4282.04,438.26,18194.0,40
CPT,50684,INJ CATH URETERAL BI,432.0,154.66,49.6,5681.0,80
CPT,50684,INJ CATH URETERAL LT,288.0,103.1,49.6,5681.0,80
CPT,50684,INJ CATH URETERAL RT,288.0,103.1,49.6,5681.0,80
CPT,50688,CHANGE OF URETEROSTOMY TUBE OR EXTERNALLY ACCESSIBLE URETERAL STENT VIA ILEAL CONDUIT,,,75.45,5681.0,52
CPT,50688,CHG TB/STNT URETER CONDUIT ILEAL,2584.0,925.07,75.45,5681.0,63
CPT,50690,INJ VISUAL ILEAL CONDUIT,316.0,113.13,58.78,5681.0,40
CPT,50690,"INJECTION PROCEDURE FOR VISUALIZATION OF ILEAL CONDUIT AND/OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE",,,67.66,5681.0,14
CPT,50693,"PLACEMENT OF URETERAL STENT, PERCUTANEOUS, INCLUDING DIAGNOSTIC NEPHROSTOGRAM AND/OR URETEROGRAM WHEN PERFORMED, IMAGING GUIDANCE (EG, ULTRASOUND AND/OR FLUOROSCOPY), AND ALL ASSOCIATED RADIOLOGICAL S",,,194.14,18194.0,52
CPT,50693,PLC STNT URTR NEPH PREEXIST BI S&I,7725.0,2765.55,194.14,18194.0,40
CPT,50693,PLC STNT URTR NEPH PREEXIST LT S&I,5150.0,1843.7,194.14,18194.0,40
CPT,50693,PLC STNT URTR NEPH PREEXIST RT S&I,5150.0,1843.7,194.14,18194.0,40
CPT,50694,PLC STNT URTR WO NEPH CATH BI S&I,10038.0,3593.6,253.48,18194.0,40
CPT,50694,PLC STNT URTR WO NEPH CATH LT S&I,6692.0,2395.74,253.48,18194.0,40
CPT,50694,PLC STNT URTR WO NEPH CATH RT S&I,6692.0,2395.74,253.48,18194.0,40
CPT,50695,PLC STNT URTR W NEPH CATH BI S&I,12846.0,4598.87,325.16,18194.0,40
CPT,50695,PLC STNT URTR W NEPH CATH LT S&I,8564.0,3065.91,325.16,18194.0,40
CPT,50695,PLC STNT URTR W NEPH CATH RT S&I,8564.0,3065.91,325.16,18194.0,40
CPT,50705,EMB/OCCL URETERAL BI S&I,4758.0,1703.36,169.17,5681.0,40
CPT,50705,EMB/OCCL URETERAL LT S&I,3172.0,1135.58,169.17,5681.0,40
CPT,50705,EMB/OCCL URETERAL RT S&I,3172.0,1135.58,169.17,5681.0,40
CPT,50706,DIL BLN STRICTURE URETERAL BI S&I,4709.0,1685.82,171.94,5681.0,40
CPT,50706,DIL BLN STRICTURE URETERAL LT S&I,3139.0,1123.76,171.94,5681.0,40
CPT,50706,DIL BLN STRICTURE URETERAL RT S&I,3139.0,1123.76,171.94,5681.0,40
CPT,50760,URETEROURETEROSTOMY,,,982.0,13802.9,14
CPT,50947,"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITH CYSTOSCOPY AND URETERAL STENT PLACEMENT",,,1342.48,18715.8,52
CPT,50949,"UNLISTED LAPAROSCOPY PROCEDURE, URETER",,,3668.82,10644.28,49
CPT,51100,ASP BLADDER NDL,742.0,265.64,37.89,5681.0,189
CPT,51101,ASP BLADDER TROCAR/CATH,1374.0,491.89,49.33,5681.0,189
CPT,51102,ASP BLADDER W INS CATH SUPRAPUBIC,3433.0,1229.01,137.96,6226.0,189
CPT,51600,INJ CYSTOGRAM,689.0,246.66,41.91,4664.0,80
CPT,51610,INJ URETHROCYSTOGRAM RETROGRADE,350.0,125.3,62.38,4664.0,120
CPT,51700,ED PROCEDURE IRRG BLADDER,805.0,198.84,29.06,2503.0,64
CPT,51700,PROCEDURE IRRG BLADDER,805.0,288.19,29.06,5681.0,63
CPT,51701,ED INS CATH BLADDER NONINDWL,257.0,63.48,24.8,2503.0,64
CPT,51701,INS CATH BLADDER NONINDWL,257.0,112.57,24.8,5681.0,189
CPT,51702,ED INS CATH BLADDER INDWL SMPL,284.0,70.15,24.52,2503.0,64
CPT,51702,INS CATH BLADDER INDWL SMPL,284.0,124.39000000000001,24.52,5681.0,252
CPT,51703,INS CATH BLADDER INDWL CMP,459.0,164.32,73.85,5681.0,63
CPT,51703,"INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; COMPLICATED (EG, ALTERED ANATOMY, FRACTURED CATHETER/BALLOON)",,,73.85,5681.0,52
CPT,51705,CHG TUBE CYSTO SIMPLE,622.0,222.675,50.29,5681.0,252
CPT,51710,CHG TUBE CYSTO COMPLICATED,3433.0,1229.01,78.01,5681.0,63
CPT,51715,ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSAL TISSUES OF THE URETHRA AND/OR BLADDER NECK,,,193.19,7704.0,52
CPT,51720,BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME),,,42.15,5681.0,52
CPT,51720,INSTILL BLADDER ANTICARCINOGENIC,1268.0,656.82,42.15,1267.21,63
CPT,51798,MEAS URINE&/CAPACITY BLADDER US,270.0,96.66,10.99,2481.0,63
CPT,51860,"CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE; SIMPLE",,,727.8,16667.46,50
CPT,52000,Cystourethroscopy (separate procedure),,,77.75,5849.0,52
CPT,52005,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;",,,129.0,6226.0,52
CPT,52204,"Cystourethroscopy, with biopsy(s)",,,136.85,6689.0,52
CPT,52234,"CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION OF; SMALL BLADDER TUMOR(S) (0.5 UP TO 2.0 CM)",,,236.89,6689.0,52
CPT,52235,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)",,,278.02,7704.0,52
CPT,52240,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)",,,377.39,9440.44,52
CPT,52275,"CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; MALE",,,239.22,6689.0,52
CPT,52276,Cystourethroscopy with direct vision internal urethrotomy,,,254.56,7704.0,52
CPT,52281,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female",,,146.97,6689.0,104
CPT,52284,"CYSTOURETHROSCOPY, WITH MECHANICAL URETHRAL DILATION AND URETHRAL THERAPEUTIC DRUG DELIVERY BY DRUG-COATED BALLOON CATHETER FOR URETHRAL STRICTURE OR STENOSIS, MALE, INCLUDING FLUOROSCOPY, WHEN PERFOR",,,158.78,9440.44,50
CPT,52287,"CYSTOURETHROSCOPY, WITH INJECTION(S) FOR CHEMODENERVATION OF THE BLADDER",,,162.96,10059.0,52
CPT,52300,"CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ORTHOTOPIC URETEROCELE(S), UNILATERAL OR BILATERAL",,,269.59,6689.0,52
CPT,52310,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",,,146.33,18194.0,104
CPT,52317,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM),,,333.37,6226.0,52
CPT,52318,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM),,,455.47,18194.0,104
CPT,52332,"Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,150.23,18194.0,104
CPT,52351,"CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; DIAGNOSTIC",,,291.75,7704.0,52
CPT,52352,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)",,,340.82,8715.0,52
CPT,52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)",,,377.07,9440.44,52
CPT,52354,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion",,,401.26,9440.44,52
CPT,52356,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,399.96,18194.0,52
CPT,52450,TRANSURETHRAL INCISION OF PROSTATE,,,466.11,7704.0,52
CPT,52601,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,709.72,9440.44,52
CPT,52640,Transurethral resection; of postoperative bladder neck contracture,,,317.76,6689.0,52
CPT,52647,"LASER COAGULATION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY ARE INCLUD",,,635.1,18194.0,7
CPT,53230,EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE); FEMALE,,,596.86,9440.44,52
CPT,53442,"Removal or revision of sling for male urinary incontinence (e.g., fascia or synthetic)",,,768.29,9440.44,52
CPT,53510,"URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PERINEAL",,,618.79,9440.44,52
CPT,53605,"DILATION OF URETHRAL STRICTURE OR VESICAL NECK BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE, GENERAL OR CONDUCTION (SPINAL) ANESTHESIA",,,61.76,6689.0,52
CPT,53899,BX BLADDER NDL PERC,1856.0,664.45,192.95,5681.0,62
CPT,53899,PLC STENT NEPHROURTR CONDUIT ILEAL,5492.0,1966.14,192.95,5681.0,62
CPT,53899,REM STENT URETER CONDUIT ILEAL,2375.0,850.25,192.95,5681.0,62
CPT,53899,REM&PUNCT CATH BLN BLADDER PERC,616.0,220.53,192.95,5681.0,62
CPT,53899,"UNLISTED PROCEDURE, URINARY SYSTEM",,,192.95,5681.0,49
CPT,54001,"SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN",,,138.06,6689.0,52
CPT,54150,CIRCUMCISION W BLOCK REGIONAL,762.0,250.72,93.11,5681.0,118
CPT,54161,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age",,,193.29,6689.0,52
CPT,54162,Lysis or excision of penile post-circumcision adhesions,,,196.53,6689.0,52
CPT,54220,IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM,,,130.87,5681.0,52
CPT,54401,INSERTION OF PENILE PROSTHESIS; INFLATABLE (SELF-CONTAINED),,,653.0,36492.19,47
CPT,54405,"INSERTION OF MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS, INCLUDING PLACEMENT OF PUMP, CYLINDERS, AND RESERVOIR",,,787.82,36492.19,47
CPT,54410,"REMOVAL AND REPLACEMENT OF ALL COMPONENT(S) OF A MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS AT THE SAME OPERATIVE SESSION",,,842.85,36492.19,52
CPT,54411,"REMOVAL AND REPLACEMENT OF ALL COMPONENTS OF A MULTI-COMPONENT INFLATABLE PENILE PROSTHESIS THROUGH AN INFECTED FIELD AT THE SAME OPERATIVE SESSION, INCLUDING IRRIGATION AND DEBRIDEMENT OF INFECTED TI",,,1002.67,36492.19,50
CPT,54435,"CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION (EG, BIOPSY NEEDLE, WINTER PROCEDURE, RONGEUR, OR PUNCH) FOR PRIAPISM",,,407.08,8715.0,52
CPT,54450,FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIAL ADHESIONS AND STRETCHING,,,55.22,5681.0,52
CPT,54500,BX TESTIS NEEDLE BI,7662.0,2743.0,72.5,5746.5,80
CPT,54500,BX TESTIS NEEDLE LT,5108.0,1828.66,72.5,5681.0,80
CPT,54500,BX TESTIS NEEDLE RT,5108.0,1828.66,72.5,5681.0,80
CPT,54520,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach",,,322.49,7704.0,52
CPT,54530,"ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH",,,499.26,8715.0,52
CPT,54620,FIXATION OF CONTRALATERAL TESTIS (SEPARATE PROCEDURE),,,291.62,7704.0,52
CPT,54840,"EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY",,,316.62,8715.0,52
CPT,55040,Excision of hydrocele; unilateral,,,333.08,7704.0,52
CPT,55250,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)",,,226.11,6689.0,52
CPT,55700,"Biopsy, prostate; needle or punch, single or multiple, any approach",,,126.11,6689.0,7
CPT,55707,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",,,2610.96,6226.0,45
CPT,55708,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION",,,2610.96,6226.0,45
CPT,55711,"BIOPSY, PROSTATE, TRANSRECTAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",,,2610.96,6226.0,45
CPT,55866,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;",,,1160.79,18715.8,50
CPT,55867,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,1019.6,18715.8,50
CPT,55868,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH LYMPH NODE BIOPSY(IES) (LIMITED PELVIC LYMPHADENECTOMY)",,,7873.55,18715.8,45
CPT,55873,CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE AND MONITORING),,,745.95,18194.0,52
CPT,55874,"TRANSPERINEAL PLACEMENT OF BIODEGRADABLE MATERIAL, PERI-PROSTATIC, SINGLE OR MULTIPLE INJECTION(S), INCLUDING IMAGE GUIDANCE, WHEN PERFORMED",,,159.29,18194.0,52
CPT,55875,"TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY",,,761.93,18194.0,52
CPT,55876,"PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PROSTATE (VIA NEEDLE, ANY APPROACH), SINGLE OR MULTIPLE",,,99.66,5681.0,52
CPT,55876,PLC DEV/S RT GD PROSTATE,2071.0,741.42,99.66,5681.0,126
CPT,56405,Incision and drainage of vulva or perineal abscess,,,125.19,6689.0,104
CPT,56420,INCISION AND DRAINAGE OF BARTHOLIN'S GLAND ABSCESS,,,108.96,5681.0,52
CPT,56440,MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST,,,178.65,6689.0,52
CPT,56441,Lysis of labial adhesions,,,153.26,6226.0,52
CPT,56442,"HYMENOTOMY, SIMPLE INCISION",,,46.49,6226.0,52
CPT,56501,"DESTRUCTION OF LESION(S), VULVA; SIMPLE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,131.79,5681.0,50
CPT,56515,"DESTRUCTION OF LESION(S), VULVA; EXTENSIVE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,209.24,7704.0,52
CPT,56605,BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION,,,57.64,5681.0,52
CPT,56606,BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,28.33,5681.0,19
CPT,56620,VULVECTOMY SIMPLE; PARTIAL,,,579.18,10059.0,52
CPT,56625,VULVECTOMY SIMPLE; COMPLETE,,,659.08,14124.0,52
CPT,56700,PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING,,,200.07,6226.0,52
CPT,56740,EXCISION OF BARTHOLIN'S GLAND OR CYST,,,309.69,7704.0,52
CPT,56800,PLASTIC REPAIR OF INTROITUS,,,249.3,7704.0,52
CPT,56810,"PERINEOPLASTY, REPAIR OF PERINEUM, NONOBSTETRICAL (SEPARATE PROCEDURE)",,,268.79,10059.0,52
CPT,57000,COLPOTOMY; WITH EXPLORATION,,,198.8,6226.0,52
CPT,57061,"DESTRUCTION OF VAGINAL LESION(S); SIMPLE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,113.79,6226.0,50
CPT,57065,"DESTRUCTION OF VAGINAL LESION(S); EXTENSIVE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,183.21,6226.0,52
CPT,57100,BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE),,,63.81,5681.0,52
CPT,57120,COLPOCLEISIS (LE FORT TYPE),,,522.44,10257.38,50
CPT,57135,EXCISION OF VAGINAL CYST OR TUMOR,,,185.15,6689.0,52
CPT,57155,INS TANDEM UTERI&/OVOID VAG BRACHY,2027.0,725.67,277.69,8807.75,63
CPT,57156,INS DEV AFTERLOAD VAG BRACHY,990.0,354.42,148.05,6689.0,63
CPT,57180,INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONTANEOUS OR TRAUMATIC NONOBSTETRICAL VAGINAL HEMORRHAGE (SEPARATE PROCEDURE),,,119.1,4664.0,52
CPT,57200,"COLPORRHAPHY, SUTURE OF INJURY OF VAGINA (NONOBSTETRICAL)",,,328.17,6226.0,52
CPT,57220,"PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL APPROACH (EG, KELLY URETHRAL PLICATION)",,,341.35,8807.75,52
CPT,57240,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed",,,602.81,10059.0,52
CPT,57250,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy",,,605.17,10059.0,52
CPT,57260,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;",,,764.09,10059.0,52
CPT,57265,"COMBINED ANTEROPOSTERIOR COLPORRHAPHY, INCLUDING CYSTOURETHROSCOPY, WHEN PERFORMED; WITH ENTEROCELE REPAIR",,,854.24,14124.0,52
CPT,57267,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)",,,243.16,11751.0,19
CPT,57268,"REPAIR OF ENTEROCELE, VAGINAL APPROACH (SEPARATE PROCEDURE)",,,498.97,8807.75,52
CPT,57282,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)",,,681.27,13802.9,50
CPT,57283,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)",,,685.88,13802.9,50
CPT,57288,"Sling operation for stress incontinence (e.g., fascia or synthetic)",,,730.29,11085.56,52
CPT,57289,"PEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHY",,,779.87,13056.25,52
CPT,57295,REVISION (INCLUDING REMOVAL) OF PROSTHETIC VAGINAL GRAFT; VAGINAL APPROACH,,,493.62,7704.0,52
CPT,57310,CLOSURE OF URETHROVAGINAL FISTULA;,,,485.52,13056.25,52
CPT,57410,PELVIC EXAMINATION UNDER ANESTHESIA (OTHER THAN LOCAL),,,103.82,6689.0,52
CPT,57415,REMOVAL OF IMPACTED VAGINAL FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA (OTHER THAN LOCAL),,,173.12,6689.0,52
CPT,57425,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)",,,953.06,18715.8,50
CPT,57454,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage,,,130.51,6689.0,52
CPT,57455,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix,,,105.81,5681.0,52
CPT,57500,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)",,,73.54,5681.0,52
CPT,57505,Endocervical curettage (not done as part of a dilation and curettage),,,107.94,5681.0,52
CPT,57520,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser",,,292.7,6689.0,52
CPT,57522,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision",,,251.8,6689.0,52
CPT,57555,"EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITH ANTERIOR AND/OR POSTERIOR REPAIR",,,608.74,8807.75,50
CPT,57720,"TRACHELORRHAPHY, PLASTIC REPAIR OF UTERINE CERVIX, VAGINAL APPROACH",,,329.83,7704.0,52
CPT,58100,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)",,,61.54,5681.0,104
CPT,58110,ENDOMETRIAL SAMPLING (BIOPSY) PERFORMED IN CONJUNCTION WITH COLPOSCOPY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,39.06,5681.0,14
CPT,58120,"DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)",,,229.71,6689.0,52
CPT,58140,"MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 1 TO 4 INTRAMURAL MYOMA(S) WITH TOTAL WEIGHT OF 250 G OR LESS AND/OR REMOVAL OF SURFACE MYOMAS; ABDOMINAL APPROACH",,,903.95,13802.9,15
CPT,58146,"MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 5 OR MORE INTRAMURAL MYOMAS AND/OR INTRAMURAL MYOMAS WITH TOTAL WEIGHT GREATER THAN 250 G, ABDOMINAL APPROACH",,,982.0,13802.9,15
CPT,58150,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);",,,996.47,13802.9,15
CPT,58260,"Vaginal hysterectomy, for uterus 250 g or less;",,,823.67,18194.0,52
CPT,58262,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)",,,910.04,18194.0,52
CPT,58263,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele",,,975.18,18194.0,52
CPT,58270,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele",,,877.13,18194.0,52
CPT,58291,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)",,,1217.49,13802.9,50
CPT,58300,INSERTION OF INTRAUTERINE DEVICE (IUD),,,49.12,5681.0,16
CPT,58301,ED REM IUD,643.0,158.82,64.47,5261.73,64
CPT,58301,REMOVAL OF INTRAUTERINE DEVICE (IUD),,,64.47,5681.0,52
CPT,58340,INJ SIS/HYSTEROSALPINGOGRAPHY,501.0,179.36,56.32,5681.0,120
CPT,58345,INTRO CATH FALLOPIAN TUBE BI,5103.0,1826.87,284.06,6226.0,72
CPT,58345,INTRO CATH FALLOPIAN TUBE LT,3402.0,1217.92,284.06,6226.0,72
CPT,58345,INTRO CATH FALLOPIAN TUBE RT,3402.0,1217.92,284.06,6226.0,72
CPT,58350,"CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIALS",,,93.63,8807.75,47
CPT,58353,"ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE",,,226.79,14124.0,52
CPT,58542,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,814.51,18715.8,52
CPT,58545,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas",,,884.53,18194.0,52
CPT,58546,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g",,,1090.23,18715.8,52
CPT,58550,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;",,,865.65,18194.0,52
CPT,58552,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,961.4,18715.8,52
CPT,58554,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)",,,1277.76,18715.8,52
CPT,58555,"Hysteroscopy, diagnostic (separate procedure)",,,147.46,6226.0,52
CPT,58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",,,225.2,7704.0,52
CPT,58559,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)",,,276.33,8807.75,52
CPT,58560,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)",,,304.3,8807.75,52
CPT,58561,"Hysteroscopy, surgical; with removal of leiomyomata",,,348.21,8807.75,52
CPT,58562,"HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF IMPACTED FOREIGN BODY",,,215.77,7704.0,52
CPT,58563,"Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)",,,239.25,18194.0,52
CPT,58570,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;",,,792.71,18715.8,52
CPT,58571,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,892.5,18715.8,52
CPT,58572,"LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G;",,,994.57,18715.8,52
CPT,58573,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)",,,1194.84,18715.8,52
CPT,58575,"LAPAROSCOPY, SURGICAL, TOTAL HYSTERECTOMY FOR RESECTION OF MALIGNANCY (TUMOR DEBULKING), WITH OMENTECTOMY INCLUDING SALPINGO-OOPHORECTOMY, UNILATERAL OR BILATERAL, WHEN PERFORMED",,,982.0,13802.9,15
CPT,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS",,,3668.82,10644.28,49
CPT,58579,"UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS",,,123.48,7704.0,49
CPT,58660,"LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) (SEPARATE PROCEDURE)",,,670.78,10644.28,52
CPT,58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",,,639.46,10644.28,52
CPT,58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",,,699.81,10644.28,52
CPT,58674,"LAPAROSCOPY, SURGICAL, ABLATION OF UTERINE FIBROID(S) INCLUDING INTRAOPERATIVE ULTRASOUND GUIDANCE AND MONITORING, RADIOFREQUENCY",,,797.0,18715.8,50
CPT,58679,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT, OVARY",,,3668.82,10644.28,49
CPT,58720,"SALPINGO-OOPHORECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)",,,746.63,13802.9,15
CPT,58925,"OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL",,,752.62,9728.0,50
CPT,58999,BX MASS CUFF VAGINAL NDL PERC,2983.0,1067.91,123.48,5681.0,62
CPT,58999,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)",,,123.48,5681.0,49
CPT,59000,AMNIOCENTESIS DIAGNOSTIC,1473.0,527.33,78.34,5681.0,126
CPT,59001,AMNIOCENTESIS THER US GD,2837.0,1015.65,172.43,5681.0,63
CPT,59020,TEST STRESS CONTRACTION FETAL,914.0,816.2,34.03,711.0,63
CPT,59025,TEST NONSTRESS FETAL,626.0,559.02,19.76,711.0,126
CPT,59074,DRN FLUID FETAL W US GD,1726.0,617.91,204.07,5681.0,63
CPT,59150,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHOUT SALPINGECTOMY AND/OR OOPHORECTOMY,,,774.66,10644.28,50
CPT,59151,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITH SALPINGECTOMY AND/OR OOPHORECTOMY,,,757.83,10644.28,50
CPT,59160,"Curettage, postpartum",,,184.52,7704.0,52
CPT,59200,INS DILATOR CERVICAL,1608.0,1004.1949999999999,42.9,5681.0,126
CPT,59300,"EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING",,,143.45,6689.0,100
CPT,59320,"CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL",,,147.04,6226.0,52
CPT,59412,"EXTERNAL CEPHALIC VERSION, WITH OR WITHOUT TOCOLYSIS",,,99.62,6226.0,48
CPT,59412,VERSION CEPHALIC EXTERNAL,2430.0,2165.13,99.62,5699.56,63
CPT,59414,DELIVERY OF PLACENTA,4275.0,3809.02,87.64,5699.56,63
CPT,59414,ED DELIVERY PLACENTA,4275.0,1055.92,87.64,5699.56,64
CPT,59514,Cesarean delivery only;,,,877.93,10257.38,10
CPT,59812,"Treatment of incomplete abortion, any trimester, completed surgically",,,301.71,10059.0,52
CPT,59820,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER",,,380.11,10059.0,52
CPT,59821,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER",,,371.19,10059.0,52
CPT,59840,"Induced abortion, by dilation and curettage",,,218.16,10059.0,52
CPT,59841,"Induced abortion, by dilation and evacuation",,,364.84,10059.0,52
CPT,59870,UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE,,,527.04,10059.0,52
CPT,59871,REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA (OTHER THAN LOCAL),,,129.58,10059.0,52
CPT,60100,BX THYROID NDL CORE PERC,1291.0,462.18,73.96,5681.0,189
CPT,60210,"PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY",,,692.43,10644.28,50
CPT,60212,"PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHMUSECTOMY",,,998.53,10644.28,50
CPT,60220,"Total thyroid lobectomy, unilateral; with or without isthmusectomy",,,692.32,10644.28,52
CPT,60225,"TOTAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHMUSECTOMY",,,918.06,10644.28,52
CPT,60240,"Thyroidectomy, total or complete",,,895.67,11751.0,50
CPT,60252,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection",,,1287.28,11751.0,50
CPT,60254,"THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITH RADICAL NECK DISSECTION",,,1624.71,13802.9,15
CPT,60260,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid",,,1062.18,10422.97,50
CPT,60271,"THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID; CERVICAL APPROACH",,,1029.28,13802.9,50
CPT,60281,EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS; RECURRENT,,,587.35,10644.28,52
CPT,60300,ASP&/INJ CYST THYROID,1291.0,462.18,46.82,5681.0,189
CPT,60500,Parathyroidectomy or exploration of parathyroid(s);,,,946.94,11751.0,50
CPT,60502,PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); RE-EXPLORATION,,,1270.35,18194.0,52
CPT,60512,PARATHYROID AUTOTRANSPLANTATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,233.3,7704.0,19
CPT,60520,"THYMECTOMY, PARTIAL OR TOTAL; TRANSCERVICAL APPROACH (SEPARATE PROCEDURE)",,,1020.64,13802.9,50
CPT,60650,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal",,,1157.25,13802.9,15
CPT,60699,ABL TUMOR/S ADRENAL MICROWAVE CT GD,7263.0,2600.15,1229.0,10644.28,62
CPT,61050,PUNCT C1-C2 WO INJ,778.0,278.52,77.65,5681.0,63
CPT,61055,PUNCT C1-C2 W INJ,1365.0,488.67,113.61,5681.0,189
CPT,61070,PUNCT SHUNT TUBE/RESV ASP/INJ,1276.0,456.81,54.62,5681.0,126
CPT,61070,Puncture of shunt tubing or reservoir for aspiration or injection procedure,,,54.62,5681.0,52
CPT,61500,CRANIECTOMY; WITH EXCISION OF TUMOR OR OTHER BONE LESION OF SKULL,,,1272.56,13802.9,15
CPT,61580,"CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL RHINOTOMY, ETHMOIDECTOMY, SPHENOIDECTOMY, WITHOUT MAXILLECTOMY OR ORBITAL EXENTERATION",,,982.0,13802.9,14
CPT,61600,"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF ANTERIOR CRANIAL FOSSA; EXTRADURAL",,,982.0,13802.9,14
CPT,61623,OCC EV ART BLN TEMP CNS W ANG,13803.0,4941.47,555.57,20325.69,63
CPT,61624,EMB/OCCL PERM TRANSCTH CNS IM GD,5818.0,2082.84,1119.88,32276.26,63
CPT,61626,EMB/OCCL PERM TRANSCTH NO CNS IM GD,5600.0,2004.8,872.13,20325.69,63
CPT,61630,PTA INTRACRANIAL PERC,15089.0,5401.86,982.0,13802.9,36
CPT,61635,PLC STNT/S INTRAVASC INTRACRN,16981.0,6079.2,982.0,13802.9,40
CPT,61640,DIL BLN VASO INTRACRN INIT S&I,13393.0,4794.69,458.14,10044.75,36
CPT,61641,DIL BLN VASO INTRACRN ADDL S&I,10045.0,3596.11,160.91,7533.75,36
CPT,61642,DIL BLN VASO INTRACRN ADD FAM S&I,10045.0,3596.11,321.81,7533.75,36
CPT,61645,THROMBECTOMY&/INF TRNSL ART PERC BI,7764.0,2779.51,812.51,10737.0,40
CPT,61645,THROMBECTOMY&/INF TRNSL ART PERC LT,5176.0,1853.01,812.51,10737.0,40
CPT,61645,THROMBECTOMY&/INF TRNSL ART PERC RT,5176.0,1853.01,812.51,10737.0,40
CPT,61650,ADM PRLNG AGNT RX INTRACRN EV INIT,4693.0,1680.09,560.84,15325.0,40
CPT,61651,ENDOVASCULAR PRLNG ADM RX AGNT ADDL,4157.0,1488.21,239.45,15325.0,40
CPT,61736,"LASER INTERSTITIAL THERMAL THERAPY (LITT) OF LESION, INTRACRANIAL, INCLUDING BURR HOLE(S), WITH MAGNETIC RESONANCE IMAGING GUIDANCE, WHEN PERFORMED; SINGLE TRAJECTORY FOR 1 SIMPLE LESION",,,982.0,7390.37,14
CPT,61737,"LASER INTERSTITIAL THERMAL THERAPY (LITT) OF LESION, INTRACRANIAL, INCLUDING BURR HOLE(S), WITH MAGNETIC RESONANCE IMAGING GUIDANCE, WHEN PERFORMED; MULTIPLE TRAJECTORIES FOR MULTIPLE OR COMPLEX LESIO",,,982.0,7390.37,14
CPT,61751,BX BRAIN STEREOTACTIC W CT,8235.0,2948.13,982.0,13802.9,40
CPT,61781,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (list separately in addition to code for primary procedure)",,,226.7,5681.0,14
CPT,61782,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (list separately in addition to code for primary procedure)",,,167.25,5681.0,14
CPT,61783,Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure),,,222.6,5681.0,14
CPT,61850,"TWIST DRILL OR BURR HOLE(S) FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CORTICAL",,,969.22,13802.9,14
CPT,61867,"TWIST DRILL, BURR HOLE, CRANIOTOMY, OR CRANIECTOMY WITH STEREOTACTIC IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY IN SUBCORTICAL SITE (EG, THALAMUS, GLOBUS PALLIDUS, SUBTHALAMIC NUCLEUS, PERIVENTRI",,,982.0,13802.9,14
CPT,61880,REVISION OR REMOVAL OF INTRACRANIAL NEUROSTIMULATOR ELECTRODES,,,579.76,10257.38,50
CPT,61885,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array",,,521.18,54330.72,52
CPT,61886,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays",,,869.02,54330.72,52
CPT,61888,REVISION OR REMOVAL OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER,,,390.96,19618.78,52
CPT,62140,CRANIOPLASTY FOR SKULL DEFECT; UP TO 5 CM DIAMETER,,,982.0,13802.9,14
CPT,62143,REPLACEMENT OF BONE FLAP OR PROSTHETIC PLATE OF SKULL,,,982.0,13802.9,14
CPT,62223,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus",,,982.0,13802.9,14
CPT,62230,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system",,,826.3,15451.52,52
CPT,62267,ASP INTERDISCAL DX PERC,2769.0,991.3,148.96,13802.9,126
CPT,62268,ASP CYST SPINAL CORD PERC,1822.0,652.28,319.3,5681.0,63
CPT,62269,BX CORD SPINAL NDL PERC,3006.0,1076.15,250.68,5681.0,63
CPT,62269,BX SPINAL CORD NDL PERC,3006.0,1076.15,250.68,5681.0,63
CPT,62270,PUNCT LUMBAR DIAGNOSTIC,1604.0,702.55,61.59,5681.0,252
CPT,62272,PUNCT SPINE THER DRN CSF,1386.0,496.19,88.71,5681.0,63
CPT,62273,ED INJ EPID PATCH BLOOD/CLOT,1604.0,396.19,110.28,2503.0,64
CPT,62273,INJ EPID PATCH BLOOD/CLOT,1604.0,702.55,110.28,5681.0,378
CPT,62280,INJ/INF NEUROLYTIC SUBARACHNOID,1807.0,646.91,156.24,5681.0,126
CPT,62281,INJ/INF NEUROLYTIC EPIDURAL C/T,1822.0,652.28,151.88,5681.0,189
CPT,62282,INJ/INF NEUROLYTIC EPIDURAL L/S,1980.0,708.84,138.66,5681.0,189
CPT,62284,INJ MYELOGRAM&/CT LUMBAR,660.0,236.28,80.44,5681.0,120
CPT,62290,INJ DISCOGRAM LUMBAR,659.0,235.92,122.57,5681.0,40
CPT,62291,INJ DISCOGRAM CERVICAL/THORACIC,618.0,221.24,114.95,5681.0,40
CPT,62302,INJ LUMB MYELOGRPHY CERVICAL S&I,1847.0,661.23,114.94,8022.0,63
CPT,62303,INJ LUMB MYELOGRPHY THORACIC S&I,1648.0,589.98,114.98,8022.0,63
CPT,62304,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,1755.0,628.29,113.61,8022.0,189
CPT,62305,INJ LUMB MYELOGRPHY 2+ S&I,2077.0,743.57,117.91,8022.0,126
CPT,62320,INJ/S EPID/SUB C/T WO IMG,1308.0,468.26,97.21,5681.0,126
CPT,62321,INJ/S EPID/SUB C/T W IMG,1867.0,668.39,104.71,5681.0,126
CPT,62322,INJ/S EPID/SUB L/S WO IMG,1412.0,505.5,77.2,5681.0,189
CPT,62323,INJ/S EPID/SUB L/S W IMG,1867.0,668.39,96.84,5681.0,126
CPT,62325,INJ/S PLC CATH EPID/SUB C/T W IMG,2469.0,883.9,107.48,5681.0,63
CPT,62327,INJ/S PLC CATH EPID/SUB L/S W IMG,2469.0,883.9,104.63,5681.0,63
CPT,62328,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,1604.0,1562.17,82.54,5681.0,126
CPT,62329,PUNCT SPINE THER DRN CSF W FL/CT GD,1604.0,574.23,100.77,5681.0,126
CPT,62350,IMP/REV/REPOS CATH IT/EPIDURAL,8872.0,3176.18,390.92,15451.52,126
CPT,62361,IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; NONPROGRAMMABLE PUMP,,,429.39,31734.35,52
CPT,62362,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming",,,378.42,31734.35,52
CPT,62365,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion",,,293.25,10065.0,52
CPT,63001,"LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), 1 OR 2 VERTEBRAL SEGMENTS; CERVICAL",,,1203.96,18194.0,52
CPT,63003,"LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), 1 OR 2 VERTEBRAL SEGMENTS; THORACIC",,,1208.7,18194.0,52
CPT,63012,"LAMINECTOMY WITH REMOVAL OF ABNORMAL FACETS AND/OR PARS INTER-ARTICULARIS WITH DECOMPRESSION OF CAUDA EQUINA AND NERVE ROOTS FOR SPONDYLOLISTHESIS, LUMBAR (GILL TYPE PROCEDURE)",,,1169.44,18194.0,52
CPT,63015,"LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), MORE THAN 2 VERTEBRAL SEGMENTS; CERVICAL",,,1450.28,18194.0,52
CPT,63020,"LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, CERVICAL",,,1076.72,18194.0,52
CPT,63030,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar",,,898.16,18194.0,52
CPT,63035,"LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; EACH ADDITIONAL INTERSPACE, CERVICAL OR",,,224.88,18194.0,21
CPT,63042,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,1268.1,18194.0,52
CPT,63045,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [e.g., spinal or lateral recess stenosis]), single vertebral se",,,1261.33,18194.0,52
CPT,63046,"LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S], [EG, SPINAL OR LATERAL RECESS STENOSIS]), SINGLE VERTEBRAL SEGM",,,1204.82,18194.0,52
CPT,63047,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [e.g., spinal or lateral recess stenosis]), single vertebral se",,,1083.8,18194.0,52
CPT,63048,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [e.g., spinal or lateral recess stenosis]), single vertebral se",,,202.89,18194.0,21
CPT,63267,"LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; LUMBAR",,,1343.6,18194.0,52
CPT,63268,"LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; SACRAL",,,1435.16,18194.0,52
CPT,63655,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural",,,824.56,34157.51,52
CPT,63661,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed",,,323.05,14124.0,52
CPT,63662,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed",,,836.84,14124.0,52
CPT,63664,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed",,,870.87,19618.78,52
CPT,63685,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,333.49,54330.72,52
CPT,63688,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array",,,294.57,7697.0,52
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR BI,1977.0,488.32,50.08,2503.0,41
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR LT,1318.0,325.55,50.08,2503.0,41
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR RT,1318.0,325.55,50.08,2503.0,41
CPT,64400,INJ/S ANES NRV TRIGEMINAL BR EA,1318.0,471.84,50.08,5681.0,63
CPT,64405,INJ/S ANES NRV OCCIPITAL GREAT BI,1920.0,687.36,51.18,5681.0,40
CPT,64405,INJ/S ANES NRV OCCIPITAL GREAT LT,1280.0,458.24,51.18,5681.0,40
CPT,64405,INJ/S ANES NRV OCCIPITAL GREAT RT,1280.0,458.24,51.18,5681.0,40
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL BI,2348.0,840.58,56.64,5681.0,80
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL LT,1565.0,560.27,56.64,5681.0,80
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL RT,1565.0,560.27,56.64,5681.0,80
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD BI,2937.0,1051.45,24.23,5681.0,80
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD LT,1958.0,700.96,24.23,5681.0,80
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD RT,1958.0,700.96,24.23,5681.0,80
CPT,64430,"INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; PUDENDAL NERVE",,,53.25,5681.0,52
CPT,64445,INJ/S ANES NRV SCIATIC W IMG BI,2406.0,861.35,70.05,5681.0,40
CPT,64445,INJ/S ANES NRV SCIATIC W IMG LT,1604.0,574.23,70.05,5681.0,40
CPT,64445,INJ/S ANES NRV SCIATIC W IMG RT,1604.0,574.23,70.05,5681.0,40
CPT,64447,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed",,,61.36,4664.0,52
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER,1386.0,717.95,40.83,1603.86,63
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER BI,2079.0,744.28,40.83,5681.0,40
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER LT,1386.0,496.19,40.83,5681.0,40
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER RT,1386.0,496.19,40.83,5681.0,40
CPT,64451,INJ/S ANES NRV JT SI W FL/CT GD BI,1692.0,605.74,79.57,5681.0,80
CPT,64451,INJ/S ANES NRV JT SI W FL/CT GD LT,1128.0,403.82,79.57,5681.0,80
CPT,64451,INJ/S ANES NRV JT SI W FL/CT GD RT,1128.0,403.82,79.57,5681.0,80
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGBI,1692.0,605.74,80.22,5681.0,40
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGLT,1128.0,403.82,80.22,5681.0,40
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGRT,1128.0,403.82,80.22,5681.0,40
CPT,64466,"THORACIC FASCIAL PLANE BLOCK, UNILATERAL; BY INJECTION(S), INCLUDING IMAGING GUIDANCE, WHEN PERFORMED",,,76.35,5681.0,13
CPT,64479,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,3932.0,1407.66,127.31,5681.0,120
CPT,64479,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2621.0,938.32,127.31,5681.0,120
CPT,64479,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2621.0,938.32,127.31,5681.0,120
CPT,64480,INJ/S EPID TRFR C/T FL/CT GD ADD BI,2046.0,732.47,59.3,5681.0,40
CPT,64480,INJ/S EPID TRFR C/T FL/CT GD ADD LT,1364.0,488.31,59.3,5681.0,40
CPT,64480,INJ/S EPID TRFR C/T FL/CT GD ADD RT,1364.0,488.31,59.3,5681.0,40
CPT,64483,INJ/S EPID TRFR L/S FL/CT GD 1LV BI,3699.0,1324.24,108.61,5681.0,80
CPT,64483,INJ/S EPID TRFR L/S FL/CT GD 1LV LT,2466.0,882.83,108.61,5681.0,80
CPT,64483,INJ/S EPID TRFR L/S FL/CT GD 1LV RT,2466.0,882.83,108.61,5681.0,80
CPT,64484,INJ/S EPID TRFR L/S FL/CT GD ADD BI,1752.0,627.22,50.09,5681.0,40
CPT,64484,INJ/S EPID TRFR L/S FL/CT GD ADD LT,1168.0,418.14,50.09,5681.0,40
CPT,64484,INJ/S EPID TRFR L/S FL/CT GD ADD RT,1168.0,418.14,50.09,5681.0,40
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL BI,1427.0,510.87,102.7,5681.0,120
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL LT,951.0,340.46,102.7,5681.0,120
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL RT,951.0,340.46,102.7,5681.0,120
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL BI,1253.0,448.57,57.6,5681.0,120
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL LT,835.0,298.93,57.6,5681.0,120
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL RT,835.0,298.93,57.6,5681.0,120
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL BI,1365.0,488.67,58.58,5681.0,120
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL LT,910.0,325.78,58.58,5681.0,120
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL RT,910.0,325.78,58.58,5681.0,120
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL BI,4019.0,1438.8,88.29,5681.0,120
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL LT,2679.0,959.08,88.29,5681.0,120
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL RT,2679.0,959.08,88.29,5681.0,120
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL BI,1421.0,508.72,49.44,5681.0,120
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL LT,947.0,339.03,49.44,5681.0,120
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL RT,947.0,339.03,49.44,5681.0,120
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL BI,1445.0,517.31,50.41,5681.0,120
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL LT,963.0,344.75,50.41,5681.0,120
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL RT,963.0,344.75,50.41,5681.0,120
CPT,64505,INJ ANES GANGLION SPHENO BI,1215.0,434.97,102.52,5681.0,120
CPT,64505,INJ ANES GANGLION SPHENO LT,810.0,289.98,102.52,5681.0,120
CPT,64505,INJ ANES GANGLION SPHENO RT,810.0,289.98,102.52,5681.0,120
CPT,64510,INJ ANES GANGLION STELLA,2187.0,1132.87,75.18,3151.58,63
CPT,64510,INJ ANES GANGLION STELLA BI,3281.0,1174.6,75.18,5681.0,40
CPT,64510,INJ ANES GANGLION STELLA LT,2187.0,782.95,75.18,5681.0,40
CPT,64510,INJ ANES GANGLION STELLA RT,2187.0,782.95,75.18,5681.0,40
CPT,64517,INJ ANES PLEXUS HYPOGASTRIC,1626.0,582.11,123.1,6689.0,126
CPT,64520,INJ ANES LUMB/THOR SYMPATHETIC,1866.0,668.03,83.04,5681.0,126
CPT,64530,INJ ANES PLEXUS CELIAC,1822.0,652.28,92.23,5681.0,189
CPT,64561,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed",,,295.59,11220.84,52
CPT,64568,"OPEN IMPLANTATION OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR",,,591.42,77552.01,50
CPT,64569,"REVISION OR REPLACEMENT OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY, INCLUDING CONNECTION TO EXISTING PULSE GENERATOR",,,755.9,19618.78,52
CPT,64570,"REMOVAL OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR",,,725.84,18194.0,52
CPT,64582,"OPEN IMPLANTATION OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY",,,819.04,54330.72,50
CPT,64584,"REMOVAL OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY",,,713.42,10257.38,50
CPT,64590,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,287.88,34157.51,52
CPT,64595,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array",,,224.52,7697.0,52
CPT,64611,CHEMODENERV GLANDS PAR&SUBMAND BI,974.0,348.69,110.57,5681.0,63
CPT,64612,CHEMODENERV MUSC/S NRV FAC UNI,585.0,209.43,116.8,5681.0,63
CPT,64612,"CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL NERVE, UNILATERAL (EG, FOR BLEPHAROSPASM, HEMIFACIAL SPASM)",,,116.8,5681.0,52
CPT,64615,CHEMODENERV MUSC/S FAC/TRI/CERV BI,591.0,211.58,119.09,5681.0,63
CPT,64615,"CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL, TRIGEMINAL, CERVICAL SPINAL AND ACCESSORY NERVES, BILATERAL (EG, FOR CHRONIC MIGRAINE)",,,119.09,5681.0,52
CPT,64620,DST NRV INTERCOSTAL,2290.0,819.82,173.7,5681.0,126
CPT,64624,"DESTRUCTION BY NEUROLYTIC AGENT, GENICULAR NERVE BRANCHES INCLUDING IMAGING GUIDANCE, WHEN PERFORMED",,,142.66,6226.0,52
CPT,64624,DST NRV BR GENICULAR INCL IMG GD BI,4728.0,1692.62,142.66,6226.0,80
CPT,64624,DST NRV BR GENICULAR INCL IMG GD LT,3152.0,1128.42,142.66,6226.0,80
CPT,64624,DST NRV BR GENICULAR INCL IMG GD RT,3152.0,1128.42,142.66,6226.0,80
CPT,64625,ABL RF JOINT SI INCL IMG GD BI,4640.0,1661.12,191.07,14124.0,160
CPT,64625,ABL RF JOINT SI INCL IMG GD LT,3093.0,1107.29,191.07,14124.0,160
CPT,64625,ABL RF JOINT SI INCL IMG GD RT,3093.0,1107.29,191.07,14124.0,160
CPT,64628,DST NRV BV IO L/S IMG GD LVL 1-2,11313.0,4050.05,403.8,22604.88,63
CPT,64629,DST NRV BV IO L/S IMG GD ADDL LVL,4376.0,1566.61,190.99,5681.0,38
CPT,64630,DESTRUCTION BY NEUROLYTIC AGENT; PUDENDAL NERVE,,,186.82,6689.0,52
CPT,64630,DST NRV PUDENDAL,1822.0,652.28,186.82,6689.0,63
CPT,64640,DST NRV PERIPH/BRANCH BI,2733.0,978.41,116.34,5681.0,40
CPT,64640,DST NRV PERIPH/BRANCH LT,1822.0,652.28,116.34,5681.0,40
CPT,64640,DST NRV PERIPH/BRANCH RT,1822.0,652.28,116.34,5681.0,40
CPT,64643,"CHEMODENERVATION OF ONE EXTREMITY; EACH ADDITIONAL EXTREMITY, 1-4 MUSCLE(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,67.88,5681.0,14
CPT,64644,CHEMODENERVATION OF ONE EXTREMITY; 5 OR MORE MUSCLES,,,112.85,5681.0,52
CPT,64646,CHEMODENERVATION OF TRUNK MUSCLE(S); 1-5 MUSCLE(S),,,112.79,5681.0,52
CPT,64647,CHEMODENERVATION OF TRUNK MUSCLE(S); 6 OR MORE MUSCLES,,,129.85,5681.0,52
CPT,64680,DST NRV PLEXUS CELIAC,2603.0,931.87,156.64,6689.0,63
CPT,64681,DST NRV PLEXUS HYPOGASTRIC SUPERIOR,4511.0,1614.94,213.34,6689.0,63
CPT,64702,"NEUROPLASTY; DIGITAL, 1 OR BOTH, SAME DIGIT",,,509.19,6226.0,52
CPT,64708,"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG, OPEN; OTHER THAN SPECIFIED",,,503.23,6689.0,52
CPT,64713,"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG, OPEN; BRACHIAL PLEXUS",,,786.87,6689.0,52
CPT,64718,NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW,,,597.58,6689.0,52
CPT,64719,Neuroplasty and/or transposition; ulnar nerve at wrist,,,404.62,6689.0,52
CPT,64721,Neuroplasty and/or transposition; median nerve at carpal tunnel,,,434.0,6689.0,52
CPT,64722,DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY),,,366.49,6226.0,52
CPT,64727,"INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR NEUROPLASTY) (NEUROPLASTY INCLUDES EXTERNAL NEUROLYSIS)",,,173.91,5681.0,19
CPT,64738,TRANSECTION OR AVULSION OF; INFERIOR ALVEOLAR NERVE BY OSTEOTOMY,,,440.78,6689.0,52
CPT,64740,TRANSECTION OR AVULSION OF; LINGUAL NERVE,,,449.87,6689.0,52
CPT,64772,"Transection or avulsion of other spinal nerve, extradural",,,549.87,6689.0,52
CPT,64786,EXCISION OF NEUROMA; SCIATIC NERVE,,,978.46,8755.0,52
CPT,64787,IMPLANTATION OF NERVE END INTO BONE OR MUSCLE (LIST SEPARATELY IN ADDITION TO NEUROMA EXCISION),,,225.83,6689.0,19
CPT,64788,EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS NERVE,,,403.8,7704.0,52
CPT,64790,EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERAL NERVE,,,833.43,7704.0,52
CPT,64831,"SUTURE OF DIGITAL NERVE, HAND OR FOOT; 1 NERVE",,,683.92,8715.0,52
CPT,64836,SUTURE OF 1 NERVE; ULNAR MOTOR,,,801.38,8755.0,52
CPT,64857,"SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT SCIATIC; WITHOUT TRANSPOSITION",,,1028.22,8755.0,52
CPT,64905,NERVE PEDICLE TRANSFER; FIRST STAGE,,,977.88,15451.52,52
CPT,64907,NERVE PEDICLE TRANSFER; SECOND STAGE,,,1229.0,15451.52,52
CPT,64910,"NERVE REPAIR; WITH SYNTHETIC CONDUIT OR VEIN ALLOGRAFT (EG, NERVE TUBE), EACH NERVE",,,747.25,15451.52,52
CPT,64912,"NERVE REPAIR; WITH NERVE ALLOGRAFT, EACH NERVE, FIRST STRAND (CABLE)",,,875.64,15451.52,50
CPT,64999,ASP CYST PERINEURAL,1386.0,496.19,189.35,5681.0,62
CPT,64999,INJ ANES GANGLION IMPAR CT GD,1305.0,467.19,189.35,5681.0,62
CPT,64999,INJ ANES GANGLION IMPAR FLUORO GD,1305.0,467.19,189.35,5681.0,62
CPT,64999,RUPTURE CYST SYNOVIAL INJ,651.0,233.06,189.35,5681.0,62
CPT,64999,"UNLISTED PROCEDURE, NERVOUS SYSTEM",,,189.35,5681.0,49
CPT,65101,ENUCLEATION OF EYE; WITHOUT IMPLANT,,,830.24,7704.0,52
CPT,65103,"ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES NOT ATTACHED TO IMPLANT",,,857.1,7704.0,52
CPT,65105,"ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES ATTACHED TO IMPLANT",,,932.05,8715.0,52
CPT,65270,"REPAIR OF LACERATION; CONJUNCTIVA, WITH OR WITHOUT NONPERFORATING LACERATION SCLERA, DIRECT CLOSURE",,,136.36,6689.0,52
CPT,65280,"REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, NOT INVOLVING UVEAL TISSUE",,,650.53,9369.15,52
CPT,66680,"REPAIR OF IRIS, CILIARY BODY (AS FOR IRIDODIALYSIS)",,,507.05,7704.0,52
CPT,67400,"ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); FOR EXPLORATION, WITH OR WITHOUT BIOPSY",,,1009.82,7704.0,52
CPT,67450,"ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); FOR EXPLORATION, WITH OR WITHOUT BIOPSY",,,1356.1,10059.0,52
CPT,67550,ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); INSERTION,,,1056.14,8715.0,52
CPT,67560,ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); REMOVAL OR REVISION,,,1079.89,7697.0,52
CPT,67715,CANTHOTOMY (SEPARATE PROCEDURE),,,104.59,6226.0,52
CPT,67900,"REPAIR OF BROW PTOSIS (SUPRACILIARY, MID-FOREHEAD OR CORONAL APPROACH)",,,490.66,8715.0,52
CPT,67904,"REPAIR OF BLEPHAROPTOSIS; (TARSO) LEVATOR RESECTION OR ADVANCEMENT, EXTERNAL APPROACH",,,578.03,8715.0,52
CPT,67906,REPAIR OF BLEPHAROPTOSIS; SUPERIOR RECTUS TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FASCIA),,,489.77,10059.0,52
CPT,67912,"CORRECTION OF LAGOPHTHALMOS, WITH IMPLANTATION OF UPPER EYELID LID LOAD (EG, GOLD WEIGHT)",,,471.82,7704.0,52
CPT,67973,"RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; TOTAL EYELID, LOWER, 1 STAGE OR FIRST STAGE",,,896.06,7704.0,52
CPT,68525,BIOPSY OF LACRIMAL SAC,,,248.73,6226.0,52
CPT,68700,PLASTIC REPAIR OF CANALICULI,,,585.0,6689.0,52
CPT,68720,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity),,,788.46,8715.0,52
CPT,68815,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent",,,216.21,6689.0,52
CPT,69005,"DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED",,,159.17,5681.0,50
CPT,69110,"EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR",,,322.48,5681.0,52
CPT,69145,"EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL",,,254.11,6689.0,52
CPT,69205,REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA,,,93.79,5681.0,52
CPT,69210,REM CERUMEN IMPACTED W INST BI,426.0,220.67,31.67,319.5,63
CPT,69210,REM CERUMEN IMPACTED W INST UNI,284.0,147.11,31.67,283.97,63
CPT,69424,VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA,,,59.37,7697.0,52
CPT,69436,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia",,,157.59,7704.0,52
CPT,70030,XR EYE FOREIGN BODY LT,189.0,53.3,23.66,333.39,40
CPT,70030,XR EYE FOREIGN BODY RT,189.0,53.3,23.66,333.39,40
CPT,70100,XR MANDIBLE PARTIAL 1-3 VW,223.0,62.89,29.49,333.39,63
CPT,70110,XR MANDIBLE CMP 4+ VW,345.0,97.29,31.11,449.06,63
CPT,70120,XR MASTOIDS 0-2 VW PER SIDE LT,334.0,94.19,28.84,449.06,40
CPT,70120,XR MASTOIDS 0-2 VW PER SIDE RT,334.0,94.19,28.84,449.06,40
CPT,70130,XR MASTOIDS CMP 3+ VW PER SIDE LT,836.0,235.75,44.75,627.0,40
CPT,70130,XR MASTOIDS CMP 3+ VW PER SIDE RT,836.0,235.75,44.75,627.0,40
CPT,70134,XR MEATI AUDITORY INTERNAL CMP,766.0,216.01,43.78,1989.95,63
CPT,70140,XR BONES FACIAL 0-2 VW,285.0,80.37,22.02,333.39,63
CPT,70150,XR BONES FACIAL CMP 3+ VW,351.0,98.98,34.04,449.06,63
CPT,70160,XR BONES NASAL CMP 3+ VW,301.0,84.88,28.85,333.39,63
CPT,70200,XR ORBITS CMP 4+ VW,282.0,79.52,33.72,449.06,63
CPT,70210,XR SINUSES PARANASAL 0-2 VW,235.0,66.27,23.32,333.39,63
CPT,70220,XR SINUSES PARANASAL CMP 3+ VW,267.0,75.29,26.58,333.39,63
CPT,70250,XR SKULL 0-3 VW,338.0,95.32,26.57,449.06,63
CPT,70260,XR SKULL CMP 4+ VW,384.0,108.29,30.47,449.06,63
CPT,70328,XR TMJ MOUTH OPEN&CLOSE LT,208.0,58.66,25.27,333.39,40
CPT,70328,XR TMJ MOUTH OPEN&CLOSE RT,208.0,58.66,25.27,333.39,40
CPT,70330,XR TMJ MOUTH OPEN&CLOSE BI,377.0,106.31,40.53,333.39,63
CPT,70336,MRI JOINT TEMPOROMANDIBULAR BI,2258.0,433.54,166.84,1693.5,61
CPT,70336,MRI JOINT TEMPOROMANDIBULAR LT,1505.0,288.96,166.84,1618.0,38
CPT,70336,MRI JOINT TEMPOROMANDIBULAR RT,1505.0,288.96,166.84,1618.0,38
CPT,70355,ORTHOPANTOGRAM,190.0,53.58,8.4,333.39,63
CPT,70360,XR TISSUE SOFT NECK,237.0,66.83,22.03,333.39,63
CPT,70370,XR PHARYNX/LARYNX W FLUORO,505.0,142.41,58.65,484.2,63
CPT,70371,EVAL SPEECH COMPLEX CINE/VIDEO,486.0,137.05,66.49,948.33,63
CPT,70380,XR GLAND SALIVARY CALCULUS,235.0,66.27,28.85,333.39,63
CPT,70390,SIALOGRAPHY LT S&I,688.0,194.02,95.38,948.33,40
CPT,70390,SIALOGRAPHY RT S&I,688.0,194.02,95.38,948.33,40
CPT,70450,CT HEAD WO CNT,1626.0,271.54,67.14,1219.5,126
CPT,70460,CT HEAD W CNT,2033.0,339.51,96.35,1524.75,126
CPT,70470,CT HEAD W&WO CNT,2439.0,407.31,115.14,1829.25,126
CPT,70471,CTA HEAD&NECK W&WO CNT&PP,4083.0,698.19,258.41,3062.25,62
CPT,70472,CT PERFUSION CEREBRAL W CNT ADD-ON,1221.0,208.79,175.95,1218.0,34
CPT,70473,CT PERFUSION CEREBRAL W CNT,1886.0,322.51,129.92,1414.5,62
CPT,70480,CT ORB/PF/SEL/IAC WO CNT,1239.0,206.91,79.0,1218.0,63
CPT,70481,CT ORB/PF/SEL/IAC W CNT,1549.0,258.68,128.77,1218.0,63
CPT,70482,CT ORB/PF/SEL/IAC W&WO CNT,1859.0,310.45,129.45,1394.25,126
CPT,70486,CT MAXFACIAL WO CNT,1083.0,180.86,79.0,1218.0,126
CPT,70487,CT MAXFACIAL W CNT,1354.0,226.12,100.53,1218.0,126
CPT,70488,CT MAXFACIAL W&WO CNT,1625.0,271.38,126.17,1218.75,126
CPT,70490,CT NECK ST WO CNT,966.0,161.32,79.0,1218.0,126
CPT,70491,CT NECK ST W CNT,1208.0,201.74,120.98,1218.0,126
CPT,70492,CT NECK ST W&WO CNT,1449.0,241.98,129.45,1218.0,126
CPT,70496,CTA HEAD W CNT&PP,2561.0,427.69,129.45,1920.75,126
CPT,70498,CTA NECK W CNT&PP,1522.0,254.17,129.45,1418.01,126
CPT,70540,MRI ORBIT FACE&/NECK WO CNT,1329.0,211.31,165.12,1618.0,61
CPT,70542,MRI ORBIT FACE&/NECK W CNT,1662.0,264.26,194.94,1618.0,61
CPT,70543,MRI ORBIT FACE&/NECK W&WO CNT,1994.0,317.05,241.34,1885.71,61
CPT,70544,MRA HEAD WO CNT,2067.0,415.47,161.18,1618.0,61
CPT,70545,MRA HEAD W CNT,2584.0,519.38,172.87,1938.0,61
CPT,70546,MRA HEAD W&WO CNT,3101.0,623.3,262.72,2325.75,61
CPT,70547,MRA NECK WO CNT,1791.0,359.99,161.51,1618.0,61
CPT,70548,MRA NECK W CNT,2239.0,450.04,177.73,1679.25,61
CPT,70549,MRA NECK W&WO CNT,2687.0,540.09,264.03,2062.39,61
CPT,70551,MRI BRAIN WO CNT,2004.0,318.64,128.76,1618.0,61
CPT,70552,MRI BRAIN W CNT,2505.0,398.3,189.42,1878.75,61
CPT,70553,MRI BRAIN W&WO CNT,3006.0,477.95,214.41,2254.5,61
CPT,70554,MRI FUNCTIONAL BRAIN BY TECH,2221.0,426.43,166.84,2215.65,61
CPT,70555,MRI FUNCTIONAL BRAIN W PHYS,1489.0,285.89,166.84,1618.0,61
CPT,70557,MRI BRAIN OPEN WO CNT,3915.0,622.48,350.1,4414.93,61
CPT,70558,MRI BRAIN OPEN W CNT,4894.0,778.15,129.45,3670.5,61
CPT,70559,MRI BRAIN OPEN W&WO CNT,5873.0,933.81,129.45,4404.75,61
CPT,71045,XR CHEST 1 VW,368.0,88.32,16.84,333.39,63
CPT,71046,XR CHEST 2 VW,443.0,106.32,22.68,333.39,63
CPT,71047,XR CHEST 3 VW,495.0,118.8,28.52,371.25,63
CPT,71048,XR CHEST 4+ VW,599.0,143.76,30.47,449.25,63
CPT,71100,XR RIBS 2 VW LT,192.0,54.14,25.6,333.39,40
CPT,71100,XR RIBS 2 VW RT,192.0,54.14,25.6,333.39,40
CPT,71101,XR RIBS W CXR 3+ VW,216.0,60.91,28.84,449.06,63
CPT,71110,XR RIBS 3+ VW BI,306.0,86.29,29.49,449.06,63
CPT,71111,XR RIBS W CXR 4+ VW BI,462.0,130.28,36.3,449.06,63
CPT,71120,XR STERNUM 2+ VW,235.0,66.27,23.66,333.39,63
CPT,71130,XR JT/S STERNOCLAVICULAR 3+ VW,275.0,77.55,30.15,333.39,63
CPT,71250,CT CHEST DX WO CNT,1526.0,253.32,79.0,1218.0,126
CPT,71260,CT CHEST DX W CNT,1908.0,316.73,113.51,1431.0,126
CPT,71270,CT CHEST DX W&WO CNT,2289.0,379.97,129.45,1716.75,126
CPT,71271,CT LOW DOSE SCRN CA LUNG WO CNT,538.0,89.31,79.0,1218.0,126
CPT,71275,CTA CHEST W CNT&PP,2404.0,399.06,129.45,1803.0,126
CPT,71550,MRI CHEST WO CNT,1908.0,366.34,166.84,1927.95,61
CPT,71551,MRI CHEST W CNT,2385.0,457.92,295.23,2311.1,61
CPT,71552,MRI CHEST W&WO CNT,2862.0,549.5,266.89,2818.12,61
CPT,71555,MRA CHEST W CNT,2505.0,483.46,252.66,1993.67,38
CPT,71555,MRA CHEST W/WO CNT,3006.0,580.16,252.66,2254.5,38
CPT,71555,MRA CHEST WO CNT,2004.0,386.77,252.66,1993.67,38
CPT,72020,XR SPINE 1 VW,202.0,56.96,16.18,333.39,126
CPT,72040,XR SPINE CERVICAL 2-3 VW,293.0,82.63,28.19,333.39,63
CPT,72050,XR SPINE CERVICAL 4-5 VW,402.0,113.36,39.88,449.06,63
CPT,72052,XR SPINE CERVICAL 6+ VW,463.0,130.57,47.02,449.06,63
CPT,72070,XR SPINE THORACIC 2 VW,284.0,80.09,22.68,449.06,63
CPT,72072,XR SPINE THORACIC 3 VW,345.0,97.29,28.19,449.06,63
CPT,72074,XR SPINE THORACIC 4+ VW,398.0,112.24,32.09,449.06,63
CPT,72080,XR SPINE THORACOLUMBAR => 2 VW,300.0,84.6,23.98,333.39,63
CPT,72081,XR SPINE ENTIRE THOR&LUMB 1 VW,360.0,101.52,29.5,333.39,63
CPT,72082,XR SPINE ENTIRE THOR&LUMB 2-3 VW,384.0,108.29,53.84,449.06,63
CPT,72083,XR SPINE ENTIRE THOR&LUMB 4-5 VW,445.0,125.49,60.65,449.06,63
CPT,72084,XR SPINE ENTIRE THOR&LUMB 6+ VW,530.0,149.46,76.84,451.6,63
CPT,72100,XR SPINE LS 2-3 VW,345.0,97.29,28.52,449.06,63
CPT,72110,XR SPINE LS 4+ VW,392.0,110.54,38.59,449.06,63
CPT,72114,XR SPINE LS CMP W BEND 6+ VW,413.0,116.47,45.73,449.06,63
CPT,72125,CT SPINE CERVICAL WO CNT,1718.0,285.19,79.0,1288.5,126
CPT,72126,CT SPINE CERVICAL W CNT,2148.0,356.57,112.87,1611.0,126
CPT,72127,CT SPINE CERVICAL W&WO CNT,2577.0,427.78,129.45,1932.75,126
CPT,72128,CT SPINE THORACIC WO CNT,1711.0,284.03,79.0,1283.25,126
CPT,72129,CT SPINE THORACIC W CNT,2139.0,355.07,113.83,1604.25,126
CPT,72130,CT SPINE THORACIC W&WO CNT,2567.0,426.12,129.45,1925.25,126
CPT,72131,CT SPINE LUMBAR WO CNT,1686.0,279.88,79.0,1264.5,126
CPT,72132,CT SPINE LUMBAR W CNT,2108.0,349.93,113.19,1581.0,126
CPT,72133,CT SPINE LUMBAR W&WO CNT,2529.0,419.81,129.45,1896.75,126
CPT,72141,MRI SPINE CERVICAL WO CNT,1973.0,284.11,123.25,1618.0,61
CPT,72142,MRI SPINE CERVICAL W CNT,2467.0,355.25,193.96,1850.25,61
CPT,72146,MRI SPINE THORACIC WO CNT,1645.0,236.88,122.92,1618.0,61
CPT,72147,MRI SPINE THORACIC W CNT,2057.0,296.21,192.01,1618.0,61
CPT,72148,MRI SPINE LUMBAR WO CNT,1953.0,281.23,123.58,1618.0,61
CPT,72149,MRI SPINE LUMBAR W CNT,2442.0,351.65,189.42,1831.5,61
CPT,72156,MRI SPINE CERVICAL W&WO CNT,2960.0,426.24,215.71,2220.0,61
CPT,72157,MRI SPINE THORACIC W&WO CNT,2468.0,355.39,216.35,1851.0,61
CPT,72158,MRI SPINE LUMBAR W&WO CNT,2930.0,421.92,215.06,2197.5,61
CPT,72159,MRA SPINE W CNT,2591.0,500.06,263.7,2017.49,38
CPT,72159,MRA SPINE W/WO CNT,3108.0,599.84,263.7,2331.0,38
CPT,72159,MRA SPINE WO CNT,2072.0,399.9,263.7,2017.49,38
CPT,72170,XR PELVIS 1-2 VW,329.0,92.78,19.1,449.06,63
CPT,72190,XR PELVIS CMP 3+ VW,339.0,95.6,29.5,449.06,63
CPT,72191,CTA PELVIS W CNT&PP,2006.0,333.0,129.45,1504.5,126
CPT,72192,CT PELVIS WO CNT,1273.0,211.32,79.0,1218.0,126
CPT,72193,CT PELVIS W CNT,1592.0,264.27,129.45,1362.8,126
CPT,72194,CT PELVIS W&WO CNT,1910.0,317.06,129.45,1432.5,126
CPT,72195,MRI PELVIS WO CNT,1517.0,291.26,162.52,1618.0,61
CPT,72196,MRI PELVIS W CNT,1897.0,364.22,190.07,1618.0,61
CPT,72197,MRI PELVIS W&WO CNT,2276.0,436.99,237.13,1843.4,61
CPT,72198,MRA PELVIS W CNT,1992.0,384.46,257.21,2012.16,38
CPT,72198,MRA PELVIS W/WO CNT,2390.0,461.27,257.21,2012.16,38
CPT,72198,MRA PELVIS WO CNT,1593.0,307.45,257.21,2012.16,38
CPT,72200,XR JTS SACROILIAC 1-2 VW,212.0,59.78,24.63,449.06,63
CPT,72202,XR JTS SACROILIAC 3+ VW,308.0,86.86,27.87,449.06,63
CPT,72220,XR SACRUM&COCCYX 2+ VW,253.0,71.35,23.65,333.39,63
CPT,72240,MYELOGRAPHY CERVICAL S&I,1391.0,392.26,67.15,2947.19,63
CPT,72255,MYELOGRAPHY THORACIC S&I,1392.0,392.54,63.25,2947.19,63
CPT,72265,MYELOGRAPHY LUMBOSACRAL S&I,1391.0,392.26,67.79,2947.19,63
CPT,72270,MYELOGRAPHY 2+ REGIONS S&I,1928.0,543.7,85.97,2947.19,63
CPT,72295,DISCOGRAM LUMBAR S&I,3093.0,872.23,70.39,7229.66,126
CPT,73000,XR CLAVICLE CMP LT,238.0,67.12,23.98,333.39,40
CPT,73000,XR CLAVICLE CMP RT,238.0,67.12,23.98,333.39,40
CPT,73010,XR SCAPULA CMP LT,290.0,81.78,14.89,449.06,40
CPT,73010,XR SCAPULA CMP RT,290.0,81.78,14.89,449.06,40
CPT,73020,XR SHOULDER 1 VW LT,252.0,71.06,13.92,333.39,40
CPT,73020,XR SHOULDER 1 VW RT,252.0,71.06,13.92,333.39,40
CPT,73030,XR SHOULDER CMP 2+ VW LT,279.0,78.68,25.28,333.39,40
CPT,73030,XR SHOULDER CMP 2+ VW RT,279.0,78.68,25.28,333.39,40
CPT,73040,XR ARTHRO SHOULDER LT S&I,716.0,219.81,102.52,1516.98,40
CPT,73040,XR ARTHRO SHOULDER RT S&I,716.0,219.81,102.52,1516.98,40
CPT,73050,XR JTS ACROMIOCLAVICULAR BI,220.0,62.04,19.44,333.39,63
CPT,73060,XR HUMERUS 2 VW LT RDC,273.0,76.99,23.65,333.39,40
CPT,73060,XR HUMERUS 2 VW RT RDC,273.0,76.99,23.65,333.39,40
CPT,73060,XR HUMERUS 2+ VW LT,273.0,76.99,23.65,333.39,40
CPT,73060,XR HUMERUS 2+ VW RT,273.0,76.99,23.65,333.39,40
CPT,73070,XR ELBOW 2 VW LT,221.0,62.32,20.73,333.39,40
CPT,73070,XR ELBOW 2 VW LT RDC,221.0,62.32,20.73,333.39,40
CPT,73070,XR ELBOW 2 VW RT,221.0,62.32,20.73,333.39,40
CPT,73070,XR ELBOW 2 VW RT RDC,221.0,62.32,20.73,333.39,40
CPT,73080,XR ELBOW CMP 3+ VW LT,284.0,80.09,23.97,333.39,40
CPT,73080,XR ELBOW CMP 3+ VW RT,284.0,80.09,23.97,333.39,40
CPT,73085,XR ARTHRO ELBOW LT S&I,716.0,219.81,72.66,1516.98,40
CPT,73085,XR ARTHRO ELBOW RT S&I,716.0,219.81,72.66,1516.98,40
CPT,73090,XR FOREARM 2 VW LT,260.0,73.32,21.05,333.39,40
CPT,73090,XR FOREARM 2 VW LT RDC,260.0,73.32,21.05,333.39,40
CPT,73090,XR FOREARM 2 VW RT,260.0,73.32,21.05,333.39,40
CPT,73090,XR FOREARM 2 VW RT RDC,260.0,73.32,21.05,333.39,40
CPT,73092,XR EXT UPPER INFANT 2+ VW LT,340.0,95.88,23.33,449.06,40
CPT,73092,XR EXT UPPER INFANT 2+ VW RT,340.0,95.88,23.33,449.06,40
CPT,73100,XR WRIST 2 VW LT,266.0,75.01,25.28,333.39,40
CPT,73100,XR WRIST 2 VW LT RDC,266.0,75.01,25.28,333.39,40
CPT,73100,XR WRIST 2 VW RT,266.0,75.01,25.28,333.39,40
CPT,73100,XR WRIST 2 VW RT RDC,266.0,75.01,25.28,333.39,40
CPT,73110,XR WRIST CMP 3+ VW LT,276.0,77.83,32.09,333.39,40
CPT,73110,XR WRIST CMP 3+ VW RT,276.0,77.83,32.09,333.39,40
CPT,73115,XR ARTHRO WRIST LT S&I,709.0,217.66,105.44,1516.98,40
CPT,73115,XR ARTHRO WRIST RT S&I,709.0,217.66,105.44,1516.98,40
CPT,73120,XR HAND 2 VW LT,216.0,60.91,23.01,449.06,40
CPT,73120,XR HAND 2 VW LT RDC,216.0,60.91,23.01,449.06,40
CPT,73120,XR HAND 2 VW RT,216.0,60.91,23.01,449.06,40
CPT,73120,XR HAND 2 VW RT RDC,216.0,60.91,23.01,449.06,40
CPT,73130,XR HAND 3+ VW LT,305.0,86.01,28.19,333.39,40
CPT,73130,XR HAND 3+ VW RT,305.0,86.01,28.19,333.39,40
CPT,73140,XR FINGER/S 2+ VW LT,186.0,52.45,30.79,333.39,40
CPT,73140,XR FINGER/S 2+ VW RT,186.0,52.45,30.79,333.39,40
CPT,73200,CT EXT UPPER WO CNT LT,1120.0,185.92,79.0,1218.0,80
CPT,73200,CT EXT UPPER WO CNT RT,1120.0,185.92,79.0,1218.0,80
CPT,73201,CT EXT UPPER W CNT LT,1400.0,232.4,147.59,1516.98,80
CPT,73201,CT EXT UPPER W CNT RT,1400.0,232.4,147.59,1516.98,80
CPT,73202,CT EXT UPPER W&WO CNT LT,1680.0,278.88,129.45,1418.27,80
CPT,73202,CT EXT UPPER W&WO CNT RT,1680.0,278.88,129.45,1418.27,80
CPT,73206,CTA EXT UPPER W CNT&PP LT,1764.0,292.82,129.45,1418.01,80
CPT,73206,CTA EXT UPPER W CNT&PP RT,1764.0,292.82,129.45,1418.01,80
CPT,73218,MRI EXT UPPER NONJT WO CNT LT,1849.0,355.01,166.84,1904.2,38
CPT,73218,MRI EXT UPPER NONJT WO CNT RT,1849.0,355.01,166.84,1904.2,38
CPT,73219,MRI EXT UPPER NONJT W CNT LT,2312.0,443.9,257.9,2017.82,38
CPT,73219,MRI EXT UPPER NONJT W CNT RT,2312.0,443.9,257.9,2017.82,38
CPT,73220,MRI EXT UPPER NONJT W&WO CNT LT,2774.0,532.61,266.89,2432.3,38
CPT,73220,MRI EXT UPPER NONJT W&WO CNT RT,2774.0,532.61,266.89,2432.3,38
CPT,73221,MRI EXT UPPER JT WO CNT LT,1791.0,343.87,141.1,1618.0,38
CPT,73221,MRI EXT UPPER JT WO CNT RT,1791.0,343.87,141.1,1618.0,38
CPT,73222,MRI EXT UPPER JT W CNT LT,2239.0,429.89,239.4,1877.73,38
CPT,73222,MRI EXT UPPER JT W CNT RT,2239.0,429.89,239.4,1877.73,38
CPT,73223,MRI EXT UPPER JT W&WO CNT LT,2687.0,515.9,266.89,2245.05,38
CPT,73223,MRI EXT UPPER JT W&WO CNT RT,2687.0,515.9,266.89,2245.05,38
CPT,73225,MRA EXT UPPER W CNT LT,2351.0,453.74,263.7,1943.51,38
CPT,73225,MRA EXT UPPER W CNT RT,2351.0,453.74,263.7,1943.51,38
CPT,73225,MRA EXT UPPER W/WO CNT LT,2822.0,544.65,263.7,2116.5,38
CPT,73225,MRA EXT UPPER W/WO CNT RT,2822.0,544.65,263.7,2116.5,38
CPT,73225,MRA EXT UPPER WO CNT LT,1881.0,363.03,263.7,1943.51,38
CPT,73225,MRA EXT UPPER WO CNT RT,1881.0,363.03,263.7,1943.51,38
CPT,73501,XR HIP W PELVIS 1 VW LT,256.0,72.19,23.33,333.39,40
CPT,73501,XR HIP W PELVIS 1 VW RT,256.0,72.19,23.33,333.39,40
CPT,73502,XR HIP W PELVIS 2-3 VW LT,270.0,76.14,35.98,333.39,40
CPT,73502,XR HIP W PELVIS 2-3 VW RT,270.0,76.14,35.98,333.39,40
CPT,73503,XR HIP W PELVIS 4+ VW LT,282.0,79.52,45.72,449.06,40
CPT,73503,XR HIP W PELVIS 4+ VW RT,282.0,79.52,45.72,449.06,40
CPT,73521,XR HIPS W PELVIS 2 VW BI,322.0,90.8,29.82,449.06,63
CPT,73522,XR HIPS W PELVIS 3-4 VW BI,350.0,98.7,38.91,449.06,63
CPT,73523,XR HIPS W PELVIS 5+ VW BI,411.0,115.9,45.72,449.06,63
CPT,73525,XR ARTHRO HIP LT S&I,806.0,247.44,98.3,1516.98,80
CPT,73525,XR ARTHRO HIP RT S&I,806.0,247.44,98.3,1516.98,80
CPT,73551,XR FEMUR 1 VW LT,158.0,44.56,20.73,333.39,40
CPT,73551,XR FEMUR 1 VW RT,158.0,44.56,20.73,333.39,40
CPT,73552,XR FEMUR 2+ VW LT,265.0,74.73,26.25,333.39,40
CPT,73552,XR FEMUR 2+ VW RT,265.0,74.73,26.25,333.39,40
CPT,73560,XR KNEE 1-2 VW LT,247.0,69.65,25.6,333.39,40
CPT,73560,XR KNEE 1-2 VW RT,247.0,69.65,25.6,333.39,40
CPT,73562,XR KNEE 3 VW LT,270.0,76.14,31.12,333.39,40
CPT,73562,XR KNEE 3 VW RT,270.0,76.14,31.12,333.39,40
CPT,73564,XR KNEE CMP 4+ VW LT,365.0,102.93,35.34,449.06,40
CPT,73564,XR KNEE CMP 4+ VW RT,365.0,102.93,35.34,449.06,40
CPT,73565,XR KNEES STANDING AP BI,258.0,72.76,31.12,333.39,63
CPT,73580,XR ARTHRO KNEE LT S&I,716.0,219.81,78.18,1516.98,40
CPT,73580,XR ARTHRO KNEE RT S&I,716.0,219.81,78.18,1516.98,40
CPT,73590,XR TIBIA&FIBULA 2 VW LT,261.0,73.6,23.33,333.39,40
CPT,73590,XR TIBIA&FIBULA 2 VW LT RDC,261.0,73.6,23.33,333.39,40
CPT,73590,XR TIBIA&FIBULA 2 VW RT,261.0,73.6,23.33,333.39,40
CPT,73590,XR TIBIA&FIBULA 2 VW RT RDC,261.0,73.6,23.33,333.39,40
CPT,73592,XR EXT LOWER INFANT 2+ VW LT,307.0,86.57,23.33,333.39,40
CPT,73592,XR EXT LOWER INFANT 2+ VW RT,307.0,86.57,23.33,333.39,40
CPT,73600,XR ANKLE 2 VW LT,221.0,62.32,23.97,333.39,40
CPT,73600,XR ANKLE 2 VW LT RDC,221.0,62.32,23.97,333.39,40
CPT,73600,XR ANKLE 2 VW RT,221.0,62.32,23.97,333.39,40
CPT,73600,XR ANKLE 2 VW RT RDC,221.0,62.32,23.97,333.39,40
CPT,73610,XR ANKLE CMP 3+ VW LT,298.0,84.04,27.54,333.39,40
CPT,73610,XR ANKLE CMP 3+ VW RT,298.0,84.04,27.54,333.39,40
CPT,73615,XR ARTHRO ANKLE LT S&I,1101.0,338.01,98.3,1516.98,40
CPT,73615,XR ARTHRO ANKLE RT S&I,1101.0,338.01,98.3,1516.98,40
CPT,73620,XR FOOT 2 VW LT,220.0,62.04,20.73,333.39,40
CPT,73620,XR FOOT 2 VW LT RDC,220.0,62.04,20.73,333.39,40
CPT,73620,XR FOOT 2 VW RT,220.0,62.04,20.73,333.39,40
CPT,73620,XR FOOT 2 VW RT RDC,220.0,62.04,20.73,333.39,40
CPT,73630,XR FOOT CMP 3+ VW LT,313.0,88.27,25.6,333.39,40
CPT,73630,XR FOOT CMP 3+ VW RT,313.0,88.27,25.6,333.39,40
CPT,73650,XR CALCANEUS 2+ VW LT,192.0,54.14,20.4,333.39,40
CPT,73650,XR CALCANEUS 2+ VW RT,192.0,54.14,20.4,333.39,40
CPT,73660,XR TOE/S 2+ VW LT,164.0,46.25,22.36,333.39,40
CPT,73660,XR TOE/S 2+ VW RT,164.0,46.25,22.36,333.39,40
CPT,73700,CT EXT LOWER WO CNT LT,1061.0,176.13,79.0,1218.0,80
CPT,73700,CT EXT LOWER WO CNT RT,1061.0,176.13,79.0,1218.0,80
CPT,73701,CT EXT LOWER W CNT LT,1327.0,220.28,113.51,1218.0,80
CPT,73701,CT EXT LOWER W CNT RT,1327.0,220.28,113.51,1218.0,80
CPT,73702,CT EXT LOWER W&WO CNT LT,1592.0,264.27,129.45,1218.0,80
CPT,73702,CT EXT LOWER W&WO CNT RT,1592.0,264.27,129.45,1218.0,80
CPT,73706,CTA EXT LOWER W CNT&PP LT,1672.0,277.55,129.45,1415.35,80
CPT,73706,CTA EXT LOWER W CNT&PP RT,1672.0,277.55,129.45,1415.35,80
CPT,73718,MRI EXT LOWER NONJT WO CNT LT,1778.0,341.38,162.2,1618.0,38
CPT,73718,MRI EXT LOWER NONJT WO CNT RT,1778.0,341.38,162.2,1618.0,38
CPT,73719,MRI EXT LOWER NONJT W CNT LT,2223.0,426.82,189.74,1667.25,38
CPT,73719,MRI EXT LOWER NONJT W CNT RT,2223.0,426.82,189.74,1667.25,38
CPT,73720,MRI EXT LOWER NONJT W&WO CNT LT,2667.0,512.06,239.72,2000.25,38
CPT,73720,MRI EXT LOWER NONJT W&WO CNT RT,2667.0,512.06,239.72,2000.25,38
CPT,73721,MRI EXT LOWER JT WO CNT LT,1547.0,297.02,140.78,1618.0,38
CPT,73721,MRI EXT LOWER JT WO CNT RT,1547.0,297.02,140.78,1618.0,38
CPT,73722,MRI EXT LOWER JT W CNT LT,1934.0,371.33,240.05,1898.88,38
CPT,73722,MRI EXT LOWER JT W CNT RT,1934.0,371.33,240.05,1898.88,38
CPT,73723,MRI EXT LOWER JT W&WO CNT LT,2321.0,445.63,266.89,2234.47,38
CPT,73723,MRI EXT LOWER JT W&WO CNT RT,2321.0,445.63,266.89,2234.47,38
CPT,73725,MRA EXT LOWER W CNT LT,2031.0,668.26,254.29,2012.16,38
CPT,73725,MRA EXT LOWER W CNT RT,2031.0,668.26,254.29,2012.16,38
CPT,73725,MRA EXT LOWER W/WO CNT LT,2438.0,802.18,254.29,2012.16,38
CPT,73725,MRA EXT LOWER W/WO CNT RT,2438.0,802.18,254.29,2012.16,38
CPT,73725,MRA EXT LOWER WO CNT LT,1625.0,534.67,254.29,2012.16,38
CPT,73725,MRA EXT LOWER WO CNT RT,1625.0,534.67,254.29,2012.16,38
CPT,74018,XR ABDOMEN 1 VW,597.0,168.35,21.05,447.75,63
CPT,74019,XR ABDOMEN 2 VW,721.0,203.32,25.27,540.75,63
CPT,74021,XR ABDOMEN 3+ VW,845.0,238.29,29.49,633.75,63
CPT,74022,XR ABDOMEN CMP 2+VW W CHEST 1 VW,971.0,273.82,34.04,728.25,63
CPT,74150,CT ABDOMEN WO CNT,1157.0,192.06,79.0,1218.0,126
CPT,74160,CT ABDOMEN W CNT,1447.0,240.2,129.45,1360.2,126
CPT,74170,CT ABDOMEN W&WO CNT,1736.0,288.18,129.45,1418.27,126
CPT,74174,CTA ABDOMEN&PELVIS W CNT&PP,4589.0,761.77,241.82,3441.75,126
CPT,74175,CTA ABDOMEN W CNT&PP,1823.0,302.62,129.45,1415.68,126
CPT,74176,CT ABDOMEN&PELVIS WO CNT,2913.0,483.56,103.45,2184.75,126
CPT,74177,CT ABDOMEN&PELVIS W CNT,3642.0,604.57,220.29,2731.5,126
CPT,74177,CT ABDOMEN&PELVIS W CNT RDC,3642.0,604.57,220.29,2731.5,80
CPT,74178,CT ABDOMEN&PELVIS W&WO CNT,4370.0,725.42,241.82,3277.5,126
CPT,74181,MRCP WO CNT,2110.0,405.12,129.41,1618.0,61
CPT,74181,MRI ABDOMEN WO CNT,2110.0,405.12,129.41,1618.0,61
CPT,74182,MRCP W CNT,2638.0,506.5,224.14,1978.5,61
CPT,74182,MRI ABDOMEN W CNT,2638.0,506.5,224.14,1978.5,61
CPT,74183,MRCP W&WO CNT,3165.0,607.68,238.43,2373.75,61
CPT,74183,MRI ABDOMEN W&WO CNT,3165.0,607.68,238.43,2373.75,61
CPT,74185,MRA ABDOMEN W CNT,2770.0,534.61,255.92,2077.5,38
CPT,74185,MRA ABDOMEN W/WO CNT,3324.0,641.53,255.92,2493.0,38
CPT,74185,MRA ABDOMEN WO CNT,2216.0,427.69,255.92,2004.25,38
CPT,74190,PERITONEOGRAM S&I,1117.0,314.99,3.06,3186.84,63
CPT,74210,XR PHARYNX&/CERV ESOPHAGUS STDY CNT,467.0,131.69,65.52,735.79,63
CPT,74220,XR ESOPHAGUS STUDY CNT SINGLE,508.0,143.26,67.47,735.79,63
CPT,74221,XR ESOPHAGUS STUDY CNT DOUBLE,512.0,144.38,74.93,735.79,63
CPT,74230,FNCT SWALLOW W CINE/VIDEO STUDY CNT,619.0,174.56,97.0,735.79,63
CPT,74235,REM FB ESOPHAGUS S&I,688.0,194.02,98.66,516.0,37
CPT,74240,XR UGI STUDY CNT SINGLE,606.0,170.89,82.72,735.79,63
CPT,74246,XR UGI STUDY CNT DOUBLE,615.0,173.43,94.41,735.79,63
CPT,74248,XR INTESTINE SM STUDY FOLLOW THRU,279.0,78.68,48.32,366.49,37
CPT,74250,XR INTESTINE SM STUDY CNT SINGLE,549.0,154.82,81.74,735.79,63
CPT,74251,XR INTESTINE SM STUDY CNT DOUBLE,1285.0,362.37,129.45,1650.89,63
CPT,74261,CT COLONOGRAPHY DX WO CNT,844.0,144.32,79.0,1901.53,63
CPT,74262,CT COLONOGRAPHY DX W CNT,1055.0,180.4,129.45,2148.57,63
CPT,74270,XR COLON STUDY CNT SINGLE,610.0,172.02,102.2,735.79,63
CPT,74280,XR COLON STUDY CNT DOUBLE,898.0,253.24,129.45,980.24,63
CPT,74283,ENEMA THERAPEUTIC,920.0,259.44,129.45,1126.49,63
CPT,74290,CHOLECYSTOGRAPHY CNT ORAL,737.0,207.83,68.12,735.79,63
CPT,74300,CHOLANGIO&/PANCREATOGRAM OR S&I,436.0,122.95,22.83,327.0,37
CPT,74301,CHOLANGIO&/PANCREATOGRAM OR ADD S&I,370.0,104.34,17.12,277.5,37
CPT,74328,CATH ENDO DUCT BILIARY S&I,725.0,204.45,7.51,543.75,74
CPT,74329,CATH ENDO DUCT PANCREAS S&I,735.0,207.27,40.63,551.25,74
CPT,74330,CATH ENDO DUCT BILIARY&PANCREAS S&I,800.0,225.6,7.51,600.0,74
CPT,74340,INTRO TUBE GI LONG W FLUORO S&I,344.0,97.01,6.16,258.0,74
CPT,74355,PLC TUBE ENTEROCLYSIS PERC S&I,720.0,203.04,6.16,540.0,37
CPT,74360,DIL STRICT&/OBSTRUCT INTRALUM S&I,717.0,202.19,7.51,537.75,37
CPT,74363,DIL STRICT DUCT BILI TRANSHEP S&I,1019.0,287.36,72.04,764.25,37
CPT,74400,UROGRAPHY IV W/WO KUB,985.0,277.77,108.97,738.75,63
CPT,74410,UROGRAPHY INF&/BOLUS,2339.0,659.6,115.78,1754.25,63
CPT,74415,UROGRAPHY INF&/BOLUS W NEPHRO,2730.0,769.86,124.87,2047.5,63
CPT,74420,UROGRAPHY RETROGRADE W/WO KUB,716.0,201.91,52.54,1516.98,126
CPT,74425,UROGRAPHY ANTEGRADE S&I,880.0,248.16,109.34,1516.98,63
CPT,74430,CYSTOGRAM 3+ VW S&I,743.0,209.53,25.6,1516.98,126
CPT,74440,VASOGRAM S&I,702.0,197.96,77.86,948.33,126
CPT,74445,CAVERNOSOGRAPHY CORPORA S&I,818.0,230.68,2.64,613.5,63
CPT,74450,URETHROCYSTOGRAM RETROGRADE S&I,1434.0,404.39,3.56,1392.13,126
CPT,74455,URETHROCYSTOGRAM VOIDING S&I,495.0,139.59,86.29,948.33,63
CPT,74470,XR CYST RENAL TRANSLUMBAR S&I,1893.0,533.83,3.06,3186.84,63
CPT,74485,DIL URETER(S)/URETHRA S&I,3129.0,882.38,78.83,7388.73,63
CPT,74712,MRI FETAL W PELVIC SGL/1ST GEST,947.0,181.82,166.84,1927.95,61
CPT,74740,HYSTEROSALPINGOGRAM S&I,600.0,169.2,73.63,948.33,126
CPT,74742,CATH TUBE FALLOPIAN LT S&I,789.0,222.5,50.76,591.75,33
CPT,74742,CATH TUBE FALLOPIAN RT S&I,789.0,222.5,50.76,591.75,33
CPT,74775,PERINEOGRAM/VAGINOGRAM,1434.0,404.39,3.56,1392.13,63
CPT,75557,MRI CARD MOR&FUNC WO CNT,1311.0,251.71,166.84,1618.0,61
CPT,75559,MRI CARD MOR&FUNC W SI WO CNT,1891.0,363.07,243.01,1938.79,61
CPT,75561,MRI CARD MOR&FUNC W&WO CNT,1967.0,377.66,246.54,1941.19,61
CPT,75563,MRI CARD MOR&FUNC W SI W&WO CNT,2837.0,544.7,290.03,2308.44,61
CPT,75565,MRI CARDIAC VELOCITY FLW MAP ADD-ON,860.0,118.68,34.08,1618.0,38
CPT,75571,CT EVAL QN CALCIUM HRT WO CNT,1683.0,287.79,58.65,1262.25,63
CPT,75572,CT EVAL STRUC&MORPH HRT W CNT,1484.0,253.76,129.45,1218.0,63
CPT,75573,CT EVAL STRUC&MORPH CONG HRT W CNT,1553.0,265.56,129.45,1512.8,63
CPT,75574,CTA ART&GRAFTS HEART W CNT,1631.0,278.9,129.45,1700.38,63
CPT,75577,QUAN&CHAR PLAQ ATHEROSCLEROTIC COR,1750.0,299.25,572.25,3916.93,62
CPT,75580,FFR COR ANLY SW CTA W I&R PHYS/QHCP,4898.0,1435.11,666.87,4269.99,63
CPT,75600,AORTO THORACIC WO SERIAL S&I,4502.0,949.92,155.06,11792.62,63
CPT,75605,AORTO THORACIC SERIAL S&I,6871.0,1449.78,66.45,19658.22,126
CPT,75625,AORTO ABD SERIAL S&I,4923.0,1038.75,58.38,11792.62,126
CPT,75630,AORTO ABD ILIOFEM BI SERIAL S&I,5792.0,1222.11,62.88,11792.62,126
CPT,75635,CTA AORTA ABD RUNOFF W CNT,1824.0,311.9,129.45,1832.84,126
CPT,75705,ANGIO SPINAL SEL S&I,7413.0,1564.14,131.97,19658.22,63
CPT,75710,ANGIO EXTREMITY LT S&I,5894.0,1243.63,67.1,11792.62,120
CPT,75710,ANGIO EXTREMITY RT S&I,5894.0,1243.63,67.1,11792.62,120
CPT,75716,ANGIO EXTREMITY BI S&I,6003.0,1266.63,70.02,11792.62,189
CPT,75726,ANGIO VISCERAL SEL S&I,7413.0,1564.14,75.54,19658.22,126
CPT,75731,ANGIO ADRENAL SEL LT S&I,4220.0,890.42,97.24,11792.62,40
CPT,75731,ANGIO ADRENAL SEL RT S&I,4220.0,890.42,97.24,11792.62,40
CPT,75733,ANGIO ADRENAL SEL BI S&I,4262.0,899.28,109.21,11792.62,63
CPT,75736,ANGIO PELVIC S&I,7413.0,1564.14,89.78,19658.22,126
CPT,75741,ANGIO PULMONARY SEL LT S&I,4102.0,865.52,68.73,11792.62,80
CPT,75741,ANGIO PULMONARY SEL RT S&I,4102.0,865.52,68.73,11792.62,80
CPT,75743,ANGIO PULMONARY SEL BI S&I,4220.0,890.42,70.02,11792.62,189
CPT,75746,ANGIO PULMONARY NONSEL S&I,4220.0,890.42,80.74,11792.62,63
CPT,75756,ANGIO MAMMARY INTERNAL S&I,4017.0,847.59,108.28,11792.62,126
CPT,75774,ANGIO SEL VESSEL ADDL S&I,1487.0,313.76,49.61,1115.25,74
CPT,75801,LYMPHANGIOGRAPHY EXT LT S&I,3186.0,898.45,12.79,3659.86,40
CPT,75801,LYMPHANGIOGRAPHY EXT RT S&I,3186.0,898.45,12.79,3659.86,40
CPT,75803,LYMPHANGIOGRAPHY EXT BIL S&I,4069.0,1147.46,12.79,9183.29,63
CPT,75805,LYMPHANGIOGRAPHY PLVC/ABD UNI S&I,2534.0,714.59,14.58,18420.25,63
CPT,75807,LYMPHANGIOGRAPHY PLVC/ABD BI S&I,3672.0,1035.5,196.71,18420.25,63
CPT,75809,SHUNTOGRAM NONVASCULAR S&I,336.0,94.75,57.73,449.06,126
CPT,75810,SPLENOPORTOGRAPHY S&I,3643.0,1027.33,28.68,18420.25,63
CPT,75820,VENOGRAM EXTREMITY LT S&I,2093.0,590.23,57.73,5794.55,160
CPT,75820,VENOGRAM EXTREMITY RT S&I,2093.0,590.23,57.73,5794.55,160
CPT,75822,VENOGRAM EXTREMITY BI S&I,2282.0,643.52,63.9,5794.55,252
CPT,75825,VENOGRAM IVC SERIAL S&I,4923.0,1388.29,60.0,11792.62,126
CPT,75827,VENOGRAM SVC SERIAL S&I,1731.0,488.14,64.23,5794.55,189
CPT,75831,VENOGRAM RENAL SEL LT S&I,4220.0,1190.04,66.78,11792.62,80
CPT,75831,VENOGRAM RENAL SEL RT S&I,4220.0,1190.04,66.78,11792.62,80
CPT,75833,VENOGRAM RENAL SEL BI S&I,4393.0,1238.83,77.17,11792.62,126
CPT,75840,VENOGRAM ADRENAL SEL LT S&I,4220.0,1190.04,72.94,11792.62,40
CPT,75840,VENOGRAM ADRENAL SEL RT S&I,4220.0,1190.04,72.94,11792.62,40
CPT,75860,VENOGRAM SINUS VEN/JUG S&I,4220.0,1190.04,71.0,11792.62,126
CPT,75870,VENOGRAM SINUS SAGITTAL SUP S&I,4220.0,1190.04,95.34,11792.62,63
CPT,75872,VENOGRAM EPIDURAL S&I,2756.0,777.19,72.94,2231.96,63
CPT,75880,VENOGRAM ORBITAL S&I,2160.0,609.12,72.62,2231.96,63
CPT,75885,PORTOGRAM W EVAL HEMO S&I,4923.0,1388.29,70.35,11792.62,63
CPT,75887,PORTOGRAM WO EVAL HEMO S&I,3952.0,1114.46,71.0,11792.62,63
CPT,75889,VENOGRAM HEPATIC W EVAL HEMO S&I,4501.0,1269.28,70.35,11792.62,126
CPT,75891,VENOGRAM HEPATIC WO EVAL HEMO S&I,4274.0,1205.27,71.0,11792.62,63
CPT,75893,SAMPLE VENOUS CATH W/WO ANG S&I,6289.0,1773.5,77.81,19658.22,63
CPT,75894,THERAPY TRANSCATH EMB S&I,2708.0,763.66,56.0,2031.0,74
CPT,75898,ANGIO SUBSQ THRPY EMB/INF NONTHROMB,2927.0,617.6,2.64,11792.62,63
CPT,75901,REM OBSTRUCT CVD PERICATHETER S&I,1020.0,287.64,189.72,1174.48,37
CPT,75902,REM OBSTRUCT CVD INTRALUMINAL S&I,456.0,128.59,68.11,402.7,37
CPT,75970,BX TRANSCATHETER S&I,1787.0,503.93,26.45,1340.25,111
CPT,75984,CHG CATH DRN/TUBE PERC S&I,797.0,224.75,56.43,597.75,74
CPT,75989,CT GD W PLC CATH DRN PERC S&I,962.0,164.5,55.46,1218.0,37
CPT,75989,GD W PLC CATH DRN PERC S&I,962.0,271.28,55.46,721.5,74
CPT,75989,US GD W PLC CATH DRN PERC S&I,962.0,335.74,55.46,721.5,74
CPT,76000,FLUORO 0-1HR TIME PHYS/QHCP,475.0,133.95,27.22,948.33,252
CPT,76010,XR FB NOSE TO RECTUM CHILD 1 VW,253.0,71.35,20.41,333.39,63
CPT,76014,MR ASSESS IMP&/FB CLIN INIT 15MIN,46.0,12.97,14.5,100.91,62
CPT,76015,MR ASSESS IMP&/FB CLIN EA ADD 30MIN,129.0,36.38,23.99,96.75,36
CPT,76016,MR DETERMIN SAFETY PHYS/QHCP,143.0,40.33,46.76,362.84,62
CPT,76017,MR CUST EXAM MED PHYSICS SAFETY PLN,562.0,158.48,166.84,996.1,62
CPT,76018,MR PREP ELECT IMP SAFETY PHYS/QHCP,196.0,55.27,64.09,378.25,62
CPT,76019,MR POS IMP SAFETY&/IMMOB PHYS/QHCP,305.0,86.01,40.35,244.78,62
CPT,76080,XR ABSCESS/SINUS/FISTULA S&I,918.0,258.88,34.36,1989.95,189
CPT,76098,XR SPECIMEN SURGICAL,694.0,195.71,26.9,1989.95,63
CPT,76100,TOMOGRAPHY SGL EXCEPT URO,1085.0,305.97,60.32,813.75,63
CPT,76376,CT REND 3D W I&R W PP SAME WRKST,440.0,75.24,15.22,1218.0,74
CPT,76376,ECHO REND 3D W I&R W PP SAME WRKST,440.0,153.56,15.22,330.0,37
CPT,76376,MRI REND 3D W I&R W PP SAME WRKST,440.0,84.48,15.22,1618.0,38
CPT,76377,CT REND 3D W I&R W PP DIFF WRKST,542.0,92.68,39.51,1218.0,74
CPT,76377,ECHO REND 3D W I&R W PP DIFF WRKST,542.0,189.16,39.51,406.5,37
CPT,76377,MRI REND 3D W I&R W PP DIFF WRKST,542.0,104.06,39.51,1618.0,38
CPT,76380,CT LTD/FOLLOWUP,674.0,115.25,58.65,1218.0,189
CPT,76390,MRI SPECTROSCOPY,2395.0,459.84,58.65,2619.16,61
CPT,76391,MRI ELASTOGRAPHY,1153.0,221.38,150.84,1618.0,61
CPT,76497,CT BODY WHOLE,4073.0,676.12,58.65,3054.75,62
CPT,76498,MRI BODY WHOLE,4073.0,782.02,58.65,3054.75,60
CPT,76506,US HEAD NEONATAL,506.0,176.59,79.0,498.37,63
CPT,76536,US TISSUE SOFT HEAD&NECK,498.0,173.8,79.0,483.77,63
CPT,76604,ED US CHEST,424.0,147.98,29.5,449.06,63
CPT,76604,US CHEST,424.0,147.98,29.5,449.06,63
CPT,76641,US BREAST CMP BI,614.0,214.29,66.49,460.5,80
CPT,76641,US BREAST CMP LT,409.0,142.74,66.49,449.06,80
CPT,76641,US BREAST CMP RT,409.0,142.74,66.49,449.06,80
CPT,76642,US BREAST LTD BI,485.0,169.26,51.57,363.75,80
CPT,76642,US BREAST LTD LT,323.0,112.73,51.57,333.39,80
CPT,76642,US BREAST LTD RT,323.0,112.73,51.57,333.39,80
CPT,76700,US ABDOMEN CMP,640.0,223.36,76.51,508.37,63
CPT,76705,ED US ABDOMEN LTD,532.0,214.99,58.06,449.06,63
CPT,76705,US ABDOMEN LTD,532.0,214.99,58.06,449.06,63
CPT,76706,US SCREEN AAA,668.0,233.13,78.82,501.0,63
CPT,76770,US RETROPERITONEAL CMP,608.0,212.19,71.68,470.82,63
CPT,76775,US RETROPERITONEAL LTD,438.0,152.86,31.77,449.06,63
CPT,76776,US KIDNEY TRANSPLANTED W DOPPLER,635.0,221.61,79.0,644.71,63
CPT,76800,US SPINAL CANAL&CONTENTS,632.0,220.57,79.0,630.07,63
CPT,76801,US UTERUS PREG 0-13WK GEST SGL,495.0,172.76,69.09,508.29,63
CPT,76802,US UTERUS PREG 0-13WK GEST ADDL,227.0,79.22,20.45,264.93,37
CPT,76805,US UTERUS PREG 14+WK GEST SGL,569.0,198.58,79.0,583.82,63
CPT,76810,US UTERUS PREG 14+WK GEST ADDL,344.0,120.06,40.21,381.34,37
CPT,76811,US UTERUS PREG DETAIL GEST SGL,773.0,269.78,85.88,948.33,63
CPT,76812,US UTERUS PREG DETAIL GEST ADDL,920.0,321.08,62.26,835.67,37
CPT,76815,US UTERUS PREG LTD 1+ FETUS,329.0,114.82,49.3,449.06,126
CPT,76816,US UTERUS PREG RE-EVAL FETUS,421.0,146.93,68.12,474.46,63
CPT,76816,US UTERUS PREG RE-EVAL FETUS ADDL,421.0,146.93,68.12,449.06,40
CPT,76817,US UTERUS PREG TRANSVAGINAL,437.0,152.51,55.78,449.06,63
CPT,76818,US PROFILE BIO FETAL W NST,633.0,220.92,67.38,494.34,63
CPT,76818,US PROFILE BIO FETAL W NST ADDL,633.0,220.92,67.38,474.75,40
CPT,76819,US PROFILE BIO FETAL WO NST,414.0,144.49,48.28,449.06,63
CPT,76819,US PROFILE BIO FETAL WO NST ADDL,414.0,144.49,48.28,449.06,40
CPT,76820,VELOCIMETRY DOPPLER ART UMB FETAL,359.0,125.29,20.74,449.06,126
CPT,76821,VELOCIMETRY DOPPLER ART CERE FETAL,384.0,134.02,54.49,449.06,126
CPT,76825,ECHO 2D CV FETAL W/WO M-MODE,1319.0,460.33,178.71,1989.95,63
CPT,76826,ECHO 2D CV FETAL W/WO M-MODE FLWUP,662.0,231.04,114.81,948.33,63
CPT,76827,ECHO DOPP FETAL CMP,500.0,174.5,41.5,449.06,126
CPT,76828,ECHO DOPP FETAL FOLLOWUP/REPEAT,392.0,136.81,22.03,449.06,63
CPT,76830,US TRANSVAGINAL,590.0,205.91,79.0,518.9,63
CPT,76831,SONOHYSTEROGRAPHY INF SALINE,461.0,160.89,80.13,948.33,63
CPT,76856,US PELVIS NON OB CMP,504.0,175.9,71.36,459.04,63
CPT,76857,ED US PELVIS NON OB LTD,426.0,148.67,25.6,449.06,63
CPT,76857,US PELVIS NON OB LTD,426.0,148.67,25.6,449.06,63
CPT,76870,US SCROTUM&CONTENTS,479.0,167.17,68.44,449.06,63
CPT,76872,US TRANSRECTAL,630.0,219.87,79.0,875.38,189
CPT,76873,US TRANSRECTAL STDY VOL PROSTATE,570.0,198.93,79.0,748.87,63
CPT,76881,ED US JOINT CMP REALTIME,439.0,153.21,10.67,449.06,63
CPT,76881,US JOINT CMP REALTIME,439.0,153.21,10.67,449.06,63
CPT,76882,ED US JT/EVAL FOCAL EXT NONVASC LTD,306.0,106.79,30.15,449.06,63
CPT,76882,US JT/EVAL FOCAL EXT NONVASC LTD,306.0,106.79,30.15,449.06,63
CPT,76885,US HIPS INFANT DYNAMIC,522.0,182.18,58.65,594.69,63
CPT,76886,US HIPS INFANT STATIC,401.0,139.95,58.65,435.74,63
CPT,76936,US GD RPR PSEUDOAN ART/FISTULA AV,625.0,218.12,163.78,1128.44,63
CPT,76937,US GD VA EVAL SITE W REC PERM,827.0,288.62,23.97,620.25,148
CPT,76940,US GD ABLATION TISSUE,372.0,129.83,12.79,370.32,74
CPT,76942,ED US GD PLCMT NEEDLE ADDL S&I,507.0,176.94,27.55,380.25,37
CPT,76942,US GD PLCMT NEEDLE ADDL S&I,507.0,176.94,27.55,380.25,74
CPT,76942,US GD PLCMT NEEDLE S&I,507.0,176.94,27.55,380.25,111
CPT,76946,US GD AMNIOCENTESIS S&I,260.0,90.74,14.89,195.0,74
CPT,76965,US GD APP RADIOELEMENT INTERSTITIAL,1162.0,405.54,26.9,871.5,74
CPT,76981,US ELASTOGRAPHY ORGAN,445.0,155.3,74.29,478.28,63
CPT,76982,US ELASTOGRAPHY LSN TARGET 1ST,371.0,129.48,63.57,449.06,126
CPT,76983,US ELASTOGRAPHY LSN TARGET ADDL,210.0,73.29,35.99,264.1,74
CPT,76998,US GD INTRAOPERATIVE,679.0,236.97,24.58,509.25,37
CPT,77001,FLUORO GD PLC/REPL/REM CVAD,526.0,148.33,78.82,537.02,111
CPT,77002,FLUORO GD PLCMT NEEDLE,582.0,164.12,87.26,623.23,111
CPT,77003,FLUORO GD&LOC NEEDLE SPINE,497.0,140.15,74.93,503.82,74
CPT,77011,CT GD LOC STEREOTACTIC,2020.0,345.42,156.4,1515.0,37
CPT,77012,CT GD PLCMT NEEDLE S&I,1529.0,261.46,68.76,1218.0,74
CPT,77013,CT GD ABLATION TISSUE,1791.0,306.26,333.13,1343.25,74
CPT,77021,MRI GD PLC NDL S&I,2301.0,441.79,346.22,2365.12,38
CPT,77022,MRI GD ABLATION TISSUE,2215.0,425.28,411.99,1661.25,38
CPT,77046,MRI BREAST WO CNT LT,1264.0,242.69,146.94,1618.0,76
CPT,77046,MRI BREAST WO CNT RT,1264.0,242.69,146.94,1618.0,76
CPT,77047,MRI BREAST WO CNT BI,1896.0,364.03,146.29,1618.0,122
CPT,77048,MRI BREAST W&WO CNT LT,1896.0,364.03,240.37,1618.0,76
CPT,77048,MRI BREAST W&WO CNT RT,1896.0,364.03,240.37,1618.0,76
CPT,77049,MRI BREAST W&WO CNT BI,2844.0,546.05,238.1,2133.0,76
CPT,77053,DUCTO/GALACTOGRAM MAMMARY SGL LTS&I,520.0,146.64,35.99,948.33,40
CPT,77053,DUCTO/GALACTOGRAM MAMMARY SGL RTS&I,520.0,146.64,35.99,948.33,40
CPT,77054,DUCTO/GALACTOGRAM MAMMARY MULTI S&I,676.0,190.63,47.02,948.33,63
CPT,77063,TOMOSYNTHESIS SCRN DIG BRST BI,52.0,28.6,9.67,226.21,40
CPT,77063,TOMOSYNTHESIS SCRN DIG BRST BI MBL,52.0,28.6,9.67,226.21,40
CPT,77065,MAMMO DX W/WO CAD LT,467.0,213.89,84.99,485.06,40
CPT,77065,MAMMO DX W/WO CAD RT,467.0,213.89,84.99,485.06,40
CPT,77066,MAMMO DX W/WO CAD BI,599.0,274.34,108.97,683.56,40
CPT,77067,MAMMO SCRN W/WO CAD 2 VW BI,563.0,309.65,89.86,550.77,40
CPT,77067,MAMMO SCRN W/WO CAD 2 VW BI MBL,563.0,309.65,89.86,550.77,40
CPT,77067,MAMMO SCRN W/WO CAD 2 VW BI RDC,375.0,206.25,69.75,512.54,40
CPT,77067,MAMMO SCRN W/WO CAD 2 VW BI RDC MBL,375.0,206.25,69.75,512.54,40
CPT,77071,APPLY MANUAL STRESS JOINT UNI/BI,361.0,101.8,53.61,387.94,63
CPT,77072,STUDIES AGE BONE,307.0,86.57,16.51,449.06,63
CPT,77073,STUDIES LENGTH BONE,278.0,78.4,31.44,449.06,63
CPT,77074,XR SURVEY OSSEOUS LTD,338.0,95.32,43.45,449.06,63
CPT,77075,XR SURVEY OSSEOUS CMP,486.0,137.05,71.65,477.01,63
CPT,77076,XR SURVEY OSSEOUS INFANT,685.0,193.17,72.3,513.75,63
CPT,77077,SURVEY JOINT SGL VW 2+ JTS,269.0,75.86,29.82,449.06,63
CPT,77080,DXA STUDY DENSITY 1+SKEL AX,442.0,124.64,28.85,449.06,63
CPT,77081,DXA STUDY DENSITY 1+SKEL APPEND,176.0,49.63,21.71,333.39,63
CPT,77084,MRI BONE MARROW,1629.0,312.77,166.84,1618.0,61
CPT,77085,DXA STUDY DENSITY 1+SKEL AX FX VERT,482.0,135.92,38.22,449.06,63
CPT,77086,DXA VERTEBRAL FRACTURE ASSESSMENT,202.0,56.96,24.95,333.39,63
CPT,77280,RAD THER FIELD SIMULAT LVL 01 SMPL,1533.0,706.71,91.98,2724.0,63
CPT,77285,RAD THER FIELD SIMULAT LVL 02 INTRM,2511.0,1157.57,245.54,2724.0,63
CPT,77290,RAD THER FIELD SIMULAT LVL 03 CMPLX,2637.0,1215.66,245.54,2724.0,63
CPT,77293,SIMULAT MGMT MOTION RESPIRATORY,1977.0,911.4,295.87,2724.0,40
CPT,77295,PLAN RADTHRPY 3D W HISTGMS DOSE-VOL,5412.0,2494.93,250.27,4059.0,63
CPT,77300,CALC DOSIMETRY RAD BASIC,563.0,259.54,32.74,2724.0,63
CPT,77301,PLAN IMRT HISTOGRAMS DOSE-VOLUME,9504.0,4381.34,915.08,10291.24,63
CPT,77306,PLAN ISODOSE TELETHRPY LVL 01 SMPL,889.0,409.83,73.27,2724.0,63
CPT,77307,PLAN ISODOSE TELETHRPY LVL 02 CMPLX,1202.0,554.12,132.58,2724.0,63
CPT,77316,PLAN ISODOSE BRACHY LVL 01 SMPL,1158.0,533.84,168.57,2724.0,63
CPT,77317,PLAN ISODOSE BRACHY LVL 02 INTRM,1697.0,782.32,222.07,2724.0,63
CPT,77318,PLAN ISODOSE BRACHY LVL 03 CMPLX,2064.0,951.5,245.54,2724.0,63
CPT,77321,PLAN PORT TELETHRPY SPEC,1199.0,552.74,43.45,2724.0,63
CPT,77321,PLAN PORT TELETHRPY SPEC TBI,1199.0,552.74,43.45,2724.0,63
CPT,77331,CALC DOSIMETRY SPEC,600.0,276.6,18.78,2724.0,63
CPT,77331,CALC DOSIMETRY SPEC DIODE,600.0,276.6,18.78,2724.0,63
CPT,77331,CALC DOSIMETRY SPEC TLD,600.0,276.6,18.78,2724.0,63
CPT,77332,DEVICE TX DESIGN&CONST LVL 01 SMPL,568.0,261.85,15.21,2724.0,63
CPT,77333,DEVICE TX DESIGN&CONST LVL 02 INTRM,739.0,340.68,91.98,2724.0,63
CPT,77334,DEVICE TX DESIGN&CONST LVL 03 CMPLX,1006.0,463.77,63.89,2724.0,63
CPT,77336,CONSULT PHYSICS MEDICAL CONTINUING,692.0,319.01,86.33,2724.0,63
CPT,77338,DEVICE MLC DESIGN&CONST PER IMRT,1654.0,762.49,238.18,2724.0,63
CPT,77370,CONSULT PHYSICS RAD MEDICAL SPECIAL,995.0,458.7,91.98,2724.0,63
CPT,77372,SRS CRANIAL COURSE 1 SESSN,17370.0,8007.57,927.09,41139.0,63
CPT,77372,SRS CRANIAL ROBOTIC COURSE 1 SESSN,17370.0,8007.57,927.09,41139.0,63
CPT,77373,SRS/SBRT LINEAR COURSE MAX 5 SESSNS,11571.0,5334.23,967.78,13203.0,63
CPT,77373,SRS/SBRT ROBOTIC COURSE 1 SESSN,11571.0,5334.23,967.78,13203.0,63
CPT,77373,SRS/SBRT ROBOTIC COURSE 2-5 SESSNS,11571.0,5334.23,967.78,13203.0,63
CPT,77387,GD LOC VOL TARGET DELIVERY TX RAD,349.0,160.89,64.91,2724.0,80
CPT,77402,TX RAD LVL 1 E-SGL/MULTI 2D IMG GD,900.0,414.9,87.39,2724.0,63
CPT,77407,TX RAD LVL 2 ISOCNTR SGL IMG GD,2520.0,1161.72,169.01,2724.0,63
CPT,77412,TX RAD LVL 3 ISOCNTRS MULTI IMG GD,2960.0,1364.56,175.22,2724.0,63
CPT,77417,RAD THER IMG/S PORT,246.0,113.41,2.84,2724.0,40
CPT,77470,PROCEDURE TX SPECIAL THRPY RAD,2188.0,1008.67,34.98,2724.0,63
CPT,77600,HYPERTHERMIA EXTERNAL SUPERFICIAL,1494.0,688.73,175.22,3168.61,63
CPT,77605,HYPERTHERMIA EXTERNAL DEEP,2718.0,1253.0,513.63,6175.38,63
CPT,77610,HYPERTHERMIA INTERSTITIAL 1-5 APPL,2192.0,1010.51,393.35,4039.69,63
CPT,77615,HYPERTHERMIA INTERSTITIAL 6+ APPL,3419.0,1576.16,393.35,6449.98,63
CPT,77761,APPL BRACHY INTRACAV LVL 01 SMPL,1629.0,750.97,214.9,2724.0,63
CPT,77762,APPL BRACHY INTRACAV LVL 02 INTRM,2150.0,991.15,246.62,2724.0,63
CPT,77763,APPL BRACHY INTRACAV LVL 03 CMPLX,3046.0,1404.21,322.08,3251.63,63
CPT,77767,BRACHY HDR RDNCL SURF SKN DOSI 1 CH,2019.0,930.76,175.22,2724.0,63
CPT,77768,BRACHY HDR RDNCL SURF SKN DOSI 2+CH,3031.0,1397.29,175.22,2724.0,63
CPT,77770,BRACHY HDR RDNCL ICAV/ISTL 1 CH,2403.0,1107.78,239.93,2724.0,63
CPT,77771,BRACHY HDR RDNCL ICAV/ISTL 2-12 CH,2925.0,1348.42,396.49,2724.0,63
CPT,77772,BRACHY HDR RDNCL ICAV/ISTL 13+CH,5256.0,2423.02,513.63,4233.86,63
CPT,77778,APPL SOURCE RAD INTERSTITIAL CMPLX,3363.0,1550.34,451.46,3825.05,126
CPT,77778,"INTERSTITIAL RADIATION SOURCE APPLICATION, COMPLEX, INCLUDES SUPERVISION, HANDLING, LOADING OF RADIATION SOURCE, WHEN PERFORMED",,,451.46,3825.05,47
CPT,77789,APPL SURF SOURCE LDR RDNCL,488.0,224.97,71.65,2724.0,63
CPT,77790,SPVN/HANDLING/LOAD RADIOELEMENT,403.0,185.78,17.45,2724.0,80
CPT,78012,NM THYROID UPTAKE MEAS QN SGL/MULT,640.0,254.08,70.3,1554.07,63
CPT,78013,NM THYROID W/WO FLOW VASCULAR,1158.0,459.73,150.11,1554.07,63
CPT,78014,NM THYROID UPTAKE MEAS W/WO FLW STM,1658.0,658.23,189.7,1554.07,63
CPT,78018,NM METS CA THYROID WHOLE BODY,3492.0,1386.32,239.32,2619.0,63
CPT,78020,NM UPTAKE METS CA THYROID,358.0,142.13,50.87,340.24,37
CPT,78070,NM PLANAR PARATHYROID,1943.0,771.37,226.01,1777.02,63
CPT,78071,NM PLANAR PARATHYROID W SPECT,1982.0,786.85,258.14,2022.47,63
CPT,78072,NM PLANAR PARATHYROID W SPECT/CT,2800.0,1111.6,316.53,2471.62,63
CPT,78102,NM MARROW BONE LTD,1369.0,543.49,132.26,1554.07,63
CPT,78103,NM MARROW BONE MULTIPLE,2885.0,1145.34,137.78,2163.75,63
CPT,78104,NM MARROW BONE BODY WHOLE,3339.0,1325.58,188.36,2504.25,63
CPT,78111,NM VOLUME PLASMA SAMPLING MULTI,2599.0,1031.8,62.48,5381.65,63
CPT,78120,NM VOLUME CELL RED SAMPLING SINGLE,1073.0,425.98,59.56,1554.07,63
CPT,78121,NM VOLUME CELL RED SAMPLING MULTI,1575.0,625.28,62.48,2016.76,63
CPT,78122,NM VOLUME BLOOD PLASMA&CELL RED,1540.0,611.38,75.78,2016.76,63
CPT,78140,NM SEQUESTRATION CELL RED LABELED,1777.0,705.47,82.88,1554.07,63
CPT,78185,NM SPLEEN W/WO FLOW VASCULAR,1255.0,498.24,135.17,1554.07,63
CPT,78195,NM LYMPH SYSTEM,2007.0,796.78,261.68,2043.63,63
CPT,78201,NM LIVER STATIC,1186.0,470.84,152.71,2016.76,63
CPT,78202,NM LIVER W FLOW VASCULAR,1306.0,518.48,166.66,2016.76,63
CPT,78215,NM LIVER&SPLEEN STATIC,1201.0,476.8,155.3,1554.07,63
CPT,78216,NM LIVER&SPLEEN W FLOW VASCULAR,949.0,376.75,99.44,1554.07,63
CPT,78226,NM HEPATOBILIARY W/WO GB,1956.0,776.53,255.23,1988.08,63
CPT,78227,NM HEPATOBILIARY W PHARM W/WO GB,2435.0,966.7,346.99,2703.51,63
CPT,78231,NM GLAND SALIVARY W SERIAL,1259.0,499.82,80.94,1554.07,63
CPT,78258,NM MOTILITY ESOPHAGEAL,1249.0,495.85,160.49,1554.07,63
CPT,78262,NM REFLUX GASTROESOPHAGEAL,1672.0,663.78,189.34,1554.07,63
CPT,78264,NM EMPTYING GASTRIC,1984.0,787.65,258.43,2011.83,63
CPT,78267,NM TEST BREATH UREA C14 ACQ,347.0,137.76,11.06,260.25,63
CPT,78268,NM TEST BREATH UREA C14 ANALYSIS,2884.0,1144.95,94.41,2163.0,63
CPT,78278,NM LOSS BLOOD GI ACUTE,2040.0,809.88,265.56,2062.12,63
CPT,78290,NM INTESTINE,2017.0,800.75,262.0,2056.8,63
CPT,78291,NM PATENCY SHUNT PERITONEAL VENOUS,1505.0,597.48,195.5,1554.07,63
CPT,78300,NM BONE&/JOINT LTD,2452.0,973.44,173.19,1839.0,63
CPT,78305,NM BONE&/JOINT MULTIPLE,2668.0,1059.2,205.6,2001.0,63
CPT,78306,NM BONE&/JOINT BODY WHOLE,4375.0,1736.88,223.78,3281.25,63
CPT,78315,NM BONE&/JOINT PHASE 3,5105.0,2026.69,262.32,3828.75,63
CPT,78428,NM DETECTION SHUNT CARDIAC,1106.0,439.08,134.53,1554.07,63
CPT,78429,PET EVAL METAB MYOC STUDY SGL W CT,5664.0,2056.03,1073.25,11557.05,63
CPT,78430,PET EVAL METAB MYOC SGL R/S W CT,3956.0,1436.03,990.66,11557.05,63
CPT,78431,PET EVAL METAB MYOC MULT R/S W CT,4983.0,1808.83,1629.44,17803.35,63
CPT,78432,PET EVAL METAB MYOC TWO RDTRCR,4905.0,1780.52,1469.35,13055.22,63
CPT,78433,PET EVAL METAB MYOC TWO RDTRCR W CT,5379.0,1952.58,1414.11,17803.35,63
CPT,78434,PET QUAN ABSLT MYOC REST&RX STRESS,1001.0,363.36,100.41,5069.0,37
CPT,78445,NM FLOW VASCULAR NON-CARDIAC,1132.0,449.4,160.17,1554.07,63
CPT,78451,NM PERF MYOC SPECT WM/EF SGL,2315.0,919.06,243.21,5381.65,63
CPT,78452,NM PERF MYOC SPEC WM/EF MULT,3591.0,1425.63,348.9,5381.65,63
CPT,78453,NM PERF MYOC PLANAR WM/EF SGL,2315.0,919.06,215.63,5381.65,63
CPT,78454,NM PERF MYOC PLANAR WM/EF MULT,3464.0,1375.21,326.55,5381.65,63
CPT,78456,NM THROMBOSIS VENOUS ACUTE,2111.0,838.07,236.03,5381.65,63
CPT,78457,NM THROMBOSIS VENOUS UNI,1721.0,683.24,116.03,2016.76,63
CPT,78458,NM THROMBOSIS VENOUS BI,1883.0,747.55,146.21,1554.07,63
CPT,78459,PET EVAL METAB MYOCARDIAL STUDY SGL,5380.0,1952.94,867.56,10463.13,63
CPT,78466,NM MYOCARDIAL INFARCT PLANAR,1672.0,663.78,131.61,1554.07,63
CPT,78469,NM MYOCARDIAL INFARCT SPECT,1886.0,748.74,158.87,2016.76,63
CPT,78472,NM MUGA REST/STRESS PLANAR SGL,3546.0,1407.76,160.82,2659.5,63
CPT,78473,NM MUGA REST&STRESS MULTI,4227.0,1678.12,195.5,3170.25,63
CPT,78481,NM POOL BLOOD CARDIAC 1ST PASS SGL,1298.0,515.31,117.04,2016.76,63
CPT,78494,NM MUGA REST W SPECT,1528.0,606.62,153.35,1554.07,63
CPT,78496,NM MUGA REST VENTRICLE RT,1260.0,500.22,18.46,945.0,37
CPT,78579,NM VENT PULMONARY,1120.0,444.64,145.93,1554.07,63
CPT,78580,NM PERF PULMONARY,1367.0,542.7,177.69,1554.07,63
CPT,78582,NM VENT&PERF PULMONARY,1892.0,751.12,247.43,2016.76,63
CPT,78597,NM PERF PULM DIFF QN W/WO IMG,1132.0,449.4,146.58,1554.07,63
CPT,78598,NM PERF&VENT PULM DIFF QN W/WO IMG,1765.0,700.7,230.88,2016.76,63
CPT,78600,NM BRAIN 1-3 VW STATIC,1117.0,443.45,143.94,1554.07,63
CPT,78601,NM BRAIN 1-3 VW STATIC W FLOW,1323.0,525.23,172.18,1554.07,63
CPT,78605,NM BRAIN 4+ VW STATIC,1211.0,480.77,156.6,2016.76,63
CPT,78606,NM BRAIN 4+ VW STATIC W FLOW,2030.0,805.91,264.6,2051.54,63
CPT,78608,PET EVL METAB BR C11 NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CPT,78608,PET EVL METAB BR C11 ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR C11 ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR C11 ONC FDG SUB1-3,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR DA NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CPT,78608,PET EVL METAB BR DA ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR DA ONC FDG SUB 1-3,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR DA ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CPT,78608,PET EVL METAB BR ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR ONC FDG SUB 1-3,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR QN NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CPT,78608,PET EVL METAB BR QN ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR QN ONC FDG SUB 1-3,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB BR QN ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB TMR BR NON ONC FDG,6351.0,2305.41,1073.25,11557.05,63
CPT,78608,PET EVL METAB TMR BR ONC FDG INIT,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB TMR BR ONC FDG SUB 4+,6351.0,2305.41,1073.25,11557.05,40
CPT,78608,PET EVL METAB TMR BR ONC FDG SUB1-3,6351.0,2305.41,1073.25,11557.05,40
CPT,78610,NM FLOW VASCULAR BRAIN,1322.0,524.83,144.26,2016.76,63
CPT,78630,NM FLOW CSF CISTERNOGRAM,2066.0,820.2,269.14,2088.2,63
CPT,78645,NM FLOW CSF EVAL SHUNT,2020.0,801.94,262.0,2054.14,63
CPT,78650,NM DETECTION&LOC LEAK CSF,2073.0,822.98,217.53,5381.65,63
CPT,78700,NM KIDNEY,1096.0,435.11,134.21,1554.07,63
CPT,78701,NM KIDNEY W FLOW VASCULAR,2705.0,1073.88,180.29,2028.75,63
CPT,78707,NM KIDNEY FUNCTION&FLOW,1497.0,594.31,166.98,2016.76,63
CPT,78708,NM KIDNEY FUNCTION&FLOW PHARM SGL,1598.0,634.41,116.63,2016.76,63
CPT,78709,NM KIDNEY FUNCTION&FLOW PHARM MULTI,2045.0,811.86,266.21,2082.87,63
CPT,78725,NM KIDNEY FUNCTION NON IMG,1096.0,435.11,77.74,1554.07,63
CPT,78740,NM REFLEX URETERAL,1395.0,553.82,179.32,1554.07,63
CPT,78761,NM TESTICULAR W FLOW VASCULAR,1366.0,542.3,159.19,1554.07,63
CPT,78800,NM LOC RRX TMR PLNR 1 AREA 1D IMG,1472.0,584.38,196.51,1589.69,63
CPT,78802,NM LOC RRX TMR PLNR WHL BODY 1D IMG,1824.0,724.13,238.39,5381.65,63
CPT,78803,NM LOC RRX TMR SPECT 1AREA 1ACQ 1D,2209.0,876.97,289.95,5381.65,63
CPT,78804,NM LOC RRX TMR PLNR WHL BODY 2D IMG,4713.0,1871.06,525.41,5381.65,63
CPT,78808,INJ RRX LOC STDY PROBE NON-IMG IV,664.0,263.61,38.69,1554.07,126
CPT,78811,PET IMG LTD AREA NON ONC FDG,5785.0,2099.96,946.81,10463.13,63
CPT,78811,PET IMG LTD AREA ONC FDG INIT,5785.0,2099.96,946.81,10463.13,40
CPT,78811,PET IMG LTD AREA ONC FDG SUB 1-3,5785.0,2099.96,946.81,10463.13,40
CPT,78811,PET IMG LTD AREA ONC FDG SUB 4+,5785.0,2099.96,946.81,10463.13,40
CPT,78812,PET IMG SKULL-THGH ONC FDG SUB 1-3,7282.0,2643.37,1073.25,11557.05,40
CPT,78812,PET IMG SKULL-THIGH NON ONC FDG,7282.0,2643.37,1073.25,11557.05,63
CPT,78812,PET IMG SKULL-THIGH ONC FDG INIT,7282.0,2643.37,1073.25,11557.05,40
CPT,78812,PET IMG SKULL-THIGH ONC FDG SUB 4+,7282.0,2643.37,1073.25,11557.05,40
CPT,78813,PET IMG WHOLE BODY NON ONC FDG,8422.0,3057.19,1073.25,11557.05,63
CPT,78813,PET IMG WHOLE BODY ONC FDG INIT,8422.0,3057.19,1073.25,11557.05,40
CPT,78813,PET IMG WHOLE BODY ONC FDG SUB 1-3,8422.0,3057.19,1073.25,11557.05,40
CPT,78813,PET IMG WHOLE BODY ONC FDG SUB 4+,8422.0,3057.19,1073.25,11557.05,40
CPT,78814,PET/CT LTD AREA NON ONC FDG,8631.0,3133.05,1073.25,11557.05,63
CPT,78814,PET/CT LTD AREA ONC FDG INIT,8631.0,3133.05,1073.25,11557.05,40
CPT,78814,PET/CT LTD AREA ONC FDG SUB 1-3,8631.0,3133.05,1073.25,11557.05,40
CPT,78814,PET/CT LTD AREA ONC FDG SUB 4+,8631.0,3133.05,1073.25,11557.05,40
CPT,78815,PET/CT SKULL-THIGH NON ONC FDG,10206.0,3704.78,1073.25,11895.84,63
CPT,78815,PET/CT SKULL-THIGH ONC FDG INIT,10206.0,3704.78,1073.25,11895.84,40
CPT,78815,PET/CT SKULL-THIGH ONC FDG SUB 1-3,10206.0,3704.78,1073.25,11895.84,40
CPT,78815,PET/CT SKULL-THIGH ONC FDG SUB 4+,10206.0,3704.78,1073.25,11895.84,40
CPT,78816,PET/CT WHOLE BODY NON ONC FDG,9876.0,3584.99,1073.25,11557.05,63
CPT,78816,PET/CT WHOLE BODY ONC FDG INIT,9876.0,3584.99,1073.25,11557.05,40
CPT,78816,PET/CT WHOLE BODY ONC FDG SUB 1-3,9876.0,3584.99,1073.25,11557.05,40
CPT,78816,PET/CT WHOLE BODY ONC FDG SUB 4+,9876.0,3584.99,1073.25,11557.05,40
CPT,78830,NM LOC RRX TMR SPECT CT 1AREA 1ACQ,2744.0,1089.37,359.04,5381.65,63
CPT,78831,NM LOC RRX TMR SPECT 2+AREA 2ACQ,4198.0,1666.61,552.03,5381.65,63
CPT,78832,NM LOC RRX TMR SPECT CT 2+AREA 2ACQ,5398.0,2143.01,707.74,6100.33,63
CPT,79005,THERAPY RRX PO HYPTHYROID INIT,1166.0,464.07,49.9,1028.66,63
CPT,79005,THERAPY RRX PO THYROID CA ABL,1166.0,464.07,49.9,1028.66,63
CPT,79005,THERAPY RRX PO THYROID CA METS,1166.0,464.07,49.9,1028.66,63
CPT,79101,THERAPY RRX IV,1220.0,485.56,52.17,1028.66,63
CPT,79200,THERAPY RRX INTRACAVITARY,1562.0,621.68,51.16,1171.5,63
CPT,79403,THERAPY RRX INF IV RMA,1640.0,652.72,98.17,1230.0,63
CPT,79440,THERAPY RRX INTRAARTICULAR,582.0,231.64,38.54,1028.66,63
CPT,79445,THERAPY RRX INTRAARTERIAL PARTICUL,1625.0,646.75,83.45,1218.75,63
CPT,80048,LAB PANEL METAB BASIC W CA TOTAL,377.0,60.32,8.46,282.75,63
CPT,80051,LAB PANEL ELECTROLYTE,158.0,25.28,7.01,118.5,63
CPT,80051,POC PANEL ELECTROLYTE TELCOR,158.0,25.28,7.01,118.5,63
CPT,80053,LAB PANEL METAB COMP,671.0,107.36,10.56,503.25,63
CPT,80061,LAB PANEL LIPID,171.0,27.36,13.39,128.25,63
CPT,80061,LAB PANEL LIPID NS,69.0,11.04,13.39,69.11,63
CPT,80069,LAB PANEL FUNCTION RENAL,230.0,36.8,8.68,172.5,63
CPT,80074,LAB PANEL HEPATITIS ACUTE,299.0,47.84,47.63,224.25,63
CPT,80076,LAB PANEL FUNCTION HEPATIC,244.0,39.04,8.17,183.0,63
CPT,80145,LAB ADALIMUMAB,300.0,48.0,38.57,225.0,63
CPT,80150,LAB AMIKACIN PEAK,59.0,9.44,15.08,70.78,63
CPT,80150,LAB AMIKACIN RANDOM,46.0,7.36,15.08,70.78,63
CPT,80150,LAB AMIKACIN TROUGH,62.0,9.92,15.08,70.78,63
CPT,80151,LAB AMIODARONE,90.0,14.4,18.64,87.47,63
CPT,80155,LAB CAFFEINE,116.0,18.56,38.57,181.07,63
CPT,80156,LAB CARBAMAZEPINE TOTAL,52.0,8.32,14.57,68.38,63
CPT,80157,LAB CARBAMAZEPINE FREE,90.0,14.4,13.25,67.5,63
CPT,80158,LAB CYCLOSPORINE,55.0,8.8,18.05,84.75,63
CPT,80158,LAB CYCLOSPORINE A,58.0,9.28,18.05,84.75,63
CPT,80159,LAB CLOZAPINE/NORCLOZAPINE,68.0,10.88,20.15,94.59,63
CPT,80161,LAB CARBAMAZEPINE -10 11-EPOXIDE,58.0,9.28,18.64,87.47,63
CPT,80161,LAB CARBAMAZEPINE -10 11-EPOXIDE NS,90.0,14.4,18.64,87.47,63
CPT,80162,LAB DIGOXIN TOTAL,53.0,8.48,13.28,62.33,63
CPT,80163,LAB DIGOXIN FREE,40.0,6.4,13.28,62.33,63
CPT,80164,LAB ACID VALPROIC TOTAL,53.0,8.48,13.54,63.53,63
CPT,80164,LAB ACID VALPROIC TOTAL NS,66.0,10.56,13.54,63.53,63
CPT,80165,LAB ACID VALPROIC FREE,66.0,10.56,13.54,63.53,63
CPT,80167,LAB FELBAMATE,74.0,11.84,18.64,87.47,63
CPT,80168,LAB ETHOSUXIMIDE,107.0,17.12,16.34,80.25,63
CPT,80169,LAB EVEROLIMUS,60.0,9.6,13.73,64.46,63
CPT,80170,LAB GENTAMICIN PEAK,50.0,8.0,16.38,76.9,63
CPT,80170,LAB GENTAMICIN RANDOM,50.0,8.0,16.38,76.9,63
CPT,80170,LAB GENTAMICIN TROUGH,50.0,8.0,16.38,76.9,63
CPT,80171,LAB GABAPENTIN SRM/PLASMA/BLD WHL,77.0,12.32,21.67,101.71,63
CPT,80173,LAB HALOPERIDOL,99.0,15.84,15.78,74.25,63
CPT,80175,LAB LAMOTRIGINE,66.0,10.56,13.25,62.2,63
CPT,80176,LAB LIDOCAINE,62.0,9.92,14.69,68.91,63
CPT,80177,LAB LEVETIRACETAM,40.0,6.4,13.25,62.2,63
CPT,80177,LAB LEVETIRACETAM NS,63.0,10.08,13.25,62.2,63
CPT,80178,LAB LITHIUM,52.0,8.32,6.61,39.0,63
CPT,80180,LAB ACID MYCOPHENOLIC,55.0,8.8,18.05,84.75,63
CPT,80181,LAB FLECAINIDE,68.0,10.88,18.64,87.47,63
CPT,80183,LAB OXCARBAZEPINE,69.0,11.04,13.25,62.2,63
CPT,80184,LAB PHENOBARBITAL,53.0,8.48,15.3,71.78,63
CPT,80184,LAB PHENOBARBITAL NS,59.0,9.44,15.3,71.78,63
CPT,80185,LAB PHENYTOIN TOTAL,53.0,8.48,13.25,62.2,63
CPT,80186,LAB PHENYTOIN FREE,63.0,10.08,13.76,64.59,63
CPT,80187,LAB POSACONAZOLE,118.0,18.88,27.11,117.41,63
CPT,80188,LAB PRIMIDONE NS,59.0,9.44,16.59,77.83,63
CPT,80189,LAB ITRACONAZOLE,131.0,20.96,27.11,117.41,63
CPT,80192,LAB PROCAINAMIDE W NAPA,51.0,8.16,16.75,78.63,63
CPT,80193,LAB LEFLUNOMIDE,116.0,18.56,38.57,167.05,63
CPT,80194,LAB QUINIDINE,60.0,9.6,14.6,68.52,63
CPT,80195,LAB SIROLIMUS,57.0,9.12,13.73,64.46,63
CPT,80197,LAB TACROLIMUS FK-506,57.0,9.12,13.73,64.46,63
CPT,80197,LAB TACROLIMUS FK-506 NS,64.0,10.24,13.73,64.46,63
CPT,80198,LAB THEOPHYLLINE,43.0,6.88,14.14,66.39,63
CPT,80200,LAB TOBRAMYCIN PEAK,49.0,7.84,16.13,75.7,63
CPT,80200,LAB TOBRAMYCIN RANDOM,49.0,7.84,16.13,75.7,63
CPT,80200,LAB TOBRAMYCIN TROUGH,49.0,7.84,16.13,75.7,63
CPT,80201,LAB TOPIRAMATE,36.0,5.76,11.92,55.94,63
CPT,80202,LAB VANCOMYCIN PEAK,64.0,10.24,13.54,63.53,63
CPT,80202,LAB VANCOMYCIN RANDOM,64.0,10.24,13.54,63.53,63
CPT,80202,LAB VANCOMYCIN TROUGH,64.0,10.24,13.54,63.53,63
CPT,80203,LAB ZONISAMIDE,79.0,12.64,13.25,62.2,63
CPT,80204,LAB METHOTREXATE,116.0,18.56,38.57,167.05,63
CPT,80220,LAB HYDROXYCHLOROQUINE,291.0,46.56,18.64,218.25,63
CPT,80230,LAB INFLIXIMAB,266.0,42.56,38.57,199.5,63
CPT,80235,LAB LACOSAMIDE,82.0,13.12,27.11,117.41,63
CPT,80280,LAB VEDOLIZUMAB,317.0,50.72,38.57,237.75,63
CPT,80285,LAB VORICONAZOLE,127.0,20.32,27.11,117.41,63
CPT,80299,LAB ANTI-CD19 CAR T-CELL,500.0,80.0,18.64,375.0,63
CPT,80299,LAB BACLOFEN,132.0,21.12,18.64,99.0,63
CPT,80299,LAB BUSULFAN,56.0,8.96,18.64,87.47,63
CPT,80299,LAB CERTOLIZUMAB,335.0,53.6,18.64,251.25,63
CPT,80299,LAB CHLORDIAZEPOXIDE,169.0,27.04,18.64,126.75,63
CPT,80299,LAB CLOMIPRAMINE,62.0,9.92,18.64,87.47,63
CPT,80299,LAB CLONAZEPAM,67.0,10.72,18.64,87.47,63
CPT,80299,LAB DEXAMETHASONE,60.0,9.6,18.64,87.47,63
CPT,80299,LAB ETHAMBUTOL,155.0,24.8,18.64,116.25,63
CPT,80299,LAB FLUCONAZOLE,111.0,17.76,18.64,87.47,63
CPT,80299,LAB ISAVUCONAZOLE,135.0,21.6,18.64,101.25,63
CPT,80299,LAB ISONIAZID,155.0,24.8,18.64,116.25,63
CPT,80299,LAB LINEZOLID,155.0,24.8,18.64,116.25,63
CPT,80299,LAB METFORMIN,189.0,30.24,18.64,141.75,63
CPT,80299,LAB NORTRIPTYLINE,68.0,10.88,18.64,87.47,63
CPT,80299,LAB PYRAZINAMIDE,155.0,24.8,18.64,116.25,63
CPT,80299,LAB RIFAMPIN,155.0,24.8,18.64,116.25,63
CPT,80299,LAB THIOPURINE,160.0,25.6,18.64,120.0,63
CPT,80299,LAB USTEKINUMAB,226.0,36.16,18.64,169.5,63
CPT,80305,LAB DRG SCR DIRECT OPT OBS ONLY DAY,64.0,10.24,12.6,59.14,63
CPT,80307,LAB DRG SC INST ALYZ CORD TIS DAY,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ CORD TIS DAYNS,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ MECON DAY,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ MECON DAY NS,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ SERUM DAY,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ SERUM DAY NS,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ URINE DAY,290.0,46.4,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ URINE DAY NS,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ URINE ETOH DAY,187.0,29.92,62.14,291.62,63
CPT,80307,LAB DRG SC INST ALYZ URINE PMGT DAY,449.0,71.84,62.14,336.75,63
CPT,80307,LAB DRG SC INST ALYZ WHL BLOOD DAY,282.0,45.12,62.14,291.62,63
CPT,80320,LAB DRG DF ETOH EXCEPT BR DAY,312.0,49.92,23.37,234.0,37
CPT,80320,LAB DRG DF ETOH EXCEPT BR DAY NS,61.0,9.76,11.35,101.51,37
CPT,80321,LAB DRG DF ETOH BIOMRK 1-2,130.0,20.8,13.47,97.5,37
CPT,80321,LAB DRG DF ETOH BIOMRK TIS CORD 1-2,110.0,17.6,13.47,82.5,37
CPT,80321,LAB DRG DF ETOH BIOMRK URINE 1-2,158.0,25.28,13.47,118.5,37
CPT,80323,LAB DRG DF ALKALOIDS NICOTINE DAY,160.0,25.6,23.37,176.34,37
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2,156.0,24.96,23.37,117.0,37
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2 NON UR,56.0,8.96,10.42,91.27,37
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2 NS,73.0,11.68,13.58,91.27,37
CPT,80324,LAB DRG DF AMPH/METH MCNIUM DAY 1-2,83.0,13.28,15.44,91.27,37
CPT,80324,LAB DRG DF CNFRM AMPH DAY 1-2,73.0,11.68,13.58,91.27,37
CPT,80329,LAB DRG DF ANLG ACETAMINPHN DAY 1-2,331.0,52.96,23.37,248.25,37
CPT,80329,LAB DRG DF ANLG NON-OPIOID DAY 1-2,57.0,9.12,10.6,118.94,37
CPT,80329,LAB DRG DF ANLG SALICYLATE DAY 1-2,331.0,52.96,23.37,248.25,37
CPT,80332,LAB DRG DF ANTD SEROTONERG DAY 1-2,208.0,33.28,23.37,156.0,37
CPT,80335,LAB DRG DF ANTD CLOM DAY 1-2,62.0,9.92,11.53,100.58,37
CPT,80335,LAB DRG DF ANTD CYCL AMIT DAY 1-2,62.0,9.92,11.53,100.58,37
CPT,80335,LAB DRG DF ANTD CYCL DESI DAY 1-2NS,62.0,9.92,11.53,100.58,37
CPT,80335,LAB DRG DF ANTD CYCL DOXE DAY 1-2,30.0,4.8,5.58,100.58,37
CPT,80335,LAB DRG DF ANTD CYCL IMIPRM DAY 1-2,62.0,9.92,11.53,100.58,37
CPT,80335,LAB DRG DF ANTD CYCL NORT DAY 1-2,68.0,10.88,12.65,100.58,37
CPT,80337,LAB DRG DF ANTD CYCL DAY 6+,87.0,13.92,10.35,100.58,37
CPT,80338,LAB DRG DF BUPROPION DAY,198.0,31.68,12.75,148.5,37
CPT,80338,LAB DRG DF TRAZODONE DAY,70.0,11.2,12.75,74.37,37
CPT,80339,LAB DRG DF ANTIEPILEPTICS DAY 1-3,176.0,28.16,23.37,132.0,37
CPT,80342,LAB DRG DF ANTPSY DAY 1-3,57.0,9.12,10.6,91.53,37
CPT,80345,LAB DRG DF BARB PHENOBARB DAY,174.0,27.84,23.37,130.5,37
CPT,80345,LAB DRG DF BARB PHENOBARB DAY NS,158.0,25.28,23.37,118.5,37
CPT,80345,LAB DRG DF BARB PHENOBARB NON URINE,56.0,8.96,10.42,74.37,37
CPT,80345,LAB DRG DF BARB URINE DAY,73.0,11.68,13.58,74.37,37
CPT,80346,LAB DRG DF BENZ CLONAZEPM DAY 1-12,67.0,10.72,12.46,116.28,37
CPT,80346,LAB DRG DF BENZ CLORAZEPAT DAY 1-12,98.0,15.68,18.23,116.28,37
CPT,80346,LAB DRG DF BENZ DAY 1-12,84.0,13.44,15.62,116.28,37
CPT,80346,LAB DRG DF BENZ DAY 1-12 NON URINE,56.0,8.96,10.42,116.28,37
CPT,80346,LAB DRG DF BENZ FLUNTRZPM DAY 1-12,166.0,26.56,23.37,124.5,37
CPT,80348,LAB DRG DF BUPRENORPHINE DAY,88.0,14.08,16.36,74.37,37
CPT,80348,LAB DRG DF BUPRENORPHINE DAY NON UR,56.0,8.96,10.42,74.37,37
CPT,80348,LAB DRG DF BUPRENORPHINE DAY NS,109.0,17.44,16.36,81.75,37
CPT,80348,LAB DRG DF BUPRENORPHINE MECON DAY,129.0,20.64,16.36,96.75,37
CPT,80349,LAB DRG DF CANNABINOIDS DAY,84.0,13.44,15.62,74.37,37
CPT,80349,LAB DRG DF CANNABINOIDS DAY NON UR,56.0,8.96,10.42,74.37,37
CPT,80352,LAB DRG DF CANNABINOIDS SYN DAY 7+,175.0,28.0,16.1,131.25,37
CPT,80353,LAB DRG DF COCAINE DAY,67.0,10.72,12.46,74.37,37
CPT,80353,LAB DRG DF COCAINE DAY NON URINE,56.0,8.96,10.42,74.37,37
CPT,80353,LAB DRG DF COCAINE MECONIUM,149.0,23.84,23.37,111.75,37
CPT,80354,LAB DRG DF FENTANYL DAY,67.0,10.72,12.46,74.37,37
CPT,80354,LAB DRG DF FENTANYL DAY NON URINE,56.0,8.96,10.42,74.37,37
CPT,80355,LAB DRG DF GABAPENTN NON BLD DAY,56.0,8.96,10.42,74.37,37
CPT,80356,LAB DRG DF HEROIN METABOLITE DAY,56.0,8.96,10.42,74.37,37
CPT,80357,LAB DRG DF KETAMN&NORKETMN DAY,145.0,23.2,23.37,108.75,37
CPT,80358,LAB DRG DF CNFRM METHADONE DAY,158.0,25.28,23.37,118.5,37
CPT,80358,LAB DRG DF METHADONE DAY,158.0,25.28,23.37,118.5,37
CPT,80358,LAB DRG DF METHADONE DAY NON URINE,56.0,8.96,10.42,95.99,37
CPT,80358,LAB DRG DF METHADONE DAY NS,67.0,10.72,12.46,95.99,37
CPT,80358,LAB DRG DF METHADONE MECONIUM DAY,165.0,26.4,23.37,123.75,37
CPT,80359,LAB DRG DF METHYLENEDIOXYAMP NON UR,56.0,8.96,10.42,74.37,37
CPT,80359,LAB DRG DF METHYLENEDIOXYAMPH,156.0,24.96,23.37,117.0,37
CPT,80359,LAB DRG DF METHYLENEDIOXYAMPH NS,70.0,11.2,13.02,74.37,37
CPT,80360,LAB DRG DF METHYLPHENIDATE DAY,67.0,10.72,12.46,74.37,37
CPT,80361,LAB DRG DF OPIATE DAY 1+,104.0,16.64,19.34,78.0,37
CPT,80361,LAB DRG DF OPIATE DAY 1+ NON URINE,56.0,8.96,10.42,74.37,37
CPT,80361,LAB DRG DF OPIATE MECONIUM DAY 1+,70.0,11.2,13.02,74.37,37
CPT,80362,LAB DRG DF OPIOID DAY 1-2 SERUM,162.0,25.92,23.37,121.5,37
CPT,80362,LAB DRG DF OPIOID DAY 1-2 TISSUE,56.0,8.96,10.42,74.37,37
CPT,80362,LAB DRG DF OPIOID MEPRD DAY 1-2,162.0,25.92,23.37,121.5,37
CPT,80364,LAB DRG DF ANLG OPIOID&NITAZ S/P 5+,428.0,68.48,15.93,321.0,37
CPT,80364,LAB DRG DF ANLG OPIOID&OPIAT S/P 5+,347.0,55.52,15.93,260.25,37
CPT,80364,LAB DRG DF ANLG OPIOID&OPIAT UR 5+,97.0,15.52,15.93,74.37,37
CPT,80365,LAB DRG DF OXYCODONE DAY,104.0,16.64,19.34,78.0,37
CPT,80365,LAB DRG DF OXYCODONE DAY NON URINE,56.0,8.96,10.42,74.37,37
CPT,80365,LAB DRG DF OXYCODONE MECONIUM DAY,70.0,11.2,13.02,74.37,37
CPT,80366,LAB DRG DF PREGABALIN,95.0,15.2,17.67,74.37,37
CPT,80367,LAB DRG DF CONF PROPOXYPHENE DAY NS,56.0,8.96,10.42,74.37,37
CPT,80368,LAB DRG DF HYPNOTICS SED DAY,56.0,8.96,10.42,74.37,37
CPT,80369,LAB DRG DF MSCL RELAX DAY 1-2,154.0,24.64,23.37,115.5,37
CPT,80371,LAB DRG DF STIMULANTS SYN DAY,160.0,25.6,23.37,120.0,37
CPT,80372,LAB DRG DF TAPENTADOL DAY,56.0,8.96,10.42,74.37,37
CPT,80373,LAB DRG DF TRAMADOL,67.0,10.72,12.46,74.37,37
CPT,80373,LAB DRG DF TRAMADOL NON URINE,56.0,8.96,10.42,74.37,37
CPT,80375,LAB DRG DF DAY 1-3,366.0,58.56,23.37,274.5,37
CPT,80375,LAB DRG DF DIPHENHYDRAMINE DAY 1-3,132.0,21.12,23.37,99.0,37
CPT,80375,LAB DRG DF FLUCYTOSINE DAY 1-3,435.0,69.6,23.37,326.25,37
CPT,80375,LAB DRG DF FUROSEMIDE DAY 1-3,120.0,19.2,22.32,90.0,37
CPT,80375,LAB DRG DF GOLD DAY 1-3,120.0,19.2,22.32,90.0,37
CPT,80375,LAB DRG DF METFORMIN DAY 1-3,182.0,29.12,23.37,136.5,37
CPT,80375,LAB DRG DF MITOTANE DAY 1-3,187.0,29.92,23.37,140.25,37
CPT,80375,LAB DRG DF SULFONAMIDES DAY 1-3,147.0,23.52,23.37,110.25,37
CPT,80375,LAB DRG DF THIOPURINE DAY 1-3,160.0,25.6,23.37,120.0,37
CPT,80375,LAB DRG DF TPMT ACTIVITY DAY 1-3,120.0,19.2,22.32,90.0,37
CPT,80375,LAB DRG DF XYLAZINE DAY 1-3,583.0,93.28,23.37,437.25,37
CPT,80377,LAB DRG DF SULFONYLUREAS DAY 7+,178.0,28.48,23.37,133.5,37
CPT,81001,LAB UA AUTO W MICRO,91.0,25.02,3.17,68.25,63
CPT,81002,LAB UA NONAUTO WO MICRO,11.0,3.03,3.48,16.3,63
CPT,81002,LAB UA REDUCING SUBSTANCE,11.0,3.03,3.48,16.3,63
CPT,81002,POC UA NONAUTO WO MICRO DIPSTICK,11.0,3.03,3.48,16.3,63
CPT,81003,LAB UA AUTO WO MICRO,12.0,3.3,2.25,10.58,63
CPT,81003,LAB UA GRAVITY SPCFC AUTO WO MICRO,53.0,14.58,2.25,39.75,63
CPT,81003,LAB UA KETONES AUTO WO MICRO,12.0,3.3,2.25,10.58,63
CPT,81003,LAB UA PH AUTO WO MICRO,12.0,3.3,2.25,10.58,63
CPT,81003,POC UA AUTO WO MICRO,107.0,29.42,2.25,80.25,63
CPT,81005,LAB UA QL/SEMI QN,7.0,1.93,2.17,10.18,63
CPT,81015,LAB UA MICROSCOPIC ONLY,10.0,2.75,3.05,14.3,63
CPT,81025,LAB PREGNANCY URINE,58.0,15.95,8.61,43.5,63
CPT,81025,POC PREGNANCY URINE,42.0,11.55,8.61,40.44,63
CPT,81050,LAB MEASUREMENT VOL COLL TIMED EA,11.0,3.03,3.64,17.1,63
CPT,81105,LAB GENE HPA-1,367.0,102.39,122.22,644.05,63
CPT,81106,LAB GENOTYPING HPA-2,367.0,102.39,122.22,644.05,63
CPT,81107,LAB GENOTYPING HPA-3,367.0,102.39,122.22,644.05,63
CPT,81108,LAB GENOTYPING HPA-4,367.0,102.39,122.22,644.05,63
CPT,81109,LAB GENOTYPING HPA-5,367.0,102.39,122.22,644.05,63
CPT,81110,LAB GENOTYPING HPA-6,367.0,102.39,122.22,644.05,63
CPT,81111,LAB GENOTYPING HPA-9,367.0,102.39,122.22,644.05,63
CPT,81112,LAB GENOTYPING HPA-15,367.0,102.39,122.22,644.05,63
CPT,81120,LAB GENE IDH1 VAR COMMON,580.0,161.82,193.25,1018.35,63
CPT,81121,LAB GENE IDH2 VAR COMMON,888.0,247.75,295.79,1558.63,63
CPT,81162,LAB GENE BRCA1&2 SEQ&DUP/DEL FULL,5475.0,1527.52,1824.88,9616.0,63
CPT,81170,LAB GENE ABL1 VAR KD,900.0,251.1,300.0,1580.85,63
CPT,81206,LAB GENE BCR/ABL1 BREAKPOINT MAJOR,492.0,137.27,163.96,863.96,63
CPT,81206,LAB GENE BCR/ABL1 REFLEX P210,492.0,137.27,163.96,863.96,63
CPT,81206,LAB GENE BCR/ABL1 REFLEX P210 NS,492.0,137.27,163.96,863.96,63
CPT,81207,LAB GENE BCR/ABL1 BREAKPOINT MIN,435.0,121.36,144.84,763.18,63
CPT,81207,LAB GENE BCR/ABL1 BREAKPOINT MIN NS,435.0,121.36,144.84,763.18,63
CPT,81208,LAB GENE BCR/ABL1 BREAKPOINT OTHER,644.0,179.68,214.62,1130.91,63
CPT,81209,LAB GENE BLM VAR 2281DEL6INS7,118.0,32.92,39.31,207.14,63
CPT,81210,LAB GENE BRAF VAR V600E,527.0,147.03,175.4,924.23,63
CPT,81210,LAB GENE BRAF VAR V600E NS,527.0,147.03,175.4,924.23,63
CPT,81218,LAB GENE CEBPA SEQ FULL,726.0,202.55,241.9,1274.66,63
CPT,81219,LAB GENE ANLYS MUT CALRETICULIN,365.0,101.84,121.63,640.92,63
CPT,81220,LAB GENE CFTR VAR COMMON,1670.0,465.93,556.6,2932.93,63
CPT,81222,LAB GENE CFTR VAR DUP/DEL,1306.0,364.37,435.07,2292.55,63
CPT,81223,LAB GENE CFTR SEQ FULL,1497.0,417.66,499.0,2629.47,63
CPT,81225,LAB GENE CYP2C19 VAR COMMON,875.0,244.13,291.36,1535.28,63
CPT,81225,LAB GENE CYP2C19 VAR COMMON NS,875.0,244.13,291.36,1535.28,63
CPT,81226,LAB GENE CYP2D6 VAR COMMON,1353.0,377.49,450.91,2376.03,63
CPT,81227,LAB GENE CYP2C9 VAR COMMON,525.0,146.48,174.81,921.17,63
CPT,81227,LAB GENE CYP2C9 VAR COMMON NS,525.0,146.48,174.81,921.17,63
CPT,81229,LAB GENE MA CYTO COPY NO&SNP BLD,3480.0,970.92,1160.0,6112.52,63
CPT,81229,LAB GENE MA CYTO COPY NO&SNP BLD NS,3480.0,970.92,1160.0,6112.52,63
CPT,81229,LAB GENE MA CYTO COPY NO&SNP POC,3480.0,970.92,1160.0,6112.52,63
CPT,81230,LAB GENE CYP3A4 VAR COMMON,525.0,146.48,174.81,921.17,63
CPT,81231,LAB GENE CYP3A5 VAR COMMON,525.0,146.48,174.81,921.17,63
CPT,81232,LAB GENE DPYD VAR COMMON,525.0,146.48,174.81,921.17,63
CPT,81232,LAB GENE DPYD VAR COMMON NS,525.0,146.48,174.81,921.17,63
CPT,81233,LAB GENE BTK VAR COMMON,674.0,188.05,175.4,924.23,63
CPT,81234,LAB GENE DMPK DET ALLELES ABNRM MYO,825.0,230.18,137.0,721.88,63
CPT,81235,LAB GENE EGFR VAR COMMON,974.0,271.75,324.58,1710.3,63
CPT,81235,LAB GENE EGFR VAR COMMON NS,974.0,271.75,324.58,1710.3,63
CPT,81240,LAB GENE F2 VAR 20210G>A,198.0,55.24,65.69,346.17,63
CPT,81240,LAB GENE F2 VAR 20210G>A NS,198.0,55.24,65.69,346.17,63
CPT,81241,LAB GENE F5 VAR LEIDEN,221.0,61.66,73.37,386.61,63
CPT,81241,LAB GENE F5 VAR LEIDEN NS,221.0,61.66,73.37,386.61,63
CPT,81243,LAB GENE FMR1 DET ALLELES ABNORMAL,172.0,47.99,57.04,300.6,63
CPT,81245,LAB GENE FLT3 VAR ITD,497.0,138.66,165.51,872.14,63
CPT,81246,LAB GENE FLT3 VAR TKD,249.0,69.47,83.0,1932.41,63
CPT,81247,LAB GENE G6PD VAR COMMON,525.0,146.48,174.81,921.17,63
CPT,81249,LAB GENE G6PD ANLYS SEQ FULL,1800.0,502.2,600.0,3161.63,63
CPT,81250,LAB GENE G6PC VAR COMMON,176.0,49.1,58.49,308.19,63
CPT,81256,LAB GENE HFE VAR COMMON,197.0,54.96,65.36,344.37,63
CPT,81256,LAB GENE HFE VAR COMMON NS,197.0,54.96,65.36,344.37,63
CPT,81257,LAB GENE HBA1/HBA2 DEL/VAR COMMON,307.0,85.65,102.26,538.88,63
CPT,81259,LAB GENE HBA1/HBA2 SEQ FULL,1800.0,502.2,600.0,3161.63,63
CPT,81261,LAB GENE IGH REARRANGEMENT AMP,594.0,165.73,197.99,1043.3,63
CPT,81263,LAB GENE IGH MUT VARIABLE REGION,884.0,246.64,294.52,1551.91,63
CPT,81264,LAB GENE IGK REARRANGEMENT CLONAL,519.0,144.8,172.73,910.19,63
CPT,81265,LAB GENE MARKERS STR SPEC PT&CMP,700.0,195.3,233.07,1228.16,63
CPT,81265,LAB GENE MARKERS STR SPEC PT&CMP NS,1427.0,398.13,233.07,1228.16,63
CPT,81267,LAB GENE CHIMERISM WO CELL SLCT,623.0,173.82,207.46,1093.19,63
CPT,81267,LAB GENE CHIMERISM WO CELL SLCT NS,1139.0,317.78,207.46,1093.19,63
CPT,81268,LAB GENE CHIMERISM W CELL SLCT EA,783.0,218.46,260.79,1374.17,63
CPT,81268,LAB GENE CHIMERISM W MYELOID SLCTEA,783.0,218.46,260.79,1374.17,63
CPT,81268,LAB GENE CHIMERISM W TCELL SLCT EA,783.0,218.46,260.79,1374.17,63
CPT,81269,LAB GENE HBA1/HBA2 VAR DUP/DEL,608.0,169.63,202.4,1066.52,63
CPT,81270,LAB GENE JAK2 VAR V617F,275.0,76.73,91.66,483.0,63
CPT,81270,LAB GENE JAK2 VAR V617F NS,275.0,76.73,91.66,483.0,63
CPT,81272,LAB GENE ANLYS MUT C-KIT,989.0,275.93,329.51,1736.37,63
CPT,81273,LAB GENE KIT VAR D816,375.0,104.63,124.87,658.02,63
CPT,81274,LAB GENE HTT ALLELES CHARACTERIZATN,825.0,230.18,274.83,1448.21,63
CPT,81275,LAB GENE KRAS VAR CODONS 12&13 NS,580.0,161.82,193.25,1018.35,63
CPT,81276,LAB GENE KRAS VAR ADDL NS,580.0,161.82,193.25,1018.35,63
CPT,81277,LAB GENE ANLYS NEOPLASIA CYTOGENOMC,3480.0,970.92,1160.0,6112.52,63
CPT,81279,LAB GENE JAK2 EXON TGT SEQ 12,556.0,155.12,185.2,975.85,63
CPT,81283,LAB GENE IFNL3,221.0,61.66,73.37,386.61,63
CPT,81287,LAB GENE MGMT ANLYS METHYLATION,671.0,187.21,124.64,656.82,63
CPT,81288,LAB GENE MLH1 METHYLATION,577.0,160.98,192.32,1013.43,63
CPT,81291,LAB GENE MTHFR VAR COMMON,197.0,54.96,65.34,344.31,63
CPT,81291,LAB GENE MTHFR VAR COMMON NS,197.0,54.96,65.34,344.31,63
CPT,81301,LAB GENE INSTABILITY MICROSATELLITE,1046.0,291.83,348.56,1836.68,63
CPT,81305,LAB GENE MYD88 VAR L265P,527.0,147.03,175.4,924.23,63
CPT,81306,LAB GENE NUDT15 VAR COMMON,875.0,244.13,291.36,1535.28,63
CPT,81306,LAB GENE NUDT15 VAR COMMON NS,875.0,244.13,291.36,1535.28,63
CPT,81309,LAB GENE PIK3CA ANLYS SEQ TARGETED,825.0,230.18,274.83,1448.21,63
CPT,81310,LAB GENE NPM1 VAR EXON 12,740.0,206.46,246.52,1299.0,63
CPT,81311,LAB GENE NRAS VAR EXON 2&3 NS,888.0,247.75,295.79,1558.63,63
CPT,81314,LAB GENE PDGFRA,989.0,275.93,329.51,1736.37,63
CPT,81315,LAB GENE PML/RARALPHA BREAKPOINTS,622.0,173.54,207.31,1092.39,63
CPT,81320,LAB GENE PLCG2 VAR COMMON,875.0,244.13,291.36,1535.28,63
CPT,81321,LAB GENE PTEN SEQ FULL,1800.0,502.2,600.0,3161.63,63
CPT,81324,LAB GENE PMP22 DUP/DEL,2276.0,635.0,758.36,3996.06,63
CPT,81328,LAB GENE SLCO1B1 VAR COMMON,525.0,146.48,174.81,921.17,63
CPT,81331,LAB GENE SNRPN/UBE3A METHYLATION,198.0,55.24,51.07,269.14,63
CPT,81331,LAB GENE SNRPN/UBE3A METHYLATON ALD,475.0,132.52,51.07,356.25,63
CPT,81332,LAB GENE SERPINA1 VAR COMMON,346.0,96.53,43.65,259.5,63
CPT,81335,LAB GENE TPMT,525.0,146.48,174.81,921.17,63
CPT,81335,LAB GENE TPMT NS,525.0,146.48,174.81,921.17,63
CPT,81339,LAB GENE MPL MUTATION EXON 10 ANLYS,556.0,155.12,185.2,975.85,63
CPT,81340,LAB GENE TRB REARRANGEMENT AMP,627.0,174.93,208.92,1100.91,63
CPT,81342,LAB GENE TRG REARRANGEMENT CLONAL,605.0,168.8,201.5,1061.79,63
CPT,81345,LAB GENE TERT TARGETED SEQ ANLYS,556.0,155.12,185.2,975.85,63
CPT,81350,LAB GENE UGT1A1 VAR COMMON,702.0,195.86,234.0,1233.01,63
CPT,81350,LAB GENE UGT1A1 VAR COMMON NS,702.0,195.86,234.0,1233.01,63
CPT,81352,LAB GENE TP53 SEQ TARGETED,989.0,275.93,329.51,1736.37,63
CPT,81355,LAB GENE VKORC1 VAR COMMON,265.0,73.94,88.2,464.78,63
CPT,81364,LAB GENE HBB SEQ FULL,974.0,271.75,324.58,1710.3,63
CPT,81370,LAB GENE TYPING HLA 1&2 LR,1207.0,336.75,402.12,2118.93,63
CPT,81371,LAB GENE TYPING HLA 1&2 LR VERIF,1214.0,338.71,404.52,2131.57,63
CPT,81371,LAB GENE TYPING HLA 1&2 LR VERIF NS,1214.0,338.71,404.52,2131.57,63
CPT,81372,LAB GENE TYPING HLA 1 LR CMP,1211.0,337.87,403.59,2126.64,63
CPT,81373,LAB GENE TYPING HLA 1 LR LOCUS NS,383.0,106.86,127.43,671.45,63
CPT,81374,LAB GENE TYPING HLA 1 LR AG 1 EA,223.0,62.22,74.33,391.67,63
CPT,81374,LAB GENE TYPING HLA 1 LR AG 1 EA NS,223.0,62.22,74.33,391.67,63
CPT,81375,LAB TYPING HLA 2 LR ANTIGEN EQUIV,663.0,184.98,220.74,1163.17,63
CPT,81376,LAB GENE TYPING HLA 2 LR LOCUS EA,367.0,102.39,122.22,644.05,63
CPT,81376,LAB GENE TYPING HLA 2 LR LOCUS NS,367.0,102.39,122.22,644.05,63
CPT,81378,LAB GENE TYPING HLA 1&2 HR,1037.0,289.32,345.57,1820.98,63
CPT,81378,LAB GENE TYPING HLA 1&2 HR NS,1037.0,289.32,345.57,1820.98,63
CPT,81379,LAB GENE TYPING HLA 1 HR CMP,1007.0,280.95,335.38,1767.24,63
CPT,81380,LAB GENE TYPING HLA 1 HR LOCUS EA,532.0,148.43,177.25,934.01,63
CPT,81381,LAB GENE TYPING HLA 1 HR ALLE 1/GRP,510.0,142.29,169.9,895.29,63
CPT,81382,LAB GENE TYPING HLA 2 HR LOCUS EA,372.0,103.79,123.68,651.7,63
CPT,81382,LAB GENE TYPING HLA 2 HR LOCUS NS,372.0,103.79,123.68,651.7,63
CPT,81383,LAB GENE TYPING HLA 2 HR ALLE 1/GRP,328.0,91.51,109.13,575.07,63
CPT,81400,LAB PROC PATHOLOGY MOLEC LEVEL 1,192.0,53.57,63.96,336.99,63
CPT,81401,LAB MOPATH LVL2 CARDIO IQ APOE GENO,411.0,114.67,137.0,721.88,63
CPT,81401,LAB MOPATH LVL2 CBFB/MYH11 DET QN,411.0,114.67,137.0,721.88,63
CPT,81401,LAB MOPATH LVL2 EML4-ALK,411.0,114.67,137.0,721.88,63
CPT,81401,LAB MOPATH LVL2 RUNX1,411.0,114.67,137.0,721.88,63
CPT,81402,LAB PROC PATHOLOGY MOLEC LEVEL 3,451.0,125.83,150.33,792.12,63
CPT,81403,LAB PROC PATHOLOGY MOLEC LEVEL 4,556.0,155.12,185.2,975.85,63
CPT,81403,LAB PROC PATHOLOGY MOLEC LEVEL 4 NS,617.0,172.14,185.2,975.85,63
CPT,81404,LAB PROC PATHOLOGY MOLEC LEVEL 5,825.0,230.18,274.83,1448.21,63
CPT,81405,LAB PROC PATHOLOGY MOLEC LEVEL 6,905.0,252.5,301.35,1587.9,63
CPT,81406,LAB PROC PATHOLOGY MOLEC LEVEL 7,1931.0,538.75,282.88,1490.65,63
CPT,81407,LAB PROC PATHOLOGY MOLEC LEVEL 8,2539.0,708.38,846.27,4459.3,63
CPT,81408,LAB PROC PATHOLOGY MOLEC LEVEL 9,6000.0,1674.0,2000.0,10538.76,63
CPT,81410,LAB PANEL DYSFNCT/DILAT AO GENES>=9,1512.0,421.85,217.88,2655.74,59
CPT,81411,LAB PANEL DYSFNCT/DILAT AO DUP/DEL,4051.0,1130.23,583.75,7114.71,59
CPT,81415,LAB EXOME ANALYSIS SEQ,14340.0,4000.86,4780.0,25187.73,63
CPT,81418,LAB GSAP METAB RX >=6,3039.0,847.88,437.92,3037.44,59
CPT,81419,LAB GSAP EPILEPSY,7346.0,2049.53,2448.56,12902.42,63
CPT,81420,LAB FETAL CHROMOSOMAL ANEUPLOIDY,2278.0,635.56,759.05,3999.78,63
CPT,81422,LAB FETAL CHROMOSOMAL MICRODELTJ,2278.0,635.56,328.26,3999.78,59
CPT,81439,LAB GENE 5 CARDIOMYOPATH HRDTRY,1755.0,489.65,584.9,3082.07,63
CPT,81442,LAB NOONAN SPECTRUM DISORDERS,6431.0,1794.25,926.71,11295.43,59
CPT,81445,LAB GENOMIC ANLY SEQ SO 5-50,1794.0,500.53,597.91,3150.65,63
CPT,81445,LAB GENOMIC ANLY SEQ SO 5-50 NS,1794.0,500.53,597.91,3150.65,63
CPT,81449,LAB GENO ANLY SEQ SO RNA 5-50 NGN,2088.0,582.55,300.88,2372.5,59
CPT,81450,LAB GENOMIC ANLY SEQ HL 5-50,2279.0,635.84,759.53,4002.24,63
CPT,81450,LAB GENOMIC ANLY SEQ HL 5-50 NS,2395.0,668.2,759.53,4002.24,63
CPT,81455,LAB GENOMIC ANLY SEQ SO/HL 51+,15385.0,4292.42,2216.98,15384.55,59
CPT,81455,LAB GENOMIC ANLY SEQ SO/HL 51+ NS,8759.0,2443.76,1262.17,15384.55,59
CPT,81456,LAB GENOMIC ANLY SEQ SO/HL RNA 51+,8759.0,2443.76,1262.17,11584.72,59
CPT,81457,LAB GSAP DNA NPLSM SO IFSV MSI NGN,2691.0,750.79,879.96,3558.75,62
CPT,81460,LAB GENOMIC ANLY SEQ MITOCHNDRL WHL,3861.0,1077.22,556.37,6781.71,59
CPT,81479,LAB ANLY MUTATION LCHAD,241.0,67.24,44.83,883.39,37
CPT,81479,LAB CSF3R MUTATION EXONS 14&17,300.0,83.7,55.8,883.39,37
CPT,81479,LAB GENE CRANIOSYNOSTOSIS,940.0,262.26,174.84,883.39,37
CPT,81479,LAB GENE DEFICIENCY MCAD ANLY FULL,1754.0,489.37,317.42,1315.5,37
CPT,81479,LAB GENE NAT2 VARIES,908.0,253.33,168.89,883.39,37
CPT,81479,LAB GENE PHARMOCOGENOMICS PANEL,51.0,14.23,9.49,883.39,37
CPT,81479,LAB GENE SEQ MUTATION FAM TARGETED,401.0,111.88,74.59,883.39,37
CPT,81479,LAB GENE SEQ THROMBOCYTOSIS PANEL,925.0,258.08,172.05,883.39,37
CPT,81479,LAB NGS MI PROFILE,3550.0,990.45,317.42,2662.5,37
CPT,81479,LAB PANEL DISEASE LUNG INTERSTITIAL,1340.0,373.86,249.24,1005.0,37
CPT,81479,LAB PANEL GENE DEFECTS TELOMERE,1040.0,290.16,193.44,883.39,37
CPT,81479,LAB PANEL GENE DYSTONIA NGS,1040.0,290.16,193.44,883.39,37
CPT,81479,LAB PANEL GENE PA HYPERTENSION,1040.0,290.16,193.44,883.39,37
CPT,81479,LAB PANEL GENETIC AHUS,1072.0,299.09,199.39,883.39,37
CPT,81479,LAB PANEL NGS DIS KIDNEY INHERITED,1840.0,513.36,317.42,1380.0,37
CPT,81479,LAB PANEL NGS POLYDACTYLY&SYNDACTYL,1640.0,457.56,305.04,1230.0,37
CPT,81479,LAB PROFILE TUMOR THYROID,2112.0,589.25,317.42,1584.0,37
CPT,81503,LAB ONC BIOCHEMICAL PROT 5 SERUM,2691.0,750.79,387.77,4210.05,59
CPT,81540,LAB GENE ONCOLOGY TUMOR UNKNOWN ORG,11250.0,3138.75,1621.12,17600.66,59
CPT,81596,LAB HCV INFCT DIS CHRNC 6 ASSAYS,217.0,60.54,72.19,338.79,63
CPT,81596,LAB HCV INFCT DIS CHRNC 6 ASSAYS NS,217.0,60.54,72.19,338.79,63
CPT,82010,LAB KETONES ACETONE QN,25.0,4.0,8.17,38.32,63
CPT,82010,LAB KETONES BETA-HYDROXYBUTYRATE QN,60.0,9.6,8.17,45.0,63
CPT,82010,LAB KETONES NS,61.0,9.76,8.17,45.75,63
CPT,82017,LAB ACYLCARNITINES QN EA,115.0,18.4,16.87,86.25,63
CPT,82024,LAB HORMONE ADRENOCORTICOTROPIC,116.0,18.56,38.62,181.27,63
CPT,82040,LAB ALBUMIN SRM/PLASMA/BLD WHL,63.0,10.08,4.95,47.25,63
CPT,82040,LAB ALBUMIN SRM/PLASMA/BLD WHL NS,63.0,10.08,4.95,47.25,63
CPT,82042,LAB ALBUMIN OTHER SOURCE QN EA,58.0,9.28,7.78,43.5,63
CPT,82042,LAB ALBUMIN OTHER SOURCE QN EA NS,24.0,3.84,7.78,36.52,63
CPT,82043,LAB MICROALBUMIN URINE QN,56.0,8.96,5.78,42.0,63
CPT,82075,LAB ALCOHOL BREATH,90.0,14.4,30.0,140.82,63
CPT,82085,LAB ALDOLASE,53.0,8.48,9.71,45.57,63
CPT,82088,LAB ALDOSTERONE,270.0,43.2,40.75,202.5,63
CPT,82088,LAB ALDOSTERONE NS,123.0,19.68,40.75,191.25,63
CPT,82088,LAB ALDOSTERONE URINE,123.0,19.68,40.75,191.25,63
CPT,82103,LAB ALPHA-1-ANTITRYPSIN TOTAL,41.0,6.56,13.44,63.06,63
CPT,82103,LAB ALPHA-1-ANTITRYPSIN TOTAL NS,59.0,9.44,13.44,63.06,63
CPT,82104,LAB ALPHA-1-ANTITRYPSIN PHENOTYPE,63.0,10.08,14.46,67.85,63
CPT,82105,LAB AFP SERUM,51.0,8.16,16.77,78.69,63
CPT,82106,LAB AFP AMNIOTIC FLUID,51.0,8.16,17.0,79.76,63
CPT,82107,LAB AFP-L3 ISOFORM FRAC&AFP TOTAL,194.0,31.04,64.41,302.33,63
CPT,82108,LAB ALUMINUM,77.0,12.32,25.48,119.6,63
CPT,82131,LAB ACIDS AMINO SGL QN SPEC EA,91.0,14.56,22.98,107.83,63
CPT,82135,LAB ACID AMINOLEVULINIC DELTA URINE,75.0,12.0,16.45,77.16,63
CPT,82139,LAB ACIDS AMINO 6+ QN SPEC EA,51.0,8.16,16.87,79.23,63
CPT,82139,LAB ACIDS AMINO 6+ QN URINE SPEC EA,141.0,22.56,16.87,105.75,63
CPT,82140,LAB AMMONIA,69.0,11.04,14.57,68.38,63
CPT,82140,LAB AMMONIA STONE RISK,115.0,18.4,14.57,86.25,63
CPT,82150,LAB AMYLASE,20.0,3.2,6.48,30.4,63
CPT,82150,LAB AMYLASE FLUID BODY,52.0,8.32,6.48,39.0,63
CPT,82150,LAB AMYLASE FLUID CYST PANCREATIC,341.0,54.56,6.48,255.75,63
CPT,82150,LAB AMYLASE TOTAL,54.0,8.64,6.48,40.5,63
CPT,82150,LAB AMYLASE URINE,53.0,8.48,6.48,39.75,63
CPT,82157,LAB ANDROSTENEDIONE,88.0,14.08,29.28,137.43,63
CPT,82163,LAB ANGIOTENSIN 2,89.0,14.24,20.52,96.32,63
CPT,82164,LAB ANGIOTENSIN I CONVERTING ENZYME,61.0,9.76,14.6,68.52,63
CPT,82166,LAB HORMONE ANTIMULLERIAN,116.0,18.56,37.93,135.3,63
CPT,82166,LAB HORMONE ANTIMULLERIAN NS,116.0,18.56,37.93,135.3,63
CPT,82172,LAB APOLIPOPROTEIN A1 EA,64.0,10.24,21.09,98.98,63
CPT,82172,LAB APOLIPOPROTEIN A1 EA NS,77.0,12.32,21.09,98.98,63
CPT,82172,LAB APOLIPOPROTEIN B EA,64.0,10.24,21.09,98.98,63
CPT,82172,LAB APOLIPOPROTEIN EA,64.0,10.24,21.09,98.98,63
CPT,82175,LAB ARSENIC BLOOD NS,63.0,10.08,18.97,89.07,63
CPT,82175,LAB ARSENIC NON BLOOD,95.0,15.2,18.97,89.07,63
CPT,82180,LAB ACID ASCORBIC BLOOD,59.0,9.44,9.89,46.43,63
CPT,82232,LAB MICROGLOBULIN BETA-2,58.0,9.28,16.18,75.97,63
CPT,82232,LAB MICROGLOBULIN BETA-2 NS,93.0,14.88,16.18,75.97,63
CPT,82232,LAB MICROGLOBULIN BETA-2 URINE,61.0,9.76,16.18,75.97,63
CPT,82233,LAB BETA AMYLOID 1-40,387.0,61.92,102.94,290.25,62
CPT,82234,LAB BETA AMYLOID 1-42,387.0,61.92,102.94,290.25,62
CPT,82239,LAB ACIDS BILE TOTAL,63.0,10.08,17.12,80.36,63
CPT,82247,LAB BILIRUBIN TOTAL,65.0,10.4,5.02,48.75,63
CPT,82247,LAB BILIRUBIN TOTAL FLUID BODY,57.0,9.12,5.02,42.75,63
CPT,82247,LAB BILIRUBIN TOTAL FLUID BODY NS,136.0,21.76,5.02,102.0,63
CPT,82247,LAB BILIRUBIN TOTAL NS,58.0,9.28,5.02,43.5,63
CPT,82248,LAB BILIRUBIN DIRECT,78.0,12.48,5.02,58.5,63
CPT,82248,LAB BILIRUBIN DIRECT FLUID BODY,78.0,12.48,5.02,58.5,63
CPT,82270,LAB BLOOD OCCULT FECES SINGLE QL,14.0,2.24,4.38,20.55,63
CPT,82271,LAB BLOOD OCCULT OTHER SOURCE QL,16.0,2.56,5.32,24.95,63
CPT,82271,POC BLOOD OCCULT OTHER SOURCE QL,16.0,2.56,5.32,24.95,63
CPT,82272,POC BLOOD OCCULT FECES 1-3 TESTS QL,13.0,2.08,4.23,19.82,63
CPT,82274,LAB BLOOD OCCULT FECES 1-3 IMM NS,62.0,9.92,15.92,74.77,63
CPT,82274,LAB BLOOD OCCULT FECES 1-3 IMM QL,62.0,9.92,15.92,74.77,63
CPT,82300,LAB CADMIUM,71.0,11.36,23.64,110.96,63
CPT,82306,LAB VITAMIN D 25 HYDROXY W FRAC,89.0,14.24,29.6,155.32,63
CPT,82306,LAB VITAMIN D 25 HYDROXY W FRAC NS,89.0,14.24,29.6,155.32,63
CPT,82308,LAB CALCITONIN,81.0,12.96,26.79,125.72,63
CPT,82310,LAB CALCIUM TOTAL,66.0,10.56,5.16,49.5,63
CPT,82310,LAB CALCIUM TOTAL NS,65.0,10.4,5.16,48.75,63
CPT,82310,LAB CALCIUM TOTAL URINE,56.0,8.96,5.16,42.0,63
CPT,82330,LAB CALCIUM IONIZED,77.0,12.32,13.68,64.19,63
CPT,82330,POC CALCIUM IONIZED,77.0,12.32,13.68,64.19,126
CPT,82330,POC CALCIUM IONIZED TELCOR,77.0,12.32,13.68,64.19,63
CPT,82340,LAB CALCIUM STONE RISK,77.0,12.32,6.03,57.75,63
CPT,82340,LAB CALCIUM URINE QN TIMED,56.0,8.96,6.03,42.0,63
CPT,82365,LAB CALCULUS SPECTROSCOPY INFRARED,74.0,11.84,12.9,60.53,63
CPT,82373,LAB TRANSFERRIN CARBOHYDRATE DEF,55.0,8.8,18.06,84.75,63
CPT,82374,LAB CARBON DIOXIDE HCO3,54.0,8.64,4.88,40.5,63
CPT,82374,LAB CARBON DIOXIDE HCO3 NS,54.0,8.64,4.88,40.5,63
CPT,82374,LAB CARBON DIOXIDE HCO3 URINE,131.0,20.96,4.88,98.25,63
CPT,82375,LAB CARBOXYHEMOGLOBIN QN,56.0,8.96,12.32,57.81,63
CPT,82375,LAB CARBOXYHEMOGLOBIN QN NS,75.0,12.0,12.32,57.81,63
CPT,82375,POC CARBOXYHEMOGLOBIN QN,37.0,5.92,12.32,57.81,63
CPT,82378,LAB AG CARCINOEMBRYONIC,57.0,9.12,18.96,89.0,63
CPT,82378,LAB AG CARCINOEMBRYONIC ARUP NS,68.0,10.88,18.96,89.0,63
CPT,82378,LAB AG CARCINOEMBRYONIC MAYO NS,329.0,52.64,18.96,246.75,63
CPT,82379,LAB CARNITINE TOTAL&FREE QN,78.0,12.48,16.87,79.23,63
CPT,82379,LAB CARNITINE TOTAL&FREE QN URINE,115.0,18.4,16.87,86.25,63
CPT,82380,LAB CAROTENE,67.0,10.72,9.22,50.25,63
CPT,82384,LAB CATECHOLAMINES FRACTIONATED,76.0,12.16,25.25,118.54,63
CPT,82390,LAB CERULOPLASMIN,53.0,8.48,10.74,50.42,63
CPT,82397,LAB CHEMILUMINESCENT,70.0,11.2,14.12,66.25,63
CPT,82397,LAB CHEMILUMINESCENT NITRO URINE,43.0,6.88,14.12,66.25,63
CPT,82435,LAB CHLORIDE BLOOD,47.0,7.52,4.6,35.25,63
CPT,82435,POC CHLORIDE BLOOD,47.0,7.52,4.6,35.25,126
CPT,82435,POC CHLORIDE BLOOD TELCOR,47.0,7.52,4.6,35.25,63
CPT,82436,LAB CHLORIDE URINE,18.0,2.88,5.75,27.01,63
CPT,82438,LAB CHLORIDE FLUID BODY,15.0,2.4,5.0,23.48,63
CPT,82438,LAB CHLORIDE OTHER SOURCE,15.0,2.4,5.0,23.48,63
CPT,82438,LAB CHLORIDE STOOL NS,58.0,9.28,5.0,43.5,63
CPT,82465,LAB CHOLESTEROL SRM/BLD WHL TTL,55.0,8.8,4.35,41.25,63
CPT,82465,LAB CHOLESTEROL SRM/BLD WHL TTL NS,56.0,8.96,4.35,42.0,63
CPT,82480,LAB CHOLINESTERASE PLASMA,55.0,8.8,7.87,41.25,63
CPT,82480,LAB CHOLINESTERASE SERUM,60.0,9.6,7.87,45.0,63
CPT,82482,LAB CHOLINESTERASE RBC,59.0,9.44,9.81,46.03,63
CPT,82495,LAB CHROMIUM,61.0,9.76,20.28,95.19,63
CPT,82507,LAB CITRATE,84.0,13.44,27.8,130.51,63
CPT,82507,LAB CITRATE STONE RISK,174.0,27.84,27.8,130.51,63
CPT,82523,LAB CROSS LINKS DEOXYPYRIDINOLINE,113.0,18.08,18.68,87.67,63
CPT,82523,LAB CROSS LINKS N-TELOPEPTIDE,68.0,10.88,18.68,87.67,63
CPT,82525,LAB COPPER SERUM,63.0,10.08,12.41,58.27,63
CPT,82525,LAB COPPER TISSUE NS,211.0,33.76,12.41,158.25,63
CPT,82525,LAB COPPER URINE,65.0,10.4,12.41,58.27,63
CPT,82528,LAB CORTICOSTERONE,83.0,13.28,22.52,105.7,63
CPT,82530,LAB CORTISOL FREE,55.0,8.8,16.71,78.43,63
CPT,82533,LAB CORTISOL TOTAL,58.0,9.28,16.3,76.5,63
CPT,82533,LAB CORTISOL TOTAL NS,323.0,51.68,16.3,242.25,63
CPT,82540,LAB CREATINE URINE,60.0,9.6,4.64,45.0,63
CPT,82542,LAB CHROMAT MS GLOMERULONEPH FIBRIL,326.0,52.16,24.09,244.5,63
CPT,82542,LAB CHROMAT MS IGF-2,222.0,35.52,24.09,166.5,63
CPT,82542,LAB CHROMAT MS IODINE QL/QN,73.0,11.68,24.09,113.08,63
CPT,82542,LAB CHROMAT MS METHOXYTYRAMINE,392.0,62.72,24.09,294.0,63
CPT,82542,LAB CHROMAT MS N-METHYLHIST URINE,115.0,18.4,24.09,113.08,63
CPT,82542,LAB CHROMAT MS NON-DRUG QL/QN,75.0,12.0,24.09,113.08,63
CPT,82542,LAB CHROMAT MS NON-DRUG QL/QN NS,73.0,11.68,24.09,113.08,63
CPT,82542,LAB CHROMAT MS OMEGA FATTY ACIDS,100.0,16.0,24.09,113.08,63
CPT,82542,LAB CHROMAT MS ORGANIC ACIDS,153.0,24.48,24.09,114.75,63
CPT,82542,LAB CHROMAT MS PESTICIDE,1823.0,291.68,24.09,1367.25,63
CPT,82542,LAB CHROMAT MS PROT AMYLOID QN,909.0,145.44,24.09,681.75,63
CPT,82542,LAB CHROMAT/MS METHYLTETRAHYDOFOLAT,266.0,42.56,24.09,199.5,63
CPT,82542,LAB CHROMAT/MS NEOPTERIN,275.0,44.0,24.09,206.25,63
CPT,82550,LAB CREATINE KINASE TOTAL,158.0,25.28,6.51,118.5,63
CPT,82550,LAB CREATINE KINASE TOTAL NS,55.0,8.8,6.51,41.25,63
CPT,82552,LAB CREATINE KINASE ISOENZYMES,59.0,9.44,13.39,62.86,63
CPT,82553,LAB CREATINE KINASE MB ONLY QN,66.0,10.56,11.55,54.21,63
CPT,82565,LAB CREATININE BLOOD,60.0,9.6,5.12,45.0,63
CPT,82565,POC CREATININE BLOOD,60.0,9.6,5.12,45.0,63
CPT,82565,POC CREATININE BLOOD TELCOR,60.0,9.6,5.12,45.0,63
CPT,82570,LAB CREATININE FLUID BODY,56.0,8.96,5.18,42.0,63
CPT,82570,LAB CREATININE OTHER SOURCE,26.0,4.16,5.18,24.35,63
CPT,82570,LAB CREATININE OTHER SOURCE NS,101.0,16.16,5.18,75.75,63
CPT,82570,LAB CREATININE STONE RISK,73.0,11.68,5.18,54.75,63
CPT,82570,LAB CREATININE URINE,26.0,4.16,5.18,24.35,63
CPT,82570,LAB CREATININE URINE NS,52.0,8.32,5.18,39.0,63
CPT,82575,LAB CREATININE CLEARANCE,29.0,4.64,9.46,44.37,63
CPT,82585,LAB CRYOFIBRINOGEN NS,69.0,11.04,14.14,66.39,63
CPT,82595,LAB CRYOGLOBULIN QL/SEMI QN,63.0,10.08,6.47,47.25,63
CPT,82595,LAB CRYOGLOBULIN QL/SEMI QN NS,63.0,10.08,6.47,47.25,63
CPT,82600,LAB CYANIDE,78.0,12.48,19.4,91.07,63
CPT,82607,LAB CYANOCOBALAMIN,72.0,11.52,15.08,70.78,63
CPT,82608,LAB VITAMIN B-12 CAPACITY BNDG NS,66.0,10.56,14.32,67.19,63
CPT,82610,LAB CYSTATIN C,56.0,8.96,18.52,86.94,63
CPT,82626,LAB DEHYDROEPIANDROSTERONE,76.0,12.16,25.27,118.61,63
CPT,82627,LAB DEHYDROEPIANDROSTERONE-SULFATE,67.0,10.72,22.23,104.3,63
CPT,82633,LAB DESOXYCORTICOSTERONE,93.0,14.88,30.98,145.41,63
CPT,82634,LAB DEOXYCORTISOL 11-,88.0,14.08,29.28,137.43,63
CPT,82642,LAB DIHYDROTESTOSTERONE,88.0,14.08,12.68,137.43,59
CPT,82652,LAB VITAMIN D 1 25 DIHYDROXY FRAC,116.0,18.56,38.5,234.88,63
CPT,82653,LAB IMM ELASTASE PANCREATIC QN,100.0,16.0,22.97,99.48,63
CPT,82656,LAB ELASTASE PANCREATIC FECAL,104.0,16.64,11.53,78.0,63
CPT,82657,LAB ACTIVITY ENZYME ALPHA GALACTOS,375.0,60.0,22.17,281.25,63
CPT,82657,LAB ACTIVITY ENZYME CHITOTRIOSIDASE,362.0,57.92,22.17,271.5,63
CPT,82657,LAB ACTIVITY ENZYME L-ASPARAGNSE,325.0,52.0,22.17,243.75,63
CPT,82657,LAB ACTIVITY ENZYME NONRADIOACTIVE,121.0,19.36,22.17,104.04,63
CPT,82657,LAB UROPORPHYRINOGEN-1-SYNTH,67.0,10.72,22.17,104.04,63
CPT,82664,LAB ELECTRO,185.0,29.6,61.5,288.7,63
CPT,82664,LAB ELECTRO LIPOPROTEIN,185.0,29.6,61.5,288.7,63
CPT,82664,LAB ELECTRO NS,185.0,29.6,61.5,288.7,63
CPT,82668,LAB ERYTHROPOIETIN,57.0,9.12,18.79,88.21,63
CPT,82670,LAB ESTRADIOL TOTAL,84.0,13.44,27.94,131.11,63
CPT,82670,LAB ESTRADIOL TOTAL NS,84.0,13.44,27.94,131.11,63
CPT,82672,LAB ESTROGEN TOTAL,66.0,10.56,21.7,132.37,63
CPT,82672,LAB ESTROGEN TOTAL NS,66.0,10.56,21.7,132.37,63
CPT,82677,LAB ESTRIOL SERUM,73.0,11.68,24.18,113.48,63
CPT,82677,LAB ESTRIOL SERUM NS,73.0,11.68,24.18,113.48,63
CPT,82679,LAB ESTRONE,75.0,12.0,24.95,117.08,63
CPT,82681,LAB ESTRADIOL FREE MEASURE DIRECT,84.0,13.44,27.94,131.11,63
CPT,82693,LAB ETHYLENE GLYCOL,81.0,12.96,14.9,69.91,63
CPT,82693,LAB ETHYLENE GLYCOL NS,94.0,15.04,14.9,70.5,63
CPT,82705,LAB FAT/LIPIDS FECES QL NS,68.0,10.88,5.1,51.0,63
CPT,82710,LAB FAT/LIPIDS FECES QN,51.0,8.16,16.8,78.83,63
CPT,82725,LAB ACIDS FATTY NONESTERIFIED,69.0,11.04,18.77,88.14,63
CPT,82726,LAB ACIDS FATTY VERY LONG CHAIN,205.0,32.8,19.75,153.75,63
CPT,82728,LAB FERRITIN,65.0,10.4,13.63,63.93,63
CPT,82731,LAB FIBRONECTIN FETAL SEMI QL,194.0,31.04,64.41,302.33,63
CPT,82735,LAB FLUORIDE,285.0,45.6,18.54,213.75,63
CPT,82746,LAB ACID FOLIC SERUM,45.0,7.2,14.7,68.98,63
CPT,82747,LAB ACID FOLIC RBC,55.0,8.8,17.65,82.88,63
CPT,82775,LAB TRANSFERASE GALACTOSE-1 QN,173.0,27.68,21.07,129.75,63
CPT,82776,LAB SCR TRANSFERASE GALACTOSE-1,36.0,5.76,11.74,55.08,63
CPT,82784,LAB IG IGA IGD IGG IGM CSF EA,63.0,10.08,9.3,47.25,63
CPT,82784,LAB IG IGA IGD IGG IGM SERUM EA,52.0,8.32,9.3,43.64,63
CPT,82784,LAB IG IGA IGD IGG IGM SERUM EA NS,59.0,9.44,9.3,44.25,63
CPT,82784,LAB IG IGA SERUM NS,56.0,8.96,9.3,43.64,63
CPT,82784,LAB IG IGD SERUM EA,63.0,10.08,9.3,47.25,63
CPT,82784,LAB IG IGG SERUM EA,56.0,8.96,9.3,43.64,63
CPT,82785,LAB IG IGE,58.0,9.28,16.46,77.23,63
CPT,82785,LAB IG IGE NS,58.0,9.28,16.46,77.23,63
CPT,82787,LAB IG SUBCLASSES EA,59.0,9.44,8.02,44.25,63
CPT,82800,LAB GASES BLD PH ONLY,33.0,5.28,11.0,51.62,63
CPT,82800,POC GASES BLD PH ONLY,33.0,5.28,11.0,51.62,63
CPT,82800,POC GASES BLD PH ONLY TELCOR,33.0,5.28,11.0,51.62,63
CPT,82803,LAB GASES BLD ANY COMBO ARTERIAL,123.0,19.68,26.07,122.33,63
CPT,82803,LAB GASES BLD ANY COMBO VENOUS,123.0,19.68,26.07,122.33,63
CPT,82803,POC GASES BLD ANY COMBO,123.0,19.68,26.07,122.33,63
CPT,82803,POC GASES BLD ANY COMBO TELCOR,123.0,19.68,26.07,122.33,63
CPT,82805,LAB GASES BLD ANY COMBO W SAT O2,237.0,37.92,78.77,369.72,63
CPT,82805,POC GASES BLD ANY COMBO W SAT O2,237.0,37.92,78.77,369.72,63
CPT,82810,LAB GASES BLD SAT O2 ONLY,30.0,4.8,9.77,45.83,63
CPT,82941,LAB GASTRIN,58.0,9.28,17.63,82.75,63
CPT,82943,LAB GLUCAGON,67.0,10.72,14.29,67.05,63
CPT,82945,LAB GLUCOSE CSF,55.0,8.8,3.93,41.25,63
CPT,82945,LAB GLUCOSE FLUID BODY,56.0,8.96,3.93,42.0,63
CPT,82945,LAB GLUCOSE FLUID BODY NS,131.0,20.96,3.93,98.25,63
CPT,82945,LAB GLUCOSE URINE RANDOM,12.0,1.92,3.93,18.43,63
CPT,82945,LAB GLUCOSE URINE TIMED,56.0,8.96,3.93,42.0,63
CPT,82950,LAB GLUCOSE POST DOSE,15.0,2.4,4.75,22.28,63
CPT,82951,LAB GLUCOSE TOLERANCE SPEC 1ST 3,39.0,6.24,12.87,60.4,63
CPT,82952,LAB GLUCOSE TOLERANCE SPEC EA ADDL,12.0,1.92,3.92,18.43,63
CPT,82955,LAB DEHYDROGENASE G6PD QN NS,56.0,8.96,9.7,45.57,63
CPT,82977,LAB TRANSFERASE GAMMA-GLUTAMYL,22.0,3.52,7.2,33.79,63
CPT,82977,LAB TRANSFERASE GAMMA-GLUTAMYL NS,62.0,9.92,7.2,46.5,63
CPT,82985,LAB PROT GLYCATED,53.0,8.48,16.76,78.69,63
CPT,83001,LAB GONADOTROPIN FSH SERUM,56.0,8.96,18.58,87.21,63
CPT,83001,LAB GONADOTROPIN FSH SERUM NS,58.0,9.28,18.58,87.21,63
CPT,83002,LAB GONADOTROPIN LH,58.0,9.28,18.52,86.94,63
CPT,83002,LAB GONADOTROPIN LH NS,57.0,9.12,18.52,86.94,63
CPT,83003,LAB HORMONE HUMAN GROWTH,51.0,8.16,16.67,78.29,63
CPT,83006,LAB GROWTH STIMULATION GENE 2,900.0,144.0,75.6,675.0,63
CPT,83010,LAB HAPTOGLOBIN QN,53.0,8.48,12.58,59.07,63
CPT,83010,LAB HAPTOGLOBIN QN NS,59.0,9.44,12.58,59.07,63
CPT,83013,LAB H PYLORI UREASE NONRADIOACT,203.0,32.48,67.36,316.17,63
CPT,83018,LAB HEAVY METAL QN BISMUTH,67.0,10.72,21.96,103.11,63
CPT,83018,LAB HEAVY METAL QN COBALT,288.0,46.08,21.96,216.0,63
CPT,83018,LAB HEAVY METAL QN EA,106.0,16.96,21.96,103.11,63
CPT,83020,LAB HEMOGLOBIN FRCTN&QN ELECTRO NS,71.0,11.36,12.87,78.63,63
CPT,83021,LAB HEMOGLOBIN FRCTN&QN CHROMAT NS,55.0,8.8,18.06,84.75,63
CPT,83033,LAB HEMOGLOBIN FETAL QL,123.0,19.68,8.0,92.25,63
CPT,83036,LAB HEMOGLOBIN A1C,47.0,7.52,9.71,45.57,63
CPT,83050,LAB HEMOGLOBIN METHEMOGLOBIN QN,59.0,9.44,8.2,44.25,63
CPT,83050,POC HEMOGLOBIN METHEMOGLOBIN QN,25.0,4.0,8.2,38.52,63
CPT,83051,LAB HEMOGLOBIN PLASMA,59.0,9.44,7.31,44.25,63
CPT,83060,LAB HEMOGLOBIN SULFHEMOGLOBIN QN,172.0,27.52,8.8,129.0,63
CPT,83069,LAB HEMOGLOBIN URINE,12.0,1.92,3.95,18.56,63
CPT,83070,LAB HEMOSIDERIN QL,67.0,10.72,4.75,50.25,63
CPT,83088,LAB HISTAMINE,89.0,14.24,29.53,138.63,63
CPT,83090,LAB HOMOCYSTEINE SERUM,58.0,9.28,17.92,84.08,63
CPT,83150,LAB ACID HOMOVANILLIC,68.0,10.88,22.41,105.17,63
CPT,83497,LAB ACID HYDROXYINDOLACETIC 5-,61.0,9.76,12.9,60.53,63
CPT,83498,LAB HYDROXYPROGESTERONE 17-D NS,82.0,13.12,27.17,127.52,63
CPT,83500,LAB HYDROXYPROLINE FREE,112.0,17.92,22.65,106.3,63
CPT,83516,LAB IMM GANGLIOSIDE AB,67.0,10.72,11.53,54.08,63
CPT,83516,LAB IMM MS 21-HYDROXYLASE QL,114.0,18.24,11.53,85.5,63
CPT,83516,LAB IMM MS ALPHA 2 MACROGLOBULIN,59.0,9.44,11.53,54.08,63
CPT,83516,LAB IMM MS ANTI GMCSF AB,197.0,31.52,11.53,147.75,63
CPT,83516,LAB IMM MS ANTI IFNG AB,197.0,31.52,11.53,147.75,63
CPT,83516,LAB IMM MS ANTI TH/TO AB,135.0,21.6,11.53,101.25,63
CPT,83516,LAB IMM MS ANTI-CFH AB,475.0,76.0,11.53,356.25,63
CPT,83516,LAB IMM MS ANTI-COLLAGEN 7,294.0,47.04,11.53,220.5,63
CPT,83516,LAB IMM MS C1Q AB,156.0,24.96,11.53,117.0,63
CPT,83516,LAB IMM MS CARBAMYLATED PROTEIN AB,105.0,16.8,11.53,78.75,63
CPT,83516,LAB IMM MS CYTOSOLC 5 NUCLEOTDAS 1A,315.0,50.4,11.53,236.25,63
CPT,83516,LAB IMM MS DESMOGLEIN,143.0,22.88,11.53,107.25,63
CPT,83516,LAB IMM MS HISTONE QL,62.0,9.92,11.53,54.08,63
CPT,83516,LAB IMM MS MYOSITIS,67.0,10.72,11.53,54.08,63
CPT,83516,LAB IMM MS NATALIZUMAB AB,337.0,53.92,11.53,252.75,63
CPT,83516,LAB IMM MS NEUROMYLTS OPT IGG QL,35.0,5.6,11.53,54.08,63
CPT,83516,LAB IMM MS PHOSPHAT/PROTHROMBIN NS,59.0,9.44,11.53,54.08,63
CPT,83516,LAB IMM MS POLYMERASE III AB,107.0,17.12,11.53,80.25,63
CPT,83516,LAB IMM MS QL/SEMI QN NS,57.0,9.12,11.53,54.08,63
CPT,83516,LAB IMM MS RIBO P PROTEIN QL,35.0,5.6,11.53,54.08,63
CPT,83518,LAB IMM SGL STEP QL/SEMI QN NS,524.0,83.84,9.64,393.0,63
CPT,83519,LAB IMM RBA AB 21 HYDROXYLASE QN,114.0,18.24,18.4,86.34,63
CPT,83519,LAB IMM RIA BETAPROTEIN,360.0,57.6,18.4,270.0,63
CPT,83519,LAB IMM RIA GAD 65 QN,56.0,8.96,18.4,86.34,63
CPT,83519,LAB IMM RIA NEUROMYOTONIA QN,56.0,8.96,18.4,86.34,63
CPT,83519,LAB IMM RIA NITRATE/NITRITE QN,200.0,32.0,18.4,150.0,63
CPT,83519,LAB IMM RIA OREXIN A/HYPROCRET-1 QN,1055.0,168.8,18.4,791.25,63
CPT,83519,LAB IMM RIA PB3 IGF QN,106.0,16.96,18.4,86.34,63
CPT,83519,LAB IMM RIA POLY PANCREATIC QN,78.0,12.48,18.4,86.34,63
CPT,83519,LAB IMM RIA PTH REL PROT QN,72.0,11.52,18.4,86.34,63
CPT,83519,LAB IMM RIA QN,94.0,15.04,18.4,86.34,63
CPT,83519,LAB IMM RIA RECEPTOR TSH QN,101.0,16.16,18.4,86.34,63
CPT,83519,LAB IMM RIA TRYPSIN QN,82.0,13.12,18.4,86.34,63
CPT,83519,LAB IMM RIA VOLT GATED POTAS QN,470.0,75.2,18.4,352.5,63
CPT,83520,LAB IMM AB ADAMTS 13,300.0,48.0,17.27,225.0,63
CPT,83520,LAB IMM AB ANTI-MOUSE HUMAN QN,263.0,42.08,17.27,197.25,63
CPT,83520,LAB IMM AB BP180 QN,73.0,11.68,17.27,81.09,63
CPT,83520,LAB IMM AB BP230 QN,90.0,14.4,17.27,81.09,63
CPT,83520,LAB IMM AB GBM QN,60.0,9.6,17.27,81.09,63
CPT,83520,LAB IMM AB GBM QN NS,52.0,8.32,17.27,81.09,63
CPT,83520,LAB IMM AB HMGCR IGG,315.0,50.4,17.27,236.25,63
CPT,83520,LAB IMM AB LDL OXIDIZED,100.0,16.0,17.27,81.09,63
CPT,83520,LAB IMM AB NEURONAL QN,52.0,8.32,17.27,81.09,63
CPT,83520,LAB IMM AG ANTI-SOLUBLE LIVER QN,71.0,11.36,17.27,81.09,63
CPT,83520,LAB IMM ALZHEIMER EVALUATION,351.0,56.16,17.27,263.25,63
CPT,83520,LAB IMM ANALYTE CXCL9 QN,431.0,68.96,17.27,323.25,63
CPT,83520,LAB IMM ANALYTE CYTOKINES QN,135.0,21.6,17.27,101.25,63
CPT,83520,LAB IMM ANALYTE IL-18 QN,597.0,95.52,17.27,447.75,63
CPT,83520,LAB IMM ANALYTE OTHER QN,80.0,12.8,17.27,81.09,63
CPT,83520,LAB IMM ANALYTE PIGF,72.0,11.52,17.27,81.09,63
CPT,83520,LAB IMM ANALYTE SFIT-1,72.0,11.52,17.27,81.09,63
CPT,83520,LAB IMM FACTOR H QN,328.0,52.48,17.27,246.0,63
CPT,83520,LAB IMM FIBRO GROWTH FACTOR,305.0,48.8,17.27,228.75,63
CPT,83520,LAB IMM GANGLIOSIDE GM TRIPLE QN,70.0,11.2,17.27,81.09,63
CPT,83520,LAB IMM GLYCPROT MYELIN ASSC IGM,69.0,11.04,17.27,81.09,63
CPT,83520,LAB IMM IGFBP 3 QN,64.0,10.24,17.27,81.09,63
CPT,83520,LAB IMM IL-2 RECPT SOLUBLE QN,368.0,58.88,17.27,276.0,63
CPT,83520,LAB IMM INHIBIN B QN,104.0,16.64,17.27,81.09,63
CPT,83520,LAB IMM MATRIX METALLOPROTEINASE-7,377.0,60.32,17.27,282.75,63
CPT,83520,LAB IMM NEUTRPHL GEL-ASSC LIPOCALIN,52.0,8.32,17.27,81.09,63
CPT,83520,LAB IMM PHOS TAU/TTL TAU/BETA42,650.0,104.0,17.27,487.5,63
CPT,83520,LAB IMM POLY PANCREATIC QN,91.0,14.56,17.27,81.09,63
CPT,83520,LAB IMM RECEPTOR TSH QN,52.0,8.32,17.27,81.09,63
CPT,83520,LAB IMM SOLUBLE CD163,808.0,129.28,17.27,606.0,63
CPT,83520,LAB IMM TRYPTASE QN,77.0,12.32,17.27,81.09,63
CPT,83520,LAB IMM VWF BINDING ASSAY,145.0,23.2,17.27,108.75,63
CPT,83521,LAB IG FREE LIGHT CHAIN CSF EA,263.0,42.08,17.27,197.25,63
CPT,83521,LAB IG FREE LIGHT CHAIN SERUM EA,61.0,9.76,17.27,74.8,63
CPT,83521,LAB IG FREE LIGHT CHAIN URINE EA,69.0,11.04,17.27,74.8,63
CPT,83525,LAB INSULIN TOTAL,57.0,9.12,11.43,53.68,63
CPT,83527,LAB INSULIN FREE,79.0,12.64,12.95,60.8,63
CPT,83529,LAB IMM INTERLEUKIN 6 QN,109.0,17.44,17.27,81.75,63
CPT,83540,LAB IRON,20.0,3.2,6.47,30.33,63
CPT,83540,LAB IRON TISSUE LIVER,208.0,33.28,6.47,156.0,63
CPT,83550,LAB CAPACITY IRON BINDING,27.0,4.32,8.74,40.98,63
CPT,83586,LAB KETOSTEROIDS 17- TOTAL,80.0,12.8,12.8,60.07,63
CPT,83605,LAB D-LACTATE URINE,544.0,87.04,11.57,408.0,63
CPT,83605,LAB LACTATE/LACTIC ACID,115.0,18.4,11.57,86.25,63
CPT,83605,LAB LACTATE/LACTIC ACID CSF,88.0,14.08,11.57,66.0,63
CPT,83605,LAB LACTATE/LACTIC ACID NS,35.0,5.6,11.57,54.28,63
CPT,83615,LAB LDH,30.0,4.8,6.04,28.34,63
CPT,83615,LAB LDH CSF,56.0,8.96,6.04,42.0,63
CPT,83615,LAB LDH FLUID BODY,30.0,4.8,6.04,28.34,63
CPT,83615,LAB LDH NS,55.0,8.8,6.04,41.25,63
CPT,83625,LAB LDH ISOENZYMES,59.0,9.44,12.79,60.0,63
CPT,83630,LAB LACTOFERRIN FECAL QL,73.0,11.68,19.7,92.46,63
CPT,83630,LAB LACTOFERRIN FECAL QL NS,98.0,15.68,19.7,92.46,63
CPT,83655,LAB LEAD BLOOD,59.0,9.44,12.11,56.81,63
CPT,83655,LAB LEAD BLOOD NS,37.0,5.92,12.11,56.81,63
CPT,83655,LAB LEAD NON BLOOD,79.0,12.64,12.11,59.25,63
CPT,83690,LAB LIPASE,187.0,29.92,6.89,140.25,63
CPT,83690,LAB LIPASE FLUID BODY,52.0,8.32,6.89,39.0,63
CPT,83690,LAB LIPASE FLUID BODY NS,58.0,9.28,6.89,43.5,63
CPT,83695,LAB LIPOPROTEIN A,57.0,9.12,14.32,67.19,63
CPT,83695,LAB LIPOPROTEIN A NS,58.0,9.28,14.32,67.19,63
CPT,83698,LAB LIPOPROTEIN PHOSPHOLIPASE A2,139.0,22.24,46.31,217.39,63
CPT,83700,LAB LIPOPROTEIN ELECTRO,64.0,10.24,11.26,52.88,63
CPT,83701,LAB LIPOPROTEIN FRCTN HR,102.0,16.32,33.86,158.92,63
CPT,83704,LAB LIPOPROTEIN PART NO/S&SBCLS QN,103.0,16.48,34.19,192.51,63
CPT,83718,LAB LIPOPROTEIN CHOLESTEROL HDL,62.0,9.92,8.19,46.5,63
CPT,83718,LAB LIPOPROTEIN CHOLESTEROL HDL NS,25.0,4.0,8.19,38.45,63
CPT,83721,LAB LIPOPROTEIN CHOLESTEROL LDL,32.0,5.12,10.5,49.29,63
CPT,83721,LAB LIPOPROTEIN CHOLESTEROL LDL NS,94.0,15.04,10.5,70.5,63
CPT,83722,LAB LIPOPROTEIN CHOLESTEROL LDL SD,103.0,16.48,34.19,160.51,63
CPT,83735,LAB MAGNESIUM,99.0,15.84,6.7,74.25,63
CPT,83735,LAB MAGNESIUM NS,88.0,14.08,6.7,66.0,63
CPT,83735,LAB MAGNESIUM STOOL,21.0,3.36,6.7,31.46,63
CPT,83735,LAB MAGNESIUM URINE,52.0,8.32,6.7,39.0,63
CPT,83785,LAB MANGANESE,80.0,12.8,26.65,125.12,63
CPT,83789,LAB MS&MS TNDM NON-DRUG QL/QN,73.0,11.68,24.11,113.15,63
CPT,83825,LAB MERCURY BLOOD QN,49.0,7.84,16.26,76.3,63
CPT,83825,LAB MERCURY NON BLOOD QN,88.0,14.08,16.26,76.3,63
CPT,83835,LAB METANEPHRINES,66.0,10.56,16.94,79.49,63
CPT,83873,LAB PROT MYELIN BASIC CSF,63.0,10.08,17.2,80.69,63
CPT,83874,LAB MYOGLOBIN,59.0,9.44,12.92,60.67,63
CPT,83874,LAB MYOGLOBIN URINE,59.0,9.44,12.92,60.67,63
CPT,83880,LAB PEPTIDE NATRIURETIC PB,286.0,45.76,39.26,214.5,63
CPT,83880,LAB PEPTIDE NATRIURETIC PB NS,121.0,19.36,39.26,184.26,63
CPT,83883,LAB ALPHA2-MACROGLOBULIN QN,72.0,11.52,13.6,63.79,63
CPT,83883,LAB KAPPA/LAMBDA LIGHT,69.0,11.04,13.6,63.79,63
CPT,83883,LAB KAPPA/LAMBDA LIGHT NS,55.0,8.8,13.6,63.79,63
CPT,83883,LAB NEPHELOMETRY ANALYTE EA,41.0,6.56,13.6,63.79,63
CPT,83883,LAB NEPHELOMETRY C3PA COMPLEMENT,41.0,6.56,13.6,63.79,63
CPT,83884,LAB NEUROFILAMENT LC PLASMA,350.0,56.0,93.1,262.5,62
CPT,83915,LAB NUCLEOTIDASE 5-,99.0,15.84,11.15,74.25,63
CPT,83916,LAB BANDS OLIGOCLONAL CSF,83.0,13.28,27.39,128.52,63
CPT,83918,LAB ACIDS ORGANIC TOTAL EA QN,406.0,64.96,23.6,304.5,63
CPT,83918,LAB ACIDS ORGANIC TOTAL URINE EA QN,101.0,16.16,23.6,110.76,63
CPT,83919,LAB ACIDS ORGANIC EA QL,50.0,8.0,16.45,77.16,63
CPT,83919,LAB ACIDS ORGANIC URINE EA QL,50.0,8.0,16.45,77.16,63
CPT,83921,LAB ACID ORGANIC SINGLE METHY QN NS,64.0,10.24,21.21,99.58,63
CPT,83921,LAB ACID ORGANIC SINGLE QN,195.0,31.2,21.21,146.25,63
CPT,83930,LAB OSMOLALITY BLOOD,56.0,8.96,6.61,42.0,63
CPT,83935,LAB OSMOLALITY URINE,56.0,8.96,6.82,42.0,63
CPT,83937,LAB OSTEOCALCIN,90.0,14.4,29.85,140.09,63
CPT,83945,LAB OXALATE,109.0,17.44,14.45,81.75,63
CPT,83945,LAB OXALATE STONE RISK,108.0,17.28,14.45,81.0,63
CPT,83945,LAB OXALATE URINE,67.0,10.72,14.45,67.85,63
CPT,83951,LAB ONCOPROTEIN DCP,194.0,31.04,64.41,302.33,63
CPT,83970,LAB PARATHORMONE,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE C-TERMINAL,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE INTRAOP BASELINE 1,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE INTRAOP BASELINE 2,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE INTRAOP BASELINE 3,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE INTRAOP EA ADDL,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE INTRAOP POST 10 MN,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE INTRAOP POST 5 MN,124.0,19.84,41.28,193.71,63
CPT,83970,LAB PARATHORMONE NS,124.0,19.84,41.28,193.71,63
CPT,83986,LAB PH FLUID BODY NOS,51.0,8.16,3.58,38.25,63
CPT,83986,LAB PH FLUID BODY NOS NS,104.0,16.64,3.58,78.0,63
CPT,83986,LAB PH STONE RISK,66.0,10.56,3.58,49.5,63
CPT,83986,LAB PH STOOL NS,72.0,11.52,3.58,54.0,63
CPT,83992,LAB DRG DF CNFRM PHENCYCLDN/PCP DAY,67.0,10.72,2.17,75.67,40
CPT,83992,LAB DRG DF PHENCYCLDN NON URINE,56.0,8.96,2.17,75.67,40
CPT,83993,LAB CALPROTECTIN FECAL,250.0,40.0,19.63,187.5,63
CPT,84030,LAB PHENYLALANINE BLOOD,17.0,2.72,5.5,25.81,63
CPT,84060,LAB ACID PHOSPHATASE TOTAL NS,63.0,10.08,7.64,47.25,63
CPT,84066,LAB ACID PHOSPHATASE PROSTATIC,60.0,9.6,9.66,45.3,63
CPT,84075,LAB ALKALINE PHOSPHATASE,70.0,11.2,5.18,52.5,63
CPT,84075,LAB ALKALINE PHOSPHATASE NS,70.0,11.2,5.18,52.5,63
CPT,84078,LAB ALKALINE PHOSPHATASE HEAT,25.0,4.0,8.26,38.78,63
CPT,84080,LAB ALKALINE PHOSPHATASE ISOENZYMES,57.0,9.12,14.78,69.38,63
CPT,84100,LAB PHOSPHORUS INORGANIC,61.0,9.76,4.74,45.75,63
CPT,84105,LAB PHOSPHORUS INORGANIC URINE,52.0,8.32,5.78,39.0,63
CPT,84105,LAB PHOSPHORUS INORGANIC URINE NS,18.0,2.88,5.78,27.14,63
CPT,84105,LAB PHOSPHORUS STONE RISK,74.0,11.84,5.78,55.5,63
CPT,84110,LAB PORPHOBILINOGEN URINE QN,62.0,9.92,8.44,46.5,63
CPT,84112,POC PAMG-1 CERVICOVAGINAL QL,295.0,47.2,98.11,460.45,63
CPT,84120,LAB PORPHYRINS URINE QN&FRCTN,62.0,9.92,14.71,69.05,63
CPT,84126,LAB PORPHYRINS FECES QN,173.0,27.68,39.11,183.6,63
CPT,84132,LAB POTASS BLD WHL RBC,82.0,13.12,4.76,61.5,63
CPT,84132,LAB POTASS PLASMA,59.0,9.44,4.76,44.25,63
CPT,84132,LAB POTASS SRM/PLASMA/BLD WHL,60.0,9.6,4.76,45.0,63
CPT,84132,POC POTASS SRM/PLASMA/BLD WHL,60.0,9.6,4.76,45.0,126
CPT,84132,POC POTASS SRM/PLASMA/BLD WHL TLCR,60.0,9.6,4.76,45.0,63
CPT,84133,LAB POTASS URINE,55.0,8.8,4.73,41.25,63
CPT,84133,LAB POTASSIUM STONE RISK,70.0,11.2,4.73,52.5,63
CPT,84134,LAB PREALBUMIN,54.0,8.64,14.59,68.45,63
CPT,84140,LAB PREGNENOLONE,63.0,10.08,20.67,97.05,63
CPT,84143,LAB 17-HYDROXYPREGNENOLONE,69.0,11.04,22.81,107.03,63
CPT,84144,LAB PROGESTERONE,63.0,10.08,20.86,97.92,63
CPT,84145,LAB PROCALCITONIN,155.0,24.8,27.22,127.78,63
CPT,84146,LAB PROLACTIN,59.0,9.44,19.38,90.93,63
CPT,84150,LAB PROSTAGLANDIN EA ARP,335.0,53.6,41.77,251.25,63
CPT,84153,LAB PSA TOTAL,56.0,8.96,18.39,86.34,63
CPT,84154,LAB PSA FREE,56.0,8.96,18.39,86.34,63
CPT,84155,LAB PROT TTL SRM/PLASMA/BLD WHL,56.0,8.96,3.67,42.0,63
CPT,84155,LAB PROT TTL SRM/PLASMA/BLD WHL NS,53.0,8.48,3.67,39.75,63
CPT,84156,LAB PROT URINE,56.0,8.96,3.67,42.0,63
CPT,84156,LAB PROT URINE TIMED,12.0,1.92,3.67,17.23,63
CPT,84157,LAB PROT FLUID BODY,12.0,1.92,4.0,18.76,63
CPT,84157,LAB PROT FLUID BODY NS,52.0,8.32,4.0,39.0,63
CPT,84157,LAB PROT FLUID CEREBROSPINAL,56.0,8.96,4.0,42.0,63
CPT,84165,LAB PROT FRCTN ELECTRO&QN SERUM,57.0,9.12,10.74,78.63,63
CPT,84165,LAB PROT FRCTN ELECTRO&QN SERUM NS,56.0,8.96,10.74,78.63,63
CPT,84166,LAB PROT FRCTN ELECTRO&QN OTHER,54.0,8.64,17.83,78.63,63
CPT,84166,LAB PROT FRCTN ELECTRO&QN URINE,54.0,8.64,17.83,78.63,63
CPT,84181,LAB HSP 70 WB W INTRP,174.0,27.84,17.03,130.5,63
CPT,84181,LAB PROT WB W INTRP,104.0,16.64,17.03,78.63,63
CPT,84182,LAB PROT WB W INTRP ENCEPHALITIS,155.0,24.8,29.21,126.51,63
CPT,84182,LAB PROT WB W INTRP ID BAND,139.0,22.24,29.21,126.51,63
CPT,84182,LAB PROT WB W INTRP ID CREUTZ-JAKOB,89.0,14.24,29.21,126.51,63
CPT,84182,LAB PROT WB W INTRP ID MATA AUTOAB,380.0,60.8,29.21,285.0,63
CPT,84182,LAB PROT WB W INTRP ID MYOSITIS,88.0,14.08,29.21,126.51,63
CPT,84182,LAB PROT WB W INTRP ID RECOVERING,88.0,14.08,29.21,126.51,63
CPT,84202,LAB PROTOPORPHYRIN RBC QN,111.0,17.76,14.35,83.25,63
CPT,84206,LAB PROINSULIN,81.0,12.96,26.69,125.26,63
CPT,84207,LAB PYRIDOXAL PHOSPHATE,85.0,13.6,28.1,131.91,63
CPT,84210,LAB PYRUVATE,44.0,7.04,14.48,67.98,63
CPT,84220,LAB PYRUVATE KINASE NS,187.0,29.92,9.44,140.25,63
CPT,84228,LAB QUININE,136.0,21.76,11.63,102.0,63
CPT,84238,LAB INTERLEUKIN 2 RECEPTOR,110.0,17.6,36.57,171.62,63
CPT,84238,LAB RECEPTOR ACETYLCHOLINE NON-ENDO,110.0,17.6,36.57,171.62,63
CPT,84238,LAB RECEPTOR INTERLEUK 2 SOL N-END,500.0,80.0,36.57,375.0,63
CPT,84244,LAB RENIN,140.0,22.4,21.99,105.0,63
CPT,84244,LAB RENIN NS,66.0,10.56,21.99,103.24,63
CPT,84252,LAB RIBOFLAVIN,74.0,11.84,20.24,94.99,63
CPT,84255,LAB SELENIUM,77.0,12.32,25.53,119.87,63
CPT,84260,LAB SEROTONIN,93.0,14.88,30.98,145.41,63
CPT,84270,LAB HORMONE SEX BINDING GLOBULIN,66.0,10.56,21.73,101.98,63
CPT,84295,LAB SODIUM SRM/PLASMA/BLD WHL,48.0,7.68,4.81,36.0,63
CPT,84295,POC SODIUM SRM/PLASMA/BLD WHL,48.0,7.68,4.81,36.0,63
CPT,84295,POC SODIUM SRM/PLASMA/BLD WHL TLCR,48.0,7.68,4.81,36.0,63
CPT,84295,POC SODIUM SRM/PLASMA/WHOLE BLD,48.0,7.68,4.81,36.0,63
CPT,84300,LAB SODIUM STONE RISK,72.0,11.52,5.06,54.0,63
CPT,84300,LAB SODIUM URINE,16.0,2.56,5.06,23.75,63
CPT,84300,LAB SODIUM URINE TIMED,16.0,2.56,5.06,23.75,63
CPT,84302,LAB SODIUM FLUID BODY,15.0,2.4,4.86,22.82,63
CPT,84302,LAB SODIUM OTHER SOURCE,15.0,2.4,4.86,22.82,63
CPT,84302,LAB SODIUM STOOL NS,58.0,9.28,4.86,43.5,63
CPT,84305,LAB SOMATOMEDIN NS,64.0,10.24,21.26,99.78,63
CPT,84307,LAB SOMATOSTATIN,82.0,13.12,18.28,85.81,63
CPT,84311,LAB SPCTPHOT 1-3-BETA-D-GLUCAN,157.0,25.12,8.1,117.75,63
CPT,84311,LAB SPCTPHOT ANALYTE NS,58.0,9.28,8.1,43.5,63
CPT,84311,LAB SPCTPHOT PORPHYRINS SERUM,70.0,11.2,8.1,52.5,63
CPT,84311,LAB SPCTPHOT SULFONAMIDE,25.0,4.0,8.1,38.05,63
CPT,84315,LAB GRAVITY SPECIFIC FLUID BODY,10.0,1.6,3.28,15.37,63
CPT,84376,LAB SUGARS SINGLE QL STOOL NS,64.0,10.24,5.5,48.0,63
CPT,84377,LAB SUGARS MULTIPLE QL EA,229.0,36.64,5.5,171.75,63
CPT,84392,LAB SULFATE STONE RISK,72.0,11.52,5.49,54.0,63
CPT,84392,LAB SULFATE URINE,17.0,2.72,5.49,25.74,63
CPT,84393,LAB TAU181 PHOSPHORYLATED EA,387.0,61.92,102.94,290.25,62
CPT,84393,LAB TAU217 PHOSPHORYLATED EA,387.0,61.92,102.94,290.25,62
CPT,84394,LAB TAU TOTAL,387.0,61.92,102.94,290.25,62
CPT,84402,LAB TESTOSTERONE FREE,77.0,12.32,25.47,119.54,63
CPT,84403,LAB TESTOSTERONE TOTAL,78.0,12.48,25.81,121.13,63
CPT,84403,LAB TESTOSTERONE TOTAL NS,78.0,12.48,25.81,121.13,63
CPT,84425,LAB THIAMINE,64.0,10.24,21.23,99.65,63
CPT,84430,LAB THIOCYANATE,35.0,5.6,11.63,54.61,63
CPT,84432,LAB THYROGLOBULIN,58.0,9.28,16.06,75.37,63
CPT,84432,LAB THYROGLOBULIN FNA,82.0,13.12,16.06,75.37,63
CPT,84432,LAB THYROGLOBULIN NS,57.0,9.12,16.06,75.37,63
CPT,84433,LAB THIOPURINE S-METHYLTRANSFERASE,112.0,17.92,22.17,84.0,63
CPT,84436,LAB THYROXINE T4 TOTAL,56.0,8.96,6.87,42.0,63
CPT,84439,LAB THYROXINE T4 FREE,43.0,6.88,9.02,42.37,63
CPT,84439,LAB THYROXINE T4 FREE NS,66.0,10.56,9.02,49.5,63
CPT,84442,LAB THYROXINE BINDING GLOBULIN,45.0,7.2,14.78,69.38,63
CPT,84443,LAB THYROID STIMULATING HORMONE,246.0,39.36,16.8,184.5,63
CPT,84443,LAB THYROID STIMULATING HORMONE NS,51.0,8.16,16.8,78.83,63
CPT,84445,LAB THYROID STIMULATING IMMUN GLOB,153.0,24.48,50.86,238.74,63
CPT,84446,LAB TOCOPHEROL ALPHA,62.0,9.92,14.18,66.52,63
CPT,84449,LAB CORTISOL BINDING GLOBULIN,54.0,8.64,18.0,84.48,63
CPT,84450,LAB TRANSFERASE AMINO ASPARTATE,65.0,10.4,5.18,48.75,63
CPT,84450,LAB TRANSFERASE AMINO ASPARTATE NS,76.0,12.16,5.18,57.0,63
CPT,84460,LAB TRANSFERASE AMINO ALANINE,65.0,10.4,5.3,48.75,63
CPT,84460,LAB TRANSFERASE AMINO ALANINE NS,59.0,9.44,5.3,44.25,63
CPT,84466,LAB TRANSFERRIN,61.0,9.76,12.76,59.87,63
CPT,84466,LAB TRANSFERRIN NS,39.0,6.24,12.76,59.87,63
CPT,84478,LAB TRIGLYCERIDES,73.0,11.68,5.74,54.75,63
CPT,84478,LAB TRIGLYCERIDES FLUID BODY,73.0,11.68,5.74,54.75,63
CPT,84478,LAB TRIGLYCERIDES NS,73.0,11.68,5.74,54.75,63
CPT,84479,LAB UPTAKE HORMONE T3,56.0,8.96,6.47,42.0,63
CPT,84480,LAB TRIIODOTHYRONINE T3 TOTAL,43.0,6.88,14.18,66.52,63
CPT,84480,LAB TRIIODOTHYRONINE T3 TOTAL NS,43.0,6.88,14.18,66.52,63
CPT,84481,LAB TRIIODOTHYRONINE T3 FREE,54.0,8.64,16.94,79.49,63
CPT,84481,LAB TRIIODOTHYRONINE T3 FREE TR DIA,71.0,11.36,16.94,79.49,63
CPT,84482,LAB TRIIODOTHYRONINE T3 REVERSE,59.0,9.44,15.76,73.97,63
CPT,84484,LAB TROPONIN QN,249.0,39.84,12.47,186.75,63
CPT,84484,POC TROPONIN QN,38.0,6.08,12.47,58.54,63
CPT,84485,LAB TRYPSIN FLUID DUODENAL,22.0,3.52,7.2,33.79,63
CPT,84510,LAB TYROSINE,100.0,16.0,10.63,75.0,63
CPT,84520,LAB NITROGEN UREA QN,83.0,13.28,3.95,62.25,63
CPT,84520,LAB NITROGEN UREA QN NS,67.0,10.72,3.95,50.25,63
CPT,84520,POC NITROGEN UREA QN,83.0,13.28,3.95,62.25,63
CPT,84520,POC NITROGEN UREA QN TELCOR,83.0,13.28,3.95,62.25,63
CPT,84540,LAB NITROGEN UREA URINE,52.0,8.32,5.56,39.0,63
CPT,84550,LAB ACID URIC BLOOD,23.0,3.68,4.52,21.22,63
CPT,84560,LAB ACID URIC FLUID BODY,16.0,2.56,5.08,23.81,63
CPT,84560,LAB ACID URIC OTHER SOURCE,16.0,2.56,5.08,23.81,63
CPT,84560,LAB ACID URIC OTHER SOURCE NS,58.0,9.28,5.08,43.5,63
CPT,84560,LAB ACID URIC URINE,56.0,8.96,5.08,42.0,63
CPT,84560,LAB URIC ACID STONE RISK,72.0,11.52,5.08,54.0,63
CPT,84585,LAB ACID VANILLYLMANDELIC URINE,82.0,13.12,15.5,72.71,63
CPT,84586,LAB VASOACTIVE INTS PEPTIDE NS,160.0,25.6,35.33,165.83,63
CPT,84588,LAB VASOPRESSIN,102.0,16.32,33.94,159.32,63
CPT,84590,LAB VITAMIN A,62.0,9.92,11.61,54.48,63
CPT,84591,LAB BIOTIN,160.0,25.6,17.06,120.0,63
CPT,84591,LAB NIACIN,94.0,15.04,17.06,80.09,63
CPT,84591,LAB PANTOTHENIC ACID B5,69.0,11.04,17.06,80.09,63
CPT,84591,LAB VITAMIN E BETA/GAMMA TOCOPHER,52.0,8.32,17.06,80.09,63
CPT,84597,LAB VITAMIN K,85.0,13.6,13.72,64.39,63
CPT,84600,LAB SCR VOLATILE,52.0,8.32,17.11,80.29,63
CPT,84600,LAB VOLATILE,52.0,8.32,17.11,80.29,63
CPT,84600,LAB VOLATILE NS,184.0,29.44,17.11,138.0,63
CPT,84630,LAB ZINC,35.0,5.6,11.39,53.42,63
CPT,84630,LAB ZINC NS,135.0,21.6,11.39,101.25,63
CPT,84681,LAB C-PEPTIDE,63.0,10.08,20.81,97.72,63
CPT,84702,LAB HCG QN,71.0,11.36,15.05,70.64,63
CPT,84702,LAB HCG QN NS,71.0,11.36,15.05,70.64,63
CPT,84702,LAB HCG TUMOR MARKER QN,71.0,11.36,15.05,70.64,63
CPT,84703,LAB HCG QL,188.0,30.08,7.52,141.0,63
CPT,84999,LAB CHOLESTEROL FLUID BODY,55.0,8.8,10.23,176.48,37
CPT,84999,LAB GENE B-CELL CLONALITY PCR,51.0,8.16,9.49,176.48,37
CPT,84999,LAB GENE T-CELL BETA REARRANGEMENT,51.0,8.16,9.49,176.48,37
CPT,84999,LAB OSMOLALITY STOOL,68.0,10.88,12.65,176.48,37
CPT,84999,LAB POTASS FLUID BODY,56.0,8.96,10.42,176.48,37
CPT,85007,LAB COUNT BLD DIFF MANUAL WBC,54.0,9.88,3.8,40.5,63
CPT,85014,LAB COUNT BLD HEMATOCRIT,8.0,1.46,2.37,11.18,63
CPT,85014,LAB COUNT BLD HEMATOCRIT NS,8.0,1.46,2.37,11.18,63
CPT,85018,LAB COUNT BLD HEMOGLOBIN,13.0,2.38,2.37,11.18,63
CPT,85018,LAB COUNT BLD HEMOGLOBIN NS,13.0,2.38,2.37,11.18,63
CPT,85025,LAB CBC AUTO W AUTO DIFF,142.0,25.99,7.77,106.5,63
CPT,85025,LAB HEMO PLT AUTO W AUTO SCAN,24.0,4.39,7.77,36.45,63
CPT,85027,LAB CBC AUTO WO DIFF,106.0,19.4,6.47,79.5,63
CPT,85041,LAB COUNT BLD RBC AUTO,10.0,1.83,3.02,14.17,63
CPT,85041,LAB COUNT BLD RBC AUTO NS,10.0,1.83,3.02,14.17,63
CPT,85044,LAB COUNT BLD RETIC MANUAL,13.0,2.38,4.31,20.22,63
CPT,85046,LAB COUNT BLD RETIC AUTO W PARAM,57.0,10.43,5.57,42.75,63
CPT,85048,LAB COUNT BLD LEUKO AUTO,8.0,1.46,2.54,11.91,63
CPT,85049,LAB COUNT BLD PLATELET AUTOMATED,14.0,2.56,4.48,21.02,63
CPT,85055,LAB PLATELET RETICULATED,108.0,19.76,35.74,167.76,63
CPT,85130,LAB SUBSTRATE CHROMOGENIC,62.0,11.35,11.89,55.81,63
CPT,85130,LAB SUBSTRATE CHROMOGENIC NS,145.0,26.54,11.89,108.75,63
CPT,85210,LAB CLOTTING FACTOR 2 PROTHROM,64.0,11.71,12.98,60.93,63
CPT,85220,LAB CLOTTING FACTOR 5 LABILE,75.0,13.72,17.65,82.88,63
CPT,85230,LAB CLOTTING FACTOR 7,76.0,13.91,17.9,84.01,63
CPT,85240,LAB CLOTTING FACTOR 8 1-STG,66.0,12.08,17.9,84.01,63
CPT,85240,LAB CLOTTING FACTOR 8 1-STG NS,114.0,20.86,17.9,85.5,63
CPT,85244,LAB CLOTTING FACTOR 8 AG RELATED,62.0,11.35,20.42,95.86,63
CPT,85245,LAB CLOTTING FACTOR 8 VWF RIST,74.0,13.54,22.94,107.7,63
CPT,85245,LAB CLOTTING FACTOR 8 VWF RIST NS,87.0,15.92,22.94,107.7,63
CPT,85246,LAB CLOTTING FACTOR 8 VWF AG,74.0,13.54,22.94,107.7,63
CPT,85247,LAB CLOTTING FACTOR 8 VWF MULTI,69.0,12.63,22.94,107.7,63
CPT,85250,LAB CLOTTING FACTOR 9 PTC/XMAS,79.0,14.46,19.04,89.34,63
CPT,85250,LAB CLOTTING FACTOR 9 PTC/XMAS NS,75.0,13.72,19.04,89.34,63
CPT,85260,LAB CLOTTING FACTOR 10 STUART-PR NS,54.0,9.88,17.9,84.01,63
CPT,85260,LAB CLOTTING FACTOR 10 STUART-PROWR,76.0,13.91,17.9,84.01,63
CPT,85270,LAB CLOTTING FACTOR 11 PTA,69.0,12.63,17.9,84.01,63
CPT,85270,LAB CLOTTING FACTOR 11 PTA NS,89.0,16.29,17.9,84.01,63
CPT,85280,LAB CLOTTING FACTOR 12 HAGEMAN,76.0,13.91,19.35,90.8,63
CPT,85290,LAB CLOTTING FACTOR 13 STB FBR NS,98.0,17.93,16.34,76.7,63
CPT,85291,LAB CLOTTING FACTOR 13 SCR SOL,28.0,5.12,9.11,42.77,63
CPT,85292,LAB CLOTTING PREKALLIKREIN,166.0,30.38,18.93,124.5,63
CPT,85293,LAB CLOTTING KININOGEN WT HI MOLEC,229.0,41.91,18.93,171.75,63
CPT,85300,LAB CLOTTING ACT ANTITHROM 3,63.0,11.53,11.85,55.61,63
CPT,85300,LAB CLOTTING ACT ANTITHROM 3 NS,56.0,10.25,11.85,55.61,63
CPT,85301,LAB CLOTTING AG ANTITHROMBIN 3 NS,69.0,12.63,10.81,51.75,63
CPT,85302,LAB CLOTTING AG PROTEIN C,65.0,11.9,12.01,56.41,63
CPT,85303,LAB CLOTTING ACT PROTEIN C,42.0,7.69,13.84,64.92,63
CPT,85305,LAB CLOTTING PROTEIN S TOTAL,64.0,11.71,11.61,54.48,63
CPT,85305,LAB CLOTTING PROTEIN S TOTAL NS,58.0,10.61,11.61,54.48,63
CPT,85306,LAB CLOTTING PROTEIN S FREE,66.0,12.08,15.32,71.91,63
CPT,85306,LAB CLOTTING PROTEIN S FREE NS,60.0,10.98,15.32,71.91,63
CPT,85307,LAB PROT C ACT RESISTANCE,66.0,12.08,15.32,71.91,63
CPT,85335,LAB INHIBITOR FACTOR 8,97.0,17.75,12.87,72.75,63
CPT,85335,LAB INHIBITOR FACTOR 9,39.0,7.14,12.87,60.4,63
CPT,85335,LAB INHIBITOR VWF PROTEASE,225.0,41.18,12.87,168.75,63
CPT,85347,LAB COAGULATION TIME ACTIVATED,55.0,10.06,4.28,41.25,63
CPT,85347,POC COAGULATION TIME ACTIVAT TELCOR,13.0,2.38,4.28,20.09,63
CPT,85347,POC COAGULATION TIME ACTIVATED,13.0,2.38,4.28,20.09,63
CPT,85360,LAB LYSIS EUGLOBULIN,26.0,4.76,8.41,39.51,63
CPT,85362,LAB FDP FSP AGG SEMI QN,21.0,3.84,6.89,32.33,63
CPT,85362,LAB FDP FSP AGG SEMI QN NS,80.0,14.64,6.89,60.0,63
CPT,85379,LAB FDP D-DIMER QN,240.0,43.92,10.18,180.0,63
CPT,85384,LAB FIBRINOGEN ACTIVITY,47.0,8.6,9.72,45.63,63
CPT,85384,LAB FIBRINOGEN ACTIVITY NS,47.0,8.6,9.72,45.63,63
CPT,85384,POC FIBRINOGEN ACTIVITY,47.0,8.6,9.72,45.63,63
CPT,85385,LAB FIBRINOGEN ANTIGEN,44.0,8.05,14.46,67.85,63
CPT,85390,LAB SCR FIBRINOLYSINS/COAG,65.0,11.9,15.48,157.25,63
CPT,85390,POC SCR FIBRINOLYSINS/COAG,47.0,8.6,15.48,157.25,63
CPT,85397,LAB COAGULATION&FIBRINOLYSIS,164.0,30.01,30.86,144.88,63
CPT,85410,LAB ANTIPLASMIN ALPHA-2,24.0,4.39,7.71,36.19,63
CPT,85415,LAB PLASMINOGEN ACTIVATOR,84.0,15.37,17.19,80.69,63
CPT,85420,LAB PLASMINOGEN NON-ANTIGENIC,57.0,10.43,6.53,42.75,63
CPT,85420,LAB PLASMINOGEN NON-ANTIGENIC NS,71.0,12.99,6.53,53.25,63
CPT,85421,LAB PLASMINOGEN ANTIGENIC,31.0,5.67,10.18,47.76,63
CPT,85460,LAB HGB FETAL KLEIHAUER-BETKE,59.0,10.8,7.73,44.25,63
CPT,85461,LAB HGB FETAL ROSETTE,29.0,5.31,9.36,43.97,63
CPT,85520,LAB ASSAY HEPARIN,263.0,48.13,13.09,197.25,63
CPT,85525,POC NEUTRALIZATION HEPARIN,36.0,6.59,11.84,55.54,63
CPT,85530,POC TOLERANCE HEPARIN-PROTAMINE,40.0,7.32,13.09,61.46,63
CPT,85540,LAB LEUKOCYTE ALK PHOS W COUNT NS,26.0,4.76,8.6,40.38,63
CPT,85549,LAB MURAMIDASE,57.0,10.43,18.75,88.01,63
CPT,85557,LAB FRAGILITY OSMOTIC RBC INCUB,57.0,10.43,13.36,62.73,63
CPT,85576,LAB AGGREGATION PLT ASPIRIN,197.0,36.05,24.91,147.75,63
CPT,85576,LAB AGGREGATION PLT CLOPIDOGREL,79.0,14.46,24.91,107.89,63
CPT,85576,LAB AGGREGATION PLT EA AGENT,79.0,14.46,24.91,107.89,63
CPT,85576,POC AGGREGATION PLT EA AGENT,79.0,14.46,24.91,107.89,63
CPT,85598,LAB NEUTRAL PHOSPHO HEXAGONAL,71.0,12.99,17.98,84.35,63
CPT,85598,LAB NEUTRAL PHOSPHO HEXAGONAL NS,64.0,11.71,17.98,84.35,63
CPT,85610,LAB PROTHROMBIN TIME,95.0,17.38,4.29,71.25,63
CPT,85610,LAB PROTHROMBIN TIME NS,63.0,11.53,4.29,47.25,63
CPT,85610,POC PROTHROMBIN TIME TELCOR,13.0,2.38,4.29,20.16,63
CPT,85611,LAB PROTHROMBIN TIME SUB,58.0,10.61,3.94,43.5,63
CPT,85613,LAB VENOM TIME RUSSELL VIPER DLT,60.0,10.98,9.58,45.0,63
CPT,85635,LAB REPTILASE,80.0,14.64,9.85,60.0,63
CPT,85651,LAB RATE SEDIMENTATION RBC NONAUTO,13.0,2.38,4.27,20.09,63
CPT,85652,LAB RATE SEDIMENTATION RBC AUTO,9.0,1.65,2.7,12.64,63
CPT,85660,LAB SICKLING RBC REDUCTION,56.0,10.25,5.51,42.0,63
CPT,85670,LAB THROMBIN TIME PLASMA,56.0,10.25,5.77,42.0,63
CPT,85670,LAB THROMBIN TIME PLASMA NS,18.0,3.29,5.77,27.07,63
CPT,85730,LAB PTT PLASMA/BLD WHL,114.0,20.86,6.01,85.5,63
CPT,85730,LAB PTT PLASMA/BLD WHL NS,54.0,9.88,6.01,40.5,63
CPT,85732,LAB PTT SUBSTITUTION FRAC PLASMA,103.0,18.85,6.47,77.25,63
CPT,85810,LAB VISCOSITY,57.0,10.43,11.67,54.75,63
CPT,85999,LAB EOSINOPHILS URINE/OTHER,57.0,10.43,10.6,176.48,37
CPT,86000,LAB AGGLUTININS FEBRILE AG EA,21.0,3.99,6.98,32.73,63
CPT,86001,LAB ALLG IGG QN/SEMI QN EA,24.0,4.56,7.82,36.72,63
CPT,86003,LAB ALLG IGE QN/SEMI QN CRUDE EA,56.0,10.64,5.22,42.0,63
CPT,86003,LAB ALLG IGE QN/SEMI QN CRUDE EA NS,55.0,10.45,5.22,41.25,63
CPT,86005,LAB SCR ALLG IGE QL MULTI,56.0,10.64,7.97,42.0,63
CPT,86005,LAB SCR ALLG IGE QL MULTI NS,59.0,11.21,7.97,44.25,63
CPT,86008,LAB ALLG IGE QN/SEMI QN EA,64.0,12.16,17.93,84.15,63
CPT,86008,LAB ALLG IGE QN/SEMI QN EA NS,80.0,15.2,17.93,84.15,63
CPT,86015,LAB SCR AB MUSCLE SMOOTH FL,60.0,11.4,11.53,49.94,63
CPT,86015,LAB SCR AB MUSCLE SMOOTH FL NS,56.0,10.64,11.53,49.94,63
CPT,86021,LAB AB ID ANTI-NEUTROPHIL,46.0,8.74,15.05,70.64,63
CPT,86021,LAB AB ID LEUKOCYTE,55.0,10.45,15.05,70.64,63
CPT,86021,LAB AB ID LEUKOCYTE NS,54.0,10.26,15.05,70.64,63
CPT,86022,LAB AB ID PLATELET BLOOD PRODUCT,238.0,45.22,18.37,178.5,63
CPT,86022,LAB AB ID PLATELET IGG FLOW CYTO,236.0,44.84,18.37,177.0,63
CPT,86022,LAB AB ID PLATELET PATIENT SERUM,56.0,10.64,18.37,86.21,63
CPT,86022,LAB AB ID PLATELET PATIENT SERUM NS,72.0,13.68,18.37,86.21,63
CPT,86023,LAB AB ID IG PLATELET ASSOCIATED,236.0,44.84,12.46,177.0,63
CPT,86036,LAB SCR AB ANCA FL EA AB,54.0,10.26,12.05,52.19,63
CPT,86036,LAB SCR AB ANCA INFL/BOWEL FL,57.0,10.83,12.05,52.19,63
CPT,86037,LAB SCR ANCA TITER AB EA,62.0,11.78,12.05,52.19,63
CPT,86038,LAB SCR ANA,53.0,10.07,12.09,56.74,63
CPT,86039,LAB ANA TITER,59.0,11.21,11.16,52.35,63
CPT,86039,LAB ANA TITER NS,115.0,21.85,11.16,86.25,63
CPT,86041,LAB IMM ACHR BINDING QN,70.0,13.3,18.4,64.46,63
CPT,86042,LAB IMM ACHR BLOCKING QN,99.0,18.81,18.4,74.25,63
CPT,86043,LAB IMM ACHR MODULATING QN,78.0,14.82,12.05,58.5,63
CPT,86051,LAB AQUAPORIN AB,268.0,50.92,11.53,201.0,63
CPT,86052,LAB SCR AQUAPORIN 4 AB IGG CSF,350.0,66.5,12.05,262.5,63
CPT,86052,LAB SCR AQUAPORIN 4 AB IGG SERUM,225.0,42.75,12.05,168.75,63
CPT,86053,LAB AQUAPORIN 4 AB FLOW CYTO MAYO,575.0,109.25,12.05,431.25,63
CPT,86053,LAB AQUAPORIN 4 AB FLOW CYTOMETRY,118.0,22.42,12.05,132.18,63
CPT,86060,LAB ANTISTREPTOLYSIN O TITER,57.0,10.83,7.3,42.75,63
CPT,86140,LAB PROT C-REACTIVE,26.0,4.94,5.18,24.35,63
CPT,86140,LAB PROT C-REACTIVE NS,26.0,4.94,5.18,24.35,63
CPT,86141,LAB PROT C-REACTIVE SENS HIGH,57.0,10.83,12.95,60.8,63
CPT,86141,LAB PROT C-REACTIVE SENS HIGH NS,131.0,24.89,12.95,98.25,63
CPT,86146,LAB AB BETA 2 GLYCOPROTEIN I,77.0,14.63,25.45,119.47,63
CPT,86147,LAB AB CARDIOLIPIN IG EA,80.0,15.2,25.45,119.47,63
CPT,86148,LAB AB ANTIPHOSPHATIDYLSERINE,57.0,10.83,16.07,75.43,63
CPT,86156,LAB SCR AGGLUTININ COLD,25.0,4.75,8.07,37.92,63
CPT,86156,LAB SCR AGGLUTININ COLD NS,25.0,4.75,8.07,37.92,63
CPT,86157,LAB AGGLUTININ COLD TITER,25.0,4.75,8.06,37.85,63
CPT,86160,LAB COMPLEMENT AG C1 ESTER NONFUNC,36.0,6.84,12.0,56.34,63
CPT,86160,LAB COMPLEMENT AG C1Q COMP EA,76.0,14.44,12.0,57.0,63
CPT,86160,LAB COMPLEMENT AG C2 COMP EA,36.0,6.84,12.0,56.34,63
CPT,86160,LAB COMPLEMENT AG C3 COMP EA,36.0,6.84,12.0,56.34,63
CPT,86160,LAB COMPLEMENT AG C4 COMP EA,53.0,10.07,12.0,56.34,63
CPT,86160,LAB COMPLEMENT AG C5 COMP EA,77.0,14.63,12.0,57.75,63
CPT,86160,LAB COMPLEMENT AG C6 COMP EA,36.0,6.84,12.0,56.34,63
CPT,86160,LAB COMPLEMENT AG COMP EA NS,222.0,42.18,12.0,166.5,63
CPT,86160,LAB COMPLEMENT AG SC5B-9 COMP EA,292.0,55.48,12.0,219.0,63
CPT,86161,LAB COMPLEMENT ACT FUNC,66.0,12.54,12.0,56.34,63
CPT,86161,LAB COMPLEMENT ACT FUNC C1 ESTER,66.0,12.54,12.0,56.34,63
CPT,86161,LAB COMPLEMENT ACT FUNC C3NEF,300.0,57.0,12.0,225.0,63
CPT,86161,LAB COMPLEMENT ACT FUNC NS,185.0,35.15,12.0,138.75,63
CPT,86162,LAB COMPLEMENT TOTAL HEMOLYTIC,61.0,11.59,20.32,95.39,63
CPT,86171,LAB COMPLEMENT FIX COCCI NS,31.0,5.89,10.01,46.96,63
CPT,86200,LAB AB PEPTIDE CYCLIC CITRUL,59.0,11.21,12.95,60.8,63
CPT,86215,LAB AB DEOXYRIBONUCLEASE,40.0,7.6,13.25,62.2,63
CPT,86225,LAB AB DNA STRANDED NATVE/DOUBLE,42.0,7.98,13.74,64.46,63
CPT,86225,LAB AB DNA STRANDED NATVE/DOUBLE NS,62.0,11.78,13.74,64.46,63
CPT,86231,LAB SCR AB ENDOMYSIAL FL,61.0,11.59,12.09,52.36,63
CPT,86235,LAB AB ENA CENTROMERE B,60.0,11.4,17.93,84.15,63
CPT,86235,LAB AB ENA CHROMATIN,124.0,23.56,17.93,93.0,63
CPT,86235,LAB AB ENA FIBRILLARIN,130.0,24.7,17.93,97.5,63
CPT,86235,LAB AB ENA JO1,123.0,23.37,17.93,92.25,63
CPT,86235,LAB AB ENA MYOSITIS,77.0,14.63,17.93,84.15,63
CPT,86235,LAB AB ENA NS,65.0,12.35,17.93,84.15,63
CPT,86235,LAB AB ENA PM/SC1-100,115.0,21.85,17.93,86.25,63
CPT,86235,LAB AB ENA RNP,55.0,10.45,17.93,84.15,63
CPT,86235,LAB AB ENA SCLERODERMA,123.0,23.37,17.93,92.25,63
CPT,86235,LAB AB ENA SCLERODERMA PANEL,161.0,30.59,17.93,120.75,63
CPT,86235,LAB AB ENA SM/RNP,54.0,10.26,17.93,84.15,63
CPT,86235,LAB AB ENA SMITH,55.0,10.45,17.93,84.15,63
CPT,86235,LAB AB ENA SS-A/RO,55.0,10.45,17.93,84.15,63
CPT,86235,LAB AB ENA SS-B/LA,55.0,10.45,17.93,84.15,63
CPT,86255,LAB SCR AB ADRENAL FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB ANTICENTROMERE FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB ANTIMYOCARDIAL FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB CIDP/NP EVALUATION FL,376.0,71.44,12.05,282.0,63
CPT,86255,LAB SCR AB COPEPTIN FL,300.0,57.0,12.05,225.0,63
CPT,86255,LAB SCR AB CSF FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB ENCEPHALITIS FL,98.0,18.62,12.05,78.63,63
CPT,86255,LAB SCR AB FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB FL NS,55.0,10.45,12.05,78.63,63
CPT,86255,LAB SCR AB GABA-BR FL,195.0,37.05,12.05,146.25,63
CPT,86255,LAB SCR AB HISTONE FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB LRP4 AUTO FL,850.0,161.5,12.05,637.5,63
CPT,86255,LAB SCR AB MUSCLE STRIATED FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB NEUROMYOTONIA FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB NMDA RECEPTOR FL,167.0,31.73,12.05,125.25,63
CPT,86255,LAB SCR AB PARANEOPLASTIC CSF FL,200.0,38.0,12.05,150.0,63
CPT,86255,LAB SCR AB PARANEOPLASTIC FL,37.0,7.03,12.05,78.63,63
CPT,86255,LAB SCR AB PARIETAL FL,55.0,10.45,12.05,78.63,63
CPT,86255,LAB SCR AB PHOSPHOLIPAS A2 RECPT FL,190.0,36.1,12.05,142.5,63
CPT,86255,LAB SCR AB PURKINJE FL,64.0,12.16,12.05,78.63,63
CPT,86255,LAB SCR AB REFLEX ENCEPHALITIS FL,525.0,99.75,12.05,393.75,63
CPT,86255,LAB SCR AB RETICULUM FL,54.0,10.26,12.05,78.63,63
CPT,86256,LAB AB FL TITER,37.0,7.03,12.05,78.63,63
CPT,86256,LAB AB FL TITER ANTIMYOCARDIAL,37.0,7.03,12.05,78.63,63
CPT,86256,LAB AB FL TITER AQUAPORIN 4,219.0,41.61,12.05,164.25,63
CPT,86256,LAB AB FL TITER ENCEPHALITIS,194.0,36.86,12.05,145.5,63
CPT,86256,LAB AB FL TITER ENDOMYSIAL,103.0,19.57,12.05,78.63,63
CPT,86256,LAB AB FL TITER HU,55.0,10.45,12.05,78.63,63
CPT,86256,LAB AB FL TITER MITOCHONDRIA,60.0,11.4,12.05,78.63,63
CPT,86256,LAB AB FL TITER MOG,837.0,159.03,12.05,627.75,63
CPT,86256,LAB AB FL TITER MUSCLE SMOOTH,37.0,7.03,12.05,78.63,63
CPT,86256,LAB AB FL TITER MUSCLE STRIATED,65.0,12.35,12.05,78.63,63
CPT,86256,LAB AB FL TITER NMDA,194.0,36.86,12.05,145.5,63
CPT,86256,LAB AB FL TITER NS,78.0,14.82,12.05,78.63,63
CPT,86256,LAB AB FL TITER PARIETAL,55.0,10.45,12.05,78.63,63
CPT,86256,LAB AB FL TITER PHOSPHOLPS A2 RECPT,285.0,54.15,12.05,213.75,63
CPT,86256,LAB AB FL TITER PURKINJE,190.0,36.1,12.05,142.5,63
CPT,86258,LAB IMM MS GLIADIN IGA QL,37.0,7.03,11.53,49.94,63
CPT,86258,LAB IMM MS GLIADIN IGG QL,37.0,7.03,11.53,49.94,63
CPT,86258,LAB IMM MS GLIADIN QL,59.0,11.21,11.53,49.94,63
CPT,86300,LAB IMM AG TUMOR CA 15-3,63.0,11.97,20.81,97.72,63
CPT,86300,LAB IMM AG TUMOR CA 27-29,63.0,11.97,20.81,97.72,63
CPT,86301,LAB IMM AG TUMOR CA 19-9,63.0,11.97,20.81,97.72,63
CPT,86304,LAB IMM AG TUMOR CA 125,63.0,11.97,20.81,97.72,63
CPT,86305,LAB PROT 4 HUMAN EPIDIDYMIS,97.0,18.43,13.98,97.72,59
CPT,86308,LAB SCR AB HETEROPHILE,16.0,3.04,5.18,24.35,63
CPT,86316,LAB IMM AG TUMOR OTHER QN NS,75.0,14.25,20.81,97.72,63
CPT,86317,LAB IMM AB QN CREUTZFELDT-JAKOB,83.0,15.77,14.99,70.38,63
CPT,86317,LAB IMM AB QN HAEMOPHILUS INFLU B,63.0,11.97,14.99,70.38,63
CPT,86317,LAB IMM AB QN NS,142.0,26.98,14.99,106.5,63
CPT,86317,LAB IMM AB QN PNEUMOCOCCAL,51.0,9.69,14.99,70.38,63
CPT,86318,LAB IMM AB QL/SEMI QN SGL STEP,245.0,46.55,18.09,183.75,63
CPT,86320,LAB IMMUNOELECTROPHORESIS SERUM,90.0,17.1,29.92,129.58,63
CPT,86325,LAB IMMUNOELECTROPHORESIS OTHER,70.0,13.3,23.13,100.18,63
CPT,86328,LAB IMM AB QL/SEMI QN SGL COVID-19,136.0,25.84,45.23,207.81,63
CPT,86329,LAB IMDF,55.0,10.45,14.05,65.99,63
CPT,86329,LAB IMDF AB ACID TEICHOIC,43.0,8.17,14.05,65.99,63
CPT,86331,LAB IMDF GEL AB/AG QL,36.0,6.84,11.98,56.28,63
CPT,86332,LAB IMMUNE COMPLEX,74.0,14.06,24.37,114.35,63
CPT,86332,LAB IMMUNE COMPLEX C1Q BINDING,74.0,14.06,24.37,114.35,63
CPT,86332,LAB IMMUNE COMPLEX C3D CIRCULATING,74.0,14.06,24.37,114.35,63
CPT,86334,LAB IMMUNOFIXATION EP CRYOGLOBULIN,68.0,12.92,22.34,96.75,63
CPT,86334,LAB IMMUNOFIXATION EP IGD IGE,142.0,26.98,22.34,106.5,63
CPT,86334,LAB IMMUNOFIXATION EP SERUM,68.0,12.92,22.34,96.75,63
CPT,86334,LAB IMMUNOFIXATION EP SERUM NS,74.0,14.06,22.34,96.75,63
CPT,86335,LAB IMMUNOFIXATION EP TRANSFRN BETA,89.0,16.91,29.35,127.11,63
CPT,86335,LAB IMMUNOFIXATION EP URINE/CSF,89.0,16.91,29.35,127.11,63
CPT,86335,LAB IMMUNOFIXATION EP URINE/CSF NS,89.0,16.91,29.35,127.11,63
CPT,86336,LAB INHIBIN A,57.0,10.83,15.59,73.17,63
CPT,86336,LAB INHIBIN A NS,77.0,14.63,15.59,73.17,63
CPT,86337,LAB AB INSULIN,66.0,12.54,21.41,100.51,63
CPT,86340,LAB AB INTRINSIC FACTOR,59.0,11.21,15.08,70.78,63
CPT,86341,LAB AB ISLET CELL NS,71.0,13.49,23.57,110.62,63
CPT,86341,LAB AB ISLET ENCEPHALITIS,144.0,27.36,23.57,110.62,63
CPT,86341,LAB AB ZINC TRANSPORTER,240.0,45.6,23.57,180.0,63
CPT,86343,LAB LEUKOCYTE HISTAMINE RELEASE,64.0,12.16,12.46,58.47,63
CPT,86352,LAB FNCT CELL W STIM&DET BIOMARK,408.0,77.52,135.86,637.66,63
CPT,86353,LAB STIM LYMPHOCYTE BERYLLIUM,378.0,71.82,49.03,283.5,63
CPT,86353,LAB TRANSFORM LYMPHOCYTE MITOGEN,205.0,38.95,49.03,230.09,63
CPT,86355,LAB B CELLS CD19 COUNT TOTAL,114.0,21.66,37.73,177.08,63
CPT,86355,LAB B CELLS CD19 COUNT TOTAL NS,114.0,21.66,37.73,177.08,63
CPT,86356,LAB AG CELL MONONUC CD57&CD57 ABSOL,81.0,15.39,26.78,125.66,63
CPT,86356,LAB AG CELL MONONUC QN EA AG,93.0,17.67,26.78,125.66,63
CPT,86357,LAB COUNT TOTAL CELLS CD56 NK,114.0,21.66,37.73,177.08,63
CPT,86357,LAB COUNT TOTAL CELLS CD56 NK NS,114.0,21.66,37.73,177.08,63
CPT,86359,LAB COUNT TOTAL CELLS T,114.0,21.66,37.73,177.08,63
CPT,86359,LAB COUNT TOTAL CELLS T NS,114.0,21.66,37.73,177.08,63
CPT,86360,LAB COUNT CELLS T CD4&CD8 RATIO,141.0,26.79,46.98,220.45,63
CPT,86360,LAB COUNT CELLS T CD4&CD8 RATIO NS,141.0,26.79,46.98,220.45,63
CPT,86362,LAB SCR AB MOG FL,86.0,16.34,12.05,64.5,63
CPT,86362,LAB SCR AB MOG TITER,837.0,159.03,12.05,627.75,63
CPT,86363,LAB AB CYTOM FLOW MOG,211.0,40.09,12.05,158.25,63
CPT,86363,LAB AB CYTOM FLOW MOG MAYO,654.0,124.26,12.05,490.5,63
CPT,86364,LAB IMM MS TRANSGLUTAMINASE NS,35.0,6.65,11.53,49.94,63
CPT,86364,LAB IMM MS TRANSGLUTAMINASE QL,59.0,11.21,11.53,49.94,63
CPT,86366,LAB IMM MUSK QN,56.0,10.64,18.31,64.46,63
CPT,86376,LAB AB MICROSOMAL EA,44.0,8.36,14.55,68.25,63
CPT,86376,LAB AB MICROSOMAL LC-1 EA,44.0,8.36,14.55,68.25,63
CPT,86376,LAB AB MICROSOMAL LIVER-KIDNEY EA,63.0,11.97,14.55,68.25,63
CPT,86376,LAB AB MICROSOMAL THYROID EA,44.0,8.36,14.55,68.25,63
CPT,86381,LAB SCR AB MITOCHONDRIAL,77.0,14.63,25.45,110.22,63
CPT,86382,LAB NEUTRALIZATION VIRAL,69.0,13.11,16.91,79.36,63
CPT,86382,LAB NEUTRALIZATION VIRAL RABIES,127.0,24.13,16.91,95.25,63
CPT,86384,LAB DYE TETRAZOLIUM NITROBLUE NS,236.0,44.84,13.61,177.0,63
CPT,86403,LAB SCR AB AGG PARTICLE EA,74.0,14.06,11.54,55.5,63
CPT,86403,LAB SCR AB CRYPTO AGG PARTICLE,59.0,11.21,11.54,54.15,63
CPT,86403,LAB SCR AB H INFLUENZA AGG PARTICLE,53.0,10.07,11.54,54.15,63
CPT,86403,LAB SCR AB MICRO AGG PARTICLE,62.0,11.78,11.54,54.15,63
CPT,86403,LAB SCR AB NEISS AGG PARTICLE,74.0,14.06,11.54,55.5,63
CPT,86403,LAB SCR AB NEISS GRP A AGG PARTICLE,53.0,10.07,11.54,54.15,63
CPT,86403,LAB SCR AB NEISS GRP C AGG PARTICLE,53.0,10.07,11.54,54.15,63
CPT,86403,LAB SCR AB STREP PNEUMO AGGPARTICLE,53.0,10.07,11.54,54.15,63
CPT,86406,LAB AGG PARTICLE TITER,59.0,11.21,10.64,49.89,63
CPT,86406,LAB AGG PARTICLE TITER STREPTOZYME,81.0,15.39,10.64,60.75,63
CPT,86430,LAB FACTOR RHEUMATOID QL,70.0,13.3,6.14,52.5,63
CPT,86431,LAB FACTOR RHEUMATOID QN,18.0,3.42,5.67,26.61,63
CPT,86431,LAB FACTOR RHEUMATOID QN NS,55.0,10.45,5.67,41.25,63
CPT,86480,LAB TB MEAS IMMUNITY GAMMA INTERFRN,186.0,35.34,61.98,378.1,63
CPT,86481,LAB TB MEAS IMMUNITY T-CELL SUSP,300.0,57.0,100.0,469.37,63
CPT,86481,LAB TB MEAS IMMUNITY T-CELL SUSP NS,300.0,57.0,100.0,469.37,63
CPT,86581,LAB AB STREP PNEU SEROT IA,372.0,70.68,92.03,279.0,62
CPT,86592,LAB SYPHILIS VDRL/RPR QL,52.0,9.88,4.27,39.0,63
CPT,86592,LAB SYPHILIS VDRL/RPR QL CSF,62.0,11.78,4.27,46.5,63
CPT,86592,LAB SYPHILIS VDRL/RPR QL DNR TESTNG,134.0,25.46,4.27,100.5,63
CPT,86592,LAB SYPHILIS VDRL/RPR QL NS,63.0,11.97,4.27,47.25,63
CPT,86593,LAB SYPHILIS VDRL/RPR QN,52.0,9.88,4.4,39.0,63
CPT,86596,LAB AB CHANNEL CA VOLTAGE-GATED,444.0,84.36,12.05,333.0,63
CPT,86603,LAB AB ADENOVIRUS,61.0,11.59,12.87,60.4,63
CPT,86606,LAB AB ASPERGILLUS,55.0,10.45,15.05,70.64,63
CPT,86609,LAB AB BACTERIUM NONSPECIFIED NS,153.0,29.07,12.88,114.75,63
CPT,86609,LAB AB LISTERIA,153.0,29.07,12.88,114.75,63
CPT,86609,LAB AB M FAENI,153.0,29.07,12.88,114.75,63
CPT,86609,LAB AB S VIRIDIS,153.0,29.07,12.88,114.75,63
CPT,86609,LAB AB T CANDIDUS,153.0,29.07,12.88,114.75,63
CPT,86609,LAB AB T VULGARIS,153.0,29.07,12.88,114.75,63
CPT,86611,LAB AB BARTONELLA,62.0,11.78,10.18,62.13,63
CPT,86612,LAB DET AB BLASTOMYCES NS,78.0,14.82,12.9,60.53,63
CPT,86615,LAB AB BORDETELLA,70.0,13.3,13.19,61.93,63
CPT,86617,LAB AB LYME DISEASE CONFIRMATORY,61.0,11.59,15.49,72.71,63
CPT,86618,LAB AB LYME DISEASE IGG IGM,66.0,12.54,17.03,79.89,63
CPT,86622,LAB AB BRUCELLA,67.0,12.73,8.93,50.25,63
CPT,86625,LAB AB CAMPYLOBACTER NS,40.0,7.6,13.12,61.6,63
CPT,86628,LAB AB CANDIDA,71.0,13.49,12.01,56.41,63
CPT,86631,LAB AB CHLAMYDIA,81.0,15.39,11.82,60.75,63
CPT,86631,LAB AB CHLAMYDIA PNEU IGG IGA,61.0,11.59,11.82,55.48,63
CPT,86631,LAB AB CHLAMYDIA PSITTACI IGG IGA,61.0,11.59,11.82,55.48,63
CPT,86631,LAB AB CHLAMYDIA TRAC IGG IGA,61.0,11.59,11.82,55.48,63
CPT,86632,LAB AB CHLAMYDIA PNEUM IGM,61.0,11.59,12.68,59.47,63
CPT,86632,LAB AB CHLAMYDIA PSITTACI IGM,61.0,11.59,12.68,59.47,63
CPT,86632,LAB AB CHLAMYDIA TRAC IGM,61.0,11.59,12.68,59.47,63
CPT,86635,LAB AB COCCIDIOIDES,55.0,10.45,11.47,53.81,63
CPT,86635,LAB AB COCCIDIOIDES IGG,63.0,11.97,11.47,53.81,63
CPT,86635,LAB AB COCCIDIOIDES IGM,63.0,11.97,11.47,53.81,63
CPT,86635,LAB AB COCCIDIOIDES NS,66.0,12.54,11.47,53.81,63
CPT,86638,LAB AB COXIELLA BRUNETII,57.0,10.83,12.12,56.87,63
CPT,86641,LAB AB CRYPTOCOCCUS IFA,44.0,8.36,14.41,67.65,63
CPT,86644,LAB AB CYTOMEGALOVIRUS,60.0,11.4,14.39,67.52,63
CPT,86644,LAB AB CYTOMEGALOVIRUS NS,56.0,10.64,14.39,67.52,63
CPT,86645,LAB AB CYTOMEGALOVIRUS IGM,61.0,11.59,16.85,79.09,63
CPT,86645,LAB AB CYTOMEGALOVIRUS IGM NS,51.0,9.69,16.85,79.09,63
CPT,86648,LAB AB DIPTHERIA,63.0,11.97,15.21,71.38,63
CPT,86651,LAB AB ENCEPHALITIS CALIFORNIA,65.0,12.35,13.19,61.93,63
CPT,86652,LAB AB ENCEPHALITIS EQUINE EASTERN,65.0,12.35,13.19,61.93,63
CPT,86653,LAB AB ENCEPHALITIS SAINT LOUIS NS,65.0,12.35,13.19,61.93,63
CPT,86654,LAB AB ENCEPHALITIS EQUINE WEST NS,65.0,12.35,13.19,61.93,63
CPT,86658,LAB AB COXSACKIE,53.0,10.07,13.03,61.13,63
CPT,86658,LAB AB ENTEROVIRUS,40.0,7.6,13.03,61.13,63
CPT,86663,LAB AB EBV EARLY AG,55.0,10.45,13.12,61.6,63
CPT,86664,LAB AB EBV EBNA,46.0,8.74,15.29,71.78,63
CPT,86664,LAB AB EBV EBNA NS,54.0,10.26,15.29,71.78,63
CPT,86665,LAB AB EBV VCA,55.0,10.45,18.14,85.15,63
CPT,86665,LAB AB EBV VCA IGG,55.0,10.45,18.14,85.15,63
CPT,86665,LAB AB EBV VCA IGM,62.0,11.78,18.14,85.15,63
CPT,86665,LAB AB EBV VCA IGM NS,55.0,10.45,18.14,85.15,63
CPT,86666,LAB AB EHRLICHIA,80.0,15.2,10.18,60.0,63
CPT,86668,LAB AB FRANCISELLA TULARENSIS,100.0,19.0,14.16,75.0,63
CPT,86671,LAB AB FUNGUS NOT SPECIFIED,55.0,10.45,12.25,57.47,63
CPT,86674,LAB AB GIARDIA LAMBLIA,67.0,12.73,14.72,69.11,63
CPT,86677,LAB AB HELICOBACTER PYLORI,78.0,14.82,16.85,79.09,63
CPT,86682,LAB AB CYSTICERCUS CSF,64.0,12.16,13.01,61.07,63
CPT,86682,LAB AB CYSTICERCUS SERUM,64.0,12.16,13.01,61.07,63
CPT,86682,LAB AB ECHINOCOCCUS,71.0,13.49,13.01,61.07,63
CPT,86682,LAB AB HELMINTH NONSPECIFIED,64.0,12.16,13.01,61.07,63
CPT,86682,LAB AB SCHISTOSOMA SERUM,64.0,12.16,13.01,61.07,63
CPT,86682,LAB AB STRONGYLOIDES,69.0,13.11,13.01,61.07,63
CPT,86684,LAB AB HAEMOPHILUS INFLUENZA IGG,62.0,11.78,15.84,74.37,63
CPT,86687,LAB AB HTLV-I,28.0,5.32,9.09,42.64,63
CPT,86689,LAB AB HTLV/HIV CONFIRM CSF,472.0,89.68,19.35,354.0,63
CPT,86689,LAB AB HTLV/HIV CONFIRM DONOR NS,503.0,95.57,19.35,377.25,63
CPT,86689,LAB AB HTLV/HIV CONFIRM SRM/PLASMA,472.0,89.68,19.35,354.0,63
CPT,86692,LAB AB HEPATITIS DELTA AGENT,85.0,16.15,17.16,80.56,63
CPT,86694,LAB AB HERPES SIMPLEX NONSPECIFIC,44.0,8.36,14.39,67.52,63
CPT,86695,LAB AB HERPES SIMPLEX TYPE 1,40.0,7.6,13.19,80.42,63
CPT,86695,LAB AB HERPES SIMPLEX TYPE 1 NS,53.0,10.07,13.19,80.42,63
CPT,86696,LAB AB HERPES SIMPLEX TYPE 2,59.0,11.21,19.35,118.14,63
CPT,86696,LAB AB HERPES SIMPLEX TYPE 2 NS,59.0,11.21,19.35,118.14,63
CPT,86698,LAB AB HISTOPLASMA COMP FIXATION,63.0,11.97,13.79,64.72,63
CPT,86698,LAB AB HISTOPLASMA IMMUNODIFFUSION,68.0,12.92,13.79,64.72,63
CPT,86701,LAB AB HIV-1,76.0,14.44,8.89,57.0,63
CPT,86702,LAB AB HIV-2,88.0,16.72,13.52,66.0,63
CPT,86703,LAB AB HIV-1&HIV-2 RESULT SGL,42.0,7.98,13.71,64.32,63
CPT,86704,LAB AB HEPATITIS B CORE TOTAL,55.0,10.45,12.05,56.54,63
CPT,86705,LAB AB HEPATITIS B CORE IGM,89.0,16.91,11.77,66.75,63
CPT,86706,LAB AB HEPATITIS B SURFACE,55.0,10.45,10.74,50.42,63
CPT,86707,LAB AB HEPATITIS BE,59.0,11.21,11.57,54.28,63
CPT,86708,LAB AB HEPATITIS A,55.0,10.45,12.39,58.14,63
CPT,86708,LAB AB HEPATITIS A NS,57.0,10.83,12.39,58.14,63
CPT,86709,LAB AB HEPATITIS A IGM,84.0,15.96,11.26,63.0,63
CPT,86710,LAB AB INFLUENZA A,68.0,12.92,13.55,63.59,63
CPT,86710,LAB AB INFLUENZA B,68.0,12.92,13.55,63.59,63
CPT,86711,LAB AB JOHN CUNNINGHAM VIRUS,51.0,9.69,16.89,79.29,63
CPT,86713,LAB AB LEGIONELLA,72.0,13.68,15.3,71.78,63
CPT,86717,LAB AB LEISHMANIA,37.0,7.03,12.25,57.47,63
CPT,86720,LAB AB LEPTOSPIRA IGM DOT BLOT,102.0,19.38,16.2,76.5,63
CPT,86720,LAB AB LEPTOSPIRA TITER,154.0,29.26,16.2,115.5,63
CPT,86727,LAB AB CHORIOMENINGITIS LYMPHOCYTIC,62.0,11.78,12.87,60.4,63
CPT,86735,LAB AB MUMPS,61.0,11.59,13.05,61.26,63
CPT,86735,LAB AB MUMPS IGG,56.0,10.64,13.05,61.26,63
CPT,86735,LAB AB MUMPS IGM,62.0,11.78,13.05,61.26,63
CPT,86738,LAB AB MYCOPLASMA IGG NS,55.0,10.45,13.24,62.13,63
CPT,86738,LAB AB MYCOPLASMA IGM,55.0,10.45,13.24,62.13,63
CPT,86747,LAB AB PARVOVIRUS B19 IGG,62.0,11.78,15.03,70.58,63
CPT,86747,LAB AB PARVOVIRUS B19 IGM,62.0,11.78,15.03,70.58,63
CPT,86753,LAB AB AMOEBIC,65.0,12.35,12.39,58.14,63
CPT,86753,LAB AB CHAGAS IGG,72.0,13.68,12.39,58.14,63
CPT,86753,LAB AB CHAGAS RIPA,38.0,7.22,12.39,58.14,63
CPT,86753,LAB AB PROTOZOA BABESIA,58.0,11.02,12.39,58.14,63
CPT,86753,LAB SCR AB CHAGAS,62.0,11.78,12.39,58.14,63
CPT,86756,LAB AB RSV,72.0,13.68,15.89,74.57,63
CPT,86757,LAB AB RICKETTSIA,71.0,13.49,19.35,90.8,63
CPT,86762,LAB AB RUBELLA IGG,56.0,10.64,14.39,67.52,63
CPT,86762,LAB AB RUBELLA IGM NS,56.0,10.64,14.39,67.52,63
CPT,86762,LAB AB RUBELLA TITER,44.0,8.36,14.39,67.52,63
CPT,86765,LAB AB RUBEOLA IGG,60.0,11.4,12.88,60.47,63
CPT,86765,LAB AB RUBEOLA IGM,56.0,10.64,12.88,60.47,63
CPT,86765,LAB AB RUBEOLA TITER NS,39.0,7.41,12.88,60.47,63
CPT,86768,LAB AB SALMONELLA,73.0,13.87,13.19,61.93,63
CPT,86769,LAB AB SARS-COV-2 COVID-19,127.0,24.13,42.13,193.37,63
CPT,86769,LAB AB SARS-COV-2 COVID-19 NS,127.0,24.13,42.13,193.37,63
CPT,86774,LAB AB TETANUS,63.0,11.97,14.8,69.51,63
CPT,86777,LAB AB TOXOPLASMA,44.0,8.36,14.39,67.52,63
CPT,86777,LAB AB TOXOPLASMA IGG,60.0,11.4,14.39,67.52,63
CPT,86777,LAB AB TOXOPLASMA IGG NS,63.0,11.97,14.39,67.52,63
CPT,86778,LAB AB TOXOPLASMA IGM,60.0,11.4,14.41,67.65,63
CPT,86778,LAB AB TOXOPLASMA IGM NS,63.0,11.97,14.41,67.65,63
CPT,86780,LAB AB FTA CONFIRM,40.0,7.6,13.24,62.13,63
CPT,86780,LAB AB TREPONEMA PALLIDUM CONF,74.0,14.06,13.24,62.13,63
CPT,86780,LAB AB TREPONEMA PALLIDUM CONF CSF,77.0,14.63,13.24,62.13,63
CPT,86780,LAB SCR AB SYPHILIS,53.0,10.07,13.24,62.13,63
CPT,86780,LAB SCR AB SYPHILIS NS,40.0,7.6,13.24,62.13,63
CPT,86784,LAB AB TRICHINELLA,69.0,13.11,12.56,58.94,63
CPT,86787,LAB AB VARICELLA-ZOSTER IGG,39.0,7.41,12.88,60.47,63
CPT,86787,LAB AB VARICELLA-ZOSTER IGG NS,53.0,10.07,12.88,60.47,63
CPT,86787,LAB AB VARICELLA-ZOSTER IGM,39.0,7.41,12.88,60.47,63
CPT,86787,LAB AB VARICELLA-ZOSTER IGM NS,39.0,7.41,12.88,60.47,63
CPT,86788,LAB AB WEST NILE VIRUS IGM NS,72.0,13.68,16.85,79.09,63
CPT,86789,LAB AB WEST NILE VIRUS NS,72.0,13.68,14.39,67.52,63
CPT,86790,LAB AB PARAINFLUENZA,66.0,12.54,12.88,60.47,63
CPT,86790,LAB AB VIRUS DENGUE,70.0,13.3,12.88,60.47,63
CPT,86790,LAB AB VIRUS HEPATITIS E IGG,71.0,13.49,12.88,60.47,63
CPT,86790,LAB AB VIRUS NONSPECIFIED,240.0,45.6,12.88,180.0,63
CPT,86790,LAB HANTAVIRUS,102.0,19.38,12.88,76.5,63
CPT,86793,LAB AB YERSINIA,76.0,14.44,13.19,61.93,63
CPT,86794,LAB AB VIRUS ZIKA IGM,325.0,61.75,16.85,243.75,63
CPT,86800,LAB AB THYROGLOBULIN,57.0,10.83,15.91,74.64,63
CPT,86800,LAB AB THYROGLOBULIN NS,96.0,18.24,15.91,74.64,63
CPT,86803,LAB AB HEPATITIS C,93.0,17.67,14.27,69.75,63
CPT,86803,LAB AB HEPATITIS C NS,255.0,48.45,14.27,191.25,63
CPT,86804,LAB AB HEPATITIS C CONFIRMATORY,47.0,8.93,15.49,72.71,63
CPT,86808,LAB SCR SERUM PRA CYTOTOXIC QUICK,90.0,17.1,29.68,156.39,63
CPT,86812,LAB BLOOD TYPE HLA B-27 AG SINGLE,78.0,14.82,25.81,183.46,63
CPT,86816,LAB BLOOD TYPE HLA DR/DQ AG SGL,91.0,17.29,30.17,158.98,63
CPT,86825,LAB HLA X-MATCH NON-CYTOTOXIC,329.0,62.51,109.49,576.93,63
CPT,86825,LAB HLA X-MATCH NON-CYTOTOXIC NS,329.0,62.51,109.49,576.93,63
CPT,86828,LAB HLA CLASS I&II AB QL,193.0,36.67,64.19,338.25,63
CPT,86830,LAB HLA CLASS I PHENOTYPE QL,287.0,54.53,95.52,503.36,63
CPT,86830,LAB HLA CLASS I PHENOTYPE QL NS,287.0,54.53,95.52,503.36,63
CPT,86831,LAB HLA CLASS II PHENOTYPE QL,246.0,46.74,81.88,431.45,63
CPT,86831,LAB HLA CLASS II PHENOTYPE QL NS,246.0,46.74,81.88,431.45,63
CPT,86832,LAB HLA CLASS I AB HIGH DEF QL,972.0,184.68,323.75,1705.97,63
CPT,86832,LAB HLA CLASS I AB HIGH DEF QL NS,972.0,184.68,323.75,1705.97,63
CPT,86833,LAB HLA CLASS II AB HIGH DEF QL,978.0,185.82,325.8,1716.75,63
CPT,86833,LAB HLA CLASS II AB HIGH DEF QL NS,978.0,185.82,325.8,1716.75,63
CPT,86850,LAB SCR AB RBC SERUM EA,131.0,22.53,9.77,98.25,63
CPT,86850,LAB SCR AB RBC SERUM EA NS,158.0,27.18,9.77,118.5,63
CPT,86860,LAB ELUTION AB RBC EA,363.0,68.97,1.78,299.97,63
CPT,86860,LAB ELUTION AB RBC EA NS,363.0,68.97,1.78,299.97,63
CPT,86870,LAB PANEL AB RBC 4C EA TECH SERUM,760.0,130.72,2.44,631.11,63
CPT,86870,LAB PANEL AB RBC EA TECH SERUM,760.0,130.72,2.44,631.11,63
CPT,86870,LAB PANEL AB RBC EA TECH SERUM NS,760.0,130.72,2.44,631.11,63
CPT,86880,LAB COOMBS DIR ANTISERUM EA,126.0,23.94,5.39,94.5,63
CPT,86880,LAB COOMBS DIR ANTISERUM EA NS,126.0,23.94,5.39,94.5,63
CPT,86885,LAB COOMBS INDIRECT REAGENT EA,363.0,68.97,5.72,272.25,63
CPT,86886,LAB COOMBS INDIRECT TITER AB EA,363.0,68.97,5.18,272.25,63
CPT,86886,LAB COOMBS INDIRECT TITER AB EA NS,363.0,68.97,5.18,272.25,63
CPT,86900,LAB BLOOD TYPE ABO,284.0,48.85,2.99,213.0,63
CPT,86900,LAB BLOOD TYPE ABO DISCREPANCY,284.0,48.85,2.99,213.0,63
CPT,86900,LAB BLOOD TYPE ABO NS,284.0,48.85,2.99,213.0,63
CPT,86901,LAB BLOOD TYPE RHD,80.0,13.76,2.99,60.0,63
CPT,86901,LAB BLOOD TYPE RHD NS,80.0,13.76,2.99,60.0,63
CPT,86902,LAB BLOOD TYPE DONOR SERUM RGT,760.0,130.72,6.35,570.0,63
CPT,86902,LAB BLOOD TYPE DONOR SERUM RGT NS,760.0,130.72,6.35,570.0,63
CPT,86904,LAB SCR AG BLD TYPE SERUM PT U NS,153.0,26.32,16.34,114.75,63
CPT,86905,LAB BLOOD TYPE AG RBC EA,760.0,130.72,3.83,570.0,63
CPT,86905,LAB BLOOD TYPE AG RBC EA NS,760.0,130.72,3.83,570.0,63
CPT,86905,LAB BLOOD TYPE AG RBC PT EA,760.0,130.72,3.83,570.0,63
CPT,86905,LAB BLOOD TYPE IMMUNOPHENOTYPE,760.0,130.72,3.83,570.0,63
CPT,86906,LAB BLOOD TYPE PHENOTYPING RH COMP,80.0,13.76,7.75,60.0,63
CPT,86920,LAB CROSSMATCH SPIN IMMEDIATE,363.0,62.44,1.99,299.97,63
CPT,86922,LAB CROSSMATCH ANTIGLOBULIN,363.0,62.44,2.11,299.97,63
CPT,86923,LAB CROSSMATCH ELECTRONIC,363.0,62.44,1.6,299.97,63
CPT,86927,LAB THAWING PLASMA FRESH FROZEN,363.0,62.44,1.12,299.97,63
CPT,86940,LAB SCR HEMOLYSINS&AGGLUTININS AUTO,490.0,93.1,8.77,367.5,63
CPT,86941,LAB HEMOLYSINS&AGGLUTININS INCUBATE,37.0,7.03,12.11,63.79,63
CPT,86965,LAB POOLING PLATELETS/BLOOD PROD,363.0,92.93,1.84,381.0,63
CPT,86970,LAB PRETREAT RBC AB CHEMICAL NS,150.0,25.8,1.66,153.06,63
CPT,86971,LAB PRETREAT RBC INCUB ENZYME,363.0,62.44,1.33,530.82,63
CPT,86975,LAB PRETREAT SERUM INCUB W DRUGS,951.0,180.69,1.78,786.54,63
CPT,86976,LAB PRETREAT SERUM RBC AB DILUTION,170.0,32.3,1.99,127.5,63
CPT,86977,LAB PRETREAT SERUM INCUB INHIB,363.0,68.97,1.99,299.97,63
CPT,86978,LAB PRETREAT SERUM ABSORP NS,277.0,52.63,1.99,214.26,63
CPT,86985,LAB SPLITTING BLOOD/BLOOD PROD EA,363.0,62.44,1.45,299.97,63
CPT,86999,HLA MATCH,250.0,43.0,17.89,376.04,62
CPT,86999,LAB HLA SEARCH,62.0,10.66,17.89,376.04,62
CPT,86999,LAB SEPARATION RED CELL,268.0,46.1,17.89,376.04,62
CPT,87015,LAB CONCENTRATION AFB IA,58.0,12.82,6.68,43.5,63
CPT,87015,LAB CONCENTRATION AFB IA NS,71.0,15.69,6.68,53.25,63
CPT,87015,LAB CONCENTRATION ANY TYPE IA,21.0,4.64,6.68,31.33,63
CPT,87015,LAB CONCENTRATION ANY TYPE IA NS,128.0,28.29,6.68,96.0,63
CPT,87040,LAB CULT BACT AEROBIC BLOOD,270.0,59.67,10.32,202.5,63
CPT,87045,LAB CULT BACT AEROBIC STOOL,29.0,6.41,9.44,44.3,63
CPT,87045,LAB CULT BACT AEROBIC STOOL NS,63.0,13.92,9.44,47.25,63
CPT,87046,LAB CULT BACT AEROBIC STOOL CAMPY,29.0,6.41,9.44,44.3,63
CPT,87046,LAB CULT BACT AEROBIC STOOL E COLI,29.0,6.41,9.44,44.3,63
CPT,87046,LAB CULT BACT AEROBIC STOOL PATH,79.0,17.46,9.44,59.25,63
CPT,87046,LAB CULT BACT AEROBIC STOOL PATH NS,63.0,13.92,9.44,47.25,63
CPT,87046,LAB CULT BACT AEROBIC STOOL VIBRO,29.0,6.41,9.44,44.3,63
CPT,87046,LAB CULT BACT AEROBIC STOOL YERSNIA,29.0,6.41,9.44,44.3,63
CPT,87070,LAB CULT BACT AEROBIC BARTONELLA,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC CATHETER TIP,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC CSF,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC EAR,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC EYE,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC GENITAL,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC OTHER,75.0,16.58,8.62,56.25,63
CPT,87070,LAB CULT BACT AEROBIC RESP LOWER,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC RESP UPPER,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC TISSUE,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT AEROBIC WOUND,42.0,9.28,8.62,40.44,63
CPT,87070,LAB CULT BACT FLUID BODY STERILE,42.0,9.28,8.62,40.44,63
CPT,87071,LAB CULT BACT AEROBIC OTHER QN,61.0,13.48,9.89,46.43,63
CPT,87073,LAB CULT BACT ANAEROBIC OTHER QN,392.0,86.63,9.66,294.0,63
CPT,87075,LAB CULT BACT ANAEROBIC OTHER,279.0,61.66,9.47,209.25,63
CPT,87076,LAB CULT BACT ANAEROBIC ID DF,25.0,5.52,8.08,37.92,63
CPT,87076,LAB CULT BACT ANAEROBIC ID DF NS,118.0,26.08,8.08,88.5,63
CPT,87077,LAB CULT BACT AEROBIC ID DF,39.0,8.62,8.08,37.92,63
CPT,87077,LAB CULT BACT AEROBIC ID DF ADDL,39.0,8.62,7.25,37.92,40
CPT,87077,LAB CULT BACT AEROBIC ID DF ADDL NS,103.0,22.76,8.08,77.25,63
CPT,87077,LAB CULT BACT AEROBIC ID DF NOCARD,39.0,8.62,8.08,37.92,63
CPT,87077,LAB CULT BACT AEROBIC ID DF NS,96.0,21.22,8.08,72.0,63
CPT,87077,POC CULT BACT H PYLORI FAST,39.0,8.62,8.08,37.92,63
CPT,87081,LAB SCR CULT ACANTHAMOEBA,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT BORDETELLA,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT BRUCELLA,97.0,21.44,6.63,72.75,63
CPT,87081,LAB SCR CULT GONORRHEA,58.0,12.82,6.63,43.5,63
CPT,87081,LAB SCR CULT H PYLORI SGL,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT H PYLORI SGL NS,131.0,28.95,6.63,98.25,63
CPT,87081,LAB SCR CULT LEGIONELLA,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT ORGANISMS SGL,59.0,13.04,6.63,44.25,63
CPT,87081,LAB SCR CULT STAPH MRSA,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT STREP GROUP A,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT STREP GROUP B,20.0,4.42,6.63,31.13,63
CPT,87081,LAB SCR CULT VRE,58.0,12.82,6.63,43.5,63
CPT,87086,LAB CULT BACT COLONY COUNT URINE,201.0,44.42,8.07,150.75,63
CPT,87088,LAB CULT BACT ID ISOLATE URINE,25.0,5.52,8.09,37.98,63
CPT,87101,LAB CULT FUNGI ID DERMATOPHYTE,59.0,13.04,7.71,44.25,63
CPT,87102,LAB CULT FUNGI ID ISOLATES,78.0,17.24,8.41,58.5,63
CPT,87102,LAB CULT FUNGI YEAST ID ISOLATES,60.0,13.26,8.41,45.0,63
CPT,87103,LAB CULT FUNGI ID ISOLATES BLOOD,69.0,15.25,20.46,96.05,63
CPT,87106,LAB CULT FUNGI ID DF YEAST,62.0,13.7,10.32,48.43,63
CPT,87106,LAB CULT FUNGI ID DF YEAST NS,136.0,30.06,10.32,102.0,63
CPT,87107,LAB CULT FUNGI ID DF MOLD,62.0,13.7,10.32,48.43,63
CPT,87107,LAB CULT FUNGI ID DF MOLD NS,138.0,30.5,10.32,103.5,63
CPT,87109,LAB CULT MYCOPLASMA/UREAPLASMA,63.0,13.92,15.39,72.24,63
CPT,87110,LAB CULT CHLAMYDIA,71.0,15.69,19.6,92.0,63
CPT,87116,LAB CULT AFB ID ISOLATES,63.0,13.92,10.8,50.69,63
CPT,87116,LAB CULT AFB ID ISOLATES BLOOD,33.0,7.29,10.8,50.69,63
CPT,87118,LAB CULT MYCOBACTERIAL ID DF,64.0,14.14,14.61,68.58,63
CPT,87140,LAB CULT TYPING IF ANTISERUM EA,57.0,12.6,5.57,42.75,63
CPT,87140,LAB CULT TYPING IF ANTISERUM EA NS,56.0,12.38,5.57,42.0,63
CPT,87143,LAB CULT TYPING GLC/HPLC,38.0,8.4,12.52,58.74,63
CPT,87147,LAB CULT TYPING SEROLOGICAL,16.0,3.54,5.18,24.35,63
CPT,87147,LAB CULT TYPING SEROLOGICAL NS,85.0,18.78,5.18,63.75,63
CPT,87149,LAB CULT TYPING ID NUC ACID PRB DIR,73.0,16.13,20.05,94.06,63
CPT,87153,LAB CULT TYPING ID SEQ NUC ACID,347.0,59.68,50.0,541.47,59
CPT,87153,LAB CULT TYPING ID SEQ NUC ACID NS,347.0,76.69,50.0,541.47,59
CPT,87168,LAB EXAM MACROSCOPIC ARTHROPOD,13.0,2.87,4.27,20.09,63
CPT,87169,LAB EXAM MACROSCOPIC PARASITE,58.0,12.82,4.31,43.5,63
CPT,87172,LAB EXAM PINWORM,13.0,2.87,4.27,20.09,63
CPT,87176,LAB HOMOGENIZATION TISSUE,57.0,12.6,5.88,42.75,63
CPT,87176,LAB HOMOGENIZATION TISSUE NS,18.0,3.98,5.88,27.61,63
CPT,87177,LAB SMEARS DIRECT OVA&PARASITES,27.0,5.97,8.9,41.77,63
CPT,87181,LAB SUSCPT ETEST AGENT EA,15.0,3.32,4.75,22.28,63
CPT,87181,LAB SUSCPT ETEST AGENT EA NS,66.0,14.59,4.75,49.5,63
CPT,87182,LAB SUSCPT CARBAPENEMASE DET ENZ,56.0,12.38,8.07,42.0,35
CPT,87184,LAB SUSCPT DISK KIRBY BAUER,23.0,5.08,7.48,35.12,63
CPT,87185,LAB SUSCPT DETECTION ENZYME EA,56.0,12.38,4.75,42.0,63
CPT,87186,LAB SUSCPT MIC PLATE EA,162.0,35.8,8.65,121.5,63
CPT,87186,LAB SUSCPT MIC PLATE EA LSI NS,200.0,34.4,8.65,150.0,63
CPT,87186,LAB SUSCPT MIC PLATE EA NS,152.0,26.14,8.65,114.0,63
CPT,87186,LAB SUSCPT MICRODILUTION PLATE EA,60.0,13.26,8.65,45.0,63
CPT,87188,LAB SUSCPT DILUTION MACROBROTH,58.0,12.82,6.64,43.5,63
CPT,87188,LAB SUSCPT DILUTION MACROBROTH NS,115.0,25.42,6.64,86.25,63
CPT,87190,LAB SUSCPT AFB PROPORTION EA NS,63.0,13.92,7.31,47.25,63
CPT,87205,LAB SMEAR GRAM/GIEMSA,21.0,4.64,4.27,20.09,63
CPT,87205,LAB SMEAR GRAM/GIEMSA NS,91.0,15.65,4.27,68.25,63
CPT,87205,LAB SMEAR GRAM/GIEMSA URINE EOSNPHL,21.0,4.64,4.27,20.09,63
CPT,87206,LAB SMEAR STAIN ACID FAST AFB,57.0,12.6,5.39,42.75,63
CPT,87206,LAB SMEAR STAIN FL AFB,57.0,12.6,5.39,42.75,63
CPT,87206,LAB SMEAR STAIN FL AFB NS,68.0,15.03,5.39,51.0,63
CPT,87206,LAB SMEAR STAIN FL FUNGI,58.0,12.82,5.39,43.5,63
CPT,87207,LAB SMEAR INCL BODIES/PARASITE,18.0,3.98,5.99,78.63,63
CPT,87207,LAB SMEAR INCL BODIES/PARASITE NS,64.0,14.14,5.99,78.63,63
CPT,87209,LAB SMEAR STAIN CMPLX OVA&PARASITES,71.0,15.69,17.98,84.35,63
CPT,87210,LAB SMEAR IA INDIA INK,18.0,3.98,5.82,27.34,63
CPT,87210,LAB SMEAR IA WET MOUNT,53.0,11.71,5.82,39.75,63
CPT,87220,LAB TISSUE KOH SKIN/HAIR/NAIL FUNGI,64.0,14.14,4.27,48.0,63
CPT,87220,LAB TISSUE KOH SKN/HAR/NAL FUNGI NS,215.0,47.52,4.27,161.25,63
CPT,87230,LAB TOXIN CULT TISSUE,60.0,13.26,19.74,92.66,63
CPT,87230,LAB TOXIN CULT TISSUE C DIFF NS,79.0,17.46,19.74,92.66,63
CPT,87252,LAB ISO VIRUS INOC TISSUE,79.0,17.46,26.07,122.33,63
CPT,87252,LAB ISO VIRUS INOC TISSUE NS,100.0,22.1,26.07,122.33,63
CPT,87253,LAB ISO VIRUS INOC TISSUE ADDL,65.0,14.36,20.2,94.79,63
CPT,87253,LAB ISO VIRUS INOC TISSUE ADDL NS,61.0,13.48,20.2,94.79,63
CPT,87254,LAB ISO VIRUS SHELL VIAL ID W IF,64.0,14.14,19.56,91.8,63
CPT,87254,LAB ISO VIRUS SHELL VIAL ID W IF NS,106.0,23.43,19.56,91.8,63
CPT,87255,LAB ISO VIRUS ID ACT ENZYMATIC,102.0,22.54,33.86,158.92,63
CPT,87255,LAB ISO VIRUS ID ACT ENZYMATIC NS,102.0,22.54,33.86,158.92,63
CPT,87260,LAB DET AG IA IF ADENOVIRUS,44.0,9.72,14.43,67.72,63
CPT,87265,LAB DET AG IA IF BORDETELLA,36.0,7.96,11.98,56.28,63
CPT,87269,LAB DET AG IA IF GIARDIA,61.0,13.48,13.61,63.86,63
CPT,87270,LAB DET AG IA IF CHLAMYDIA TRAC,36.0,7.96,11.98,56.28,63
CPT,87272,LAB DET AG IA IF CRYPTOSPORIDIUM,61.0,13.48,11.98,56.28,63
CPT,87272,LAB DET AG IA IF CRYPTOSPORIDIUM NS,111.0,24.53,11.98,83.25,63
CPT,87273,LAB DET AG IA IF HSV TYPE 2,60.0,13.26,11.98,56.28,63
CPT,87274,LAB DET AG IA IF HSV TYPE 1,60.0,13.26,11.98,56.28,63
CPT,87275,LAB DET AG IA IF INFLUENZA B VIRUS,60.0,13.26,12.25,57.47,63
CPT,87276,LAB DET AG IA IF INFLUENZA A VIRUS,60.0,13.26,16.07,75.43,63
CPT,87278,LAB DET AG IA IF LEGIONELLA NS,47.0,10.39,15.6,73.24,63
CPT,87279,LAB DET AG IA IF PARAINFLUENZA,50.0,11.05,16.43,77.1,63
CPT,87280,LAB DET AG IA IF RSV,60.0,13.26,13.42,62.99,63
CPT,87281,LAB DET AG IA IF PNEUMOCYSTIS,36.0,7.96,11.98,56.28,63
CPT,87281,LAB DET AG IA IF PNEUMOCYSTIS NS,76.0,16.8,11.98,57.0,63
CPT,87290,LAB DET AG IA IF VARICELLA-ZOSTER,60.0,13.26,13.42,62.99,63
CPT,87300,LAB DET AG IA IF PLYVLT ORG MULT,60.0,13.26,11.98,56.28,63
CPT,87305,LAB DET AG IA IMM ENZ ASPRGLS NS,152.0,33.59,11.98,114.0,63
CPT,87324,LAB DET AG IA IMM ENZ TOXIN C DIFF,60.0,13.26,11.98,56.28,63
CPT,87329,LAB DET AG IA IMM ENZ GIARDIA,36.0,7.96,11.98,56.28,63
CPT,87329,LAB DET AG IA IMM ENZ GIARDIA NS,66.0,14.59,11.98,56.28,63
CPT,87337,LAB DET AG IA IMM ENZ ENTAM HIST NS,73.0,16.13,11.98,56.28,63
CPT,87338,LAB DET AG IA IMM H PYLORI STOOL,74.0,16.35,14.38,67.45,63
CPT,87338,LAB DET AG IA IMM H PYLORI STOOL NS,44.0,9.72,14.38,67.45,63
CPT,87340,LAB DET AG IA HBSAG QL/SEMI QN,67.0,14.81,10.33,50.25,63
CPT,87340,LAB DET AG IA HBSAG QL/SEMI QN NS,231.0,51.05,10.33,173.25,63
CPT,87341,LAB DET AG IA IMM ENZ HEP B SURF,59.0,13.04,10.33,48.49,63
CPT,87341,LAB DET AG IA IMM ENZ HEP B SURF NS,85.0,18.78,10.33,63.75,63
CPT,87350,LAB DET AG IA IMM ENZ HEP BE,59.0,13.04,11.53,54.08,63
CPT,87385,LAB DET AG IA IMM ENZ HISTOPLASMA,152.0,33.59,13.25,114.0,63
CPT,87389,LAB DET AG IA IMM HIV1 W HIV 1&2,87.0,19.23,24.08,104.29,63
CPT,87425,LAB DET AG IA IMM ENZ ROTAVIRUS,36.0,7.96,11.98,56.28,63
CPT,87427,LAB DET AG IA IMM ENZ TOX SHIGA,64.0,14.14,11.98,56.28,63
CPT,87430,POC AG EIA STREP GROUP A QL,51.0,11.27,16.81,78.89,63
CPT,87449,LAB DET AG IA IMM ENZ BLASTOMYCES,130.0,28.73,11.98,97.5,63
CPT,87449,LAB DET AG IA IMM ENZ CAMPY,78.0,17.24,11.98,58.5,63
CPT,87449,LAB DET AG IA IMM ENZ FUNGITELL,97.0,21.44,11.98,72.75,63
CPT,87449,LAB DET AG IA IMM ENZ FUNGITELL NS,157.0,34.7,11.98,117.75,63
CPT,87449,LAB DET AG IA IMM ENZ LEGN URINE NS,66.0,14.59,11.98,56.28,63
CPT,87449,LAB DET AG IA IMM ENZ QL,36.0,7.96,11.98,56.28,63
CPT,87449,LAB DET AG IA IMM ENZ SEMI QN,147.0,32.49,11.98,110.25,63
CPT,87449,LAB DET AG IA IMM ENZ STREP PNEU QL,65.0,14.36,11.98,56.28,63
CPT,87471,LAB DET IA BARTONELLA PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87480,LAB DET IA CANDIDA PRB DIR,61.0,13.48,20.05,94.06,63
CPT,87481,LAB DET IA CANDIDA PRB AMP,237.0,52.38,35.09,214.06,63
CPT,87483,LAB DET IA CNS PRB AMP 12-25 TGT,1251.0,276.47,416.78,1956.15,63
CPT,87486,LAB DET IA CHLAMYD PNEU PRB AMP NS,328.0,72.49,35.09,246.0,63
CPT,87491,LAB DET IA CHLAMYD TRAC PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87491,LAB DET IA CHLAMYD TRAC PRB AMP NS,115.0,25.42,35.09,164.7,63
CPT,87493,LAB DET IA TOXIN C DIFF PRB AMP,112.0,24.75,37.27,174.95,63
CPT,87493,LAB DET IA TOXIN C DIFF PRB AMP NS,112.0,24.75,37.27,174.95,63
CPT,87494,LAB DET IA CT&NG PRB AMP MULTIPLEX,211.0,46.63,69.0,158.25,62
CPT,87496,LAB DET IA CMV PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87496,LAB DET IA CMV PRB AMP NS,106.0,23.43,35.09,164.7,63
CPT,87497,LAB DET IA CMV QN,129.0,28.51,42.84,201.02,63
CPT,87497,LAB DET IA CMV QN NS,129.0,28.51,42.84,201.02,63
CPT,87498,LAB DET IA ENTEROVRS PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87498,LAB DET IA ENTEROVRS PRB AMP CSF,106.0,23.43,35.09,164.7,63
CPT,87498,LAB DET IA ENTEROVRS PRB AMP NS,139.0,30.72,35.09,164.7,63
CPT,87502,LAB DET IA FLU REV T&PRB AMP 1-2,288.0,63.65,95.8,449.68,63
CPT,87505,LAB DET IA GI MULT PRB AMP 3-5 TGT,385.0,85.08,128.29,602.14,63
CPT,87507,LAB DET IA GI MULT PRB 12-25TGT NS,1251.0,276.47,416.78,1956.15,63
CPT,87510,LAB DET IA GARDNERELLA VAG PRB DIR,61.0,13.48,20.05,94.06,63
CPT,87516,LAB DET IA HEP B PRB AMP,135.0,29.84,35.09,164.7,63
CPT,87517,LAB DET IA HEP B QN,129.0,28.51,42.84,201.02,63
CPT,87521,LAB DET IA HEP C PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87522,LAB DET IA HEP C QN,129.0,28.51,42.84,201.02,63
CPT,87522,LAB DET IA HEP C QN NS,147.0,32.49,42.84,201.02,63
CPT,87523,LAB DET IA HEP D PCR QN,690.0,152.49,42.84,517.5,63
CPT,87529,LAB DET IA HSV PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87529,LAB DET IA HSV PRB AMP NS,106.0,23.43,35.09,164.7,63
CPT,87529,LAB DET IA HSV PRB AMP PCR CSF,106.0,23.43,35.09,164.7,63
CPT,87530,LAB DET IA HSV QN,129.0,28.51,42.84,201.02,63
CPT,87532,LAB DET IA HERPES 6 PRB AMP,120.0,26.52,35.09,164.7,63
CPT,87533,LAB DET IA HERPES 6 PCR QN,126.0,27.85,41.76,196.03,63
CPT,87535,LAB DET IA HIV-1 PRB AMP,152.0,33.59,35.09,164.7,63
CPT,87535,LAB DET IA HIV-1 PRB AMP NS,108.0,23.87,35.09,164.7,63
CPT,87536,LAB DET IA HIV-1 QN,256.0,56.58,85.1,399.45,63
CPT,87536,LAB DET IA HIV-1 QN NS,256.0,56.58,85.1,399.45,63
CPT,87538,LAB DET IA HIV-2 REV T&PRB AMP,122.0,26.96,35.09,164.7,63
CPT,87541,LAB DET IA LEGIONELL PNEUM PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87551,LAB DET IA MYCOBCT PRB AMP,450.0,99.45,48.24,337.5,63
CPT,87556,LAB DET IA MYCOBCT TB PRB AMP,126.0,27.85,41.68,195.64,63
CPT,87556,LAB DET IA MYCOBCT TB PRB AMP NS,126.0,27.85,41.68,195.64,63
CPT,87561,LAB DET IA MYCOBCT AV-INTRA PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87563,LAB DET IA MYCOPLAS GEN PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87581,LAB DET IA MYCOPLAS PNEU PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87581,LAB DET IA MYCOPLAS PNEU PRB AMP NS,106.0,23.43,35.09,164.7,63
CPT,87591,LAB DET IA GC PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87591,LAB DET IA GC PRB AMP NS,106.0,23.43,35.09,164.7,63
CPT,87593,LAB DET IA ORTHOPOXVIRUS PRB AMP,154.0,34.03,35.09,240.8,63
CPT,87594,LAB DET IA PNEUM JIROVECII PRB AMP,109.0,24.09,35.09,81.75,62
CPT,87594,LAB DET IA PNEUM JIROVECII RFLX PRB,421.0,93.04,35.09,315.75,62
CPT,87624,LAB DET IA HPV TYPE RISK HIGH POOL,106.0,23.43,35.09,214.06,63
CPT,87625,LAB DET IA HPV TYPES 16&18,122.0,26.96,40.55,214.06,63
CPT,87625,LAB DET IA HPV TYPES 16&18 NS,122.0,26.96,40.55,214.06,63
CPT,87627,LAB DET IA PATH JT&GENE RXRST 26+,2040.0,450.84,667.08,1530.0,62
CPT,87631,LAB DET IA RESP MLTPLX 3-5 TGT,664.0,146.74,142.63,669.39,63
CPT,87632,LAB DET IA RESP MLTPLX 6-11 TGT,655.0,144.76,218.06,1023.48,63
CPT,87632,LAB DET IA RESP MLTPLX 6-11 TGT NS,655.0,144.76,218.06,1023.48,63
CPT,87633,LAB DET IA RESP MLTPLX 12-25 TGT,1251.0,276.47,416.78,1956.15,63
CPT,87633,LAB DET IA RESP MLTPLX 12-25 TGT NS,1251.0,276.47,416.78,1956.15,63
CPT,87634,LAB DET IA RSV PRB AMP,211.0,46.63,70.2,329.47,63
CPT,87635,LAB DET IA COV19 PRB AMP,249.0,55.03,51.31,247.99,63
CPT,87635,LAB DET IA COV19 PRB AMP NS,249.0,55.03,51.31,247.99,63
CPT,87636,LAB DET IA COV19&FLU A&B PRB AMP,96.0,21.22,43.2,617.73,63
CPT,87641,LAB DET IA MRSA PRB AMP NS,106.0,23.43,35.09,164.7,63
CPT,87651,LAB DET IA STREP GROUP A PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87653,LAB DET IA STREP GROUP B PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87660,LAB DET IA TRICHOMONAS VAG PRB DIR,61.0,13.48,20.05,94.06,63
CPT,87661,LAB DET IA TRICHOMON VAG PRB AMP NS,111.0,24.53,35.09,214.06,63
CPT,87661,LAB DET IA TRICHOMONAS VAG PRB AMP,106.0,23.43,35.09,214.06,63
CPT,87662,LAB DET IA VIRUS ZIKA PRB AMP,200.0,44.2,51.31,240.8,63
CPT,87798,LAB DET IA ASPERGILLUS PCR PRB AMP,115.0,25.42,35.09,164.7,63
CPT,87798,LAB DET IA B PERTUSSIS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA BK VIRUS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA C BURNETII PCR PRB AMP,744.0,164.42,35.09,558.0,63
CPT,87798,LAB DET IA COCCI IMMT PCR PRB AMP,521.0,115.14,35.09,390.75,63
CPT,87798,LAB DET IA DENGUE TYPES 1-4 PRB AMP,290.0,64.09,35.09,217.5,63
CPT,87798,LAB DET IA EBV PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA EBV PCR PRB BF AMP,546.0,120.67,35.09,409.5,63
CPT,87798,LAB DET IA HEPATITIS D PCR PRB AMP,371.0,81.99,35.09,278.25,63
CPT,87798,LAB DET IA HHV-8 PCR PRB AMP,124.0,27.4,35.09,164.7,63
CPT,87798,LAB DET IA IGM PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA JC VIRUS PCR PRB AMP,123.0,27.18,35.09,164.7,63
CPT,87798,LAB DET IA LEGIONELL PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA LEPTOSPIRA PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA MOLD PANEL PCR PRB AMP,778.0,171.94,35.09,583.5,63
CPT,87798,LAB DET IA MUCORALES PCR PRB AMP,275.0,60.78,35.09,206.25,63
CPT,87798,LAB DET IA NORCARDIA PCR PRB AMP,362.0,80.0,35.09,271.5,63
CPT,87798,LAB DET IA PARVOVIRUS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA PNEUMOCYSTIS PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA PRB AMP NS,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA RUBELLA PCR PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB DET IA TOXOPLASMA RFLX PCR PRB,421.0,93.04,35.09,315.75,63
CPT,87798,LAB DET IA VARICELLA-ZOSTER PRB AMP,106.0,23.43,35.09,164.7,63
CPT,87798,LAB RNA NOROVIRUS AMP PROBE,109.0,24.09,35.09,164.7,63
CPT,87799,LAB DET IA ADENOVIRUS PCR QN,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA BK VIRUS PCR QN,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA BK VIRUS PCR QN NS,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA EBV PCR QN,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA EBV PCR QN NS,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA HEP E PCR QN,251.0,55.47,42.84,261.36,63
CPT,87799,LAB DET IA HHV NON 6 PCR QN,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA JC VIRUS PCR QN,129.0,28.51,42.84,261.36,63
CPT,87799,LAB DET IA PARVOVIRUS PCR QN,141.0,31.16,42.84,261.36,63
CPT,87799,LAB DET IA PNEUMOCYSTIS PCR QN,275.0,60.78,42.84,261.36,63
CPT,87799,LAB DET IA TOXOPLASMA PCR QN,130.0,28.73,42.84,261.36,63
CPT,87799,LAB DET IA TRYPANOSOMA CRUZI PCR QN,230.0,50.83,42.84,261.36,63
CPT,87799,LAB DET IA VZV PCR QN,129.0,28.51,42.84,261.36,63
CPT,87801,LAB DET IA BACTERIAL MULT PRB AMP,1309.0,289.29,70.2,981.75,63
CPT,87801,LAB DET IA ENTEROBACTR MULT PRB AMP,411.0,90.83,70.2,329.47,63
CPT,87801,LAB DET IA FUNGAL MULT PRB AMP,1372.0,303.21,70.2,1029.0,63
CPT,87801,LAB DET IA ORGANISMS FNGL MULT PRB,638.0,141.0,70.2,478.5,63
CPT,87801,LAB DET IA ORGANISMS MULT PRB AMP,211.0,46.63,70.2,329.47,63
CPT,87801,LAB DET IA PERTUSSIS MULT PRB AMP,211.0,46.63,70.2,329.47,63
CPT,87804,LAB DET AG IA INFLUENZA IMM OPT,50.0,11.05,16.55,77.7,63
CPT,87807,LAB DET AG IA RSV IMM OPT,40.0,8.84,13.1,61.53,63
CPT,87880,LAB DET AG IA STREP GROUP A IMM OPT,50.0,11.05,16.53,77.56,63
CPT,87899,LAB DET AG IA IMM CRYPTO PLEURAL,293.0,64.75,16.07,219.75,63
CPT,87899,LAB DET AG IA IMM OPTICAL,65.0,14.36,16.07,75.43,63
CPT,87900,LAB SUSCPT PHENOTYPE IA DRUG,392.0,86.63,130.35,611.78,63
CPT,87901,LAB GENOTYPE IA HIV-1 REV T NS,773.0,170.83,257.45,1208.34,63
CPT,87902,LAB GENOTYPE IA HEPATITIS C NS,773.0,170.83,257.45,1570.47,63
CPT,87906,LAB GENOTYPE IA HIV-1 TROPISM CORCP,387.0,85.53,128.73,604.2,63
CPT,87910,LAB GENOTYPE IA CYTOMEGALOVIRUS,773.0,170.83,257.45,1208.34,63
CPT,87912,LAB GENOTYPE IA HEPATITIS B,773.0,170.83,257.45,1208.34,63
CPT,88108,LAB CYTOPATH CONCENTRATION,80.0,19.76,24.53,357.61,63
CPT,88112,LAB CYTOP SLD LIQ NONGYN,112.0,27.66,36.08,281.77,63
CPT,88112,LAB CYTOP SLD LIQ NONGYN MAYO NS,613.0,151.41,36.08,459.75,63
CPT,88120,LAB CYTOPATH URIN MANUAL PRB 3-5 EA,603.0,148.94,108.14,3308.24,63
CPT,88142,LAB SCR MANUAL CYTOPATH CERV/VAG,61.0,15.07,20.26,127.05,63
CPT,88161,LAB CYTOPATH OTH SRCE SMEARS SC&IN,62.0,15.31,17.89,311.27,63
CPT,88172,LAB CYTOPATH EVAL FNA IMMED 1ST,363.0,89.66,21.05,299.97,63
CPT,88173,LAB CYTOPATH EVAL FNA INTRP&RPT,466.0,115.1,36.08,666.15,63
CPT,88173,LAB CYTOPATH EVAL FNA INTRP&RPT NS,466.0,115.1,36.08,666.15,63
CPT,88175,LAB CYTOPATH CERV/VAG AUTO&MANUAL,80.0,19.76,26.61,166.9,63
CPT,88177,LAB CYTOPATH EVAL FNA IMMED ADDL,47.0,11.61,8.11,122.65,40
CPT,88182,LAB CYTOM FLOW CELL CYCLE/DNA NS,600.0,148.2,36.08,619.29,63
CPT,88184,LAB CYTOM FLOW TECH MARKER 1ST,760.0,187.72,75.86,631.11,63
CPT,88184,LAB CYTOM FLOW TECH MARKER 1ST NS,760.0,187.72,75.86,631.11,63
CPT,88185,LAB CYTOM FLOW TECH MARKER ADDL,333.0,82.25,12.26,332.53,40
CPT,88185,LAB CYTOM FLOW TECH MARKER ADDL NS,334.0,82.5,12.26,332.53,40
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYT MYO,1148.0,283.56,116.49,861.0,63
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYTE,350.0,86.45,116.49,613.85,63
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYTE NS,350.0,86.45,116.49,613.85,63
CPT,88233,LAB CULT TISS NON-NEO SKIN/BX,423.0,104.48,140.73,741.56,63
CPT,88233,LAB CULT TISS NON-NEO SKIN/BX NS,423.0,104.48,140.73,741.56,63
CPT,88235,LAB CULT TISS NON-NEO AF/CELL CV,451.0,111.4,150.3,791.99,63
CPT,88235,LAB CULT TISS NON-NEO AF/CELL CV NS,451.0,111.4,150.3,791.99,63
CPT,88237,LAB CULT TISS NON-NEO MARROW BLD,759.0,187.47,143.75,757.46,63
CPT,88239,LAB CULT TISS NEO TMR SOLID,443.0,109.42,147.52,777.35,63
CPT,88249,LAB CHROM BRK STRS CLASTGN 100 CELL,520.0,128.44,173.17,912.52,63
CPT,88261,LAB CHROM W BND 5 CLL 1 K CVS DIR,794.0,196.12,264.34,1392.93,63
CPT,88261,LAB CHROM W BND 5 CLL 1 KRTY,794.0,196.12,264.34,1392.93,63
CPT,88262,LAB CHROM W BND 15-20 CLL 2 KRTY,377.0,93.12,125.49,661.28,63
CPT,88262,LAB CHROM W BND 15-20 CLL 2 KRTY NS,532.0,131.4,125.49,661.28,63
CPT,88264,LAB CHROM 20-25 CELLS,763.0,188.46,144.61,761.99,63
CPT,88267,LAB CHROM W BND AF/CV 15 CLL 1 K,566.0,139.8,188.57,993.61,63
CPT,88269,LAB CHROM W BND AF 6-12 COL 1 K,521.0,128.69,173.66,915.12,63
CPT,88269,LAB CHROM W BND AF 6-12 COL 1 K NS,521.0,128.69,173.66,915.12,63
CPT,88271,LAB MCG PROBE DNA PROBE EA,65.0,16.06,21.42,112.88,63
CPT,88271,LAB MCG PROBE DNA PROBE EA NS,65.0,16.06,21.42,112.88,63
CPT,88273,LAB MCG IN SITU CHROM 10-30 CELL,105.0,25.94,34.81,183.46,63
CPT,88274,LAB MCG IN SITU INT 25-99 CELL,128.0,31.62,42.38,223.31,63
CPT,88274,LAB MCG IN SITU INT 25-99 CELL NS,128.0,31.62,42.38,223.31,63
CPT,88275,LAB MCG IN SITU INT 100-300 CELL,154.0,38.04,51.19,269.74,63
CPT,88275,LAB MCG IN SITU INT 100-300 CELL NS,357.0,88.18,51.19,269.74,63
CPT,88280,LAB CHROM KARYOTYPES ADDL EA,101.0,24.95,33.47,176.34,63
CPT,88285,LAB CHROM STUDY CELLS COUNTED ADDL,81.0,20.01,26.91,141.75,63
CPT,88289,LAB CHROM STUDY RES HIGH ADDL,104.0,25.69,34.43,181.4,63
CPT,88300,LAB PATH GROSS ONLY LVL 1,62.0,17.24,11.64,64.45,63
CPT,88302,LAB PATH GROSS&MICRO LVL 2,80.0,22.24,24.53,146.21,63
CPT,88304,LAB PATH GROSS&MICRO LVL 3,200.0,55.6,31.12,198.56,63
CPT,88305,LAB PATH GROSS&MICRO LVL 4,282.0,78.4,34.68,301.7,63
CPT,88305,LAB PATH GROSS&MICRO LVL 4 NS,200.0,55.6,34.68,301.7,63
CPT,88307,LAB PATH GROSS&MICRO LVL 5,1291.0,358.9,203.34,1290.75,63
CPT,88307,LAB PATH GROSS&MICRO LVL 5 NS,1292.0,359.18,203.34,1290.75,63
CPT,88309,LAB PATH GROSS&MICRO LVL 6,1832.0,509.3,285.45,1838.03,63
CPT,88311,LAB DECALCIFICATION,43.0,11.95,8.0,88.44,40
CPT,88312,LAB STAIN SPECIAL 1,409.0,113.7,36.08,475.46,63
CPT,88312,LAB STAIN SPECIAL 1 NS,409.0,113.7,36.08,475.46,63
CPT,88313,LAB STAIN SPECIAL 2,326.0,90.63,24.53,340.72,63
CPT,88313,LAB STAIN SPECIAL 2 NS,326.0,90.63,24.53,340.72,63
CPT,88313,LAB STAIN SPECIAL 2 PROT AMYLOID,326.0,90.63,24.53,340.72,63
CPT,88314,LAB STAIN HISTOCHEM W BLOCK FROZEN,241.0,67.0,22.59,416.38,40
CPT,88319,LAB STAIN CONSTITUENTS ENZYME NS,1684.0,468.15,107.67,1418.55,63
CPT,88321,LAB CONSULT SLIDES REFERRED,80.0,22.24,24.53,555.18,63
CPT,88321,LAB CONSULT SLIDES REFERRED NS,80.0,22.24,24.53,555.18,63
CPT,88323,LAB CONSULT SLIDES PREP REQ,112.0,31.14,28.84,483.38,63
CPT,88323,LAB CONSULT SLIDES PREP REQ NS,112.0,31.14,28.84,483.38,63
CPT,88325,LAB CONSULT COMP REVIEW REC&SPEC,363.0,100.91,108.14,873.94,63
CPT,88329,LAB CONSULT PATH SURGERY,126.0,35.03,40.35,236.28,63
CPT,88331,LAB CONSULT PATH SURG BLOCK 1ST,363.0,100.91,40.21,434.49,63
CPT,88332,LAB CONSULT PATH SURG BLOCK EA ADDL,108.0,30.02,12.26,230.67,40
CPT,88341,LAB IMHST/IMCYT AB PER SPEC ADDL,266.0,73.95,49.48,373.16,39
CPT,88341,LAB IMHST/IMCYT AB PER SPEC NS ADDL,228.0,63.38,42.41,373.16,39
CPT,88342,LAB IMHST/IMCYT AB 1ST PER SPEC,363.0,100.91,70.39,426.78,63
CPT,88342,LAB IMHST/IMCYT AB 1ST PER SPEC NS,363.0,100.91,70.39,426.78,63
CPT,88344,LAB IMHST/IMCYT MLTPLX PER SPEC,760.0,211.28,132.37,718.04,63
CPT,88344,LAB IMHST/IMCYT MLTPLX PER SPEC NS,760.0,211.28,132.37,718.04,63
CPT,88346,LAB IF AB STAIN INITIAL PER SPEC,363.0,100.91,108.14,646.57,63
CPT,88346,LAB IF AB STAIN INITIAL PER SPEC NS,363.0,100.91,108.14,646.57,63
CPT,88348,LAB MICROSCOPY ELECTRON DIAG,1684.0,468.15,398.84,1917.94,63
CPT,88348,LAB MICROSCOPY ELECTRON DIAG NS,2082.0,578.8,398.84,1917.94,63
CPT,88350,LAB IF AB STAIN PER SPEC ADDL,257.0,71.45,47.8,498.63,39
CPT,88350,LAB IF AB STAIN PER SPEC ADDL NS,257.0,71.45,47.8,498.63,39
CPT,88355,LAB MORPHO MUSCLE SKELETAL NS,363.0,100.91,51.19,601.97,63
CPT,88360,LAB MORPHO ER MANUAL PER SPEC,468.0,130.1,78.18,510.54,63
CPT,88360,LAB MORPHO HER2 MANUAL PER SPEC,363.0,100.91,78.18,510.54,63
CPT,88360,LAB MORPHO HER2 MANUAL PER SPEC NS,374.0,103.97,78.18,510.54,63
CPT,88360,LAB MORPHO PR MANUAL PER SPEC,468.0,130.1,78.18,510.54,63
CPT,88360,LAB MORPHO TMR IHC MNL PER SPEC,363.0,100.91,78.18,510.54,63
CPT,88360,LAB MORPHO TMR IHC MNL PER SPEC NS,363.0,100.91,78.18,510.54,63
CPT,88361,LAB MORPHO HER2 COMP PER SPEC,760.0,211.28,75.26,638.06,63
CPT,88362,LAB PREPARATIONS NERVE TEASING,1684.0,468.15,118.34,1418.55,63
CPT,88364,LAB ISH PRB STAIN PER SPEC ADDL,366.0,101.75,68.08,582.13,39
CPT,88364,LAB ISH PRB STAIN PER SPEC ADDL NS,366.0,101.75,68.08,582.13,39
CPT,88365,LAB ISH 1ST PRB STAIN HPV PER SPEC,1335.0,371.13,108.14,1001.25,63
CPT,88365,LAB ISH 1ST PRB STAIN PER SPEC,363.0,100.91,108.14,758.49,63
CPT,88365,LAB ISH 1ST PRB STAIN PER SPEC NS,363.0,100.91,108.14,758.49,63
CPT,88366,LAB ISH MLTPLX PER SPEC,517.0,143.73,108.14,1201.55,63
CPT,88367,LAB MORPHO ISH COMP 1ST SPEC,760.0,211.28,77.53,631.11,63
CPT,88367,LAB MORPHO ISH COMP 1ST SPEC NS,760.0,211.28,77.53,631.11,63
CPT,88368,LAB MORPHO ISH MANUAL 1ST SPEC,760.0,211.28,104.42,631.11,63
CPT,88368,LAB MORPHO ISH MANUAL 1ST SPEC NS,760.0,211.28,104.42,631.11,63
CPT,88369,LAB MORPHO ISH MANUAL ADDL SPEC,335.0,93.13,62.31,486.63,39
CPT,88373,LAB MORPHO ISH COMP ADDL SPEC,201.0,55.88,37.39,293.47,39
CPT,88374,LAB MORPHO ISH COMP MULT PER SPEC,951.0,264.38,108.14,1373.45,63
CPT,88374,LAB MORPHO ISH COMP MULT SPEC NS,553.0,153.73,108.14,1373.45,63
CPT,88377,LAB MORPHO ISH MAN MULT PER SPEC,872.0,242.42,108.14,1705.89,63
CPT,88377,LAB MORPHO ISH MAN MULT PER SPEC NS,872.0,242.42,108.14,1705.89,63
CPT,88380,LAB MICRODISSECTION LASER,909.0,252.7,71.61,681.75,39
CPT,88380,LAB MICRODISSECTION LASER FIB GN,1567.0,435.63,71.61,1175.25,39
CPT,88380,LAB MICRODISSECTION LASER PROT AMYL,202.0,56.16,37.57,539.47,39
CPT,88381,LAB MICRODISSECTION MANUAL,230.0,63.94,42.78,884.04,39
CPT,88720,POC BILIRUBIN TOTAL TRANSQ,16.0,2.56,5.02,23.55,126
CPT,89050,LAB COUNT CELL CSF,15.0,2.58,4.72,22.15,63
CPT,89050,LAB COUNT CELL FLUID BODY,15.0,2.58,4.72,22.15,63
CPT,89051,LAB COUNT CELL W DIFF CSF,17.0,2.92,5.6,26.28,63
CPT,89051,LAB COUNT CELL W DIFF FLUID BODY,17.0,2.92,5.6,26.28,63
CPT,89055,LAB ASSESSMENT LEUKOCYTE FECAL,13.0,2.24,4.27,20.09,63
CPT,89060,LAB ID CRYSTAL MICROSCOPY LIGHT,22.0,3.78,7.33,78.63,63
CPT,89125,LAB STAIN FAT/FECES/URINE/SPUTUM,18.0,3.1,5.88,27.61,63
CPT,89220,POC COLLECT SPEC SPUTUM AEROSOL,363.0,62.44,18.78,299.97,63
CPT,89230,LAB COLLECTION SWEAT IONTOPHORESIS,112.0,19.26,2.88,91.76,63
CPT,89310,LAB SEMEN MOTILITY&CT WO HUHNER,26.0,4.47,3.75,40.44,59
CPT,89325,LAB AB SPERM,78.0,13.42,10.67,58.5,59
CPT,90471,ED IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,63
CPT,90471,IMMUNIZATION 1ST VACCINE,116.0,21.58,20.22,139.0,315
CPT,90472,ED IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,40
CPT,90472,IMMUNIZATION ADDL VACCINE,47.0,8.74,8.74,139.0,160
CPT,90472,IMMUNIZATION VACCINE ADDL,47.0,8.74,8.74,139.0,40
CPT,90870,THERAPY ELECTROCONVULSIVE W MNTR,1896.0,623.84,102.94,3006.3,138
CPT,90935,DIALYSIS OP UNSCH/ER NON ESRD PT,2680.0,511.88,69.03,2010.0,63
CPT,90935,HEMODIALYSIS IP BEDSIDE,2680.0,485.08,69.03,2010.0,63
CPT,90935,HEMODIALYSIS IP DIALYSIS UNIT,2680.0,485.08,69.03,2010.0,63
CPT,91010,MOTILITY ESOPHAGEAL,979.0,983.11,153.43,5681.0,63
CPT,91034,TEST ESOPHAGUS PH CATH NASAL,1074.0,1245.83,138.83,4664.0,63
CPT,91035,TEST ESOPHAGUS PH CAP,2648.0,1125.4,353.64,4664.0,63
CPT,91037,TEST ESOPHAGEAL PH CATH NASAL IMPED,1147.0,487.48,117.73,4664.0,63
CPT,91040,"ESOPHAGEAL BALLOON DISTENSION STUDY, DIAGNOSTIC, WITH PROVOCATION WHEN PERFORMED",,,353.64,4664.0,50
CPT,91110,IMG GI ESOPH-ILEUM INTRALUM W I&R,3739.0,1589.08,586.96,5662.85,63
CPT,91120,"RECTAL SENSATION, TONE, AND COMPLIANCE TEST (IE, RESPONSE TO GRADED BALLOON DISTENTION)",,,440.71,4664.0,5
CPT,91122,ANORECTAL MANOMETRY,,,184.87,4664.0,5
CPT,91124,SENSATION RECTAL&TONE&STUDY COMPLNC,535.0,227.38,159.94,2726.46,62
CPT,91125,MANOMETRY ANORECTAL SENS&BLN EXPLSN,1133.0,481.52,276.4,2481.0,62
CPT,91299,STUDY CAPSULE PATENCY,323.0,137.28,101.17,2481.0,62
CPT,92507,ST TX SPEECH/LANG/VOICE/COM IND,391.0,64.52,72.73,293.25,78
CPT,92508,ST TX SPEECH/LANG/VOICE/COM GROUP,128.0,42.12,23.81,283.0,39
CPT,92521,ST EVAL FLUENCY SPEECH,582.0,96.03,85.0,875.34,39
CPT,92522,ST EVAL PROD SOUND SP,638.0,105.27,85.0,710.57,39
CPT,92523,ST EVAL PROD SOUND SP W LANG&EXPRSN,777.0,128.21,85.0,1476.15,39
CPT,92524,ST ANALYSIS VOICE&RESON BEH&QUAL,741.0,122.26,85.0,740.3,39
CPT,92526,OT TX DYSFNCT SWALLOW FNCT FEED,446.0,61.55,82.96,334.5,39
CPT,92526,OTA TX DYSFNCT SWALLOW FNCT FEED,446.0,61.55,82.96,334.5,39
CPT,92526,ST TX DYSFNCT SWALLOW FNCT FEED,446.0,73.59,82.96,334.5,78
CPT,92549,CDP-SOT 6 CONDITIONS W MCT&ADT,1609.0,1436.84,19.76,1206.75,63
CPT,92597,ST EVAL DEVICE VOICE PROSTHETIC,563.0,92.9,71.32,422.25,78
CPT,92606,ST THER DEVICE NON SP W PRG,383.0,63.2,66.4,287.25,33
CPT,92607,ST EVAL DEVICE SP COMM W PT 1ST HR,1009.0,248.21,85.0,1245.32,39
CPT,92608,ST EVAL DEVICE SP COMM W PT AD 30MN,405.0,99.63,47.89,622.69,39
CPT,92609,ST THER DEVICE SP W PRG,540.0,89.1,85.0,662.41,39
CPT,92610,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,572.0,140.71,69.08,642.78,78
CPT,92611,ST EVAL FNCT SWALLOW FLUOROSCOPIC,720.0,177.12,85.0,699.59,78
CPT,92612,ST EVAL SWALLOW ENDOSCOPIC FLEX,717.0,176.38,85.0,556.84,78
CPT,92614,ST EVAL TST SENSORY LARYNGEAL ENDO,794.0,195.32,85.0,595.5,39
CPT,92652,EVOK PTNTL AUD THRSHLD MULT I&R,1887.0,620.88,109.98,1415.25,63
CPT,92653,EVOK PTNTL AUD NEURODX I&R,1548.0,509.34,81.45,1161.0,63
CPT,92920,PTCA ART COR MAJ SGL&/BR,11428.0,3028.42,500.65,39957.0,63
CPT,92921,PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,10528.0,39957.0,9
CPT,92924,ATHER W ANGIO COR ART MAJ SGL&/BR,15821.0,4192.57,597.17,39957.0,63
CPT,92928,PLC STNT/S W ANGIO SGL&/BR 1 LSN,15477.0,4101.41,557.04,32670.0,63
CPT,92930,PLC STNT/S W ANGIO SGL&/BR 2+ LSN,16883.0,4474.0,3935.48,32276.26,62
CPT,92933,ATHER W STENT ANGIO ART MAJ SGL&/BR,18490.0,4899.85,624.73,32670.0,63
CPT,92937,REVASC GRFT BYPASS ART COR SGL&/BR,17497.0,4636.7,556.99,32670.0,63
CPT,92941,REVASC OCC MI ACUTE ART COR SGL&/BR,19695.0,5219.18,625.43,32670.0,40
CPT,92943,REVASC OCC CHRONIC ART/BR/GRFT COR,21180.0,5612.7,625.39,32670.0,63
CPT,92950,CPR,1318.0,320.93,177.3,1317.89,189
CPT,92950,ED CPR,1318.0,325.55,177.3,2503.0,64
CPT,92953,ED PACING TRANSCUTANEOUS TEMP,1318.0,325.55,0.94,2503.0,64
CPT,92953,PACING TRANSCUTANEOUS TEMP,1318.0,386.17,0.94,1317.89,63
CPT,92960,CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,252
CPT,92960,"CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL",,,104.27,3698.0,46
CPT,92960,ED CARDIOVERSION ELECTIVE EXTERNAL,2340.0,1206.66,104.27,2921.16,64
CPT,92972,LITHOTRIPSY CORONARY PERC TRANSL,11282.0,2989.73,140.37,14891.0,37
CPT,92973,THROMBECT ASP MECH COR PERC,6948.0,1841.22,166.89,14891.0,80
CPT,92974,PLC DEVICE RAD BRACHY CORONARY,5714.0,1514.21,152.95,14891.0,40
CPT,92978,IMG ENDOLMNL IVUS/OCT COR VSL INIT,5379.0,1425.44,10.59,14891.0,39
CPT,92979,IMG ENDOLMNL IVUS/OCT COR VSL ADDL,3115.0,825.48,5.75,14891.0,39
CPT,92986,VALVULOPLASTY BLN AORTA PERC,14532.0,5202.46,1263.13,26761.0,63
CPT,92987,VALVULOPLASTY BLN MITRAL PERC,14660.0,5248.28,1301.84,26761.0,63
CPT,92990,VALVULOPLASTY BLN PULMONARY PERC,14774.0,5289.09,1042.29,26761.0,63
CPT,92997,PTA BLN ART PULMONARY VSL SGL,14057.0,4118.7,601.98,26761.0,126
CPT,92998,PTA BLN ART PULMONARY VSL ADDL,6283.0,1840.92,301.58,15325.0,80
CPT,93005,ED EKG TRACING ROUTINE 12+ LEADS,543.0,118.92,6.13,433.0,63
CPT,93005,EKG TRACING ROUTINE 12+ LEADS,543.0,118.92,6.13,433.0,63
CPT,93017,TEST CV STRESS TREAD/BIKE&/RX TRACE,848.0,223.87,36.59,636.0,63
CPT,93041,ED EKG TRACING RHYTHM 1-3 LEADS,130.0,28.47,6.13,433.0,63
CPT,93041,EKG TRACING RHYTHM 1-3 LEADS,130.0,28.47,6.13,433.0,126
CPT,93225,EKG RECORD EXTERNAL 0-48HR,494.0,313.2,17.81,370.5,63
CPT,93226,EKG ANALYSIS EXTERNAL 0-48HR,583.0,369.62,34.69,495.11,63
CPT,93260,EVAL DEV PROG DEV SUBQ IN PERSON,1386.0,406.1,26.93,1039.5,126
CPT,93261,EVAL DEV INTRGTN DEV SUBQ IN PERSON,1386.0,406.1,26.93,1039.5,126
CPT,93278,EKG SIGNAL AVERAGED,586.0,128.33,18.78,439.5,63
CPT,93279,EVAL DEV PROG PM SGL LD/LDLS,179.0,52.45,26.93,238.75,63
CPT,93282,EVAL DEV PROG ICD TV SGL IN PERSON,191.0,55.96,26.93,285.62,126
CPT,93283,EVAL DEV PROG ICD TV DUAL IN PERSON,219.0,64.17,26.93,348.21,126
CPT,93284,EVAL DEV PROG ICD TV MULT IN PERSON,248.0,72.66,26.93,375.2,126
CPT,93285,EVAL DEV PROG CRM SUBQ IN PERSON,169.0,49.52,26.93,215.04,63
CPT,93286,EVAL DEV PERIPRO PM/PM LDLS,145.0,42.48,26.97,164.52,117
CPT,93287,EVAL DEV PERIPRO PROG ICD IN PERSON,145.0,42.48,26.97,190.53,117
CPT,93288,EVAL DEV ANYLS PM/PM LDLS,174.0,50.98,26.93,200.75,63
CPT,93289,EVAL DEV INTRGTN ICD TV IN PERSON,196.0,57.43,26.93,257.48,63
CPT,93296,EVAL DEV PM/IDS REM ACQ 0-90 DAY,196.0,57.43,20.73,10528.0,63
CPT,93303,ECHO CONG ANM CMP WO CNT,1707.0,419.92,155.02,2497.0,63
CPT,93304,ECHO CONG ANM LTD WO CNT,875.0,215.25,117.08,2497.0,63
CPT,93306,ECHO 2D DOPP&CLR FLW CMP WO CNT,2678.0,658.79,125.48,2497.0,63
CPT,93307,ECHO 2D CMP WO CNT,1384.0,340.46,91.45,2497.0,63
CPT,93308,ECHO 2D LTD WO CNT,988.0,243.05,72.3,2497.0,63
CPT,93308,ED ECHO 2D LTD WO CNT,988.0,243.05,72.3,2497.0,63
CPT,93312,ECHO 2D TEE CMP WO CNT W I&R,2357.0,1045.7,128.08,2497.0,63
CPT,93314,ECHO 2D TEE IMG I&R ONLY,1938.0,476.75,135.22,2497.0,39
CPT,93315,ECHO TEE CONG ANM WO CNT W I&R,3340.0,821.64,219.84,4956.07,63
CPT,93317,ECHO TEE CONG IMG I&R ONLY,1938.0,476.75,81.53,2497.0,39
CPT,93320,ECHO DOPP CMP,747.0,183.76,32.42,2497.0,39
CPT,93321,ECHO DOPP LTD,374.0,92.0,17.53,2497.0,39
CPT,93325,ECHO DOPP MAP VELOCITY COLOR FLOW,462.0,113.65,19.8,2497.0,39
CPT,93350,ECHO 2D REST&STRESS WO CNT W I&R,1432.0,352.27,114.81,2497.0,63
CPT,93351,ECHO 2D REST&STRESS/EKG MNTR WO CNT,1875.0,461.25,147.18,2497.0,63
CPT,93355,ECHO TEE INTRACARDIAC TRANSCATH GD,2931.0,721.03,216.1,2497.0,39
CPT,93356,ASSESS STRAIN MYOCARDIAL W IMG,279.0,68.63,36.14,2497.0,39
CPT,93451,RHC O2 SAT&CARDIAC OUTPUT,13154.0,5893.54,703.83,16111.14,126
CPT,93452,LHC W INJ/S VENTRCLGRPHY LT S&I,14207.0,3764.86,636.89,16111.14,126
CPT,93453,RHC&LHC W INJ/S VENTRCLGRPHY LT S&I,16112.0,4269.68,799.5,16111.14,126
CPT,93454,PLC CATH& INJ/S CAG S&I,16112.0,4269.68,641.77,16111.14,63
CPT,93454,PLC CATH&INJ/S CAG S&I,16112.0,4269.68,641.77,16111.14,63
CPT,93455,PLC CATH&INJ/S CAG&GRF S&I,17682.0,4685.73,703.43,16111.14,63
CPT,93456,PLC CATH&INJ/S CAG W RHC S&I,19761.0,5236.66,785.22,16111.14,126
CPT,93457,PLC CATH&INJ/S CAG&GRF W RHC S&I,21305.0,5645.83,846.19,16111.14,63
CPT,93458,PLC CATH&INJ/S CAG&LV W LHC S&I,18066.0,7091.32,719.33,16111.14,126
CPT,93459,PLC CATH CAG&GRF&LV W LHC S&I,19034.0,5044.01,757.92,16111.14,63
CPT,93460,PLC CATH CAG&LV W RHC&LHC S&I,21046.0,5577.19,838.07,16111.14,126
CPT,93461,PLC CATH CAG&GRF&LV W RHC&LHC S&I,23175.0,6141.38,923.72,17381.25,63
CPT,93462,LHC PUNCT TRANSSEPTAL/TRANSAPICAL,7006.0,1856.59,196.36,15325.0,80
CPT,93463,ADMIN DRUG&MEAS HEMODYNAMIC,2937.0,778.3,93.84,14891.0,66
CPT,93464,STUDY EXERCISE&MEAS HEMODYNAMIC,871.0,230.82,127.84,14891.0,78
CPT,93503,INS&PLC CATH DIRECTED FLOW,5656.0,1578.025,84.35,16111.14,252
CPT,93505,BX ENDOMYOCARDIAL,7560.0,6831.17,405.28,16111.14,189
CPT,93563,INJ SEL CAG HRT CATH CONGENITAL S&I,1429.0,378.68,49.2,14891.0,39
CPT,93564,INJ GRFT HRT CATH CONGENITAL S&I,1507.0,399.36,52.47,14891.0,39
CPT,93565,INJ ANGIO LV/LA HRT CATH S&I,829.0,219.68,25.57,14891.0,39
CPT,93566,INJ ANGIO RV/RA HRT CATH S&I,1040.0,275.6,24.72,14891.0,39
CPT,93567,INJ AORTO SUPRVLV HRT CATH S&I,1086.0,287.79,35.64,14891.0,39
CPT,93568,INJ ANGIO PULM NONSEL HRT CATH S&I,1069.0,283.29,44.15,14891.0,39
CPT,93569,INJ ANGIO PULM SEL HRT CATH UNI S&I,877.0,232.4,36.43,14891.0,39
CPT,93571,VEL&/FLW DOPP INTRAV VSL INIT,5841.0,1547.86,201.01,14891.0,39
CPT,93571,VEL&/FLW DOPP INTRAV VSL INIT RDC,5841.0,1547.86,201.01,14891.0,39
CPT,93572,VEL&/FLW DOPP INTRAV VSL ADDL,2921.0,774.06,54.88,14891.0,39
CPT,93572,VEL&/FLW DOPP INTRAV VSL ADDL RDC,2921.0,774.06,54.88,14891.0,39
CPT,93573,INJ ANGIO PULM SEL HRT CATH BI S&I,2351.0,623.02,60.44,14891.0,39
CPT,93580,CLOSE TRANSCATH PFO/ASD CONG W IMP,25279.0,9049.88,924.31,79657.7,63
CPT,93581,CLOSE TRANSCATH VSD CONG W IMP,22297.0,5908.7,1253.6,79657.7,63
CPT,93583,THERAPY RDC SEPTAL TRANSCATH PERC,25374.0,7434.58,702.35,79657.7,78
CPT,93590,CLOSE LEAK PARAVALVUL MITRAL INIT,68082.0,24373.36,1025.52,79657.7,63
CPT,93591,CLOSE LEAK PARAVALVUL AORTIC INIT,55973.0,20038.33,843.66,79657.7,63
CPT,93592,CLOSE LEAK PARAVALVUL ADDITIONAL,18475.0,6614.05,369.93,39745.7,39
CPT,93593,RHC CHD CONN NTV NORM W IMG,8605.0,2280.33,178.62,16111.14,63
CPT,93594,RHC CHD CONN NTV ABNRM W IMG,10757.0,2850.6,271.34,16111.14,63
CPT,93595,LHC CHD CONN NTV NORM/ABNRM W IMG,10327.0,2736.66,246.14,16111.14,63
CPT,93596,RHC&LHC CHD CONN NTV NORM W IMG,14742.0,3906.63,901.64,16111.14,63
CPT,93597,RHC&LHC CHD CONN NTV ABNRM W IMG,16112.0,4269.68,1569.82,16111.14,63
CPT,93598,MEAS OUTPUT CARD DUR CATH CARD CHD,960.0,281.28,63.24,8055.57,39
CPT,93600,RECORDING BUNDLE OF HIS,7186.0,2105.5,5.75,44695.0,126
CPT,93602,RECORDING INTRA-ATRIAL,7186.0,2105.5,3.06,44695.0,126
CPT,93603,RECORDING VENTRICULAR RT,5137.0,1505.14,4.85,44695.0,126
CPT,93609,MAP TACHYCARDIA INTRAVENT&/ATRIAL,15507.0,4543.55,7.51,44695.0,78
CPT,93610,PACING INTRA-ATRIAL,7186.0,2105.5,4.41,44695.0,126
CPT,93612,PACING INTRAVENTRICULAR,7186.0,2105.5,4.85,44695.0,126
CPT,93613,MAP 3D EP INTRACARDIAC,9313.0,2728.71,276.0,44695.0,78
CPT,93615,RECORDING ESOPH EGM ATR W/WO VENT,2516.0,737.19,0.86,44695.0,63
CPT,93618,INDUCTION ARRTHYMIA BY PACING,5137.0,1505.14,10.59,44695.0,126
CPT,93619,EVAL EP COMP WO ARRHYTHMIA,14190.0,4157.67,20.74,44695.0,126
CPT,93620,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,190.05,44695.0,52
CPT,93620,EVAL EP COMP W ARRHYTHMIA,19066.0,5586.34,190.05,44695.0,126
CPT,93621,EVAL EP COMP PACING&REC ATRIAL LT,4990.0,1462.07,928.14,44695.0,78
CPT,93622,COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS WITH INDUCTION OR ATTEMPTED INDUCTION OF ARRHYTHMIA; WITH LEFT VENTRICULAR PACING AND ,,,1047.52,44695.0,16
CPT,93622,EVAL EP COMP PACING&REC VENT LT,7484.0,2192.81,1047.52,44695.0,78
CPT,93623,PROGRAMMED STIMULATION AND PACING AFTER INTRAVENOUS DRUG INFUSION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,1047.52,44695.0,16
CPT,93623,STIMULATION&PACING INF IV DRUG,12537.0,3673.34,1047.52,44695.0,78
CPT,93624,STUDY EP FLWUP PACING&REC,14856.0,4352.81,62.5,44695.0,126
CPT,93640,EVAL EP LEADS ICD INITIAL,2635.0,772.06,18.52,44695.0,78
CPT,93640,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,18.52,44695.0,16
CPT,93641,EVAL EP LEADS W TEST ICD INITIAL,2641.0,773.81,18.52,11751.0,78
CPT,93642,EVAL EP ICD TV CHAMBER SGL/DUAL,2097.0,614.42,79.4,44695.0,126
CPT,93644,EVAL EP DEFIBRILLATOR SUBQ,1936.0,567.25,49.29,1452.0,78
CPT,93650,ABL CATH IC NODE A/V W/WO PM TEMP,12089.0,3542.08,550.92,44695.0,126
CPT,93653,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,791.27,46020.56,52
CPT,93653,EVAL EP&ABL ARRHYTHMIA SV,42001.0,38882.06,791.27,46020.56,63
CPT,93654,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,953.3,46020.56,52
CPT,93654,EVAL EP&ABL ARRHYTHMIA VT,42851.0,39104.58,953.3,46020.56,63
CPT,93655,ABL ARRHYTHMIA ADDL,21426.0,6277.82,290.02,44695.0,39
CPT,93655,"INTRACARDIAC CATHETER ABLATION OF A DISCRETE MECHANISM OF ARRHYTHMIA WHICH IS DISTINCT FROM THE PRIMARY ABLATED MECHANISM, INCLUDING REPEAT DIAGNOSTIC MANEUVERS, TO TREAT A SPONTANEOUS OR INDUCED ARRH",,,290.02,44695.0,16
CPT,93656,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,897.25,46020.56,52
CPT,93656,EVAL EP&ABL FIB ATRIAL VEIN PULM,40792.0,38008.64,897.25,46020.56,63
CPT,93657,ABL FIB ATRIAL ADDL,20396.0,5976.03,290.34,44695.0,39
CPT,93657,ADDITIONAL LINEAR OR FOCAL INTRACARDIAC CATHETER ABLATION OF THE LEFT OR RIGHT ATRIUM FOR TREATMENT OF ATRIAL FIBRILLATION REMAINING AFTER COMPLETION OF PULMONARY VEIN ISOLATION (LIST SEPARATELY IN AD,,,290.34,44695.0,16
CPT,93660,EVAL FNCT CARDIO W TILT TABLE/EKG,3891.0,1140.06,70.95,44695.0,189
CPT,93662,ECHO ICRD INTRV THER/DX,5728.0,1678.3,21.59,44695.0,78
CPT,93724,ANLYS ELECT SYSTEM PM ANTITACHYCARD,512.0,150.02,45.08,44695.0,63
CPT,93750,INTERROGATION VAD IN PERSON,389.0,113.98,49.47,422.73,126
CPT,93797,CR II WO EKG 36+ SESSIONS,408.0,252.55,8.55,400.0,40
CPT,93797,CR II WO EKG 36+ SESSIONS TELEHLTH,408.0,252.55,8.55,400.0,40
CPT,93797,CR II WO EKG PER SESSION,408.0,252.55,8.55,400.0,63
CPT,93797,CR II WO EKG PER SESSION TELEHLTH,408.0,252.55,8.55,400.0,63
CPT,93798,CR II W EKG 36+ SESSIONS,842.0,521.2,13.13,631.5,40
CPT,93798,CR II W EKG PER SESSION,842.0,521.2,13.13,631.5,63
CPT,93799,ECHO ICRD INTRV THER/DX STAND ALONE,5728.0,1678.3,101.17,4296.0,62
CPT,93799,EVAL EP&ABL CARDIONEURAL,46799.0,13712.11,101.17,35099.25,62
CPT,93799,PVC INDUCTION DRUG MNTR STAND ALONE,6753.0,1978.63,101.17,5064.75,62
CPT,93799,RECALIBRATION CARDIOMEMS,167.0,48.93,54.61,536.75,62
CPT,93799,VEL&/FLW DOPP IVAS VSL WO DRUG INT,4812.0,1275.18,101.17,14891.0,62
CPT,93799,VEL&/FLW DOPP IVAS VSL WO DRUG MULT,8662.0,2295.43,101.17,14891.0,62
CPT,93880,US DUPLEX EXTRACRANIAL CMP BI,1672.0,444.75,148.53,1671.18,63
CPT,93882,US DUPLEX EXTRACRANIAL UNI/LTD,1292.0,343.67,79.0,1291.29,63
CPT,93886,US TCD INTRACRANIAL CMP,1554.0,413.36,166.84,1821.25,63
CPT,93888,US TCD INTRACRANIAL LTD,1051.0,279.57,79.0,1051.95,63
CPT,93892,US TCD INTRACRANIAL DET EMB WO INJ,1044.0,277.7,79.0,1475.35,63
CPT,93893,TCD DETECT SHUNT VEN/ART W/INJ,1145.0,304.57,79.0,1470.49,63
CPT,93896,STUDY VASOREACT TCD INTRACRNL COMP,1001.0,266.27,186.19,750.75,38
CPT,93922,ART PHYS 1-2 LEVEL LTD BI,1463.0,389.16,68.72,1097.25,126
CPT,93922,ART PHYS 1-2 LEVEL LTD UNI,975.0,259.35,68.72,974.25,40
CPT,93922,MEAS TENSION O2 TRANSQ 1-2 LEVEL BI,1463.0,389.16,68.72,1097.25,63
CPT,93923,ART PHYS 3+ LEVEL CMP BI,1820.0,484.12,101.17,1471.62,126
CPT,93923,ART PHYS 3+ LEVEL CMP UNI,1213.0,322.66,101.17,1471.62,40
CPT,93923,MEAS TENSION O2 TRANSQ 3+ LEVEL BI,1820.0,484.12,101.17,1471.62,63
CPT,93924,US ART PHYS EXT LWR TREADMILL BI,1654.0,439.96,101.17,1830.83,63
CPT,93925,US DUPLEX ART EXT LWR BI,1950.0,518.7,166.84,1949.57,63
CPT,93926,US DUPLEX ART EXT LWR UNI/LTD LT,1240.0,329.84,79.0,1239.07,40
CPT,93926,US DUPLEX ART EXT LWR UNI/LTD RT,1240.0,329.84,79.0,1239.07,40
CPT,93930,US DUPLEX ART EXT UPR CMP BI,1684.0,447.94,156.32,1683.55,63
CPT,93931,US DUPLEX ART EXT UPR UNI/LTD LT,1106.0,294.2,79.0,1105.36,40
CPT,93931,US DUPLEX ART EXT UPR UNI/LTD RT,1106.0,294.2,79.0,1105.36,40
CPT,93970,US DUPLEX VEIN EXT CMP BI,2080.0,553.28,150.47,1675.9,63
CPT,93971,US DUPLEX VEIN EXT LTD/UNI,1093.0,290.74,79.0,1092.72,63
CPT,93975,US DUPLEX ABD/PEL/SCR&/RETRO CMP,1978.0,526.15,166.84,1977.97,63
CPT,93976,US DUPLEX ABD/PEL/SCR&/RETRO LTD,1395.0,371.07,79.0,1394.39,63
CPT,93978,US DUPLEX AO/IVC/ILIAC/GRFT CMP,1615.0,429.59,139.12,1614.24,63
CPT,93979,US DUPLEX AO/IVC/ILIAC/GRFT LTD,855.0,227.43,79.0,1082.41,63
CPT,93985,US DUPLEX ART&VEN B4 HEMO CMP BI,1581.0,420.55,166.84,1969.52,63
CPT,93986,US DUPLEX ART&VEN B4 HEMO CMP UNI,953.0,253.5,79.0,952.43,63
CPT,93990,US DUPLEX HEMODIALYSIS,1094.0,291.0,79.0,1255.7,63
CPT,94002,VENT INITIAL DAY,3875.0,751.75,88.64,2906.25,63
CPT,94003,VENT SUBSQ DAY,3193.0,619.44,62.36,2394.75,63
CPT,94010,SPIROMETRY W VITAL CAP W/WO VENT,686.0,242.16,18.78,514.5,63
CPT,94060,BRONCHDLTN PRE&POST SPIROMETRY W VC,867.0,306.05,28.2,657.01,63
CPT,94070,EVAL BRONCHSPSM SPIRO W AGENTS,1085.0,383.0,34.97,813.75,63
CPT,94150,CAPACITY VITAL TOTAL,232.0,81.9,21.05,226.54,63
CPT,94200,CAPACITY BREATHING MAX VENT VOL MAX,226.0,79.78,11.97,169.5,63
CPT,94375,LOOP VOLUME FLOW RESP,554.0,195.56,24.3,415.5,63
CPT,94452,HAST W REPORT,252.0,88.96,35.66,334.2,63
CPT,94453,HAST W REPORT&TITRATE OXYGEN SUPP,345.0,121.78,47.63,450.81,63
CPT,94610,ADMIN SURFACTANT INTRAPULMONARY,230.0,81.19,54.84,540.08,63
CPT,94618,TEST STRESS PULMONARY,542.0,191.33,11.97,406.5,126
CPT,94621,TEST EXERCISE CARDIOPULMONARY,1714.0,605.04,85.88,1285.5,126
CPT,94625,REHAB PULM OP WO CONT OX 36+ SESSN,199.0,61.09,29.58,149.25,40
CPT,94625,REHAB PULM OP WO CONT OX SESSN,199.0,61.09,29.58,149.25,63
CPT,94626,REHAB PULM OP W CONT OX 36+ SESSN,242.0,74.29,40.35,181.5,40
CPT,94626,REHAB PULM OP W CONT OX SESSN,242.0,74.29,40.35,181.5,63
CPT,94642,INHALATION AEROSOL PENTAMIDINE,400.0,77.6,35.35,385.56,63
CPT,94660,BIPAP INITIAL DAY,1783.0,345.9,63.35,1337.25,63
CPT,94660,BIPAP PER DAY,1783.0,345.9,63.35,1337.25,63
CPT,94660,BIPAP SUBSQ DAY,1783.0,345.9,63.35,1337.25,63
CPT,94660,CPAP INITIAL DAY,1783.0,345.9,63.35,1337.25,63
CPT,94660,CPAP PER DAY,1783.0,345.9,63.35,1337.25,63
CPT,94660,CPAP SUBSQ DAY,1783.0,345.9,63.35,1337.25,63
CPT,94664,DEMO&/EVAL PT AEROSOL/NEB/MDI/IPPB,473.0,91.76,17.45,385.56,63
CPT,94667,CLEARANCE AIRWAY INITIAL,385.0,74.69,24.26,288.75,63
CPT,94667,PHYSIOTHERAPY CHEST COMP INITIAL,385.0,74.69,24.26,288.75,63
CPT,94667,PHYSIOTHERAPY CHEST INITIAL,385.0,74.69,24.26,288.75,63
CPT,94668,CLEARANCE AIRWAY SUBSQ,405.0,78.57,38.18,303.75,63
CPT,94668,PHYSIOTHERAPY CHEST COMP SUBSQ,405.0,78.57,38.18,303.75,63
CPT,94668,PHYSIOTHERAPY CHEST SUBSQ,405.0,78.57,38.18,303.75,63
CPT,94669,OSCILLATION CHEST WALL MECH SESSN,522.0,101.27,20.04,391.5,63
CPT,94680,OXYGN UPTAKE REST&EXERCISE DIRECT,770.0,271.81,40.49,577.5,63
CPT,94681,OXYGN UPTAKE GAS EXPIRD OUTPUT CO2,763.0,269.34,37.57,657.01,63
CPT,94690,OXYGN UPTAKE REST CALORMTRY INDIRCT,734.0,259.1,40.35,550.5,63
CPT,94726,PLETHYSMOGRAPHY VOLUMES LUNG,640.0,225.92,43.08,657.01,63
CPT,94727,DILUT GAS/WASHOUT VOLUMES LUNG,519.0,183.21,32.09,389.25,63
CPT,94728,RESIST AIRWAY OSCILLOMETRY,334.0,117.9,31.44,250.5,63
CPT,94729,CAPACITY DIFFUSING,870.0,307.11,46.69,652.5,40
CPT,95070,CHALLENGE BROCH INHAL W HISTAMINE,761.0,250.39,34.0,657.01,63
CPT,95700,EEG CONT SETUP ED TECH MIN CHAN 8,808.0,341.78,101.17,1328.01,63
CPT,95705,EEG CONT WO VID 2-12HR UNMNTR,1010.0,427.23,191.73,3000.05,63
CPT,95706,EEG CONT WO VID 2-12HR W INT MNTR,1162.0,491.53,191.73,3000.05,63
CPT,95707,EEG CONT WO VID 2-12HR W CONT MNTR,1263.0,534.25,191.73,3000.05,63
CPT,95708,EEG CONT WO VID 12-26HR UNMNTR,1515.0,640.84,283.13,3000.05,63
CPT,95709,EEG CONT WO VID 12-26HR W INT MNTR,1667.0,705.14,353.64,3000.05,63
CPT,95710,EEG CONT WO VID 12-26HR W CONT MNTR,1768.0,747.86,353.64,3000.05,63
CPT,95711,EEG CONT W VID 2-12HR UNMNTR,1263.0,534.25,191.73,3000.05,63
CPT,95712,EEG CONT W VID 2-12HR W INT MNTR,1453.0,614.62,191.73,3000.05,63
CPT,95713,EEG CONT W VID 2-12HR W CONT MNTR,1579.0,667.92,353.64,3000.05,63
CPT,95714,EEG CONT W VID 12-26HR UNMNTR,1894.0,801.16,283.13,2700.05,63
CPT,95715,EEG CONT W VID 12-26HR W INT MNTR,2084.0,881.53,353.64,3000.05,63
CPT,95716,EEG CONT W VID 12-26HR W CONT MNTR,2210.0,934.83,666.87,3000.05,63
CPT,95782,PSG W 4+ PARAM 0-5YRS,8391.0,3549.39,666.87,7531.93,63
CPT,95782,PSG W 4+PARAM 0-5YR RDC<7HRS,8391.0,3549.39,666.87,7531.93,40
CPT,95783,PSG W 4+ PARAM 0-5YR W CPAP RDC<7HR,8855.0,7907.52,640.0,7843.17,40
CPT,95783,PSG W 4+ PARAM 0-5YRS W CPAP,8855.0,7907.52,640.0,7843.17,63
CPT,95800,SLP UNATND HOM RT/SAT/ANLY&TIME,844.0,753.69,94.69,946.71,63
CPT,95800,SLP UNATND HOM RT/SAT/ANLY&TIME<6HR,844.0,753.69,94.69,946.71,40
CPT,95805,TEST LATENCY SLEEP MULT,4709.0,4205.14,353.64,3531.75,63
CPT,95805,TEST LATENCY SLEEP MULT PEDS,5887.0,5257.09,353.64,4415.25,63
CPT,95805,TEST LATENCY SLEEP MULT PEDS<4 NAPS,5887.0,5257.09,353.64,4415.25,40
CPT,95805,TEST LATENCY SLEEP MULT RDC<4 NAPS,4709.0,4205.14,353.64,3531.75,40
CPT,95806,SLP UNATND HOM RT/SAT/FLW&EFF,785.0,701.0,49.9,1051.88,63
CPT,95807,STUDY SLEEP ATTENDED PEDS RDC<6HR,3662.0,1549.03,342.28,3410.41,40
CPT,95810,PSG W 4+ PARAM 6+YRS,6000.0,2538.0,494.34,4945.1,63
CPT,95810,PSG W 4+ PARAM 6+YRS PEDS,7500.0,3172.5,494.34,5625.0,63
CPT,95810,PSG W 4+PARAM 6+YR PEDS RDC<6HRS,7500.0,3172.5,494.34,5625.0,40
CPT,95810,PSG W 4+PARAM 6+YR RDC<6HRS,6000.0,2538.0,494.34,4945.1,40
CPT,95811,PSG W 4+ PARAM 6+YR W CPAP PED<6HR,8647.0,3657.68,517.35,6485.25,40
CPT,95811,PSG W 4+ PARAM 6+YR W CPAP RDC<6HR,6917.0,2925.89,517.35,5486.04,40
CPT,95811,PSG W 4+ PARAM 6+YRS W CPAP,6917.0,2925.89,517.35,5486.04,63
CPT,95811,PSG W 4+ PARAM 6+YRS W CPAP PED,8647.0,3657.68,517.35,6485.25,63
CPT,95812,EEG EXTENDED 41-60MIN,1501.0,634.92,191.73,1500.03,63
CPT,95813,EEG EXTENDED 61-119MIN,1677.0,709.37,191.73,1676.57,63
CPT,95816,EEG AWAKE&DROWSY,1339.0,566.4,191.73,1338.91,63
CPT,95816,EEG AWAKE&DROWSY RDC,1339.0,566.4,191.73,1338.91,40
CPT,95819,EEG AWAKE&ASLEEP,1471.0,622.23,191.73,1470.56,63
CPT,95819,EEG AWAKE&ASLEEP RDC,1471.0,622.23,191.73,1470.56,40
CPT,95822,EEG COMA/SLEEP ONLY,1464.0,619.27,191.73,1463.31,63
CPT,95824,EEG EVAL DEATH CEREBRAL,1128.0,477.14,56.47,1463.31,63
CPT,95829,ELECTROCORTICOGRAM AT SURGERY,2628.0,1111.64,488.81,7331.17,39
CPT,95860,EMG NEEDLE 1 EXTREMITY,331.0,108.91,60.97,259.43,63
CPT,95861,EMG NEEDLE 2 EXTREMITIES,474.0,155.96,77.86,355.5,63
CPT,95863,EMG NEEDLE 3 EXTREMITIES,587.0,193.14,101.17,440.25,63
CPT,95864,EMG NEEDLE 4 EXTREMITIES,686.0,225.71,101.17,514.5,63
CPT,95865,EMG NEEDLE LARYNX,267.0,87.85,66.17,255.97,63
CPT,95867,EMG NEEDLE MUSC/S NRV CRANIAL UNI,346.0,113.84,63.9,380.18,63
CPT,95868,EMG NEEDLE MUSC/S NRV CRANIAL BI,353.0,116.15,75.26,380.18,63
CPT,95869,EMG NEEDLE MUSC/S THOR PARASPINAL,346.0,113.84,73.63,380.18,63
CPT,95870,EMG NEEDLE MUSC/S LTD,213.0,70.08,61.95,234.25,63
CPT,95874,EMG NEEDLE CHEMODENERVATION GD,350.0,115.16,55.5,262.5,39
CPT,95875,TEST LIMB ISCHEMIC W ACQ SPECIMEN,587.0,193.14,62.92,440.25,63
CPT,95885,EMG NEEDLE EXT DONE W STUDY LTD,237.0,77.98,42.51,303.26,40
CPT,95886,EMG NEEDLE EXT DONE W STUDY CMP,280.0,92.13,50.63,210.0,40
CPT,95887,EMG NEEDLE NON-EXT DONE W STUDY,173.0,56.92,32.18,172.02,40
CPT,95907,STUDIES CONDUCTION NERVE 1-2,346.0,113.84,37.28,380.18,63
CPT,95908,STUDIES CONDUCTION NERVE 3-4,416.0,136.88,45.72,415.02,63
CPT,95909,STUDIES CONDUCTION NERVE 5-6,500.0,164.52,55.14,499.76,63
CPT,95910,STUDIES CONDUCTION NERVE 7-8,645.0,212.22,70.06,657.01,63
CPT,95911,STUDIES CONDUCTION NERVE 9-10,749.0,246.44,80.12,748.35,63
CPT,95912,STUDIES CONDUCTION NERVE 11-12,847.0,278.69,90.47,846.67,63
CPT,95913,STUDIES CONDUCTION NERVE 13+,948.0,311.92,100.21,947.84,63
CPT,95925,SSEP STIM NERVE LIMBS UPPER,804.0,264.54,144.63,733.38,63
CPT,95926,SSEP STIM NERVE LIMBS LOWER,773.0,254.34,127.43,718.42,63
CPT,95928,CMEP STIM TRANSCRANIAL LIMBS UPPER,1374.0,1226.98,158.95,1511.98,63
CPT,95929,CMEP STIM TRANSCRANIAL LIMBS LOWER,1029.0,918.9,161.87,1000.86,63
CPT,95930,EVOK POTENT VIS CNS NO GLAUC W I&R,1399.0,460.31,47.99,1049.25,63
CPT,95937,TEST NEUROMUS JUNCTION EA NERVE,249.0,81.93,68.44,226.54,63
CPT,95938,SSEP STIM NERVE LIMBS UPR&LW,2007.0,660.36,321.76,2006.24,63
CPT,95939,CMEP STIM TRANSCRANIAL LIMBS UPR&LW,2770.0,911.41,430.44,2769.76,63
CPT,95940,MONITOR NEURO 1:1 IN OR 15MIN,254.0,226.82,31.17,711.0,78
CPT,95941,MONITOR NEURO OUT OR/MULTI IN OR HR,881.0,786.73,163.87,711.0,38
CPT,95954,EEG ACTIVATION PHARM/PHYSICAL,1116.0,472.07,275.87,1077.36,63
CPT,95955,EEG DURING SURGERY NONINTRACRANIAL,1364.0,576.97,134.65,1023.0,39
CPT,95957,EEG ANALYSIS DIGITAL,1086.0,459.38,188.4,1302.2,39
CPT,95958,TEST ACTIVATION WADA W EEG MONITOR,1377.0,582.47,450.28,1511.98,63
CPT,95961,MAPPING CORTICAL&SUBCORTICAL 1ST HR,1202.0,508.45,165.12,1511.98,63
CPT,95962,MAPPING CORTICAL&SUBCORTICAL ADD HR,754.0,318.94,106.38,934.0,40
CPT,95970,ANLYS NEUROSTIM WO REPROGRAMMING,341.0,304.51,18.35,711.0,63
CPT,95972,ANLYS NEUROSTIM CMPLX W PROGRAMMING,646.0,576.88,55.52,711.0,63
CPT,95976,ANLYS NEUROSTIM SMPL CRNL W PRG,466.0,416.14,26.93,711.0,63
CPT,95990,REFILL PUMP/RESV IMP W/WO ANLYS,572.0,169.88,87.75,945.0,126
CPT,95992,OT REPOSITIONING CANALITH PER DAY,243.0,33.53,34.91,283.0,39
CPT,95992,PT REPOSITIONING CANALITH PER DAY,243.0,25.27,34.91,283.0,39
CPT,95992,PTA REPOSITIONING CANALITH PER DAY,243.0,25.27,34.91,283.0,39
CPT,96105,ST EVAL/EXAM APHASIA W RPT PER HR,603.0,99.5,85.0,602.67,39
CPT,96110,OT SCRN DVLPMNTL W S&D INST STD,265.0,36.57,11.32,283.0,40
CPT,96110,ST SCRN DVLPMNTL W S&D INST STD,265.0,43.72,11.32,283.0,40
CPT,96112,OT TEST DVLPMNTL W RPT 1ST HR,688.0,226.37,101.17,1015.76,63
CPT,96112,PT TEST DVLPMNTL W RPT 1ST HR,688.0,226.37,101.17,1015.76,63
CPT,96112,ST TEST DVLPMNTL W RPT 1ST HR,688.0,226.37,101.17,1015.76,63
CPT,96113,OT TEST DVLPMNTL W RPT ADDL 30MIN,316.0,103.97,55.53,463.98,39
CPT,96113,PT TEST DVLPMNTL W RPT ADDL 30MIN,316.0,103.97,55.53,463.98,39
CPT,96113,ST TEST DVLPMNTL W RPT ADDL 30MIN,316.0,103.97,55.53,463.98,39
CPT,96125,ST TEST COGNITIVE HC PRO PER HR,687.0,113.36,85.0,686.15,39
CPT,96360,ED INF IV HYDRATION 31-60MIN,469.0,115.84,31.58,2503.0,64
CPT,96360,INF IV HYDRATION 31-60MIN,469.0,178.69,31.58,478.0,315
CPT,96361,ED INF IV HYDRATION ADDL HR,138.0,34.09,12.04,2503.0,64
CPT,96361,INF IV HYDRATION ADDL HR,138.0,52.58,12.04,478.0,315
CPT,96365,ED INF IV THRPY 1ST HR,882.0,217.85,61.03,2503.0,64
CPT,96365,INF IV THRPY 1ST HR,882.0,336.04,61.03,661.5,504
CPT,96366,ED INF IV THRPY ADDL HR,184.0,45.45,19.91,2503.0,64
CPT,96366,INF IV THRPY ADDL HR,184.0,70.1,19.91,478.0,504
CPT,96367,ED INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,71.38,27.7,2503.0,64
CPT,96367,INF IV THRPY SEQ DRUG NEW 1ST HR,289.0,110.11,27.7,478.0,315
CPT,96368,ED INF IV THRPY CONCURRENT,175.0,43.22,19.25,2503.0,40
CPT,96368,INF IV THRPY CONCURRENT,175.0,66.68,19.25,478.0,195
CPT,96372,ED INJ SUBQ/IM,176.0,43.47,14.06,2503.0,64
CPT,96372,INJ SUBQ/IM,176.0,52.27,14.06,945.0,504
CPT,96373,INJ INTRA-ARTERIAL,532.0,158.0,18.28,945.0,63
CPT,96374,ED INJ IVP DRUG INITIAL,585.0,144.5,35.77,2503.0,64
CPT,96374,INJ IVP DRUG INITIAL,585.0,173.74,35.77,945.0,378
CPT,96374,INJ IVP DRUG INITIAL INCMP TEST,585.0,173.74,35.77,945.0,63
CPT,96375,ED INJ IVP SEQ DRUG ADDL NEW,377.0,93.12,14.97,2503.0,64
CPT,96375,INJ IVP SEQ DRUG ADDL NEW,377.0,111.97,14.97,945.0,378
CPT,96376,ED INJ IVP SEQ DRUG ADDL SAME,198.0,48.91,9.45,2503.0,40
CPT,96376,INJ IVP SEQ DRUG ADDL SAME,198.0,58.81,9.45,945.0,234
CPT,96377,APPL INJECTOR ON-BODY,417.0,123.85,17.95,945.0,126
CPT,96401,CHEMO SUBQ/IM NONHORMONAL,562.0,187.71,44.93,950.0,252
CPT,96402,CHEMO SUBQ/IM HORMONAL,308.0,102.87,34.48,950.0,189
CPT,96405,CHEMO INTRALESIONAL LSN 1-7,246.0,82.16,43.93,950.0,63
CPT,96406,CHEMO INTRALESIONAL LSN 8+,357.0,119.24,68.44,950.0,63
CPT,96409,CHEMO IVP DRUG INITIAL,900.0,300.6,97.32,950.0,252
CPT,96411,CHEMO IVP DRUG ADDL,512.0,171.01,44.93,950.0,252
CPT,96413,CHEMO INF IV 1ST HR,979.0,334.82,125.88,1221.24,252
CPT,96415,CHEMO INF IV ADDL HR,225.0,76.95,27.02,950.0,252
CPT,96416,CHEMO IV HOME PMP EXT VNDR SUPPLIED,1028.0,351.58,123.87,1038.24,126
CPT,96417,CHEMO INF IV SEQ 1ST HR,461.0,157.66,44.93,950.0,252
CPT,96420,CHEMO PUSH INTRAARTERIAL,613.0,204.74,99.21,950.0,126
CPT,96446,CHEMO CAVITY PERTNL PORT/CATH,529.0,176.69,40.13,950.0,57
CPT,96450,CHEMO CNS REQ PUNCTURE SPINAL,747.0,249.5,117.45,950.0,315
CPT,96521,REFILL&MAINT PUMP PORTABLE,662.0,196.61,120.63,1053.28,189
CPT,96522,REFILL&MAINT PUMP IMPLANTABLE,653.0,193.94,114.46,945.0,126
CPT,96523,IRRG VAD IMP DELIVERY DRUG,257.0,76.33,24.33,945.0,189
CPT,96542,CHEMO SUBARACHNOID/INTRAVENTRICULAR,546.0,182.36,64.74,950.0,63
CPT,97010,OT MODALITY APPL HOT/COLD,61.0,8.42,6.18,283.0,36
CPT,97010,OTA MODALITY APPL HOT/COLD,61.0,8.42,6.18,283.0,36
CPT,97010,PT MODALITY APPL HOT/COLD,61.0,6.34,6.18,283.0,36
CPT,97010,PTA MODALITY APPL HOT/COLD,61.0,6.34,6.18,283.0,36
CPT,97012,PT MODALITY APPL TRACTION MECHANIC,121.0,12.58,13.8,283.0,39
CPT,97012,PTA MODALITY APPL TRACTION MECHANIC,121.0,12.58,13.8,283.0,39
CPT,97014,OT MODALITY APPL E-STIM UNATND OTH,106.0,14.63,12.12,283.0,39
CPT,97014,OT MODALITY APPL E-STIM UNATND ULC,106.0,14.63,12.12,283.0,39
CPT,97014,OTA MODALITY APPL E-STIM UNATND OTH,106.0,14.63,12.12,283.0,39
CPT,97014,OTA MODALITY APPL E-STIM UNATND ULC,106.0,14.63,12.12,283.0,39
CPT,97014,PT MODALITY APPL E-STIM UNATND OTH,106.0,11.02,12.12,283.0,39
CPT,97014,PT MODALITY APPL E-STIM UNATND ULC,106.0,11.02,12.12,283.0,39
CPT,97014,PTA MODALITY APPL E-STIM UNATND OTH,106.0,11.02,12.12,283.0,39
CPT,97014,PTA MODALITY APPL E-STIM UNATND ULC,106.0,11.02,12.12,283.0,39
CPT,97016,OT MODALITY APPL DEV VASOPNEUMATIC,107.0,14.77,11.47,283.0,39
CPT,97016,OTA MODALITY APPL DEV VASOPNEUMATIC,107.0,14.77,11.47,283.0,39
CPT,97016,PT MODALITY APPL DEV VASOPNEUMATIC,107.0,11.13,11.47,283.0,39
CPT,97016,PTA MODALITY APPL DEV VASOPNEUMATIC,107.0,11.13,11.47,283.0,39
CPT,97018,OT MODALITY APPL BATH PARAFFIN,66.0,9.11,5.53,283.0,39
CPT,97018,OTA MODALITY APPL BATH PARAFFIN,66.0,9.11,5.53,283.0,39
CPT,97018,PT MODALITY APPL BATH PARAFFIN,66.0,6.86,5.53,283.0,39
CPT,97018,PTA MODALITY APPL BATH PARAFFIN,66.0,6.86,5.53,283.0,39
CPT,97022,OT MODALITY APPL WHIRLPOOL,133.0,18.35,16.65,283.0,39
CPT,97022,OTA MODALITY APPL WHIRLPOOL,133.0,18.35,16.65,283.0,39
CPT,97022,PT MODALITY APPL WHIRLPOOL,133.0,13.83,16.65,283.0,39
CPT,97022,PTA MODALITY APPL WHIRLPOOL,133.0,13.83,16.65,283.0,39
CPT,97032,OT MODALITY APPL E-STIM MAN 15MN,139.0,19.18,14.12,283.0,39
CPT,97032,OTA MODALITY APPL E-STIM MAN 15MN,139.0,19.18,14.12,283.0,39
CPT,97032,PT MODALITY APPL E-STIM MAN 15MN,139.0,14.46,14.12,283.0,39
CPT,97032,PTA MODALITY APPL E-STIM MAN 15MN,139.0,14.46,14.12,283.0,39
CPT,97033,OT MODALITY APPL IONTOPHORES 15MN,195.0,26.91,19.0,283.0,39
CPT,97033,OTA MODALITY APPL IONTOPHORES 15MN,195.0,26.91,19.0,283.0,39
CPT,97033,PT MODALITY APPL IONTOPHORES 15MN,195.0,20.28,19.0,283.0,39
CPT,97033,PTA MODALITY APPL IONTOPHORES 15MN,195.0,20.28,19.0,283.0,39
CPT,97035,OT MODALITY APPL ULTRASOUND 15MN,122.0,16.84,13.77,283.0,39
CPT,97035,OTA MODALITY APPL ULTRASOUND 15MN,122.0,16.84,13.77,283.0,39
CPT,97035,PT MODALITY APPL ULTRASOUND 15MN,122.0,12.69,13.77,283.0,39
CPT,97035,PTA MODALITY APPL ULTRASOUND 15MN,122.0,12.69,13.77,283.0,39
CPT,97110,OT THER EXERCISE 15MN,168.0,23.18,28.89,283.0,78
CPT,97110,OTA THER EXERCISE 15MN,168.0,23.18,28.89,283.0,39
CPT,97110,PT THER EXERCISE 15MN,168.0,17.47,28.89,283.0,78
CPT,97110,PTA THER EXERCISE 15MN,168.0,17.47,28.89,283.0,39
CPT,97112,OT THER NEUROMUS REEDUCATE 15MN,172.0,23.74,31.99,283.0,78
CPT,97112,OTA THER NEUROMUS REEDUCATE 15MN,172.0,23.74,31.99,283.0,39
CPT,97112,PT THER NEUROMUS REEDUCATE 15MN,172.0,17.89,31.99,283.0,78
CPT,97112,PTA THER NEUROMUS REEDUCATE 15MN,172.0,17.89,31.99,283.0,39
CPT,97116,OT THER TRAIN GAIT 15MN,181.0,24.98,28.89,283.0,39
CPT,97116,OTA THER TRAIN GAIT 15MN,181.0,24.98,28.89,283.0,39
CPT,97116,PT THER TRAIN GAIT 15MN,181.0,18.82,28.89,283.0,78
CPT,97116,PTA THER TRAIN GAIT 15MN,181.0,18.82,28.89,283.0,39
CPT,97124,OT THER MASSAGE 15MN,186.0,25.67,29.79,283.0,78
CPT,97124,OTA THER MASSAGE 15MN,186.0,25.67,29.79,283.0,39
CPT,97124,PT THER MASSAGE 15MN,186.0,19.34,29.79,283.0,78
CPT,97124,PTA THER MASSAGE 15MN,186.0,19.34,29.79,283.0,39
CPT,97129,OT SKILLS DEVLPMT COGNITIVE 15MN,142.0,19.6,21.8,283.0,78
CPT,97129,OTA SKILLS DEVLPMT COGNITIVE 15MN,142.0,19.6,21.8,283.0,39
CPT,97129,ST SKILLS DEVLPMT COGNITIVE 15MN,142.0,23.43,21.8,283.0,39
CPT,97130,OT SKILLS DEVLPMT COGNITIVE AD 15MN,131.0,18.08,20.81,283.0,78
CPT,97130,OTA SKILL DEVLPMT COGNITIVE AD 15MN,131.0,18.08,20.81,283.0,39
CPT,97130,ST SKILLS DEVLPMT COGNITIVE AD 15MN,131.0,21.62,20.81,283.0,39
CPT,97140,OT THERAPY MANUAL 15MN,169.0,23.32,26.61,283.0,78
CPT,97140,OTA THERAPY MANUAL 15MN,169.0,23.32,26.61,283.0,39
CPT,97140,PT THERAPY MANUAL 15MN,169.0,17.58,26.61,283.0,78
CPT,97140,PTA THERAPY MANUAL 15MN,169.0,17.58,26.61,283.0,39
CPT,97150,OT THER GROUP,120.0,39.48,17.73,283.0,39
CPT,97150,OTA THER GROUP,120.0,39.48,17.73,283.0,39
CPT,97150,PT THER GROUP,120.0,39.48,17.73,283.0,39
CPT,97150,PTA THER GROUP,120.0,39.48,17.73,283.0,39
CPT,97161,PT EVAL THERAPY LOW,424.0,73.78,78.86,531.03,78
CPT,97162,PT EVAL THERAPY MOD,559.0,97.27,85.0,558.97,78
CPT,97163,PT EVAL THERAPY HIGH,606.0,105.44,85.0,558.97,78
CPT,97164,PT RE-EVAL THERAPY,368.0,64.03,68.45,379.96,78
CPT,97165,OT EVAL THERAPY LOW,424.0,67.42,78.86,541.74,78
CPT,97166,OT EVAL THERAPY MOD,559.0,88.88,85.0,541.74,78
CPT,97167,OT EVAL THERAPY HIGH,606.0,96.35,85.0,541.74,78
CPT,97168,OT RE-EVAL THERAPY,368.0,58.51,68.45,358.08,78
CPT,97530,OT THER ACTIVITIES 15MN,218.0,30.08,36.03,283.0,78
CPT,97530,OTA THER ACTIVITIES 15MN,218.0,30.08,36.03,283.0,39
CPT,97530,PT THER ACTIVITIES 15MN,218.0,22.67,36.03,283.0,78
CPT,97530,PTA THER ACTIVITIES 15MN,218.0,22.67,36.03,283.0,39
CPT,97533,OT TECHNIQUES SENSORY 15MN,155.0,21.39,28.83,283.0,78
CPT,97533,OTA TECHNIQUES SENSORY 15MN,155.0,21.39,28.83,283.0,39
CPT,97533,PT TECHNIQUES SENSORY 15MN,155.0,16.12,28.83,283.0,39
CPT,97533,PTA TECHNIQUES SENSORY 15MN,155.0,16.12,28.83,283.0,39
CPT,97533,ST TECHNIQUES SENSORY 15MN,155.0,25.58,28.83,283.0,39
CPT,97535,OT MANAGEMENT SELF-CARE/HOME 15MN,241.0,33.26,32.14,283.0,78
CPT,97535,OTA MANAGEMENT SELF-CARE/HOME 15MN,241.0,33.26,32.14,283.0,39
CPT,97535,PT MANAGEMENT SELF-CARE/HOME 15MN,241.0,25.06,32.14,283.0,78
CPT,97535,PTA MANAGEMENT SELF-CARE/HOME 15MN,241.0,25.06,32.14,283.0,39
CPT,97535,ST MANAGEMENT SELF-CARE/HOME 15MN,241.0,39.76,32.14,283.0,39
CPT,97537,OT REINTEGRATION COMM/WORK 15MN,156.0,21.53,29.02,283.0,39
CPT,97537,OTA REINTEGRATION COMM/WORK 15MN,156.0,21.53,29.02,283.0,39
CPT,97537,PT REINTEGRATION COMM/WORK 15MN,156.0,16.22,29.02,283.0,39
CPT,97537,PTA REINTEGRATION COMM/WORK 15MN,156.0,16.22,29.02,283.0,39
CPT,97542,OT MANAGEMENT WHEELCHAIR 15MN,162.0,22.36,30.13,283.0,78
CPT,97542,OTA MANAGEMENT WHEELCHAIR 15MN,162.0,22.36,30.13,283.0,39
CPT,97542,PT MANAGEMENT WHEELCHAIR 15MN,162.0,16.85,30.13,283.0,78
CPT,97542,PTA MANAGEMENT WHEELCHAIR 15MN,162.0,16.85,30.13,283.0,39
CPT,97597,DEBRIDE SLCT WND OPEN 1ST 20CM,522.0,270.4,34.48,666.6,126
CPT,97598,DEBRIDE SLCT WND OPEN ADDL 20CM,334.0,173.01,23.87,333.33,80
CPT,97602,DEBRIDE NONSELECT WO ANES SESSN,295.0,152.81,83.39,363.86,63
CPT,97602,PT DEBRIDE NONSELECT WO ANES SESSN,295.0,30.68,54.87,363.86,40
CPT,97602,PTA DEBRIDE NONSELECT WO ANES SESSN,295.0,30.68,54.87,363.86,40
CPT,97605,WOUND NEG PRESS W DME 0-50 SC,318.0,164.72,23.79,363.86,126
CPT,97606,WOUND NEG PRESS W DME 51+ SC,581.0,300.96,26.1,715.75,126
CPT,97607,WOUND NEG PRESS NONDME 0-50 SC,792.0,410.26,250.73,715.75,126
CPT,97608,WOUND NEG PRESS NONDME 51+ SC,914.0,473.45,250.73,715.75,126
CPT,97610,OT THERAPY MIST,322.0,44.44,46.4,416.69,36
CPT,97610,PT THERAPY MIST,322.0,33.49,46.4,416.69,72
CPT,97610,PTA THERAPY MIST,322.0,33.49,46.4,416.69,36
CPT,97610,THERAPY MIST PER DAY,322.0,166.8,46.4,416.69,118
CPT,97750,PT MEAS/TEST PERFORMANCE 15MIN,205.0,21.32,33.44,283.0,78
CPT,97750,PTA MEAS/TEST PERFORMANCE 15MIN,205.0,21.32,33.44,283.0,39
CPT,97755,OT ASSESSMENT ASSIST TECH 15MN,177.0,24.43,32.92,283.0,39
CPT,97755,PT ASSESSMENT ASSIST TECH 15MN,177.0,18.41,32.92,283.0,39
CPT,97760,OT TRAIN ORTHO UE/LE INIT 15MN,177.0,24.43,32.92,283.0,78
CPT,97760,OTA TRAIN ORTHO UE/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CPT,97760,PT TRAIN ORTHO UE/LE INIT 15MN,177.0,18.41,32.92,283.0,78
CPT,97760,PTA TRAIN ORTHO UE/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CPT,97761,OT TRAIN PROSTH UE&/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CPT,97761,OTA TRAIN PROSTH UE&/LE INIT 15MN,177.0,24.43,32.92,283.0,39
CPT,97761,PT TRAIN PROSTH UE&/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CPT,97761,PTA TRAIN PROSTH UE&/LE INIT 15MN,177.0,18.41,32.92,283.0,39
CPT,97763,OT TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,26.36,35.53,329.34,78
CPT,97763,OTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,26.36,35.53,329.34,39
CPT,97763,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,19.86,35.53,329.34,78
CPT,97763,PTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,191.0,19.86,35.53,329.34,39
CPT,99151,ED SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,39
CPT,99151,SED MOD SAME 0-4Y INIT 15MN,525.0,166.95,23.34,393.75,468
CPT,99152,ED SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CPT,99152,SED MOD ENDO SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,39
CPT,99152,SED MOD SAME 5+Y INIT 15MN,580.0,184.44,11.77,435.0,546
CPT,99153,ED SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,39
CPT,99153,SED MOD SAME ADDL 15MN,265.0,84.27,11.28,198.75,546
CPT,99155,ED SED MOD DIFF 0-4Y INIT 15MN,525.0,166.95,80.25,752.08,39
CPT,99155,SED MOD DIFF 0-4Y INIT 15MN,525.0,166.95,80.25,752.08,390
CPT,99156,ED SED MOD DIFF 5+Y INIT 15MN,580.0,184.44,72.74,614.45,39
CPT,99156,SED MOD DIFF 5+Y INIT 15MN,580.0,184.44,72.74,614.45,390
CPT,99157,ED SED MOD DIFF ADDL 15MN,265.0,84.27,49.29,465.97,39
CPT,99157,SED MOD DIFF ADDL 15MN,265.0,84.27,49.29,465.97,390
CPT,99195,PHLEBOTOMY THERAPEUTIC,897.0,266.41,81.16,945.0,252
CPT,99202,VISIT NEW LEVEL 1,160.0,76.16,29.76,120.0,280
CPT,99202,VISIT NEW LEVEL 2,270.0,128.52,46.21,202.5,280
CPT,99202,VISIT OB TRIAGE NEW LEVEL 1,845.0,643.04,46.21,1318.0,34
CPT,99202,VISIT OB TRIAGE NEW LEVEL 2,1625.0,1236.62,46.21,1318.0,34
CPT,99203,VISIT NEW LEVEL 3,375.0,178.5,54.54,281.25,280
CPT,99203,VISIT OB TRIAGE NEW LEVEL 3,2430.0,1849.23,54.54,1822.5,34
CPT,99204,VISIT NEW LEVEL 4,480.0,228.48,54.54,360.0,280
CPT,99204,VISIT OB TRIAGE NEW LEVEL 4,2925.0,2225.93,54.54,2193.75,34
CPT,99205,VISIT NEW LEVEL 5,590.0,280.84,54.54,442.5,280
CPT,99205,VISIT OB TRIAGE NEW LEVEL 5,3915.0,2979.32,54.54,2936.25,34
CPT,99211,VISIT ESTABLISHED LEVEL 1,135.0,64.26,8.55,101.25,308
CPT,99211,VISIT OB TRIAGE ESTABLISHED LEVEL 1,320.0,243.52,8.55,1318.0,34
CPT,99212,VISIT ESTABLISHED LEVEL 2,215.0,102.34,34.42,161.25,280
CPT,99212,VISIT OB TRIAGE ESTABLISHED LEVEL 2,810.0,616.41,34.42,1318.0,34
CPT,99213,VISIT ESTABLISHED LEVEL 3,320.0,152.32,54.54,240.0,280
CPT,99213,VISIT OB TRIAGE ESTABLISHED LEVEL 3,1625.0,1236.62,54.54,1318.0,34
CPT,99214,VISIT ESTABLISHED LEVEL 4,430.0,204.68,54.54,322.5,280
CPT,99214,VISIT OB TRIAGE ESTABLISHED LEVEL 4,2505.0,1906.3,54.54,1878.75,34
CPT,99215,VISIT ESTABLISHED LEVEL 5,535.0,254.66,54.54,401.25,280
CPT,99215,VISIT OB TRIAGE ESTABLISHED LEVEL 5,3525.0,2682.52,54.54,2643.75,34
CPT,99281,ED VISIT LEVEL 1,725.0,219.99,11.12,2503.0,58
CPT,99282,ED VISIT LEVEL 2,1280.0,493.41,40.62,2503.0,58
CPT,99283,ED VISIT LEVEL 3,1835.0,916.94,69.13,2503.0,58
CPT,99284,ED VISIT LEVEL 4,2935.0,1461.69,117.63,2503.0,58
CPT,99285,ED VISIT LEVEL 5,3610.0,1508.88,170.4,2707.5,58
CPT,99291,ED VISIT CRITICAL CARE 1ST 30-74MIN,10280.0,2539.16,206.85,7710.0,58
CPT,99292,ED VISIT CRITICAL CARE ADDL 30MIN,4495.0,1110.27,104.15,3371.25,34
CPT,99366,OT CONF TEAM HCP W PT&/FM 30+MN,206.0,28.43,38.32,283.0,33
CPT,99366,PT CONF TEAM HCP W PT&/FM 30+MN,206.0,21.42,38.32,283.0,33
CPT,99366,ST CONF TEAM HCP W PT&/FM 30+MN,206.0,33.99,38.32,283.0,33
CPT,99368,OT CONF TEAM HCP WO PT&/FM 30+MN,155.0,21.39,28.83,293.82,39
CPT,99368,PT CONF TEAM HCP WO PT&/FM 30+MN,155.0,16.12,28.83,293.82,39
CPT,99368,ST CONF TEAM HCP WO PT&/FM 30+MN,155.0,25.58,28.83,293.82,39
CPT,99406,VISIT SMK&TOB INTRM 3-10MIN,56.0,18.43,8.07,98.05,118
CPT,C5275,"APPLICATION OF LOW COST SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ ",,,1727.0,6689.0,6
CPT,C5276,"APPLICATION OF LOW COST SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIO",,,1229.0,5681.0,4
CPT,C7555,"THYROIDECTOMY, TOTAL OR COMPLETE WITH PARATHYROID AUTOTRANSPLANTATION",,,4900.0,11751.0,13
CPT,C9739,"CYSTOURETHROSCOPY, WITH INSERTION OF TRANSPROSTATIC IMPLANT; 1 TO 3 IMPLANTS",,,3200.08,18194.0,51
CPT,C9740,"CYSTOURETHROSCOPY, WITH INSERTION OF TRANSPROSTATIC IMPLANT; 4 OR MORE IMPLANTS",,,5987.14,20704.35,49
CPT,C9776,"INTRAOPERATIVE NEAR-INFRARED FLUORESCENCE IMAGING OF MAJOR EXTRA-HEPATIC BILE DUCT(S) (E.G., CYSTIC DUCT, COMMON BILE DUCT AND COMMON HEPATIC DUCT) WITH INTRAVENOUS ADMINISTRATION OF INDOCYANINE GREEN",,,982.0,4664.0,10
CPT,C9779,"ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD), INCLUDING ENDOSCOPY OR COLONOSCOPY, MUCOSAL CLOSURE, WHEN PERFORMED",,,2273.53,18194.0,51
CPT,C9785,"ENDOSCOPIC OUTLET REDUCTION, GASTRIC POUCH APPLICATION, WITH ENDOSCOPY AND INTRALUMINAL TUBE INSERTION, IF PERFORMED, INCLUDING ALL SYSTEM AND TISSUE ANCHORING COMPONENTS",,,4299.0,18715.8,49
CPT,G0104,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,,,55.07,5681.0,50
CPT,G0105,Colorectal cancer screening; colonoscopy on individual at high risk,,,177.9,4596.53,52
CPT,G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,178.19,4596.53,52
CPT,G0413,"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, (INCLUDES ILIUM, SACROILIAC JOINT AND",,,1042.59,18194.0,47
HCPCS,90647,HIB-PRP-OMP 3DOSE/0.5ML 0.5ML IM,122.0,5.86,22.69,218.78,40
HCPCS,A2032,MYRIAD MATRIX FIX INT 10X10 THIN/SC,27.4,7.84,3.95,219.1,61
HCPCS,A2032,MYRIAD MATRIX FIX INT 10X20 THIN/SC,28.0,8.01,4.03,219.1,61
HCPCS,A2032,MYRIAD MATRIX FIX INT 20X20 THIN/SC,27.4,7.84,3.95,219.1,61
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 01,166.0,47.48,23.92,1044.96,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 02,313.0,89.52,45.1,1044.96,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 03,594.0,169.88,85.6,1044.96,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 04,1413.0,404.12,203.61,1059.75,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 05,2695.0,770.77,388.35,2021.25,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 06,3853.0,1101.96,555.22,2889.75,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 07,6105.0,1746.03,769.35,4578.75,38
HCPCS,A4264,IMP DEV OCCL I-TUBAL CONTRCP LVL 08,11580.0,3311.88,769.35,8685.0,38
HCPCS,A4335,DEVICE SYS DIVRT FECAL INCNT LVL 01,166.0,35.69,30.88,124.5,39
HCPCS,A4335,DEVICE SYS DIVRT FECAL INCNT LVL 02,313.0,67.3,36.73,234.75,39
HCPCS,A4335,DEVICE SYS DIVRT FECAL INCNT LVL 03,594.0,127.71,36.73,445.5,39
HCPCS,A4335,DEVICE SYS DIVRT FECAL INCNT LVL 04,1413.0,303.8,36.73,1059.75,39
HCPCS,A4648,IMP MARKER TISSUE LVL 01,313.0,89.52,58.22,234.75,42
HCPCS,A4648,IMP MARKER TISSUE LVL 02,594.0,169.88,110.48,445.5,42
HCPCS,A4648,IMP MARKER TISSUE LVL 03,1132.0,323.75,149.28,849.0,42
HCPCS,A4648,IMP MARKER TISSUE LVL 04,1894.0,541.68,149.28,1420.5,42
HCPCS,A4648,IMP MARKER TISSUE LVL 05,2580.0,737.88,149.28,1935.0,42
HCPCS,A4648,IMP MARKER TISSUE LVL 06,3355.0,959.53,149.28,2516.25,42
HCPCS,A9500,RRX TC-99 SESTAMIBI DX/DOSE,277.9,99.49,51.69,469.7,34
HCPCS,A9502,RRX TETROFOSMIN DX/DOSE,820.0,293.56,85.27,615.0,34
HCPCS,A9503,RRX TC99 MEDRONATE/0-30MCI DOSE,354.3,126.84,13.0,265.73,34
HCPCS,A9512,RRX PERTECHNETATE DX/MCI,3.0,1.07,0.558,6.79,34
HCPCS,A9516,RRX I-123 IOD NA DX/100UCI <1MCI,207.0,74.11,38.5,467.44,34
HCPCS,A9517,RRX I-131 IOD NA THPY/MCI CAP,132.0,53.72,18.5,163.78,61
HCPCS,A9520,RRX TC-99 TILMANOCEPT/0.5MCI INJ,2399.5,859.02,446.31,2608.78,34
HCPCS,A9521,RRX EXAMETAZIME DX/0-25MCI DOSE,7586.0,2715.79,641.87,6758.7,34
HCPCS,A9524,RRX I-131 ALBUMIN SERUM DX/5UCI,232.0,83.06,43.15,7369.09,34
HCPCS,A9526,RRX N13 AMMONIA DX/0-40MCI DOSE,1375.0,492.25,255.75,2858.5,34
HCPCS,A9527,RRX I-125 IOD NA THR/MCI SOLN,352.0,143.26,50.72,683.0,56
HCPCS,A9528,RRX I-131 IOD NA DX/MCI CAP,373.0,133.53,0.01,279.75,34
HCPCS,A9529,RRX I-131 IOD NA DX/MCI SOLN,444.0,158.95,0.01,333.0,34
HCPCS,A9530,RRX I-131 IOD NA THR/MCI SOLN,109.0,44.36,9.66,81.75,61
HCPCS,A9537,RRX MEBROFENIN DX/0-15MCI DOSE,205.0,73.39,38.13,218.12,34
HCPCS,A9538,RRX PYROPHOSPHATE DX/0-25MCI DOSE,463.2,165.83,64.05,347.4,34
HCPCS,A9539,RRX PENTETATE DX/0-25MCI DOSE,228.0,81.62,35.72,171.0,28
HCPCS,A9540,RRX MAA DX/0-10MCI DOSE,127.0,45.47,23.62,118.27,34
HCPCS,A9541,RRX SULFUR COLLOID DX/0-20MCI DOSE,306.0,109.55,56.92,1054.34,34
HCPCS,A9543,RRX YTTR90 ZEV THR/0-40MCI DOSE,127245.0,51788.72,41609.11,267382.59,61
HCPCS,A9547,RRX INDIUM 111 OXYQ DX/0.5MCI,2816.0,1008.13,618.11,8300.57,58
HCPCS,A9548,RRX INDIUM 111 PENTETATE DX/0.5MCI,1585.0,567.43,572.23,3491.77,58
HCPCS,A9552,RRX F18 FDG DX/0-45MCI DOSE,2495.0,893.21,359.05,1871.25,32
HCPCS,A9553,RRX CHROMIUM 51 DX/0-250UCI DOSE,1411.0,505.14,352.62,3164.63,58
HCPCS,A9555,RRX RUBIDIUM RB82 DX/0-60MCI DOSE,1673.9,599.26,311.35,1801.3,34
HCPCS,A9557,RRX BICISATE DX/0-25MCI DOSE,2310.0,826.98,547.04,14891.17,58
HCPCS,A9558,RRX XENON 133 DX/10MCI,247.0,88.43,45.94,1036.12,34
HCPCS,A9560,RRX RBC LABELED DX/0-30MCI DOSE,626.0,224.11,106.48,469.5,34
HCPCS,A9561,RRX TC-99 OXIDRONATE/0-30MCI DOSE,460.2,164.75,50.16,345.15,28
HCPCS,A9562,RRX MERTIATIDE DX/0-15MCI DOSE,1144.0,409.55,212.78,3055.13,32
HCPCS,A9563,RRX NA PHOS 32 THR/MCI,2788.0,1134.72,143.3,2091.0,61
HCPCS,A9567,RRX DTPA AEROSOL DOSE 0-75MCI,279.0,99.88,24.23,209.25,34
HCPCS,A9568,RRX ARCITUMOMAB DX/0-45MCI DOSE,6955.0,2489.89,647.61,5216.25,28
HCPCS,A9569,RRX EXAMETAZIME WBC LABELED DX/DOSE,6945.0,2486.31,832.26,8515.96,58
HCPCS,A9570,RRX INDIUM-111 WBC LABELED DX/DOSE,3442.0,1232.24,825.11,16601.13,58
HCPCS,A9572,RRX INDIUM-111 PENTET DX/0-6MCI,9723.0,3480.83,1531.69,15260.62,58
HCPCS,A9579,GADOTERIDOL/1ML 7.5MMOL/15ML SNIV,7.0,0.34,1.3,5.25,36
HCPCS,A9580,RRX F18 SOD FLUOR DX/0-30MCI DOSE,733.0,262.41,136.34,1138.42,33
HCPCS,A9582,RRX I-123 IOBENG DX/0-15MCI DOSE,10594.0,3792.65,1659.85,20144.05,62
HCPCS,A9584,RRX I-123 IOFLUPANE DX/0-5MCI DOSE,5852.0,2095.02,1110.42,10221.06,58
HCPCS,A9586,RRX F18 FLORBETAPIR DX/0-10MCI DOSE,5790.0,2072.82,1755.7,6500.53,58
HCPCS,A9587,RRX GA-68 DOTATATE/0.1MCI 54MCI MDV,132.0,47.26,40.87,239.21,58
HCPCS,A9591,RRX F18 FLUOROESTRADIOL DX/1MCI,2.6,0.93,0.8502,3123.78,62
HCPCS,A9592,RRX COPPER CU64 DOTATATE/1MCI INJ,2868.5,1026.92,476.08,3795.43,62
HCPCS,A9595,RRX F18 PIFLUFOLASTAT/1MCI,1632.5,584.43,265.95,2498.09,62
HCPCS,A9596,RRX GA-68 GOZT/1MCI 50MCI/7.5ML MDV,292.6,104.75,95.68,4277.7,62
HCPCS,A9604,RRX SM153 LEXI THR/0-150MCI DOSE,20167.0,8207.97,3159.8,64208.36,61
HCPCS,A9606,RRX RADIUM RA223 DICHLORIDE/UCI,392.0,159.54,137.78,666.46,60
HCPCS,A9608,RRX F18 FLOTUFOLASTAT/1MCI,1978.7,708.37,536.98,1484.03,62
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 01,313.0,67.3,58.22,234.75,39
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 02,1413.0,303.8,135.66,1059.75,39
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 03,2695.0,579.42,135.66,2021.25,39
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 04,3853.0,828.4,135.66,2889.75,39
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 05,6105.0,1312.58,135.66,4578.75,39
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 06,9265.0,1991.98,135.66,6948.75,39
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 07,13895.0,2987.42,135.66,10421.25,39
HCPCS,C1062,IMP SYS VERTEBRAL AUG SPINEJACK,13720.0,3923.92,2551.92,13802.9,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 01,313.0,89.52,58.22,978.38,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 02,1413.0,404.12,262.82,1059.75,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 04,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 05,6105.0,1746.03,720.32,4578.75,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 06,9265.0,2649.79,720.32,6948.75,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 07,13895.0,3973.97,720.32,10421.25,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 08,17524.0,5011.86,720.32,13143.0,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 09,21904.0,6264.54,720.32,16428.0,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 10,26284.0,7517.22,720.32,19713.0,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 11,30664.0,8769.9,720.32,22998.0,42
HCPCS,C1602,IMP MTRX FILLER BONE DE LVL 12,35044.0,10022.58,720.32,26283.0,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 01,17520.0,5308.56,3258.72,41774.56,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 02,21904.0,6636.91,4074.14,41774.56,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 03,26284.0,7964.05,4888.82,41774.56,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 04,43804.0,13272.61,8147.54,41774.56,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 05,65704.0,19908.31,12220.94,49278.0,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 06,87604.0,26544.01,16294.34,65703.0,42
HCPCS,C1605,IMP PCMKR DUAL LEADLESS RR LVL 07,109504.0,33179.71,20367.74,82128.0,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 01,70.0,20.02,13.02,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 02,102.0,29.17,18.97,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 03,166.0,47.48,30.88,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 04,221.0,63.21,41.11,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 05,313.0,89.52,58.22,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 06,447.0,127.84,83.14,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 07,594.0,169.88,110.48,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 08,850.0,243.1,158.1,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 09,1132.0,323.75,210.55,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 10,1413.0,404.12,262.82,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 11,1619.0,463.03,301.13,1363.66,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 12,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 13,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 14,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 15,6105.0,1746.03,1003.99,4578.75,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 16,6950.0,1987.7,1003.99,5212.5,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 17,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 18,11580.0,3311.88,1003.99,8685.0,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 19,13895.0,3973.97,1003.99,10421.25,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 20,17524.0,5011.86,1003.99,13143.0,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 21,21904.0,6264.54,1003.99,16428.0,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 22,26284.0,7517.22,1003.99,19713.0,42
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 23,30664.0,8769.9,1003.99,22998.0,42
HCPCS,C1713,IMP BLADE LVL 01,1413.0,404.12,262.82,1363.66,42
HCPCS,C1713,IMP BLADE LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP BLADE LVL 03,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1713,IMP BOLT LVL 01,709.0,202.77,131.87,1363.66,42
HCPCS,C1713,IMP BOLT LVL 02,1413.0,404.12,262.82,1363.66,42
HCPCS,C1713,IMP BOLT LVL 03,2157.0,616.9,401.2,1617.75,42
HCPCS,C1713,IMP BOLT LVL 04,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1713,IMP BOLT LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1713,IMP BOLT LVL 06,6950.0,1987.7,1003.99,5212.5,42
HCPCS,C1713,IMP BOLT LVL 07,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP BOLT LVL 08,12506.0,3576.72,1003.99,9379.5,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 01,313.0,89.52,58.22,1363.66,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 02,850.0,243.1,158.1,1363.66,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 03,1619.0,463.03,301.13,1363.66,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 04,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 05,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 06,4880.0,1395.68,907.68,3660.0,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 07,5861.0,1676.25,1003.99,4395.75,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 08,6950.0,1987.7,1003.99,5212.5,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 09,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 10,11580.0,3311.88,1003.99,8685.0,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 11,13895.0,3973.97,1003.99,10421.25,42
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 12,17524.0,5011.86,1003.99,13143.0,42
HCPCS,C1713,IMP CEMENT LVL 01,313.0,89.52,58.22,1363.66,42
HCPCS,C1713,IMP CEMENT LVL 02,594.0,169.88,110.48,1363.66,42
HCPCS,C1713,IMP CEMENT LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP CEMENT LVL 04,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1713,IMP CEMENT LVL 05,6950.0,1987.7,1003.99,5212.5,42
HCPCS,C1713,IMP CEMENT LVL 06,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP CEMENT LVL 07,11580.0,3311.88,1003.99,8685.0,42
HCPCS,C1713,IMP CEMENT LVL 08,13895.0,3973.97,1003.99,10421.25,42
HCPCS,C1713,IMP CEMENT LVL 09,17524.0,5011.86,1003.99,13143.0,42
HCPCS,C1713,IMP CEMENT LVL 10,21904.0,6264.54,1003.99,16428.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 01,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 02,6105.0,1746.03,1003.99,4578.75,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 03,7413.0,2120.12,1003.99,5559.75,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 04,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 05,13895.0,3973.97,1003.99,10421.25,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 06,17524.0,5011.86,1003.99,13143.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 07,21904.0,6264.54,1003.99,16428.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 08,26284.0,7517.22,1003.99,19713.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 09,30664.0,8769.9,1003.99,22998.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 10,35044.0,10022.58,1003.99,26283.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 11,43804.0,12527.94,1003.99,32853.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 12,52564.0,15033.3,1003.99,39423.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 13,61324.0,17538.66,1003.99,45993.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 14,70084.0,20044.02,1003.99,52563.0,42
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 15,78844.0,22549.38,1003.99,59133.0,42
HCPCS,C1713,IMP PIN/WIRE LVL 01,313.0,89.52,58.22,1363.66,42
HCPCS,C1713,IMP PIN/WIRE LVL 02,594.0,169.88,110.48,1363.66,42
HCPCS,C1713,IMP PIN/WIRE LVL 03,850.0,243.1,158.1,1363.66,42
HCPCS,C1713,IMP PIN/WIRE LVL 04,1132.0,323.75,210.55,1363.66,42
HCPCS,C1713,IMP PIN/WIRE LVL 05,1413.0,404.12,262.82,1363.66,42
HCPCS,C1713,IMP PIN/WIRE LVL 06,1619.0,463.03,301.13,1363.66,42
HCPCS,C1713,IMP PIN/WIRE LVL 07,1888.0,539.97,351.17,1416.0,42
HCPCS,C1713,IMP PIN/WIRE LVL 08,2426.0,693.84,451.24,1819.5,42
HCPCS,C1713,IMP PIN/WIRE LVL 09,2827.0,808.52,525.82,2120.25,42
HCPCS,C1713,IMP PIN/WIRE LVL 10,3340.0,955.24,621.24,2505.0,42
HCPCS,C1713,IMP PIN/WIRE LVL 11,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1713,IMP PIN/WIRE LVL 12,6105.0,1746.03,1003.99,4578.75,42
HCPCS,C1713,IMP PIN/WIRE LVL 13,8107.0,2318.6,1003.99,6080.25,42
HCPCS,C1713,IMP PIN/WIRE LVL 14,10422.0,2980.69,1003.99,7816.5,42
HCPCS,C1713,IMP PIN/WIRE LVL 15,12737.0,3642.78,1003.99,9552.75,42
HCPCS,C1713,IMP PIN/WIRE LVL 16,13895.0,3973.97,1003.99,10421.25,42
HCPCS,C1713,IMP PIN/WIRE LVL 17,16210.0,4636.06,1003.99,12157.5,42
HCPCS,C1713,IMP PLATE CUST LVL 01,65704.0,18791.34,1003.99,49278.0,42
HCPCS,C1713,IMP PLATE CUST LVL 02,87604.0,25054.74,1003.99,65703.0,42
HCPCS,C1713,IMP PLATE CUST LVL 03,109504.0,31318.14,1003.99,82128.0,42
HCPCS,C1713,IMP PLATE CUST LVL 04,131404.0,37581.54,1003.99,98553.0,42
HCPCS,C1713,IMP PLATE LVL 01,313.0,89.52,58.22,1363.66,42
HCPCS,C1713,IMP PLATE LVL 02,594.0,169.88,110.48,1363.66,42
HCPCS,C1713,IMP PLATE LVL 03,850.0,243.1,158.1,1363.66,42
HCPCS,C1713,IMP PLATE LVL 04,1132.0,323.75,210.55,1363.66,42
HCPCS,C1713,IMP PLATE LVL 05,1619.0,463.03,301.13,1363.66,42
HCPCS,C1713,IMP PLATE LVL 06,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP PLATE LVL 07,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1713,IMP PLATE LVL 08,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1713,IMP PLATE LVL 09,6105.0,1746.03,1003.99,4578.75,42
HCPCS,C1713,IMP PLATE LVL 10,6950.0,1987.7,1003.99,5212.5,42
HCPCS,C1713,IMP PLATE LVL 11,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP PLATE LVL 12,11580.0,3311.88,1003.99,8685.0,42
HCPCS,C1713,IMP PLATE LVL 13,13895.0,3973.97,1003.99,10421.25,42
HCPCS,C1713,IMP PLATE LVL 14,15334.0,4385.52,1003.99,11500.5,42
HCPCS,C1713,IMP PLATE LVL 15,18400.0,5262.4,1003.99,13800.0,42
HCPCS,C1713,IMP PLATE LVL 16,21904.0,6264.54,1003.99,16428.0,42
HCPCS,C1713,IMP PLATE LVL 17,24094.0,6890.88,1003.99,18070.5,42
HCPCS,C1713,IMP PLATE LVL 18,26284.0,7517.22,1003.99,19713.0,42
HCPCS,C1713,IMP PLATE LVL 19,28474.0,8143.56,1003.99,21355.5,42
HCPCS,C1713,IMP PLATE LVL 20,30664.0,8769.9,1003.99,22998.0,42
HCPCS,C1713,IMP PLATE LVL 21,32854.0,9396.24,1003.99,24640.5,42
HCPCS,C1713,IMP PLATE LVL 22,35044.0,10022.58,1003.99,26283.0,42
HCPCS,C1713,IMP PLATE LVL 23,37234.0,10648.92,1003.99,27925.5,42
HCPCS,C1713,IMP PLATE LVL 24,39424.0,11275.26,1003.99,29568.0,42
HCPCS,C1713,IMP PLATE LVL 25,43804.0,12527.94,1003.99,32853.0,42
HCPCS,C1713,IMP PLATE LVL 26,48184.0,13780.62,1003.99,36138.0,42
HCPCS,C1713,IMP PLATE LVL 27,52564.0,15033.3,1003.99,39423.0,42
HCPCS,C1713,IMP PLATE LVL 28,56944.0,16285.98,1003.99,42708.0,42
HCPCS,C1713,IMP RING LVL 01,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP RING LVL 02,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1713,IMP RING LVL 03,4397.0,1257.54,817.84,3297.75,42
HCPCS,C1713,IMP ROD/NAIL LVL 01,313.0,89.52,58.22,1363.66,42
HCPCS,C1713,IMP ROD/NAIL LVL 02,850.0,243.1,158.1,1363.66,42
HCPCS,C1713,IMP ROD/NAIL LVL 03,1413.0,404.12,262.82,1363.66,42
HCPCS,C1713,IMP ROD/NAIL LVL 04,2695.0,770.77,501.27,2021.25,42
HCPCS,C1713,IMP ROD/NAIL LVL 05,3909.0,1117.97,727.07,2931.75,42
HCPCS,C1713,IMP ROD/NAIL LVL 06,5373.0,1536.68,999.38,4029.75,42
HCPCS,C1713,IMP ROD/NAIL LVL 07,6487.0,1855.28,1003.99,4865.25,42
HCPCS,C1713,IMP ROD/NAIL LVL 08,7876.0,2252.54,1003.99,5907.0,42
HCPCS,C1713,IMP ROD/NAIL LVL 09,9265.0,2649.79,1003.99,6948.75,42
HCPCS,C1713,IMP ROD/NAIL LVL 10,11580.0,3311.88,1003.99,8685.0,42
HCPCS,C1713,IMP ROD/NAIL LVL 11,15334.0,4385.52,1003.99,11500.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 12,19714.0,5638.2,1003.99,14785.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 13,24094.0,6890.88,1003.99,18070.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 14,28474.0,8143.56,1003.99,21355.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 15,32854.0,9396.24,1003.99,24640.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 16,37234.0,10648.92,1003.99,27925.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 17,41614.0,11901.6,1003.99,31210.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 18,45994.0,13154.28,1003.99,34495.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 19,54754.0,15659.64,1003.99,41065.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 20,65704.0,18791.34,1003.99,49278.0,42
HCPCS,C1713,IMP ROD/NAIL LVL 21,76654.0,21923.04,1003.99,57490.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 22,87604.0,25054.74,1003.99,65703.0,42
HCPCS,C1713,IMP ROD/NAIL LVL 23,98554.0,28186.44,1003.99,73915.5,42
HCPCS,C1713,IMP ROD/NAIL LVL 24,109504.0,31318.14,1003.99,82128.0,42
HCPCS,C1713,IMP STAPLE BONE LVL 01,166.0,47.48,30.88,1363.66,42
HCPCS,C1713,IMP STAPLE BONE LVL 02,447.0,127.84,83.14,1363.66,42
HCPCS,C1713,IMP STAPLE BONE LVL 03,709.0,202.77,131.87,1363.66,42
HCPCS,C1713,IMP STAPLE BONE LVL 04,991.0,283.43,184.33,1363.66,42
HCPCS,C1713,IMP STAPLE BONE LVL 05,1490.0,426.14,277.14,1363.66,42
HCPCS,C1713,IMP STAPLE BONE LVL 06,2157.0,616.9,401.2,1617.75,42
HCPCS,C1713,IMP STAPLE BONE LVL 07,3083.0,881.74,573.44,2312.25,42
HCPCS,C1713,IMP STAPLE BONE LVL 08,3909.0,1117.97,727.07,2931.75,42
HCPCS,C1713,IMP STAPLE BONE LVL 09,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1713,IMP STAPLE BONE LVL 10,5861.0,1676.25,1003.99,4395.75,42
HCPCS,C1713,IMP STAPLE BONE LVL 11,6487.0,1855.28,1003.99,4865.25,42
HCPCS,C1713,IMP STAPLE BONE LVL 12,7413.0,2120.12,1003.99,5559.75,42
HCPCS,C1713,IMP STAPLE BONE LVL 13,8339.0,2384.95,1003.99,6254.25,42
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 01,4885.0,1050.28,908.61,10952.52,39
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 02,9265.0,1991.98,1723.29,10952.52,39
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 03,13895.0,2987.42,2584.47,10952.52,39
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 04,17524.0,3767.66,3259.46,13143.0,39
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 01,166.0,35.69,30.88,745.56,39
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 02,588.0,126.42,109.37,745.56,39
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 01,43800.0,13271.4,8146.8,63194.0,42
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 02,65704.0,19908.31,12220.94,63194.0,42
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 03,87604.0,26544.01,16294.34,65703.0,42
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 04,109504.0,33179.71,20367.74,82128.0,42
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 05,131404.0,39815.41,24441.14,98553.0,42
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 01,43800.0,13271.4,8146.8,63194.0,42
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 02,65704.0,19908.31,12220.94,63194.0,42
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 03,87604.0,26544.01,16294.34,65703.0,42
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 04,109504.0,33179.71,20367.74,82128.0,42
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 01,4885.0,1050.28,908.61,10952.52,39
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 02,9265.0,1991.98,1723.29,10952.52,39
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 03,13895.0,2987.42,2584.47,10952.52,39
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 04,17524.0,3767.66,3259.46,13143.0,39
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 05,21904.0,4709.36,4074.14,16428.0,39
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 06,26284.0,5651.06,4888.82,19713.0,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 01,850.0,182.75,158.1,744.82,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 02,1413.0,303.8,262.82,1059.75,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 03,1888.0,405.92,351.17,1416.0,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 04,2695.0,579.42,501.27,2021.25,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 05,3083.0,662.84,548.37,2312.25,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 06,4397.0,945.36,548.37,3297.75,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 07,5861.0,1260.12,548.37,4395.75,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 08,7413.0,1593.8,548.37,5559.75,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 09,9265.0,1991.98,548.37,6948.75,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 10,12969.0,2788.34,548.37,9726.75,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 11,15772.0,3390.98,548.37,11829.0,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 12,19276.0,4144.34,548.37,14457.0,39
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 13,22780.0,4897.7,548.37,17085.0,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 01,1413.0,303.8,262.82,3297.73,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 02,2695.0,579.42,501.27,3297.73,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 03,4885.0,1050.28,908.61,3663.75,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 04,6950.0,1494.25,1292.7,5212.5,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 05,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 06,13895.0,2987.42,2427.94,10421.25,39
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 07,17524.0,3767.66,2427.94,13143.0,39
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 01,1413.0,404.12,262.82,1059.75,42
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 03,3853.0,1101.96,590.83,2889.75,42
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 04,6105.0,1746.03,590.83,4578.75,42
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 05,9265.0,2649.79,590.83,6948.75,42
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 06,13895.0,3973.97,590.83,10421.25,42
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 07,17524.0,5011.86,590.83,13143.0,42
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 01,594.0,127.71,110.48,445.5,39
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 02,1888.0,405.92,236.01,1416.0,39
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 03,2695.0,579.42,236.01,2021.25,39
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 04,3853.0,828.4,236.01,2889.75,39
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 01,594.0,169.88,110.48,445.5,42
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 02,1888.0,539.97,236.01,1416.0,42
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 03,2695.0,770.77,236.01,2021.25,42
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 04,3853.0,1101.96,236.01,2889.75,42
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 05,6105.0,1746.03,236.01,4578.75,42
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 01,594.0,127.71,110.48,1633.6,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 02,1132.0,243.38,210.55,1633.6,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 03,2157.0,463.76,401.2,1633.6,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 04,3083.0,662.84,573.44,2312.25,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 05,4885.0,1050.28,908.61,3663.75,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 06,9265.0,1991.98,1202.73,6948.75,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 07,13895.0,2987.42,1202.73,10421.25,39
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 08,17524.0,3767.66,1202.73,13143.0,39
HCPCS,C1731,CATH EP NON 3D 20+ LVL 01,3083.0,662.84,573.44,2968.92,39
HCPCS,C1731,CATH EP NON 3D 20+ LVL 02,5861.0,1260.12,1090.15,4395.75,39
HCPCS,C1731,CATH EP NON 3D 20+ LVL 03,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C1731,CATH EP NON 3D 20+ LVL 04,13895.0,2987.42,2185.85,10421.25,39
HCPCS,C1731,CATH EP NON 3D 20+ LVL 05,17524.0,3767.66,2185.85,13143.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 01,2157.0,463.76,401.2,6049.13,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 02,3083.0,662.84,573.44,6049.13,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 03,4885.0,1050.28,908.61,6049.13,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 04,11580.0,2489.7,2153.88,8685.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 05,17524.0,3767.66,3259.46,13143.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 06,21904.0,4709.36,4074.14,16428.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 07,26284.0,5651.06,4453.64,19713.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 08,30664.0,6592.76,4453.64,22998.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 09,35044.0,7534.46,4453.64,26283.0,39
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 10,39424.0,8476.16,4453.64,29568.0,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 01,1619.0,348.08,301.13,4990.33,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 02,3083.0,662.84,573.44,4990.33,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 03,4885.0,1050.28,908.61,4990.33,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 04,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 05,13895.0,2987.42,2584.47,10421.25,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 06,21028.0,4521.02,3674.1,15771.0,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 07,25408.0,5462.72,3674.1,19056.0,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 08,29788.0,6404.42,3674.1,22341.0,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 09,34168.0,7346.12,3674.1,25626.0,39
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 10,38548.0,8287.82,3674.1,28911.0,39
HCPCS,C1733,IDE G250226 CATH PFA FARAPOINT,4832.0,1589.87,898.75,4990.33,36
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 01,313.0,89.52,58.22,1629.74,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 02,1413.0,404.12,262.82,1629.74,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 04,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 05,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 06,9265.0,2649.79,1199.89,6948.75,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 07,13895.0,3973.97,1199.89,10421.25,42
HCPCS,C1734,IMP MTRX DEV/DRUG BN/TIS-BN LVL 08,17524.0,5011.86,1199.89,13143.0,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 01,313.0,89.52,58.22,407.44,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 02,1413.0,404.12,262.82,1059.75,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 03,2695.0,770.77,299.97,2021.25,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 04,3853.0,1101.96,299.97,2889.75,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 05,6105.0,1746.03,299.97,4578.75,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 06,9265.0,2649.79,299.97,6948.75,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 07,13895.0,3973.97,299.97,10421.25,42
HCPCS,C1737,IMP DEV/S FUSN&FIX JT SI&PEL LVL 08,17524.0,5011.86,299.97,13143.0,42
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 01,166.0,47.48,23.92,887.84,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 02,313.0,89.52,45.1,887.84,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 03,594.0,169.88,85.6,887.84,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 04,1413.0,404.12,203.61,1059.75,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 05,2695.0,770.77,388.35,2021.25,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 06,3853.0,1101.96,555.22,2889.75,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 07,6105.0,1746.03,653.67,4578.75,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 08,6950.0,1987.7,653.67,5212.5,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 09,9265.0,2649.79,653.67,6948.75,40
HCPCS,C1742,IMP SYS MNTR PRESS IM CMPRT LVL 10,11580.0,3311.88,653.67,8685.0,40
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 01,313.0,67.3,58.22,1537.74,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 02,1413.0,303.8,262.82,1537.74,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 03,2695.0,579.42,501.27,2021.25,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 04,3853.0,828.4,716.66,2889.75,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 05,6105.0,1312.58,1132.16,4578.75,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 06,9265.0,1991.98,1132.16,6948.75,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 07,13895.0,2987.42,1132.16,10421.25,39
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 08,17524.0,3767.66,1132.16,13143.0,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 01,313.0,67.3,58.22,2301.59,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 02,1413.0,303.8,262.82,2301.59,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 03,2695.0,579.42,501.27,2301.59,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 04,3853.0,828.4,716.66,2889.75,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 05,6105.0,1312.58,1135.53,4578.75,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 06,9265.0,1991.98,1694.54,6948.75,39
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 07,13895.0,2987.42,1694.54,10421.25,39
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 01,313.0,89.52,58.22,958.22,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 02,594.0,169.88,110.48,958.22,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 03,1132.0,323.75,210.55,958.22,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 04,1619.0,463.03,301.13,1214.25,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 05,2695.0,770.77,501.27,2021.25,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 06,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 07,4885.0,1397.11,705.48,3663.75,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 08,6950.0,1987.7,705.48,5212.5,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 09,7876.0,2252.54,705.48,5907.0,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 10,9265.0,2649.79,705.48,6948.75,42
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 11,11580.0,3311.88,705.48,8685.0,42
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 01,313.0,67.3,58.22,490.65,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 02,594.0,127.71,110.48,490.65,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 03,850.0,182.75,158.1,637.5,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 04,1132.0,243.38,210.55,849.0,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 05,1619.0,348.08,301.13,1214.25,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 06,2695.0,579.42,361.24,2021.25,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 07,4885.0,1050.28,361.24,3663.75,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 08,6950.0,1494.25,361.24,5212.5,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 09,9265.0,1991.98,361.24,6948.75,39
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 10,13895.0,2987.42,361.24,10421.25,39
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 01,313.0,67.3,58.22,490.65,39
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 02,594.0,127.71,110.48,490.65,39
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 03,1132.0,243.38,210.55,849.0,39
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 04,1619.0,348.08,301.13,1214.25,39
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 05,2157.0,463.76,361.24,1617.75,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 01,850.0,182.75,158.1,2467.89,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 02,2426.0,521.59,451.24,2467.89,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 03,3853.0,828.4,716.66,2889.75,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 04,4885.0,1050.28,908.61,3663.75,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 05,6950.0,1494.25,1292.7,5212.5,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 06,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 07,11580.0,2489.7,1816.97,8685.0,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 08,13895.0,2987.42,1816.97,10421.25,39
HCPCS,C1753,CATH INTRAVASCULAR US LVL 09,15334.0,3296.81,1816.97,11500.5,39
HCPCS,C1755,CATH INTRASPINAL LVL 01,166.0,35.69,30.88,1952.83,39
HCPCS,C1755,CATH INTRASPINAL LVL 02,313.0,67.3,58.22,1952.83,39
HCPCS,C1755,CATH INTRASPINAL LVL 03,594.0,127.71,110.48,1952.83,39
HCPCS,C1755,CATH INTRASPINAL LVL 04,1413.0,303.8,262.82,1952.83,39
HCPCS,C1755,CATH INTRASPINAL LVL 05,2695.0,579.42,501.27,2021.25,39
HCPCS,C1755,CATH INTRASPINAL LVL 06,3853.0,828.4,716.66,2889.75,39
HCPCS,C1755,CATH INTRASPINAL LVL 07,4885.0,1050.28,908.61,3663.75,39
HCPCS,C1757,CATH THROMBECTOMY/EMBO ARTIX PPP,25952.0,5579.68,575.51,19464.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBO DVT PPP,27531.0,5919.16,575.51,20648.25,39
HCPCS,C1757,CATH THROMBECTOMY/EMBO VTE PPP,37856.0,8139.04,575.51,28392.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 01,313.0,67.3,58.22,781.68,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 02,594.0,127.71,110.48,781.68,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 03,1132.0,243.38,210.55,849.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 04,2157.0,463.76,401.2,1617.75,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 05,3083.0,662.84,573.44,2312.25,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 06,4885.0,1050.28,575.51,3663.75,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 07,6950.0,1494.25,575.51,5212.5,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 08,9265.0,1991.98,575.51,6948.75,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 09,11580.0,2489.7,575.51,8685.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 10,13895.0,2987.42,575.51,10421.25,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 11,17524.0,3767.66,575.51,13143.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 12,21904.0,4709.36,575.51,16428.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 13,26284.0,5651.06,575.51,19713.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 14,32854.0,7063.61,575.51,24640.5,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 15,35044.0,7534.46,575.51,26283.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 16,39424.0,8476.16,575.51,29568.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 17,43804.0,9417.86,575.51,32853.0,39
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 18,48184.0,10359.56,575.51,36138.0,39
HCPCS,C1758,CATH URETERAL LVL 01,313.0,67.3,58.22,234.75,39
HCPCS,C1758,CATH URETERAL LVL 02,850.0,182.75,141.24,637.5,39
HCPCS,C1758,CATH URETERAL LVL 03,1888.0,405.92,141.24,1416.0,39
HCPCS,C1758,CATH URETERAL LVL 04,2827.0,607.8,141.24,2120.25,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 01,2690.0,578.35,500.34,2467.89,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 02,3596.0,773.14,668.86,2697.0,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 03,6487.0,1394.7,1206.58,4865.25,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 04,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 05,11580.0,2489.7,1816.97,8685.0,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 06,13895.0,2987.42,1816.97,10421.25,39
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 07,17524.0,3767.66,1816.97,13143.0,39
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 01,313.0,89.52,58.22,2334.85,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 02,594.0,169.88,110.48,2334.85,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 03,1132.0,323.75,210.55,2334.85,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 04,1619.0,463.03,301.13,2334.85,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 05,2157.0,616.9,401.2,2334.85,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 06,2695.0,770.77,501.27,2334.85,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 07,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 08,9265.0,2649.79,1719.02,6948.75,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 09,13895.0,3973.97,1719.02,10421.25,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 10,17524.0,5011.86,1719.02,13143.0,42
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 11,21904.0,6264.54,1719.02,16428.0,42
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 01,4885.0,1050.28,908.61,10952.52,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 02,6950.0,1494.25,1292.7,10952.52,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 03,9265.0,1991.98,1723.29,10952.52,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 04,11580.0,2489.7,2153.88,10952.52,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 05,13895.0,2987.42,2584.47,10952.52,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 06,15334.0,3296.81,2852.12,11500.5,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 07,17524.0,3767.66,3259.46,13143.0,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 08,19714.0,4238.51,3666.8,14785.5,39
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 09,21904.0,4709.36,4074.14,16428.0,39
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 01,2695.0,770.77,501.27,8965.57,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 02,4885.0,1397.11,908.61,8965.57,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 03,6950.0,1987.7,1292.7,8965.57,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 04,9265.0,2649.79,1723.29,8965.57,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 05,11580.0,3311.88,2153.88,8965.57,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 07,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 08,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 09,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 10,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 11,30664.0,8769.9,5703.5,22998.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 12,35044.0,10022.58,6518.18,26283.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 13,39424.0,11275.26,6600.85,29568.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 14,43804.0,12527.94,6600.85,32853.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 15,48184.0,13780.62,6600.85,36138.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 16,54754.0,15659.64,6600.85,41065.5,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 17,61324.0,17538.66,6600.85,45993.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 18,67894.0,19417.68,6600.85,50920.5,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 19,72274.0,20670.36,6600.85,54205.5,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 20,78844.0,22549.38,6600.85,59133.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 21,87604.0,25054.74,6600.85,65703.0,42
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 22,96364.0,27560.1,6600.85,72273.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 01,850.0,243.1,158.1,8418.7,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 02,2157.0,616.9,401.2,8418.7,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 03,3083.0,881.74,573.44,8418.7,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 04,4885.0,1397.11,908.61,8418.7,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 05,9265.0,2649.79,1723.29,8418.7,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 08,30664.0,8769.9,5703.5,22998.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 09,39424.0,11275.26,6198.23,29568.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 10,43804.0,12527.94,6198.23,32853.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 11,48184.0,13780.62,6198.23,36138.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 12,52564.0,15033.3,6198.23,39423.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 13,56944.0,16285.98,6198.23,42708.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 14,65704.0,18791.34,6198.23,49278.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 15,74464.0,21296.7,6198.23,55848.0,42
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 16,83224.0,23802.06,6198.23,62418.0,42
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 01,6105.0,1746.03,1135.53,41774.56,42
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 02,11575.0,3310.45,2152.95,41774.56,42
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 03,14892.0,4259.11,2769.91,41774.56,42
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 04,24970.0,7141.42,4644.42,41774.56,42
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 01,850.0,182.75,158.1,1201.48,39
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 02,2695.0,579.42,501.27,2021.25,39
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 03,4885.0,1050.28,884.59,3663.75,39
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 04,9265.0,1991.98,884.59,6948.75,39
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 01,850.0,243.1,158.1,1201.48,42
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 03,4885.0,1397.11,884.59,3663.75,42
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 04,9265.0,2649.79,884.59,6948.75,42
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 01,1413.0,303.8,262.82,2935.13,39
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 02,2695.0,579.42,501.27,2935.13,39
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 03,4885.0,1050.28,908.61,3663.75,39
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 04,6105.0,1312.58,1135.53,4578.75,39
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 05,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 01,28470.0,8142.42,5295.42,86476.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 02,43800.0,12526.8,8146.8,86476.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 03,65704.0,18791.34,12220.94,86476.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 04,87604.0,25054.74,16294.34,86476.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 05,109504.0,31318.14,20367.74,86476.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 06,131404.0,37581.54,24441.14,98553.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 07,153304.0,43844.94,28514.54,114978.0,42
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 08,175204.0,50108.34,32587.94,131403.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 01,594.0,169.88,110.48,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 02,1132.0,323.75,210.55,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 03,1619.0,463.03,301.13,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 04,2157.0,616.9,401.2,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 05,2695.0,770.77,501.27,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 06,3083.0,881.74,573.44,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 07,3909.0,1117.97,727.07,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 08,4885.0,1397.11,908.61,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 09,6950.0,1987.7,1292.7,5293.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 10,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 11,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 12,21904.0,6264.54,3896.94,16428.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 13,32854.0,9396.24,3896.94,24640.5,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 14,43804.0,12527.94,3896.94,32853.0,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 15,54754.0,15659.64,3896.94,41065.5,42
HCPCS,C1768,IMP GRAFT VASCULAR LVL 16,61324.0,17538.66,3896.94,45993.0,42
HCPCS,C1769,WIRE GUIDE LVL 01,166.0,35.69,30.88,1524.84,39
HCPCS,C1769,WIRE GUIDE LVL 02,313.0,67.3,58.22,1524.84,39
HCPCS,C1769,WIRE GUIDE LVL 03,594.0,127.71,110.48,1524.84,39
HCPCS,C1769,WIRE GUIDE LVL 04,850.0,182.75,158.1,1524.84,39
HCPCS,C1769,WIRE GUIDE LVL 05,1413.0,303.8,262.82,1524.84,39
HCPCS,C1769,WIRE GUIDE LVL 06,2695.0,579.42,501.27,2021.25,39
HCPCS,C1769,WIRE GUIDE LVL 07,4885.0,1050.28,908.61,3663.75,39
HCPCS,C1769,WIRE GUIDE LVL 08,6950.0,1494.25,1122.65,5212.5,39
HCPCS,C1769,WIRE GUIDE LVL 09,9265.0,1991.98,1122.65,6948.75,39
HCPCS,C1769,WIRE GUIDE LVL 10,11580.0,2489.7,1122.65,8685.0,39
HCPCS,C1769,WIRE GUIDE LVL 11,13895.0,2987.42,1122.65,10421.25,39
HCPCS,C1770,COIL IMAGING MAGNETIC RESON LVL 01,313.0,67.3,58.22,307.99,39
HCPCS,C1770,COIL IMAGING MAGNETIC RESON LVL 02,594.0,127.71,110.48,445.5,39
HCPCS,C1771,IMP DEV URINARY W SLING LVL 01,2690.0,769.34,500.34,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 02,4885.0,1397.11,908.61,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 03,6950.0,1987.7,1292.7,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 04,9265.0,2649.79,1723.29,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 05,11580.0,3311.88,2153.88,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 06,14020.0,4009.72,2607.72,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 07,17962.0,5137.13,3340.93,15395.12,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 08,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 09,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1771,IMP DEV URINARY W SLING LVL 10,30664.0,8769.9,5703.5,22998.0,42
HCPCS,C1772,IMP PUMP INF PRG LVL 01,6105.0,1746.03,1135.53,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 02,8112.0,2320.03,1508.83,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 03,10431.0,2983.27,1940.17,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 04,13895.0,3973.97,2584.47,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 05,19714.0,5638.2,3666.8,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 06,26284.0,7517.22,4888.82,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 07,32854.0,9396.24,6110.84,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 08,39424.0,11275.26,7332.86,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 09,46870.0,13404.82,8717.82,58151.78,42
HCPCS,C1772,IMP PUMP INF PRG LVL 10,51250.0,14657.5,9532.5,58151.78,42
HCPCS,C1773,DEVICE INSERT RETRV LVL 01,1132.0,243.38,210.55,1773.49,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 02,2157.0,463.76,401.2,1773.49,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 03,3596.0,773.14,668.86,2697.0,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 04,4397.0,945.36,817.84,3297.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 05,6105.0,1312.58,1135.53,4578.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 06,8107.0,1743.0,1305.72,6080.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 07,10422.0,2240.73,1305.72,7816.5,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 08,12737.0,2738.46,1305.72,9552.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 09,14239.0,3061.38,1305.72,10679.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 10,16429.0,3532.24,1305.72,12321.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 11,18619.0,4003.08,1305.72,13964.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 12,20809.0,4473.93,1305.72,15606.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 13,22999.0,4944.78,1305.72,17249.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 14,25189.0,5415.64,1305.72,18891.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 15,27379.0,5886.48,1305.72,20534.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 16,29569.0,6357.34,1305.72,22176.75,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 17,31759.0,6828.18,1305.72,23819.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 18,36139.0,7769.88,1305.72,27104.25,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 19,43366.0,9323.69,1305.72,32524.5,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 20,47746.0,10265.39,1305.72,35809.5,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 21,52126.0,11207.09,1305.72,39094.5,39
HCPCS,C1773,DEVICE INSERT RETRV LVL 22,56506.0,12148.79,1305.72,42379.5,39
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 04,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 05,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 07,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 09,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 10,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 11,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 12,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 13,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 14,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 15,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 16,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 17,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 18,61324.0,17538.66,5497.98,45993.0,42
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 19,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 01,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 07,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 08,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 09,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 10,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 11,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 12,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 13,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 14,61324.0,17538.66,5497.98,45993.0,42
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 15,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP DEV JT FINGER LVL 01,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP DEV JT FINGER LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT FINGER LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT FINGER LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT FINGER LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 02,1132.0,323.75,210.55,7467.6,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 03,1619.0,463.03,301.13,7467.6,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 04,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 05,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 07,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 09,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 10,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 11,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 12,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 13,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 14,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 15,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 16,87604.0,25054.74,5497.98,65703.0,42
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 17,109504.0,31318.14,5497.98,82128.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 01,1132.0,323.75,210.55,7467.6,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 02,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 03,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 04,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 08,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 09,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 10,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 11,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 12,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 13,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 14,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 15,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 16,61324.0,17538.66,5497.98,45993.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 17,70084.0,20044.02,5497.98,52563.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 18,78844.0,22549.38,5497.98,59133.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 19,87604.0,25054.74,5497.98,65703.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 20,96364.0,27560.1,5497.98,72273.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 21,109504.0,31318.14,5497.98,82128.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 22,122644.0,35076.18,5497.98,91983.0,42
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 23,135784.0,38834.22,5497.98,101838.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 04,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 05,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 07,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 09,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 10,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 11,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 12,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 13,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 14,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 15,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 16,55630.0,15910.18,5497.98,41722.5,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 17,61324.0,17538.66,5497.98,45993.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 18,70084.0,20044.02,5497.98,52563.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 19,78844.0,22549.38,5497.98,59133.0,42
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 20,87604.0,25054.74,5497.98,65703.0,42
HCPCS,C1776,IMP DEV JT TOE LVL 01,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP DEV JT TOE LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT TOE LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT TOE LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT TOE LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 01,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 07,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 08,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 09,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 10,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 02,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 03,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 04,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE BASE/TOP LVL 08,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 02,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 03,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 04,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 08,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 09,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 10,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 11,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 12,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 13,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 14,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 15,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 16,61324.0,17538.66,5497.98,45993.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 17,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE DOME LVL 18,70084.0,20044.02,5497.98,52563.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 02,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 03,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 04,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 08,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 09,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 10,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 11,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 12,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 13,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 14,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 15,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 16,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP RV/AD/RP ANKLE STEM LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE STEM LVL 02,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE STEM LVL 03,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE STEM LVL 04,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ANKLE STEM LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ANKLE STEM LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 02,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 03,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 04,5856.0,1674.82,1089.22,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 05,6487.0,1855.28,1206.58,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 06,7413.0,2120.12,1378.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 07,8339.0,2384.95,1551.05,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 09,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 10,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 12,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 13,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HUM/ULNR LVL 01,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HUM/ULNR LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HUM/ULNR LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HUM/ULNR LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HUM/ULNR LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW HUM/ULNR LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW INSERT LVL 01,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW INSERT LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW INSERT LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ELBOW INSERT LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 01,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 02,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 03,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 04,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 05,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 06,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 07,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 04,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 05,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CN/CALC/SP LVL 01,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CN/CALC/SP LVL 02,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CN/CALC/SP LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP CN/CALC/SP LVL 04,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP CN/CALC/SP LVL 05,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP HIP CN/CALC/SP LVL 06,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 02,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 03,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 04,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 05,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 07,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 08,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 04,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 05,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 06,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 07,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 09,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 10,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 11,16210.0,4636.06,3015.06,12157.5,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 12,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 13,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 01,1132.0,323.75,210.55,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 02,1619.0,463.03,301.13,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 04,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 05,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 06,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 07,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 09,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 10,14896.0,4260.26,2770.66,11172.0,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 11,17962.0,5137.13,3340.93,13471.5,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 12,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 13,28474.0,8143.56,5296.16,21355.5,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 14,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 15,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 16,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 04,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 05,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 06,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 07,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 09,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 10,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 11,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 02,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 03,4392.0,1256.11,816.91,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 04,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 05,6487.0,1855.28,1206.58,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 06,6950.0,1987.7,1292.7,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 07,7876.0,2252.54,1464.94,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 08,8802.0,2517.37,1637.17,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 09,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 10,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 02,3591.0,1027.03,667.93,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 03,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 04,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 05,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 07,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 08,13582.0,3884.45,2526.25,10186.5,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 09,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1776,IMP RV/AD/RP HIP NECK LVL 10,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 02,3591.0,1027.03,667.93,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 03,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 04,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 05,6487.0,1855.28,1206.58,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 06,6950.0,1987.7,1292.7,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 07,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 08,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 09,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 10,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 11,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 12,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 13,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 14,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 01,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 02,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 04,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 05,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 06,32854.0,9396.24,5497.98,24640.5,42
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 07,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 01,9260.0,2648.36,1722.36,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 02,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 03,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 04,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 05,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 06,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 01,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 02,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 03,24094.0,6890.88,4481.48,18070.5,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 04,28474.0,8143.56,5296.16,21355.5,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 05,32854.0,9396.24,5497.98,24640.5,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 01,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 02,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 04,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 05,32854.0,9396.24,5497.98,24640.5,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 01,313.0,89.52,58.22,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 02,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 03,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 04,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 05,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 06,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 07,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 08,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 09,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 10,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 04,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 05,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 07,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 01,1126.0,322.04,209.44,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 02,1619.0,463.03,301.13,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 03,2157.0,616.9,401.2,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 04,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 05,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 06,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 07,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 09,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 10,13582.0,3884.45,2526.25,10186.5,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 11,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 12,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 13,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 01,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 02,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 03,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 04,9260.0,2648.36,1722.36,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 01,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 02,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 04,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 05,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 06,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 07,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 08,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 09,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 10,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 11,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 12,61324.0,17538.66,5497.98,45993.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 13,65704.0,18791.34,5497.98,49278.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 14,72274.0,20670.36,5497.98,54205.5,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 15,78844.0,22549.38,5497.98,59133.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 16,85414.0,24428.4,5497.98,64060.5,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 17,91984.0,26307.42,5497.98,68988.0,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 18,98554.0,28186.44,5497.98,73915.5,42
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 19,105124.0,30065.46,5497.98,78843.0,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 03,2152.0,615.47,400.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 04,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 05,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 07,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 02,2152.0,615.47,400.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 03,3083.0,881.74,573.44,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 04,3909.0,1117.97,727.07,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 05,4885.0,1397.11,908.61,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 06,5861.0,1676.25,1090.15,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 07,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 08,6950.0,1987.7,1292.7,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 02,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 03,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 04,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 06,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 07,24094.0,6890.88,4481.48,18070.5,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 08,28474.0,8143.56,5296.16,21355.5,42
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 09,32854.0,9396.24,5497.98,24640.5,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 01,2690.0,769.34,500.34,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 02,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 03,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 04,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 05,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 07,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 08,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 09,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 10,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 01,1126.0,322.04,209.44,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 02,1619.0,463.03,301.13,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 03,2157.0,616.9,401.2,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 04,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 05,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 06,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 07,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 09,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 10,13582.0,3884.45,2526.25,10186.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 11,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 12,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 13,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 01,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 02,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 03,6950.0,1987.7,1292.7,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 04,8802.0,2517.37,1637.17,7467.6,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 05,10654.0,3047.04,1981.64,7990.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 06,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 07,13582.0,3884.45,2526.25,10186.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 08,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 09,17086.0,4886.6,3178.0,12814.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 10,21466.0,6139.28,3992.68,16099.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 11,25846.0,7391.96,4807.36,19384.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 12,30226.0,8644.64,5497.98,22669.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 13,34606.0,9897.32,5497.98,25954.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 14,38986.0,11150.0,5497.98,29239.5,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 15,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 16,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 17,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 02,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 03,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 04,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 05,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 07,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 01,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 07,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 08,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 09,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 10,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 11,48184.0,13780.62,5497.98,36138.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 12,52564.0,15033.3,5497.98,39423.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 13,56944.0,16285.98,5497.98,42708.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 01,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 02,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 03,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 04,5856.0,1674.82,1089.22,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 05,6487.0,1855.28,1206.58,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 06,7413.0,2120.12,1378.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 07,8339.0,2384.95,1551.05,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 08,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 09,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 10,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 11,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 01,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 02,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 03,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 04,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 05,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 01,594.0,169.88,110.48,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 02,1413.0,404.12,262.82,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 03,2695.0,770.77,501.27,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 04,3853.0,1101.96,716.66,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 05,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 06,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 07,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 01,6105.0,1746.03,1135.53,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 01,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 02,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 03,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 01,4880.0,1395.68,907.68,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 02,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 07,30664.0,8769.9,5497.98,22998.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 08,35044.0,10022.58,5497.98,26283.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 09,39424.0,11275.26,5497.98,29568.0,42
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 10,43804.0,12527.94,5497.98,32853.0,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 01,588.0,168.17,109.37,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 02,1132.0,323.75,210.55,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 03,1619.0,463.03,301.13,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 04,2157.0,616.9,401.2,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 05,3596.0,1028.46,668.86,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 06,4397.0,1257.54,817.84,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 07,5373.0,1536.68,999.38,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 08,6024.0,1722.86,1120.46,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 09,9265.0,2649.79,1723.29,7467.6,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 10,12506.0,3576.72,2326.12,9379.5,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 11,13582.0,3884.45,2526.25,10186.5,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 12,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 13,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 14,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 01,2695.0,770.77,501.27,10514.88,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 02,4885.0,1397.11,908.61,10514.88,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 03,6950.0,1987.7,1292.7,10514.88,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 04,9265.0,2649.79,1723.29,10514.88,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 05,11580.0,3311.88,2153.88,10514.88,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 06,13895.0,3973.97,2584.47,10514.88,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 07,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 08,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1777,IMP LD ICD COIL SGL LVL 09,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 01,6950.0,1987.7,1292.7,7574.37,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 02,9265.0,2649.79,1723.29,7574.37,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 04,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 05,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 06,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 07,30664.0,8769.9,5576.59,22998.0,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 08,35044.0,10022.58,5576.59,26283.0,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 09,39424.0,11275.26,5576.59,29568.0,42
HCPCS,C1778,IMP LD NEUROSTIM LVL 10,43804.0,12527.94,5576.59,32853.0,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 01,2690.0,769.34,500.34,2025.13,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 02,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 03,9265.0,2649.79,1490.99,6948.75,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 04,11580.0,3311.88,1490.99,8685.0,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 05,13895.0,3973.97,1490.99,10421.25,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 06,15334.0,4385.52,1490.99,11500.5,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 07,17524.0,5011.86,1490.99,13143.0,42
HCPCS,C1779,IMP LD PCMKR VDD LVL 08,19714.0,5638.2,1490.99,14785.5,42
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 01,1413.0,464.92,262.82,2540.2,42
HCPCS,C1781,IMP MESH LVL 01,313.0,89.52,58.22,5596.13,42
HCPCS,C1781,IMP MESH LVL 02,594.0,169.88,110.48,5596.13,42
HCPCS,C1781,IMP MESH LVL 03,1132.0,323.75,210.55,5596.13,42
HCPCS,C1781,IMP MESH LVL 04,2157.0,616.9,401.2,5596.13,42
HCPCS,C1781,IMP MESH LVL 05,3596.0,1028.46,668.86,5596.13,42
HCPCS,C1781,IMP MESH LVL 06,4885.0,1397.11,908.61,5596.13,42
HCPCS,C1781,IMP MESH LVL 07,6950.0,1987.7,1292.7,5596.13,42
HCPCS,C1781,IMP MESH LVL 08,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1781,IMP MESH LVL 09,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1781,IMP MESH LVL 10,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1781,IMP MESH LVL 11,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1781,IMP MESH LVL 12,24094.0,6890.88,4120.12,18070.5,42
HCPCS,C1781,IMP MESH LVL 13,28474.0,8143.56,4120.12,21355.5,42
HCPCS,C1781,IMP MESH LVL 14,32854.0,9396.24,4120.12,24640.5,42
HCPCS,C1781,IMP MESH LVL 15,37234.0,10648.92,4120.12,27925.5,42
HCPCS,C1781,IMP MESH LVL 16,41614.0,11901.6,4120.12,31210.5,42
HCPCS,C1781,IMP MESH LVL 17,45994.0,13154.28,4120.12,34495.5,42
HCPCS,C1781,IMP MESH LVL 18,50374.0,14406.96,4120.12,37780.5,42
HCPCS,C1781,IMP MESH LVL 19,54754.0,15659.64,4120.12,41065.5,42
HCPCS,C1781,IMP MESH LVL 20,59134.0,16912.32,4120.12,44350.5,42
HCPCS,C1781,IMP MESH LVL 21,63514.0,18165.0,4120.12,47635.5,42
HCPCS,C1781,IMP MESH LVL 22,67894.0,19417.68,4120.12,50920.5,42
HCPCS,C1781,IMP MESH LVL 23,72362.0,20695.53,4120.12,54271.5,42
HCPCS,C1781,IMP MESH LVL 24,76742.0,21948.21,4120.12,57556.5,42
HCPCS,C1781,IMP MESH LVL 25,81122.0,23200.89,4120.12,60841.5,42
HCPCS,C1781,IMP MESH LVL 26,85502.0,24453.57,4120.12,64126.5,42
HCPCS,C1781,IMP MESH LVL 27,89882.0,25706.25,4120.12,67411.5,42
HCPCS,C1781,IMP MESH LVL 28,94262.0,26958.93,4120.12,70696.5,42
HCPCS,C1781,IMP MESH LVL 29,111694.0,31944.48,4120.12,83770.5,42
HCPCS,C1781,IMP MESH LVL 30,133594.0,38207.88,4120.12,100195.5,42
HCPCS,C1782,MORCELLATOR LVL 01,2690.0,578.35,500.34,3610.64,39
HCPCS,C1782,MORCELLATOR LVL 02,4880.0,1049.2,907.68,3660.0,39
HCPCS,C1782,MORCELLATOR LVL 03,9260.0,1990.9,1722.36,6945.0,39
HCPCS,C1782,MORCELLATOR LVL 04,13895.0,2987.42,2584.47,10421.25,39
HCPCS,C1785,IMP PCMKR DUAL RR LVL 01,17520.0,5308.56,3258.72,41774.56,42
HCPCS,C1785,IMP PCMKR DUAL RR LVL 02,21904.0,6636.91,4074.14,41774.56,42
HCPCS,C1785,IMP PCMKR DUAL RR LVL 03,26284.0,7964.05,4888.82,41774.56,42
HCPCS,C1785,IMP PCMKR DUAL RR LVL 04,43804.0,13272.61,8147.54,41774.56,42
HCPCS,C1785,IMP PCMKR DUAL RR LVL 05,65704.0,19908.31,12220.94,49278.0,42
HCPCS,C1785,IMP PCMKR DUAL RR LVL 06,87604.0,26544.01,16294.34,65703.0,42
HCPCS,C1785,IMP PCMKR DUAL RR LVL 07,109504.0,33179.71,20367.74,82128.0,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 01,11575.0,3507.22,2152.95,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 02,17520.0,5308.56,3258.72,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 03,21904.0,6636.91,4074.14,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 04,26284.0,7964.05,4888.82,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 05,30664.0,9291.19,5703.5,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 06,35044.0,10618.33,6518.18,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 07,39424.0,11945.47,7332.86,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 08,43804.0,13272.61,8147.54,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 09,48184.0,14599.75,8962.22,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 10,52564.0,15926.89,9776.9,41774.56,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 11,56944.0,17254.03,10591.58,42708.0,42
HCPCS,C1786,IMP PCMKR SGL RR LVL 12,61324.0,18581.17,11406.26,45993.0,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 01,4885.0,1397.11,908.61,3820.84,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 02,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 03,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 04,17524.0,5011.86,2813.08,13143.0,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 05,21904.0,6264.54,2813.08,16428.0,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 06,26284.0,7517.22,2813.08,19713.0,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 07,30664.0,8769.9,2813.08,22998.0,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 08,35044.0,10022.58,2813.08,26283.0,42
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 09,39424.0,11275.26,2813.08,29568.0,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 01,166.0,47.48,30.88,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 02,447.0,127.84,83.14,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 03,850.0,243.1,158.1,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 04,1413.0,404.12,262.82,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 05,1888.0,539.97,351.17,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 06,2695.0,770.77,501.27,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 07,3340.0,955.24,621.24,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 08,4153.0,1187.76,772.46,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 09,4641.0,1327.33,863.23,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 10,6105.0,1746.03,1135.53,7147.71,42
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 11,6950.0,1987.7,1292.7,7147.71,42
HCPCS,C1789,IMP PROSTH BREAST LVL 01,2695.0,770.77,501.27,4536.66,42
HCPCS,C1789,IMP PROSTH BREAST LVL 02,4885.0,1397.11,908.61,4536.66,42
HCPCS,C1789,IMP PROSTH BREAST LVL 03,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1789,IMP PROSTH BREAST LVL 04,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 01,844.0,241.38,156.98,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 02,4885.0,1397.11,908.61,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 03,9265.0,2649.79,1723.29,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 04,21904.0,6264.54,4074.14,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 05,30664.0,8769.9,5703.5,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 06,43804.0,12527.94,8147.54,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 07,56944.0,16285.98,10591.58,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 08,65704.0,18791.34,12220.94,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 09,74464.0,21296.7,13850.3,62427.29,42
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 10,83224.0,23802.06,15479.66,62427.29,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 01,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 02,14020.0,4009.72,2607.72,10515.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 03,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 04,25408.0,7266.69,4725.89,19056.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 05,30664.0,8769.9,5694.62,22998.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 06,35044.0,10022.58,5694.62,26283.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 07,39424.0,11275.26,5694.62,29568.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 08,43804.0,12527.94,5694.62,32853.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 09,48184.0,13780.62,5694.62,36138.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 10,52564.0,15033.3,5694.62,39423.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 11,56944.0,16285.98,5694.62,42708.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 12,61324.0,17538.66,5694.62,45993.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 13,67894.0,19417.68,5694.62,50920.5,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 14,74464.0,21296.7,5694.62,55848.0,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 15,76654.0,21923.04,5694.62,57490.5,42
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 16,87604.0,25054.74,5694.62,65703.0,42
HCPCS,C1816,IMP NEUROSTIM RECVR&/TRANS LVL 01,21904.0,6264.54,2614.58,16428.0,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 01,15334.0,4385.52,2852.12,52268.89,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 02,19714.0,5638.2,3666.8,52268.89,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 03,24094.0,6890.88,4481.48,52268.89,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 04,28474.0,8143.56,5296.16,52268.89,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 05,32854.0,9396.24,6110.84,52268.89,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 06,37234.0,10648.92,6925.52,52268.89,42
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 07,43804.0,12527.94,8147.54,52268.89,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 01,594.0,169.88,110.48,788.86,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 02,1413.0,404.12,262.82,1059.75,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 04,3853.0,1101.96,580.79,2889.75,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 05,6105.0,1746.03,580.79,4578.75,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 06,9265.0,2649.79,580.79,6948.75,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 07,11580.0,3311.88,580.79,8685.0,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 08,13895.0,3973.97,580.79,10421.25,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 09,15334.0,4385.52,580.79,11500.5,42
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 10,17524.0,5011.86,580.79,13143.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 01,4885.0,1397.11,908.61,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 02,6945.0,1986.27,1291.77,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 03,14892.0,4259.11,2769.91,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 04,28470.0,8142.42,5295.42,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 05,43800.0,12526.8,8146.8,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 06,65704.0,18791.34,12220.94,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 07,87604.0,25054.74,16294.34,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 08,109504.0,31318.14,20367.74,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 09,131404.0,37581.54,24441.14,111421.0,42
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 10,153304.0,43844.94,28514.54,114978.0,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 01,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 02,9265.0,2649.79,1094.44,6948.75,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 03,13895.0,3973.97,1094.44,10421.25,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 04,17524.0,5011.86,1094.44,13143.0,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 05,21904.0,6264.54,1094.44,16428.0,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 06,26284.0,7517.22,1094.44,19713.0,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 07,30664.0,8769.9,1094.44,22998.0,42
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 08,35044.0,10022.58,1094.44,26283.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 01,6105.0,1746.03,1135.53,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 02,9265.0,2649.79,1723.29,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 03,13895.0,3973.97,2584.47,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 04,17524.0,5011.86,3259.46,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 05,21904.0,6264.54,4074.14,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 06,26284.0,7517.22,4888.82,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 07,30664.0,8769.9,5703.5,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 08,43804.0,12527.94,8147.54,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 09,65704.0,18791.34,12220.94,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 10,87604.0,25054.74,16294.34,111421.0,42
HCPCS,C1822,IMP GEN NRSTM HF W BAT RECHG LVL 11,109504.0,31318.14,20367.74,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 01,21904.0,6264.54,4074.14,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 02,43804.0,12527.94,8147.54,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 03,65704.0,18791.34,12220.94,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 04,87604.0,25054.74,16294.34,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 05,109504.0,31318.14,20367.74,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 06,131404.0,37581.54,24441.14,111421.0,42
HCPCS,C1823,IMP NRSTM SEN TV&LD STIM LVL 07,153304.0,43844.94,28514.54,114978.0,42
HCPCS,C1824,IDE G200042 IMP GEN CCM OPTIM SMART,66144.0,21763.36,12302.78,55710.5,36
HCPCS,C1824,IMP GEN CCM OPTIMIZER SMART,176923.0,50599.98,32907.68,132692.25,42
HCPCS,C1825,IMP DEV SYS BAROSTIM,152211.0,43532.35,28311.25,114158.25,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 01,313.0,89.52,58.22,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 02,1413.0,404.12,262.82,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 03,3853.0,1101.96,716.66,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 04,13895.0,3973.97,2584.47,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 05,21904.0,6264.54,4074.14,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 06,30664.0,8769.9,5703.5,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 07,43804.0,12527.94,8147.54,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 08,65704.0,18791.34,12220.94,55710.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 09,87604.0,25054.74,16294.34,65703.0,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 10,109504.0,31318.14,20367.74,82128.0,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 11,118264.0,33823.5,21997.1,88698.0,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 12,124834.0,35702.52,23219.12,93625.5,42
HCPCS,C1826,IMP GEN NRSTM LD W BAT RECHG LVL 13,131404.0,37581.54,24441.14,98553.0,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 01,30664.0,8769.9,5703.5,55710.5,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 02,43804.0,12527.94,8147.54,55710.5,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 03,65704.0,18791.34,12220.94,55710.5,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 04,87604.0,25054.74,16294.34,65703.0,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 05,109504.0,31318.14,20367.74,82128.0,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 06,131404.0,37581.54,24441.14,98553.0,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 07,153304.0,43844.94,28514.54,114978.0,42
HCPCS,C1827,IMP GEN NRSTM W LD&CNTRL EP LVL 08,175204.0,50108.34,32587.94,131403.0,42
HCPCS,C1830,NEEDLE BIOPSY MRW BONE PWR LVL 01,594.0,127.71,85.6,745.56,35
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 01,313.0,67.3,58.22,4596.53,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 02,1413.0,303.8,262.82,4596.53,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 03,3853.0,828.4,716.66,4596.53,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 04,6105.0,1312.58,1135.53,4596.53,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 05,13895.0,2987.42,2584.47,10421.25,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 06,17524.0,3767.66,3259.46,13143.0,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 07,21904.0,4709.36,3384.17,16428.0,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 08,26284.0,5651.06,3384.17,19713.0,39
HCPCS,C1832,SUSPNSN AUTOGRFT SYS W APPL LVL 09,30664.0,6592.76,3384.17,22998.0,39
HCPCS,C1874,IMP STENT COAT W DEL LVL 01,594.0,169.88,110.48,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 02,2695.0,770.77,501.27,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 03,4885.0,1397.11,908.61,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 04,6950.0,1987.7,1292.7,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 05,9265.0,2649.79,1723.29,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 06,11580.0,3311.88,2153.88,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 07,13895.0,3973.97,2584.47,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 08,15334.0,4385.52,2852.12,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 09,17524.0,5011.86,3259.46,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 10,21904.0,6264.54,4074.14,18372.82,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 11,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 12,30664.0,8769.9,5703.5,22998.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 13,35044.0,10022.58,6518.18,26283.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 14,39424.0,11275.26,7332.86,29568.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 15,43804.0,12527.94,8147.54,32853.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 16,48184.0,13780.62,8962.22,36138.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 17,52564.0,15033.3,9776.9,39423.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 18,56944.0,16285.98,10591.58,42708.0,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 19,63514.0,18165.0,11813.6,47635.5,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 20,67894.0,19417.68,12628.28,50920.5,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 21,72274.0,20670.36,13442.96,54205.5,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 22,76654.0,21923.04,13526.9,57490.5,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 23,81034.0,23175.72,13526.9,60775.5,42
HCPCS,C1874,IMP STENT COAT W DEL LVL 24,85414.0,24428.4,13526.9,64060.5,42
HCPCS,C1875,IMP STENT COAT WO DEL LVL 01,1413.0,404.12,262.82,3671.9,42
HCPCS,C1875,IMP STENT COAT WO DEL LVL 02,2695.0,770.77,501.27,3671.9,42
HCPCS,C1875,IMP STENT COAT WO DEL LVL 03,3853.0,1101.96,716.66,3671.9,42
HCPCS,C1875,IMP STENT COAT WO DEL LVL 04,4885.0,1397.11,908.61,3671.9,42
HCPCS,C1875,IMP STENT COAT WO DEL LVL 05,6945.0,1986.27,1291.77,5208.75,42
HCPCS,C1875,IMP STENT COAT WO DEL LVL 06,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 01,594.0,169.88,110.48,6652.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 02,1619.0,463.03,301.13,6652.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 03,3083.0,881.74,573.44,6652.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 04,4885.0,1397.11,908.61,6652.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 05,6950.0,1987.7,1292.7,6652.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 06,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 07,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 08,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 09,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 10,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 11,30664.0,8769.9,4897.5,22998.0,42
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 12,35044.0,10022.58,4897.5,26283.0,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 01,447.0,127.84,83.14,1330.4,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 02,850.0,243.1,158.1,1330.4,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 03,1619.0,463.03,301.13,1330.4,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 04,2695.0,770.77,501.27,2021.25,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 06,6950.0,1987.7,979.5,5212.5,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 07,9265.0,2649.79,979.5,6948.75,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 08,11580.0,3311.88,979.5,8685.0,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 09,13895.0,3973.97,979.5,10421.25,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 10,17524.0,5011.86,979.5,13143.0,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 11,21904.0,6264.54,979.5,16428.0,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 12,26284.0,7517.22,979.5,19713.0,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 13,30664.0,8769.9,979.5,22998.0,42
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 14,35044.0,10022.58,979.5,26283.0,42
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 01,588.0,168.17,109.37,1435.1,42
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 02,1614.0,461.6,300.2,1435.1,42
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1880,IMP FILTER VENA CAVA LVL 01,1407.0,402.4,261.7,3310.63,42
HCPCS,C1880,IMP FILTER VENA CAVA LVL 02,2690.0,769.34,500.34,3310.63,42
HCPCS,C1880,IMP FILTER VENA CAVA LVL 03,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1880,IMP FILTER VENA CAVA LVL 04,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1880,IMP FILTER VENA CAVA LVL 05,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 01,594.0,169.88,110.48,5703.09,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 02,1132.0,323.75,210.55,5703.09,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 03,2157.0,616.9,401.2,5703.09,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 04,3596.0,1028.46,668.86,5703.09,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 05,5861.0,1676.25,1090.15,5703.09,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 06,8107.0,2318.6,1507.9,6080.25,42
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 07,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 01,61320.0,17537.52,11405.52,63194.0,42
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 02,70080.0,20042.88,13034.88,63194.0,42
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 03,78840.0,22548.24,14664.24,63194.0,42
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 04,96364.0,27560.1,17923.7,72273.0,42
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 05,109504.0,31318.14,20367.74,82128.0,42
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 06,122644.0,35076.18,22811.78,91983.0,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 01,1126.0,322.04,209.44,11779.23,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 02,4397.0,1257.54,817.84,11779.23,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 03,7413.0,2120.12,1378.82,11779.23,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 04,10654.0,3047.04,1981.64,11779.23,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 05,13895.0,3973.97,2584.47,11779.23,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 01,5861.0,1676.25,1090.15,4845.25,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 02,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 03,8339.0,2384.95,1551.05,6254.25,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 04,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 06,19714.0,5638.2,3567.29,14785.5,42
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 07,21904.0,6264.54,3567.29,16428.0,42
HCPCS,C1884,PMA P140026 DEV SYS CAS ENROUTE,11676.0,3841.75,2171.74,8757.0,36
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 01,2695.0,579.42,501.27,8505.58,39
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 02,4885.0,1050.28,908.61,8505.58,39
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 03,6950.0,1494.25,1292.7,8505.58,39
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 04,9265.0,1991.98,1723.29,8505.58,39
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 05,11580.0,2489.7,2153.88,8685.0,39
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 06,13895.0,2987.42,2584.47,10421.25,39
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 01,6105.0,1312.58,951.39,4578.75,39
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 02,11580.0,2489.7,951.39,8685.0,39
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 03,13895.0,2987.42,951.39,10421.25,39
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 04,17524.0,3767.66,951.39,13143.0,39
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 05,21904.0,4709.36,951.39,16428.0,39
HCPCS,C1887,CATH GUIDE LVL 01,166.0,35.69,30.88,457.19,39
HCPCS,C1887,CATH GUIDE LVL 02,313.0,67.3,58.22,457.19,39
HCPCS,C1887,CATH GUIDE LVL 03,447.0,96.1,83.14,457.19,39
HCPCS,C1887,CATH GUIDE LVL 04,594.0,127.71,110.48,457.19,39
HCPCS,C1887,CATH GUIDE LVL 05,850.0,182.75,158.1,637.5,39
HCPCS,C1887,CATH GUIDE LVL 06,1413.0,303.8,262.82,1059.75,39
HCPCS,C1887,CATH GUIDE LVL 07,2827.0,607.8,336.61,2120.25,39
HCPCS,C1887,CATH GUIDE LVL 08,3596.0,773.14,336.61,2697.0,39
HCPCS,C1887,CATH GUIDE LVL 09,4885.0,1050.28,336.61,3663.75,39
HCPCS,C1887,CATH GUIDE LVL 10,6105.0,1312.58,336.61,4578.75,39
HCPCS,C1887,CATH GUIDE LVL 11,9265.0,1991.98,336.61,6948.75,39
HCPCS,C1887,CATH GUIDE LVL 12,11580.0,2489.7,336.61,8685.0,39
HCPCS,C1887,CATH GUIDE LVL 13,13895.0,2987.42,336.61,10421.25,39
HCPCS,C1887,CATH GUIDE LVL 14,15334.0,3296.81,336.61,11500.5,39
HCPCS,C1887,CATH GUIDE LVL 15,17524.0,3767.66,336.61,13143.0,39
HCPCS,C1887,CATH GUIDE LVL 16,21904.0,4709.36,336.61,16428.0,39
HCPCS,C1888,CATH ABL NONCARDIAC LVL 01,1619.0,348.08,301.13,4307.3,39
HCPCS,C1888,CATH ABL NONCARDIAC LVL 02,3083.0,662.84,573.44,4307.3,39
HCPCS,C1889,DURAL SLNT ADHERUS AUTOSPRAY,4621.8,1321.83,859.65,3466.35,42
HCPCS,C1889,DURAL SLNT ADHERUS AUTOSPRAY ET,1756.0,502.22,326.62,1782.74,42
HCPCS,C1889,IDE G140240 DEV SYS VALVE MITRAL,109800.0,36127.49,1312.53,82350.0,36
HCPCS,C1889,IDE G160013 DEV SYS REVIVENT TC,109500.0,36028.78,1312.53,82125.0,36
HCPCS,C1889,IDE G160223 DEV SYS MITRAL CONTOUR,57240.0,18833.68,1312.53,42930.0,36
HCPCS,C1889,IDE G180266 IMP SYS TVRS PASCAL,128100.0,42148.74,1312.53,96075.0,36
HCPCS,C1889,IDE G190128 IMP DEV SYS ALTAVALVE,219000.0,72057.57,1312.53,164250.0,36
HCPCS,C1889,IDE G220079 DEV SYS PFA FP PVI,22260.0,7324.21,1312.53,16695.0,36
HCPCS,C1889,IDE G220079 DEV SYS PFA FP PVI+CTI,28865.0,9497.45,1312.53,21648.75,36
HCPCS,C1889,IDE G230187 DEV SYS HRT ARTF TOTAL,1110768.0,365476.0,1312.53,833076.0,36
HCPCS,C1889,IDE G230249 DEV SYS PFA FARAPULSE,77088.0,25364.26,1312.53,57816.0,36
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 04,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 05,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 07,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 08,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 09,30664.0,8769.9,1312.53,22998.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 10,39424.0,11275.26,1312.53,29568.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 11,52564.0,15033.3,1312.53,39423.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 12,65704.0,18791.34,1312.53,49278.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 13,78844.0,22549.38,1312.53,59133.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 14,87604.0,25054.74,1312.53,65703.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 15,100744.0,28812.78,1312.53,75558.0,42
HCPCS,C1889,IMP ANCHOR FIX NON BONE LVL 16,109504.0,31318.14,1312.53,82128.0,42
HCPCS,C1889,IMP BAND LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP BAND LVL 02,850.0,243.1,158.1,1782.74,42
HCPCS,C1889,IMP BAND LVL 03,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP BAND LVL 04,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP BAND LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP BAND LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP BAND LVL 07,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP BAND LVL 08,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP CABLE LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP CABLE LVL 02,844.0,241.38,156.98,1782.74,42
HCPCS,C1889,IMP CABLE LVL 03,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP CABLE LVL 04,2157.0,616.9,401.2,1782.74,42
HCPCS,C1889,IMP CABLE LVL 05,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1889,IMP CABLE LVL 06,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP CABLE LVL 07,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1889,IMP CABLE LVL 08,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP CABLE LVL 09,11580.0,3311.88,1312.53,8685.0,42
HCPCS,C1889,IMP CABLE LVL 10,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP CABLE LVL 11,15772.0,4510.79,1312.53,11829.0,42
HCPCS,C1889,IMP CABLE LVL 12,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP CABLE LVL 13,19714.0,5638.2,1312.53,14785.5,42
HCPCS,C1889,IMP CABLE LVL 14,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP CLIP ANEURYSM LVL 01,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP CLIP ANEURYSM LVL 02,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1889,IMP CLIP ANEURYSM LVL 03,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP CLIP ANEURYSM LVL 04,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP CLIP/S 1-3 REPAIR TRICUSPID KIT,170820.0,48854.52,1312.53,128115.0,42
HCPCS,C1889,IMP CLIP/S 1-4 REPAIR MITRAL KIT,109800.0,31402.8,1312.53,82350.0,42
HCPCS,C1889,IMP COVER BURR HOLE LVL 01,588.0,168.17,109.37,1782.74,42
HCPCS,C1889,IMP COVER BURR HOLE LVL 02,1132.0,323.75,210.55,1782.74,42
HCPCS,C1889,IMP COVER BURR HOLE LVL 03,1619.0,463.03,301.13,1782.74,42
HCPCS,C1889,IMP COVER BURR HOLE LVL 04,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP COVER BURR HOLE LVL 05,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 01,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 02,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 03,26284.0,7517.22,1312.53,19713.0,42
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 04,43804.0,12527.94,1312.53,32853.0,42
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 05,61324.0,17538.66,1312.53,45993.0,42
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 06,78844.0,22549.38,1312.53,59133.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 01,48184.0,13780.62,1312.53,36138.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 02,52564.0,15033.3,1312.53,39423.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 03,56944.0,16285.98,1312.53,42708.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 04,61324.0,17538.66,1312.53,45993.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 05,65704.0,18791.34,1312.53,49278.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 06,70084.0,20044.02,1312.53,52563.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION ANEUR LVL 07,74464.0,21296.7,1312.53,55848.0,42
HCPCS,C1889,IMP DEV EMBOLIZATION PIPELIN LVL 01,56506.0,16160.72,1312.53,42379.5,42
HCPCS,C1889,IMP DEV EMBOLIZATION PIPELIN LVL 02,60886.0,17413.4,1312.53,45664.5,42
HCPCS,C1889,IMP DEV EMBOLIZATION PIPELIN LVL 03,65266.0,18666.08,1312.53,48949.5,42
HCPCS,C1889,IMP DEV EMBOLIZATION PIPELIN LVL 04,69646.0,19918.76,1312.53,52234.5,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 01,1132.0,323.75,210.55,1782.74,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 03,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 04,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 05,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 07,11580.0,3311.88,1312.53,8685.0,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 08,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 09,15334.0,4385.52,1312.53,11500.5,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 10,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 11,19714.0,5638.2,1312.53,14785.5,42
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 01,1619.0,463.03,301.13,1782.74,42
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 02,3596.0,1028.46,668.86,2697.0,42
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 03,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 04,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 05,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 06,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 01,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 02,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 03,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 04,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 05,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 06,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 07,26284.0,7517.22,1312.53,19713.0,42
HCPCS,C1889,IMP FIX SPINE LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP FIX SPINE LVL 02,1132.0,323.75,210.55,1782.74,42
HCPCS,C1889,IMP FIX SPINE LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP FIX SPINE LVL 04,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP FIX SPINE LVL 05,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP FIX SPINE LVL 06,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP FIX SPINE LVL 07,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP FIX SPINE LVL 08,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP FIX SPINE LVL 09,27160.0,7767.76,1312.53,20370.0,42
HCPCS,C1889,IMP FIX SPINE LVL 10,32854.0,9396.24,1312.53,24640.5,42
HCPCS,C1889,IMP FIX SPINE LVL 11,39424.0,11275.26,1312.53,29568.0,42
HCPCS,C1889,IMP FIX SPINE LVL 12,52564.0,15033.3,1312.53,39423.0,42
HCPCS,C1889,IMP FIX SPINE LVL 13,65704.0,18791.34,1312.53,49278.0,42
HCPCS,C1889,IMP FIX SPINE LVL 14,78844.0,22549.38,1312.53,59133.0,42
HCPCS,C1889,IMP HOOK LVL 01,2690.0,769.34,500.34,2017.5,42
HCPCS,C1889,IMP HOOK LVL 02,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP HOOK LVL 03,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1889,IMP HOOK LVL 04,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP HOOK LVL 05,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP MARKER BONE LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP MARKER BONE LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP NEURO LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP NEURO LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP NEURO LVL 03,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP NEURO LVL 04,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP NEURO LVL 05,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP NEURO LVL 06,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP NEURO LVL 07,43804.0,12527.94,1312.53,32853.0,42
HCPCS,C1889,IMP NEURO LVL 08,65704.0,18791.34,1312.53,49278.0,42
HCPCS,C1889,IMP PATCH PERICARDIAL LVL 01,166.0,47.48,30.88,1782.74,42
HCPCS,C1889,IMP PATCH PERICARDIAL LVL 02,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP PATCH PERICARDIAL LVL 03,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP PATCH PERICARDIAL LVL 04,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP PATCH PERICARDIAL LVL 05,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP PLUG FISTULA LVL 01,2157.0,616.9,401.2,1782.74,42
HCPCS,C1889,IMP PLUG FISTULA LVL 02,3083.0,881.74,573.44,2312.25,42
HCPCS,C1889,IMP PLUG FISTULA LVL 03,4397.0,1257.54,817.84,3297.75,42
HCPCS,C1889,IMP PLUG FISTULA LVL 04,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP POUCH ECM LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP POUCH ECM LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP POUCH ECM LVL 03,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1889,IMP POUCH ECM LVL 04,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP RING FALLOPE LVL 01,166.0,47.48,30.88,1782.74,42
HCPCS,C1889,IMP RING FALLOPE LVL 02,588.0,168.17,109.37,1782.74,42
HCPCS,C1889,IMP RING FALLOPE LVL 03,1619.0,463.03,301.13,1782.74,42
HCPCS,C1889,IMP RING GERD LVL 01,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP RING GERD LVL 02,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP RING GERD LVL 03,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP RING GERD LVL 04,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP RING GERD LVL 05,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP RING GERD LVL 06,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP RING GERD LVL 07,26284.0,7517.22,1312.53,19713.0,42
HCPCS,C1889,IMP SLEEVE SMIT INTRAUTERINE LVL 01,166.0,47.48,30.88,1782.74,42
HCPCS,C1889,IMP SLEEVE SMIT INTRAUTERINE LVL 02,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP SLEEVE SMIT INTRAUTERINE LVL 03,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP SLEEVE SMIT INTRAUTERINE LVL 04,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP SLEEVE SMIT INTRAUTERINE LVL 05,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 04,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 05,6024.0,1722.86,1120.46,4518.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 07,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 08,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 09,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 10,26284.0,7517.22,1312.53,19713.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 11,30664.0,8769.9,1312.53,22998.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 12,35044.0,10022.58,1312.53,26283.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 13,39424.0,11275.26,1312.53,29568.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 14,43804.0,12527.94,1312.53,32853.0,42
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 15,54754.0,15659.64,1312.53,41065.5,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 02,850.0,243.1,158.1,1782.74,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 03,1132.0,323.75,210.55,1782.74,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 04,1413.0,404.12,262.82,1782.74,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 05,1619.0,463.03,301.13,1782.74,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 06,1888.0,539.97,351.17,1782.74,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 07,2426.0,693.84,451.24,1819.5,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 08,2827.0,808.52,525.82,2120.25,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 09,3340.0,955.24,621.24,2505.0,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 10,3853.0,1101.96,716.66,2889.75,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 11,4153.0,1187.76,772.46,3114.75,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 12,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 13,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1889,IMP SPINE FUSION LVL 01,2690.0,769.34,500.34,2017.5,42
HCPCS,C1889,IMP SPINE FUSION LVL 02,4880.0,1395.68,907.68,3660.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 03,7413.0,2120.12,1312.53,5559.75,42
HCPCS,C1889,IMP SPINE FUSION LVL 04,8339.0,2384.95,1312.53,6254.25,42
HCPCS,C1889,IMP SPINE FUSION LVL 05,9728.0,2782.21,1312.53,7296.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 06,11117.0,3179.46,1312.53,8337.75,42
HCPCS,C1889,IMP SPINE FUSION LVL 07,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP SPINE FUSION LVL 08,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 09,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 10,26284.0,7517.22,1312.53,19713.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 11,30664.0,8769.9,1312.53,22998.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 12,35044.0,10022.58,1312.53,26283.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 13,39424.0,11275.26,1312.53,29568.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 14,43804.0,12527.94,1312.53,32853.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 15,48184.0,13780.62,1312.53,36138.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 16,52564.0,15033.3,1312.53,39423.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 17,56944.0,16285.98,1312.53,42708.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 18,61324.0,17538.66,1312.53,45993.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 19,65704.0,18791.34,1312.53,49278.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 20,70084.0,20044.02,1312.53,52563.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 21,74464.0,21296.7,1312.53,55848.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 22,78844.0,22549.38,1312.53,59133.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 23,83224.0,23802.06,1312.53,62418.0,42
HCPCS,C1889,IMP SPINE FUSION LVL 24,111694.0,31944.48,1312.53,83770.5,42
HCPCS,C1889,IMP SPINE KYPHX LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP SPINE KYPHX LVL 02,1132.0,323.75,210.55,1782.74,42
HCPCS,C1889,IMP SPINE KYPHX LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP SPINE KYPHX LVL 04,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1889,IMP SPINE KYPHX LVL 05,9265.0,2649.79,1312.53,6948.75,42
HCPCS,C1889,IMP SPINE KYPHX LVL 06,13895.0,3973.97,1312.53,10421.25,42
HCPCS,C1889,IMP SPINE KYPHX LVL 07,17524.0,5011.86,1312.53,13143.0,42
HCPCS,C1889,IMP SPINE KYPHX LVL 08,21904.0,6264.54,1312.53,16428.0,42
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 02,594.0,169.88,110.48,1782.74,42
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 03,1132.0,323.75,210.55,1782.74,42
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 04,1619.0,463.03,301.13,1782.74,42
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 05,2157.0,616.9,401.2,1782.74,42
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 06,2695.0,770.77,501.27,2021.25,42
HCPCS,C1889,IMP STIMULATOR BONE LVL 01,13890.0,3972.54,1312.53,10417.5,42
HCPCS,C1889,IMP STIMULATOR BONE LVL 02,19714.0,5638.2,1312.53,14785.5,42
HCPCS,C1889,IMP STIMULATOR BONE LVL 03,24094.0,6890.88,1312.53,18070.5,42
HCPCS,C1889,IMP STIMULATOR BONE LVL 04,28474.0,8143.56,1312.53,21355.5,42
HCPCS,C1889,SEALANT SYS DURASEAL 5ML,2180.2,623.54,405.52,1782.74,42
HCPCS,C1889,SPINE SLNT DURASEAL SYS 3ML 5U,1867.0,533.96,347.26,1782.74,42
HCPCS,C1889,SPINE SLNT DURASEAL SYS 5ML 5U,4246.5,1214.5,789.85,3184.88,42
HCPCS,C1889,SURGICAL SLNT COSEAL ADH VASC 4ML,1273.7,364.28,236.91,1782.74,42
HCPCS,C1889,SURGICAL SLNT COSEAL PREMIX 8ML,1970.2,563.48,366.46,1782.74,42
HCPCS,C1891,IMP PUMP INF NONPRG PERM LVL 01,26284.0,7517.22,4888.82,58151.78,42
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 01,313.0,67.3,58.22,295.55,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 02,594.0,127.71,110.48,445.5,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 03,1413.0,303.8,217.6,1059.75,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 04,2023.0,434.94,217.6,1517.25,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 05,2695.0,579.42,217.6,2021.25,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 06,3596.0,773.14,217.6,2697.0,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 07,4397.0,945.36,217.6,3297.75,39
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 08,6105.0,1312.58,217.6,4578.75,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 01,594.0,127.71,110.48,665.33,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 02,1132.0,243.38,210.55,849.0,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 03,1888.0,405.92,351.17,1416.0,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 04,2695.0,579.42,489.85,2021.25,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 05,3853.0,828.4,489.85,2889.75,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 06,4885.0,1050.28,489.85,3663.75,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 07,6105.0,1312.58,489.85,4578.75,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 08,6950.0,1494.25,489.85,5212.5,39
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 09,8107.0,1743.0,489.85,6080.25,39
HCPCS,C1894,INTRO NON GD/EP/LASER ARTIX PPP,6899.0,1973.11,183.22,5174.25,42
HCPCS,C1894,INTRO NON GD/EP/LASER DVT PPP,7509.0,2147.57,183.22,5631.75,42
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 01,96.0,20.64,17.86,248.85,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 02,313.0,67.3,58.22,248.85,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 03,594.0,127.71,110.48,445.5,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 04,1619.0,348.08,183.22,1214.25,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 05,2695.0,579.42,183.22,2021.25,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 06,3596.0,773.14,183.22,2697.0,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 07,5861.0,1260.12,183.22,4395.75,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 08,7876.0,1693.34,183.22,5907.0,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 09,10191.0,2191.06,183.22,7643.25,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 10,13895.0,2987.42,183.22,10421.25,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 11,15334.0,3296.81,183.22,11500.5,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 12,17524.0,3767.66,183.22,13143.0,39
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 13,19714.0,4238.51,183.22,14785.5,39
HCPCS,C1894,INTRO NON GD/EP/LASER VTE PPP,10324.0,2952.66,183.22,7743.0,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 01,2695.0,770.77,501.27,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 02,4885.0,1397.11,908.61,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 03,6950.0,1987.7,1292.7,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 04,9265.0,2649.79,1723.29,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 05,11580.0,3311.88,2153.88,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 06,13895.0,3973.97,2584.47,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 07,15334.0,4385.52,2852.12,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 08,17524.0,5011.86,3259.46,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 09,19714.0,5638.2,3666.8,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 10,24094.0,6890.88,4481.48,60907.18,42
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 11,32854.0,9396.24,6110.84,60907.18,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 01,2695.0,770.77,501.27,5958.8,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 02,3853.0,1101.96,716.66,5958.8,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 03,4885.0,1397.11,908.61,5958.8,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 04,6950.0,1987.7,1292.7,5958.8,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 05,11580.0,3311.88,2153.88,8685.0,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 06,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 07,15334.0,4385.52,2852.12,11500.5,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 08,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 09,19714.0,5638.2,3666.8,14785.5,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 10,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 11,24094.0,6890.88,4387.13,18070.5,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 01,166.0,47.48,30.88,2624.81,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 02,313.0,89.52,58.22,2624.81,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 03,594.0,169.88,110.48,2624.81,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 04,1413.0,404.12,262.82,2624.81,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 05,1883.0,538.54,350.24,2624.81,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 06,2695.0,770.77,501.27,2624.81,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 07,3909.0,1117.97,727.07,2931.75,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 08,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 09,7644.0,2186.18,1421.78,5733.0,42
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 10,9496.0,2715.86,1766.26,7122.0,42
HCPCS,C1898,IDE G210349 SYS LD PM SOLIA CSP S,1835.0,603.77,341.31,2025.13,36
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 01,2695.0,770.77,501.27,2025.13,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 02,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 03,9265.0,2649.79,1490.99,6948.75,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 04,13895.0,3973.97,1490.99,10421.25,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 05,17524.0,5011.86,1490.99,13143.0,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 06,21904.0,6264.54,1490.99,16428.0,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 07,26284.0,7517.22,1490.99,19713.0,42
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 08,30664.0,8769.9,1490.99,22998.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 01,594.0,169.88,110.48,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 02,1132.0,323.75,210.55,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 03,2695.0,770.77,501.27,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 04,4885.0,1397.11,908.61,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 05,9265.0,2649.79,1723.29,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 06,13895.0,3973.97,2584.47,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 07,17524.0,5011.86,3259.46,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 08,21904.0,6264.54,4074.14,63194.0,42
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 09,26284.0,7517.22,4888.82,63194.0,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 01,2695.0,770.77,501.27,8750.91,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 02,3853.0,1101.96,716.66,8750.91,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 03,4880.0,1395.68,907.68,8750.91,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 04,9265.0,2649.79,1723.29,8750.91,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 05,13895.0,3973.97,2584.47,10421.25,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 06,17524.0,5011.86,3259.46,13143.0,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 07,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 08,26284.0,7517.22,4888.82,19713.0,42
HCPCS,C1900,IMP LD VENOUS COR LV LVL 09,30664.0,8769.9,5703.5,22998.0,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 01,4885.0,1397.11,908.61,3663.75,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 02,6950.0,1987.7,1292.7,5212.5,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 03,9265.0,2649.79,1441.19,6948.75,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 04,11580.0,3311.88,1441.19,8685.0,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 05,13895.0,3973.97,1441.19,10421.25,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 06,17524.0,5011.86,1441.19,13143.0,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 07,21904.0,6264.54,1441.19,16428.0,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 08,26284.0,7517.22,1441.19,19713.0,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 09,30664.0,8769.9,1441.19,22998.0,42
HCPCS,C1982,CATH OCC VALV 1WAY PRESS GEN LVL 10,35044.0,10022.58,1441.19,26283.0,42
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 01,594.0,169.88,110.48,445.5,42
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 02,1413.0,404.12,244.88,1059.75,42
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 03,2695.0,770.77,244.88,2021.25,42
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 04,3853.0,1101.96,244.88,2889.75,42
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 05,6105.0,1746.03,244.88,4578.75,42
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 06,13895.0,3973.97,244.88,10421.25,42
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 01,2695.0,770.77,501.27,3552.17,42
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 02,3596.0,1028.46,668.86,3552.17,42
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 03,4397.0,1257.54,817.84,3552.17,42
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 04,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C2616,BRACHY N-STRND YTTR 90 SIRSP/SRCE,86508.0,24741.29,12613.29,79092.28,65
HCPCS,C2616,BRACHY N-STRND YTTR 90 THERASP/SRCE,86969.0,24873.13,12613.29,79092.28,65
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 01,166.0,47.48,30.88,413.09,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 02,594.0,169.88,110.48,445.5,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 03,850.0,243.1,158.1,637.5,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 04,1132.0,323.75,210.55,849.0,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 05,1619.0,463.03,301.13,1214.25,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 06,2695.0,770.77,304.13,2021.25,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 07,4885.0,1397.11,304.13,3663.75,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 08,6950.0,1987.7,304.13,5212.5,42
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 09,9265.0,2649.79,304.13,6948.75,42
HCPCS,C2618,IDE G220229 DEV SYS CRYOABLATION VT,26280.0,8646.91,1700.61,19710.0,36
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 01,588.0,126.42,109.37,2309.84,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 02,2690.0,578.35,500.34,2309.84,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 03,4885.0,1050.28,908.61,3663.75,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 04,9265.0,1991.98,1700.61,6948.75,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 05,13895.0,2987.42,1700.61,10421.25,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 06,17524.0,3767.66,1700.61,13143.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 07,21904.0,4709.36,1700.61,16428.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 08,26284.0,5651.06,1700.61,19713.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 09,30664.0,6592.76,1700.61,22998.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 10,35044.0,7534.46,1700.61,26283.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 11,39424.0,8476.16,1700.61,29568.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 12,43804.0,9417.86,1700.61,32853.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 13,48184.0,10359.56,1700.61,36138.0,39
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 14,52564.0,11301.26,1700.61,39423.0,39
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 01,19714.0,5973.34,3666.8,25942.8,42
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 02,24090.0,7299.27,4480.74,25942.8,42
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 03,28474.0,8627.62,5296.16,25942.8,42
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 01,15330.0,4644.99,2851.38,25942.8,42
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 02,19714.0,5973.34,3666.8,25942.8,42
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 03,22776.0,6901.13,4236.34,25942.8,42
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 04,28474.0,8627.62,5296.16,25942.8,42
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 01,6105.0,1849.82,1135.53,25942.8,42
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 02,13895.0,4210.18,2584.47,25942.8,42
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 03,21900.0,6635.7,4073.4,25942.8,42
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 04,35040.0,10617.12,6517.44,26280.0,42
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 05,43804.0,13272.61,8147.54,32853.0,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 01,4885.0,1397.11,908.61,20543.04,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 02,9265.0,2649.79,1723.29,20543.04,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 03,21904.0,6264.54,4074.14,20543.04,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 04,28474.0,8143.56,5296.16,21355.5,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 05,32854.0,9396.24,6110.84,24640.5,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 06,37234.0,10648.92,6925.52,27925.5,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 07,41614.0,11901.6,7740.2,31210.5,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 08,45994.0,13154.28,8554.88,34495.5,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 09,50374.0,14406.96,9369.56,37780.5,42
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 10,54754.0,15659.64,10184.24,41065.5,42
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 01,166.0,35.69,30.88,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 02,313.0,67.3,58.22,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 03,594.0,127.71,110.48,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 04,1413.0,303.8,262.82,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 05,1888.0,405.92,351.17,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 06,2695.0,579.42,501.27,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 07,3853.0,828.4,716.66,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 08,4397.0,945.36,817.84,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 09,6105.0,1312.58,1135.53,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 10,7413.0,1593.8,1378.82,6399.56,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 11,9265.0,1991.98,1723.29,6948.75,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 12,11580.0,2489.7,2153.88,8685.0,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 13,13895.0,2987.42,2584.47,10421.25,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 14,17524.0,3767.66,3259.46,13143.0,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 15,21904.0,4709.36,4074.14,16428.0,39
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 16,26284.0,5651.06,4711.64,19713.0,39
HCPCS,C2624,IMP SENSOR PRESS PA ALL LVL 01,43804.0,12527.94,2614.58,32853.0,38
HCPCS,C2624,IMP SENSOR PRESS PA ALL LVL 02,65704.0,18791.34,2614.58,49278.0,38
HCPCS,C2624,IMP SENSOR PRESS PA ALL LVL 03,87604.0,25054.74,2614.58,65703.0,38
HCPCS,C2624,IMP SENSOR PRESS PA ALL LVL 04,109504.0,31318.14,2614.58,82128.0,38
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 01,850.0,243.1,158.1,1345.83,42
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 02,1132.0,323.75,210.55,1345.83,42
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 04,3909.0,1117.97,727.07,2931.75,42
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 05,5373.0,1536.68,990.86,4029.75,42
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 06,6487.0,1855.28,990.86,4865.25,42
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 01,594.0,169.88,110.48,11191.46,42
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 02,2695.0,770.77,501.27,11191.46,42
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 03,4885.0,1397.11,908.61,11191.46,42
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 04,21904.0,6264.54,4074.14,16428.0,42
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 05,43804.0,12527.94,8147.54,32853.0,42
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 01,251.0,53.96,46.69,299.61,39
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 02,594.0,127.71,110.48,445.5,39
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 03,1132.0,243.38,210.55,849.0,39
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 04,2157.0,463.76,220.58,1617.75,39
HCPCS,C2628,CATH OCCLUSION LVL 01,594.0,127.71,110.48,1957.48,39
HCPCS,C2628,CATH OCCLUSION LVL 02,1132.0,243.38,210.55,1957.48,39
HCPCS,C2628,CATH OCCLUSION LVL 03,2695.0,579.42,501.27,2021.25,39
HCPCS,C2628,CATH OCCLUSION LVL 04,4885.0,1050.28,908.61,3663.75,39
HCPCS,C2628,CATH OCCLUSION LVL 05,9265.0,1991.98,1441.19,6948.75,39
HCPCS,C2628,CATH OCCLUSION LVL 06,13895.0,2987.42,1441.19,10421.25,39
HCPCS,C2629,INTRO EP LASER LVL 01,313.0,67.3,58.22,234.75,39
HCPCS,C2629,INTRO EP LASER LVL 02,594.0,127.71,110.48,445.5,39
HCPCS,C2629,INTRO EP LASER LVL 03,1888.0,405.92,162.55,1416.0,39
HCPCS,C2629,INTRO EP LASER LVL 04,3083.0,662.84,162.55,2312.25,39
HCPCS,C2629,INTRO EP LASER LVL 05,4885.0,1050.28,162.55,3663.75,39
HCPCS,C2629,INTRO EP LASER LVL 06,9265.0,1991.98,162.55,6948.75,39
HCPCS,C2629,INTRO EP LASER LVL 07,13895.0,2987.42,162.55,10421.25,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 01,1413.0,303.8,262.82,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 02,2695.0,579.42,501.27,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 03,3853.0,828.4,716.66,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 04,4880.0,1049.2,907.68,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 05,5861.0,1260.12,1090.15,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 06,6487.0,1394.7,1206.58,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 07,7413.0,1593.8,1378.82,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 08,9265.0,1991.98,1723.29,8015.46,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 09,11575.0,2488.62,2152.95,8681.25,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 10,13432.0,2887.88,2498.35,10074.0,39
HCPCS,C2630,CATH ABL COOL-TIP LVL 11,17086.0,3673.49,3178.0,12814.5,39
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 01,2421.0,692.41,450.31,2669.58,42
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 02,3853.0,1101.96,716.66,2889.75,42
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 03,6105.0,1746.03,1135.53,4578.75,42
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 04,9265.0,2649.79,1723.29,6948.75,42
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 05,11580.0,3311.88,1965.46,8685.0,42
HCPCS,C2638,BRACHY STRND I-125/SRCE,445.0,127.27,27.12,333.75,65
HCPCS,C2641,BRACHY N-STRND P-103/SRCE,251.0,71.79,50.39,291.96,130
HCPCS,C2642,BRACHY STRND C-131/SRCE,7118.0,2035.75,52.1,5338.5,65
HCPCS,C8001,IMG 3D SEG ANAT PLAN&PREP&TRANS,275.0,49.915,33.89,1618.0,122
HCPCS,C8921,ECHO CONG ANM CMP W CNT,2134.0,524.96,518.51,2497.0,62
HCPCS,C8922,ECHO CONG ANM LTD W CNT,1094.0,269.12,357.74,2497.0,62
HCPCS,C8923,ECHO 2D CMP W CNT,1730.0,425.58,518.51,2497.0,62
HCPCS,C8924,ECHO 2D LTD W CNT,1235.0,303.81,266.89,2497.0,62
HCPCS,C8924,ED ECHO 2D LTD W CNT,1235.0,303.81,266.89,2497.0,62
HCPCS,C8925,ECHO 2D TEE CMP W CNT W I&R,2947.0,724.96,518.51,4552.1,62
HCPCS,C8928,ECHO 2D REST&STRESS W CNT W I&R,1790.0,440.34,518.51,5498.74,62
HCPCS,C8929,ECHO 2D DOPP&CLR FLW CMP W CNT,3348.0,823.61,518.51,3741.75,62
HCPCS,C8930,ECHO 2D REST&STRESS/EKG MNTR W CNT,2344.0,576.62,518.51,3741.75,62
HCPCS,C8937,MRI CAD BREAST,253.0,48.58,47.06,1618.0,74
HCPCS,C9352,IMP NEURAGEN NRV GUIDE/CM LVL 01,1413.0,404.12,262.82,8367.75,42
HCPCS,C9352,IMP NEURAGEN NRV GUIDE/CM LVL 02,2695.0,770.77,501.27,8367.75,42
HCPCS,C9352,IMP NEURAGEN NRV GUIDE/CM LVL 03,3853.0,1101.96,716.66,8367.75,42
HCPCS,C9352,IMP NEURAGEN NRV GUIDE/CM LVL 04,6105.0,1746.03,1038.0,8367.75,42
HCPCS,C9352,IMP NEURAGEN NRV GUIDE/CM LVL 05,9265.0,2649.79,1038.0,8367.75,42
HCPCS,C9352,IMP NEURAGEN NRV GUIDE/CM LVL 06,11580.0,3311.88,1038.0,8685.0,42
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 01,2695.0,770.77,501.27,6089.17,42
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 02,3853.0,1101.96,716.66,6089.17,42
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 03,6100.0,1744.6,1107.13,6089.17,42
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 04,6718.0,1921.35,1107.13,6089.17,42
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 05,9265.0,2649.79,1107.13,6948.75,42
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 06,11580.0,3311.88,1107.13,8685.0,42
HCPCS,C9355,NEUROMATRIX 2.5CM LENGTH/0.5CM,430.5,123.12,62.04,1375.7,38
HCPCS,C9356,TENOGLIDE TENDON PROT 10X12.5/SC,106.8,30.54,15.39,743.56,38
HCPCS,C9356,TENOGLIDE TENDON PROT 5X5/SC,351.4,100.5,50.64,743.56,38
HCPCS,C9358,SURGIMEND FETAL FIX INT 6X12/.5 SC,34.2,9.78,4.93,152.6,38
HCPCS,C9600,PLC STENT/S DE SGL COR ART/BR SGL,19347.0,5126.96,7281.13,52235.0,62
HCPCS,C9601,PLC STENT/S DE COR ART/BR ADDL,14511.0,3845.42,1229.0,14891.0,39
HCPCS,C9602,ATHERECT&STENT/PTCA DE ART COR SGL,23113.0,6124.95,8905.0,32276.26,62
HCPCS,C9603,ATHERECT&STENT/PTCA DE ART COR ADD,17335.0,4593.78,982.0,14891.0,39
HCPCS,C9604,REVASC DE GRFT BYPASS COR VSL SGL,21872.0,5796.08,7281.13,20325.69,62
HCPCS,C9605,REVASC DE GRFT BYPASS COR VSL ADDL,16405.0,4347.32,982.0,14891.0,39
HCPCS,C9606,REVASC DE OCC MI ACUTE COR VSL SGL,24619.0,6524.04,982.0,18464.25,39
HCPCS,C9607,REVASC DE OCC CHRONIC COR VSL SGL,26475.0,7015.88,8905.0,32276.26,62
HCPCS,C9608,REVASC DE OCC CHRONIC COR VSL ADDL,19858.0,5262.37,982.0,52235.0,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL01,313.0,67.3,58.22,917.98,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL02,1413.0,303.8,262.82,1059.75,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL03,3853.0,828.4,675.86,2889.75,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL04,6105.0,1312.58,675.86,4578.75,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL05,9265.0,1991.98,675.86,6948.75,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL06,13895.0,2987.42,675.86,10421.25,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL07,17524.0,3767.66,675.86,13143.0,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL08,21904.0,4709.36,675.86,16428.0,39
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL09,26284.0,5651.06,675.86,19713.0,39
HCPCS,C9728,PLC DEV/S MRKRS THRPY RAD NON-PROS,3220.0,1152.76,915.08,4664.0,118
HCPCS,C9733,ANGIO FLUORESCENT VASC NON-OPTH,1187.0,334.73,241.82,1516.98,62
HCPCS,C9764,REVASC LITH INTRAV INCL ANGIOPLSTY,16112.0,5768.1,5221.0,20325.69,62
HCPCS,C9765,REVASC LITH INTRAV STNT ANGIOPLSTY,17769.0,6361.3,5221.0,32276.26,62
HCPCS,C9766,REVASC LITH INTRAV ATHR ANGIOPLSTY,19819.0,7095.2,6142.0,32276.26,62
HCPCS,C9767,REVASC LITH INTRAV STNT ATHR ANGIO,24644.0,8822.55,6142.0,32276.26,62
HCPCS,C9772,REVASC LITH INTRAV TIB/PER INCL ANG,11612.0,4157.1,5221.0,20325.69,62
HCPCS,C9793,GENERATE 3D PREDICT MDL CCTA&/MRI,1375.0,249.565,32.76,1618.0,120
HCPCS,C9797,EMB/OCCL VASC TMRS/ORG W CTH PG S&I,13768.0,4928.94,3873.92,32276.26,62
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL01,166.0,47.48,30.88,259.76,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL02,313.0,89.52,58.22,259.76,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL03,594.0,169.88,110.48,445.5,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL04,1413.0,404.12,191.25,1059.75,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL05,2695.0,770.77,191.25,2021.25,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL06,3853.0,1101.96,191.25,2889.75,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL07,6105.0,1746.03,191.25,4578.75,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL08,6950.0,1987.7,191.25,5212.5,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL09,9265.0,2649.79,191.25,6948.75,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL10,11580.0,3311.88,191.25,8685.0,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL11,13895.0,3973.97,191.25,10421.25,42
HCPCS,C9808,PROBE CRYOABLATION NON OPIOID LVL12,17524.0,5011.86,191.25,13143.0,42
HCPCS,G0008,ADMIN FEE INFLUENZA,116.0,21.58,29.0,139.0,63
HCPCS,G0009,ADMIN FEE PNEUMOCOCCAL,116.0,21.58,29.0,139.0,63
HCPCS,G0010,ADMIN FEE HEPATITIS B,116.0,21.58,29.0,139.0,63
HCPCS,G0166,COUNTERPULSATION EXTERNAL PER TX,1044.0,305.89,81.16,1043.3,63
HCPCS,G0237,IMPRV RESP STRENGTH MUSC/S 15MIN,168.0,32.59,10.99,126.0,59
HCPCS,G0238,IMPRV RESP FNCT 15MIN,213.0,41.32,10.02,159.75,59
HCPCS,G0239,IMPRV RESP FNCT/STRENGTH MUSC/S GRP,270.0,52.38,12.62,202.5,59
HCPCS,G0257,DIALYSIS OP UNSCH/ER ESRD PT,2395.0,457.44,474.4,3504.34,62
HCPCS,G0269,PLC DEV/S OCCLUSIVE,461.0,165.04,85.75,4664.0,99
HCPCS,G0277,HBOT CHAMBER FULL BODY 30MIN,1267.0,486.53,86.48,2356.0,63
HCPCS,G0278,ANGIO ILIAC/FEMORAL DURING HRT CATH,1800.0,477.0,12.95,14891.0,38
HCPCS,G0279,TOMOSYNTHESIS DX DIG BRST UNI/BI,52.0,23.82,9.67,104.95,40
HCPCS,G0288,CTA RECON AORTA,1715.0,293.27,42.15,1286.25,33
HCPCS,G0378,OBSRV ICU INTERMEDIATE PER HOUR,326.0,72.05,30.0,12623.0,378
HCPCS,G0378,OBSRV MEDICAL/SURGICAL PER HOUR,156.0,34.48,29.02,12623.0,1176
HCPCS,G0378,OBSRV OB PER HOUR,156.0,34.48,29.02,12623.0,210
HCPCS,G0379,ADMISSION DIRECT OBSERVATION HOSP,668.0,273.88,30.0,9768.0,62
HCPCS,G0390,ED TRAUMA ACT LVL1 EVAL/GREEN W CC,7025.0,1636.82,1012.3,7907.0,61
HCPCS,G0390,ED TRAUMA ACT LVL1 FULL/RED W CC,17610.0,4103.13,1422.32,13207.5,61
HCPCS,G0390,ED TRAUMA ACT LVL1 LTD/YELLOW W CC,11710.0,2728.43,1422.32,8782.5,61
HCPCS,G0416,LAB PATH GROSS&MICRO BX PROS NDL,1245.0,346.11,179.4,2645.23,59
HCPCS,J0287,AMPHO B LIPID/10MG 10MG/10ML SPIJ,43.4,12.37,8.07,74.57,41
HCPCS,J0881,DARBEPO/1MCG 300MCG/.6ML SNIJ,22.4,6.38,2.34,21.15,67
HCPCS,J1250,DOBUTAMN/250MG 250MG/20ML SNIV,85.0,4.08,7.58,63.75,40
HCPCS,J2265,MINOCYCLINE HCL/1MG 100MG/5ML PWIJ,9.3,2.65,2.09,18.56,67
HCPCS,J2371,PHENYLEPH/20MCG 40MG/250ML SNIV,0.2,0.01,0.01,0.15,40
HCPCS,J2560,PHENOBRB SOD/<=120MG 130MG/1ML SNIJ,120.8,5.8,22.47,213.26,40
HCPCS,J2765,METOCLOPRAMIDE/<=10MG 10MG/2ML SNIJ,0.35,0.02,0.0651,8.18,40
HCPCS,J3010,FENTNYL CITR/0.1MG 1MG/100ML EP,8.9,0.43,0.84,6.67,40
HCPCS,J3285,TREPROSTINIL/1MG 50MG/20ML SN MDV,58.6,16.7,24.44,122.52,67
HCPCS,J3480,KCL-NACL 0.90%/2MEQ 40MEQ/1L SNIV,3.7,0.18,0.11,2.77,40
HCPCS,J3490,CARDIOPLEGIA/1000ML 1000ML SNIJ,53.24,2.56,7.67,39.93,29
HCPCS,J3490,CYCLOPENTOLATE-PHENYL/2ML 2ML SNOP,35.26,11.6,5.08,26.45,29
HCPCS,J3490,D5-NACL 0.2%/500ML SNIV,5.13,0.25,0.73923,3.85,29
HCPCS,J3490,EYE LUB 1% REFRSH/0.4ML 0.4ML GL,3.6,1.18,0.51876,2.7,29
HCPCS,J3490,FAT EMULSN CLIN 20%/250ML 250ML EM,50.3,2.41,7.25,37.73,29
HCPCS,J3490,LORATA-PSEUDOE/10-240MG TBER 24H,4.0,1.32,0.5764,3.0,29
HCPCS,J3490,MENTHL-METHYL SALC 10-15%/85GM CR,5.7,1.88,0.82137,4.28,29
HCPCS,J3490,MICROFIB COLL/70X35 SNTP,190.0,9.12,27.38,142.5,29
HCPCS,J3490,NITROGLYCERIN/0.4MG 10MG FLER,0.82,0.27,0.11816,0.615,29
HCPCS,J3490,PLEGISOL/1000ML 1000ML SNIJ,85.27,4.09,12.29,63.95,29
HCPCS,J3490,POLYCARBOPHIL/625MG 625MG TB,2.3,0.76,0.33143,1.73,29
HCPCS,J3490,TRIMETHOPRIM-POLYB/10ML 10ML SNOP,23.2,7.63,3.34,17.4,29
HCPCS,J3490,ZINC OXIDE 40%/57GM 57GM PS,6.9,2.27,0.99429,5.17,29
HCPCS,J3590,TUBERCULIN PPD/1ML 5U/0.1ML SNIJ,22.735,7.48,1.21,27.82,58
HCPCS,J7999,SMOG COMP/300ML 300ML EN,95.4,31.39,17.74,71.55,31
HCPCS,J8499,ACETAZOLAMIDE/250MG 250MG TB,1.67,0.55,0.24065,13.3,35
HCPCS,J8499,BUMETANIDE/2MG 2MG TB,7.0,2.3,1.01,13.3,35
HCPCS,J8499,CETIRIZINE/5ML 5MG/5ML SNPO,4.8,1.58,0.69168,13.3,35
HCPCS,J8499,DIPHENOXYLT-ATROP/2.5-0.025MG TB,0.05,0.02,0.0072,13.3,35
HCPCS,J8499,DOXYCYCLINE MONOHYD/100MG 100MG CP,0.09,0.03,0.01297,13.3,35
HCPCS,J8499,ESTRADL/0.5MG 0.5MG TB,4.5,1.48,0.64845,13.3,35
HCPCS,J8499,ISOSORBIDE DINITRATE/30MG 30MG TB,1.05,0.35,0.1513,13.3,35
HCPCS,J8499,METOLAZONE/2.5MG 2.5MG TB,6.9,2.27,0.99429,13.3,35
HCPCS,J8499,MIRTAZAPINE/15MG 15MG TBDS,6.0,1.97,0.8646,13.3,35
HCPCS,J8499,MOXIFLOXACIN/400MG 400MG TB,2.94,0.97,0.42365,13.3,35
HCPCS,J8499,OPIUM TINCTURE/1ML 1ML TN,5.23,1.72,0.75364,13.3,35
HCPCS,J8499,PAROMOMYCIN/250MG 250MG CP,4.05,1.33,0.58361,13.3,35
HCPCS,J8499,PEN V POT/250MG 5GM/100ML PWPO,34.6,11.38,4.99,25.95,35
HCPCS,J8499,SULFASALAZINE/500MG 500MG TB,4.9,1.61,0.70609,13.3,35
HCPCS,J8499,TRAZODONE/150MG 150MG TB,4.4,1.45,0.63404,13.3,35
HCPCS,J9049,BORTEZOMIB HOS/0.1MG 2.5MG PWIJ,13.2,3.76,1.71,9.9,41
HCPCS,J9201,GEMCITABN NOS/200MG 2GM/52.6ML SNIV,1.78,0.09,0.33108,21.62,40
HCPCS,J9311,RITUXIM-HYAL/10MG 1.4GM-23400U SNIJ,23.5,6.7,4.37,271.87,44
HCPCS,J9332,EFGARTIGIMOD-AL/2MG 400MG/20ML SNIV,92.6,26.39,25.72,130.31,67
HCPCS,J9999,LIFILEUCEL TIL/DOSE 7.5B-72B SNIJ,3141500.0,1033647.74,4.9,2356125.0,32
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 01,2695.0,770.77,339.25,2021.25,43
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 02,3853.0,1101.96,339.25,2889.75,43
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 03,6105.0,1746.03,339.25,4578.75,43
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 04,13895.0,3973.97,339.25,10421.25,43
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 05,19272.0,5511.79,339.25,14454.0,43
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 06,20152.0,5763.47,339.25,15114.0,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 01,166.0,47.48,30.88,602.41,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 02,447.0,127.84,83.14,602.41,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 03,709.0,202.77,131.87,602.41,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 04,1272.0,363.79,176.16,954.0,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 05,2690.0,769.34,176.16,2017.5,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 06,3078.0,880.31,176.16,2308.5,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 07,3591.0,1027.03,176.16,2693.25,43
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 08,6105.0,1746.03,176.16,4578.75,43
HCPCS,L8610,IMP OCULAR LVL 01,166.0,47.48,30.88,1548.72,43
HCPCS,L8610,IMP OCULAR LVL 02,313.0,89.52,58.22,1548.72,43
HCPCS,L8610,IMP OCULAR LVL 03,594.0,169.88,110.48,1548.72,43
HCPCS,L8610,IMP OCULAR LVL 04,1413.0,404.12,262.82,1548.72,43
HCPCS,L8610,IMP OCULAR LVL 05,2695.0,770.77,452.85,2021.25,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 01,50370.0,14405.82,9368.82,56628.48,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 02,63510.0,18163.86,11812.86,56628.48,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 03,76650.0,21921.9,14256.9,57487.5,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 04,96364.0,27560.1,15261.64,72273.0,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 05,109504.0,31318.14,15261.64,82128.0,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 06,131404.0,37581.54,15261.64,98553.0,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 07,153304.0,43844.94,15261.64,114978.0,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 08,175204.0,50108.34,15261.64,131403.0,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 09,197104.0,56371.74,15261.64,147828.0,43
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 10,219004.0,62635.14,15261.64,164253.0,43
HCPCS,L8630,IMP DEV JT FNGR MCP LVL 01,1413.0,404.12,260.66,1059.75,43
HCPCS,L8630,IMP DEV JT FNGR MCP LVL 02,2695.0,770.77,260.66,2021.25,43
HCPCS,L8630,IMP DEV JT FNGR MCP LVL 03,3853.0,1101.96,260.66,2889.75,43
HCPCS,L8630,IMP DEV JT FNGR MCP LVL 04,6105.0,1746.03,260.66,4578.75,43
HCPCS,L8630,IMP DEV JT FNGR MCP LVL 05,9265.0,2649.79,260.66,6948.75,43
HCPCS,L8689,SYS RECHG EXT BTRY INT RPLC ONLY,6080.0,2346.88,1130.88,4560.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 01,594.0,169.88,110.48,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 02,1132.0,323.75,210.55,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 03,1619.0,463.03,301.13,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 04,2695.0,770.77,501.27,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 05,4885.0,1397.11,908.61,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 06,6950.0,1987.7,1292.7,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 07,9265.0,2649.79,1723.29,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 08,11580.0,3311.88,2153.88,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 09,13895.0,3973.97,2584.47,12356.62,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 10,17524.0,5011.86,3259.46,13143.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 11,21904.0,6264.54,3613.25,16428.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 12,26284.0,7517.22,3613.25,19713.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 13,30664.0,8769.9,3613.25,22998.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 14,35044.0,10022.58,3613.25,26283.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 15,39424.0,11275.26,3613.25,29568.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 16,43804.0,12527.94,3613.25,32853.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 17,48184.0,13780.62,3613.25,36138.0,43
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 18,52564.0,15033.3,3613.25,39423.0,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 01,313.0,120.82,58.22,3938.58,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 02,594.0,229.28,110.48,3938.58,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 03,1413.0,545.42,262.82,3938.58,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 04,2695.0,1040.27,501.27,3938.58,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 05,3853.0,1487.26,716.66,3938.58,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 06,6105.0,2356.53,1135.53,4578.75,43
HCPCS,L8693,DEVICE OSSEO AUD ABUTMENT LVL 07,9265.0,3576.29,1151.7,6948.75,43
HCPCS,L8699,DEVICE HEART ARTIFICIAL 70CC,744600.0,212955.6,1312.53,558450.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 03,2157.0,616.9,401.2,1782.74,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 04,3083.0,881.74,573.44,2312.25,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 06,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 07,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 08,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 09,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 10,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 11,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 12,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 13,35482.0,10147.85,1312.53,26611.5,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 14,39862.0,11400.53,1312.53,29896.5,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 15,44242.0,12653.21,1312.53,33181.5,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 16,48622.0,13905.89,1312.53,36466.5,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 17,53002.0,15158.57,1312.53,39751.5,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 18,61324.0,17538.66,1312.53,45993.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 19,70084.0,20044.02,1312.53,52563.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 20,78844.0,22549.38,1312.53,59133.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 21,87604.0,25054.74,1312.53,65703.0,42
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 22,96364.0,27560.1,1312.53,72273.0,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 02,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 03,1132.0,323.75,210.55,1782.74,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 04,3083.0,881.74,573.44,2312.25,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 06,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 07,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 08,11580.0,3311.88,1312.53,8685.0,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 09,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 10,15334.0,4385.52,1312.53,11500.5,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 11,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 12,19714.0,5638.2,1312.53,14785.5,42
HCPCS,L8699,IMP CONNECTOR NERVE LVL 01,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP CONNECTOR NERVE LVL 02,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP CONNECTOR NERVE LVL 03,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP CONNECTOR NERVE LVL 04,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 02,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 03,2157.0,616.9,401.2,1782.74,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 04,3596.0,1028.46,668.86,2697.0,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 06,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 07,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 08,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 01,166.0,47.48,30.88,1782.74,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 02,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 03,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 04,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 05,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 06,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 07,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 08,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP CUFF APICAL HEART LVL 09,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 01,240904.0,68898.54,1312.53,180678.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 02,262804.0,75161.94,1312.53,197103.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 03,284704.0,81425.34,1312.53,213528.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 04,306604.0,87688.74,1312.53,229953.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 05,328504.0,93952.14,1312.53,246378.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 06,350404.0,100215.54,1312.53,262803.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 07,372304.0,106478.94,1312.53,279228.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 08,394204.0,112742.34,1312.53,295653.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 09,416104.0,119005.74,1312.53,312078.0,42
HCPCS,L8699,IMP DEV ASSIST VENTRICULR LVL 10,438004.0,125269.14,1312.53,328503.0,42
HCPCS,L8699,IMP EXPANDER TISSUE LVL 01,2426.0,693.84,451.24,1819.5,42
HCPCS,L8699,IMP EXPANDER TISSUE LVL 02,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP EXPANDER TISSUE LVL 03,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP EXPANDER TISSUE LVL 04,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP EXPANDER TISSUE LVL 05,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 01,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 03,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 04,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 05,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 06,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 07,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP FIBROCARTILAGE HMN/SYNTH LVL 08,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 03,2157.0,616.9,401.2,1782.74,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 04,3083.0,881.74,573.44,2312.25,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 06,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 07,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 08,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 09,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 10,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 11,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 12,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 01,2690.0,769.34,500.34,2017.5,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 02,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 03,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 04,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 05,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 06,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 07,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 08,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 09,35044.0,10022.58,1312.53,26283.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 10,39424.0,11275.26,1312.53,29568.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 11,52564.0,15033.3,1312.53,39423.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 12,65704.0,18791.34,1312.53,49278.0,42
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 13,78844.0,22549.38,1312.53,59133.0,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 01,159.0,45.47,29.57,1782.74,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 02,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 03,850.0,243.1,158.1,1782.74,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 04,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 05,1888.0,539.97,351.17,1782.74,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 06,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 07,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 08,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 09,8107.0,2318.6,1312.53,6080.25,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 01,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 02,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 03,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 04,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 05,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 06,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 07,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 08,35044.0,10022.58,1312.53,26283.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 09,39424.0,11275.26,1312.53,29568.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 10,43804.0,12527.94,1312.53,32853.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 11,48184.0,13780.62,1312.53,36138.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 12,52564.0,15033.3,1312.53,39423.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 13,57820.0,16536.52,1312.53,43365.0,42
HCPCS,L8699,IMP PROSTH ANKLE LVL 14,67894.0,19417.68,1312.53,50920.5,42
HCPCS,L8699,IMP PROSTH CUSTOM LVL 01,87604.0,25054.74,1312.53,65703.0,42
HCPCS,L8699,IMP PROSTH CUSTOM LVL 02,109504.0,31318.14,1312.53,82128.0,42
HCPCS,L8699,IMP PROSTH CUSTOM LVL 03,131404.0,37581.54,1312.53,98553.0,42
HCPCS,L8699,IMP PROSTH CUSTOM LVL 04,153304.0,43844.94,1312.53,114978.0,42
HCPCS,L8699,IMP PROSTH CUSTOM LVL 05,175204.0,50108.34,1312.53,131403.0,42
HCPCS,L8699,IMP PROSTH ENT LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP PROSTH ENT LVL 02,1132.0,323.75,210.55,1782.74,42
HCPCS,L8699,IMP PROSTH ENT LVL 03,1619.0,463.03,301.13,1782.74,42
HCPCS,L8699,IMP PROSTH ENT LVL 04,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP PROSTH ENT LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP PROSTH ENT LVL 06,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP PROSTH ENT LVL 07,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP PROSTH ENT LVL 08,11580.0,3311.88,1312.53,8685.0,42
HCPCS,L8699,IMP PROSTH ENT LVL 09,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP PROSTH ENT LVL 10,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP PROSTH ENT LVL 11,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP PROSTH ENT LVL 12,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 04,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 05,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 07,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 08,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 09,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 10,28474.0,8143.56,1312.53,21355.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 11,35044.0,10022.58,1312.53,26283.0,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 12,41614.0,11901.6,1312.53,31210.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 13,48184.0,13780.62,1312.53,36138.0,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 14,54754.0,15659.64,1312.53,41065.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 15,59134.0,16912.32,1312.53,44350.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 16,63514.0,18165.0,1312.53,47635.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 17,67894.0,19417.68,1312.53,50920.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 18,72274.0,20670.36,1312.53,54205.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 19,76654.0,21923.04,1312.53,57490.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 20,81034.0,23175.72,1312.53,60775.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 21,85414.0,24428.4,1312.53,64060.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 22,89794.0,25681.08,1312.53,67345.5,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 23,91984.0,26307.42,1312.53,68988.0,42
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 24,98554.0,28186.44,1312.53,73915.5,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 02,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 03,2157.0,616.9,401.2,1782.74,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 04,3596.0,1028.46,668.86,2697.0,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 05,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 06,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 07,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 01,1614.0,461.6,300.2,1782.74,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 02,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 03,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 04,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 05,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 06,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 07,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 02,1619.0,463.03,301.13,1782.74,42
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 01,5368.0,1535.25,998.45,4026.0,42
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 02,11580.0,3311.88,1312.53,8685.0,42
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 03,15334.0,4385.52,1312.53,11500.5,42
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 04,19714.0,5638.2,1312.53,14785.5,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 01,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 02,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 03,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 04,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 05,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 06,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 07,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 08,35044.0,10022.58,1312.53,26283.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 01,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 02,39424.0,11275.26,1312.53,29568.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 03,52564.0,15033.3,1312.53,39423.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 04,65704.0,18791.34,1312.53,49278.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 05,78844.0,22549.38,1312.53,59133.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 06,87604.0,25054.74,1312.53,65703.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 07,100744.0,28812.78,1312.53,75558.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 08,109504.0,31318.14,1312.53,82128.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 09,118264.0,33823.5,1312.53,88698.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 10,127024.0,36328.86,1312.53,95268.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 11,135784.0,38834.22,1312.53,101838.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 12,144544.0,41339.58,1312.53,108408.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 13,153304.0,43844.94,1312.53,114978.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 14,162064.0,46350.3,1312.53,121548.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 15,170824.0,48855.66,1312.53,128118.0,42
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 16,179584.0,51361.02,1312.53,134688.0,42
HCPCS,L8699,IMP RETRACTOR SYS TISS LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP RETRACTOR SYS TISS LVL 02,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP RETRACTOR SYS TISS LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP RETRACTOR SYS TISS LVL 04,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP RETRACTOR SYS TISS LVL 05,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP RETRACTOR SYS TISS LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP RING CARDIAC LVL 01,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP RING CARDIAC LVL 02,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP RING CARDIAC LVL 03,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP SHUNT LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP SHUNT LVL 02,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP SHUNT LVL 03,1132.0,323.75,210.55,1782.74,42
HCPCS,L8699,IMP SHUNT LVL 04,1619.0,463.03,301.13,1782.74,42
HCPCS,L8699,IMP SHUNT LVL 05,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP SHUNT LVL 06,3909.0,1117.97,727.07,2931.75,42
HCPCS,L8699,IMP SHUNT LVL 07,6487.0,1855.28,1206.58,4865.25,42
HCPCS,L8699,IMP SHUNT LVL 08,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP SHUNT LVL 09,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP SHUNT LVL 10,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP SHUNT LVL 11,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP SHUNT LVL 12,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP SHUNT LVL 13,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP SHUNT TEMP LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP SHUNT TEMP LVL 02,1132.0,323.75,210.55,1782.74,42
HCPCS,L8699,IMP SHUNT TEMP LVL 03,1619.0,463.03,301.13,1782.74,42
HCPCS,L8699,IMP STENT NOS LVL 01,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP STENT NOS LVL 02,1132.0,323.75,210.55,1782.74,42
HCPCS,L8699,IMP STENT NOS LVL 03,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP STENT NOS LVL 04,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP STENT NOS LVL 05,6950.0,1987.7,1292.7,5212.5,42
HCPCS,L8699,IMP STENT NOS LVL 06,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP STENT NOS LVL 07,11580.0,3311.88,1312.53,8685.0,42
HCPCS,L8699,IMP STENT NOS LVL 08,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP STENT NOS LVL 09,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP STENT NOS LVL 10,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP STENT NOS LVL 11,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP STENT NOS LVL 12,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP STENT NOS LVL 13,35044.0,10022.58,1312.53,26283.0,42
HCPCS,L8699,IMP STENT NOS LVL 14,39424.0,11275.26,1312.53,29568.0,42
HCPCS,L8699,IMP STENT NOS LVL 15,43804.0,12527.94,1312.53,32853.0,42
HCPCS,L8699,IMP STENT NOS LVL 16,50374.0,14406.96,1312.53,37780.5,42
HCPCS,L8699,IMP STENT NOS LVL 17,56944.0,16285.98,1312.53,42708.0,42
HCPCS,L8699,IMP STENT NOS LVL 18,63514.0,18165.0,1312.53,47635.5,42
HCPCS,L8699,IMP STENT NOS LVL 19,67894.0,19417.68,1312.53,50920.5,42
HCPCS,L8699,IMP STENT NOS LVL 20,72274.0,20670.36,1312.53,54205.5,42
HCPCS,L8699,IMP STENT NOS LVL 21,76654.0,21923.04,1312.53,57490.5,42
HCPCS,L8699,IMP STENT NOS LVL 22,81034.0,23175.72,1312.53,60775.5,42
HCPCS,L8699,IMP STENT NOS LVL 23,83224.0,23802.06,1312.53,62418.0,42
HCPCS,L8699,IMP STENT NOS LVL 24,85414.0,24428.4,1312.53,64060.5,42
HCPCS,L8699,IMP STENT NOS LVL 25,87604.0,25054.74,1312.53,65703.0,42
HCPCS,L8699,IMP STENT NOS LVL 26,89794.0,25681.08,1312.53,67345.5,42
HCPCS,L8699,IMP STENT NOS LVL 27,109504.0,31318.14,1312.53,82128.0,42
HCPCS,L8699,IMP STENT NOS LVL 28,131404.0,37581.54,1312.53,98553.0,42
HCPCS,L8699,IMP STENT NOS LVL 29,153304.0,43844.94,1312.53,114978.0,42
HCPCS,L8699,IMP TUBE EAR LVL 01,166.0,47.48,30.88,1782.74,42
HCPCS,L8699,IMP TUBE EAR LVL 02,447.0,127.84,83.14,1782.74,42
HCPCS,L8699,IMP TUBE EAR LVL 03,709.0,202.77,131.87,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 01,313.0,89.52,58.22,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 02,594.0,169.88,110.48,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 03,850.0,243.1,158.1,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 04,1132.0,323.75,210.55,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 05,1413.0,404.12,262.82,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 06,1619.0,463.03,301.13,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 07,2157.0,616.9,401.2,1782.74,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 08,2695.0,770.77,501.27,2021.25,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 09,3853.0,1101.96,716.66,2889.75,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 10,6105.0,1746.03,1135.53,4578.75,42
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 11,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP VALVE LVL 01,4885.0,1397.11,908.61,3663.75,42
HCPCS,L8699,IMP VALVE LVL 02,9265.0,2649.79,1312.53,6948.75,42
HCPCS,L8699,IMP VALVE LVL 03,13895.0,3973.97,1312.53,10421.25,42
HCPCS,L8699,IMP VALVE LVL 04,17524.0,5011.86,1312.53,13143.0,42
HCPCS,L8699,IMP VALVE LVL 05,21904.0,6264.54,1312.53,16428.0,42
HCPCS,L8699,IMP VALVE LVL 06,26284.0,7517.22,1312.53,19713.0,42
HCPCS,L8699,IMP VALVE LVL 07,30664.0,8769.9,1312.53,22998.0,42
HCPCS,L8699,IMP VALVE LVL 08,35044.0,10022.58,1312.53,26283.0,42
HCPCS,L8699,IMP VALVE LVL 09,39424.0,11275.26,1312.53,29568.0,42
HCPCS,L8699,IMP VALVE LVL 10,43804.0,12527.94,1312.53,32853.0,42
HCPCS,L8699,IMP VALVE LVL 11,52564.0,15033.3,1312.53,39423.0,42
HCPCS,L8699,IMP VALVE LVL 12,61324.0,17538.66,1312.53,45993.0,42
HCPCS,L8699,IMP VALVE LVL 13,70084.0,20044.02,1312.53,52563.0,42
HCPCS,L8699,IMP VALVE LVL 14,83224.0,23802.06,1312.53,62418.0,42
HCPCS,L8699,IMP VALVE LVL 15,96364.0,27560.1,1312.53,72273.0,42
HCPCS,L8699,IMP VALVE LVL 16,109504.0,31318.14,1312.53,82128.0,42
HCPCS,L8699,IMP VALVE LVL 17,122644.0,35076.18,1312.53,91983.0,42
HCPCS,L8699,IMP VALVE LVL 18,140164.0,40086.9,1312.53,105123.0,42
HCPCS,L8699,IMP VALVE LVL 19,157684.0,45097.62,1312.53,118263.0,42
HCPCS,L8699,IMP VALVE LVL 20,175204.0,50108.34,1312.53,131403.0,42
HCPCS,L8699,IMP VALVE LVL 21,197104.0,56371.74,1312.53,147828.0,42
HCPCS,L8699,IMP VALVE LVL 22,208054.0,59503.44,1312.53,156040.5,42
HCPCS,L8699,IMP VALVE LVL 23,219004.0,62635.14,1312.53,164253.0,42
HCPCS,L8699,IMP VALVE LVL 24,240904.0,68898.54,1312.53,180678.0,42
HCPCS,L8699,IMP VALVE LVL 25,262804.0,75161.94,1312.53,197103.0,42
HCPCS,P9010,BLOOD WHOLE LR EA UNIT,650.0,166.4,108.85,598.68,63
HCPCS,P9011,BLOOD UNIT SPLIT DEGLYCEROLIZED,404.0,103.42,83.26,381.0,63
HCPCS,P9011,BLOOD UNIT SPLIT PLASMA FROZEN,54.0,13.82,17.66,381.0,63
HCPCS,P9011,BLOOD UNIT SPLIT PLATELET ALIQUOTS,379.0,97.02,83.26,381.0,63
HCPCS,P9011,BLOOD UNIT SPLIT PLATELET PTHGN RDC,379.0,97.02,83.26,381.0,63
HCPCS,P9011,BLOOD UNIT SPLIT RBC LR,135.0,34.56,44.15,381.0,63
HCPCS,P9012,CRYOPRECIPITATE EA UNIT,89.0,22.78,29.1,598.68,63
HCPCS,P9016,RBC LR AUTO EA UNIT,714.0,182.78,136.67,898.02,63
HCPCS,P9016,RBC LR EA UNIT,294.0,75.26,96.14,898.02,63
HCPCS,P9017,FFP FRZ WITHIN 8 HRS COLL EA UNIT,93.0,23.81,30.41,381.0,63
HCPCS,P9017,FFP FRZ WITHIN 8 HRS COLL PHER EA,93.0,23.81,30.41,381.0,63
HCPCS,P9022,RBC WASHED EA UNIT,441.0,112.9,144.21,917.98,63
HCPCS,P9022,RBC WASHED IRRD LR EA UNIT,497.0,127.23,162.52,917.98,63
HCPCS,P9035,PLATELETS PHER LR EA UNIT,731.0,187.14,239.04,4456.84,63
HCPCS,P9035,PLATELETS PHER LR LOW YIELD EA,1875.0,480.0,343.0,4456.84,63
HCPCS,P9037,PLATELETS PHER LR IRRD EA UNIT,787.0,201.47,257.35,4789.44,63
HCPCS,P9037,PLATELETS PHER LR IRRD LOW YIELD EA,2042.0,522.75,343.0,4789.44,63
HCPCS,P9037,PLATELETS PHER LR IRRD WASHED EA,934.0,239.1,305.42,4789.44,63
HCPCS,P9040,RBC LR IRRD EA UNIT,350.0,89.6,114.45,545.46,63
HCPCS,P9044,PLASMA CRYOPRECIPITATE RDC EA UNIT,442.0,113.15,47.63,738.97,63
HCPCS,P9050,GRANULOCYTES PHER IRRD EA UNIT,5385.0,1378.56,343.0,4038.75,40
HCPCS,P9054,RBC DGLC LR EA UNIT,891.0,228.1,215.21,798.24,63
HCPCS,P9056,BLOOD WHOLE LR IRRD EA UNIT,706.0,180.74,88.31,798.24,63
HCPCS,P9057,RBC LR IRRD DGLC EA UNIT,700.0,179.2,188.93,798.24,63
HCPCS,P9059,FFP FRZ 8-24 HRS AFTER COLL EA UNIT,93.0,23.81,30.41,381.0,63
HCPCS,P9073,PLATELETS PATHOGEN PHER LOW YIELDEA,1875.0,480.0,343.0,5243.11,62
HCPCS,P9073,PLATELETS PATHOGEN RDC EA UNIT,1875.0,480.0,343.0,5243.11,62
HCPCS,P9073,PLATELETS PATHOGEN RDC LOW YIELD EA,1875.0,480.0,343.0,5243.11,62
HCPCS,P9073,PLATELETS PATHOGEN RDC VOL RDC EA,1752.0,448.51,343.0,5243.11,62
HCPCS,P9073,PLATELETS PATHOGEN RDC WASHED EA,1752.0,448.51,343.0,5243.11,62
HCPCS,P9612,CATH COLLECT SPEC URINE,49.0,8.43,3.0,49.22,63
HCPCS,P9612,ED CATH COLLECT SPEC URINE,49.0,8.43,3.0,49.22,63
HCPCS,Q0114,POC FERN,66.0,10.56,9.74,64.79,63
HCPCS,Q0477,VAD RPL CABLE PWR MOD PT 0-12,3975.0,1534.35,739.35,2981.25,43
HCPCS,Q0477,VAD RPL CABLE PWR MOD PT 12+,3975.0,1534.35,739.35,2981.25,43
HCPCS,Q0478,VAD RPL CABLE PWR AUTO DC 0-12,1176.0,453.94,139.58,882.0,43
HCPCS,Q0479,VAD RPL E-E/P POWER MODULE 0-12,20352.0,7855.87,3785.47,31093.24,43
HCPCS,Q0481,VAD RPL ELC MICROPROC CU SYS 0-12,15363.0,5930.12,2857.52,37743.31,43
HCPCS,Q0481,VAD RPL ELC MICROPROC CU SYS 12+,15363.0,5930.12,2857.52,37743.31,43
HCPCS,Q0495,VAD RPL BATTERY CHGR 12+,24580.0,9487.88,3172.62,18435.0,43
HCPCS,Q0496,VAD RPL E-E/P BATTERY NONLITH 6+,2934.0,1132.52,545.72,3894.15,43
HCPCS,Q0497,VAD RPL E/P BATTERY CLIPS 0-12,4694.0,1811.88,355.57,3520.5,43
HCPCS,Q0497,VAD RPL E/P BATTERY CLIPS 12+,4694.0,1811.88,355.57,3520.5,43
HCPCS,Q0498,VAD RPL E-E/P HOLSTER 0-12,2214.0,854.6,390.15,1660.5,43
HCPCS,Q0498,VAD RPL E-E/P HOLSTER 12+,2214.0,854.6,390.15,1660.5,43
HCPCS,Q0499,VAD RPL ANY BAG CONSOLIDATED 0-12,1664.0,642.3,126.76,1248.0,43
HCPCS,Q0499,VAD RPL ANY BAG CONSOLIDATED 12+,1664.0,642.3,126.76,1248.0,43
HCPCS,Q0501,VAD RPL ANY SHOWER COVER 0-12,2304.0,889.34,387.89,1728.0,43
HCPCS,Q0501,VAD RPL ANY SHOWER COVER 12+,2304.0,889.34,387.89,1728.0,43
HCPCS,Q0506,VAD RPL BATTERY LI-ION 11V 0-6,2416.0,932.58,449.38,2218.58,43
HCPCS,Q0506,VAD RPL BATTERY LI-ION 11V 6+,2416.0,932.58,449.38,2218.58,43
HCPCS,Q0506,VAD RPL E-E/P BTRY LI-ION EA 6+,2401.0,926.79,446.59,2218.58,43
HCPCS,Q0508,VAD RPL CABLE PWR MOD DL 0-12,18117.0,6993.16,95.5,13587.75,42
HCPCS,Q0508,VAD RPL CABLE PWR MOD DL 12+,18117.0,6993.16,95.5,13587.75,42
HCPCS,Q2009,FOSPHENYTOIN/50MG 100MG/2ML PE SN,0.82,0.23,0.15252,5.12,44
HCPCS,Q4081,EPO ALFA ESRD/100U 2KU SNIJ,2.56,0.8400000000000001,0.04092,5.12,80
HCPCS,Q4081,EPO ALFA ESRD/100U 3KU SNIJ,4.375,1.44,0.1581,5.92,80
HCPCS,Q4081,EPO ALFA ESRD/100U 4KU SNIJ,2.56,0.8400000000000001,0.04092,5.12,80
HCPCS,Q4104,INTGR BM FIX INT 10X12.5/SC,133.8,38.27,19.28,333.86,62
HCPCS,Q4104,INTGR BM FIX INT 10X25/SC,118.6,33.92,17.09,333.86,62
HCPCS,Q4104,INTGR BM FIX INT 10X8/SC,297.7,85.14,42.9,333.86,62
HCPCS,Q4104,INTGR BM FIX INT 20X25/SC,93.9,26.86,13.53,333.86,62
HCPCS,Q4104,INTGR BM FIX INT 5X5/SC,422.0,120.69,49.53,333.86,62
HCPCS,Q4116,ALLDRM FIX INT 10.7X21.5 CNTR/SC,108.5,31.03,15.63,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 11.8X23.7 CNTR/SC,108.5,31.03,15.63,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 16X20/SC,114.9,32.86,16.56,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 20.1X23.6RSTR PRF/SC,129.0,36.89,18.59,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 2X4/SC,211.0,60.35,30.41,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 3X7/SC,136.5,39.04,19.67,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 4X12/SC,102.7,29.37,14.8,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 4X7/SC,106.0,30.32,15.27,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 7.3X14.7 CNTR/SC,108.6,31.06,15.65,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 8X16/SC,108.5,31.03,15.63,222.5,62
HCPCS,Q4116,ALLDRM FIX INT 9.6X19.3 CNTR/SC,111.8,31.97,16.11,222.5,62
HCPCS,Q4125,ARTHROFLEX INT 1.0MM 2.5X3/SC,451.1,129.01,65.0,410.16,61
HCPCS,Q4125,ARTHROFLEX INT 2.0MM 2.5X3/SC,602.9,172.43,86.88,452.18,61
HCPCS,Q4125,ARTHROFLEX INT 3.0MM 4X7/SC,421.5,120.55,60.74,410.16,61
HCPCS,Q4128,ALLPTCH HD FIX INT 2X5 THCK/SC,163.0,46.62,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 2X5 THIN/SC,104.1,29.77,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 4X8 THCK/SC,126.1,36.06,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 5X5 THCK ULT/SC,141.6,40.5,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 5X5 THCK/SC,147.7,42.24,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 5X5 THIN/SC,122.6,35.06,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 6X8 THIN/SC,154.8,44.27,29.91,222.5,66
HCPCS,Q4128,ALLPTCH HD FIX INT 8X12 THIN/SC,145.2,41.53,29.91,222.5,66
HCPCS,Q4128,FLEX HD DIAMOND XL 24X35 THCK/SC,58.5,16.73,19.13,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 10X16 THCK ULT/SC,74.8,21.39,24.46,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 12X16 THCK ULT/SC,65.1,18.62,21.29,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 12X24 THCK ULT/SC,64.3,18.39,21.03,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 15X24 THCK ULT/SC,51.3,14.67,16.78,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 16X20 THCK ULT/SC,63.0,18.02,20.6,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 1X2 THIN/SC,196.6,56.23,29.91,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 1X4 THCK ULT/SC,136.0,38.9,29.91,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 20X25 THCK/SC,85.6,24.48,27.99,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 20X30 THCK ULT/SC,71.4,20.42,23.35,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 23X26 THIN/SC,74.9,21.42,24.49,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 2X12 THCK ULT/SC,90.2,25.8,29.5,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 2X4 THIN/SC,83.2,23.8,27.21,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 2X7 THCK ULT/SC,121.9,34.86,29.91,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 3X12 THCK ULT/SC,77.4,22.14,25.31,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 3X7 THCK ULT/SC,95.2,27.23,29.91,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 3X7 THIN/SC,77.7,22.22,25.41,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 4X12 THCK ULT/SC,71.0,20.31,23.22,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 4X12 THIN/SC,48.3,13.81,15.79,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 4X16 THCK ULT/SC,68.9,19.71,22.53,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 4X7 THCK ULT/SC,80.2,22.94,26.23,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 4X7 THIN/SC,61.6,17.62,20.14,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 5X10 THCK ULT/SC,68.5,19.59,22.4,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 5X12 THCK ULT/SC,70.7,20.22,23.12,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 6X12 THCK ULT/SC,80.1,22.91,26.19,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 8X12 THCK ULT/SC,73.8,21.11,24.13,222.5,66
HCPCS,Q4128,FLEX HD FIX INT 8X16 THCK ULT/SC,82.1,23.48,26.85,222.5,66
HCPCS,Q4128,FLEXHD FIX INT 11X20 SHAPED/SC,75.0,21.45,24.52,222.5,66
HCPCS,Q4128,FLEXHD PLIABLE FIX INT 10X17 THN/SC,88.9,25.43,29.07,222.5,66
HCPCS,Q4130,STRAT TM FIX INT 10X10 FIRM/SC,89.3,25.54,12.87,410.16,61
HCPCS,Q4130,STRAT TM FIX INT 10X16 FIRM/SC,89.3,25.54,12.87,410.16,61
HCPCS,Q4130,STRAT TM FIX INT 16X20 FIRM/SC,89.3,25.54,12.87,410.16,61
HCPCS,Q4130,STRAT TM FIX INT 20X20 FIRM/SC,89.3,25.54,12.87,410.16,61
HCPCS,Q4130,STRAT TM FIX INT 20X25 FIRM/SC,89.3,25.54,12.87,410.16,61
HCPCS,Q4130,STRAT TM FIX INT 20X40 FIRM/SC,66.8,19.1,9.63,410.16,61
HCPCS,Q4130,STRAT TM FIX INT 6X8/SC,86.7,24.8,12.49,410.16,61
HCPCS,Q4133,GRAFIX PL PRIME FIX INT 16MMDISK/SC,692.6,198.08,99.8,519.45,62
HCPCS,Q4133,GRAFIX PRIME FIX EXT 3X4/SC,314.3,89.58,45.29,410.16,63
HCPCS,Q4133,GRAFIX PRIME FIX INT 16MMDISK/SC,692.6,198.08,99.8,519.45,62
HCPCS,Q4133,GRAFIX/GPL PRIM FIX INT 1.5X2/SC,819.8,234.46,118.13,614.85,62
HCPCS,Q4133,GRAFIX/GPL PRIM FIX INT 2X3/SC,512.2,146.49,73.81,410.16,62
HCPCS,Q4133,GRAFIX/GPL PRIM FIX INT 3X4/SC,314.3,89.89,45.29,410.16,62
HCPCS,Q4133,GRAFIX/GPL PRIM FIX INT 5X5/SC,310.2,88.72,44.7,410.16,62
HCPCS,Q4133,GRAFIX/GPL PRIM FIX INT 7.5X15/SC,205.8,58.86,29.66,410.16,62
HCPCS,Q4133,STRAVIX/STRAVPL PRIM FIX INT 2X2/SC,2093.5,598.74,132.79,1570.12,62
HCPCS,Q4133,STRAVIX/STRAVPL PRIM FIX INT 2X4/SC,663.2,189.68,95.57,497.4,62
HCPCS,Q4133,STRAVIX/STRAVPL PRIM FIX INT 3X6/SC,465.3,133.08,67.05,410.16,62
HCPCS,Q4137,AMNIOEXCEL FIX INT 5X8/SC,225.7,64.55,73.8,410.16,66
HCPCS,Q4151,AMNIOBAND FIX INT 16MM DISK/SC,488.0,139.57,132.79,410.16,66
HCPCS,Q4151,AMNIOBAND FIX INT 2X2/SC,436.6,124.87,132.79,410.16,66
HCPCS,Q4151,AMNIOBAND FIX INT 2X3/SC,304.7,87.14,99.64,410.16,66
HCPCS,Q4151,AMNIOBAND FIX INT 2X4/SC,359.8,102.9,117.65,410.16,66
HCPCS,Q4151,AMNIOBAND FIX INT 3X4/SC,247.9,70.9,81.06,410.16,66
HCPCS,Q4166,CYTAL MTRX 2LYR FIX INT 10X15/SC,39.6,11.33,5.71,410.16,62
HCPCS,Q4166,CYTAL MTRX 3LYR FIX INT 10X15/SC,66.2,18.93,9.54,410.16,62
HCPCS,Q4166,CYTAL MTRX 3LYR FIX INT 16X35/SC,45.0,12.87,6.48,410.16,62
HCPCS,Q4166,CYTAL MTRX 3LYR FIX INT 7X10/SC,87.9,25.14,12.67,410.16,62
HCPCS,Q4166,CYTAL MTRX 6LYR FIX INT 10X15/SC,93.7,26.8,13.5,410.16,62
HCPCS,Q4166,CYTAL MTRX 6LYR FIX INT 7X10/SC,110.1,31.49,15.87,410.16,62
HCPCS,Q4166,CYTAL MTRX BURN MSH FIX INT 7X10/SC,15.8,4.52,2.28,410.16,62
HCPCS,Q4166,CYTAL MTRX BURN MSH FIX INT10X15/SC,40.6,11.61,5.85,410.16,62
HCPCS,Q4173,PALGN/PALGN X+ FIX INT 4X8/SC,226.4,64.75,32.62,410.16,62
HCPCS,Q4174,PALGN/PM FIX INT 0.36MG/0.25CC 1CC,1253.1,358.39,180.57,2222.32,39
HCPCS,Q4174,PALGN/PM FIX INT 0.36MG/0.25CC 2CC,1081.7,309.37,155.87,2222.32,39
HCPCS,Q4186,EPIFIX FIX INT 14MM DISK/SC,526.7,150.64,75.9,410.16,62
HCPCS,Q4186,EPIFIX FIX INT 18MM DISK/SC,809.4,231.49,116.63,607.05,62
HCPCS,Q4186,EPIFIX FIX INT 2X2/SC,867.5,248.1,125.01,650.62,62
HCPCS,Q4186,EPIFIX FIX INT 2X3/SC,668.9,191.31,96.39,501.68,62
HCPCS,Q4186,EPIFIX FIX INT 2X4/SC,563.4,161.13,81.19,422.55,62
HCPCS,Q4186,EPIFIX FIX INT 3X4/SC,668.6,191.22,96.35,501.45,62
HCPCS,Q4186,EPIFIX FIX INT 4X4/SC,656.1,187.64,94.54,492.07,62
HCPCS,Q4186,EPIFIX FIX INT 5X6/SC,665.2,190.25,95.86,498.9,62
HCPCS,Q4186,EPIFIX MESH FIX EXT 3.5X3.5/SC,523.6,149.23,75.45,410.16,63
HCPCS,Q4186,EPIFIX MESH FIX INT 3.5X3.5/SC,523.6,149.75,75.45,410.16,62
HCPCS,Q4186,EPIFIX MESH FIX INT 4X4.5/SC,413.1,118.15,59.53,410.16,62
HCPCS,Q4432,DURAGEN CL 10X12.5/SH,3229.8,923.72,132.79,2422.35,61
HCPCS,Q4432,DURAGEN CL 2.5X2.5/SH 5/PKG,854.4,244.36,123.12,640.8,61
HCPCS,Q4432,DURAGEN CL 2.5X7.5/SH,1200.5,343.34,132.79,900.38,61
HCPCS,Q4432,DURAGEN CL 2.5X7.5/SH 5/PKG,1079.1,308.62,132.79,809.33,61
HCPCS,Q4432,DURAGEN CL 5X5/SH,1011.0,289.15,132.79,758.25,61
HCPCS,Q4432,DURAGEN CL 7.5X7.5/SH,1823.8,521.61,132.79,1367.85,61
HCPCS,Q4432,DURAGEN CL 7.5X7.5/SH 5/PKG,2028.5,580.15,132.79,1521.38,61
HCPCS,Q4432,DURAGEN PL 10X12.5/SH,4170.5,1192.76,132.79,3127.88,61
HCPCS,Q4432,DURAGEN PL 12.5X17.5/SH,5207.8,1489.43,132.79,3905.85,61
HCPCS,Q4432,DURAGEN PL 2.5X2.5/SH,841.0,240.53,121.19,630.75,61
HCPCS,Q4432,DURAGEN PL 2.5X7.5/SH,1366.2,390.73,132.79,1024.65,61
HCPCS,Q4432,DURAGEN PL 5X5/SH,1384.0,395.82,132.79,1038.0,61
HCPCS,Q4432,DURAGEN PL 7.5X7.5/SH,2458.7,703.19,132.79,1844.03,61
HCPCS,Q4432,DURAGEN PL 7.5X7.5/SH 5/PKG,2393.5,684.54,132.79,1795.12,61
HCPCS,Q4432,DURAGEN SU 2.5X7.5/SH,1369.5,391.68,132.79,1027.12,61
HCPCS,Q4432,DURAGEN SU 7.5X7.5/SH,2697.4,771.46,132.79,2023.05,61
HCPCS,Q4433,AMNIOFIX FIX INT 4X6/SHEET 24SC,6991.4,1999.54,132.79,5243.55,61
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 2KU SNIJ,1.81,0.5950000000000001,0.04092,5.12,80
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 3KU SNIJ,1.96,0.645,0.09672,5.12,80
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 4KU SNIJ,1.98,0.65,0.10416,5.12,80
HCPCS,Q5106,EPO ALFA EPBX/1000U 20KU SNIJ MDV,4.53,1.29,0.84258,51.22,44
HCPCS,S3620,LAB SCR METABOLIC NEWBORN,268.0,46.1,49.85,266.08,36
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 01,594.0,195.44,110.48,445.5,37
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 02,1132.0,372.46,139.52,849.0,37
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 03,2157.0,709.72,139.52,1617.75,37
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 01,594.0,195.44,110.48,445.5,37
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 02,1132.0,372.46,139.52,849.0,37
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 03,2157.0,709.72,139.52,1617.75,37
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 01,2695.0,770.77,501.27,2268.33,42
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 02,3853.0,1101.96,716.66,2889.75,42
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 03,6105.0,1746.03,1135.53,4578.75,42
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 04,9265.0,2649.79,1670.05,6948.75,42
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 05,13895.0,3973.97,1670.05,10421.25,42
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 06,17524.0,5011.86,1670.05,13143.0,42
ICD,Z95.811,Cardiac Assist Devices (BUMCP),,,14373.0,14373.0,1
LOCAL,200,SNF,,,2100.0,2100.0,1
LOCAL,212,SNF,,,778.0,1247.0,4
LOCAL,213,SNF,,,778.0,1247.0,4
LOCAL,214,SNF,,,778.0,1247.0,8
LOCAL,215,SNF,,,778.0,1247.0,4
LOCAL,216,SNF,,,778.0,1247.0,4
LOCAL,217,SNF,,,778.0,1247.0,4
LOCAL,218,SNF,,,778.0,1247.0,4
LOCAL,219,SNF,,,778.0,1247.0,4
MS-DRG,001,Heart-Kidney Transplant,,,409751.0,409751.0,1
MS-DRG,001,MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,431072.56,247408.0,918203.08,46
MS-DRG,001,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,002,Heart-Kidney Transplant,,,409751.0,409751.0,1
MS-DRG,002,MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,194769.27,106235.56,493969.32,46
MS-DRG,002,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,003,"MS-DRG 42.00: ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,339144.14,197895.34,695443.68,45
MS-DRG,004,"MS-DRG 42.00: TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,233837.66,129579.0,453841.12,45
MS-DRG,005,Kidney-Liver Transplant,,,299094.0,415564.0,3
MS-DRG,005,Liver (CAD) Transplant,,,257540.0,328795.0,3
MS-DRG,005,Liver (LRD) Transplant - Adult,,,257563.0,323940.0,2
MS-DRG,005,Liver Transplant Adult,,,261241.0,261241.0,1
MS-DRG,005,MS-DRG 42.00: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,164640.8,96773.5,361130.03,42
MS-DRG,005,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,006,Kidney-Liver Transplant,,,299094.0,415564.0,3
MS-DRG,006,Liver (CAD) Transplant,,,257540.0,328795.0,3
MS-DRG,006,Liver (LRD) Transplant - Adult,,,257563.0,323940.0,2
MS-DRG,006,Liver Transplant Adult,,,261241.0,261241.0,1
MS-DRG,006,MS-DRG 42.00: LIVER TRANSPLANT WITHOUT MCC,,76943.72,44209.99,270400.0,41
MS-DRG,006,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,007,Double Lung Transplant,,,343200.0,343200.0,1
MS-DRG,007,MS-DRG 42.00: LUNG TRANSPLANT,,195119.23,121229.62,424313.3,41
MS-DRG,007,Single Lung Transplant,,,327600.0,327600.0,1
MS-DRG,008,MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,83704.34,53174.56,285917.29,44
MS-DRG,010,MS-DRG 42.00: PANCREAS TRANSPLANT,,,66033.55,220364.57,46
MS-DRG,010,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,011,"MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,82018.16,51780.22,178703.59,45
MS-DRG,012,"MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,63708.83,40309.55,138137.24,45
MS-DRG,013,"MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,42727.07,27948.54,94422.18,45
MS-DRG,014,Allogeneic - Related BMT,,,218400.0,218400.0,1
MS-DRG,014,Allogeneic - Unrelated BMT,,,228800.0,228800.0,1
MS-DRG,014,Auto-Allo Transplant,,,379600.0,379600.0,1
MS-DRG,014,MS-DRG 42.00: ALLOGENEIC BONE MARROW TRANSPLANT,,182313.83,112592.11,393766.49,37
MS-DRG,016,Auto-Allo Transplant,,,379600.0,379600.0,1
MS-DRG,016,Auto/Auto Transplant,,,322400.0,322400.0,1
MS-DRG,016,MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,98259.54,56186.52,252866.41,38
MS-DRG,016,Tandem Auto-Auto BMT,,,322400.0,322400.0,1
MS-DRG,017,Auto-Allo Transplant,,,379600.0,379600.0,1
MS-DRG,017,Auto/Auto Transplant,,,322400.0,322400.0,1
MS-DRG,017,MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,98259.54,51578.24,173142.04,37
MS-DRG,018,MS-DRG 42.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,586073.52,199630.31,1414884.44,34
MS-DRG,019,MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,127163.14,67349.62,339065.06,44
MS-DRG,019,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,020,MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,134448.7,74151.78,341304.7,46
MS-DRG,021,MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,97686.87,50295.09,296783.86,46
MS-DRG,022,MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,62404.43,30687.19,248365.4,46
MS-DRG,023,MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,90178.62,54339.14,193940.17,46
MS-DRG,024,MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,60272.85,37492.13,160715.34,46
MS-DRG,025,MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,70246.74,43373.4,214928.57,46
MS-DRG,026,MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,46974.33,30055.33,160231.54,46
MS-DRG,027,MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,38702.52,24623.42,118004.69,46
MS-DRG,028,MS-DRG 42.00: SPINAL PROCEDURES WITH MCC,,95857.53,56914.73,196861.95,46
MS-DRG,029,MS-DRG 42.00: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,54530.31,32856.99,122685.08,46
MS-DRG,030,MS-DRG 42.00: SPINAL PROCEDURES WITHOUT CC/MCC,,36889.08,21587.35,76218.16,46
MS-DRG,031,MS-DRG 42.00: VENTRICULAR SHUNT PROCEDURES WITH MCC,,65490.45,42760.07,154860.77,46
MS-DRG,032,MS-DRG 42.00: VENTRICULAR SHUNT PROCEDURES WITH CC,,34264.37,20992.57,84138.41,46
MS-DRG,033,MS-DRG 42.00: VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,25817.59,16655.75,60943.0,46
MS-DRG,034,MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH MCC,,62054.47,37110.44,126823.49,46
MS-DRG,035,MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH CC,,36586.84,23396.76,88150.18,46
MS-DRG,036,MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,28760.44,19248.95,78783.95,46
MS-DRG,037,MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC,,53703.12,31749.85,107865.66,46
MS-DRG,038,MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC,,25451.72,16282.39,56170.19,46
MS-DRG,039,MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,18150.26,12140.12,41721.3,46
MS-DRG,040,"MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,61259.1,37022.43,126512.22,46
MS-DRG,041,"MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,35489.24,21619.8,73793.7,46
MS-DRG,042,"MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,27678.74,17256.11,58513.1,46
MS-DRG,052,MS-DRG 42.00: SPINAL DISORDERS AND INJURIES WITH CC/MCC,,30939.74,18030.63,58347.91,46
MS-DRG,053,MS-DRG 42.00: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,15652.81,10321.44,42520.39,46
MS-DRG,054,MS-DRG 42.00: NERVOUS SYSTEM NEOPLASMS WITH MCC,,23447.39,15395.75,50028.88,46
MS-DRG,055,MS-DRG 42.00: NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,17068.56,10695.73,37508.4,46
MS-DRG,056,MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,38082.13,22772.32,76116.37,46
MS-DRG,057,MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,21681.68,13252.81,42450.33,46
MS-DRG,058,MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,27487.86,17087.48,56011.77,46
MS-DRG,059,MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,18881.99,12746.02,40658.09,46
MS-DRG,060,MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,14268.87,9771.11,30137.25,46
MS-DRG,061,"MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,44588.23,26793.21,98304.62,46
MS-DRG,062,"MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,29778.51,17529.42,80387.57,46
MS-DRG,063,"MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,23654.19,14255.26,71749.76,46
MS-DRG,064,MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,31862.37,19880.81,65890.41,46
MS-DRG,065,MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,16161.84,10609.57,46238.62,46
MS-DRG,066,MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,10944.24,7590.19,38215.08,46
MS-DRG,067,MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,22540.68,14856.53,48121.96,46
MS-DRG,068,MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,13855.28,9257.85,28322.07,46
MS-DRG,069,MS-DRG 42.00: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,12709.95,8650.09,28142.17,46
MS-DRG,070,MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,,28474.11,16673.34,54547.17,46
MS-DRG,071,MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,,16893.58,10755.03,38644.52,46
MS-DRG,072,MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,12455.43,8255.41,29582.71,46
MS-DRG,073,MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,24067.78,16112.81,52564.89,46
MS-DRG,074,MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,16320.91,10799.49,33774.16,46
MS-DRG,075,MS-DRG 42.00: VIRAL MENINGITIS WITH CC/MCC,,30446.62,19014.55,62826.89,46
MS-DRG,076,MS-DRG 42.00: VIRAL MENINGITIS WITHOUT CC/MCC,,14682.46,8894.67,27620.32,46
MS-DRG,077,MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH MCC,,24035.97,15270.77,25196.77,31
MS-DRG,078,MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH CC,,16177.75,10169.63,16779.89,31
MS-DRG,079,MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,,11787.33,7088.84,11696.59,31
MS-DRG,080,MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITH MCC,,35139.28,18018.58,59304.65,46
MS-DRG,081,MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,14475.66,9546.91,29344.33,46
MS-DRG,082,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,36236.88,22424.9,74887.68,46
MS-DRG,083,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,21570.33,14181.14,53974.04,46
MS-DRG,084,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,14634.74,10104.65,44972.03,46
MS-DRG,085,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,36157.35,22297.96,74438.8,46
MS-DRG,086,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,20949.95,13318.58,42732.4,46
MS-DRG,087,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,14093.89,9723.88,31985.42,46
MS-DRG,088,MS-DRG 42.00: CONCUSSION WITH MCC,,24401.83,13773.47,44291.73,46
MS-DRG,089,MS-DRG 42.00: CONCUSSION WITH CC,,18293.42,11427.64,35995.63,46
MS-DRG,090,MS-DRG 42.00: CONCUSSION WITHOUT CC/MCC,,14873.35,8876.15,26972.15,46
MS-DRG,091,MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,28458.2,17520.14,57541.89,46
MS-DRG,092,MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,16320.91,10727.24,33518.6,46
MS-DRG,093,MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,12312.27,8626.92,26090.77,46
MS-DRG,094,MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,57632.23,33855.73,115313.14,46
MS-DRG,095,MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,37923.06,25145.03,84507.49,46
MS-DRG,096,MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,34677.97,25145.03,84507.49,46
MS-DRG,097,MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,57854.94,34711.79,118340.63,46
MS-DRG,098,MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,34280.28,22511.06,75192.4,46
MS-DRG,099,MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,20997.67,13871.68,49386.06,46
MS-DRG,100,MS-DRG 42.00: SEIZURES WITH MCC,,31544.22,19193.36,63459.25,46
MS-DRG,101,MS-DRG 42.00: SEIZURES WITHOUT MCC,,14475.66,9611.76,29573.69,46
MS-DRG,102,MS-DRG 42.00: HEADACHES WITH MCC,,19200.14,11634.25,36726.29,46
MS-DRG,103,MS-DRG 42.00: HEADACHES WITHOUT MCC,,13393.97,8997.51,27401.37,46
MS-DRG,113,MS-DRG 42.00: ORBITAL PROCEDURES WITH CC/MCC,,39879.66,23031.76,77033.79,46
MS-DRG,114,MS-DRG 42.00: ORBITAL PROCEDURES WITHOUT CC/MCC,,19597.82,13784.6,44331.04,46
MS-DRG,115,MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,24879.05,15469.85,50291.0,46
MS-DRG,116,MS-DRG 42.00: INTRAOCULAR PROCEDURES WITH CC/MCC,,29126.31,18000.98,59242.4,46
MS-DRG,117,MS-DRG 42.00: INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,19056.97,11300.72,35546.75,46
MS-DRG,121,MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,20377.28,12027.05,38115.52,46
MS-DRG,122,MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,11850.96,8529.64,25746.74,46
MS-DRG,123,MS-DRG 42.00: NEUROLOGICAL EYE DISORDERS,,12789.49,8648.24,29767.54,46
MS-DRG,124,MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,21029.48,13507.58,43351.37,46
MS-DRG,125,MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITHOUT MCC,,12694.04,8362.86,25156.97,46
MS-DRG,135,MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC,,42186.22,21353.89,69304.53,46
MS-DRG,136,MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,10655.89,34197.88,46
MS-DRG,137,MS-DRG 42.00: MOUTH PROCEDURES WITH CC/MCC,,23940.52,15083.52,48924.7,46
MS-DRG,138,MS-DRG 42.00: MOUTH PROCEDURES WITHOUT CC/MCC,,13775.74,9459.82,29036.34,46
MS-DRG,139,MS-DRG 42.00: SALIVARY GLAND PROCEDURES,,18897.9,12697.84,39599.78,46
MS-DRG,140,MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH MCC,,60097.87,40766.31,139752.55,46
MS-DRG,141,MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH CC,,32959.97,21456.73,71463.74,46
MS-DRG,142,MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,24576.81,16039.64,52306.05,46
MS-DRG,143,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,52907.76,35960.68,122757.35,46
MS-DRG,144,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,27535.58,17304.28,56778.47,46
MS-DRG,145,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,19422.84,12388.38,39393.36,46
MS-DRG,146,"MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,33580.36,20866.55,69376.61,46
MS-DRG,147,"MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,19661.45,13029.53,41660.7,46
MS-DRG,148,"MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,8634.34,27593.14,46
MS-DRG,149,MS-DRG 42.00: DYSEQUILIBRIUM,,11850.96,8212.78,24626.17,46
MS-DRG,150,MS-DRG 42.00: EPISTAXIS WITH MCC,,20918.13,13585.4,43626.6,46
MS-DRG,151,MS-DRG 42.00: EPISTAXIS WITHOUT MCC,,12264.55,8049.73,24049.51,46
MS-DRG,152,MS-DRG 42.00: OTITIS MEDIA AND URI WITH MCC,,18897.9,12202.17,38734.78,46
MS-DRG,153,MS-DRG 42.00: OTITIS MEDIA AND URI WITHOUT MCC,,11691.88,8088.64,24187.12,46
MS-DRG,154,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,24465.46,15734.82,51228.08,46
MS-DRG,155,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,15064.24,9740.55,30029.12,46
MS-DRG,156,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,10435.2,7652.27,22643.89,46
MS-DRG,157,MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH MCC,,27153.8,17155.12,56250.95,46
MS-DRG,158,MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH CC,,14936.98,9678.49,29809.6,46
MS-DRG,159,MS-DRG 42.00: DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,10737.44,7813.47,23478.08,46
MS-DRG,163,MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH MCC,,74987.12,42772.12,146846.18,46
MS-DRG,164,MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH CC,,40563.68,24633.61,95852.99,46
MS-DRG,165,MS-DRG 42.00: MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,29842.14,18983.97,82290.17,46
MS-DRG,166,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,64551.92,35878.2,122465.74,46
MS-DRG,167,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,28951.33,17957.44,84899.45,46
MS-DRG,168,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,21570.33,13908.76,63911.05,46
MS-DRG,173,MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,48915.02,28824.96,97521.75,46
MS-DRG,175,MS-DRG 42.00: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,22317.97,13975.46,46119.02,46
MS-DRG,176,MS-DRG 42.00: PULMONARY EMBOLISM WITHOUT MCC,,12980.38,8707.53,35752.57,46
MS-DRG,177,MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,26978.82,15727.41,63063.04,46
MS-DRG,178,MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,15700.53,10291.79,50092.74,46
MS-DRG,179,MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,12137.29,8244.28,40840.67,46
MS-DRG,180,MS-DRG 42.00: RESPIRATORY NEOPLASMS WITH MCC,,27646.93,17610.94,61426.8,46
MS-DRG,181,MS-DRG 42.00: RESPIRATORY NEOPLASMS WITH CC,,17513.96,11171.95,51854.0,46
MS-DRG,182,MS-DRG 42.00: RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,12709.95,8233.17,45249.26,46
MS-DRG,183,MS-DRG 42.00: MAJOR CHEST TRAUMA WITH MCC,,25054.03,15423.55,50127.17,46
MS-DRG,184,MS-DRG 42.00: MAJOR CHEST TRAUMA WITH CC,,16734.5,11108.01,34865.24,46
MS-DRG,185,MS-DRG 42.00: MAJOR CHEST TRAUMA WITHOUT CC/MCC,,12025.94,8536.13,25989.52,46
MS-DRG,186,MS-DRG 42.00: PLEURAL EFFUSION WITH MCC,,24688.17,15688.51,51064.25,46
MS-DRG,187,MS-DRG 42.00: PLEURAL EFFUSION WITH CC,,15843.69,10413.17,38013.95,46
MS-DRG,188,MS-DRG 42.00: PLEURAL EFFUSION WITHOUT CC/MCC,,11882.77,7894.07,31006.94,46
MS-DRG,189,MS-DRG 42.00: PULMONARY EDEMA AND RESPIRATORY FAILURE,,19597.82,12695.08,45977.69,46
MS-DRG,190,MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,17529.87,11511.96,36714.74,46
MS-DRG,191,MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,13505.32,9059.59,31001.51,46
MS-DRG,192,MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,10212.5,7197.37,26848.4,46
MS-DRG,193,MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,21109.02,13426.98,43066.32,46
MS-DRG,194,MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC,,13075.82,8715.85,27522.47,46
MS-DRG,195,MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,9957.98,7072.29,23070.38,46
MS-DRG,196,MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH MCC,,30144.38,18733.82,61834.11,46
MS-DRG,197,MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH CC,,15875.51,10042.57,31974.55,46
MS-DRG,198,MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,12375.9,7884.82,26940.82,46
MS-DRG,199,MS-DRG 42.00: PNEUMOTHORAX WITH MCC,,28219.59,17593.34,57800.74,46
MS-DRG,200,MS-DRG 42.00: PNEUMOTHORAX WITH CC,,17132.19,11434.13,36687.56,46
MS-DRG,201,MS-DRG 42.00: PNEUMOTHORAX WITHOUT CC/MCC,,11230.57,7874.62,29300.04,46
MS-DRG,202,MS-DRG 42.00: BRONCHITIS AND ASTHMA WITH CC/MCC,,15239.22,10247.33,31821.37,46
MS-DRG,203,MS-DRG 42.00: BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,11055.59,7456.78,21952.55,46
MS-DRG,204,MS-DRG 42.00: RESPIRATORY SIGNS AND SYMPTOMS,,13091.73,8729.77,26454.46,46
MS-DRG,205,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,28792.26,18213.13,59992.71,46
MS-DRG,206,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,14539.29,9968.46,30835.14,46
MS-DRG,207,MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,109887.79,60865.2,210832.95,46
MS-DRG,208,MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,42933.87,26715.41,90061.16,46
MS-DRG,212,MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,171337.78,101995.1,356289.89,46
MS-DRG,215,MS-DRG 42.00: OTHER HEART ASSIST SYSTEM IMPLANT,,162493.31,93498.41,467805.85,46
MS-DRG,216,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,154380.57,91884.48,320533.44,46
MS-DRG,217,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,101250.11,62167.83,250061.44,46
MS-DRG,218,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,90624.02,62167.83,226257.19,46
MS-DRG,219,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,122661.37,72386.85,265124.59,46
MS-DRG,220,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,83433.91,50656.4,203507.53,46
MS-DRG,221,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,73953.15,47945.55,192988.87,46
MS-DRG,228,MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,80157.0,47085.79,237868.49,46
MS-DRG,229,MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,50585.29,30428.71,187721.39,46
MS-DRG,231,MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITH MCC,,129087.93,79350.22,276205.67,46
MS-DRG,232,MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITHOUT MCC,,94632.67,57417.8,224191.51,46
MS-DRG,233,MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,124077.12,72080.2,251366.08,46
MS-DRG,234,MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,82686.27,51859.9,197571.42,46
MS-DRG,235,MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,93550.97,55620.46,203040.04,46
MS-DRG,236,MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,64281.49,40057.55,147424.32,46
MS-DRG,239,MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,76466.5,46847.68,161259.5,46
MS-DRG,240,MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,44683.67,27658.54,93396.63,46
MS-DRG,241,MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,22174.81,14075.5,72701.06,46
MS-DRG,242,MS-DRG 42.00: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,54959.8,30829.87,120891.2,46
MS-DRG,243,MS-DRG 42.00: PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,36236.88,20991.65,94537.48,46
MS-DRG,244,MS-DRG 42.00: PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,29110.4,17995.44,79267.75,46
MS-DRG,245,MS-DRG 42.00: AICD GENERATOR PROCEDURES,,72076.08,43518.86,149487.04,46
MS-DRG,250,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,37398.12,21469.71,88726.39,46
MS-DRG,251,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,25244.92,15095.56,57110.62,46
MS-DRG,252,MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH MCC,,53353.16,33567.59,114294.15,46
MS-DRG,253,MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH CC,,40579.58,25296.96,85044.83,46
MS-DRG,254,MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,27599.21,17756.4,61693.16,46
MS-DRG,255,MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,43697.42,26240.1,88380.31,46
MS-DRG,256,MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,26088.01,16980.02,57545.5,46
MS-DRG,257,MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,15764.16,11368.36,47787.88,46
MS-DRG,258,MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,43092.94,30360.13,102950.91,46
MS-DRG,259,MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,29698.97,19983.64,66254.11,46
MS-DRG,260,MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,52732.78,31385.75,106577.99,46
MS-DRG,261,MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,29937.58,18764.4,61942.23,46
MS-DRG,262,MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,26167.55,16350.01,53403.67,46
MS-DRG,263,MS-DRG 42.00: VEIN LIGATION AND STRIPPING,,44938.19,22431.65,100175.71,46
MS-DRG,264,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,51953.32,32199.21,109454.76,46
MS-DRG,265,MS-DRG 42.00: AICD LEAD PROCEDURES,,56216.48,34771.09,120646.58,46
MS-DRG,266,MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,99357.14,58027.43,289755.11,46
MS-DRG,267,MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,77627.74,45356.98,266755.39,46
MS-DRG,268,MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,109044.7,64971.34,225354.39,46
MS-DRG,269,MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,66158.56,40376.24,138373.15,46
MS-DRG,270,MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,80443.34,50132.94,172877.97,46
MS-DRG,271,MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,54975.71,34197.59,116522.17,46
MS-DRG,272,MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,38813.87,24902.28,83649.04,46
MS-DRG,273,MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,61990.84,39471.09,135172.01,46
MS-DRG,274,MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,51555.64,31746.15,107852.55,46
MS-DRG,275,MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,111923.93,67310.68,331443.79,46
MS-DRG,276,MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,98784.48,56898.99,200137.21,46
MS-DRG,277,MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,76068.82,44038.62,172707.16,46
MS-DRG,278,MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,70946.66,52818.8,182376.54,46
MS-DRG,279,MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,50919.34,34661.76,118163.7,46
MS-DRG,280,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,25244.92,16110.98,63508.79,46
MS-DRG,281,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,14523.39,9764.64,47929.21,46
MS-DRG,282,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,11421.46,7948.73,38769.55,46
MS-DRG,283,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,31353.33,19601.01,64900.91,46
MS-DRG,284,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,11771.42,7662.46,43651.08,46
MS-DRG,285,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,7778.68,6798.06,37671.48,46
MS-DRG,286,"MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,34296.19,21750.43,72502.39,46
MS-DRG,287,"MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,17211.72,11163.6,41628.89,46
MS-DRG,288,MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,41247.69,26321.64,88668.64,46
MS-DRG,289,MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,23511.02,17063.38,58926.24,46
MS-DRG,290,MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,17259.45,9862.83,50391.72,46
MS-DRG,291,MS-DRG 42.00: HEART FAILURE AND SHOCK WITH MCC,,20425.0,13143.49,42063.71,46
MS-DRG,292,MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC,,13632.58,9115.18,32066.96,46
MS-DRG,293,MS-DRG 42.00: HEART FAILURE AND SHOCK WITHOUT CC/MCC,,8939.92,6493.24,27734.47,46
MS-DRG,294,MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,,17402.61,12309.98,20311.47,31
MS-DRG,295,MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,,12678.14,8233.9,13585.93,31
MS-DRG,296,"MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH MCC",,25499.44,15720.01,51175.65,46
MS-DRG,297,"MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH CC",,11596.44,7123.26,32474.66,46
MS-DRG,298,"MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,6999.22,5465.78,25059.96,46
MS-DRG,299,MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITH MCC,,25069.94,16375.95,53495.42,46
MS-DRG,300,MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITH CC,,16973.11,11139.53,34976.64,46
MS-DRG,301,MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,11294.2,7917.26,23580.97,46
MS-DRG,302,MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC,,17832.11,12335.6,39206.6,46
MS-DRG,303,MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC,,10467.02,7486.44,22057.4,46
MS-DRG,304,MS-DRG 42.00: HYPERTENSION WITH MCC,,18277.51,12274.47,38990.35,46
MS-DRG,305,MS-DRG 42.00: HYPERTENSION WITHOUT MCC,,11994.12,8245.2,24740.85,46
MS-DRG,306,MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,24449.56,15848.78,51631.09,46
MS-DRG,307,MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,15000.61,9709.96,29921.0,46
MS-DRG,308,MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,19120.6,12404.16,39449.06,46
MS-DRG,309,MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,11850.96,8065.48,27054.97,46
MS-DRG,310,MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,8796.75,6494.18,21156.91,46
MS-DRG,311,MS-DRG 42.00: ANGINA PECTORIS,,11103.31,7752.32,22997.75,46
MS-DRG,312,MS-DRG 42.00: SYNCOPE AND COLLAPSE,,13743.93,9324.55,28557.97,46
MS-DRG,313,MS-DRG 42.00: CHEST PAIN,,11516.9,7920.01,23590.8,46
MS-DRG,314,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,33309.94,20568.23,68321.58,46
MS-DRG,315,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,15382.38,10174.13,35546.0,46
MS-DRG,316,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,11023.78,7568.89,27527.9,46
MS-DRG,317,MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,63198.1,219083.17,46
MS-DRG,319,MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,69387.75,42597.01,195348.1,46
MS-DRG,320,MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,35409.7,23533.88,113166.65,46
MS-DRG,321,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,45733.56,26456.91,126811.01,46
MS-DRG,322,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,28999.05,17583.14,100614.92,46
MS-DRG,323,MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,65856.32,41341.64,141787.26,46
MS-DRG,324,MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,47228.84,30442.61,103242.51,46
MS-DRG,325,MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,42058.96,30992.93,105188.76,46
MS-DRG,326,"MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,80793.3,47456.34,163412.16,46
MS-DRG,327,"MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,39720.59,23894.28,103224.2,46
MS-DRG,328,"MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,25404.0,16094.31,56458.3,46
MS-DRG,329,MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,71853.38,43834.77,150604.32,46
MS-DRG,330,MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,37732.17,23458.85,92836.01,46
MS-DRG,331,MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,26597.04,16841.04,59083.88,46
MS-DRG,332,MS-DRG 42.00: RECTAL RESECTION WITH MCC,,58125.36,34794.25,118632.24,46
MS-DRG,333,MS-DRG 42.00: RECTAL RESECTION WITH CC,,33087.23,22949.3,76742.18,46
MS-DRG,334,MS-DRG 42.00: RECTAL RESECTION WITHOUT CC/MCC,,25531.25,16424.13,54278.46,46
MS-DRG,335,MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITH MCC,,56868.68,34332.87,117000.54,46
MS-DRG,336,MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITH CC,,33484.92,20785.96,76392.11,46
MS-DRG,337,MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,23797.36,15470.78,53903.38,46
MS-DRG,344,MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,43586.07,25178.38,91112.8,46
MS-DRG,345,MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,24513.19,15190.06,61671.42,46
MS-DRG,346,MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,20488.63,12239.25,45695.02,46
MS-DRG,347,MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC,,40547.77,22517.56,75215.33,46
MS-DRG,348,MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC,,20695.43,13375.11,42882.83,46
MS-DRG,349,MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,15525.55,9315.28,28525.21,46
MS-DRG,350,MS-DRG 42.00: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,38177.58,24336.21,81647.1,46
MS-DRG,351,MS-DRG 42.00: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,23161.06,15373.5,49950.24,46
MS-DRG,352,MS-DRG 42.00: INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,17641.22,12068.78,38262.97,46
MS-DRG,353,MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,46513.01,28135.67,95084.03,46
MS-DRG,354,MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,27328.78,16836.39,55123.84,46
MS-DRG,355,MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,21681.68,13710.5,44068.93,46
MS-DRG,356,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,68067.44,41947.55,143930.09,46
MS-DRG,357,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,34948.39,22794.55,78881.8,46
MS-DRG,358,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,20377.28,14200.6,54805.75,46
MS-DRG,368,MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH MCC,,26278.9,15997.94,52158.6,46
MS-DRG,369,MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH CC,,15716.44,10516.01,34029.36,46
MS-DRG,370,MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,11835.05,7742.12,30006.72,46
MS-DRG,371,MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,27806.0,17676.72,58095.62,46
MS-DRG,372,MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,16575.43,10708.7,42020.28,46
MS-DRG,373,MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,11405.55,7988.58,35741.7,46
MS-DRG,374,MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH MCC,,33389.47,21063.91,70074.51,46
MS-DRG,375,MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH CC,,19056.97,12456.05,40389.48,46
MS-DRG,376,MS-DRG 42.00: DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,14173.43,9812.8,31099.36,46
MS-DRG,377,MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH MCC,,28474.11,18185.36,59894.42,46
MS-DRG,378,MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH CC,,15652.81,10335.32,32436.61,46
MS-DRG,379,MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,10069.34,7089.89,26962.56,46
MS-DRG,380,MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC,,31003.37,19428.67,64291.48,46
MS-DRG,381,MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC,,17068.56,11287.75,35643.85,46
MS-DRG,382,MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,12041.84,8666.76,30474.22,46
MS-DRG,383,MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITH MCC,,22238.44,14041.23,45238.64,46
MS-DRG,384,MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,13934.82,9168.89,28007.52,46
MS-DRG,385,MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH MCC,,24926.78,15908.99,51844.06,46
MS-DRG,386,MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH CC,,15461.92,10294.56,34447.93,46
MS-DRG,387,MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,10880.61,7561.48,30360.06,46
MS-DRG,388,MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH MCC,,23129.25,14931.59,48387.35,46
MS-DRG,389,MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH CC,,12662.23,8566.71,30501.4,46
MS-DRG,390,MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,8892.19,6289.43,23228.03,46
MS-DRG,391,"MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,20297.74,12999.87,41555.85,46
MS-DRG,392,"MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,12503.16,8472.2,25543.59,46
MS-DRG,393,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,25769.86,16066.51,52401.06,46
MS-DRG,394,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,14905.16,9918.44,34649.06,46
MS-DRG,395,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,10307.95,7262.22,26598.35,46
MS-DRG,397,MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC,,35743.76,23437.52,78468.9,46
MS-DRG,398,MS-DRG 42.00: APPENDIX PROCEDURES WITH CC,,24067.78,15272.54,53560.91,46
MS-DRG,399,MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC,,17704.85,11854.75,37747.58,46
MS-DRG,402,MS-DRG 42.00: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,38498.29,186998.4,46
MS-DRG,405,"MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,87569.82,51932.16,179240.93,46
MS-DRG,406,"MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,45924.44,28119.0,110062.69,46
MS-DRG,407,"MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,34216.65,21813.4,76055.08,46
MS-DRG,408,MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,59207.06,34283.76,133573.39,46
MS-DRG,409,MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,31130.63,21421.52,100946.52,46
MS-DRG,410,MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,24894.96,15959.04,72070.49,46
MS-DRG,411,MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,48358.26,31853.62,120825.97,46
MS-DRG,412,MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC,,32864.53,20728.52,93401.35,46
MS-DRG,413,MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,24020.06,16633.51,71776.94,46
MS-DRG,414,MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,56073.32,34255.97,116728.59,46
MS-DRG,415,MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,31432.87,20396.84,73532.77,46
MS-DRG,416,MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,21299.91,13880.01,49772.02,46
MS-DRG,417,MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,36873.18,23358.79,78190.4,46
MS-DRG,418,MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,26008.47,16921.62,55425.27,46
MS-DRG,419,MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,20886.32,13903.19,44750.44,46
MS-DRG,420,MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,50919.34,32815.3,116623.94,46
MS-DRG,421,MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,27201.52,17346.89,75484.3,46
MS-DRG,422,MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,22445.23,14215.42,65025.43,46
MS-DRG,423,MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,62213.54,39725.88,136073.05,46
MS-DRG,424,MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,33914.41,21519.73,95554.01,46
MS-DRG,425,MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,25483.53,15149.3,81925.96,46
MS-DRG,426,MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,103357.95,361109.62,46
MS-DRG,427,MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,68127.84,251784.65,46
MS-DRG,428,MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,53335.77,218162.99,46
MS-DRG,429,MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,84720.99,295199.54,46
MS-DRG,430,MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,54680.09,218162.99,46
MS-DRG,432,MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,30478.43,19484.27,64488.07,46
MS-DRG,433,MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,16400.45,11034.83,42036.59,46
MS-DRG,434,MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,10657.91,7850.53,37231.16,46
MS-DRG,435,MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,27996.89,18265.96,60179.48,46
MS-DRG,436,MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,17513.96,11728.75,41161.39,46
MS-DRG,437,MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,13218.99,9155.02,37345.32,46
MS-DRG,438,MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,26549.32,16352.79,54854.68,46
MS-DRG,439,MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,13600.76,9042.92,37252.91,46
MS-DRG,440,MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,9798.91,7006.53,31295.05,46
MS-DRG,441,"MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,29078.59,17876.84,58803.35,46
MS-DRG,442,"MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,15143.77,10192.65,37421.42,46
MS-DRG,443,"MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,11373.74,7731.93,31066.74,46
MS-DRG,444,MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITH MCC,,25976.66,16729.85,54747.04,46
MS-DRG,445,MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITH CC,,17291.26,11388.73,35858.02,46
MS-DRG,446,MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,12757.67,8914.13,27106.48,46
MS-DRG,447,MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,63152.67,218922.62,46
MS-DRG,448,MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,40539.31,138949.81,46
MS-DRG,450,MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,50626.76,174624.34,46
MS-DRG,451,MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,31178.23,111465.18,46
MS-DRG,456,"MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,134082.83,79104.72,275337.4,46
MS-DRG,457,"MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,96636.99,56495.97,195380.97,46
MS-DRG,458,"MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,72076.08,39907.46,163884.53,46
MS-DRG,461,MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,108472.04,52418.57,187933.39,46
MS-DRG,462,MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,45272.24,25893.61,151898.15,46
MS-DRG,463,MS-DRG 42.00: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,90099.08,54053.79,186744.12,46
MS-DRG,464,MS-DRG 42.00: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,47737.88,30106.29,102053.15,46
MS-DRG,465,MS-DRG 42.00: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,29762.6,18145.51,71423.6,46
MS-DRG,466,MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,82511.29,49476.08,170554.93,46
MS-DRG,467,MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,55452.93,33922.43,115549.05,46
MS-DRG,468,MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,42472.55,26708.9,93548.12,46
MS-DRG,469,MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,52971.39,29351.21,99973.48,46
MS-DRG,470,MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,29937.58,19120.17,79332.98,46
MS-DRG,471,MS-DRG 42.00: CERVICAL SPINAL FUSION WITH MCC,,78248.12,45986.04,158212.36,46
MS-DRG,472,MS-DRG 42.00: CERVICAL SPINAL FUSION WITH CC,,47006.14,28544.24,96528.97,46
MS-DRG,473,MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC,,39147.92,23867.41,79989.19,46
MS-DRG,474,MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,68449.21,41022.01,140656.87,46
MS-DRG,475,MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,34121.21,22333.17,74563.31,46
MS-DRG,476,MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,18722.92,12183.63,54718.78,46
MS-DRG,477,MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,53591.77,33255.39,113189.97,46
MS-DRG,478,MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,37923.06,24033.26,80575.69,46
MS-DRG,479,MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,29651.25,18471.65,60906.86,46
MS-DRG,480,MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,46910.7,28231.1,95421.51,46
MS-DRG,481,MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,33007.7,20654.41,69885.22,46
MS-DRG,482,MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,25260.83,16360.2,59143.68,46
MS-DRG,483,MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,39513.79,26930.34,90821.3,46
MS-DRG,485,MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,52398.72,31147.63,105735.93,46
MS-DRG,486,MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,31941.91,20622.92,71619.3,46
MS-DRG,487,MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,24576.81,15759.84,54436.1,46
MS-DRG,488,MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,33516.73,17637.81,60796.22,46
MS-DRG,489,MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,19693.27,11596.27,51228.86,46
MS-DRG,492,"MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,55071.15,35265.82,120299.97,46
MS-DRG,493,"MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,38209.39,24745.7,83095.32,46
MS-DRG,494,"MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,29730.79,19839.11,65742.97,46
MS-DRG,495,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,56964.13,34840.57,118796.06,46
MS-DRG,496,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,31623.76,17962.07,59104.78,46
MS-DRG,497,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,22699.75,12443.98,39476.23,46
MS-DRG,498,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,41534.02,29199.28,98845.45,46
MS-DRG,499,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,20520.45,19916.01,66014.92,46
MS-DRG,500,MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH MCC,,51587.45,30570.46,103694.67,46
MS-DRG,501,MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH CC,,27615.11,17445.11,57276.5,46
MS-DRG,502,MS-DRG 42.00: SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,21999.83,13718.82,44098.41,46
MS-DRG,503,MS-DRG 42.00: FOOT PROCEDURES WITH MCC,,42663.44,27108.22,91450.39,46
MS-DRG,504,MS-DRG 42.00: FOOT PROCEDURES WITH CC,,27471.95,18567.05,61244.34,46
MS-DRG,505,MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC,,27137.89,17859.21,58741.09,46
MS-DRG,506,MS-DRG 42.00: MAJOR THUMB OR JOINT PROCEDURES,,23272.41,13749.4,39304.89,46
MS-DRG,507,MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,33914.41,17985.24,59186.7,46
MS-DRG,508,MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,22811.1,15279.92,49619.32,46
MS-DRG,509,MS-DRG 42.00: ARTHROSCOPY,,,17227.89,28426.02,31
MS-DRG,510,"MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,43283.83,29233.56,98966.68,46
MS-DRG,511,"MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,31719.2,20514.51,68131.54,46
MS-DRG,512,"MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,25674.42,16586.24,54239.18,46
MS-DRG,513,"MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,25785.77,15834.9,51581.94,46
MS-DRG,514,"MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,16575.43,10720.75,33495.66,46
MS-DRG,515,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,50298.96,30775.21,104418.78,46
MS-DRG,516,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,32466.85,20502.47,71222.47,46
MS-DRG,517,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,23765.54,15486.53,60181.96,46
MS-DRG,518,MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,58093.55,35874.52,122452.63,46
MS-DRG,519,MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,31321.52,19780.73,65536.55,46
MS-DRG,520,MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,22779.29,15089.99,48947.63,46
MS-DRG,521,MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,47626.53,27841.05,99973.48,46
MS-DRG,522,MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,33596.27,20869.35,80952.91,46
MS-DRG,533,MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC,,25944.84,15773.75,51365.69,46
MS-DRG,534,MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC,,12884.93,8717.72,26411.87,46
MS-DRG,535,MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC,,20631.8,13126.8,42004.73,46
MS-DRG,536,MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC,,12519.06,8731.62,26461.01,46
MS-DRG,537,"MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,15382.38,10090.74,31267.64,46
MS-DRG,538,"MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,11278.29,7922.81,23600.63,46
MS-DRG,539,MS-DRG 42.00: OSTEOMYELITIS WITH MCC,,31560.13,19498.17,64537.22,46
MS-DRG,540,MS-DRG 42.00: OSTEOMYELITIS WITH CC,,20647.71,13259.29,42473.27,46
MS-DRG,541,MS-DRG 42.00: OSTEOMYELITIS WITHOUT CC/MCC,,13648.48,8544.46,29082.6,46
MS-DRG,542,MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,29014.96,17615.57,57879.37,46
MS-DRG,543,MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,17354.89,10773.55,36361.4,46
MS-DRG,544,MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,12216.82,8240.59,30637.3,46
MS-DRG,545,MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH MCC,,39656.96,24241.71,81312.9,46
MS-DRG,546,MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH CC,,19072.88,11935.36,41438.63,46
MS-DRG,547,MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,13091.73,8996.58,31028.69,46
MS-DRG,548,MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC,,31019.28,19138.69,63265.94,46
MS-DRG,549,MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC,,19184.23,12433.81,39553.91,46
MS-DRG,550,MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC,,15016.51,9347.72,28639.89,46
MS-DRG,551,MS-DRG 42.00: MEDICAL BACK PROBLEMS WITH MCC,,27074.26,16778.02,54917.42,46
MS-DRG,552,MS-DRG 42.00: MEDICAL BACK PROBLEMS WITHOUT MCC,,15366.47,10155.61,31496.99,46
MS-DRG,553,MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC,,21506.7,13259.29,42473.27,46
MS-DRG,554,MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,13075.82,8940.08,27198.23,46
MS-DRG,555,MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,22254.35,13495.57,43308.78,46
MS-DRG,556,MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,13107.63,8944.71,27214.61,46
MS-DRG,557,"MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,24767.7,15025.14,48718.28,46
MS-DRG,558,"MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,13966.63,9524.67,29265.7,46
MS-DRG,559,"MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,29444.46,18527.22,61103.45,46
MS-DRG,560,"MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,18007.09,11682.43,36896.67,46
MS-DRG,561,"MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,12407.71,8697.34,26339.78,46
MS-DRG,562,"MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,24195.04,14449.82,46683.57,46
MS-DRG,563,"MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,14252.96,9545.99,29341.06,46
MS-DRG,564,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,24847.24,15550.45,50576.05,46
MS-DRG,565,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,15891.42,10276.96,31926.22,46
MS-DRG,566,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,11946.4,8191.49,24550.81,46
MS-DRG,570,MS-DRG 42.00: SKIN DEBRIDEMENT WITH MCC,,46481.2,28497.92,96365.14,46
MS-DRG,571,MS-DRG 42.00: SKIN DEBRIDEMENT WITH CC,,26915.19,16902.18,55356.47,46
MS-DRG,572,MS-DRG 42.00: SKIN DEBRIDEMENT WITHOUT CC/MCC,,18134.35,11869.58,37558.52,46
MS-DRG,573,MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,98911.74,61946.41,214656.62,46
MS-DRG,574,MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,54180.34,33411.03,113740.42,46
MS-DRG,575,MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,32546.38,17898.16,53524.9,46
MS-DRG,576,MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,90401.32,46657.75,160587.82,46
MS-DRG,577,MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,42138.5,25807.45,86850.19,46
MS-DRG,578,MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,25626.7,16132.29,52633.7,46
MS-DRG,579,"MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,53162.28,31253.26,106109.45,46
MS-DRG,580,"MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,27790.09,17258.86,56617.92,46
MS-DRG,581,"MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,21427.16,14619.35,47283.17,46
MS-DRG,582,MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,27694.65,19098.86,63125.05,46
MS-DRG,583,MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,24210.95,17225.51,56499.97,46
MS-DRG,584,"MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,31162.45,21082.44,70140.04,46
MS-DRG,585,"MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,26787.93,19122.01,63206.96,46
MS-DRG,592,MS-DRG 42.00: SKIN ULCERS WITH MCC,,33246.31,19179.48,63410.1,46
MS-DRG,593,MS-DRG 42.00: SKIN ULCERS WITH CC,,19247.86,12240.16,38869.12,46
MS-DRG,594,MS-DRG 42.00: SKIN ULCERS WITHOUT CC/MCC,,12519.06,9280.08,28400.7,46
MS-DRG,595,MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC,,34598.43,20897.15,69484.74,46
MS-DRG,596,MS-DRG 42.00: MAJOR SKIN DISORDERS WITHOUT MCC,,16050.49,11278.49,35468.11,46
MS-DRG,597,MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH MCC,,25467.62,16694.65,54622.53,46
MS-DRG,598,MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH CC,,19072.88,11730.61,37067.04,46
MS-DRG,599,MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,10705.63,8377.7,24037.99,46
MS-DRG,600,MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,16320.91,10899.55,34128.02,46
MS-DRG,601,MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,10085.24,6854.57,21107.99,46
MS-DRG,602,MS-DRG 42.00: CELLULITIS WITH MCC,,23670.1,14417.39,46568.89,46
MS-DRG,603,MS-DRG 42.00: CELLULITIS WITHOUT MCC,,14077.98,9318.08,28535.04,46
MS-DRG,604,"MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,23956.43,14888.04,48233.36,46
MS-DRG,605,"MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,14459.76,9735.9,30012.74,46
MS-DRG,606,MS-DRG 42.00: MINOR SKIN DISORDERS WITH MCC,,25229.02,15268.81,49580.0,46
MS-DRG,607,MS-DRG 42.00: MINOR SKIN DISORDERS WITHOUT MCC,,14221.15,9646.99,29698.2,46
MS-DRG,614,MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,35823.29,21555.87,99891.94,46
MS-DRG,615,MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,23399.67,14213.58,74212.27,46
MS-DRG,616,"MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,62961.19,33559.25,114264.66,46
MS-DRG,617,"MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,31576.04,18577.25,67982.62,46
MS-DRG,618,"MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,18484.31,14389.6,54071.89,46
MS-DRG,619,MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH MCC,,41406.76,20478.0,97962.16,46
MS-DRG,620,MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH CC,,25801.68,16075.77,68417.5,46
MS-DRG,621,MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,24131.41,15224.34,59844.92,46
MS-DRG,622,"MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,60861.42,34224.48,116617.19,46
MS-DRG,623,"MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,29603.53,17869.42,64492.7,46
MS-DRG,624,"MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,17736.67,12847.93,51603.95,46
MS-DRG,625,"MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,29229.83,98953.58,46
MS-DRG,626,"MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,23733.73,15140.96,49127.84,46
MS-DRG,627,"MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,19661.45,13555.76,43521.75,46
MS-DRG,628,"MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,63867.9,35777.23,122108.6,46
MS-DRG,629,"MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,35998.27,21435.42,71388.38,46
MS-DRG,630,"MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,22206.62,14771.29,47820.52,46
MS-DRG,637,MS-DRG 42.00: DIABETES WITH MCC,,23049.71,14560.06,47073.48,46
MS-DRG,638,MS-DRG 42.00: DIABETES WITH CC,,14300.68,9552.46,29363.99,46
MS-DRG,639,MS-DRG 42.00: DIABETES WITHOUT CC/MCC,,9910.26,7004.67,21287.38,46
MS-DRG,640,"MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,20918.13,13623.39,43760.93,46
MS-DRG,641,"MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,12423.62,8459.24,25497.72,46
MS-DRG,642,MS-DRG 42.00: INBORN AND OTHER DISORDERS OF METABOLISM,,20727.24,14424.8,46595.11,46
MS-DRG,643,MS-DRG 42.00: ENDOCRINE DISORDERS WITH MCC,,26167.55,16500.08,53934.47,46
MS-DRG,644,MS-DRG 42.00: ENDOCRINE DISORDERS WITH CC,,16893.58,10745.77,33584.12,46
MS-DRG,645,MS-DRG 42.00: ENDOCRINE DISORDERS WITHOUT CC/MCC,,12105.47,8367.51,25173.35,46
MS-DRG,650,Heart-Kidney Transplant,,,409751.0,409751.0,1
MS-DRG,650,Kidney (CAD) Transplant,,,121282.0,134881.0,3
MS-DRG,650,Kidney (LRD) Transplant,,,121282.0,134881.0,3
MS-DRG,650,Kidney-Liver Transplant,,,299094.0,415564.0,3
MS-DRG,650,MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,71551.14,44806.64,173540.0,43
MS-DRG,650,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,651,Heart-Kidney Transplant,,,409751.0,409751.0,1
MS-DRG,651,Kidney (CAD) Transplant,,,121282.0,134881.0,3
MS-DRG,651,Kidney (LRD) Transplant,,,121282.0,134881.0,3
MS-DRG,651,Kidney-Liver Transplant,,,299094.0,415564.0,3
MS-DRG,651,MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,55007.52,35582.68,173540.0,43
MS-DRG,651,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,652,Heart-Kidney Transplant,,,409751.0,409751.0,1
MS-DRG,652,Kidney (CAD) Transplant,,,121282.0,134881.0,3
MS-DRG,652,Kidney (LRD) Transplant,,,121282.0,134881.0,3
MS-DRG,652,Kidney-Liver Transplant,,,299094.0,415564.0,3
MS-DRG,652,MS-DRG 42.00: KIDNEY TRANSPLANT,,47785.6,31169.87,173540.0,43
MS-DRG,652,"Multi Organ Transplant (Kidney, Liver, Pancreas and/or Heart)",,,,,0
MS-DRG,653,MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH MCC,,86122.25,49392.7,170260.05,46
MS-DRG,654,MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH CC,,43554.25,27184.19,109888.74,46
MS-DRG,655,MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,33532.64,20859.15,93385.04,46
MS-DRG,656,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,49917.18,30746.48,104317.21,46
MS-DRG,657,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,29333.1,18203.88,68634.94,46
MS-DRG,658,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,23542.84,15626.42,59812.31,46
MS-DRG,659,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,41184.06,24790.17,85986.65,46
MS-DRG,660,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,21411.26,13494.62,63008.68,46
MS-DRG,661,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,16670.88,10842.13,42824.81,46
MS-DRG,662,MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH MCC,,47674.25,29613.39,100310.05,46
MS-DRG,663,MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH CC,,23208.79,15333.66,49809.35,46
MS-DRG,664,MS-DRG 42.00: MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,16893.58,10948.66,34763.22,46
MS-DRG,665,MS-DRG 42.00: PROSTATECTOMY WITH MCC,,49137.72,30166.51,102266.12,46
MS-DRG,666,MS-DRG 42.00: PROSTATECTOMY WITH CC,,27312.87,17456.21,57315.81,46
MS-DRG,667,MS-DRG 42.00: PROSTATECTOMY WITHOUT CC/MCC,,16702.69,11498.06,36244.64,46
MS-DRG,668,MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH MCC,,44826.84,28302.44,95673.8,46
MS-DRG,669,MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH CC,,24417.74,15628.29,50851.28,46
MS-DRG,670,MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,15318.75,10303.83,32021.23,46
MS-DRG,671,MS-DRG 42.00: URETHRAL PROCEDURES WITH CC/MCC,,27233.34,17879.62,58813.18,46
MS-DRG,672,MS-DRG 42.00: URETHRAL PROCEDURES WITHOUT CC/MCC,,14921.07,11250.7,35369.82,46
MS-DRG,673,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,58825.28,40176.12,137665.42,46
MS-DRG,674,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,37891.24,22915.93,76624.23,46
MS-DRG,675,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,25244.92,16456.55,53780.47,46
MS-DRG,682,MS-DRG 42.00: RENAL FAILURE WITH MCC,,23876.89,14970.48,48524.96,46
MS-DRG,683,MS-DRG 42.00: RENAL FAILURE WITH CC,,14332.5,9363.46,36524.48,46
MS-DRG,684,MS-DRG 42.00: RENAL FAILURE WITHOUT CC/MCC,,9687.56,6811.05,30082.82,46
MS-DRG,686,MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,29253.57,17960.21,59098.23,46
MS-DRG,687,MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,16623.15,10956.98,34331.17,46
MS-DRG,688,MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,12423.62,8571.32,25894.18,46
MS-DRG,689,MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,18675.2,11999.29,38017.23,46
MS-DRG,690,MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,12837.21,8749.21,26523.27,46
MS-DRG,693,MS-DRG 42.00: URINARY STONES WITH MCC,,22524.77,13705.85,44052.54,46
MS-DRG,694,MS-DRG 42.00: URINARY STONES WITHOUT MCC,,12455.43,8491.67,25612.4,46
MS-DRG,695,MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,19025.16,11846.43,37476.61,46
MS-DRG,696,MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,11007.87,7632.82,22575.08,46
MS-DRG,697,MS-DRG 42.00: URETHRAL STRICTURE,,17704.85,11234.95,35314.12,46
MS-DRG,698,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,26310.71,16577.0,54206.42,46
MS-DRG,699,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,16241.38,10653.13,34605.58,46
MS-DRG,700,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,11262.39,7641.16,27517.03,46
MS-DRG,707,MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,31210.17,19781.68,65539.83,46
MS-DRG,708,MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,23208.79,15463.38,50268.06,46
MS-DRG,709,MS-DRG 42.00: PENIS PROCEDURES WITH CC/MCC,,34534.8,22809.4,76247.43,46
MS-DRG,710,MS-DRG 42.00: PENIS PROCEDURES WITHOUT CC/MCC,,20631.8,14231.15,45910.32,46
MS-DRG,711,MS-DRG 42.00: TESTES PROCEDURES WITH CC/MCC,,33771.25,20555.27,68275.71,46
MS-DRG,712,MS-DRG 42.00: TESTES PROCEDURES WITHOUT CC/MCC,,18897.9,11437.83,36031.67,46
MS-DRG,713,MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,23081.53,15178.01,49258.9,46
MS-DRG,714,MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,15255.12,11045.95,34645.71,46
MS-DRG,715,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,35123.37,21977.41,73305.13,46
MS-DRG,716,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,22620.21,14877.85,48197.32,46
MS-DRG,717,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,28855.88,18764.4,61942.23,46
MS-DRG,718,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,18707.01,13692.87,44006.67,46
MS-DRG,722,"MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,29826.23,18015.82,59294.82,46
MS-DRG,723,"MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,17720.76,11836.23,37440.57,46
MS-DRG,724,"MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,12884.93,7324.3,20711.16,46
MS-DRG,725,MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC,,19740.99,12091.01,38341.6,46
MS-DRG,726,MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,11628.25,7938.55,23656.33,46
MS-DRG,727,MS-DRG 42.00: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,25785.77,14988.09,48587.22,46
MS-DRG,728,MS-DRG 42.00: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,12725.86,8764.96,28761.88,46
MS-DRG,729,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,15970.95,11057.99,36687.56,46
MS-DRG,730,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,9894.36,7475.32,27141.95,46
MS-DRG,734,"MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,34582.52,20983.32,69789.45,46
MS-DRG,735,"MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,13715.1,48249.94,46
MS-DRG,736,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,61831.77,34366.23,121331.52,46
MS-DRG,737,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,31401.06,20340.33,79436.27,46
MS-DRG,738,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,21713.5,14854.68,63307.66,46
MS-DRG,739,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,57520.88,34443.13,115539.22,46
MS-DRG,740,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,28426.39,18014.87,59291.54,46
MS-DRG,741,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,20663.61,14461.86,46726.17,46
MS-DRG,742,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,28346.85,18248.35,60117.22,46
MS-DRG,743,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,18484.31,12744.17,40651.54,46
MS-DRG,744,"MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,29937.58,20233.77,67138.76,46
MS-DRG,745,"MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,16479.99,11788.05,37270.19,46
MS-DRG,746,"MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,26660.67,17343.18,56916.08,46
MS-DRG,747,"MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,14109.8,9214.32,32480.1,46
MS-DRG,748,MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,22349.79,14102.37,45454.88,46
MS-DRG,749,MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,40038.73,25037.55,84127.41,46
MS-DRG,750,MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,21633.96,14922.32,48354.59,46
MS-DRG,754,"MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,29476.27,18312.28,60343.3,46
MS-DRG,755,"MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,17259.45,11327.59,38916.32,46
MS-DRG,756,"MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,10148.2,31470.78,46
MS-DRG,757,"MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,23733.73,14515.59,46916.2,46
MS-DRG,758,"MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,15795.97,10319.59,32076.94,46
MS-DRG,759,"MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,10276.13,7397.49,21742.85,46
MS-DRG,760,MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,15827.79,10583.63,33010.74,46
MS-DRG,761,MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,9639.84,6534.94,22755.1,46
MS-DRG,768,MS-DRG 42.00: VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,19375.12,5297.0,24130.4,46
MS-DRG,769,MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,24560.91,16904.96,55366.3,46
MS-DRG,770,"MS-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,12709.95,10539.17,32853.47,46
MS-DRG,776,MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,11405.55,7315.04,21451.25,46
MS-DRG,779,MS-DRG 42.00: ABORTION WITHOUT D&C,,15732.34,9043.83,23364.72,46
MS-DRG,783,MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC,,28187.78,5297.0,42362.75,46
MS-DRG,784,MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC,,16289.1,5297.0,29707.74,46
MS-DRG,785,MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,13775.74,5297.0,26136.29,46
MS-DRG,786,MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,27837.82,5297.0,33235.7,46
MS-DRG,787,MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,16718.6,5297.0,26815.79,46
MS-DRG,788,MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,13600.76,5297.0,23771.63,46
MS-DRG,789,"MS-DRG 42.00: NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,28935.42,2150.0,59049.08,46
MS-DRG,790,"MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,95443.94,2150.0,213895.73,46
MS-DRG,791,MS-DRG 42.00: PREMATURITY WITH MAJOR PROBLEMS,,65188.21,2150.0,132993.14,46
MS-DRG,792,MS-DRG 42.00: PREMATURITY WITHOUT MAJOR PROBLEMS,,39338.81,2150.0,80248.04,46
MS-DRG,793,MS-DRG 42.00: FULL TERM NEONATE WITH MAJOR PROBLEMS,,66953.92,3310.0,136616.94,46
MS-DRG,794,MS-DRG 42.00: NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,23701.91,2150.0,48357.86,46
MS-DRG,795,MS-DRG 42.00: NORMAL NEWBORN,,3213.28,1376.0,6546.45,46
MS-DRG,796,MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,22556.58,5297.0,29022.8,46
MS-DRG,797,MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,15843.69,5297.0,18493.27,46
MS-DRG,798,MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,13282.62,5297.0,16692.57,46
MS-DRG,799,MS-DRG 42.00: SPLENIC PROCEDURES WITH MCC,,78820.79,43208.48,148389.41,46
MS-DRG,800,MS-DRG 42.00: SPLENIC PROCEDURES WITH CC,,44826.84,27277.78,92049.99,46
MS-DRG,801,MS-DRG 42.00: SPLENIC PROCEDURES WITHOUT CC/MCC,,28474.11,18934.88,65482.06,46
MS-DRG,802,MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,54578.03,38161.06,130539.04,46
MS-DRG,803,MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,29555.81,18471.65,60906.86,46
MS-DRG,804,MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,19247.86,13812.39,48353.22,46
MS-DRG,805,MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,16034.58,5297.0,22206.06,46
MS-DRG,806,MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,11882.77,5297.0,13617.18,46
MS-DRG,807,MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,10403.39,5297.0,12367.92,46
MS-DRG,808,MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,34837.04,21705.02,72341.84,46
MS-DRG,809,MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,19152.42,12977.63,45760.25,46
MS-DRG,810,MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,15986.86,10945.87,40851.54,46
MS-DRG,811,MS-DRG 42.00: RED BLOOD CELL DISORDERS WITH MCC,,22333.88,14259.88,46011.89,46
MS-DRG,812,MS-DRG 42.00: RED BLOOD CELL DISORDERS WITHOUT MCC,,14332.5,9756.29,30084.82,46
MS-DRG,813,MS-DRG 42.00: COAGULATION DISORDERS,,24815.42,15380.93,49976.45,46
MS-DRG,814,MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,33850.78,20952.71,69681.33,46
MS-DRG,815,MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,15811.88,10643.85,34632.76,46
MS-DRG,816,MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,11294.2,7104.72,27038.66,46
MS-DRG,817,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,44810.93,22387.83,67819.54,46
MS-DRG,818,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,22763.38,11989.09,37263.78,46
MS-DRG,819,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,14427.94,9216.16,28174.62,46
MS-DRG,820,MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,96191.59,55585.25,192160.17,46
MS-DRG,821,MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,35505.15,21989.44,105164.86,46
MS-DRG,822,MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,19709.17,12404.16,62633.59,46
MS-DRG,823,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,71614.77,43726.39,150220.97,46
MS-DRG,824,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,35521.05,22239.59,86041.01,46
MS-DRG,825,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,20536.35,13751.25,55392.84,46
MS-DRG,826,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,73619.09,44588.0,162335.27,46
MS-DRG,827,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,36857.27,22662.07,98875.4,46
MS-DRG,828,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,26088.01,17034.66,61655.11,46
MS-DRG,829,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,50171.7,30525.98,103537.4,46
MS-DRG,830,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,25149.48,15192.84,52147.55,46
MS-DRG,831,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,17100.37,12390.28,39399.91,46
MS-DRG,832,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,11739.6,7934.85,23643.22,46
MS-DRG,833,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,8144.55,6093.94,17132.82,46
MS-DRG,834,MS-DRG 42.00: ACUTE LEUKEMIA WITH MCC,,89065.1,52111.9,179876.57,46
MS-DRG,835,MS-DRG 42.00: ACUTE LEUKEMIA WITH CC,,35568.78,20573.8,116319.53,46
MS-DRG,836,MS-DRG 42.00: ACUTE LEUKEMIA WITHOUT CC/MCC,,22461.14,12547.76,98886.28,46
MS-DRG,837,MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,77055.08,45759.99,157412.89,46
MS-DRG,838,MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,31846.46,20588.62,88971.01,46
MS-DRG,839,MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,20727.24,14626.76,60024.31,46
MS-DRG,840,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,49710.39,31219.91,105991.5,46
MS-DRG,841,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,25038.13,16363.91,62704.26,46
MS-DRG,842,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,16957.21,10610.48,46472.36,46
MS-DRG,843,MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,29603.53,19730.71,65359.62,46
MS-DRG,844,MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,18404.77,12528.3,39888.11,46
MS-DRG,845,MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,13759.83,9139.26,30544.88,46
MS-DRG,846,MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,38877.5,25268.26,84943.26,46
MS-DRG,847,MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,19295.58,13369.54,42863.17,46
MS-DRG,848,MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,13298.52,9118.88,31083.05,46
MS-DRG,849,MS-DRG 42.00: RADIOTHERAPY,,42806.61,26352.22,88776.77,46
MS-DRG,850,MS-DRG 42.00: ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,81477.41,283728.52,46
MS-DRG,853,MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,79520.71,47004.26,173022.44,46
MS-DRG,854,MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,32419.13,19761.28,120282.37,46
MS-DRG,855,MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,27074.26,15120.58,82355.4,46
MS-DRG,856,MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,70437.63,43391.93,149038.16,46
MS-DRG,857,MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,33978.04,21089.85,72472.75,46
MS-DRG,858,MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,20409.1,14154.27,55566.79,46
MS-DRG,862,MS-DRG 42.00: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,29301.29,18145.51,59753.53,46
MS-DRG,863,MS-DRG 42.00: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,16002.77,10494.69,33186.78,46
MS-DRG,864,MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS,,14046.17,9473.73,29085.49,46
MS-DRG,865,MS-DRG 42.00: VIRAL ILLNESS WITH MCC,,26088.01,15130.77,49091.8,46
MS-DRG,866,MS-DRG 42.00: VIRAL ILLNESS WITHOUT MCC,,14602.92,9306.04,28492.44,46
MS-DRG,867,MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,33278.12,20642.36,68583.7,46
MS-DRG,868,MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,17275.35,10802.29,38285.75,46
MS-DRG,869,MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,10991.96,8009.9,34154.39,46
MS-DRG,870,MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,110794.51,65285.43,235460.34,46
MS-DRG,871,MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,31544.22,19246.16,63646.01,46
MS-DRG,872,MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,16384.54,10730.02,42531.26,46
MS-DRG,876,MS-DRG 42.00: O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,59366.13,37056.69,126633.45,45
MS-DRG,880,MS-DRG 42.00: ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,15191.49,2093.0,31460.95,45
MS-DRG,881,MS-DRG 42.00: DEPRESSIVE NEUROSES,,14427.94,2093.0,30828.59,45
MS-DRG,882,MS-DRG 42.00: NEUROSES EXCEPT DEPRESSIVE,,14936.98,2093.0,35183.06,45
MS-DRG,883,MS-DRG 42.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,29826.23,2093.0,64425.82,46
MS-DRG,884,MS-DRG 42.00: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,27949.17,2093.0,52715.61,45
MS-DRG,885,MS-DRG 42.00: PSYCHOSES,,21729.4,2093.0,45766.15,45
MS-DRG,886,MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,26756.12,2093.0,67997.2,45
MS-DRG,887,MS-DRG 42.00: OTHER MENTAL DISORDER DIAGNOSES,,20615.89,2093.0,35088.04,45
MS-DRG,894,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,9146.71,2093.0,20212.73,45
MS-DRG,895,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,25594.88,2093.0,46382.13,46
MS-DRG,896,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,28283.22,2093.0,57178.2,45
MS-DRG,897,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,13616.67,2093.0,28924.94,45
MS-DRG,901,MS-DRG 42.00: WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,68846.9,40129.81,137501.6,46
MS-DRG,902,MS-DRG 42.00: WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,29985.3,18986.75,62728.59,46
MS-DRG,903,MS-DRG 42.00: WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,19756.9,12085.44,46782.22,46
MS-DRG,904,MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITH CC/MCC,,51794.25,35279.73,120349.12,46
MS-DRG,905,MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,25197.2,14992.72,47488.9,46
MS-DRG,906,MS-DRG 42.00: HAND PROCEDURES FOR INJURIES,,29937.58,19448.12,57745.04,46
MS-DRG,907,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,59175.24,36819.53,125794.66,46
MS-DRG,908,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,31878.28,19734.41,67901.08,46
MS-DRG,909,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,21570.33,13411.23,43825.03,46
MS-DRG,913,MS-DRG 42.00: TRAUMATIC INJURY WITH MCC,,23781.45,16393.54,53557.67,46
MS-DRG,914,MS-DRG 42.00: TRAUMATIC INJURY WITHOUT MCC,,14443.85,9453.33,29013.41,46
MS-DRG,915,MS-DRG 42.00: ALLERGIC REACTIONS WITH MCC,,28219.59,16829.0,55097.62,46
MS-DRG,916,MS-DRG 42.00: ALLERGIC REACTIONS WITHOUT MCC,,10482.93,7422.51,21831.32,46
MS-DRG,917,MS-DRG 42.00: POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,25388.09,15780.22,51388.63,46
MS-DRG,918,MS-DRG 42.00: POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,13696.21,9190.22,28082.88,46
MS-DRG,919,MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC,,29030.87,18211.3,59986.16,46
MS-DRG,920,MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC,,16448.17,10535.45,33936.95,46
MS-DRG,921,MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,11103.31,7627.26,24597.9,46
MS-DRG,922,"MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,27758.28,17457.14,57319.09,46
MS-DRG,923,"MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,16082.3,10678.13,33344.94,46
MS-DRG,927,MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,419301.14,199056.2,613034.03,46
MS-DRG,928,MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,110078.68,67702.6,235013.52,46
MS-DRG,929,MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,51157.95,31089.28,105529.51,46
MS-DRG,933,MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,37328.16,125054.18,46
MS-DRG,934,MS-DRG 42.00: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,33294.03,21730.03,72430.31,46
MS-DRG,935,MS-DRG 42.00: NON-EXTENSIVE BURNS,,32466.85,20334.78,67495.9,46
MS-DRG,939,MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,51142.05,34866.49,118887.8,46
MS-DRG,940,MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,34471.17,22900.18,76568.53,46
MS-DRG,941,MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,29523.99,20035.53,66437.59,46
MS-DRG,945,MS-DRG 42.00: REHABILITATION WITH CC/MCC,,,15596.79,54311.08,46
MS-DRG,946,MS-DRG 42.00: REHABILITATION WITHOUT CC/MCC,,,11874.23,50060.12,46
MS-DRG,947,MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC,,19915.97,13010.07,41591.89,46
MS-DRG,948,MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC,,12741.77,8665.83,26228.38,46
MS-DRG,949,MS-DRG 42.00: AFTERCARE WITH CC/MCC,,17068.56,10893.74,38980.52,46
MS-DRG,950,MS-DRG 42.00: AFTERCARE WITHOUT CC/MCC,,10164.78,7064.88,20566.59,46
MS-DRG,951,MS-DRG 42.00: OTHER FACTORS INFLUENCING HEALTH STATUS,,9385.32,6400.6,18217.34,46
MS-DRG,955,MS-DRG 42.00: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,96875.6,63611.29,241314.91,46
MS-DRG,956,"MS-DRG 42.00: LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,61688.6,36112.63,149511.74,46
MS-DRG,957,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,115057.67,71845.79,249666.02,46
MS-DRG,958,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,64345.12,40290.07,149968.37,46
MS-DRG,959,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,40277.34,28525.74,123853.82,46
MS-DRG,963,MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,43490.62,26577.34,89572.96,46
MS-DRG,964,MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,23876.89,15448.54,61138.69,46
MS-DRG,965,MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,15207.4,9962.89,50690.7,46
MS-DRG,969,MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,109331.03,57961.65,200564.39,46
MS-DRG,970,MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,44222.36,25684.22,122543.75,46
MS-DRG,974,MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH MCC,,46401.66,27987.45,94559.79,46
MS-DRG,975,MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC,,21681.68,13247.24,68368.57,46
MS-DRG,976,MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,13441.69,9612.68,57371.54,46
MS-DRG,977,MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION,,22524.77,13272.25,41532.91,46
MS-DRG,981,MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,75209.83,44717.71,153726.83,46
MS-DRG,982,MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,39545.61,24026.77,95157.18,46
MS-DRG,983,MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,26008.47,17129.18,71418.17,46
MS-DRG,987,MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,53719.03,33012.65,112331.53,46
MS-DRG,988,MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,26994.73,16476.95,58018.43,46
MS-DRG,989,MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,17179.91,12359.67,46999.66,46
MS-DRG,998,MS-DRG 42.00: PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,,,,,0
MS-DRG,999,MS-DRG 42.00: UNGROUPABLE,,,,,0
NDC,00006489700,HIB-PRP-OMP 3DOSE/0.5ML 0.5ML IM,122.0,5.86,22.69,218.78,40
NDC,00023455430,EYE LUB 1% REFRSH/0.4ML 0.4ML GL,3.6,1.18,0.51876,2.7,29
NDC,00093412773,PEN V POT/250MG 5GM/100ML PWPO,34.6,11.38,4.99,25.95,35
NDC,00270111102,GADOTERIDOL/1ML 7.5MMOL/15ML SNIV,7.0,0.34,1.3,5.25,36
NDC,00338069504,KCL-NACL 0.90%/2MEQ 40MEQ/1L SNIV,3.7,0.18,0.11,2.77,40
NDC,00338954006,FAT EMULSN CLIN 20%/250ML 250ML EM,50.3,2.41,7.25,37.73,29
NDC,00409170301,BORTEZOMIB HOS/0.1MG 2.5MG PWIJ,13.2,3.76,1.71,9.9,41
NDC,00409909428,FENTNYL CITR/0.1MG 1MG/100ML EP,8.9,0.43,0.84,6.67,40
NDC,00641047725,PHENOBRB SOD/<=120MG 130MG/1ML SNIJ,120.8,5.8,22.47,213.26,40
NDC,00904721261,TRAZODONE/150MG 150MG TB,4.4,1.45,0.63404,13.3,35
NDC,42023020701,TREPROSTINIL/1MG 50MG/20ML SN MDV,58.6,16.7,24.44,122.52,67
NDC,50268013215,BUMETANIDE/2MG 2MG TB,7.0,2.3,1.01,13.3,35
NDC,51079002320,METOLAZONE/2.5MG 2.5MG TB,6.9,2.27,0.99429,13.3,35
NDC,51660072415,LORATA-PSEUDOE/10-240MG TBER 24H,4.0,1.32,0.5764,3.0,29
NDC,51672407008,CETIRIZINE/5ML 5MG/5ML SNPO,4.8,1.58,0.69168,13.3,35
NDC,51862033201,ESTRADL/0.5MG 0.5MG TB,4.5,1.48,0.64845,13.3,35
NDC,55513011101,DARBEPO/1MCG 300MCG/.6ML SNIJ,22.4,6.38,2.34,21.15,67
NDC,57665010141,AMPHO B LIPID/10MG 10MG/10ML SPIJ,43.4,12.37,8.07,74.57,41
NDC,57896011603,MENTHL-METHYL SALC 10-15%/85GM CR,5.7,1.88,0.82137,4.28,29
NDC,59762500005,SULFASALAZINE/500MG 500MG TB,4.9,1.61,0.70609,13.3,35
NDC,61314062810,TRIMETHOPRIM-POLYB/10ML 10ML SNOP,23.2,7.63,3.34,17.4,29
NDC,65862002106,MIRTAZAPINE/15MG 15MG TBDS,6.0,1.97,0.8646,13.3,35
NDC,68286900000,SMOG COMP/300ML 300ML EN,95.4,31.39,17.74,71.55,31
NDC,70092917005,PHENYLEPH/20MCG 40MG/250ML SNIV,0.2,0.01,0.01,0.15,40
NDC,70436020382,DOBUTAMN/250MG 250MG/20ML SNIV,85.0,4.08,7.58,63.75,40
NDC,70842016010,MINOCYCLINE HCL/1MG 100MG/5ML PWIJ,9.3,2.65,2.09,18.56,67
NDC,73475304105,EFGARTIGIMOD-AL/2MG 400MG/20ML SNIV,92.6,26.39,25.72,130.31,67
NDC,74300000070,ZINC OXIDE 40%/57GM 57GM PS,6.9,2.27,0.99429,5.17,29
NDC,77333012050,POLYCARBOPHIL/625MG 625MG TB,2.3,0.76,0.33143,1.73,29
RC,360,ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITHOUT IMAGING GUIDANCE,,,71.02,6689.0,52
RC,360,"ABLATION, SOFT TISSUE OF INFERIOR TURBINATES, UNILATERAL OR BILATERAL, ANY METHOD (EG, ELECTROCAUTERY, RADIOFREQUENCY ABLATION, OR TISSUE VOLUME REDUCTION); SUPERFICIAL",,,149.56,5681.0,52
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM",,,799.88,7704.0,52
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS",,,610.53,6689.0,52
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, SCALP, ARMS AND/OR LEGS; DEFECT 10 SQ CM OR LESS",,,555.47,7704.0,52
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10 SQ CM OR LESS",,,494.03,6689.0,52
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, TRUNK; DEFECT 10.1 SQ CM TO 30.0 SQ CM",,,638.73,7704.0,52
RC,360,"ALLOGRAFT, STRUCTURAL, FOR SPINE SURGERY ONLY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,106.23,6904.78,14
RC,360,"ALVEOLOPLASTY, EACH QUADRANT (SPECIFY)",,,239.47,5837.49,50
RC,360,"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; WITH DIRECT CLOSURE",,,694.74,6689.0,52
RC,360,"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; WITH LOCAL ADVANCEMENT FLAPS (V-Y, HOOD)",,,675.51,8715.0,52
RC,360,"AMPUTATION, FOOT; TRANSMETATARSAL",,,691.25,13802.9,50
RC,360,"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA;",,,869.15,13802.9,50
RC,360,"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; RE-AMPUTATION",,,630.86,13802.9,50
RC,360,"AMPUTATION, METATARSAL, WITH TOE, SINGLE",,,415.02,6689.0,52
RC,360,"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL; RE-AMPUTATION",,,690.99,13802.9,50
RC,360,"AMPUTATION, TOE; METATARSOPHALANGEAL JOINT",,,173.28,6689.0,52
RC,360,"ANOSCOPY; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,40.34,5681.0,52
RC,360,"ANOSCOPY; WITH HIGH-RESOLUTION MAGNIFICATION (HRA) (EG, COLPOSCOPE, OPERATING MICROSCOPE) AND CHEMICAL AGENT ENHANCEMENT, WITH BIOPSY, SINGLE OR MULTIPLE",,,121.28,8022.0,52
RC,360,ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,727.74,10065.0,14
RC,360,"ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE)",,,809.98,12775.92,52
RC,360,"APPLICATION OF A MULTIPLANE (PINS OR WIRES IN MORE THAN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM (EG, ILIZAROV, MONTICELLI TYPE)",,,1108.34,22604.88,52
RC,360,"APPLICATION OF A UNIPLANE (PINS OR WIRES IN 1 PLANE), UNILATERAL, EXTERNAL FIXATION SYSTEM",,,585.87,12775.92,52
RC,360,"APPLICATION OF HALO TYPE APPLIANCE FOR MAXILLOFACIAL FIXATION, INCLUDES REMOVAL (SEPARATE PROCEDURE)",,,350.04,10422.97,52
RC,360,"APPLICATION OF LOW COST SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIO",,,1229.0,5681.0,4
RC,360,"APPLICATION OF LOW COST SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ ",,,1727.0,6689.0,6
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; EA",,,53.58,5681.0,19
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; FI",,,214.96,6689.0,52
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIONAL 25 SQ",,,24.15,5681.0,19
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LES",,,90.66,6689.0,52
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA GREATER THAN OR EQUAL TO 100 SQ CM; FIRST 100 SQ CM WOUND SURFACE AREA, OR 1% OF BODY AREA OF INFANTS AND CHILDREN",,,188.58,7697.0,52
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIONAL 25 SQ CM WOUND SURFACE AREA, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE F",,,16.3,5681.0,19
RC,360,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA",,,81.5,6689.0,52
RC,360,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION",,,693.89,10065.0,52
RC,360,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION",,,655.57,10065.0,52
RC,360,"ARTHRODESIS, ANTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; 2 TO 3 VERTEBRAL SEGMENTS",,,1783.19,30871.55,50
RC,360,"ARTHRODESIS, ELBOW JOINT; LOCAL",,,822.45,12775.92,52
RC,360,"ARTHRODESIS, ELBOW JOINT; WITH AUTOGENOUS GRAFT (INCLUDES OBTAINING GRAFT)",,,984.44,22604.88,52
RC,360,"ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT",,,568.16,12775.92,52
RC,360,"ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;",,,606.26,7704.0,52
RC,360,"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, MULTIPLE OR TRANSVERSE;",,,714.2,22604.88,52
RC,360,"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT",,,607.91,12775.92,52
RC,360,"ARTHRODESIS, POSTERIOR INTERBODY TECHNIQUE, INCLUDING LAMINECTOMY AND/OR DISCECTOMY TO PREPARE INTERSPACE (OTHER THAN FOR DECOMPRESSION), SINGLE INTERSPACE, LUMBAR; EACH ADDITIONAL INTERSPACE (LIST SE",,,309.15,6904.78,14
RC,360,"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; THORACIC (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)",,,1256.94,30871.55,50
RC,360,"ARTHRODESIS, POSTERIOR TECHNIQUE, ATLAS-AXIS (C1-C2)",,,1488.88,22604.88,50
RC,360,"ARTHRODESIS, POSTERIOR, FOR SPINAL DEFORMITY, WITH OR WITHOUT CAST; UP TO 6 VERTEBRAL SEGMENTS",,,1337.44,30871.55,50
RC,360,"ARTHRODESIS, SACROILIAC JOINT, OPEN, INCLUDES OBTAINING BONE GRAFT, INCLUDING INSTRUMENTATION, WHEN PERFORMED",,,1327.77,30871.55,50
RC,360,"ARTHRODESIS, SACROILIAC JOINT, PERCUTANEOUS OR MINIMALLY INVASIVE, WITH IMAGE GUIDANCE, INCLUDES OBTAINING BONE GRAFT WHEN PERFORMED, UNILATERAL; PLACEMENT OF TRANSARTICULAR DEVICE(S) AND/OR INTRA-ART",,,784.43,30871.55,50
RC,360,ARTHRODESIS; SUBTALAR,,,766.57,22604.88,52
RC,360,"ARTHROPLASTY, ELBOW; WITH DISTAL HUMERUS AND PROXIMAL ULNAR PROSTHETIC REPLACEMENT (EG, TOTAL ELBOW)",,,1416.16,30871.55,50
RC,360,"ARTHROPLASTY, RADIAL HEAD; WITH IMPLANT",,,672.32,22604.88,50
RC,360,"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH OR WITHOUT AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1022.29,10422.97,52
RC,360,"ARTHROPLASTY, TEMPOROMANDIBULAR JOINT, WITH PROSTHETIC JOINT REPLACEMENT",,,1634.69,47774.5,52
RC,360,"ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)",,,407.16,7704.0,52
RC,360,"ARTHROSCOPY, KNEE, SURGICAL; OSTEOCHONDRAL ALLOGRAFT (EG, MOSAICPLASTY)",,,1253.46,22604.88,50
RC,360,"ARTHROSCOPY, KNEE, SURGICAL; WITH LYSIS OF ADHESIONS, WITH OR WITHOUT MANIPULATION (SEPARATE PROCEDURE)",,,612.31,7704.0,52
RC,360,"ARTHROSCOPY, KNEE, SURGICAL; WITH MENISCUS REPAIR (MEDIAL AND LATERAL)",,,829.65,7704.0,52
RC,360,"ARTHROSCOPY, SHOULDER, SURGICAL; SYNOVECTOMY, COMPLETE",,,585.45,10065.0,52
RC,360,"ARTHROSCOPY, SHOULDER, SURGICAL; WITH REMOVAL OF LOOSE BODY OR FOREIGN BODY",,,580.26,10065.0,52
RC,360,"ARTHROSCOPY, SUBTALAR JOINT, SURGICAL; WITH SUBTALAR ARTHRODESIS",,,863.66,22604.88,52
RC,360,"ARTHROSCOPY, WRIST, SURGICAL; EXCISION AND/OR REPAIR OF TRIANGULAR FIBROCARTILAGE AND/OR JOINT DEBRIDEMENT",,,517.84,7704.0,52
RC,360,"ARTHROTOMY WITH MENISCUS REPAIR, KNEE",,,638.81,12775.92,52
RC,360,"ARTHROTOMY, ACROMIOCLAVICULAR JOINT OR STERNOCLAVICULAR JOINT, INCLUDING BIOPSY AND/OR EXCISION OF TORN CARTILAGE",,,455.92,14124.0,52
RC,360,"ARTHROTOMY, ANKLE, WITH JOINT EXPLORATION, WITH OR WITHOUT BIOPSY, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY",,,444.02,8715.0,52
RC,360,"ARTHROTOMY, ELBOW; WITH SYNOVECTOMY",,,611.89,8715.0,52
RC,360,"ARTHROTOMY, GLENOHUMERAL JOINT, WITH JOINT EXPLORATION, WITH OR WITHOUT REMOVAL OF LOOSE OR FOREIGN BODY",,,658.0,12775.92,52
RC,360,"ARTHROTOMY, INCLUDING EXPLORATION, DRAINAGE, OR REMOVAL OF LOOSE OR FOREIGN BODY; METATARSOPHALANGEAL JOINT",,,324.11,6689.0,52
RC,360,"ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTION)",,,723.53,8715.0,52
RC,360,"ARTHROTOMY, POSTERIOR CAPSULAR RELEASE, ANKLE, WITH OR WITHOUT ACHILLES TENDON LENGTHENING",,,565.5,7704.0,52
RC,360,"ARTHROTOMY, WITH EXCISION OF SEMILUNAR CARTILAGE (MENISCECTOMY) KNEE; MEDIAL OR LATERAL",,,639.77,8715.0,52
RC,360,"ARTHROTOMY, WITH SYNOVECTOMY, KNEE; ANTERIOR OR POSTERIOR",,,678.76,8715.0,52
RC,360,"ARYTENOIDECTOMY OR ARYTENOIDOPEXY, EXTERNAL APPROACH",,,992.41,10422.97,52
RC,360,AUTOGRAFT FOR SPINE SURGERY ONLY (INCLUDES HARVESTING THE GRAFT); MORSELIZED (THROUGH SEPARATE SKIN OR FASCIAL INCISION) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,160.73,7697.0,14
RC,360,"Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm",,,847.73,18194.0,52
RC,360,"Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (list separately in addition to code for primary procedure)",,,208.08,5681.0,19
RC,360,"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less",,,650.57,7704.0,52
RC,360,"Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm",,,744.89,7704.0,52
RC,360,"Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm",,,692.94,7704.0,52
RC,360,"Allograft, morselized, or placement of osteopromotive material, for spine surgery only (list separately in addition to code for primary procedure)",,,113.52,6904.78,14
RC,360,"Amputation, toe; interphalangeal joint",,,169.02,6689.0,52
RC,360,"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed",,,602.81,10059.0,52
RC,360,Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure),,,699.24,10065.0,14
RC,360,"Arteriovenous anastomosis, open; direct, any site (e.g., Cimino type) (separate procedure)",,,627.41,7704.0,52
RC,360,"Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance",,,35.9,5681.0,52
RC,360,"Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance",,,44.27,5681.0,52
RC,360,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); cervical below C2",,,1235.41,22604.88,50
RC,360,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); each additional interspace (list separately in addition to code for primar",,,312.56,10065.0,14
RC,360,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar",,,1487.89,47774.5,50
RC,360,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2",,,1658.7,22604.88,50
RC,360,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2, each additional interspace (list ",,,381.43,8755.0,14
RC,360,"Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), ",,,1763.25,47774.5,50
RC,360,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;",,,1524.58,47774.5,50
RC,360,"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segment",,,1278.31,30871.55,50
RC,360,"Arthrodesis, posterior or posterolateral technique, single interspace; each additional interspace (list separately in addition to code for primary procedure)",,,376.7,6904.78,19
RC,360,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)",,,1543.47,30871.55,50
RC,360,"Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segments",,,2064.45,30871.55,50
RC,360,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft",,,1253.83,27605.8,50
RC,360,"Arthroplasty, ankle; with implant (total ankle)",,,943.87,47774.5,50
RC,360,"Arthroplasty, glenohumeral joint; hemiarthroplasty",,,1172.23,22604.88,50
RC,360,"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (e.g., total shoulder))",,,1410.31,30871.55,50
RC,360,"Arthroplasty, intercarpal or carpometacarpal joints; interposition (e.g., tendon)",,,822.54,10059.0,52
RC,360,"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)",,,1251.96,27605.8,50
RC,360,"Arthroplasty, knee, condyle and plateau; medial or lateral compartment",,,1122.75,22604.88,50
RC,360,Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction,,,955.58,12775.92,52
RC,360,Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction,,,1202.13,22604.88,52
RC,360,"Arthroscopy, hip, surgical; with acetabuloplasty (i.e., treatment of pincer lesion)",,,998.03,18194.0,52
RC,360,"Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture",,,653.19,7704.0,52
RC,360,"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)",,,613.3,8715.0,52
RC,360,"Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection) (separate procedure)",,,491.83,8715.0,52
RC,360,"Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s",,,555.82,8715.0,52
RC,360,"Arthroscopy, knee, surgical; with meniscectomy (medial or lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s)",,,535.72,8715.0,52
RC,360,"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)",,,678.81,7704.0,52
RC,360,"Arthroscopy, shoulder, surgical; biceps tenodesis",,,899.86,18194.0,52
RC,360,"Arthroscopy, shoulder, surgical; capsulorrhaphy",,,1039.65,12775.92,52
RC,360,"Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, bicep",,,585.81,10065.0,52
RC,360,"Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anc",,,535.72,7704.0,52
RC,360,"Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with coracoacromial ligament (i.e., arch) release, when performed (list separately in addition to code f",,,165.68,7704.0,21
RC,360,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)",,,668.6,10065.0,52
RC,360,"Arthroscopy, shoulder, surgical; with rotator cuff repair",,,1047.62,12775.92,52
RC,360,"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body",,,554.05,10059.0,52
RC,360,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each",,,399.17,8715.0,52
RC,360,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each",,,338.78,8715.0,52
RC,360,"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area",,,756.25,12775.92,52
RC,360,"Autograft for spine surgery only (includes harvesting the graft); local (e.g., ribs, spinous process, or laminar fragments) obtained from same incision (list separately in addition to code for primary",,,121.28,7697.0,14
RC,360,"Avulsion of nail plate, partial or complete, simple; single",,,52.44,5681.0,52
RC,360,Axillary lymphadenectomy; complete,,,861.49,10644.28,52
RC,360,"BIOPSY OF ANORECTAL WALL, ANAL APPROACH (EG, CONGENITAL MEGACOLON)",,,298.28,5681.0,52
RC,360,BIOPSY OF LACRIMAL SAC,,,248.73,6226.0,52
RC,360,BIOPSY OF LIP,,,67.35,4664.0,52
RC,360,BIOPSY OF TONGUE; ANTERIOR TWO-THIRDS,,,105.57,5681.0,52
RC,360,BIOPSY OF VAGINAL MUCOSA; SIMPLE (SEPARATE PROCEDURE),,,63.81,5681.0,52
RC,360,BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); 1 LESION,,,57.64,5681.0,52
RC,360,BIOPSY OF VULVA OR PERINEUM (SEPARATE PROCEDURE); EACH SEPARATE ADDITIONAL LESION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,28.33,5681.0,19
RC,360,"BIOPSY, BONE, OPEN; DEEP (EG, HUMERAL SHAFT, ISCHIUM, FEMORAL SHAFT)",,,333.43,7704.0,52
RC,360,"BIOPSY, BONE, TROCAR, OR NEEDLE; SUPERFICIAL (EG, ILIUM, STERNUM, SPINOUS PROCESS, RIBS)",,,84.14,5681.0,52
RC,360,"BIOPSY, INTRANASAL",,,67.12,5681.0,52
RC,360,"BIOPSY, MUSCLE; DEEP",,,150.54,7704.0,52
RC,360,"BIOPSY, PROSTATE, TRANSRECTAL, MRI-ULTRASOUND-FUSION GUIDED, TARGETED LESION(S) ONLY, FIRST TARGETED LESION",,,2610.96,6226.0,45
RC,360,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE, FIRST TARGETED LESION",,,2610.96,6226.0,45
RC,360,"BIOPSY, PROSTATE, TRANSRECTAL, ULTRASOUND-GUIDED (IE, SEXTANT, ULTRASOUND-LOCALIZED DISCRETE LESION[S])",,,2610.96,6226.0,45
RC,360,"BIOPSY, VESTIBULE OF MOUTH",,,87.65,5681.0,52
RC,360,"BIOPSY; NASOPHARYNX, VISIBLE LESION, SIMPLE",,,121.69,5837.49,52
RC,360,BIOPSY; OROPHARYNX,,,115.57,5681.0,50
RC,360,BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME),,,42.15,5681.0,52
RC,360,"BLEPHAROPLASTY, LOWER EYELID;",,,505.65,7704.0,47
RC,360,"BLEPHAROPLASTY, UPPER EYELID;",,,390.89,7704.0,47
RC,360,"BONE GRAFT, ANY DONOR AREA; MAJOR OR LARGE",,,267.17,12775.92,52
RC,360,"BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)",,,175.42,12775.92,52
RC,360,BREAST AUGMENTATION WITH IMPLANT,,,603.05,18194.0,52
RC,360,BREAST RECONSTRUCTION; WITH LATISSIMUS DORSI FLAP,,,982.0,13802.9,14
RC,360,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF BRONCHIAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED), INITIAL BRONCHUS",,,207.49,12425.97,52
RC,360,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF TRACHEAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED)",,,216.71,12425.97,52
RC,360,"Biopsy of breast; open, incisional",,,218.25,6893.85,52
RC,360,"Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure)",,,73.54,5681.0,52
RC,360,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",,,431.82,6893.85,52
RC,360,"Biopsy or excision of lymph node(s); open, deep cervical node(s)",,,408.7,6893.85,52
RC,360,"Biopsy or excision of lymph node(s); open, superficial",,,249.43,6893.85,52
RC,360,"Biopsy, abdominal or retroperitoneal mass, percutaneous needle",,,79.3,5681.0,52
RC,360,"Biopsy, bone, open; superficial (e.g., sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)",,,136.63,6689.0,52
RC,360,"Biopsy, prostate; needle or punch, single or multiple, any approach",,,126.11,6689.0,7
RC,360,Breast reduction,,,1066.76,11691.26,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)",,,127.43,6689.0,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,150.03,6689.0,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy, cryotherapy)",,,243.51,7697.0,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor",,,237.07,7697.0,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body",,,168.46,6689.0,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial",,,141.44,6689.0,52
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture",,,190.21,7697.0,52
RC,360,CANTHOTOMY (SEPARATE PROCEDURE),,,104.59,6226.0,52
RC,360,"CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, OPEN (EG, CAPSULODESIS, LIGAMENT REPAIR, TENDON TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR CARPAL INSTABILITY",,,978.74,12775.92,52
RC,360,"CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH BONE BLOCK",,,1069.4,12775.92,52
RC,360,"CAPSULORRHAPHY, ANTERIOR, ANY TYPE; WITH CORACOID PROCESS TRANSFER",,,1046.35,14124.0,52
RC,360,"CAPSULORRHAPHY, ANTERIOR; WITH LABRAL REPAIR (EG, BANKART PROCEDURE)",,,967.74,14124.0,52
RC,360,CARTILAGE GRAFT; NASAL SEPTUM,,,475.79,7704.0,52
RC,360,"CERCLAGE OF CERVIX, DURING PREGNANCY; VAGINAL",,,147.04,6226.0,52
RC,360,CHANGE OF URETEROSTOMY TUBE OR EXTERNALLY ACCESSIBLE URETERAL STENT VIA ILEAL CONDUIT,,,75.45,5681.0,52
RC,360,"CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL NERVE, UNILATERAL (EG, FOR BLEPHAROSPASM, HEMIFACIAL SPASM)",,,116.8,5681.0,52
RC,360,"CHEMODENERVATION OF MUSCLE(S); MUSCLE(S) INNERVATED BY FACIAL, TRIGEMINAL, CERVICAL SPINAL AND ACCESSORY NERVES, BILATERAL (EG, FOR CHRONIC MIGRAINE)",,,119.09,5681.0,52
RC,360,CHEMODENERVATION OF ONE EXTREMITY; 5 OR MORE MUSCLES,,,112.85,5681.0,52
RC,360,"CHEMODENERVATION OF ONE EXTREMITY; EACH ADDITIONAL EXTREMITY, 1-4 MUSCLE(S) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,67.88,5681.0,14
RC,360,CHEMODENERVATION OF TRUNK MUSCLE(S); 1-5 MUSCLE(S),,,112.79,5681.0,52
RC,360,CHEMODENERVATION OF TRUNK MUSCLE(S); 6 OR MORE MUSCLES,,,129.85,5681.0,52
RC,360,"CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIALS",,,93.63,8807.75,47
RC,360,CLAVICULECTOMY; PARTIAL,,,584.26,10059.0,52
RC,360,CLOSED TREATMENT OF KNEE DISLOCATION; REQUIRING ANESTHESIA,,,630.04,5681.0,52
RC,360,CLOSED TREATMENT OF MANDIBULAR FRACTURE; WITH MANIPULATION,,,626.32,8715.0,52
RC,360,"CLOSED TREATMENT OF METATARSAL FRACTURE; WITH MANIPULATION, EACH",,,149.49,5681.0,52
RC,360,CLOSED TREATMENT OF POST HIP ARTHROPLASTY DISLOCATION; REQUIRING REGIONAL OR GENERAL ANESTHESIA,,,577.45,6689.0,52
RC,360,"CLOSED TREATMENT OF SHOULDER DISLOCATION, WITH MANIPULATION; REQUIRING ANESTHESIA",,,408.99,5681.0,52
RC,360,CLOSED TREATMENT OF TEMPOROMANDIBULAR DISLOCATION; INITIAL OR SUBSEQUENT,,,30.21,5681.0,52
RC,360,"CLOSURE OF ENTEROSTOMY, LARGE OR SMALL INTESTINE; WITH RESECTION AND ANASTOMOSIS OTHER THAN COLORECTAL",,,979.86,13802.9,14
RC,360,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX",,,196.68,5681.0,52
RC,360,CLOSURE OF URETHROVAGINAL FISTULA;,,,485.52,13056.25,52
RC,360,"COCCYGECTOMY, PRIMARY",,,501.42,7697.0,52
RC,360,COLPOCLEISIS (LE FORT TYPE),,,522.44,10257.38,50
RC,360,"COLPORRHAPHY, SUTURE OF INJURY OF VAGINA (NONOBSTETRICAL)",,,328.17,6226.0,52
RC,360,COLPOTOMY; WITH EXPLORATION,,,198.8,6226.0,52
RC,360,"COMBINED ANTEROPOSTERIOR COLPORRHAPHY, INCLUDING CYSTOURETHROSCOPY, WHEN PERFORMED; WITH ENTEROCELE REPAIR",,,854.24,14124.0,52
RC,360,"COMPUTER-ASSISTED MUSCULOSKELETAL SURGICAL NAVIGATIONAL ORTHOPEDIC PROCEDURE, WITH IMAGE-GUIDANCE BASED ON CT/MRI IMAGES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,219.52,5681.0,14
RC,360,"COMPUTER-ASSISTED MUSCULOSKELETAL SURGICAL NAVIGATIONAL ORTHOPEDIC PROCEDURE, WITH IMAGE-GUIDANCE BASED ON FLUOROSCOPIC IMAGES (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,109.01,5681.0,14
RC,360,"CONDYLECTOMY, TEMPOROMANDIBULAR JOINT (SEPARATE PROCEDURE)",,,844.17,10422.97,52
RC,360,"CONTROL NASAL HEMORRHAGE, ANTERIOR, SIMPLE (LIMITED CAUTERY AND/OR PACKING) ANY METHOD",,,55.0,5681.0,52
RC,360,"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); SIMPLE",,,158.59,5681.0,52
RC,360,"CORACOACROMIAL LIGAMENT RELEASE, WITH OR WITHOUT ACROMIOPLASTY",,,690.15,12775.92,52
RC,360,CORONOIDECTOMY (SEPARATE PROCEDURE),,,601.26,10422.97,52
RC,360,"CORPORA CAVERNOSA-GLANS PENIS FISTULIZATION (EG, BIOPSY NEEDLE, WINTER PROCEDURE, RONGEUR, OR PUNCH) FOR PRIAPISM",,,407.08,8715.0,52
RC,360,"CORRECTION OF LAGOPHTHALMOS, WITH IMPLANTATION OF UPPER EYELID LID LOAD (EG, GOLD WEIGHT)",,,471.82,7704.0,52
RC,360,CRANIECTOMY; WITH EXCISION OF TUMOR OR OTHER BONE LESION OF SKULL,,,1272.56,13802.9,15
RC,360,"CRANIOFACIAL APPROACH TO ANTERIOR CRANIAL FOSSA; EXTRADURAL, INCLUDING LATERAL RHINOTOMY, ETHMOIDECTOMY, SPHENOIDECTOMY, WITHOUT MAXILLECTOMY OR ORBITAL EXENTERATION",,,982.0,13802.9,14
RC,360,CRANIOPLASTY FOR SKULL DEFECT; UP TO 5 CM DIAMETER,,,982.0,13802.9,14
RC,360,CRYOSURGICAL ABLATION OF THE PROSTATE (INCLUDES ULTRASONIC GUIDANCE AND MONITORING),,,745.95,18194.0,52
RC,360,"CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE; SIMPLE",,,727.8,16667.46,50
RC,360,"CYSTOURETHROSCOPY, WITH FULGURATION (INCLUDING CRYOSURGERY OR LASER SURGERY) AND/OR RESECTION OF; SMALL BLADDER TUMOR(S) (0.5 UP TO 2.0 CM)",,,236.89,6689.0,52
RC,360,"CYSTOURETHROSCOPY, WITH INJECTION(S) FOR CHEMODENERVATION OF THE BLADDER",,,162.96,10059.0,52
RC,360,"CYSTOURETHROSCOPY, WITH INSERTION OF TRANSPROSTATIC IMPLANT; 1 TO 3 IMPLANTS",,,3200.08,18194.0,51
RC,360,"CYSTOURETHROSCOPY, WITH INSERTION OF TRANSPROSTATIC IMPLANT; 4 OR MORE IMPLANTS",,,5987.14,20704.35,49
RC,360,"CYSTOURETHROSCOPY, WITH INTERNAL URETHROTOMY; MALE",,,239.22,6689.0,52
RC,360,"CYSTOURETHROSCOPY, WITH MECHANICAL URETHRAL DILATION AND URETHRAL THERAPEUTIC DRUG DELIVERY BY DRUG-COATED BALLOON CATHETER FOR URETHRAL STRICTURE OR STENOSIS, MALE, INCLUDING FLUOROSCOPY, WHEN PERFOR",,,158.78,9440.44,50
RC,360,"CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; DIAGNOSTIC",,,291.75,7704.0,52
RC,360,"CYSTOURETHROSCOPY; WITH RESECTION OR FULGURATION OF ORTHOTOPIC URETEROCELE(S), UNILATERAL OR BILATERAL",,,269.59,6689.0,52
RC,360,Carpectomy; all bones of proximal row,,,614.95,8715.0,52
RC,360,Cervical lymphadenectomy (complete),,,1314.12,11691.26,50
RC,360,Cervical lymphadenectomy (modified radical neck dissection),,,1419.96,13802.9,15
RC,360,Cesarean delivery only;,,,877.93,10257.38,10
RC,360,"Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age",,,193.29,6689.0,52
RC,360,"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation",,,490.78,5681.0,52
RC,360,Closed treatment of ankle dislocation; without anesthesia,,,149.49,5681.0,52
RC,360,"Closed treatment of bimalleolar ankle fracture (e.g., lateral and medial malleoli, or lateral and posterior malleoli or medial and posterior malleoli); with manipulation",,,430.68,5681.0,52
RC,360,Closed treatment of clavicular fracture; with manipulation,,,338.59,5681.0,52
RC,360,Closed treatment of distal fibular fracture (lateral malleolus); with manipulation,,,149.49,5681.0,52
RC,360,"Closed treatment of distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation",,,513.49,7704.0,52
RC,360,"Closed treatment of fracture of weight bearing articular portion of distal tibia (e.g., pilon or tibial plafond), with or without anesthesia; without manipulation",,,149.49,5681.0,52
RC,360,Closed treatment of mandibular fracture with interdental fixation,,,908.34,10422.97,52
RC,360,Closed treatment of nasal bone fracture with manipulation; with stabilization,,,92.85,6689.0,52
RC,360,Closed treatment of nasal bone fracture with manipulation; without stabilization,,,58.25,6689.0,52
RC,360,Closed treatment of radial head or neck fracture; with manipulation,,,410.9,5681.0,52
RC,360,"Closed treatment of shoulder dislocation, with manipulation; without anesthesia",,,149.49,5681.0,52
RC,360,"Closed treatment of tibial shaft fracture (with or without fibular fracture); with manipulation, with or without skeletal traction",,,490.1,5681.0,52
RC,360,"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)",,,681.27,13802.9,50
RC,360,"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)",,,685.88,13802.9,50
RC,360,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix,,,105.81,5681.0,52
RC,360,Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage,,,130.51,6689.0,52
RC,360,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;",,,764.09,10059.0,52
RC,360,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser",,,292.7,6689.0,52
RC,360,"Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision",,,251.8,6689.0,52
RC,360,"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft",,,1628.07,27605.8,50
RC,360,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method",,,507.8,7704.0,52
RC,360,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method",,,593.54,22604.88,52
RC,360,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method",,,501.83,12775.92,52
RC,360,"Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)",,,383.0,7704.0,52
RC,360,"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); nonautogenous graft (e.g., biological collagen, thermoplastic graft)",,,633.52,10065.0,52
RC,360,"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus",,,982.0,13802.9,14
RC,360,"Curettage, postpartum",,,184.52,7704.0,52
RC,360,Cystourethroscopy (separate procedure),,,77.75,5849.0,52
RC,360,Cystourethroscopy with direct vision internal urethrotomy,,,254.56,7704.0,52
RC,360,"Cystourethroscopy, with biopsy(s)",,,136.85,6689.0,52
RC,360,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female",,,146.97,6689.0,52
RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)",,,377.39,9440.44,52
RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)",,,278.02,7704.0,52
RC,360,"Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,150.23,6226.0,52
RC,360,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",,,146.33,6689.0,52
RC,360,"Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;",,,129.0,6226.0,52
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion",,,401.26,9440.44,52
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)",,,377.07,9440.44,52
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,399.96,18194.0,52
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)",,,340.82,8715.0,52
RC,360,"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN AND SUBCUTANEOUS TISSUES",,,268.59,6689.0,52
RC,360,"DEBRIDEMENT INCLUDING REMOVAL OF FOREIGN MATERIAL AT THE SITE OF AN OPEN FRACTURE AND/OR AN OPEN DISLOCATION (EG, EXCISIONAL DEBRIDEMENT); SKIN, SUBCUTANEOUS TISSUE, MUSCLE FASCIA, AND MUSCLE",,,288.41,6689.0,52
RC,360,"DEBRIDEMENT, MUSCLE AND/OR FASCIA (INCLUDES EPIDERMIS, DERMIS, AND SUBCUTANEOUS TISSUE, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCED",,,52.99,5681.0,19
RC,360,"DEBRIDEMENT, SUBCUTANEOUS TISSUE (INCLUDES EPIDERMIS AND DERMIS, IF PERFORMED); EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,24.44,5681.0,19
RC,360,"DECOMPRESSION FASCIOTOMY, FOREARM AND/OR WRIST, FLEXOR OR EXTENSOR COMPARTMENT; WITHOUT DEBRIDEMENT OF NONVIABLE MUSCLE AND/OR NERVE",,,727.61,7704.0,52
RC,360,DECOMPRESSION; UNSPECIFIED NERVE(S) (SPECIFY),,,366.49,6226.0,52
RC,360,"DELAY OF FLAP OR SECTIONING OF FLAP (DIVISION AND INSET); AT EYELIDS, NOSE, EARS, OR LIPS",,,338.03,7704.0,52
RC,360,"DESTRUCTION BY NEUROLYTIC AGENT, GENICULAR NERVE BRANCHES INCLUDING IMAGING GUIDANCE, WHEN PERFORMED",,,142.66,6226.0,52
RC,360,DESTRUCTION BY NEUROLYTIC AGENT; PUDENDAL NERVE,,,186.82,6689.0,52
RC,360,"DESTRUCTION OF LESION (EXCEPT EXCISION), DENTOALVEOLAR STRUCTURES",,,117.73,5681.0,50
RC,360,"DESTRUCTION OF LESION OR SCAR OF VESTIBULE OF MOUTH BY PHYSICAL METHODS (EG, LASER, THERMAL, CRYO, CHEMICAL)",,,163.15,5837.49,52
RC,360,"DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION",,,135.48,6226.0,52
RC,360,"DESTRUCTION OF LESION(S), VULVA; EXTENSIVE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,209.24,7704.0,52
RC,360,"DESTRUCTION OF LESION(S), VULVA; SIMPLE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,131.79,5681.0,50
RC,360,"DESTRUCTION OF VAGINAL LESION(S); EXTENSIVE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,183.21,6226.0,52
RC,360,"DESTRUCTION OF VAGINAL LESION(S); SIMPLE (EG, LASER SURGERY, ELECTROSURGERY, CRYOSURGERY, CHEMOSURGERY)",,,113.79,6226.0,50
RC,360,"DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)",,,229.71,6689.0,52
RC,360,"DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES",,,77.34,5444.0,52
RC,360,DILATION OF RECTAL STRICTURE (SEPARATE PROCEDURE) UNDER ANESTHESIA OTHER THAN LOCAL,,,189.33,5681.0,52
RC,360,"DILATION OF URETHRAL STRICTURE OR VESICAL NECK BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE, GENERAL OR CONDUCTION (SPINAL) ANESTHESIA",,,61.76,6689.0,52
RC,360,DILATION SALIVARY DUCT,,,57.97,5681.0,52
RC,360,"DRAINAGE ABSCESS OR HEMATOMA, NASAL SEPTUM",,,121.08,5681.0,52
RC,360,"DRAINAGE EXTERNAL EAR, ABSCESS OR HEMATOMA; COMPLICATED",,,159.17,5681.0,50
RC,360,"DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES",,,81.16,5681.0,52
RC,360,"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; COMPLICATED",,,195.18,6689.0,52
RC,360,"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; SIMPLE",,,116.69,4664.0,52
RC,360,"DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH",,,552.48,6689.0,52
RC,360,Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity),,,788.46,8715.0,52
RC,360,"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone",,,402.77,6689.0,52
RC,360,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",,,218.85,6689.0,52
RC,360,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",,,149.28,6689.0,52
RC,360,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",,,59.06,6689.0,52
RC,360,"Dissection, deep jugular node(s)",,,514.14,10644.28,52
RC,360,"Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic",,,94.83,6689.0,52
RC,360,"ENDOMETRIAL ABLATION, THERMAL, WITHOUT HYSTEROSCOPIC GUIDANCE",,,226.79,14124.0,52
RC,360,ENDOMETRIAL SAMPLING (BIOPSY) PERFORMED IN CONJUNCTION WITH COLPOSCOPY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,39.06,5681.0,14
RC,360,ENDOSCOPIC INJECTION OF IMPLANT MATERIAL INTO THE SUBMUCOSAL TISSUES OF THE URETHRA AND/OR BLADDER NECK,,,193.19,7704.0,52
RC,360,"ENTERECTOMY, RESECTION OF SMALL INTESTINE; SINGLE RESECTION AND ANASTOMOSIS",,,982.0,13802.9,14
RC,360,"ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES ATTACHED TO IMPLANT",,,932.05,8715.0,52
RC,360,"ENUCLEATION OF EYE; WITH IMPLANT, MUSCLES NOT ATTACHED TO IMPLANT",,,857.1,7704.0,52
RC,360,ENUCLEATION OF EYE; WITHOUT IMPLANT,,,830.24,7704.0,52
RC,360,"EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING",,,143.45,6689.0,50
RC,360,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE",,,100.43,5681.0,52
RC,360,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN BODY(S)",,,136.49,5681.0,52
RC,360,"ESOPHAGOSCOPY, RIGID, TRANSORAL WITH DIVERTICULECTOMY OF HYPOPHARYNX OR CERVICAL ESOPHAGUS (EG, ZENKER'S DIVERTICULUM), WITH CRICOPHARYNGEAL MYOTOMY, INCLUDES USE OF TELESCOPE OR OPERATING MICROSCOPE ",,,536.05,18194.0,52
RC,360,"ESOPHAGOSCOPY, RIGID, TRANSORAL; WITH BALLOON DILATION (LESS THAN 30 MM DIAMETER)",,,180.54,10059.0,52
RC,360,"ETHMOIDECTOMY; INTRANASAL, ANTERIOR",,,615.87,10422.97,52
RC,360,"EXCHANGE NEPHROSTOMY CATHETER, PERCUTANEOUS, INCLUDING DIAGNOSTIC NEPHROSTOGRAM AND/OR URETEROGRAM WHEN PERFORMED, IMAGING GUIDANCE (EG, ULTRASOUND AND/OR FLUOROSCOPY) AND ALL ASSOCIATED RADIOLOGICAL ",,,95.52,5988.0,52
RC,360,"EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPE OR MATCHED RESECTION)",,,429.69,8715.0,52
RC,360,"EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR",,,322.48,5681.0,52
RC,360,"EXCISION INFERIOR TURBINATE, PARTIAL OR COMPLETE, ANY METHOD",,,409.85,7704.0,52
RC,360,EXCISION OF BARTHOLIN'S GLAND OR CYST,,,309.69,7704.0,52
RC,360,"EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE, BY ENUCLEATION AND/OR CURETTAGE",,,355.27,6689.0,52
RC,360,"EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE; REQUIRING EXTRA-ORAL OSTEOTOMY AND PARTIAL MANDIBULECTOMY (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION[S])",,,1182.93,10422.97,52
RC,360,"EXCISION OF BENIGN TUMOR OR CYST OF MANDIBLE; REQUIRING INTRA-ORAL OSTEOTOMY (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION[S])",,,965.57,10422.97,52
RC,360,EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA OR ZYGOMA BY ENUCLEATION AND CURETTAGE,,,353.97,10422.97,50
RC,360,"EXCISION OF BENIGN TUMOR OR CYST OF MAXILLA; REQUIRING INTRA-ORAL OSTEOTOMY (EG, LOCALLY AGGRESSIVE OR DESTRUCTIVE LESION[S])",,,974.26,10422.97,52
RC,360,"EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); FACIAL BONE(S)",,,421.37,10422.97,52
RC,360,"EXCISION OF BONE (EG, FOR OSTEOMYELITIS OR BONE ABSCESS); MANDIBLE",,,649.49,10422.97,52
RC,360,"EXCISION OF CERVICAL STUMP, VAGINAL APPROACH; WITH ANTERIOR AND/OR POSTERIOR REPAIR",,,608.74,8807.75,50
RC,360,"EXCISION OF HYPERPLASTIC ALVEOLAR MUCOSA, EACH QUADRANT (SPECIFY)",,,217.12,5681.0,50
RC,360,"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH COMPLEX REPAIR",,,277.84,6689.0,52
RC,360,"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITH SIMPLE REPAIR",,,178.78,5681.0,50
RC,360,"EXCISION OF LESION OF MUCOSA AND SUBMUCOSA, VESTIBULE OF MOUTH; WITHOUT REPAIR",,,120.53,5837.49,50
RC,360,EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIOR TWO-THIRDS,,,238.8,6689.0,52
RC,360,"EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH COMPLEX REPAIR",,,283.21,10422.97,52
RC,360,"EXCISION OF LESION OR TUMOR (EXCEPT LISTED ABOVE), DENTOALVEOLAR STRUCTURES; WITH SIMPLE REPAIR",,,191.23,6226.0,50
RC,360,EXCISION OF MAXILLARY TORUS PALATINUS,,,256.14,6226.0,50
RC,360,EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; CUTANEOUS NERVE,,,403.8,7704.0,52
RC,360,EXCISION OF NEUROFIBROMA OR NEUROLEMMOMA; MAJOR PERIPHERAL NERVE,,,833.43,7704.0,52
RC,360,EXCISION OF NEUROMA; SCIATIC NERVE,,,978.46,8755.0,52
RC,360,"EXCISION OF RECTAL PROCIDENTIA, WITH ANASTOMOSIS; PERINEAL APPROACH",,,982.0,13802.9,14
RC,360,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)",,,804.7,18194.0,52
RC,360,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA (IE, PARTIAL THICKNESS)",,,603.87,10059.0,52
RC,360,"EXCISION OF SPERMATOCELE, WITH OR WITHOUT EPIDIDYMECTOMY",,,316.62,8715.0,52
RC,360,EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND,,,410.67,10422.97,52
RC,360,"EXCISION OF TENDON, FINGER, FLEXOR OR EXTENSOR, EACH TENDON",,,449.57,7704.0,52
RC,360,EXCISION OF THYROGLOSSAL DUCT CYST OR SINUS; RECURRENT,,,587.35,10644.28,52
RC,360,EXCISION OF TORUS MANDIBULARIS,,,267.51,6226.0,50
RC,360,EXCISION OF URETHRAL DIVERTICULUM (SEPARATE PROCEDURE); FEMALE,,,596.86,9440.44,52
RC,360,EXCISION OF VAGINAL CYST OR TUMOR,,,185.15,6689.0,52
RC,360,EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF CLAVICLE OR SCAPULA;,,,551.7,8715.0,52
RC,360,EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF HEAD OR NECK OF RADIUS OR OLECRANON PROCESS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT),,,617.96,7704.0,52
RC,360,EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR OF PROXIMAL HUMERUS;,,,660.51,8715.0,52
RC,360,"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, TIBIA OR FIBULA; WITH ALLOGRAFT",,,731.41,12775.92,52
RC,360,"EXCISION OR DESTRUCTION (EG, LASER), INTRANASAL LESION; EXTERNAL APPROACH (LATERAL RHINOTOMY)",,,697.66,7704.0,52
RC,360,"EXCISION OR DESTRUCTION (EG, LASER), INTRANASAL LESION; INTERNAL APPROACH",,,406.69,7704.0,52
RC,360,"EXCISION OR DESTRUCTION OF LESION OF PHARYNX, ANY METHOD",,,163.84,6689.0,52
RC,360,"EXCISION SOFT TISSUE LESION, EXTERNAL AUDITORY CANAL",,,254.11,6689.0,52
RC,360,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); ARM",,,779.86,7704.0,47
RC,360,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); OTHER AREA",,,723.42,7704.0,47
RC,360,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); SUBMENTAL FAT PAD",,,636.22,7390.37,45
RC,360,"EXCISION, EXCESSIVE SKIN AND SUBCUTANEOUS TISSUE (INCLUDES LIPECTOMY); THIGH",,,900.85,7704.0,47
RC,360,"EXCISION, LESION OF PALATE, UVULA; WITHOUT CLOSURE",,,132.9,6689.0,52
RC,360,"EXCISION, NASAL POLYP(S), SIMPLE",,,131.23,5681.0,50
RC,360,"EXCISION, OLECRANON BURSA",,,361.03,7704.0,52
RC,360,"EXCISION, PREPATELLAR BURSA",,,374.91,7704.0,52
RC,360,"EXCISION, RADIAL HEAD",,,508.31,7704.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBCUTANEOUS; LESS THAN 3 CM",,,313.31,6689.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF FOREARM AND/OR WRIST AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 3 CM",,,514.42,7704.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; 3 CM OR GREATER",,,439.41,18194.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBCUTANEOUS; LESS THAN 3 CM",,,303.17,6689.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF NECK OR ANTERIOR THORAX, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM",,,520.92,6689.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; 3 CM OR GREATER",,,460.92,18194.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF PELVIS AND HIP AREA, SUBCUTANEOUS; LESS THAN 3 CM",,,356.93,6689.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; 3 CM OR GREATER",,,399.4,18194.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBCUTANEOUS; LESS THAN 3 CM",,,326.08,6689.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); 5 CM OR GREATER",,,680.32,18194.0,52
RC,360,"EXCISION, TUMOR, SOFT TISSUE OF UPPER ARM OR ELBOW AREA, SUBFASCIAL (EG, INTRAMUSCULAR); LESS THAN 5 CM",,,539.98,6689.0,52
RC,360,"EXPLORATION NOT FOLLOWED BY SURGICAL REPAIR, ARTERY; UPPER EXTREMITY (EG, AXILLARY, BRACHIAL, RADIAL, ULNAR)",,,391.91,10257.38,14
RC,360,EXPLORATION OF PENETRATING WOUND (SEPARATE PROCEDURE); EXTREMITY,,,337.18,6499.0,52
RC,360,"EXPLORATORY LAPAROTOMY, EXPLORATORY CELIOTOMY WITH OR WITHOUT BIOPSY(S) (SEPARATE PROCEDURE)",,,748.27,13802.9,15
RC,360,"EXTERNAL CEPHALIC VERSION, WITH OR WITHOUT TOCOLYSIS",,,99.62,6226.0,48
RC,360,"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; MASTICATOR SPACE",,,391.76,5681.0,52
RC,360,"EXTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF FLOOR OF MOUTH; SUBMANDIBULAR",,,335.96,5837.49,52
RC,360,Endocervical curettage (not done as part of a dilation and curettage),,,107.94,5681.0,52
RC,360,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)",,,61.54,5681.0,52
RC,360,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,118.5,5444.0,52
RC,360,"Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,85.33,5681.0,52
RC,360,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)",,,151.78,5988.0,52
RC,360,"Ethmoidectomy; intranasal, total",,,766.44,10059.0,52
RC,360,"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion",,,453.13,7704.0,52
RC,360,"Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions",,,409.89,7704.0,52
RC,360,Excision of hydrocele; unilateral,,,333.08,7704.0,52
RC,360,Excision of lingual frenum (frenectomy),,,143.94,5681.0,52
RC,360,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve",,,1039.25,14124.0,52
RC,360,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection",,,620.12,10422.97,52
RC,360,"Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve",,,1162.29,14124.0,52
RC,360,Excision of pilonidal cyst or sinus; complicated,,,567.72,7704.0,52
RC,360,Excision of pilonidal cyst or sinus; extensive,,,441.47,7704.0,52
RC,360,Excision of pilonidal cyst or sinus; simple,,,181.55,7704.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less",,,80.94,6689.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm",,,107.32,6689.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm",,,133.62,5681.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",,,154.46,5681.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",,,262.46,6689.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm",,,103.95,5681.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 1.1 to 2.0 cm",,,113.71,5681.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter 3.1 to 4.0 cm",,,161.65,5681.0,52
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",,,243.36,6689.0,52
RC,360,"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy",,,1142.73,11691.26,52
RC,360,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm",,,151.96,6689.0,52
RC,360,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm",,,177.69,6689.0,52
RC,360,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",,,221.36,6689.0,52
RC,360,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm",,,378.03,6689.0,52
RC,360,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm",,,203.82,5681.0,52
RC,360,"Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm",,,282.77,6689.0,52
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm",,,157.64,5681.0,52
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm",,,188.24,5681.0,52
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm",,,207.04,6689.0,52
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",,,307.7,6689.0,52
RC,360,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less",,,105.59,6689.0,52
RC,360,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm",,,131.26,6689.0,52
RC,360,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm",,,144.61,5681.0,52
RC,360,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm",,,175.92,5681.0,52
RC,360,"Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm",,,221.25,5681.0,52
RC,360,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater",,,432.31,18194.0,52
RC,360,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm",,,329.15,14124.0,52
RC,360,"Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); 5 cm or greater",,,652.68,18194.0,52
RC,360,"Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); less than 5 cm",,,555.68,8715.0,52
RC,360,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",,,461.28,18194.0,52
RC,360,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); 5 cm or greater",,,722.14,18194.0,52
RC,360,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); less than 5 cm",,,649.63,14124.0,52
RC,360,"Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater",,,334.0,5681.0,52
RC,360,"Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm",,,257.16,5681.0,52
RC,360,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater",,,402.09,18194.0,52
RC,360,"Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm",,,302.72,6689.0,52
RC,360,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); 5 cm or greater",,,716.9,18194.0,52
RC,360,"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater",,,413.49,18194.0,52
RC,360,"Excision, tumor, soft tissue of shoulder area, subfascial (e.g., intramuscular); 5 cm or greater",,,684.09,18194.0,52
RC,360,"Excision, tumor, soft tissue of shoulder area, subfascial (e.g., intramuscular); less than 5 cm",,,535.4,6689.0,52
RC,360,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater",,,412.84,18194.0,52
RC,360,"Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); 5 cm or greater",,,741.41,18194.0,52
RC,360,"Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); less than 5 cm",,,614.09,7704.0,52
RC,360,FIXATION OF CONTRALATERAL TESTIS (SEPARATE PROCEDURE),,,291.62,7704.0,52
RC,360,"FORMATION OF DIRECT OR TUBED PEDICLE, WITH OR WITHOUT TRANSFER; SCALP, ARMS, OR LEGS",,,720.1,7704.0,52
RC,360,"FRACTURE NASAL INFERIOR TURBINATE(S), THERAPEUTIC",,,116.84,8715.0,52
RC,360,"FULL THICKNESS GRAFT, FREE, INCLUDING DIRECT CLOSURE OF DONOR SITE, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS, AND/OR FEET; EACH ADDITIONAL 20 SQ CM, OR PART THEREOF (LIST SEPARAT",,,103.51,7704.0,19
RC,360,"Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less",,,779.19,7704.0,52
RC,360,"GENIOPLASTY; AUGMENTATION (AUTOGRAFT, ALLOGRAFT, PROSTHETIC MATERIAL)",,,497.31,14124.0,52
RC,360,"GRAFT, BONE; MANDIBLE (INCLUDES OBTAINING GRAFT)",,,772.22,14124.0,52
RC,360,"GRAFT, BONE; NASAL, MAXILLARY OR MALAR AREAS (INCLUDES OBTAINING GRAFT)",,,743.09,14124.0,52
RC,360,"GRAFTING OF AUTOLOGOUS FAT HARVESTED BY LIPOSUCTION TECHNIQUE TO FACE, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, AND/OR FEET; 25 CC OR LESS INJECTATE",,,491.37,18194.0,52
RC,360,Glossectomy; less than one-half tongue,,,1031.54,10422.97,52
RC,360,Graft; derma-fat-fascia,,,660.78,7704.0,52
RC,360,"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)",,,561.5,14124.0,52
RC,360,"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectate",,,501.68,18194.0,52
RC,360,"Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; each additional 50 cc injectate, or part thereof (list separately in addition to code for pri",,,143.36,5681.0,14
RC,360,"Grafting of autologous soft tissue, other, harvested by direct excision (e.g., fat, dermis, fascia)",,,470.44,18194.0,52
RC,360,"HEMIPHALANGECTOMY OR INTERPHALANGEAL JOINT EXCISION, TOE, PROXIMAL END OF PHALANX, EACH",,,264.63,7704.0,52
RC,360,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;",,,472.79,7704.0,52
RC,360,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP;",,,348.3,7704.0,52
RC,360,"HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; 2 OR MORE HEMORRHOID COLUMNS/GROUPS, WITHOUT IMAGING GUIDANCE",,,373.47,6689.0,52
RC,360,"HEMORRHOIDECTOMY, INTERNAL, BY LIGATION OTHER THAN RUBBER BAND; SINGLE HEMORRHOID COLUMN/GROUP, WITHOUT IMAGING GUIDANCE",,,334.21,6689.0,50
RC,360,"HYMENOTOMY, SIMPLE INCISION",,,46.49,6226.0,52
RC,360,"HYSTEROSCOPY, SURGICAL; WITH REMOVAL OF IMPACTED FOREIGN BODY",,,215.77,7704.0,52
RC,360,"Hysteroscopy, diagnostic (separate procedure)",,,147.46,6226.0,52
RC,360,"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)",,,304.3,8807.75,52
RC,360,"Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)",,,239.25,18194.0,52
RC,360,"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)",,,276.33,8807.75,52
RC,360,"Hysteroscopy, surgical; with removal of leiomyomata",,,348.21,8807.75,52
RC,360,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",,,225.2,7704.0,52
RC,360,IMPLANTATION OF NERVE END INTO BONE OR MUSCLE (LIST SEPARATELY IN ADDITION TO NEUROMA EXCISION),,,225.83,6689.0,19
RC,360,IMPLANTATION OR REPLACEMENT OF DEVICE FOR INTRATHECAL OR EPIDURAL DRUG INFUSION; NONPROGRAMMABLE PUMP,,,429.39,31734.35,52
RC,360,IMPRESSION AND CUSTOM PREPARATION; ORAL SURGICAL SPLINT,,,153.41,4664.0,50
RC,360,INCISION AND DRAINAGE ABSCESS; PERITONSILLAR,,,134.1,5681.0,52
RC,360,"INCISION AND DRAINAGE OF INTRAMURAL, INTRAMUSCULAR, OR SUBMUCOSAL ABSCESS, TRANSANAL, UNDER ANESTHESIA",,,432.03,6689.0,52
RC,360,"INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX;",,,332.68,6689.0,52
RC,360,"INCISION AND DRAINAGE, DEEP ABSCESS, BURSA, OR HEMATOMA, THIGH OR KNEE REGION",,,502.53,7704.0,52
RC,360,"INCISION AND DRAINAGE, FOREARM AND/OR WRIST; DEEP ABSCESS OR HEMATOMA",,,681.66,6226.0,52
RC,360,"INCISION AND DRAINAGE, OPEN, OF DEEP ABSCESS (SUBFASCIAL), POSTERIOR SPINE; LUMBAR, SACRAL, OR LUMBOSACRAL",,,931.79,13802.9,50
RC,360,"INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL",,,99.7,5681.0,52
RC,360,"INCISION AND DRAINAGE, SHOULDER AREA; DEEP ABSCESS OR HEMATOMA",,,250.95,6226.0,52
RC,360,"INCISION AND DRAINAGE, UPPER ARM OR ELBOW AREA; DEEP ABSCESS OR HEMATOMA",,,211.88,6226.0,52
RC,360,"INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED",,,179.82,6689.0,52
RC,360,"INCISION OF THROMBOSED HEMORRHOID, EXTERNAL",,,108.2,5681.0,52
RC,360,"INCISION, BONE CORTEX (EG, OSTEOMYELITIS OR BONE ABSCESS), SHOULDER AREA",,,669.04,7704.0,52
RC,360,INJECTION PROCEDURE FOR TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,,,43.19,5681.0,14
RC,360,"INJECTION PROCEDURE FOR VISUALIZATION OF ILEAL CONDUIT AND/OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE",,,67.66,5681.0,14
RC,360,"INJECTION(S), ANESTHETIC AGENT(S) AND/OR STEROID; PUDENDAL NERVE",,,53.25,5681.0,52
RC,360,INSERTION OF INTRAUTERINE DEVICE (IUD),,,49.12,5681.0,16
RC,360,"INSERTION OF MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS, INCLUDING PLACEMENT OF PUMP, CYLINDERS, AND RESERVOIR",,,787.82,36492.19,47
RC,360,INSERTION OF PENILE PROSTHESIS; INFLATABLE (SELF-CONTAINED),,,653.0,36492.19,47
RC,360,"INSERTION OF PERIPHERALLY INSERTED CENTRAL VENOUS CATHETER (PICC), WITHOUT SUBCUTANEOUS PORT OR PUMP, WITHOUT IMAGING GUIDANCE; AGE 5 YEARS OR OLDER",,,90.96,5681.0,52
RC,360,"INSERTION OF TEMPORARY INDWELLING BLADDER CATHETER; COMPLICATED (EG, ALTERED ANATOMY, FRACTURED CATHETER/BALLOON)",,,73.85,5681.0,52
RC,360,"INSERTION OF TRANSVENOUS INTRAHEPATIC PORTOSYSTEMIC SHUNT(S) (TIPS) (INCLUDES VENOUS ACCESS, HEPATIC AND PORTAL VEIN CATHETERIZATION, PORTOGRAPHY WITH HEMODYNAMIC EVALUATION, INTRAHEPATIC TRACT FORMAT",,,773.95,32276.26,50
RC,360,"INSERTION OF TUNNELED INTRAPERITONEAL CATHETER (EG, DIALYSIS, INTRAPERITONEAL CHEMOTHERAPY INSTILLATION, MANAGEMENT OF ASCITES), COMPLETE PROCEDURE, INCLUDING IMAGING GUIDANCE, CATHETER PLACEMENT, CON",,,191.43,18194.0,52
RC,360,"INSERTION, DRUG-DELIVERY IMPLANT (IE, BIORESORBABLE, BIODEGRADABLE, NON-BIODEGRADABLE)",,,60.79,5681.0,52
RC,360,"INSERTION, NASAL SEPTAL PROSTHESIS (BUTTON)",,,126.65,7704.0,52
RC,360,"INTERNAL NEUROLYSIS, REQUIRING USE OF OPERATING MICROSCOPE (LIST SEPARATELY IN ADDITION TO CODE FOR NEUROPLASTY) (NEUROPLASTY INCLUDES EXTERNAL NEUROLYSIS)",,,173.91,5681.0,19
RC,360,"INTERSTITIAL RADIATION SOURCE APPLICATION, COMPLEX, INCLUDES SUPERVISION, HANDLING, LOADING OF RADIATION SOURCE, WHEN PERFORMED",,,451.46,3825.05,47
RC,360,"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; LINGUAL",,,102.43,5681.0,52
RC,360,"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBLINGUAL, SUPERFICIAL",,,114.12,5681.0,52
RC,360,"INTRAORAL INCISION AND DRAINAGE OF ABSCESS, CYST, OR HEMATOMA OF TONGUE OR FLOOR OF MOUTH; SUBMANDIBULAR SPACE",,,253.37,5837.49,52
RC,360,INTRODUCTION OF ANY HEMOSTATIC AGENT OR PACK FOR SPONTANEOUS OR TRAUMATIC NONOBSTETRICAL VAGINAL HEMORRHAGE (SEPARATE PROCEDURE),,,119.1,4664.0,52
RC,360,"INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT) (SEPARATE PROCEDURE)",,,18.34,5444.0,52
RC,360,"Implantation of biologic implant (e.g., acellular dermal matrix) for soft tissue reinforcement (i.e., breast, trunk) (list separately in addition to code for primary procedure)",,,206.92,5681.0,19
RC,360,"Implantation or replacement of device for intrathecal or epidural drug infusion; programmable pump, including preparation of pump, with or without programming",,,378.42,31734.35,52
RC,360,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",,,181.2,5681.0,52
RC,360,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",,,105.0,5681.0,52
RC,360,"Incision and drainage of hematoma, seroma or fluid collection",,,116.33,5681.0,52
RC,360,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure),,,418.43,7704.0,52
RC,360,Incision and drainage of pilonidal cyst; simple,,,103.42,5681.0,52
RC,360,Incision and drainage of vulva or perineal abscess,,,125.19,6689.0,52
RC,360,"Incision and drainage, complex, postoperative wound infection",,,174.79,6689.0,52
RC,360,"Incision and removal of foreign body, subcutaneous tissues; simple",,,103.94,5681.0,52
RC,360,"Incision, bone cortex (e.g., osteomyelitis or bone abscess), foot",,,563.4,7704.0,52
RC,360,"Induced abortion, by dilation and curettage",,,218.16,10059.0,52
RC,360,"Induced abortion, by dilation and evacuation",,,364.84,10059.0,52
RC,360,Injection procedure; radioactive tracer for identification of sentinel node,,,31.05,5681.0,52
RC,360,"Injection(s), anesthetic agent(s) and/or steroid; femoral nerve, including imaging guidance, when performed",,,61.36,4664.0,52
RC,360,"Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)",,,35.93,5681.0,52
RC,360,"Injection(s); single or multiple trigger point(s), 3 or more muscles",,,40.83,5681.0,52
RC,360,"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator",,,355.92,15325.0,50
RC,360,"Insertion of breast implant on same day of mastectomy (i.e., immediate)",,,742.68,14390.77,52
RC,360,"Insertion of interbody biomechanical device(s) (e.g., synthetic cage, mesh) with integral anterior instrumentation for device anchoring (e.g., screws, flanges), when performed, to intervertebral disc ",,,248.05,6904.78,14
RC,360,"Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (list separately in addition to code for primary procedure)",,,243.16,11751.0,19
RC,360,Insertion or replacement of breast implant on separate day from mastectomy,,,745.07,14390.77,52
RC,360,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays",,,869.02,54330.72,52
RC,360,"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to a single electrode array",,,521.18,54330.72,52
RC,360,"Insertion or replacement of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,287.88,34157.51,52
RC,360,"Insertion or replacement of spinal neurostimulator pulse generator or receiver, requiring pocket creation and connection between electrode array and pulse generator or receiver",,,333.49,54330.72,52
RC,360,"Intraoperative identification (e.g., mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (list separately in addition to code for primary procedure)",,,132.45,5681.0,14
RC,360,"Intravenous injection of agent (e.g., fluorescein) to test vascular flow in flap or graft",,,102.69,5681.0,52
RC,360,"LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; LUMBAR",,,1343.6,18194.0,52
RC,360,"LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; SACRAL",,,1435.16,18194.0,52
RC,360,"LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), 1 OR 2 VERTEBRAL SEGMENTS; CERVICAL",,,1203.96,18194.0,52
RC,360,"LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), 1 OR 2 VERTEBRAL SEGMENTS; THORACIC",,,1208.7,18194.0,52
RC,360,"LAMINECTOMY WITH EXPLORATION AND/OR DECOMPRESSION OF SPINAL CORD AND/OR CAUDA EQUINA, WITHOUT FACETECTOMY, FORAMINOTOMY OR DISCECTOMY (EG, SPINAL STENOSIS), MORE THAN 2 VERTEBRAL SEGMENTS; CERVICAL",,,1450.28,18194.0,52
RC,360,"LAMINECTOMY WITH REMOVAL OF ABNORMAL FACETS AND/OR PARS INTER-ARTICULARIS WITH DECOMPRESSION OF CAUDA EQUINA AND NERVE ROOTS FOR SPONDYLOLISTHESIS, LUMBAR (GILL TYPE PROCEDURE)",,,1169.44,18194.0,52
RC,360,"LAMINECTOMY, FACETECTOMY AND FORAMINOTOMY (UNILATERAL OR BILATERAL WITH DECOMPRESSION OF SPINAL CORD, CAUDA EQUINA AND/OR NERVE ROOT[S], [EG, SPINAL OR LATERAL RECESS STENOSIS]), SINGLE VERTEBRAL SEGM",,,1204.82,18194.0,52
RC,360,"LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; 1 INTERSPACE, CERVICAL",,,1076.72,18194.0,52
RC,360,"LAMINOTOMY (HEMILAMINECTOMY), WITH DECOMPRESSION OF NERVE ROOT(S), INCLUDING PARTIAL FACETECTOMY, FORAMINOTOMY AND/OR EXCISION OF HERNIATED INTERVERTEBRAL DISC; EACH ADDITIONAL INTERSPACE, CERVICAL OR",,,224.88,18194.0,21
RC,360,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITH SALPINGECTOMY AND/OR OOPHORECTOMY,,,757.83,10644.28,50
RC,360,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHOUT SALPINGECTOMY AND/OR OOPHORECTOMY,,,774.66,10644.28,50
RC,360,"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,321.97,10644.28,52
RC,360,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH LYMPH NODE BIOPSY(IES) (LIMITED PELVIC LYMPHADENECTOMY)",,,7873.55,18715.8,45
RC,360,"LAPAROSCOPY, SURGICAL, ABLATION OF 1 OR MORE LIVER TUMOR(S); RADIOFREQUENCY",,,1218.51,18715.8,50
RC,360,"LAPAROSCOPY, SURGICAL, ABLATION OF UTERINE FIBROID(S) INCLUDING INTRAOPERATIVE ULTRASOUND GUIDANCE AND MONITORING, RADIOFREQUENCY",,,797.0,18715.8,50
RC,360,"LAPAROSCOPY, SURGICAL, ESOPHAGEAL SPHINCTER AUGMENTATION PROCEDURE, PLACEMENT OF SPHINCTER AUGMENTATION DEVICE (IE, MAGNETIC BAND), INCLUDING CRUROPLASTY WHEN PERFORMED",,,636.64,18715.8,50
RC,360,"LAPAROSCOPY, SURGICAL, ESOPHAGOGASTRIC FUNDOPLASTY (EG, NISSEN, TOUPET PROCEDURES)",,,1045.69,18715.8,52
RC,360,"LAPAROSCOPY, SURGICAL, ESOPHAGOMYOTOMY (HELLER TYPE), WITH FUNDOPLASTY, WHEN PERFORMED",,,982.0,10065.0,15
RC,360,"LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITH IMPLANTATION OF MESH",,,1673.59,18715.8,50
RC,360,"LAPAROSCOPY, SURGICAL, TOTAL HYSTERECTOMY FOR RESECTION OF MALIGNANCY (TUMOR DEBULKING), WITH OMENTECTOMY INCLUDING SALPINGO-OOPHORECTOMY, UNILATERAL OR BILATERAL, WHEN PERFORMED",,,982.0,13802.9,15
RC,360,"LAPAROSCOPY, SURGICAL, WITH TOTAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G;",,,994.57,18715.8,52
RC,360,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;",,,865.65,18194.0,52
RC,360,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)",,,1277.76,18715.8,52
RC,360,"LAPAROSCOPY, SURGICAL; COLECTOMY, PARTIAL, WITH ANASTOMOSIS, WITH COLOPROCTOSTOMY (LOW PELVIC ANASTOMOSIS) WITH COLOSTOMY",,,982.0,10257.38,19
RC,360,"LAPAROSCOPY, SURGICAL; ENTERECTOMY, RESECTION OF SMALL INTESTINE, SINGLE RESECTION AND ANASTOMOSIS",,,1344.05,13802.9,15
RC,360,"LAPAROSCOPY, SURGICAL; NEPHRECTOMY WITH TOTAL URETERECTOMY",,,1300.79,13802.9,14
RC,360,"LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE)",,,1098.98,13802.9,14
RC,360,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",,,1202.65,18715.8,52
RC,360,"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITH CYSTOSCOPY AND URETERAL STENT PLACEMENT",,,1342.48,18715.8,52
RC,360,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,336.82,10644.28,52
RC,360,"LAPAROSCOPY, SURGICAL; WITH INSERTION OF TUNNELED INTRAPERITONEAL CATHETER",,,376.31,18194.0,52
RC,360,"LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPINGOLYSIS, OVARIOLYSIS) (SEPARATE PROCEDURE)",,,670.78,10644.28,52
RC,360,"LAPAROSCOPY, SURGICAL; WITH OMENTOPEXY (OMENTAL TACKING PROCEDURE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,180.75,18194.0,21
RC,360,"LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED",,,401.19,18194.0,52
RC,360,"LARYNGOPLASTY, MEDIALIZATION, UNILATERAL",,,1080.42,10422.97,50
RC,360,"LARYNGOPLASTY; FOR LARYNGEAL STENOSIS, WITH GRAFT, WITHOUT INDWELLING STENT PLACEMENT, AGE 12 YEARS OR OLDER",,,1459.42,10422.97,50
RC,360,"LARYNGOTOMY (THYROTOMY, LARYNGOFISSURE), WITH REMOVAL OF TUMOR OR LARYNGOCELE, CORDECTOMY",,,1224.9,10059.0,52
RC,360,"LASER COAGULATION OF PROSTATE, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, AND INTERNAL URETHROTOMY ARE INCLUD",,,635.1,18194.0,7
RC,360,"LASER INTERSTITIAL THERMAL THERAPY (LITT) OF LESION, INTRACRANIAL, INCLUDING BURR HOLE(S), WITH MAGNETIC RESONANCE IMAGING GUIDANCE, WHEN PERFORMED; MULTIPLE TRAJECTORIES FOR MULTIPLE OR COMPLEX LESIO",,,982.0,7390.37,14
RC,360,"LASER INTERSTITIAL THERMAL THERAPY (LITT) OF LESION, INTRACRANIAL, INCLUDING BURR HOLE(S), WITH MAGNETIC RESONANCE IMAGING GUIDANCE, WHEN PERFORMED; SINGLE TRAJECTORY FOR 1 SIMPLE LESION",,,982.0,7390.37,14
RC,360,LATERAL CANTHOPEXY,,,392.83,10059.0,52
RC,360,"LATERAL RETINACULAR RELEASE, OPEN",,,453.09,14124.0,52
RC,360,"LENGTHENING OF PALATE, AND PHARYNGEAL FLAP",,,887.55,10422.97,52
RC,360,"LENGTHENING OR SHORTENING OF FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON",,,562.64,8715.0,52
RC,360,"LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; MULTIPLE TENDONS (THROUGH SAME INCISION), EACH",,,526.09,7704.0,52
RC,360,"LENGTHENING OR SHORTENING OF TENDON, LEG OR ANKLE; SINGLE TENDON (SEPARATE PROCEDURE)",,,461.71,7704.0,52
RC,360,"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)",,,1098.32,22604.88,52
RC,360,LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA,,,358.44,7704.0,52
RC,360,"LIGATION OR BIOPSY, TEMPORAL ARTERY",,,198.26,6689.0,52
RC,360,"LIGATION, DIVISION, AND STRIPPING, LONG (GREATER) SAPHENOUS VEINS FROM SAPHENOFEMORAL JUNCTION TO KNEE OR BELOW",,,440.98,7704.0,52
RC,360,"LIGATION, MAJOR ARTERY (EG, POST-TRAUMATIC, RUPTURE); EXTREMITY",,,379.92,13802.9,14
RC,360,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM),,,455.47,6226.0,52
RC,360,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; SIMPLE OR SMALL (LESS THAN 2.5 CM),,,333.37,6226.0,52
RC,360,LYMPHANGIOTOMY OR OTHER OPERATIONS ON LYMPHATIC CHANNELS,,,460.01,6893.85,52
RC,360,"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural",,,824.56,34157.51,52
RC,360,"Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [e.g., spinal or lateral recess stenosis]), single vertebral se",,,202.89,18194.0,125
RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumba",,,1268.1,18194.0,52
RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar",,,898.16,18194.0,52
RC,360,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;",,,1160.79,18715.8,50
RC,360,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,1019.6,18715.8,50
RC,360,"Laparoscopy, surgical, appendectomy",,,588.48,10644.28,52
RC,360,"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis",,,1600.96,13802.9,14
RC,360,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)",,,953.06,18715.8,50
RC,360,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)",,,894.06,13802.9,52
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (i.e., sleeve gastrectomy)",,,982.0,17878.0,15
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components",,,934.88,11278.0,50
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only",,,924.16,10769.59,50
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (Roux limb 150 cm or less)",,,982.0,17878.0,15
RC,360,"Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 g or less and/or removal of surface myomas",,,884.53,18194.0,52
RC,360,"Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g",,,1090.23,18715.8,52
RC,360,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh",,,1486.07,18715.8,50
RC,360,"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,814.51,18715.8,52
RC,360,"Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal",,,1157.25,13802.9,15
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;",,,792.71,18715.8,52
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,892.5,18715.8,52
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)",,,1194.84,18715.8,52
RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,961.4,18715.8,52
RC,360,"Laparoscopy, surgical; cholecystectomy",,,644.59,18194.0,52
RC,360,"Laparoscopy, surgical; cholecystectomy with cholangiography",,,700.56,18194.0,52
RC,360,"Laparoscopy, surgical; cholecystectomy with exploration of common duct",,,1088.73,18715.8,52
RC,360,"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)",,,982.0,10257.38,19
RC,360,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy",,,1168.7,13802.9,14
RC,360,"Laparoscopy, surgical; partial nephrectomy",,,1445.99,18715.8,50
RC,360,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)",,,982.0,13802.9,14
RC,360,"Laparoscopy, surgical; repair initial inguinal hernia",,,424.62,10644.28,52
RC,360,"Laparoscopy, surgical; repair recurrent inguinal hernia",,,554.03,14124.0,52
RC,360,"Laparoscopy, surgical; with aspiration of cavity or cyst (e.g., ovarian cyst) (single or multiple)",,,366.15,10644.28,52
RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy",,,645.34,18715.8,52
RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple",,,876.77,18715.8,52
RC,360,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",,,699.81,10644.28,52
RC,360,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",,,639.46,10644.28,52
RC,360,"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple",,,505.09,18194.0,52
RC,360,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn",,,156.08,6689.0,52
RC,360,"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope",,,152.82,6689.0,52
RC,360,"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial",,,140.44,6689.0,52
RC,360,"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent",,,156.77,6689.0,52
RC,360,"Laryngoscopy, direct, operative, with arytenoidectomy;",,,302.54,12425.97,52
RC,360,"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope",,,330.9,12425.97,52
RC,360,"Laryngoscopy, direct, operative, with biopsy;",,,183.82,6689.0,52
RC,360,"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope",,,204.07,7704.0,52
RC,360,"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis;",,,234.04,7704.0,52
RC,360,"Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope",,,255.23,8715.0,52
RC,360,"Laryngoscopy, direct, operative, with foreign body removal;",,,193.22,6689.0,52
RC,360,"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft)",,,531.36,12425.97,52
RC,360,"Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s)",,,350.76,8715.0,52
RC,360,"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;",,,222.43,6689.0,52
RC,360,"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope",,,241.54,6689.0,52
RC,360,"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral",,,175.71,14124.0,52
RC,360,"Laryngoscopy, flexible; with therapeutic injection(s) (e.g., chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral",,,145.04,14124.0,52
RC,360,"Ligamentous reconstruction (augmentation), knee; extra-articular",,,699.87,12775.92,52
RC,360,Lysis intranasal synechia,,,148.93,6689.0,52
RC,360,Lysis of labial adhesions,,,153.26,6226.0,52
RC,360,Lysis or excision of penile post-circumcision adhesions,,,196.53,6689.0,52
RC,360,"MANIPULATION OF TEMPOROMANDIBULAR JOINT(S) (TMJ), THERAPEUTIC, REQUIRING AN ANESTHESIA SERVICE (IE, GENERAL OR MONITORED ANESTHESIA CARE)",,,235.3,5681.0,52
RC,360,"MANIPULATION UNDER ANESTHESIA, SHOULDER JOINT, INCLUDING APPLICATION OF FIXATION APPARATUS (DISLOCATION EXCLUDED)",,,193.56,5681.0,52
RC,360,"MANIPULATION, FINGER JOINT, UNDER ANESTHESIA, EACH JOINT",,,358.87,5681.0,52
RC,360,"MANUAL PREPARATION AND INSERTION OF DRUG-DELIVERY DEVICE(S), INTRA-ARTICULAR (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,144.82,5681.0,14
RC,360,MARSUPIALIZATION OF BARTHOLIN'S GLAND CYST,,,178.65,6689.0,52
RC,360,MARSUPIALIZATION OF CYST OR ABSCESS OF LIVER,,,982.0,10257.38,14
RC,360,MASTECTOMY FOR GYNECOMASTIA,,,423.62,8715.0,52
RC,360,"MEDIASTINOSCOPY; WITH LYMPH NODE BIOPSY(IES) (EG, LUNG CANCER STAGING)",,,384.84,10644.28,50
RC,360,METATARSECTOMY,,,418.92,7704.0,52
RC,360,"MUSCLE OR TENDON TRANSFER, ANY TYPE, UPPER ARM OR ELBOW, SINGLE (EXCLUDING 24320-24331)",,,740.81,12775.92,52
RC,360,"MUSCLE TRANSFER, ANY TYPE, SHOULDER OR UPPER ARM; SINGLE",,,1258.41,12775.92,52
RC,360,"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; LOWER EXTREMITY",,,1234.0,7704.0,52
RC,360,"MUSCLE, MYOCUTANEOUS, OR FASCIOCUTANEOUS FLAP; UPPER EXTREMITY",,,1187.62,7704.0,52
RC,360,"MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 1 TO 4 INTRAMURAL MYOMA(S) WITH TOTAL WEIGHT OF 250 G OR LESS AND/OR REMOVAL OF SURFACE MYOMAS; ABDOMINAL APPROACH",,,903.95,13802.9,15
RC,360,"MYOMECTOMY, EXCISION OF FIBROID TUMOR(S) OF UTERUS, 5 OR MORE INTRAMURAL MYOMAS AND/OR INTRAMURAL MYOMAS WITH TOTAL WEIGHT GREATER THAN 250 G, ABDOMINAL APPROACH",,,982.0,13802.9,15
RC,360,Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices),,,152.54,5681.0,52
RC,360,"Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle",,,1150.43,18194.0,52
RC,360,"Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy);",,,644.95,7704.0,52
RC,360,"Mastectomy, simple, complete",,,934.61,11691.26,52
RC,360,Mastopexy,,,774.83,11691.26,52
RC,360,Maxillectomy; without orbital exenteration,,,982.0,13802.9,14
RC,360,"Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (i.e., buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)",,,1003.98,18194.0,52
RC,360,"Muscle, myocutaneous, or fasciocutaneous flap; trunk",,,1459.9,7704.0,52
RC,360,"NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONCHA BULLOSA RESECTION",,,155.13,6689.0,52
RC,360,"NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF NASAL HEMORRHAGE",,,163.27,6689.0,52
RC,360,NERVE PEDICLE TRANSFER; FIRST STAGE,,,977.88,15451.52,52
RC,360,NERVE PEDICLE TRANSFER; SECOND STAGE,,,1229.0,15451.52,52
RC,360,"NERVE REPAIR; WITH NERVE ALLOGRAFT, EACH NERVE, FIRST STRAND (CABLE)",,,875.64,15451.52,50
RC,360,"NERVE REPAIR; WITH SYNTHETIC CONDUIT OR VEIN ALLOGRAFT (EG, NERVE TUBE), EACH NERVE",,,747.25,15451.52,52
RC,360,NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW,,,597.58,6689.0,52
RC,360,"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG, OPEN; BRACHIAL PLEXUS",,,786.87,6689.0,52
RC,360,"NEUROPLASTY, MAJOR PERIPHERAL NERVE, ARM OR LEG, OPEN; OTHER THAN SPECIFIED",,,503.23,6689.0,52
RC,360,"NEUROPLASTY; DIGITAL, 1 OR BOTH, SAME DIGIT",,,509.19,6226.0,52
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)",,,236.4,12425.97,52
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)",,,313.99,12425.97,52
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed",,,485.15,18194.0,52
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy",,,432.91,18194.0,52
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus",,,457.45,18194.0,52
RC,360,"Nasal/sinus endoscopy, surgical, with frontal sinus exploration, including removal of tissue from frontal sinus, when performed",,,367.4,12425.97,52
RC,360,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;",,,175.1,7704.0,52
RC,360,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus",,,258.16,12425.97,52
RC,360,"Nasal/sinus endoscopy, surgical, with sphenoidotomy;",,,195.63,12425.97,52
RC,360,"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus",,,227.53,12425.97,52
RC,360,"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)",,,156.09,6689.0,52
RC,360,Neuroplasty and/or transposition; median nerve at carpal tunnel,,,434.0,6689.0,52
RC,360,Neuroplasty and/or transposition; ulnar nerve at wrist,,,404.62,6689.0,52
RC,360,Nipple/areola reconstruction,,,659.25,8715.0,52
RC,360,"OPEN IMPLANTATION OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR",,,591.42,77552.01,50
RC,360,"OPEN IMPLANTATION OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY",,,819.04,54330.72,50
RC,360,"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;",,,567.23,12775.92,52
RC,360,"OPEN TREATMENT OF ACROMIOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)",,,642.74,12775.92,52
RC,360,OPEN TREATMENT OF ACUTE SHOULDER DISLOCATION,,,580.47,12775.92,52
RC,360,"OPEN TREATMENT OF ANTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES PUBIC SYMPHYSIS ",,,825.28,13802.9,14
RC,360,"OPEN TREATMENT OF ARTICULAR FRACTURE, INVOLVING METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,733.91,10059.0,52
RC,360,"OPEN TREATMENT OF BIMALLEOLAR ANKLE FRACTURE (EG, LATERAL AND MEDIAL MALLEOLI, OR LATERAL AND POSTERIOR MALLEOLI, OR MEDIAL AND POSTERIOR MALLEOLI), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,753.26,12775.92,52
RC,360,"OPEN TREATMENT OF CALCANEAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED;",,,1101.94,12775.92,52
RC,360,"OPEN TREATMENT OF CARPOMETACARPAL DISLOCATION, OTHER THAN THUMB; INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH JOINT",,,573.81,7704.0,52
RC,360,"OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,712.04,12775.92,52
RC,360,"OPEN TREATMENT OF COMPLICATED (EG, COMMINUTED OR INVOLVING CRANIAL NERVE FORAMINA) FRACTURE(S) OF MALAR AREA, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD; WITH INTERNAL FIXATION AND MULTIPLE SURGICAL AP",,,1055.52,14124.0,52
RC,360,"OPEN TREATMENT OF COMPLICATED MANDIBULAR FRACTURE BY MULTIPLE SURGICAL APPROACHES INCLUDING INTERNAL FIXATION, INTERDENTAL FIXATION, AND/OR WIRING OF DENTURES OR SPLINTS",,,1140.3,10422.97,52
RC,360,"OPEN TREATMENT OF DEPRESSED MALAR FRACTURE, INCLUDING ZYGOMATIC ARCH AND MALAR TRIPOD",,,518.73,14124.0,52
RC,360,"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,637.53,12775.92,52
RC,360,"OPEN TREATMENT OF DISTAL PHALANGEAL FRACTURE, FINGER OR THUMB, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,502.73,8715.0,52
RC,360,"OPEN TREATMENT OF DISTAL RADIAL EXTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION, WITH INTERNAL FIXATION",,,733.91,12775.92,52
RC,360,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 2 FRAGMENTS,,,819.28,12775.92,52
RC,360,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 3 OR MORE FRAGMENTS,,,1037.39,12775.92,52
RC,360,"OPEN TREATMENT OF DISTAL RADIOULNAR DISLOCATION, ACUTE OR CHRONIC",,,626.27,12775.92,52
RC,360,"OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,697.86,12775.92,52
RC,360,"OPEN TREATMENT OF FEMORAL SHAFT FRACTURE, WITH OR WITHOUT EXTERNAL FIXATION, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS",,,1309.41,13802.9,50
RC,360,"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILON OR TIBIAL PLAFOND), WITH INTERNAL FIXATION, WHEN PERFORMED; OF BOTH TIBIA AND FIBULA",,,1300.59,22604.88,52
RC,360,"OPEN TREATMENT OF FRACTURE OF WEIGHT BEARING ARTICULAR SURFACE/PORTION OF DISTAL TIBIA (EG, PILON OR TIBIAL PLAFOND), WITH INTERNAL FIXATION, WHEN PERFORMED; OF TIBIA ONLY",,,1100.54,22604.88,52
RC,360,"OPEN TREATMENT OF HUMERAL CONDYLAR FRACTURE, MEDIAL OR LATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,823.77,22604.88,52
RC,360,"OPEN TREATMENT OF HUMERAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,867.46,22604.88,52
RC,360,"OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED; WITH INTERCONDYLAR EXTENSION",,,1018.53,22604.88,52
RC,360,"OPEN TREATMENT OF HUMERAL SUPRACONDYLAR OR TRANSCONDYLAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED; WITHOUT INTERCONDYLAR EXTENSION",,,913.56,22604.88,52
RC,360,"OPEN TREATMENT OF INTERPHALANGEAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, SINGLE",,,545.34,6689.0,52
RC,360,OPEN TREATMENT OF MANDIBULAR CONDYLAR FRACTURE,,,782.5,10422.97,52
RC,360,OPEN TREATMENT OF MANDIBULAR FRACTURE; WITH INTERDENTAL FIXATION,,,1132.81,10422.97,52
RC,360,"OPEN TREATMENT OF MEDIAL MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,598.39,12775.92,52
RC,360,"OPEN TREATMENT OF METATARSAL FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,558.53,12775.92,52
RC,360,"OPEN TREATMENT OF MONTEGGIA TYPE OF FRACTURE DISLOCATION AT ELBOW (FRACTURE PROXIMAL END OF ULNA WITH DISLOCATION OF RADIAL HEAD), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,669.22,12775.92,52
RC,360,OPEN TREATMENT OF NASAL FRACTURE; UNCOMPLICATED,,,437.59,8715.0,52
RC,360,"OPEN TREATMENT OF NASAL SEPTAL FRACTURE, WITH OR WITHOUT STABILIZATION",,,625.76,8715.0,52
RC,360,OPEN TREATMENT OF NASOMAXILLARY COMPLEX FRACTURE (LEFORT II TYPE); WITH WIRING AND/OR LOCAL FIXATION,,,1000.15,13802.9,50
RC,360,OPEN TREATMENT OF ORBITAL FLOOR BLOWOUT FRACTURE; PERIORBITAL APPROACH,,,677.57,13802.9,50
RC,360,"OPEN TREATMENT OF ORBITAL FLOOR BLOWOUT FRACTURE; PERIORBITAL APPROACH, WITH ALLOPLASTIC OR OTHER IMPLANT",,,786.69,14124.0,52
RC,360,OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE);,,,610.93,13802.9,50
RC,360,"OPEN TREATMENT OF PATELLAR DISLOCATION, WITH OR WITHOUT PARTIAL OR TOTAL PATELLECTOMY",,,878.22,12775.92,52
RC,360,"OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR",,,743.03,12775.92,52
RC,360,OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS);,,,1065.91,22604.88,52
RC,360,OPEN TREATMENT OF PERIARTICULAR FRACTURE AND/OR DISLOCATION OF THE ELBOW (FRACTURE DISTAL HUMERUS AND PROXIMAL ULNA AND/OR PROXIMAL RADIUS); WITH IMPLANT ARTHROPLASTY,,,1067.75,22604.88,52
RC,360,"OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,716.1,18194.0,52
RC,360,"OPEN TREATMENT OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL, INCLUDES INTERNAL FIXATION, WHEN PERFORMED (INCLUDES IPSILATERAL IL",,,982.0,13802.9,14
RC,360,"OPEN TREATMENT OF PROXIMAL HUMERAL (SURGICAL OR ANATOMICAL NECK) FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, INCLUDES REPAIR OF TUBEROSITY(S), WHEN PERFORMED;",,,869.77,22604.88,52
RC,360,"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL HEAD EXCISION, WHEN PERFORMED;",,,652.05,12775.92,52
RC,360,"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL HEAD EXCISION, WHEN PERFORMED; WITH RADIAL HEAD PROSTHETIC REPLACEMENT",,,723.74,22604.88,52
RC,360,"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,665.32,12775.92,52
RC,360,"OPEN TREATMENT OF RADIAL SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, AND CLOSED TREATMENT OF DISTAL RADIOULNAR JOINT DISLOCATION (GALEAZZI FRACTURE/ DISLOCATION), INCLUDES PERCUTANEOUS",,,781.85,12775.92,52
RC,360,"OPEN TREATMENT OF SCAPULAR FRACTURE (BODY, GLENOID OR ACROMION) INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,958.0,12775.92,52
RC,360,"OPEN TREATMENT OF SHOULDER DISLOCATION, WITH FRACTURE OF GREATER HUMERAL TUBEROSITY, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,859.28,12775.92,52
RC,360,"OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC;",,,571.24,12775.92,52
RC,360,"OPEN TREATMENT OF STERNOCLAVICULAR DISLOCATION, ACUTE OR CHRONIC; WITH FASCIAL GRAFT (INCLUDES OBTAINING GRAFT)",,,621.21,12775.92,52
RC,360,"OPEN TREATMENT OF TARSAL BONE FRACTURE (EXCEPT TALUS AND CALCANEUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED, EACH",,,634.32,12775.92,52
RC,360,"OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,817.7,12775.92,52
RC,360,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); BICONDYLAR, WITH OR WITHOUT INTERNAL FIXATION",,,1163.29,13802.9,50
RC,360,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,877.72,13802.9,50
RC,360,"OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,881.94,22604.88,52
RC,360,"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITH FIXATION OF POSTERIOR LIP",,,968.21,12775.92,52
RC,360,"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITHOUT FIXATION OF POSTERIOR LIP",,,860.13,12775.92,52
RC,360,"OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,648.37,12775.92,52
RC,360,"OPEN TREATMENT OF ULNAR SHAFT FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,620.87,12775.92,52
RC,360,ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); INSERTION,,,1056.14,8715.0,52
RC,360,ORBITAL IMPLANT (IMPLANT OUTSIDE MUSCLE CONE); REMOVAL OR REVISION,,,1079.89,7697.0,52
RC,360,"ORBITOTOMY WITH BONE FLAP OR WINDOW, LATERAL APPROACH (EG, KROENLEIN); FOR EXPLORATION, WITH OR WITHOUT BIOPSY",,,1356.1,10059.0,52
RC,360,"ORBITOTOMY WITHOUT BONE FLAP (FRONTAL OR TRANSCONJUNCTIVAL APPROACH); FOR EXPLORATION, WITH OR WITHOUT BIOPSY",,,1009.82,7704.0,52
RC,360,"ORCHIECTOMY, RADICAL, FOR TUMOR; INGUINAL APPROACH",,,499.26,8715.0,52
RC,360,"OSTECTOMY OF SCAPULA, PARTIAL (EG, SUPERIOR MEDIAL ANGLE)",,,570.9,8715.0,52
RC,360,"OSTECTOMY, CALCANEUS;",,,417.88,8715.0,52
RC,360,"OSTEOCHONDRAL ALLOGRAFT, KNEE, OPEN",,,1343.66,22604.88,50
RC,360,"OSTEOPLASTY, FEMUR; LENGTHENING",,,1160.6,13802.9,50
RC,360,"OSTEOPLASTY, RADIUS AND ULNA; SHORTENING (EXCLUDING 64876)",,,995.17,12775.92,52
RC,360,"OSTEOPLASTY, TIBIA AND FIBULA, LENGTHENING OR SHORTENING",,,1051.52,22604.88,50
RC,360,"OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, 1 VERTEBRAL SEGMENT; LUMBAR",,,1482.67,13802.9,50
RC,360,"OSTEOTOMY, CLAVICLE, WITH OR WITHOUT INTERNAL FIXATION; WITH BONE GRAFT FOR NONUNION OR MALUNION (INCLUDES OBTAINING GRAFT AND/OR NECESSARY FIXATION)",,,936.59,22604.88,52
RC,360,"OSTEOTOMY, FEMUR, SHAFT OR SUPRACONDYLAR; WITH FIXATION",,,990.65,13802.9,50
RC,360,"OSTEOTOMY, MANDIBLE, SEGMENTAL;",,,985.61,10422.97,50
RC,360,"OSTEOTOMY, TARSAL BONES, OTHER THAN CALCANEUS OR TALUS;",,,605.29,12775.92,52
RC,360,"OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATION",,,641.18,12775.92,52
RC,360,OSTEOTOMY; FIBULA,,,402.88,7697.0,52
RC,360,OSTEOTOMY; TIBIA,,,737.8,12775.92,52
RC,360,OSTEOTOMY; TIBIA AND FIBULA,,,1121.78,22604.88,52
RC,360,"OVARIAN CYSTECTOMY, UNILATERAL OR BILATERAL",,,752.62,9728.0,50
RC,360,"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement",,,1168.22,13802.9,50
RC,360,"Open treatment of fracture of orbit, except blowout; with implant",,,629.87,10422.97,52
RC,360,"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone",,,572.63,10065.0,52
RC,360,"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each",,,591.75,8715.0,52
RC,360,"Open treatment of radial and ulnar shaft fractures, with internal fixation, when performed; of radius and ulna",,,892.19,12775.92,52
RC,360,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach",,,322.49,7704.0,52
RC,360,"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic",,,1482.52,13802.9,50
RC,360,PARATHYROID AUTOTRANSPLANTATION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,233.3,7704.0,19
RC,360,PARATHYROIDECTOMY OR EXPLORATION OF PARATHYROID(S); RE-EXPLORATION,,,1270.35,18194.0,52
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); DISTAL PHALANX OF FINGER",,,440.69,7704.0,52
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS); PROXIMAL OR MIDDLE PHALANX OF FINGER",,,490.83,7704.0,52
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, OR DIAPHYSECTOMY), BONE (EG, OSTEOMYELITIS); TIBIA",,,817.82,7697.0,52
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TARSAL OR METATARSAL BONE, EXCEPT TALUS OR CALCANEUS",,,434.34,7704.0,52
RC,360,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; CERVICAL",,,931.02,18194.0,52
RC,360,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN ADDITION TO CO",,,129.76,18194.0,21
RC,360,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; LUMBAR",,,758.44,18194.0,52
RC,360,PARTIAL HYMENECTOMY OR REVISION OF HYMENAL RING,,,200.07,6226.0,52
RC,360,"PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHMUSECTOMY",,,998.53,10644.28,50
RC,360,"PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY",,,692.43,10644.28,50
RC,360,PELVIC EXAMINATION UNDER ANESTHESIA (OTHER THAN LOCAL),,,103.82,6689.0,52
RC,360,PELVIC FIXATION (ATTACHMENT OF CAUDAL END OF INSTRUMENTATION TO PELVIC BONY STRUCTURES) OTHER THAN SACRUM (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,346.55,6904.78,14
RC,360,"PERCUTANEOUS LAMINOTOMY/LAMINECTOMY (INTERLAMINAR APPROACH) FOR DECOMPRESSION OF NEURAL ELEMENTS, (WITH OR WITHOUT LIGAMENTOUS RESECTION, DISCECTOMY, FACETECTOMY AND/OR FORAMINOTOMY), ANY METHOD, UNDE",,,982.0,18194.0,6
RC,360,PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION,,,664.83,7704.0,52
RC,360,PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIOULNAR DISLOCATION,,,534.23,6226.0,52
RC,360,"PERCUTANEOUS SKELETAL FIXATION OF FEMORAL FRACTURE, PROXIMAL END, NECK",,,890.43,12775.92,50
RC,360,"PERCUTANEOUS SKELETAL FIXATION OF METATARSAL FRACTURE, WITH MANIPULATION, EACH",,,385.38,6689.0,52
RC,360,"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS THAT DISRUPT THE PELVIC RING, UNILATERAL (INCLUDES IPSILATERAL ILIUM, SACROILIAC JOINT AND/OR",,,877.71,7697.0,14
RC,360,"PERCUTANEOUS SKELETAL FIXATION OF POSTERIOR PELVIC BONE FRACTURE AND/OR DISLOCATION, FOR FRACTURE PATTERNS WHICH DISRUPT THE PELVIC RING, UNILATERAL OR BILATERAL, (INCLUDES ILIUM, SACROILIAC JOINT AND",,,1042.59,18194.0,47
RC,360,"PERCUTANEOUS SKELETAL FIXATION OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) (EG, PINS OR SCREWS)",,,573.24,12775.92,52
RC,360,"PEREYRA PROCEDURE, INCLUDING ANTERIOR COLPORRHAPHY",,,779.87,13056.25,52
RC,360,"PERINEOPLASTY, REPAIR OF PERINEUM, NONOBSTETRICAL (SEPARATE PROCEDURE)",,,268.79,10059.0,52
RC,360,"PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PROSTATE (VIA NEEDLE, ANY APPROACH), SINGLE OR MULTIPLE",,,99.66,5681.0,52
RC,360,"PLACEMENT OF NEPHROSTOMY CATHETER, PERCUTANEOUS, INCLUDING DIAGNOSTIC NEPHROSTOGRAM AND/OR URETEROGRAM WHEN PERFORMED, IMAGING GUIDANCE (EG, ULTRASOUND AND/OR FLUOROSCOPY) AND ALL ASSOCIATED RADIOLOGI",,,195.15,14124.0,52
RC,360,PLACEMENT OF SETON,,,113.73,7704.0,52
RC,360,"PLACEMENT OF URETERAL STENT, PERCUTANEOUS, INCLUDING DIAGNOSTIC NEPHROSTOGRAM AND/OR URETEROGRAM WHEN PERFORMED, IMAGING GUIDANCE (EG, ULTRASOUND AND/OR FLUOROSCOPY), AND ALL ASSOCIATED RADIOLOGICAL S",,,194.14,18194.0,52
RC,360,"PLASTIC OPERATION ON URETHRAL SPHINCTER, VAGINAL APPROACH (EG, KELLY URETHRAL PLICATION)",,,341.35,8807.75,52
RC,360,PLASTIC REPAIR OF CANALICULI,,,585.0,6689.0,52
RC,360,PLASTIC REPAIR OF INTROITUS,,,249.3,7704.0,52
RC,360,"PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; PRIMARY OR SIMPLE",,,341.03,10422.97,52
RC,360,"PROCTECTOMY, COMBINED ABDOMINOPERINEAL, PULL-THROUGH PROCEDURE (EG, COLO-ANAL ANASTOMOSIS)",,,982.0,13802.9,14
RC,360,"PROCTOSIGMOIDOSCOPY, RIGID; WITH BIOPSY, SINGLE OR MULTIPLE",,,70.9,5681.0,52
RC,360,"PROPHYLACTIC TREATMENT (NAILING, PINNING, PLATING, OR WIRING) WITH OR WITHOUT METHYLMETHACRYLATE, FEMUR",,,1106.8,13802.9,50
RC,360,"Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty)",,,677.08,10422.97,52
RC,360,"Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)",,,1049.98,10422.97,52
RC,360,Parathyroidectomy or exploration of parathyroid(s);,,,946.94,11751.0,50
RC,360,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed",,,295.59,11220.84,52
RC,360,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,678.95,16667.46,100
RC,360,"Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or",,,460.82,13802.9,50
RC,360,"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents",,,696.33,8715.0,52
RC,360,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy",,,605.17,10059.0,52
RC,360,"Posterior non-segmental instrumentation (e.g., Harrington rod technique, pedicle fixation across 1 interspace, atlantoaxial transarticular screw fixation, sublaminar wiring at C1, facet screw fixation",,,728.4,6904.78,14
RC,360,"Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (list separately in addition to code for primary procedure)",,,734.61,6904.78,14
RC,360,"Posterior segmental instrumentation (e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure)",,,786.71,6904.78,14
RC,360,"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent",,,216.21,6689.0,52
RC,360,Puncture of shunt tubing or reservoir for aspiration or injection procedure,,,54.62,5681.0,52
RC,360,"QUADRICEPSPLASTY (EG, BENNETT OR THOMPSON TYPE)",,,733.24,12775.92,52
RC,360,"RADICAL RESECTION OF CAPSULE, SOFT TISSUE, AND HETEROTOPIC BONE, ELBOW, WITH CONTRACTURE RELEASE (SEPARATE PROCEDURE)",,,1161.9,13802.9,50
RC,360,"RADICAL RESECTION OF TUMOR; ILIUM, INCLUDING ACETABULUM, BOTH PUBIC RAMI, OR ISCHIUM AND ACETABULUM",,,2443.88,13802.9,50
RC,360,"REALIGNMENT OF EXTENSOR TENDON, HAND, EACH TENDON",,,659.24,7704.0,52
RC,360,"RECONSTRUCTION FOR STABILIZATION OF UNSTABLE DISTAL ULNA OR DISTAL RADIOULNAR JOINT, SECONDARY BY SOFT TISSUE STABILIZATION (EG, TENDON TRANSFER, TENDON GRAFT OR WEAVE, OR TENODESIS) WITH OR WITHOUT O",,,877.84,12775.92,52
RC,360,"RECONSTRUCTION LATERAL COLLATERAL LIGAMENT, ELBOW, WITH TENDON GRAFT (INCLUDES HARVESTING OF GRAFT)",,,1086.9,12775.92,52
RC,360,"RECONSTRUCTION MIDFACE, LEFORT I; 2 PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (EG, UNGRAFTED UNILATERAL ALVEOLAR CLEFT)",,,1575.38,13802.9,50
RC,360,"RECONSTRUCTION MIDFACE, LEFORT I; 3 OR MORE PIECES, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS) (EG, UNGRAFTED BILATERAL ALVEOLAR CLEFT OR MULTIPLE OSTEOTO",,,1657.21,13802.9,50
RC,360,"RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION (EG, FOR LONG FACE SYNDROME), WITHOUT BONE GRAFT",,,1298.29,13802.9,50
RC,360,"RECONSTRUCTION MIDFACE, LEFORT I; SINGLE PIECE, SEGMENT MOVEMENT IN ANY DIRECTION, REQUIRING BONE GRAFTS (INCLUDES OBTAINING AUTOGRAFTS)",,,1508.52,13802.9,50
RC,360,"RECONSTRUCTION OF DISLOCATING PATELLA; WITH EXTENSOR REALIGNMENT AND/OR MUSCLE ADVANCEMENT OR RELEASE (EG, CAMPBELL, GOLDWAITE TYPE PROCEDURE)",,,732.39,14124.0,52
RC,360,"RECONSTRUCTION OF EYELID, FULL THICKNESS BY TRANSFER OF TARSOCONJUNCTIVAL FLAP FROM OPPOSING EYELID; TOTAL EYELID, LOWER, 1 STAGE OR FIRST STAGE",,,896.06,7704.0,52
RC,360,"RECONSTRUCTION OF MANDIBLE OR MAXILLA, ENDOSTEAL IMPLANT (EG, BLADE, CYLINDER); PARTIAL",,,776.06,14124.0,52
RC,360,"RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; COMPLETE",,,828.46,14124.0,52
RC,360,"RECONSTRUCTION OF MANDIBLE OR MAXILLA, SUBPERIOSTEAL IMPLANT; PARTIAL",,,923.32,14124.0,52
RC,360,"RECONSTRUCTION OF MANDIBLE, EXTRAORAL, WITH TRANSOSTEAL BONE PLATE (EG, MANDIBULAR STAPLE BONE PLATE)",,,984.84,14124.0,52
RC,360,"RECONSTRUCTION OF MANDIBULAR RAMI, HORIZONTAL, VERTICAL, C, OR L OSTEOTOMY; WITHOUT BONE GRAFT",,,1199.06,13802.9,50
RC,360,"REINSERTION OF RUPTURED BICEPS OR TRICEPS TENDON, DISTAL, WITH OR WITHOUT TENDON GRAFT",,,763.52,12775.92,52
RC,360,"RELEASE, TARSAL TUNNEL (POSTERIOR TIBIAL NERVE DECOMPRESSION)",,,354.56,8715.0,52
RC,360,"REMOVAL (VIA SNARE/CAPTURE) AND REPLACEMENT OF INTERNALLY DWELLING URETERAL STENT VIA TRANSURETHRAL APPROACH, WITHOUT USE OF CYSTOSCOPY, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,206.35,10059.0,52
RC,360,"REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLING URETERAL STENT VIA PERCUTANEOUS APPROACH, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,216.43,6226.0,52
RC,360,"REMOVAL AND REPLACEMENT OF ALL COMPONENT(S) OF A MULTI-COMPONENT, INFLATABLE PENILE PROSTHESIS AT THE SAME OPERATIVE SESSION",,,842.85,36492.19,52
RC,360,"REMOVAL AND REPLACEMENT OF ALL COMPONENTS OF A MULTI-COMPONENT INFLATABLE PENILE PROSTHESIS THROUGH AN INFECTED FIELD AT THE SAME OPERATIVE SESSION, INCLUDING IRRIGATION AND DEBRIDEMENT OF INFECTED TI",,,1002.67,36492.19,50
RC,360,REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA,,,93.79,5681.0,52
RC,360,REMOVAL OF ANTERIOR INSTRUMENTATION,,,1084.37,13802.9,50
RC,360,REMOVAL OF CERCLAGE SUTURE UNDER ANESTHESIA (OTHER THAN LOCAL),,,129.58,10059.0,52
RC,360,"REMOVAL OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR",,,725.84,18194.0,52
RC,360,REMOVAL OF ESOPHAGEAL SPHINCTER AUGMENTATION DEVICE,,,654.41,10644.28,50
RC,360,REMOVAL OF FECAL IMPACTION OR FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA,,,223.86,5681.0,52
RC,360,REMOVAL OF FOREIGN BODY IN MUSCLE OR TENDON SHEATH; SIMPLE,,,145.49,6689.0,52
RC,360,"REMOVAL OF FOREIGN BODY, DEEP, THIGH REGION OR KNEE AREA",,,395.5,14124.0,52
RC,360,"REMOVAL OF FOREIGN BODY, PELVIS OR HIP; DEEP (SUBFASCIAL OR INTRAMUSCULAR)",,,605.4,7704.0,52
RC,360,"REMOVAL OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY",,,713.42,10257.38,50
RC,360,REMOVAL OF IMPACTED VAGINAL FOREIGN BODY (SEPARATE PROCEDURE) UNDER ANESTHESIA (OTHER THAN LOCAL),,,173.12,6689.0,52
RC,360,"REMOVAL OF IMPLANT; SUPERFICIAL (EG, BURIED WIRE, PIN OR ROD) (SEPARATE PROCEDURE)",,,142.56,5681.0,52
RC,360,REMOVAL OF INTRAUTERINE DEVICE (IUD),,,64.47,5681.0,52
RC,360,"REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING URETERAL STENT)",,,51.06,5681.0,52
RC,360,REMOVAL OF PERITONEAL FOREIGN BODY FROM PERITONEAL CAVITY,,,831.36,7697.0,52
RC,360,REMOVAL OF PERITONEAL-VENOUS SHUNT,,,444.8,7697.0,50
RC,360,"REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD)",,,722.56,13802.9,50
RC,360,"REMOVAL OF PROSTHESIS, INCLUDES DEBRIDEMENT AND SYNOVECTOMY WHEN PERFORMED; HUMERAL AND GLENOID COMPONENTS (EG, TOTAL SHOULDER)",,,1239.49,13802.9,50
RC,360,"REMOVAL OF SUTURES OR STAPLES REQUIRING ANESTHESIA (IE, GENERAL ANESTHESIA, MODERATE SEDATION)",,,63.72,5681.0,52
RC,360,REMOVAL OF TISSUE EXPANDER WITHOUT INSERTION OF IMPLANT,,,542.28,6226.0,52
RC,360,"REMOVAL OF TOTAL OR NEAR TOTAL NON-INFECTED MESH OR OTHER PROSTHESIS AT THE TIME OF INITIAL OR RECURRENT ANTERIOR ABDOMINAL HERNIA REPAIR OR PARASTOMAL HERNIA REPAIR, ANY APPROACH (IE, OPEN, LAPAROSCO",,,190.78,5681.0,14
RC,360,"REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION",,,182.8,5681.0,52
RC,360,REMOVAL OF TUNNELED INTRAPERITONEAL CATHETER,,,213.06,7697.0,52
RC,360,"REMOVAL WITH REINSERTION, NON-BIODEGRADABLE DRUG DELIVERY IMPLANT",,,100.18,5681.0,52
RC,360,"REMOVAL, IMPLANTABLE CONTRACEPTIVE CAPSULES",,,90.17,5681.0,52
RC,360,"REMOVAL, UNDER ANESTHESIA, OF EXTERNAL FIXATION SYSTEM",,,338.6,5681.0,52
RC,360,"RENAL ENDOSCOPY THROUGH ESTABLISHED NEPHROSTOMY OR PYELOSTOMY, WITH OR WITHOUT IRRIGATION, INSTILLATION, OR URETEROPYELOGRAPHY, EXCLUSIVE OF RADIOLOGIC SERVICE; WITH FULGURATION AND/OR INCISION, WITH ",,,332.67,16667.46,52
RC,360,"REPAIR BLOOD VESSEL, DIRECT; HAND, FINGER",,,739.08,8715.0,52
RC,360,"REPAIR BLOOD VESSEL, DIRECT; UPPER EXTREMITY",,,757.35,10257.38,50
RC,360,REPAIR FISTULA; OROMAXILLARY (COMBINE WITH 31030 IF ANTROTOMY IS INCLUDED),,,451.97,10422.97,52
RC,360,"REPAIR LATERAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE",,,708.26,8715.0,52
RC,360,"REPAIR LIP, FULL THICKNESS; VERMILION ONLY",,,312.39,7704.0,52
RC,360,"REPAIR MEDIAL COLLATERAL LIGAMENT, ELBOW, WITH LOCAL TISSUE",,,704.98,12775.92,52
RC,360,REPAIR NASAL SEPTAL PERFORATIONS,,,658.57,14124.0,52
RC,360,REPAIR OF ANAL FISTULA WITH FIBRIN GLUE,,,176.41,6226.0,52
RC,360,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL, INCLUDING IMPLANTATION OF MESH OR OTHER PRO",,,460.62,13802.9,150
RC,360,"REPAIR OF ANTERIOR ABDOMINAL HERNIA(S) (IE, EPIGASTRIC, INCISIONAL, VENTRAL, UMBILICAL, SPIGELIAN), ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER P",,,408.75,13802.9,192
RC,360,"REPAIR OF ANTERIOR PALATE, INCLUDING VOMER FLAP",,,727.94,10422.97,52
RC,360,"REPAIR OF BLEPHAROPTOSIS; (TARSO) LEVATOR RESECTION OR ADVANCEMENT, EXTERNAL APPROACH",,,578.03,8715.0,52
RC,360,REPAIR OF BLEPHAROPTOSIS; SUPERIOR RECTUS TECHNIQUE WITH FASCIAL SLING (INCLUDES OBTAINING FASCIA),,,489.77,10059.0,52
RC,360,"REPAIR OF BROW PTOSIS (SUPRACILIARY, MID-FOREHEAD OR CORONAL APPROACH)",,,490.66,8715.0,52
RC,360,"REPAIR OF COLLATERAL LIGAMENT, METACARPOPHALANGEAL OR INTERPHALANGEAL JOINT",,,691.11,8715.0,52
RC,360,"REPAIR OF ENTEROCELE, VAGINAL APPROACH (SEPARATE PROCEDURE)",,,498.97,8807.75,52
RC,360,"REPAIR OF IRIS, CILIARY BODY (AS FOR IRIDODIALYSIS)",,,507.05,7704.0,52
RC,360,REPAIR OF LACERATION 2.5 CM OR LESS; FLOOR OF MOUTH AND/OR ANTERIOR TWO-THIRDS OF TONGUE,,,150.69,6689.0,52
RC,360,"REPAIR OF LACERATION; CONJUNCTIVA, WITH OR WITHOUT NONPERFORATING LACERATION SCLERA, DIRECT CLOSURE",,,136.36,6689.0,52
RC,360,"REPAIR OF LACERATION; CORNEA AND/OR SCLERA, PERFORATING, NOT INVOLVING UVEAL TISSUE",,,650.53,9369.15,52
RC,360,REPAIR OF NAIL BED,,,107.37,5681.0,52
RC,360,"REPAIR OF NONUNION OR MALUNION, HUMERUS; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1062.82,22604.88,52
RC,360,"REPAIR OF NONUNION OR MALUNION, HUMERUS; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)",,,1036.01,22604.88,52
RC,360,"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1018.0,12775.92,52
RC,360,"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITHOUT GRAFT (EG, COMPRESSION TECHNIQUE)",,,790.89,12775.92,52
RC,360,"REPAIR OF NONUNION OR MALUNION, TIBIA; WITH ILIAC OR OTHER AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,1225.06,13802.9,50
RC,360,"REPAIR OF NONUNION OR MALUNION, TIBIA; WITHOUT GRAFT, (EG, COMPRESSION TECHNIQUE)",,,858.09,18194.0,52
RC,360,"REPAIR OF PARASTOMAL HERNIA, ANY APPROACH (IE, OPEN, LAPAROSCOPIC, ROBOTIC), INITIAL OR RECURRENT, INCLUDING IMPLANTATION OF MESH OR OTHER PROSTHESIS, WHEN PERFORMED; REDUCIBLE",,,719.34,10065.0,14
RC,360,REPAIR OF RECTOCELE (SEPARATE PROCEDURE),,,676.22,7697.0,52
RC,360,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE",,,807.13,12775.92,52
RC,360,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; CHRONIC",,,838.91,14124.0,52
RC,360,"REPAIR OR ADVANCEMENT OF PROFUNDUS TENDON, WITH INTACT SUPERFICIALIS TENDON; PRIMARY, EACH TENDON",,,772.65,8715.0,52
RC,360,"REPAIR OR ADVANCEMENT, FLEXOR TENDON, IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); PRIMARY, WITHOUT FREE GRAFT, EACH TENDON",,,787.79,8715.0,52
RC,360,"REPAIR OR ADVANCEMENT, FLEXOR TENDON, NOT IN ZONE 2 DIGITAL FLEXOR TENDON SHEATH (EG, NO MAN'S LAND); PRIMARY OR SECONDARY WITHOUT FREE GRAFT, EACH TENDON",,,737.72,7697.0,52
RC,360,"REPAIR, COMPLEX, EYELIDS, NOSE, EARS AND/OR LIPS; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,131.93,7704.0,19
RC,360,"REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,121.39,5681.0,19
RC,360,"REPAIR, COMPLEX, TRUNK; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,69.36,5681.0,19
RC,360,"REPAIR, EXTENSOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON",,,359.26,12775.92,52
RC,360,"REPAIR, FASCIAL DEFECT OF LEG",,,338.27,6689.0,52
RC,360,"REPAIR, INTRINSIC MUSCLES OF HAND, EACH MUSCLE",,,484.22,7704.0,52
RC,360,"REPAIR, NONUNION OR MALUNION, FEMUR, DISTAL TO HEAD AND NECK; WITH ILIAC OR OTHER AUTOGENOUS BONE GRAFT (INCLUDES OBTAINING GRAFT)",,,1237.59,13802.9,50
RC,360,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",,,481.32,12775.92,52
RC,360,"REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;",,,649.06,12775.92,52
RC,360,"REPAIR, PRIMARY, TORN LIGAMENT AND/OR CAPSULE, KNEE; COLLATERAL",,,669.13,12775.92,52
RC,360,"REPAIR, TENDON OR MUSCLE, EXTENSOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE",,,492.32,8715.0,52
RC,360,"REPAIR, TENDON OR MUSCLE, FLEXOR, FOREARM AND/OR WRIST; PRIMARY, SINGLE, EACH TENDON OR MUSCLE",,,630.12,8715.0,52
RC,360,"REPAIR, TENDON OR MUSCLE, UPPER ARM OR ELBOW, EACH TENDON OR MUSCLE, PRIMARY OR SECONDARY (EXCLUDES ROTATOR CUFF)",,,743.02,12775.92,52
RC,360,"REPAIR, TENDON, EXTENSOR, FOOT; PRIMARY OR SECONDARY, EACH TENDON",,,318.02,7704.0,52
RC,360,REPLACEMENT OF BONE FLAP OR PROSTHETIC PLATE OF SKULL,,,982.0,13802.9,14
RC,360,"RESECTION OR EXCISION OF NEOPLASTIC, VASCULAR OR INFECTIOUS LESION OF BASE OF ANTERIOR CRANIAL FOSSA; EXTRADURAL",,,982.0,13802.9,14
RC,360,RESECTION OR TRANSPLANTATION OF LONG TENDON OF BICEPS,,,746.87,12775.92,52
RC,360,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ANGIOPLASTY, INCLUDING ALL MANEUVERS NECESSARY FOR ACCESSING AND SELECTIVELY CATHETER",,,4215.76,13802.9,45
RC,360,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, FEMORAL AND POPLITEAL VASCULAR TERRITORY, WITH TRANSLUMINAL ATHERECTOMY, INCLUDING TRANSLUMINAL ANGIOPLASTY WHEN PERFORMED, INCLUDING ALL MANEUVE",,,7551.94,32276.26,90
RC,360,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL, WHEN PERFORMED",,,464.62,8715.0,5
RC,360,REVISION (INCLUDING REMOVAL) OF PROSTHETIC VAGINAL GRAFT; VAGINAL APPROACH,,,493.62,7704.0,52
RC,360,REVISION OF COLOSTOMY; SIMPLE (RELEASE OF SUPERFICIAL SCAR) (SEPARATE PROCEDURE),,,615.96,7704.0,52
RC,360,"REVISION OF PERI-IMPLANT CAPSULE, BREAST, INCLUDING CAPSULOTOMY, CAPSULORRHAPHY, AND/OR PARTIAL CAPSULECTOMY",,,657.96,8715.0,52
RC,360,"REVISION OF TOTAL ELBOW ARTHROPLASTY, INCLUDING ALLOGRAFT WHEN PERFORMED; HUMERAL AND ULNAR COMPONENT",,,1723.38,30871.55,50
RC,360,"REVISION OF TOTAL ELBOW ARTHROPLASTY, INCLUDING ALLOGRAFT WHEN PERFORMED; HUMERAL OR ULNAR COMPONENT",,,1500.22,22604.88,50
RC,360,REVISION OR REMOVAL OF CRANIAL NEUROSTIMULATOR PULSE GENERATOR OR RECEIVER,,,390.96,19618.78,52
RC,360,REVISION OR REMOVAL OF INTRACRANIAL NEUROSTIMULATOR ELECTRODES,,,579.76,10257.38,50
RC,360,"REVISION OR REPLACEMENT OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY, INCLUDING CONNECTION TO EXISTING PULSE GENERATOR",,,755.9,19618.78,52
RC,360,RHINECTOMY; PARTIAL,,,785.99,10422.97,52
RC,360,"Radical resection of tumor (e.g., sarcoma), soft tissue of abdominal wall; 5 cm or greater",,,1294.49,18194.0,52
RC,360,"Radical resection of tumor (e.g., sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater",,,1305.6,18194.0,52
RC,360,"Radical resection of tumor (e.g., sarcoma), soft tissue of upper arm or elbow area; less than 5 cm",,,1004.25,7704.0,52
RC,360,"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)",,,958.56,14124.0,52
RC,360,"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation",,,1393.26,13802.9,50
RC,360,"Removal of foreign body, foot; subcutaneous",,,130.69,6689.0,52
RC,360,"Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)",,,413.2,7704.0,52
RC,360,Removal of implantable defibrillator pulse generator with replacement of implantable defibrillator pulse generator; multiple lead system,,,385.95,66010.0,50
RC,360,Removal of intact breast implant,,,542.8,7697.0,52
RC,360,Removal of permanent pacemaker pulse generator only,,,224.3,15325.0,52
RC,360,Removal of posterior segmental instrumentation,,,696.74,13802.9,50
RC,360,"Removal of ruptured breast implant, including implant contents (e.g., saline, silicone gel)",,,632.18,7697.0,52
RC,360,"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions",,,75.29,5681.0,52
RC,360,"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed",,,323.05,14124.0,52
RC,360,"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed",,,836.84,14124.0,52
RC,360,"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion",,,293.25,10065.0,52
RC,360,Removal of transvenous pacemaker electrode(s); dual lead system,,,608.32,15325.0,50
RC,360,"Removal or revision of sling for male urinary incontinence (e.g., fascia or synthetic)",,,768.29,9440.44,52
RC,360,"Removal, non-biodegradable drug delivery implant",,,70.9,5681.0,52
RC,360,Repair fistula; oronasal,,,377.93,10422.97,52
RC,360,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated",,,575.11,18194.0,52
RC,360,"Repair initial inguinal hernia, age 5 years or older; reducible",,,511.97,8715.0,52
RC,360,"Repair of anterior abdominal hernia(s) (i.e., epigastric, incisional, ventral, umbilical, Spigelian), any approach (i.e., open, laparoscopic, robotic), initial, including implantation of mesh or other",,,331.63,13802.9,114
RC,360,Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s),,,164.94,18194.0,52
RC,360,"Repair of nasal vestibular stenosis (e.g., spreader grafting, lateral nasal wall reconstruction)",,,1009.07,18194.0,52
RC,360,"Repair recurrent inguinal hernia, any age; reducible",,,619.32,14124.0,52
RC,360,"Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm",,,270.17,7704.0,52
RC,360,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm",,,325.69,7704.0,52
RC,360,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm",,,235.25,6689.0,52
RC,360,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",,,293.86,7704.0,52
RC,360,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",,,250.69,7704.0,52
RC,360,"Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (list separately in addition to code for primary procedure)",,,79.83,5681.0,19
RC,360,"Repair, complex, trunk; 2.6 cm to 7.5 cm",,,240.09,7704.0,52
RC,360,"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon",,,618.21,8715.0,52
RC,360,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm",,,250.73,6689.0,52
RC,360,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,165.56,5681.0,52
RC,360,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,194.74,5681.0,52
RC,360,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",,,214.7,6689.0,52
RC,360,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less",,,141.88,5681.0,52
RC,360,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",,,191.18,5681.0,52
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm",,,235.35,6689.0,52
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less",,,148.0,5681.0,52
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",,,185.92,5681.0,52
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm",,,274.87,6689.0,52
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm",,,200.46,6689.0,52
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm",,,319.25,6689.0,52
RC,360,"Repair, nonunion or malunion, femur, distal to head and neck; without graft (e.g., compression technique)",,,1157.4,13802.9,50
RC,360,"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments",,,950.38,12775.92,52
RC,360,Replacement of tissue expander with permanent implant,,,550.75,12775.92,52
RC,360,"Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal catheter in shunt system",,,826.3,15451.52,52
RC,360,"Revision including replacement, when performed, of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed",,,870.87,19618.78,52
RC,360,"Revision of reconstructed breast (e.g., significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue e",,,789.91,11691.26,52
RC,360,"Revision of total hip arthroplasty; both components, with or without autograft or allograft",,,1851.32,22604.88,50
RC,360,"Revision of total hip arthroplasty; femoral component only, with or without allograft",,,1482.67,22604.88,50
RC,360,"Revision of total knee arthroplasty, with or without allograft; 1 component",,,1371.05,22604.88,50
RC,360,"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component",,,1707.56,30871.55,50
RC,360,"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component",,,1692.55,22604.88,50
RC,360,"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component",,,1568.26,22604.88,50
RC,360,"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array",,,294.57,7697.0,52
RC,360,"Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array",,,224.52,7697.0,52
RC,360,"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)",,,767.08,10065.0,52
RC,360,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)",,,719.26,10065.0,52
RC,360,"Rhinoplasty, primary; including major septal repair",,,1425.54,10422.97,52
RC,360,"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip",,,1203.09,10422.97,52
RC,360,"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)",,,1709.54,14124.0,52
RC,360,"SALPINGO-OOPHORECTOMY, COMPLETE OR PARTIAL, UNILATERAL OR BILATERAL (SEPARATE PROCEDURE)",,,746.63,13802.9,15
RC,360,"SECONDARY CLOSURE OF SURGICAL WOUND OR DEHISCENCE, EXTENSIVE OR COMPLICATED",,,777.04,6689.0,52
RC,360,"SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL",,,163.19,5837.49,50
RC,360,"SIGMOIDOSCOPY, FLEXIBLE; WITH BAND LIGATION(S) (EG, HEMORRHOIDS)",,,97.84,8022.0,52
RC,360,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF FOREIGN BODY(S)",,,102.08,5681.0,52
RC,360,"SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATION",,,75.94,5681.0,52
RC,360,"SINUSOTOMY, SPHENOID, WITH OR WITHOUT BIOPSY; WITH MUCOSAL STRIPPING OR REMOVAL OF POLYP(S)",,,682.64,10422.97,52
RC,360,"SLITTING OF PREPUCE, DORSAL OR LATERAL (SEPARATE PROCEDURE); EXCEPT NEWBORN",,,138.06,6689.0,52
RC,360,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE OR PROLAPSE; ADULT",,,731.98,7704.0,52
RC,360,"SPHINCTEROPLASTY, ANAL, FOR INCONTINENCE, ADULT; LEVATOR MUSCLE IMBRICATION (PARK POSTERIOR ANAL REPAIR)",,,890.84,7704.0,52
RC,360,"SPLIT-THICKNESS AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND",,,127.28,7704.0,19
RC,360,"SPLIT-THICKNESS AUTOGRAFT, FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT ",,,674.52,7697.0,52
RC,360,"SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; EACH ADDITIONAL 100 SQ CM, OR EACH ADDITIONAL 1% OF BODY AREA OF INFANTS AND CHILDREN, OR PART THEREOF (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PR",,,107.0,7704.0,19
RC,360,"SPLIT-THICKNESS AUTOGRAFT, TRUNK, ARMS, LEGS; FIRST 100 SQ CM OR LESS, OR 1% OF BODY AREA OF INFANTS AND CHILDREN (EXCEPT 15050)",,,698.58,6689.0,52
RC,360,"STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; MORE THAN 20 INCISIONS",,,316.97,7704.0,52
RC,360,"SUBCUTANEOUS INJECTION OF FILLING MATERIAL (EG, COLLAGEN); 5.1 TO 10.0 CC",,,99.15,4664.0,47
RC,360,"SUBMUCOSAL ABLATION OF THE TONGUE BASE, RADIOFREQUENCY, 1 OR MORE SITES, PER SESSION",,,369.02,14124.0,52
RC,360,SUCTION ASSISTED LIPECTOMY; LOWER EXTREMITY,,,3781.45,7704.0,46
RC,360,SUCTION ASSISTED LIPECTOMY; TRUNK,,,3781.45,7704.0,46
RC,360,SUCTION ASSISTED LIPECTOMY; UPPER EXTREMITY,,,2201.69,7704.0,46
RC,360,SURGICAL CLOSURE TRACHEOSTOMY OR FISTULA; WITH PLASTIC REPAIR,,,478.71,6689.0,52
RC,360,"SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED",,,472.34,8715.0,52
RC,360,SUTURE AND/OR LIGATION OF THORACIC DUCT; CERVICAL APPROACH,,,567.5,13802.9,14
RC,360,SUTURE OF 1 NERVE; ULNAR MOTOR,,,801.38,8755.0,52
RC,360,"SUTURE OF DIGITAL NERVE, HAND OR FOOT; 1 NERVE",,,683.92,8715.0,52
RC,360,SUTURE OF INFRAPATELLAR TENDON; PRIMARY,,,616.44,12775.92,52
RC,360,"SUTURE OF MAJOR PERIPHERAL NERVE, ARM OR LEG, EXCEPT SCIATIC; WITHOUT TRANSPOSITION",,,1028.22,8755.0,52
RC,360,"SUTURE OF QUADRICEPS OR HAMSTRING MUSCLE RUPTURE; SECONDARY RECONSTRUCTION, INCLUDING FASCIAL OR TENDON GRAFT",,,844.12,12775.92,52
RC,360,"SYNOVECTOMY, METACARPOPHALANGEAL JOINT INCLUDING INTRINSIC RELEASE AND EXTENSOR HOOD RECONSTRUCTION, EACH DIGIT",,,550.33,8715.0,52
RC,360,Septal or other intranasal dermatoplasty (does not include obtaining graft),,,664.24,14124.0,52
RC,360,"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft",,,664.71,8715.0,52
RC,360,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,55.07,3698.0,52
RC,360,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,53.92,4664.0,52
RC,360,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,56.2,4664.0,52
RC,360,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm",,,72.72,5681.0,52
RC,360,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",,,91.24,5681.0,52
RC,360,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less",,,43.54,5681.0,52
RC,360,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm",,,57.18,4664.0,52
RC,360,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm",,,71.43,5681.0,52
RC,360,"Sling operation for stress incontinence (e.g., fascia or synthetic)",,,730.29,11085.56,52
RC,360,"Stereotactic computer-assisted (navigational) procedure; cranial, extradural (list separately in addition to code for primary procedure)",,,167.25,5681.0,14
RC,360,"Stereotactic computer-assisted (navigational) procedure; cranial, intradural (list separately in addition to code for primary procedure)",,,226.7,5681.0,14
RC,360,Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure),,,222.6,5681.0,14
RC,360,"Submucous resection inferior turbinate, partial or complete, any method",,,173.75,6689.0,52
RC,360,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, m",,,251.54,6689.0,52
RC,360,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each",,,43.43,5681.0,19
RC,360,"Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; firs",,,212.31,6689.0,52
RC,360,Suture of quadriceps or hamstring muscle rupture; primary,,,601.61,12775.92,52
RC,360,"Synovectomy, extensor tendon sheath, wrist, single compartment;",,,383.3,6689.0,52
RC,360,"TENDON LENGTHENING, UPPER ARM OR ELBOW, EACH TENDON",,,575.61,8715.0,52
RC,360,"TENDON TRANSPLANTATION OR TRANSFER, FLEXOR OR EXTENSOR, FOREARM AND/OR WRIST, SINGLE; WITH TENDON GRAFT(S) (INCLUDES OBTAINING GRAFT), EACH TENDON",,,709.46,8755.0,52
RC,360,"TENODESIS; OF DISTAL JOINT, EACH JOINT",,,644.82,6689.0,52
RC,360,"TENOLYSIS, EXTENSOR TENDON, HAND OR FINGER, EACH TENDON",,,596.89,7704.0,52
RC,360,"TENOLYSIS, FLEXOR OR EXTENSOR TENDON, FOREARM AND/OR WRIST, SINGLE, EACH TENDON",,,524.31,7704.0,52
RC,360,"TENOLYSIS, FLEXOR OR EXTENSOR TENDON, LEG AND/OR ANKLE; SINGLE, EACH TENDON",,,416.78,7704.0,52
RC,360,"TENOLYSIS, FLEXOR TENDON; PALM AND FINGER, EACH TENDON",,,976.67,7704.0,52
RC,360,"TENOTOMY, OPEN, HAMSTRING, KNEE TO HIP; SINGLE TENDON",,,449.11,6226.0,52
RC,360,"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS",,,276.89,7704.0,52
RC,360,"TENOTOMY, SHOULDER AREA; SINGLE TENDON",,,608.1,12775.92,52
RC,360,"THROMBOENDARTERECTOMY, INCLUDING PATCH GRAFT, IF PERFORMED; CAROTID, VERTEBRAL, SUBCLAVIAN, BY NECK INCISION",,,982.0,10257.38,14
RC,360,"THYMECTOMY, PARTIAL OR TOTAL; TRANSCERVICAL APPROACH (SEPARATE PROCEDURE)",,,1020.64,13802.9,50
RC,360,"THYROIDECTOMY, INCLUDING SUBSTERNAL THYROID; CERVICAL APPROACH",,,1029.28,13802.9,50
RC,360,"THYROIDECTOMY, TOTAL OR COMPLETE WITH PARATHYROID AUTOTRANSPLANTATION",,,4900.0,11751.0,13
RC,360,"THYROIDECTOMY, TOTAL OR SUBTOTAL FOR MALIGNANCY; WITH RADICAL NECK DISSECTION",,,1624.71,13802.9,15
RC,360,"TOTAL THYROID LOBECTOMY, UNILATERAL; WITH CONTRALATERAL SUBTOTAL LOBECTOMY, INCLUDING ISTHMUSECTOMY",,,918.06,10644.28,52
RC,360,"TRACHELORRHAPHY, PLASTIC REPAIR OF UTERINE CERVIX, VAGINAL APPROACH",,,329.83,7704.0,52
RC,360,"TRACHEOSTOMA REVISION; COMPLEX, WITH FLAP ROTATION",,,699.01,10422.97,52
RC,360,"TRACHEOSTOMA REVISION; SIMPLE, WITHOUT FLAP ROTATION",,,416.25,6689.0,52
RC,360,TRANSECTION OR AVULSION OF; INFERIOR ALVEOLAR NERVE BY OSTEOTOMY,,,440.78,6689.0,52
RC,360,TRANSECTION OR AVULSION OF; LINGUAL NERVE,,,449.87,6689.0,52
RC,360,"TRANSFER OR TRANSPLANT OF SINGLE TENDON (WITH MUSCLE REDIRECTION OR REROUTING); DEEP (EG, ANTERIOR TIBIAL OR POSTERIOR TIBIAL THROUGH INTEROSSEOUS SPACE, FLEXOR DIGITORUM LONGUS, FLEXOR HALLUCIS LONGU",,,732.57,12775.92,52
RC,360,"TRANSPERINEAL PLACEMENT OF BIODEGRADABLE MATERIAL, PERI-PROSTATIC, SINGLE OR MULTIPLE INJECTION(S), INCLUDING IMAGE GUIDANCE, WHEN PERFORMED",,,159.29,18194.0,52
RC,360,"TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY",,,761.93,18194.0,52
RC,360,TRANSURETHRAL INCISION OF PROSTATE,,,466.11,7704.0,52
RC,360,TREATMENT OF CLOSED ELBOW DISLOCATION; REQUIRING ANESTHESIA,,,478.41,6689.0,52
RC,360,"TREATMENT OF HUMERAL SHAFT FRACTURE, WITH INSERTION OF INTRAMEDULLARY IMPLANT, WITH OR WITHOUT CERCLAGE AND/OR LOCKING SCREWS",,,845.01,22604.88,52
RC,360,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER",,,380.11,10059.0,52
RC,360,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER",,,371.19,10059.0,52
RC,360,"TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE",,,978.06,22604.88,52
RC,360,"TWIST DRILL OR BURR HOLE(S) FOR IMPLANTATION OF NEUROSTIMULATOR ELECTRODES, CORTICAL",,,969.22,13802.9,14
RC,360,"TWIST DRILL, BURR HOLE, CRANIOTOMY, OR CRANIECTOMY WITH STEREOTACTIC IMPLANTATION OF NEUROSTIMULATOR ELECTRODE ARRAY IN SUBCORTICAL SITE (EG, THALAMUS, GLOBUS PALLIDUS, SUBTHALAMIC NUCLEUS, PERIVENTRI",,,982.0,13802.9,14
RC,360,"Tendon sheath incision (e.g., for trigger finger)",,,291.66,6689.0,52
RC,360,"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon",,,616.93,7704.0,52
RC,360,Tenodesis of long tendon of biceps,,,734.83,12775.92,52
RC,360,"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid",,,1062.18,10422.97,50
RC,360,"Thyroidectomy, total or complete",,,895.67,11751.0,50
RC,360,"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection",,,1287.28,11751.0,50
RC,360,"Tissue expander placement in breast reconstruction, including subsequent expansion(s)",,,1134.13,24263.93,52
RC,360,"Tonsillectomy, primary or secondary; age 12 or over",,,253.36,8715.0,52
RC,360,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);",,,996.47,13802.9,15
RC,360,"Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection)",,,1583.93,30871.55,50
RC,360,"Total thyroid lobectomy, unilateral; with or without isthmusectomy",,,692.32,10644.28,52
RC,360,"Transcatheter placement of an intravascular stent(s) (except lower extremity artery(s) for occlusive disease, cervical carotid, extracranial vertebral or intrathoracic carotid, intracranial, or corona",,,416.31,20325.69,50
RC,360,"Transection or avulsion of other spinal nerve, extradural",,,549.87,6689.0,52
RC,360,"Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon",,,775.25,7704.0,52
RC,360,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,709.72,9440.44,52
RC,360,Transurethral resection; of postoperative bladder neck contracture,,,317.76,6689.0,52
RC,360,"Treatment of incomplete abortion, any trimester, completed surgically",,,301.71,10059.0,52
RC,360,"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage",,,1199.45,13802.9,50
RC,360,Treatment of superficial wound dehiscence; simple closure,,,184.23,5681.0,52
RC,360,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia",,,157.59,7704.0,52
RC,360,UNLISTED CRANIOFACIAL AND MAXILLOFACIAL PROCEDURE,,,153.41,6499.0,49
RC,360,"UNLISTED HYSTEROSCOPY PROCEDURE, UTERUS",,,123.48,7704.0,49
RC,360,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,1229.0,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, BILIARY TRACT",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, ESOPHAGUS",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, INTESTINE (EXCEPT RECTUM)",,,982.0,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT, OVARY",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, RECTUM",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, URETER",,,3668.82,10644.28,49
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS",,,3668.82,10644.28,49
RC,360,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,586.96,5681.0,49
RC,360,"UNLISTED PROCEDURE, ACCESSORY SINUSES",,,153.41,4664.0,49
RC,360,"UNLISTED PROCEDURE, ARTHROSCOPY",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES",,,153.41,5681.0,49
RC,360,"UNLISTED PROCEDURE, FEMALE GENITAL SYSTEM (NONOBSTETRICAL)",,,123.48,5681.0,49
RC,360,"UNLISTED PROCEDURE, FEMUR OR KNEE",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, HANDS OR FINGERS",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM",,,287.87,5681.0,49
RC,360,"UNLISTED PROCEDURE, HUMERUS OR ELBOW",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, LARYNX",,,153.41,5681.0,49
RC,360,"UNLISTED PROCEDURE, LEG OR ANKLE",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, LIPS",,,153.41,4929.13,49
RC,360,"UNLISTED PROCEDURE, MUSCULOSKELETAL SYSTEM, GENERAL",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, NERVOUS SYSTEM",,,189.35,5681.0,49
RC,360,"UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS",,,153.41,6499.0,49
RC,360,"UNLISTED PROCEDURE, SALIVARY GLANDS OR DUCTS",,,153.41,5681.0,49
RC,360,"UNLISTED PROCEDURE, SHOULDER",,,149.49,5681.0,49
RC,360,"UNLISTED PROCEDURE, SKIN, MUCOUS MEMBRANE AND SUBCUTANEOUS TISSUE",,,130.17,5681.0,49
RC,360,"UNLISTED PROCEDURE, TONGUE, FLOOR OF MOUTH",,,153.41,4664.0,49
RC,360,"UNLISTED PROCEDURE, TRACHEA, BRONCHI",,,119.18,5681.0,49
RC,360,"UNLISTED PROCEDURE, URINARY SYSTEM",,,192.95,5681.0,49
RC,360,"UNLISTED PROCEDURE, VASCULAR SURGERY",,,392.67,6689.0,49
RC,360,URETEROURETEROSTOMY,,,982.0,13802.9,14
RC,360,"URETHRORRHAPHY, SUTURE OF URETHRAL WOUND OR INJURY; PERINEAL",,,618.79,9440.44,52
RC,360,UTERINE EVACUATION AND CURETTAGE FOR HYDATIDIFORM MOLE,,,527.04,10059.0,52
RC,360,"Unlisted procedure, foot or toes",,,149.49,5681.0,49
RC,360,"Unlisted procedure, nose",,,153.41,5681.0,49
RC,360,"VAGINAL HYSTERECTOMY, FOR UTERUS GREATER THAN 250 G; WITH REMOVAL OF TUBE(S) AND/OR OVARY(S)",,,1217.49,13802.9,50
RC,360,VENTILATING TUBE REMOVAL REQUIRING GENERAL ANESTHESIA,,,59.37,7697.0,52
RC,360,VESTIBULOPLASTY; ANTERIOR,,,621.22,10422.97,52
RC,360,"VESTIBULOPLASTY; POSTERIOR, UNILATERAL",,,663.55,10422.97,52
RC,360,VULVECTOMY SIMPLE; COMPLETE,,,659.08,14124.0,52
RC,360,VULVECTOMY SIMPLE; PARTIAL,,,579.18,10059.0,52
RC,360,"Vaginal hysterectomy, for uterus 250 g or less;",,,823.67,18194.0,52
RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)",,,910.04,18194.0,52
RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele",,,975.18,18194.0,52
RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele",,,877.13,18194.0,52
RC,360,"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)",,,226.11,6689.0,52
RC,360,Venous catheterization for selective organ blood sampling,,,173.21,5681.0,14
RC,361,ABDOMINAL PARACENTESIS (DIAGNOSTIC OR THERAPEUTIC); WITHOUT IMAGING GUIDANCE,,,71.02,6689.0,52
RC,361,APPLICATION OF LONG ARM SPLINT (SHOULDER TO HAND),,,40.59,2481.0,48
RC,361,"APPLICATION OF MULTI-LAYER COMPRESSION SYSTEM; LEG (BELOW KNEE), INCLUDING ANKLE AND FOOT",,,26.1,2481.0,48
RC,361,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; EACH ADDITIONAL 25 SQ",,,24.15,5681.0,19
RC,361,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO FACE, SCALP, EYELIDS, MOUTH, NECK, EARS, ORBITS, GENITALIA, HANDS, FEET, AND/OR MULTIPLE DIGITS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LES",,,90.66,6689.0,52
RC,361,"APPLICATION OF SKIN SUBSTITUTE GRAFT TO TRUNK, ARMS, LEGS, TOTAL WOUND SURFACE AREA UP TO 100 SQ CM; FIRST 25 SQ CM OR LESS WOUND SURFACE AREA",,,81.5,6689.0,52
RC,361,Application of rigid total contact leg cast,,,96.42,2481.0,48
RC,361,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each",,,399.17,8715.0,52
RC,361,"Avulsion of nail plate, partial or complete, simple; single",,,52.44,5681.0,52
RC,361,"BIOPSY, VESTIBULE OF MOUTH",,,87.65,5681.0,52
RC,361,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BALLOON OCCLUSION, WHEN PERFORMED, ASSESSMENT OF AIR LEAK, AIRWAY SIZING, AND INSERTION OF BRONCHIAL VALVE(S), IN",,,196.98,14124.0,52
RC,361,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH BALLOON OCCLUSION, WITH ASSESSMENT OF AIR LEAK, WITH ADMINISTRATION OF OCCLUSIVE SUBSTANCE (EG, FIBRIN GLUE), IF ",,,180.46,12425.97,52
RC,361,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH PLACEMENT OF BRONCHIAL STENT(S) (INCLUDES TRACHEAL/BRONCHIAL DILATION AS REQUIRED), INITIAL BRONCHUS",,,207.49,12425.97,52
RC,361,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH REMOVAL OF BRONCHIAL VALVE(S), INITIAL LOBE",,,190.0,14124.0,52
RC,361,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL LUNG BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,46.91,6689.0,21
RC,361,"BRONCHOSCOPY, RIGID OR FLEXIBLE, INCLUDING FLUOROSCOPIC GUIDANCE, WHEN PERFORMED; WITH TRANSBRONCHIAL NEEDLE ASPIRATION BIOPSY(S), EACH ADDITIONAL LOBE (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY",,,60.29,6689.0,21
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)",,,127.43,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage",,,128.45,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,150.03,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings",,,126.86,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with computer-assisted, image-guided navigation (list separately in addition to code for primary procedure[s])",,,92.34,5681.0,14
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy, cryotherapy)",,,243.51,7697.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[i",,,211.36,18194.0,104
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor",,,237.07,7697.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body",,,168.46,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial",,,141.44,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with tracheal/bronchial dilation or closed reduction of fracture",,,190.21,7697.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe",,,168.85,6689.0,52
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)",,,179.2,7697.0,52
RC,361,"CARDIOVERSION, ELECTIVE, ELECTRICAL CONVERSION OF ARRHYTHMIA; EXTERNAL",,,104.27,3698.0,46
RC,361,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; 2.5 CM OR LESS",,,142.5,4664.0,52
RC,361,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX",,,196.68,5681.0,52
RC,361,"Closed treatment of distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; with manipulation",,,513.49,7704.0,52
RC,361,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,177.9,5444.0,52
RC,361,"Colonoscopy, flexible; with biopsy, single or multiple",,,193.33,5444.0,52
RC,361,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,244.64,5444.0,52
RC,361,"Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female",,,146.97,6689.0,52
RC,361,DEBRIDEMENT OF NAIL(S) BY ANY METHOD(S); 1 TO 5,,,13.78,5681.0,52
RC,361,"DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR STRUCTURES",,,81.16,5681.0,52
RC,361,"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; COMPLICATED",,,195.18,6689.0,52
RC,361,"DRAINAGE OF ABSCESS, CYST, HEMATOMA, VESTIBULE OF MOUTH; SIMPLE",,,116.69,4664.0,52
RC,361,DRAINAGE OF FINGER ABSCESS; SIMPLE,,,130.17,4664.0,52
RC,361,"DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH",,,552.48,6689.0,52
RC,361,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",,,59.06,6689.0,52
RC,361,"EPISIOTOMY OR VAGINAL REPAIR, BY OTHER THAN ATTENDING",,,143.45,6689.0,50
RC,361,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,209.53,18194.0,52
RC,361,EXCISION OF LESION OF TONGUE WITH CLOSURE; ANTERIOR TWO-THIRDS,,,238.8,6689.0,52
RC,361,"Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure)",,,61.54,5681.0,52
RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,444.67,18194.0,52
RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,462.98,18194.0,52
RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s),,,349.97,6788.28,52
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,133.85,5444.0,52
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube",,,192.88,6689.0,52
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,188.79,5444.0,52
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,252.93,6499.0,52
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (e.g., anesthetic, neurolytic agent) or fiducial ",,,252.6,10059.0,52
RC,361,"Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm",,,312.01,6689.0,52
RC,361,FORESKIN MANIPULATION INCLUDING LYSIS OF PREPUTIAL ADHESIONS AND STRETCHING,,,55.22,5681.0,52
RC,361,INCISION AND DRAINAGE ABSCESS; PERITONSILLAR,,,134.1,5681.0,52
RC,361,INCISION AND DRAINAGE OF BARTHOLIN'S GLAND ABSCESS,,,108.96,5681.0,52
RC,361,"INCISION AND DRAINAGE, PERIANAL ABSCESS, SUPERFICIAL",,,99.7,5681.0,52
RC,361,"INTRAOPERATIVE NEAR-INFRARED FLUORESCENCE IMAGING OF MAJOR EXTRA-HEPATIC BILE DUCT(S) (E.G., CYSTIC DUCT, COMMON BILE DUCT AND COMMON HEPATIC DUCT) WITH INTRAVENOUS ADMINISTRATION OF INDOCYANINE GREEN",,,982.0,4664.0,10
RC,361,IRRIGATION OF CORPORA CAVERNOSA FOR PRIAPISM,,,130.87,5681.0,52
RC,361,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated or multiple",,,181.2,5681.0,52
RC,361,"Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or single",,,105.0,5681.0,52
RC,361,Incision and drainage of vulva or perineal abscess,,,125.19,6689.0,52
RC,361,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,336.82,10644.28,52
RC,361,"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery",,,432.51,7704.0,50
RC,361,"REPAIR OF LACERATION OF TONGUE, FLOOR OF MOUTH, OVER 2.6 CM OR COMPLEX",,,153.41,6689.0,52
RC,361,"REPAIR, COMPLEX, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; EACH ADDITIONAL 5 CM OR LESS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,121.39,5681.0,19
RC,361,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL ANGIOPLASTY",,,377.35,8715.0,5
RC,361,"Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm",,,293.86,7704.0,52
RC,361,"Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm",,,250.69,7704.0,52
RC,361,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,165.56,5681.0,52
RC,361,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,194.74,5681.0,52
RC,361,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm",,,214.7,6689.0,52
RC,361,"Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm",,,191.18,5681.0,52
RC,361,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm",,,235.35,6689.0,52
RC,361,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm",,,185.92,5681.0,52
RC,361,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm",,,200.46,6689.0,52
RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty",,,419.24,8715.0,5
RC,361,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE",,,116.2,5681.0,52
RC,361,"Sigmoidoscopy, flexible; with biopsy, single or multiple",,,70.12,3698.0,52
RC,361,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,53.92,4664.0,52
RC,361,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,56.2,4664.0,52
RC,361,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less",,,43.54,5681.0,52
RC,361,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm",,,57.18,4664.0,52
RC,361,"Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm",,,112.39,6689.0,52
RC,361,"TENOTOMY, OPEN, TENDON FLEXOR; TOE, SINGLE TENDON (SEPARATE PROCEDURE)",,,239.2,6689.0,50
RC,361,"THORACIC FASCIAL PLANE BLOCK, UNILATERAL; BY INJECTION(S), INCLUDING IMAGING GUIDANCE, WHEN PERFORMED",,,76.35,5681.0,13
RC,361,Tracheobronchoscopy through established tracheostomy incision,,,112.82,5681.0,52
RC,361,"UNLISTED PROCEDURE, DENTOALVEOLAR STRUCTURES",,,153.41,5681.0,49
RC,361,"UNLISTED PROCEDURE, PANCREAS",,,450.93,4664.0,49
RC,361,"UNLISTED PROCEDURE, PHARYNX, ADENOIDS, OR TONSILS",,,153.41,6499.0,49
RC,481,ADDITIONAL LINEAR OR FOCAL INTRACARDIAC CATHETER ABLATION OF THE LEFT OR RIGHT ATRIUM FOR TREATMENT OF ATRIAL FIBRILLATION REMAINING AFTER COMPLETION OF PULMONARY VEIN ISOLATION (LIST SEPARATELY IN AD,,,290.34,44695.0,16
RC,481,COMPREHENSIVE ELECTROPHYSIOLOGIC EVALUATION INCLUDING INSERTION AND REPOSITIONING OF MULTIPLE ELECTRODE CATHETERS WITH INDUCTION OR ATTEMPTED INDUCTION OF ARRHYTHMIA; WITH LEFT VENTRICULAR PACING AND ,,,1047.52,44695.0,16
RC,481,Comprehensive electrophysiologic evaluation including insertion and repositioning of multiple electrode catheters with induction or attempted induction of arrhythmia; with right atrial pacing and reco,,,190.05,44695.0,52
RC,481,"Comprehensive electrophysiologic evaluation with insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia with right atrial pacing and recording a",,,791.27,46020.56,104
RC,481,"Comprehensive electrophysiologic evaluation with transseptal catheterizations, insertion and repositioning of multiple electrode catheters, induction or attempted induction of an arrhythmia including ",,,897.25,46020.56,52
RC,481,"Electrophysiologic evaluation of single or dual chamber pacing cardioverter-defibrillator leads including defibrillation threshold evaluation (induction of arrhythmia, evaluation of sensing and pacing",,,18.52,44695.0,16
RC,481,"INTRACARDIAC CATHETER ABLATION OF A DISCRETE MECHANISM OF ARRHYTHMIA WHICH IS DISTINCT FROM THE PRIMARY ABLATED MECHANISM, INCLUDING REPEAT DIAGNOSTIC MANEUVERS, TO TREAT A SPONTANEOUS OR INDUCED ARRH",,,290.02,44695.0,16
RC,481,PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY; EACH ADDITIONAL BRANCH OF A MAJOR CORONARY ARTERY (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,10528.0,39957.0,9
RC,481,PROGRAMMED STIMULATION AND PACING AFTER INTRAVENOUS DRUG INFUSION (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,1047.52,44695.0,16
RC,750,ANORECTAL MANOMETRY,,,184.87,4664.0,5
RC,750,"BALLOON DILATION OF BILIARY DUCT(S) OR OF AMPULLA (SPHINCTEROPLASTY), PERCUTANEOUS, INCLUDING IMAGING GUIDANCE (EG, FLUOROSCOPY), AND ALL ASSOCIATED RADIOLOGICAL SUPERVISION AND INTERPRETATION, EACH D",,,128.71,5681.0,14
RC,750,"Biopsy of pancreas, percutaneous needle",,,226.28,5681.0,52
RC,750,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage",,,128.45,6689.0,52
RC,750,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[i",,,234.25,18194.0,52
RC,750,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i)",,,179.2,7697.0,52
RC,750,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,,,55.07,5681.0,50
RC,750,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,150.56,5444.0,52
RC,750,"Colonoscopy through stoma; with biopsy, single or multiple",,,165.45,5444.0,52
RC,750,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,217.01,5444.0,52
RC,750,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,177.9,5444.0,52
RC,750,"Colonoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)",,,260.19,8022.0,52
RC,750,"Colonoscopy, flexible; with band ligation(s) (e.g., hemorrhoids)",,,226.52,8022.0,52
RC,750,"Colonoscopy, flexible; with biopsy, single or multiple",,,193.33,5444.0,52
RC,750,"Colonoscopy, flexible; with control of bleeding, any method",,,248.97,5444.0,52
RC,750,"Colonoscopy, flexible; with directed submucosal injection(s), any substance",,,193.0,5444.0,52
RC,750,"Colonoscopy, flexible; with endoscopic mucosal resection",,,319.86,8022.0,52
RC,750,"Colonoscopy, flexible; with endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures",,,248.02,5444.0,52
RC,750,"Colonoscopy, flexible; with removal of foreign body(s)",,,229.63,5444.0,52
RC,750,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps",,,219.64,6689.0,52
RC,750,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,244.64,5444.0,52
RC,750,"Colonoscopy, flexible; with transendoscopic balloon dilation",,,204.05,5444.0,52
RC,750,Colorectal cancer screening; colonoscopy on individual at high risk,,,177.9,4596.53,52
RC,750,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,178.19,4596.53,52
RC,750,"DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES",,,77.34,5444.0,52
RC,750,ENDOSCOPIC CANNULATION OF PAPILLA WITH DIRECT VISUALIZATION OF PANCREATIC/COMMON BILE DUCT(S) (LIST SEPARATELY IN ADDITION TO CODE(S) FOR PRIMARY PROCEDURE),,,114.41,18194.0,21
RC,750,"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL POUCH (EG, KOCK POUCH, ILEAL RESERVOIR [S OR J]); DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,70.74,5681.0,52
RC,750,"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL POUCH (EG, KOCK POUCH, ILEAL RESERVOIR [S OR J]); WITH BIOPSY, SINGLE OR MULTIPLE",,,86.49,5681.0,52
RC,750,"ENDOSCOPIC OUTLET REDUCTION, GASTRIC POUCH APPLICATION, WITH ENDOSCOPY AND INTRALUMINAL TUBE INSERTION, IF PERFORMED, INCLUDING ALL SYSTEM AND TISSUE ANCHORING COMPONENTS",,,4299.0,18715.8,49
RC,750,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S), INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED",,,416.25,18194.0,52
RC,750,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH DESTRUCTION OF CALCULI, ANY METHOD (EG, MECHANICAL, ELECTROHYDRAULIC, LITHOTRIPSY)",,,416.29,10688.95,52
RC,750,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH TRANS-ENDOSCOPIC BALLOON DILATION OF BILIARY/PANCREATIC DUCT(S) OR OF AMPULLA (SPHINCTEROPLASTY), INCLUDING SPHINCTEROTOMY, WHEN PERFORMED, ",,,363.71,18194.0,52
RC,750,"ENDOSCOPIC SUBMUCOSAL DISSECTION (ESD), INCLUDING ENDOSCOPY OR COLONOSCOPY, MUCOSAL CLOSURE, WHEN PERFORMED",,,2273.53,18194.0,51
RC,750,"ESOPHAGEAL BALLOON DISTENSION STUDY, DIAGNOSTIC, WITH PROVOCATION WHEN PERFORMED",,,353.64,4664.0,50
RC,750,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH INSERTION OF INTRALUMINAL TUBE OR CATHETER",,,137.38,5444.0,52
RC,750,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,209.53,18194.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,189.7,18194.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BAND LIGATION OF ESOPHAGEAL VARICES",,,136.2,5681.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH BIOPSY, SINGLE OR MULTIPLE",,,99.82,5681.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE",,,100.43,5681.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,181.71,18194.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH REMOVAL OF FOREIGN BODY(S)",,,136.49,5681.0,52
RC,750,"ESOPHAGOSCOPY, FLEXIBLE, TRANSORAL; WITH TRANSENDOSCOPIC BALLOON DILATION (LESS THAN 30 MM DIAMETER)",,,114.17,6689.0,52
RC,750,"Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,310.37,6788.28,52
RC,750,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple",,,325.72,6788.28,52
RC,750,"Endoscopic retrograde cholangiopancreatography (ERCP); with placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, incl",,,444.67,18194.0,52
RC,750,"Endoscopic retrograde cholangiopancreatography (ERCP); with removal and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, inclu",,,462.98,18194.0,52
RC,750,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s),,,349.97,6788.28,52
RC,750,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s),,,361.73,18194.0,52
RC,750,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy,,,343.13,6788.28,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,118.5,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)",,,215.97,10059.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices",,,235.93,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,133.85,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method",,,192.8,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (e.g., balloon, bougie)",,,169.23,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube",,,192.88,6689.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance",,,133.85,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection",,,259.78,5988.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures",,,188.54,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is ",,,217.34,7704.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire",,,160.33,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)",,,170.39,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,188.79,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)",,,148.2,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,252.93,6499.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,223.52,5444.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided transmural injection of diagnostic or therapeutic substance(s) (e.g., anesthetic, neurolytic agent) or fiducial ",,,252.6,10059.0,52
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transmural drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when",,,377.06,10688.95,52
RC,750,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)",,,151.78,5988.0,52
RC,750,"ILEOSCOPY, THROUGH STOMA; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,55.78,5681.0,52
RC,750,"INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT) (SEPARATE PROCEDURE)",,,18.34,5444.0,52
RC,750,"LOWER ESOPHAGEAL MYOTOMY, TRANSORAL (IE, PERORAL ENDOSCOPIC MYOTOMY [POEM])",,,765.78,18194.0,52
RC,750,"RECTAL SENSATION, TONE, AND COMPLIANCE TEST (IE, RESPONSE TO GRADED BALLOON DISTENTION)",,,440.71,4664.0,5
RC,750,"REMOVAL OF BILIARY DRAINAGE CATHETER, PERCUTANEOUS, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING BILIARY STENTS), INCLUDING DIAGNOSTIC CHOLANGIOGRAPHY WHEN PERFORMED, IMAGING GUIDAN",,,91.97,5681.0,52
RC,750,"REPLACEMENT OF GASTRO-JEJUNOSTOMY TUBE, PERCUTANEOUS, UNDER FLUOROSCOPIC GUIDANCE INCLUDING CONTRAST INJECTION(S), IMAGE DOCUMENTATION AND REPORT",,,130.02,5681.0,52
RC,750,"REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT",,,36.09,5681.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,154.77,8022.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH BAND LIGATION(S) (EG, HEMORRHOIDS)",,,97.84,8022.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH DIRECTED SUBMUCOSAL INJECTION(S), ANY SUBSTANCE",,,64.89,5681.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC MUCOSAL RESECTION",,,190.82,8022.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH ENDOSCOPIC ULTRASOUND EXAMINATION",,,119.87,5681.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY HOT BIOPSY FORCEPS",,,91.2,5681.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE",,,116.2,5681.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC BALLOON DILATION",,,75.94,5681.0,52
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION/BIOPSY(S)",,,164.44,5681.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM; DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,272.95,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, INCLUDING ILEUM; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTERY, LASER, HEATER PROBE, STAPLER, PL",,,369.61,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDU",,,138.8,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH ABLATION OF TUMOR(S), POLYP(S), OR OTHER LESION(S) NOT AMENABLE TO REMOVAL BY HOT BIOPSY FORCEPS, B",,,236.27,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE",,,152.87,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH CONTROL OF BLEEDING (EG, INJECTION, BIPOLAR CAUTERY, UNIPOLAR CAUTERY, LASER, HEATER PROBE, STAPLER",,,230.74,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH REMOVAL OF FOREIGN BODY(S)",,,184.58,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH REMOVAL OF TUMOR(S), POLYP(S), OR OTHER LESION(S) BY SNARE TECHNIQUE",,,196.71,6689.0,52
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH TRANSENDOSCOPIC STENT PLACEMENT (INCLUDES PREDILATION)",,,257.11,18194.0,52
RC,750,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,55.07,3698.0,52
RC,750,"Sigmoidoscopy, flexible; with biopsy, single or multiple",,,70.12,3698.0,52
RC,750,"UNLISTED PROCEDURE, BILIARY TRACT",,,586.96,5444.0,49
RC,750,"UNLISTED PROCEDURE, ESOPHAGUS",,,586.96,13802.9,49
RC,750,"UNLISTED PROCEDURE, PANCREAS",,,450.93,4664.0,49
RC,750,"UNLISTED PROCEDURE, SMALL INTESTINE",,,586.96,7390.37,49
RC,750,"UNLISTED PROCEDURE, STOMACH",,,586.96,5681.0,49
RC,790,"Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,150.23,18194.0,52
RC,790,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",,,146.33,18194.0,52
RC,790,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM),,,455.47,18194.0,52
RC,790,"Lithotripsy, extracorporeal shock wave",,,559.87,22523.67,52
RC,790,"REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING URETERAL STENT)",,,51.06,18194.0,52
TRIS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,,,0
TRIS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,,,0
TRIS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,,,0
TRIS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,,,0
TRIS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,,,0
TRIS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,,,,,0
TRIS-DRG,007,LUNG TRANSPLANT,,,,,0
TRIS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,,,0
TRIS-DRG,010,PANCREAS TRANSPLANT,,,,,0
TRIS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,,,0
TRIS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,,,0
TRIS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,,,0
TRIS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,,,,,0
TRIS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,,,0
TRIS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,,,0
TRIS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,,,0
TRIS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,,,0
TRIS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,,,0
TRIS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,,,0
TRIS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,,,0
TRIS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,,,0
TRIS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,,,0
TRIS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 WITH MCC,,,,,0
TRIS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 WITH CC,,,,,0
TRIS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,028,SPINAL PROCEDURES WITH MCC,,,,,0
TRIS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,,,0
TRIS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,031,VENTRICULAR SHUNT PROCEDURES AGE >17 WITH MCC,,,,,0
TRIS-DRG,032,VENTRICULAR SHUNT PROCEDURES AGE >17 WITH CC,,,,,0
TRIS-DRG,033,VENTRICULAR SHUNT PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,,,0
TRIS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,,,,,0
TRIS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,,,,,0
TRIS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,,,,,0
TRIS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,,,0
TRIS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,,,0
TRIS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,,,0
TRIS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,,,0
TRIS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,,,0
TRIS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,,,0
TRIS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,,,0
TRIS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,,,0
TRIS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,,,0
TRIS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,,,0
TRIS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,,,0
TRIS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,,,0
TRIS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,,,0
TRIS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,,,0
TRIS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,,,0
TRIS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,,,0
TRIS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,,,0
TRIS-DRG,067,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,,,0
TRIS-DRG,068,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,,,0
TRIS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,,,0
TRIS-DRG,070,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,,,,,0
TRIS-DRG,071,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,,,,,0
TRIS-DRG,072,NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,,,0
TRIS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,,,0
TRIS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,,,,,0
TRIS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,077,HYPERTENSIVE ENCEPHALOPATHY WITH MCC,,,,,0
TRIS-DRG,078,HYPERTENSIVE ENCEPHALOPATHY WITH CC,,,,,0
TRIS-DRG,079,HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,,,,,0
TRIS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,,,0
TRIS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,,,0
TRIS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,,,0
TRIS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,,,0
TRIS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,,,0
TRIS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR AGE >17 WITH MCC,,,,,0
TRIS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR AGE >17 WITH CC,,,,,0
TRIS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,088,CONCUSSION AGE >17 WITH MCC,,,,,0
TRIS-DRG,089,CONCUSSION AGE >17 WITH CC,,,,,0
TRIS-DRG,090,CONCUSSION AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,,,0
TRIS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,,,0
TRIS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,,,0
TRIS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,,,0
TRIS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,,,0
TRIS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,,,0
TRIS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,,,0
TRIS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,,,0
TRIS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,100,SEIZURES AGE >17 WITH MCC,,,,,0
TRIS-DRG,101,SEIZURES AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,102,HEADACHES AGE >17 WITH MCC,,,,,0
TRIS-DRG,103,HEADACHES AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,104,"CRANIOTOMY, VENTRICULAR SHUNT AND ENDOVASCULAR INTRACRANIAL PROCEDURES AGE 0-17",,,,,0
TRIS-DRG,105,TRAUMATIC STUPOR AND COMA <1 HOUR AGE 0-17,,,,,0
TRIS-DRG,106,CONCUSSION AGE 0-17,,,,,0
TRIS-DRG,107,SEIZURES AND HEADACHES AGE 0-17,,,,,0
TRIS-DRG,108,EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE 0-17,,,,,0
TRIS-DRG,109,OTHER DISORDERS OF THE EYE AGE 0-17,,,,,0
TRIS-DRG,111,SINUS AND MASTOID PROCEDURES AGE 0-17,,,,,0
TRIS-DRG,112,OTITIS MEDIA AND URI AGE 0-17,,,,,0
TRIS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT AGE >17,,,,,0
TRIS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,118,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES AGE 0-17",,,,,0
TRIS-DRG,119,DENTAL AND ORAL DISEASES AGE 0-17,,,,,0
TRIS-DRG,120,RESPIRATORY INFECTIONS AND INFLAMMATIONS AGE 0-17,,,,,0
TRIS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,,,0
TRIS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,,,0
TRIS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,,,0
TRIS-DRG,124,OTHER DISORDERS OF THE EYE AGE >17 WITH MCC OR THROMBOLYTIC AGENT,,,,,0
TRIS-DRG,125,OTHER DISORDERS OF THE EYE AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,135,SINUS AND MASTOID PROCEDURES AGE >17 WITH CC/MCC,,,,,0
TRIS-DRG,136,SINUS AND MASTOID PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,139,SALIVARY GLAND PROCEDURES,,,,,0
TRIS-DRG,140,SIMPLE PNEUMONIA AND PLEURISY AGE 0-17,,,,,0
TRIS-DRG,141,BRONCHITIS AND ASTHMA AGE 0-17,,,,,0
TRIS-DRG,142,CARDIAC CONGENITAL AND VALVULAR DISORDERS AGE 0-17,,,,,0
TRIS-DRG,143,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES AGE 0-17",,,,,0
TRIS-DRG,144,HERNIA PROCEDURES AGE 0-17,,,,,0
TRIS-DRG,145,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS AGE 0-17",,,,,0
TRIS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,,,0
TRIS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,,,0
TRIS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,,,0
TRIS-DRG,149,DYSEQUILIBRIUM,,,,,0
TRIS-DRG,150,EPISTAXIS WITH MCC,,,,,0
TRIS-DRG,151,EPISTAXIS WITHOUT MCC,,,,,0
TRIS-DRG,152,OTITIS MEDIA AND URI AGE >17 WITH MCC,,,,,0
TRIS-DRG,153,OTITIS MEDIA AND URI AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES AGE >17 WITH MCC",,,,,0
TRIS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES AGE >17 WITH CC",,,,,0
TRIS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES AGE >17 WITHOUT CC/MCC",,,,,0
TRIS-DRG,157,DENTAL AND ORAL DISEASES AGE >17 WITH MCC,,,,,0
TRIS-DRG,158,DENTAL AND ORAL DISEASES AGE >17 WITH CC,,,,,0
TRIS-DRG,159,DENTAL AND ORAL DISEASES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,160,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE 0-17,,,,,0
TRIS-DRG,161,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE 0-17,,,,,0
TRIS-DRG,162,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR AGE 0-17",,,,,0
TRIS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,,,0
TRIS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,,,0
TRIS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,169,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH AGE 0-17",,,,,0
TRIS-DRG,170,CELLULITIS AGE 0-17,,,,,0
TRIS-DRG,171,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST AGE 0-17",,,,,0
TRIS-DRG,172,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES AGE 0-17",,,,,0
TRIS-DRG,173,URETHRAL PROCEDURES AGE 0-17,,,,,0
TRIS-DRG,174,KIDNEY AND URINARY TRACT INFECTIONS AGE 0-17,,,,,0
TRIS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,,,0
TRIS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,,,0
TRIS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS AGE >17 WITH MCC,,,,,0
TRIS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS AGE >17 WITH CC,,,,,0
TRIS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,,,0
TRIS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,,,0
TRIS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,,,0
TRIS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,,,0
TRIS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,,,0
TRIS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,,,0
TRIS-DRG,186,PLEURAL EFFUSION WITH MCC,,,,,0
TRIS-DRG,187,PLEURAL EFFUSION WITH CC,,,,,0
TRIS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,,,0
TRIS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,,,0
TRIS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,,,0
TRIS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,,,0
TRIS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,,,0
TRIS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY AGE >17 WITH MCC,,,,,0
TRIS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY AGE >17 WITH CC,,,,,0
TRIS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,,,0
TRIS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,,,0
TRIS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,,,0
TRIS-DRG,199,PNEUMOTHORAX WITH MCC,,,,,0
TRIS-DRG,200,PNEUMOTHORAX WITH CC,,,,,0
TRIS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,,,0
TRIS-DRG,202,BRONCHITIS AND ASTHMA AGE >17 WITH CC/MCC,,,,,0
TRIS-DRG,203,BRONCHITIS AND ASTHMA AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,,,0
TRIS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,,,0
TRIS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,,,0
TRIS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,,,0
TRIS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,,,0
TRIS-DRG,209,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS AGE 0-17,,,,,0
TRIS-DRG,210,URETHRAL STRICTURE AGE 0-17,,,,,0
TRIS-DRG,211,OTHER KIDNEY AND URINARY TRACT DIAGNOSES AGE 0-17,,,,,0
TRIS-DRG,212,TESTES PROCEDURES AGE 0-17,,,,,0
TRIS-DRG,213,SPLENIC PROCEDURES AGE 0-17,,,,,0
TRIS-DRG,214,RED BLOOD CELL DISORDERS AGE 0-17,,,,,0
TRIS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,,,0
TRIS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,,,0
TRIS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,,,0
TRIS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,,,0
TRIS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,,,0
TRIS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,,,0
TRIS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,,,0
TRIS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,,,0
TRIS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,,,0
TRIS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,,,0
TRIS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,,,0
TRIS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,,,,0
TRIS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,,,,0
TRIS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,,,0
TRIS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,,,0
TRIS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,,,0
TRIS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,,,0
TRIS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,,,0
TRIS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,,,0
TRIS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,,,0
TRIS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,,,0
TRIS-DRG,245,AICD GENERATOR PROCEDURES,,,,,0
TRIS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,,,0
TRIS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,,,0
TRIS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,,,0
TRIS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,,,0
TRIS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,,,0
TRIS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,,,0
TRIS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,,,0
TRIS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,,,0
TRIS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,,,0
TRIS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,,,0
TRIS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,,,0
TRIS-DRG,263,VEIN LIGATION AND STRIPPING,,,,,0
TRIS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,,,0
TRIS-DRG,265,AICD LEAD PROCEDURES,,,,,0
TRIS-DRG,266,ACUTE LEUKEMIA AGE 0-17,,,,,0
TRIS-DRG,267,"VIRAL ILLNESS, FEVER AND INFLAMMATORY CONDITIONS, AGE 0-17",,,,,0
TRIS-DRG,268,SEPTICEMIA OR SEVERE SEPSIS AGE 0-17,,,,,0
TRIS-DRG,269,TRAUMATIC INJURY AGE 0-17,,,,,0
TRIS-DRG,270,ALLERGIC REACTIONS AGE 0-17,,,,,0
TRIS-DRG,271,POISONING AND TOXIC EFFECTS OF DRUGS AGE 0-17,,,,,0
TRIS-DRG,272,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,,,,0
TRIS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,,,,0
TRIS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,,,,0
TRIS-DRG,275,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,,,0
TRIS-DRG,276,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,,,0
TRIS-DRG,277,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,,,0
TRIS-DRG,278,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,,,0
TRIS-DRG,279,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,,,0
TRIS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,,,0
TRIS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,,,0
TRIS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,,,0
TRIS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,,,0
TRIS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,,,0
TRIS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,,,,0
TRIS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,,,,0
TRIS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,,,0
TRIS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,,,0
TRIS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,,,0
TRIS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,,,0
TRIS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,,,0
TRIS-DRG,294,DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,,,,,0
TRIS-DRG,295,DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,,,0
TRIS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,,,0
TRIS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,,,0
TRIS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,,,0
TRIS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,,,0
TRIS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,,,0
TRIS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,,,0
TRIS-DRG,304,HYPERTENSION WITH MCC,,,,,0
TRIS-DRG,305,HYPERTENSION WITHOUT MCC,,,,,0
TRIS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS AGE >17 WITH MCC,,,,,0
TRIS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,,,0
TRIS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,,,0
TRIS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,311,ANGINA PECTORIS,,,,,0
TRIS-DRG,312,SYNCOPE AND COLLAPSE,,,,,0
TRIS-DRG,313,CHEST PAIN,,,,,0
TRIS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,,,0
TRIS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,,,0
TRIS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,,,0
TRIS-DRG,317,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,,,0
TRIS-DRG,318,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,,,0
TRIS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,,,0
TRIS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,,,0
TRIS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,,,0
TRIS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,,,0
TRIS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,,,0
TRIS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,,,0
TRIS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,,,0
TRIS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES AGE >17 WITH MCC",,,,,0
TRIS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES AGE >17 WITH CC",,,,,0
TRIS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES AGE >17 WITHOUT CC/MCC",,,,,0
TRIS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,,,0
TRIS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,,,0
TRIS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,332,RECTAL RESECTION WITH MCC,,,,,0
TRIS-DRG,333,RECTAL RESECTION WITH CC,,,,,0
TRIS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,,,0
TRIS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,,,0
TRIS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,,,0
TRIS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,,,0
TRIS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,,,0
TRIS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,,,0
TRIS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,,,0
TRIS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES AGE >17 WITH MCC,,,,,0
TRIS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES AGE >17 WITH CC,,,,,0
TRIS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL AGE >17 WITH MCC,,,,,0
TRIS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL AGE >17 WITH CC,,,,,0
TRIS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,359,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,,,,0
TRIS-DRG,360,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,,,0
TRIS-DRG,361,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,,,0
TRIS-DRG,362,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,,,0
TRIS-DRG,363,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,,,0
TRIS-DRG,364,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,,,0
TRIS-DRG,365,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,,,0
TRIS-DRG,366,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,,,0
TRIS-DRG,367,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,,,0
TRIS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,,,0
TRIS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,,,0
TRIS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,,,0
TRIS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,,,0
TRIS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,,,0
TRIS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,,,0
TRIS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,,,0
TRIS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,,,0
TRIS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,,,0
TRIS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,,,0
TRIS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,,,0
TRIS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,,,0
TRIS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,,,0
TRIS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,,,0
TRIS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,,,0
TRIS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,,,0
TRIS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,,,0
TRIS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,,,0
TRIS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,,,0
TRIS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,,,0
TRIS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,,,0
TRIS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS AGE >17 WITH MCC",,,,,0
TRIS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS AGE >17 WITHOUT MCC",,,,,0
TRIS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 WITH MCC,,,,,0
TRIS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 WITH CC,,,,,0
TRIS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,396,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,,,0
TRIS-DRG,397,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,,,0
TRIS-DRG,398,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,399,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES AGE >17 WITH MCC",,,,,0
TRIS-DRG,400,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES AGE 0-17",,,,,0
TRIS-DRG,401,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES AGE >17 WITH CC",,,,,0
TRIS-DRG,402,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES AGE >17 WITHOUT CC/MCC",,,,,0
TRIS-DRG,403,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,,,0
TRIS-DRG,404,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,,,0
TRIS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,,,0
TRIS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,,,0
TRIS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,,,0
TRIS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,,,0
TRIS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,,,0
TRIS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,,,0
TRIS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,,,0
TRIS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,,,0
TRIS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,,,0
TRIS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,,,0
TRIS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,,,0
TRIS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,,,0
TRIS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,,,0
TRIS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,,,0
TRIS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,,,0
TRIS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,,,0
TRIS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,426,APPENDIX PROCEDURES WITH MCC,,,,,0
TRIS-DRG,427,APPENDIX PROCEDURES WITH CC,,,,,0
TRIS-DRG,428,APPENDIX PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,,,0
TRIS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,,,0
TRIS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,,,0
TRIS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,,,0
TRIS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,,,0
TRIS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,,,0
TRIS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,,,0
TRIS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,,,0
TRIS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,,,0
TRIS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,,,0
TRIS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,,,0
TRIS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,,,0
TRIS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,,,0
TRIS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,,,0
TRIS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,,,0
TRIS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,,,0
TRIS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,,,0
TRIS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,,,0
TRIS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,,,0
TRIS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,,,,0
TRIS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,,,,0
TRIS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,,,,0
TRIS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,,,0
TRIS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,,,0
TRIS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,,,0
TRIS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,,,0
TRIS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,,,0
TRIS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,,,0
TRIS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,,,0
TRIS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,,,0
TRIS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,,,0
TRIS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,,,0
TRIS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,,,0
TRIS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,,,0
TRIS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,,,0
TRIS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,,,0
TRIS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,,,0
TRIS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,,,0
TRIS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,,,0
TRIS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 WITH MCC,,,,,0
TRIS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 WITH CC,,,,,0
TRIS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,,,,0
TRIS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,,,0
TRIS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,,,0
TRIS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,,,0
TRIS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,,,0
TRIS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,,,0
TRIS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR AGE >17 WITH MCC",,,,,0
TRIS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR AGE >17 WITH CC",,,,,0
TRIS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR AGE >17 WITHOUT CC/MCC",,,,,0
TRIS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,,,0
TRIS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,,,0
TRIS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,,,0
TRIS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,,,0
TRIS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,,,0
TRIS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,,,0
TRIS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,,,0
TRIS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,503,FOOT PROCEDURES WITH MCC,,,,,0
TRIS-DRG,504,FOOT PROCEDURES WITH CC,,,,,0
TRIS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,,,0
TRIS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,509,ARTHROSCOPY,,,,,0
TRIS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,,,0
TRIS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,,,0
TRIS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,,,0
TRIS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,,,0
TRIS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,,,0
TRIS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,,,0
TRIS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,,,0
TRIS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,,,0
TRIS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,,,0
TRIS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,,,0
TRIS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,,,0
TRIS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,,,0
TRIS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,,,0
TRIS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,,,0
TRIS-DRG,539,OSTEOMYELITIS WITH MCC,,,,,0
TRIS-DRG,540,OSTEOMYELITIS WITH CC,,,,,0
TRIS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,,,0
TRIS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,,,0
TRIS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,,,0
TRIS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,,,0
TRIS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,,,0
TRIS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,,,0
TRIS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,,,0
TRIS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,,,0
TRIS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,,,0
TRIS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,,,0
TRIS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,,,0
TRIS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,,,0
TRIS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,,,0
TRIS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,,,0
TRIS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,,,0
TRIS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,,,0
TRIS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,,,0
TRIS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH AGE >17 WITH MCC",,,,,0
TRIS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH AGE >17 WITHOUT MCC",,,,,0
TRIS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,,,0
TRIS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,,,0
TRIS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,,,0
TRIS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,,,0
TRIS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,,,0
TRIS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,,,0
TRIS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,,,0
TRIS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,,,0
TRIS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,,,0
TRIS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,,,0
TRIS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,,,0
TRIS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,,,0
TRIS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,,,0
TRIS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,,,0
TRIS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,592,SKIN ULCERS WITH MCC,,,,,0
TRIS-DRG,593,SKIN ULCERS WITH CC,,,,,0
TRIS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,,,0
TRIS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,,,0
TRIS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,,,0
TRIS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,,,0
TRIS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,,,0
TRIS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,602,CELLULITIS AGE >17 WITH MCC,,,,,0
TRIS-DRG,603,CELLULITIS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST AGE >17 WITH MCC",,,,,0
TRIS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST AGE >17 WITHOUT MCC",,,,,0
TRIS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,,,0
TRIS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,,,0
TRIS-DRG,608,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,,,0
TRIS-DRG,609,OTHER RESPIRATORY PROBLEMS AFTER BIRTH,,,,,0
TRIS-DRG,610,"NEONATE, DIED WITHIN ONE DAY OF BIRTH",,,,,0
TRIS-DRG,611,"NEONATE, TRANSFERRED <5 DAYS OLD",,,,,0
TRIS-DRG,612,"NEONATE, BIRTH WEIGHT <750 GRAMS, DISCHARGED ALIVE",,,,,0
TRIS-DRG,613,"NEONATE, BIRTH WEIGHT <750 GRAMS, DIED",,,,,0
TRIS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,,,0
TRIS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,,,0
TRIS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,,,0
TRIS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,,,0
TRIS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,,,0
TRIS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,,,0
TRIS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,,,0
TRIS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,,,0
TRIS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,,,0
TRIS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,,,0
TRIS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,,,0
TRIS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,,,0
TRIS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,,,0
TRIS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,631,"NEONATE, BIRTH WEIGHT 750-999 GRAMS, DISCHARGED ALIVE",,,,,0
TRIS-DRG,632,"NEONATE, BIRTH WEIGHT 750-999 GRAMS, DIED",,,,,0
TRIS-DRG,633,"NEONATE, BIRTH WEIGHT 1000-1499 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, DISCHARGED ALIVE",,,,,0
TRIS-DRG,634,"NEONATE, BIRTH WEIGHT 1000-1499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, DISCHARGED ALIVE",,,,,0
TRIS-DRG,635,"NEONATE, BIRTH WEIGHT 1000-1499 GRAMS, DIED",,,,,0
TRIS-DRG,636,"NEONATE, BIRTH WEIGHT 1500-1999 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, WITH MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,637,DIABETES WITH MCC,,,,,0
TRIS-DRG,638,DIABETES WITH CC,,,,,0
TRIS-DRG,639,DIABETES WITHOUT CC/MCC,,,,,0
TRIS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES AGE >17 WITH MCC",,,,,0
TRIS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES AGE >17 WITHOUT MCC",,,,,0
TRIS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,,,0
TRIS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,,,0
TRIS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,,,0
TRIS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,646,"NEONATE, BIRTH WEIGHT 1500-1999 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, WITHOUT MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,647,"NEONATE, BIRTH WEIGHT 1500-1999 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,648,"NEONATE, BIRTH WEIGHT 1500-1999 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MAJOR PROBLEM",,,,,0
TRIS-DRG,649,"NEONATE, BIRTH WEIGHT 1500-1999 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MINOR PROBLEM",,,,,0
TRIS-DRG,650,"NEONATE, BIRTH WEIGHT 1500-1999 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH OTHER PROBLEM",,,,,0
TRIS-DRG,651,"NEONATE, BIRTH WEIGHT 2000-2499 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, WITH MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,652,KIDNEY TRANSPLANT,,,,,0
TRIS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,,,0
TRIS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,,,0
TRIS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,,,0
TRIS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,,,0
TRIS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,,,0
TRIS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,,,0
TRIS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,,,0
TRIS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,,,0
TRIS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,,,0
TRIS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,,,0
TRIS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,665,PROSTATECTOMY WITH MCC,,,,,0
TRIS-DRG,666,PROSTATECTOMY WITH CC,,,,,0
TRIS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,,,0
TRIS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,,,0
TRIS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,,,0
TRIS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,671,URETHRAL PROCEDURES AGE >17 WITH CC/MCC,,,,,0
TRIS-DRG,672,URETHRAL PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,,,0
TRIS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,,,0
TRIS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,676,"NEONATE, BIRTH WEIGHT 2000-2499 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, WITHOUT MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,677,"NEONATE, BIRTH WEIGHT 2000-2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,678,"NEONATE, BIRTH WEIGHT 2000-2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MAJOR PROBLEM",,,,,0
TRIS-DRG,679,"NEONATE, BIRTH WEIGHT 2000-2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MINOR PROBLEM",,,,,0
TRIS-DRG,680,"NEONATE, BIRTH WEIGHT 2000-2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH OTHER PROBLEM",,,,,0
TRIS-DRG,681,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, WITH MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,682,RENAL FAILURE WITH MCC,,,,,0
TRIS-DRG,683,RENAL FAILURE WITH CC,,,,,0
TRIS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,,,0
TRIS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,,,0
TRIS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,,,0
TRIS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,,,0
TRIS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS AGE >17 WITH MCC,,,,,0
TRIS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,691,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,,,0
TRIS-DRG,692,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,,,0
TRIS-DRG,693,URINARY STONES WITH MCC,,,,,0
TRIS-DRG,694,URINARY STONES WITHOUT MCC,,,,,0
TRIS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS AGE >17 WITH MCC,,,,,0
TRIS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,697,URETHRAL STRICTURE AGE >17,,,,,0
TRIS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES AGE >17 WITH MCC,,,,,0
TRIS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES AGE >17 WITH CC,,,,,0
TRIS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,711,TESTES PROCEDURES AGE >17 WITH CC/MCC,,,,,0
TRIS-DRG,712,TESTES PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,,,0
TRIS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,,,0
TRIS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,,,0
TRIS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,,,0
TRIS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,,,0
TRIS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,,,0
TRIS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,,,0
TRIS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,,,0
TRIS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,,,0
TRIS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,,,0
TRIS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,,,0
TRIS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,,,0
TRIS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,,,0
TRIS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,,,0
TRIS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,,,0
TRIS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,,,0
TRIS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,,,0
TRIS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,,,,0
TRIS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,,,,0
TRIS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,,,0
TRIS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,,,0
TRIS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,,,0
TRIS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,,,0
TRIS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,,,0
TRIS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,,,0
TRIS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,,,0
TRIS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,,,0
TRIS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,,,0
TRIS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,,,0
TRIS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,,,0
TRIS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,,,0
TRIS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,,,0
TRIS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,,,0
TRIS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,762,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,,,0
TRIS-DRG,763,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,,,0
TRIS-DRG,764,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,,,0
TRIS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,,,,0
TRIS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,,,0
TRIS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,,,0
TRIS-DRG,771,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,,,0
TRIS-DRG,772,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,,,0
TRIS-DRG,773,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,,,0
TRIS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,,,0
TRIS-DRG,779,ABORTION WITHOUT D&C,,,,,0
TRIS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,,,0
TRIS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,,,0
TRIS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,,,0
TRIS-DRG,787,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITH SIGNIFICANT O.R. PROCEDURES, WITHOUT MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,788,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITH MINOR ABDOMINAL PROCEDURES",,,,,0
TRIS-DRG,789,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MULTIPLE MAJOR PROBLEMS",,,,,0
TRIS-DRG,790,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MAJOR PROBLEM",,,,,0
TRIS-DRG,791,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH MINOR PROBLEM",,,,,0
TRIS-DRG,792,"NEONATE, BIRTH WEIGHT >2499 GRAMS, WITHOUT SIGNIFICANT O.R. PROCEDURES, WITH OTHER PROBLEM",,,,,0
TRIS-DRG,793,NEONATAL AFTERCARE FOR WEIGHT GAIN,,,,,0
TRIS-DRG,794,"NEONATAL DIAGNOSIS, AGE >28 DAYS",,,,,0
TRIS-DRG,795,NORMAL NEWBORN,,,,,0
TRIS-DRG,796,"MULTIPLE, OTHER AND UNSPECIFIED CONGENITAL ANOMALIES, WITH CC/MCC",,,,,0
TRIS-DRG,797,"MULTIPLE, OTHER AND UNSPECIFIED CONGENITAL ANOMALIES, WITHOUT CC/MCC",,,,,0
TRIS-DRG,799,SPLENIC PROCEDURES AGE >17 WITH MCC,,,,,0
TRIS-DRG,800,SPLENIC PROCEDURES AGE >17 WITH CC,,,,,0
TRIS-DRG,801,SPLENIC PROCEDURES AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,,,0
TRIS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,,,0
TRIS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,,,0
TRIS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,,,,0
TRIS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,,,,0
TRIS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,,,,0
TRIS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,,,0
TRIS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,,,0
TRIS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,811,RED BLOOD CELL DISORDERS AGE >17 WITH MCC,,,,,0
TRIS-DRG,812,RED BLOOD CELL DISORDERS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,813,COAGULATION DISORDERS,,,,,0
TRIS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,,,0
TRIS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,,,0
TRIS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,,,0
TRIS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,,,0
TRIS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,,,0
TRIS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,,,0
TRIS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,834,ACUTE LEUKEMIA AGE >17 WITH MCC,,,,,0
TRIS-DRG,835,ACUTE LEUKEMIA AGE >17 WITH CC,,,,,0
TRIS-DRG,836,ACUTE LEUKEMIA AGE >17 WITHOUT CC/MCC,,,,,0
TRIS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,,,0
TRIS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,,,0
TRIS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,,,0
TRIS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,,,0
TRIS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,,,0
TRIS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,,,0
TRIS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,,,0
TRIS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,,,0
TRIS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,,,0
TRIS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,,,0
TRIS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,849,RADIOTHERAPY,,,,,0
TRIS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,,,0
TRIS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,,,0
TRIS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,,,0
TRIS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,,,0
TRIS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,,,0
TRIS-DRG,864,"FEVER AND INFLAMMATORY CONDITIONS, AGE >17",,,,,0
TRIS-DRG,865,VIRAL ILLNESS AGE >17 WITH MCC,,,,,0
TRIS-DRG,866,VIRAL ILLNESS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,,,0
TRIS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,,,0
TRIS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,,,0
TRIS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,,,0
TRIS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS AGE >17 WITH MCC,,,,,0
TRIS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,,,0
TRIS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,,,0
TRIS-DRG,881,DEPRESSIVE NEUROSES,,,,,0
TRIS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,,,0
TRIS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,,,0
TRIS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,,,0
TRIS-DRG,885,PSYCHOSES,,,,,0
TRIS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,,,0
TRIS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,,,0
TRIS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,,,0
TRIS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,,,0
TRIS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,,,0
TRIS-DRG,898,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY AGE >21 WITHOUT MCC",,,,,0
TRIS-DRG,899,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY AGE <=21 WITHOUT MCC",,,,,0
TRIS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,,,0
TRIS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,,,0
TRIS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,,,0
TRIS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,,,0
TRIS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,,,0
TRIS-DRG,906,HAND PROCEDURES FOR INJURIES,,,,,0
TRIS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,,,0
TRIS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,,,0
TRIS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,,,0
TRIS-DRG,913,TRAUMATIC INJURY AGE >17 WITH MCC,,,,,0
TRIS-DRG,914,TRAUMATIC INJURY AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,915,ALLERGIC REACTIONS AGE >17 WITH MCC,,,,,0
TRIS-DRG,916,ALLERGIC REACTIONS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS AGE >17 WITH MCC,,,,,0
TRIS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS AGE >17 WITHOUT MCC,,,,,0
TRIS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,,,0
TRIS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,,,0
TRIS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,,,0
TRIS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,,,0
TRIS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,,,0
TRIS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,,,0
TRIS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,,,0
TRIS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,,,0
TRIS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,,,0
TRIS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,,,0
TRIS-DRG,935,NON-EXTENSIVE BURNS,,,,,0
TRIS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,,,0
TRIS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,,,0
TRIS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,,,0
TRIS-DRG,945,REHABILITATION WITH CC/MCC,,,,,0
TRIS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,,,0
TRIS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,,,0
TRIS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,,,0
TRIS-DRG,949,AFTERCARE WITH CC/MCC,,,,,0
TRIS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,,,0
TRIS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,,,0
TRIS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,,,0
TRIS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,,,0
TRIS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,,,0
TRIS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,,,0
TRIS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,,,0
TRIS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,,,0
TRIS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,,,0
TRIS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,,,0
TRIS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,,,0
TRIS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,,,0
TRIS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,,,0
TRIS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,,,0
TRIS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,,,0
TRIS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,,,0
TRIS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,,,0
TRIS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,,,0
TRIS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,,,0
TRIS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,,,0
TRIS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,,,0
TRIS-DRG,998,PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,,,,,0
TRIS-DRG,999,UNGROUPABLE,,,,,0