code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
,,Bilateral Procedures,,,,,0
,,CT services furnished with equipment that don't meet NEMA standard,,,,,0
,,Computed radiography x-ray,,,,,0
,,Discontinued Procedure,,,,,0
,,Excepted off-campus service,,,,,0
,,Non-excepted off-campus service,,,,,0
,,X-ray taken using film,,,,,0
CDM,10272,R&B NURSERY LEVEL 3,8939.0,3754.38,7598.15,8760.22,13
CDM,11049,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,11064,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,12369,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,12419,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,12435,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,12450,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,13276,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,19265,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,19406,R&B ICU INTERMEDIATE,5364.0,2252.88,4559.4,5256.72,13
CDM,21048,R&B MEDICAL/SURGICAL SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,21063,R&B MEDICAL/SURGICAL SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,22368,R&B MEDICAL/SURGICAL SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,22418,R&B MEDICAL/SURGICAL SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,22434,R&B MEDICAL/SURGICAL SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,2360,R&B PEDIATRICS SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,2436,R&B PEDIATRICS SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,2601359,INF IV HYDRATION 31-60MIN,675.0,283.5,182.25,661.5,37
CDM,2601367,INF IV HYDRATION ADDL HR,237.0,99.54,47.84,232.26,37
CDM,2601375,INF IV THRPY 1ST HR,640.0,268.8,172.8,627.2,37
CDM,2601383,INF IV THRPY ADDL HR,234.0,98.28,47.84,229.32,37
CDM,2601409,INF IV THRPY CONCURRENT,426.0,178.92,115.02,417.48,30
CDM,273,R&B OBSTETRICS PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,2770006,IMP ADPT/EXT LD PACING/NEURO LVL 02,4397.0,1846.74,1187.19,4309.06,30
CDM,2770055,CLIP APPLIER LVL 01,594.0,249.48,160.38,582.12,30
CDM,2770063,CLIP APPLIER LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2770170,BIT LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2770287,BLADE LVL 07,2157.0,905.94,582.39,2113.86,30
CDM,2770329,HYPO-HYPER THERMAL LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770337,IMP BOLT LVL 01,709.0,297.78,191.43,694.82,30
CDM,2770345,IMP BOLT LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,2770352,IMP BONE HUMAN/SYNTHETIC LVL 01,594.0,249.48,160.38,582.12,30
CDM,2770360,IMP BONE HUMAN/SYNTHETIC LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,2770378,IMP BONE HUMAN/SYNTHETIC LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2770386,IMP BONE HUMAN/SYNTHETIC LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,2770394,IMP BONE HUMAN/SYNTHETIC LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,2770402,IMP BONE HUMAN/SYNTHETIC LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2770410,IMP BONE HUMAN/SYNTHETIC LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,2770428,IMP BONE HUMAN/SYNTHETIC LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,2770436,IMP BONE HUMAN/SYNTHETIC LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,2770444,IMP BONE HUMAN/SYNTHETIC LVL 10,21904.0,9199.68,5914.08,21465.92,30
CDM,2770451,BOWL CELL SAVER LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,2770469,BRA SURG POSTOP LVL 02,447.0,187.74,120.69,438.06,30
CDM,2770477,BRUSH LVL 02,447.0,187.74,120.69,438.06,30
CDM,2770485,BRUSH LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770493,IMP AGENT COLLAGN BULK 2.5ML LVL 06,20152.0,8463.84,5441.04,19748.96,30
CDM,2770501,IMP AGENT SYNTHETIC BULK 1ML LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770519,BURR LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770527,BURR LVL 02,313.0,131.46,84.51,306.74,30
CDM,2770535,BURR LVL 03,447.0,187.74,120.69,438.06,30
CDM,2770543,BURR LVL 04,594.0,249.48,160.38,582.12,30
CDM,2770550,BURR LVL 05,1132.0,475.44,305.64,1109.36,30
CDM,2770568,BURR LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2770584,IMP CABLE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2770592,IMP CABLE LVL 02,844.0,354.48,227.88,827.12,30
CDM,2770600,IMP CABLE LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,2770618,IMP CABLE LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2770626,IMP CABLE LVL 05,3596.0,1510.32,970.92,3524.08,30
CDM,2770634,CANNULA LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770642,CANNULA LVL 02,313.0,131.46,84.51,306.74,30
CDM,2770659,CANNULA LVL 03,594.0,249.48,160.38,582.12,30
CDM,2770667,CANNULA LVL 04,850.0,357.0,229.5,833.0,30
CDM,2770675,IMP PROSTH OPHTHALMIC LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2770683,CANNULA LVL 05,1132.0,475.44,305.64,1109.36,30
CDM,2770691,IMP VALVE LVL 08,35044.0,14718.48,9461.88,34343.12,30
CDM,2770709,IMP VALVE LVL 09,39424.0,16558.08,10644.48,38635.52,30
CDM,2770725,IMP VALVE LVL 10,43804.0,18397.68,11827.08,42927.92,30
CDM,2770733,IMP PROSTH OPHTHALMIC LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,2770741,CATH ABL COOL-TIP LVL 05,5861.0,2461.62,1582.47,5743.78,30
CDM,2770758,CATH ABL EP 3D/VECTOR LVL 01,2157.0,905.94,582.39,2113.86,30
CDM,2770766,CATH ABL EP NON 3D/VECTOR LVL 01,1619.0,679.98,437.13,1586.62,30
CDM,2770774,CATH ANGIO TRANSL LASER LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2770782,CATH ANGIO TRANSL NONLASER LVL 01,850.0,357.0,229.5,833.0,30
CDM,2770790,CATH ATHERECT TRANSL DIRECT LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2770808,CATH ATHERECT TRANSL ROTAT LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2770816,CATH BALLOON LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770824,CATH BALLOON DILAT NONVASC LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,2770857,CATH DIAGNOSTIC LVL 01,102.0,42.84,27.54,99.96,30
CDM,2770865,CATH CHOLANGIOGRAM LVL 01,313.0,131.46,84.51,306.74,30
CDM,2770873,CATH EP NON 3D 1-19 LVL 01,594.0,249.48,160.38,582.12,30
CDM,2770881,CATH EP NON 3D 20+ LVL 01,3083.0,1294.86,832.41,3021.34,30
CDM,2770899,CATH ENDOBRONCHIAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2770907,CATH FEEDING LVL 01,594.0,249.48,160.38,582.12,30
CDM,2770915,CATH GUIDE LVL 01,166.0,69.72,44.82,162.68,30
CDM,2770923,CATH HEM/PER SHORT TERM LVL 01,313.0,131.46,84.51,306.74,30
CDM,2770931,IMP CATH HEM/PER LONG TERM LVL 01,313.0,131.46,84.51,306.74,30
CDM,2770949,CATH HYDROPHYLIC LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2770956,CATH INF NON HEMODIALYSIS LVL 01,313.0,131.46,84.51,306.74,30
CDM,2770964,CATH INTRACARDIAC ECHO LVL 02,3596.0,1510.32,970.92,3524.08,30
CDM,2770980,CATH INTRASPINAL LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,2770998,CATH INTRAVASCULAR US LVL 01,850.0,357.0,229.5,833.0,30
CDM,2771012,CATH OCCLUSION LVL 01,594.0,249.48,160.38,582.12,30
CDM,2771020,CATH BALLOON PACING LVL 01,594.0,249.48,160.38,582.12,30
CDM,2771046,CATH SPINAL/NEURO LVL 01,850.0,357.0,229.5,833.0,30
CDM,2771053,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 01,251.0,105.42,67.77,245.98,30
CDM,2771061,CATH THROMBECTOMY/EMBOLECTMY LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771079,CATH URETERAL LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771087,CATH URETHRAL LVL 02,166.0,69.72,44.82,162.68,30
CDM,2771095,ELECTRODE ELECTROSURGICAL LVL 01,166.0,69.72,44.82,162.68,30
CDM,2771103,ELECTRODE ELECTROSURGICAL LVL 02,313.0,131.46,84.51,306.74,30
CDM,2771111,ELECTRODE ELECTROSURGICAL LVL 03,447.0,187.74,120.69,438.06,30
CDM,2771129,ELECTRODE ELECTROSURGICAL LVL 04,594.0,249.48,160.38,582.12,30
CDM,2771137,IMP VALVE LVL 11,52564.0,22076.88,14192.28,51512.72,30
CDM,2771145,ELECTRODE ELECTROSURGICAL LVL 05,850.0,357.0,229.5,833.0,30
CDM,2771152,ELECTRODE ELECTROSURGICAL LVL 06,1413.0,593.46,381.51,1384.74,30
CDM,2771160,ELECTRODE ELECTROSURGICAL LVL 07,1888.0,792.96,509.76,1850.24,30
CDM,2771178,ELECTRODE ELECTROSURGICAL LVL 08,2695.0,1131.9,727.65,2641.1,30
CDM,2771186,IMP PROSTH ENT LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2771194,IMP CEMENT LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771202,CEMENT ACCESSORIES LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771210,IMP CEMENT ACCESSORY LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771228,IMP CEMENT LVL 02,594.0,249.48,160.38,582.12,30
CDM,2771236,IMP CEMENT LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2771277,CLIP LVL 01,166.0,69.72,44.82,162.68,30
CDM,2771285,IMP CLIP ANEURYSM LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2771301,IMP DEV CLOSURE VASCULAR LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771319,IMP COIL EMBOLIZATION LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771327,COIL IMAGING MAGNETIC RESON LVL 01,313.0,131.46,84.51,306.74,30
CDM,2771335,THERAPY COLD LVL 02,850.0,357.0,229.5,833.0,30
CDM,2771343,IMP COVER BURR HOLE LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2771350,CATH ABL EP NON 3D/VECTOR LVL 02,3083.0,1294.86,832.41,3021.34,30
CDM,2771368,CATH ABL EP NON 3D/VECTOR LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2771376,CATH ABL EP NON 3D/VECTOR LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,2771384,CATH ANGIO TRANSL LASER LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2771400,IMP ACCESS SYSTEM DIALYS LVL 01,594.0,249.48,160.38,582.12,30
CDM,2771418,DIALYSIS ACCESSORIES LVL 01,166.0,69.72,44.82,162.68,30
CDM,2771426,DILATOR LVL 01,166.0,69.72,44.82,162.68,30
CDM,2771434,DILATOR LVL 02,313.0,131.46,84.51,306.74,30
CDM,2771442,DILATOR LVL 03,850.0,357.0,229.5,833.0,30
CDM,2771459,DILATOR LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,2771467,DILATOR LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2771475,DRAIN LVL 02,134.0,56.28,36.18,131.32,30
CDM,2771483,DRAIN LVL 03,313.0,131.46,84.51,306.74,30
CDM,2771491,DRAIN LVL 04,594.0,249.48,160.38,582.12,30
CDM,2771509,DRAIN LVL 05,1132.0,475.44,305.64,1109.36,30
CDM,2771517,PUNCH LVL 02,594.0,249.48,160.38,582.12,30
CDM,2771525,RESERVOIR NEURO LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2771533,DRAIN REINFUSION LVL 01,594.0,249.48,160.38,582.12,30
CDM,2771558,DRAIN W ACCESSORIES LVL 01,190.0,79.8,51.3,186.2,30
CDM,2771566,DRESSING SPECIALTY LVL 02,166.0,69.72,44.82,162.68,30
CDM,2771574,DRESSING SPECIALTY LVL 03,313.0,131.46,84.51,306.74,30
CDM,2771582,DRESSING SPECIALTY LVL 04,594.0,249.48,160.38,582.12,30
CDM,2771590,DRESSING SPECIALTY LVL 05,1132.0,475.44,305.64,1109.36,30
CDM,2771608,DRESSING SPECIALTY LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2771616,IMP DEV JT KNEE TOTAL LVL 19,87604.0,36793.68,23653.08,85851.92,30
CDM,2771624,CATH BALLOON PACING LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2771632,IMP EXPANDER TISSUE LVL 01,2426.0,1018.92,655.02,2377.48,30
CDM,2771640,IMP EXPANDER TISSUE LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2771657,IMP EXPANDER TISSUE LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,2771673,CATH ANGIO TRANSL NONLASER LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,2771681,CATH ANGIO TRANSL NONLASER LVL 03,1888.0,792.96,509.76,1850.24,30
CDM,2771699,CATH ANGIO TRANSL NONLASER LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2771707,CATH ANGIO TRANSL NONLASER LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,2771715,CATH EP NON 3D 20+ LVL 02,5861.0,2461.62,1582.47,5743.78,30
CDM,2771723,CATH ANGIO TRANSL NONLASER LVL 06,4397.0,1846.74,1187.19,4309.06,30
CDM,2771731,CATH ANGIO TRANSL NONLASER LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,2771749,CATH ANGIO TRANSL NONLASER LVL 08,7413.0,3113.46,2001.51,7264.74,30
CDM,2771756,CATH ANGIO TRANSL NONLASER LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,2771764,CATH FEEDING LVL 02,850.0,357.0,229.5,833.0,30
CDM,2771772,CATH INF NON HEMODIALYSIS LVL 02,594.0,249.48,160.38,582.12,30
CDM,2771780,CATH INF NON HEMODIALYSIS LVL 03,850.0,357.0,229.5,833.0,30
CDM,2771798,CATH INF NON HEMODIALYSIS LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2771806,CATH INF NON HEMODIALYSIS LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,2771814,CATH INF NON HEMODIALYSIS LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2771822,CATH INF NON HEMODIALYSIS LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2771830,CATH INF NON HEMODIALYSIS LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,2771848,CATH INF NON HEMODIALYSIS LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,2771855,CATH INTRAUTERN/HYST LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2771863,CATH INTRAVASCULAR US LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,2771871,CATH INTRAUTERN/HYST LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2771889,CATH INTRAUTERN/HYST LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2771897,CATH INTRAUTERN/HYST LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2771905,CATH INTRAVASCULAR US LVL 02,2426.0,1018.92,655.02,2377.48,30
CDM,2771921,CATH OCCLUSION LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2771939,CATH OCCLUSION LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2771947,CATH OCCLUSION LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2771954,CATH OCCLUSION LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2771962,CATH OCCLUSION LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2771970,CATH BALLOON PACING LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2771988,CATH BALLOON PACING LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2771996,CATH SPINAL/NEURO LVL 02,1888.0,792.96,509.76,1850.24,30
CDM,2772002,IMP EMBOLIZATION AGENT LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,2772010,CATH SPINAL/NEURO LVL 03,2827.0,1187.34,763.29,2770.46,30
CDM,2772028,CATH SPINAL/NEURO LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,2772044,IMP VALVE LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,2772119,IMP FILTER VENA CAVA LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2772143,IMP GRAFT VASCULAR LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772150,IMP GRAFT VASCULAR LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2772168,IMP GRAFT VASCULAR LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2772176,IMP GRAFT VASCULAR LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2772184,IMP GRAFT VASCULAR LVL 09,6950.0,2919.0,1876.5,6811.0,30
CDM,2772192,IMP GRAFT VASCULAR LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2772200,IMP GRAFT VASCULAR LVL 06,3083.0,1294.86,832.41,3021.34,30
CDM,2772218,IMP GRAFT VASCULAR LVL 07,3909.0,1641.78,1055.43,3830.82,30
CDM,2772226,IMP GRAFT VASCULAR LVL 08,4885.0,2051.7,1318.95,4787.3,30
CDM,2772234,IMP GRAFT VASCULAR LVL 10,9265.0,3891.3,2501.55,9079.7,30
CDM,2772242,PIN GUIDE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2772259,PIN GUIDE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2772267,PIN GUIDE LVL 03,850.0,357.0,229.5,833.0,30
CDM,2772275,WIRE GUIDE LVL 01,166.0,69.72,44.82,162.68,30
CDM,2772283,WIRE GUIDE LVL 02,313.0,131.46,84.51,306.74,30
CDM,2772291,WIRE GUIDE LVL 03,594.0,249.48,160.38,582.12,30
CDM,2772309,HANDPIECE LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772317,HANDPIECE LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2772325,HANDPIECE LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2772333,HARVESTER LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,2772341,HEMOSTATIC AGENT LVL 01,313.0,131.46,84.51,306.74,30
CDM,2772358,HEMOSTATIC AGENT LVL 02,594.0,249.48,160.38,582.12,30
CDM,2772366,HEMOSTATIC AGENT LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2772374,IMP ICD CHAMBER NON SGL/DUAL LVL 04,96364.0,40472.88,26018.28,94436.72,30
CDM,2772382,IMP ICD CHAMBER DUAL LVL 02,65704.0,27595.68,17740.08,64389.92,30
CDM,2772390,IMP ICD CHAMBER SGL LVL 02,65704.0,27595.68,17740.08,64389.92,30
CDM,2772408,IMMOBILIZER LVL 01,166.0,69.72,44.82,162.68,30
CDM,2772416,IMMOBILIZER LVL 02,313.0,131.46,84.51,306.74,30
CDM,2772424,IMMOBILIZER LVL 03,594.0,249.48,160.38,582.12,30
CDM,2772432,IMMOBILIZER LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2772440,RESERVOIR THORACIC LVL 02,850.0,357.0,229.5,833.0,30
CDM,2772457,IMP NEURO LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772465,INSERTER LVL 01,166.0,69.72,44.82,162.68,30
CDM,2772473,INSERTER LVL 02,313.0,131.46,84.51,306.74,30
CDM,2772481,INSERTER LVL 03,594.0,249.48,160.38,582.12,30
CDM,2772499,IMP DEV URINARY W SLING LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2772507,IMP DEV URINARY WO SLNG LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,2772515,INSTRUMENT DISP MULTIPLE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2772523,INSTRUMENT DISP MULTIPLE LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2772531,INSTRUMENT DISP MULTIPLE LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2772549,INSTRUMENT DISP MULTIPLE LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,2772556,INSTRUMENT DISP MULTIPLE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2772564,INSTRUMENT DISP SINGLE LVL 01,190.0,79.8,51.3,186.2,30
CDM,2772572,INSTRUMENT DISP SINGLE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2772580,INSTRUMENT DISP SINGLE LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2772598,INSTRUMENT DISP SINGLE LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2772606,INSTRUMENT DISP SINGLE LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,2772622,IMP FIX SPINE LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772630,IMP FIX SPINE LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2772648,IMP FIX SPINE LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2772655,IMP FIX SPINE LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2772663,IMP STENT NONCOR TEMP WO DEL LVL 02,594.0,249.48,160.38,582.12,30
CDM,2772671,IMP FIX SPINE LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2772689,IMP FIX SPINE LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2772697,IMP FIX SPINE LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,2772705,IMP FIX SPINE LVL 08,21904.0,9199.68,5914.08,21465.92,30
CDM,2772713,IMP STENT NONCOR TEMP WO DEL LVL 03,850.0,357.0,229.5,833.0,30
CDM,2772721,IMP STENT NONCOR TEMP WO DEL LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2772739,IMP STENT NONCOR TEMP WO DEL LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,2772770,INTRO EP FIX CRV NONPEEL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772788,INTRO EP FIX CRV PEEL LVL 01,313.0,131.46,84.51,306.74,30
CDM,2772804,INTRO LVL 01,166.0,69.72,44.82,162.68,30
CDM,2772812,INTRO LVL 02,313.0,131.46,84.51,306.74,30
CDM,2772820,INTRO LVL 03,594.0,249.48,160.38,582.12,30
CDM,2772846,INTRO EP STEER NONPEEL LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2772853,TAPS LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2772861,TAPS LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2772879,IRRIGATOR/ACCESSORY LVL 01,313.0,131.46,84.51,306.74,30
CDM,2772887,IRRIGATOR/ACCESSORY LVL 02,594.0,249.48,160.38,582.12,30
CDM,2772895,IRRIGATOR/ACCESSORY LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2772903,KNOT PUSHER LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772911,LASER FIBER LVL 01,594.0,249.48,160.38,582.12,30
CDM,2772929,LASER FIBER LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2772937,LASER FIBER LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2772945,LASER FIBER LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2772952,LASER FIBER LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,2772960,LASER PROBE LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,2772978,LASER PROBE LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2772986,LASER PROBE LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,2772994,LASER PROBE LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,2773000,LASER PROBE LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,2773018,IMP LD ICD COIL DUAL LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2773026,IMP LD ICD NON SGL/DUAL LVL 04,6950.0,2919.0,1876.5,6811.0,30
CDM,2773034,IMP LD ICD COIL SGL LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2773042,IMP LD NEUROSTIM LVL 01,6950.0,2919.0,1876.5,6811.0,30
CDM,2773059,IMP LD NEUROSTIM TEST KIT LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2773067,IMP LD PCMKR/ICD COMBO LVL 01,594.0,249.48,160.38,582.12,30
CDM,2773075,IMP LD PCMKR NON VDD LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2773083,IMP LD PCMKR VDD LVL 02,6950.0,2919.0,1876.5,6811.0,30
CDM,2773125,LENS INTRAOCULAR NEW TECH LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2773133,LENS INTRAOCULAR NEW TECH LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,2773141,MAMMOTOME LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773158,IMP MARKER TISSUE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773166,IMP MESH LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773174,IMP MESH LVL 02,594.0,249.48,160.38,582.12,30
CDM,2773182,IMP MESH LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2773190,IMP MESH LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2773208,IMP MESH LVL 09,11580.0,4863.6,3126.6,11348.4,30
CDM,2773216,IMP MESH LVL 05,3596.0,1510.32,970.92,3524.08,30
CDM,2773224,IMP MESH LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,2773232,IMP MESH LVL 07,6950.0,2919.0,1876.5,6811.0,30
CDM,2773240,IMP MESH LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,2773257,IMP MESH LVL 10,15334.0,6440.28,4140.18,15027.32,30
CDM,2773315,MORCELLATOR LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,2773331,NEEDLE BIOPSY LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773349,NEEDLE BIOPSY LVL 02,313.0,131.46,84.51,306.74,30
CDM,2773356,NEEDLE BIOPSY LVL 03,594.0,249.48,160.38,582.12,30
CDM,2773364,NEEDLE BRACHYTHERAPY LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773380,NEEDLE INSUFFLATION LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773398,NEEDLE INSUFFLATION LVL 02,313.0,131.46,84.51,306.74,30
CDM,2773406,NEEDLE SPECIALTY LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773414,NEEDLE SPECIALTY LVL 02,313.0,131.46,84.51,306.74,30
CDM,2773422,NEEDLE SPECIALTY LVL 03,850.0,357.0,229.5,833.0,30
CDM,2773430,NEEDLE SPECIALTY LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,2773448,NEEDLE SPECIALTY LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,2773455,SUPPLY NEURO LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773463,SUPPLY NEURO LVL 02,313.0,131.46,84.51,306.74,30
CDM,2773471,SUPPLY NEURO LVL 03,850.0,357.0,229.5,833.0,30
CDM,2773505,OBTURATOR DISPOSABLE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773513,OCCLUDER LVL 01,594.0,249.48,160.38,582.12,30
CDM,2773521,OCCLUDER LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2773570,SUPPLY OSTOMY LVL 02,134.0,56.28,36.18,131.32,30
CDM,2773588,SUPPLY OSTOMY LVL 03,359.0,150.78,96.93,351.82,30
CDM,2773596,SUPPLY OSTOMY LVL 04,709.0,297.78,191.43,694.82,30
CDM,2773604,PACER ACCESSORY LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773620,IMP PCMKR DUAL NON RR LVL 03,28474.0,11959.08,7687.98,27904.52,30
CDM,2773638,IMP PCMKR DUAL RR LVL 02,21904.0,9199.68,5914.08,21465.92,30
CDM,2773646,IMP PCMKR NONSGL OR DUAL LVL 05,43804.0,18397.68,11827.08,42927.92,30
CDM,2773653,IMP PCMKR SGL NON RR LVL 04,28474.0,11959.08,7687.98,27904.52,30
CDM,2773661,IMP PCMKR SGL RR LVL 03,21904.0,9199.68,5914.08,21465.92,30
CDM,2773679,CATH/WIRE/SUTURE PASSER LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773687,SUPPLY PERFUSION/ECMO LVL 01,102.0,42.84,27.54,99.96,30
CDM,2773695,SUPPLY PERFUSION/ECMO LVL 02,221.0,92.82,59.67,216.58,30
CDM,2773703,SUPPLY PERFUSION/ECMO LVL 03,447.0,187.74,120.69,438.06,30
CDM,2773711,SUPPLY PERFUSION/ECMO LVL 04,850.0,357.0,229.5,833.0,30
CDM,2773729,SUPPLY PERFUSION/ECMO LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,2773737,IMP PIN/WIRE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773745,IMP PIN/WIRE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2773752,IMP PIN/WIRE LVL 03,850.0,357.0,229.5,833.0,30
CDM,2773778,RETRIEVER BASKET LVL 02,594.0,249.48,160.38,582.12,30
CDM,2773786,IMP PLATE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2773794,IMP PLATE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2773802,IMP PLATE LVL 03,850.0,357.0,229.5,833.0,30
CDM,2773810,IMP PLATE LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2773828,IMP PLATE LVL 09,6105.0,2564.1,1648.35,5982.9,30
CDM,2773836,IMP PLATE LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,2773844,IMP PLATE LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2773851,IMP PLATE LVL 07,3596.0,1510.32,970.92,3524.08,30
CDM,2773869,IMP PLATE LVL 08,4885.0,2051.7,1318.95,4787.3,30
CDM,2773877,IMP PLATE LVL 10,6950.0,2919.0,1876.5,6811.0,30
CDM,2773885,IMP CATH PORT INDWELLING LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773893,PROBE LVL 01,166.0,69.72,44.82,162.68,30
CDM,2773901,PROBE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2773919,PROBE LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2773927,RETRIEVER BASKET LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2773935,PROGRAMMER PT NEUROSTIM LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2773943,IMP PROSTH ANKLE LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2773950,IMP PROSTH ANKLE LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2773968,IMP PROSTH ANKLE LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2773976,IMP PROSTH ANKLE LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,2773984,RETRIEVER BASKET LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2773992,IMP PROSTH ANKLE LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,2774008,RETRIEVER BASKET LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2774016,RETRIEVER SUTURE LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2774024,IMP RING CARDIAC LVL 01,9265.0,3891.3,2501.55,9079.7,30
CDM,2774032,IMP RING CARDIAC LVL 02,13895.0,5835.9,3751.65,13617.1,30
CDM,2774040,IMP ROD/NAIL LVL 07,6487.0,2724.54,1751.49,6357.26,30
CDM,2774099,IMP PROSTH BREAST LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2774107,IMP PROSTH BREAST LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2774115,IMP PROSTH BREAST LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,2774123,IMP VALVE LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2774131,IMP VALVE LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2774149,IMP VALVE LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2774156,IMP VALVE LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,2774164,IMP VALVE LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,2774172,IMP DEV COCHLEAR INT&EXT CMP LVL 05,109504.0,45991.68,29566.08,107313.92,30
CDM,2774180,IMP DEV JT ELBOW TOTAL LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2774198,IMP DEV JT ELBOW TOTAL LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2774206,IMP DEV JT ELBOW TOTAL LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2774214,IMP DEV JT ELBOW TOTAL LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,2774230,IMP DEV JT ELBOW TOTAL LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,2774248,IMP SHUNT LVL 06,3909.0,1641.78,1055.43,3830.82,30
CDM,2774255,IMP SHUNT LVL 07,6487.0,2724.54,1751.49,6357.26,30
CDM,2774263,IMP SHUNT LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,2774271,IMP SHUNT LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,2774289,IMP STENT NONCOAT WO DEL LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,2774297,IMP STENT NONCOAT WO DEL LVL 08,11580.0,4863.6,3126.6,11348.4,30
CDM,2774305,SNARE LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,2774313,IMP EMBOLIZATION SPHERE LVL 02,3596.0,1510.32,970.92,3524.08,30
CDM,2774321,IMP EMBOLIZATION SPHERE LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2774339,IMP PROSTH ENT LVL 01,594.0,249.48,160.38,582.12,30
CDM,2774347,IMP PROSTH ENT LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2774354,IMP PROSTH ENT LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2774362,IMP DEV JT FINGER LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2774370,IMP DEV JT FINGER LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2774388,IMP DEV JT FINGER LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,2774404,IMP DEV JT FINGER LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,2774412,TUBE CHEST LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2774420,TUBE SPECIALTY LVL 11,3596.0,1510.32,970.92,3524.08,30
CDM,2774446,IMP TISSUE CONNECT NONHUMAN LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2774453,IMP TISSUE CONNECT NONHUMAN LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2774461,TRANSDUCER LVL 02,850.0,357.0,229.5,833.0,30
CDM,2774479,TRANSDUCER LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,2774487,TUBE CHEST LVL 02,313.0,131.46,84.51,306.74,30
CDM,2774495,TUBE CHEST LVL 03,594.0,249.48,160.38,582.12,30
CDM,2774503,IMP DEV JT FINGER LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2774511,IMP DEV JT HIP TOTAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2774529,IMP DEV JT HIP TOTAL LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2774537,IMP DEV JT HIP TOTAL LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2774545,IMP DEV JT HIP TOTAL LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2774552,IMP DEV JT HIP TOTAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,2774560,IMP DEV JT HIP TOTAL LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2774578,IMP DEV JT HIP TOTAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,2774586,IMP DEV JT HIP TOTAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,2774594,IMP DEV JT HIP TOTAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,2774602,IMP DEV JT HIP TOTAL LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,2774610,IMP DEV JT HIP TOTAL LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,2774628,IMP DEV JT HIP TOTAL LVL 12,35044.0,14718.48,9461.88,34343.12,30
CDM,2774636,IMP DEV JT HIP TOTAL LVL 13,43804.0,18397.68,11827.08,42927.92,30
CDM,2774644,IMP DEV JT HIP TOTAL LVL 14,52564.0,22076.88,14192.28,51512.72,30
CDM,2774651,IMP EMBOLIZATION SPHERE LVL 04,6950.0,2919.0,1876.5,6811.0,30
CDM,2774669,IMP DEV JT HIP TOTAL LVL 15,65704.0,27595.68,17740.08,64389.92,30
CDM,2774677,IMP DEV JT HIP TOTAL LVL 16,87604.0,36793.68,23653.08,85851.92,30
CDM,2774685,IMP STAPLE BONE LVL 04,991.0,416.22,267.57,971.18,30
CDM,2774693,STAPLE RELOAD LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2774701,STAPLE RELOAD LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2774719,IMP DEV JT KNEE TOTAL LVL 15,56944.0,23916.48,15374.88,55805.12,30
CDM,2774727,IMP DEV JT KNEE TOTAL LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,2774735,IMP DEV JT KNEE TOTAL LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,2774743,IMP DEV JT KNEE TOTAL LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,2774750,IMP DEV JT KNEE TOTAL LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,2774768,IMP DEV JT KNEE TOTAL LVL 12,43804.0,18397.68,11827.08,42927.92,30
CDM,2774776,IMP DEV JT KNEE TOTAL LVL 08,26284.0,11039.28,7096.68,25758.32,30
CDM,2774784,IMP DEV JT KNEE TOTAL LVL 09,30664.0,12878.88,8279.28,30050.72,30
CDM,2774792,IMP DEV JT KNEE TOTAL LVL 10,35044.0,14718.48,9461.88,34343.12,30
CDM,2774800,IMP DEV JT KNEE TOTAL LVL 11,39424.0,16558.08,10644.48,38635.52,30
CDM,2774818,IMP DEV JT KNEE TOTAL LVL 13,48184.0,20237.28,13009.68,47220.32,30
CDM,2774826,IMP DEV JT KNEE TOTAL LVL 14,52564.0,22076.88,14192.28,51512.72,30
CDM,2774834,IMP DEV JT KNEE TOTAL LVL 16,61324.0,25756.08,16557.48,60097.52,30
CDM,2774842,IMP DEV JT KNEE TOTAL LVL 17,70084.0,29435.28,18922.68,68682.32,30
CDM,2774859,IMP DEV JT KNEE TOTAL LVL 18,78844.0,33114.48,21287.88,77267.12,30
CDM,2774867,RESERVOIR OTHER LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2774875,IMP PROSTH MAXILLOFACIAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2774883,IMP PROSTH MAXILLOFACIAL LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,2774891,IMP PROSTH MAXILLOFACIAL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2774909,IMP PROSTH MAXILLOFACIAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,2774917,IMP PUMP INF NONPRG TMP LVL 05,43804.0,18397.68,11827.08,42927.92,30
CDM,2774925,IMP PROSTH MAXILLOFACIAL LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,2774933,IMP PUMP INF NONPRG TMP LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2774941,IMP PUMP INF NONPRG TMP LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2774958,IMP PUMP INF NONPRG TMP LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,2774982,RESERVOIR OTHER LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2774990,RESERVOIR OTHER LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2775005,RESERVOIR OTHER LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,2775054,CATH URETHRAL LVL 06,1619.0,679.98,437.13,1586.62,30
CDM,2775070,CATH URETHRAL LVL 03,313.0,131.46,84.51,306.74,30
CDM,2775088,CATH URETHRAL LVL 04,594.0,249.48,160.38,582.12,30
CDM,2775096,CATH URETHRAL LVL 05,850.0,357.0,229.5,833.0,30
CDM,2775104,IMP PROSTH BREAST LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,2775112,PROGRAMMER PT NEUROSTIM LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2775120,LASER FIBER LVL 06,4397.0,1846.74,1187.19,4309.06,30
CDM,2775153,IMP CEMENT ACCESSORY LVL 02,850.0,357.0,229.5,833.0,30
CDM,2775161,IMP PROSTH OPHTHALMIC LVL 01,313.0,131.46,84.51,306.74,30
CDM,2775179,IMP PROSTH OPHTHALMIC LVL 02,594.0,249.48,160.38,582.12,30
CDM,2775187,IMP PROSTH OPHTHALMIC LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2775195,IMP PROSTH PENILE INFLT LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2775203,IMP PROSTH PENILE INFLT LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,2775211,IMP PROSTH PENILE INFLT LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,2775229,IMP PROSTH PENILE NONINF LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2775237,IMP PROSTH PENILE NONINF LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2775245,IMP PROSTH PENILE NONINF LVL 03,21904.0,9199.68,5914.08,21465.92,30
CDM,2775252,IMP PROSTH PLASTIC SURG LVL 01,594.0,249.48,160.38,582.12,30
CDM,2775260,IMP PROSTH PLASTIC SURG LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2775278,IMP PROSTH PLASTIC SURG LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2775286,IMP DEV JT SHDR TOTAL LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2775294,IMP DEV JT SHDR TOTAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,2775302,IMP DEV JT SHDR TOTAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,2775310,IMP DEV JT SHDR TOTAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,2775328,STAPLE RELOAD LVL 06,3596.0,1510.32,970.92,3524.08,30
CDM,2775336,IMP DEV JT SHDR TOTAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,2775344,IMP DEV JT SHDR TOTAL LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,2775351,STAPLER LVL 06,3596.0,1510.32,970.92,3524.08,30
CDM,2775369,IMP STENT COAT W DEL LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2775377,IMP STENT COAT W DEL LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2775385,IMP STENT COAT W DEL LVL 04,6950.0,2919.0,1876.5,6811.0,30
CDM,2775393,IMP STENT COAT W DEL LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2775401,IMP STENT COAT W DEL LVL 06,11580.0,4863.6,3126.6,11348.4,30
CDM,2775419,IMP STENT COAT W DEL LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,2775427,IMP STENT COAT W DEL LVL 08,15334.0,6440.28,4140.18,15027.32,30
CDM,2775435,IMP PROSTH TESTICULAR LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,2775443,IMP PROSTH TESTICULAR LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2775450,IMP PROSTH TESTICULAR LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2775468,IMP DEV JT TOE LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,2775476,IMP DEV JT TOE LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2775484,IMP DEV JT TOE LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2775492,IMP DEV JT TOE LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,2775518,IMP DEV JT TOE LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,2775526,CATH THROMBECTOMY/EMBOLECTMY LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,2775534,CATH THROMBECTOMY/EMBOLECTMY LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,2775542,CATH THROMBECTOMY/EMBOLECTMY LVL 07,6950.0,2919.0,1876.5,6811.0,30
CDM,2775559,CATH URETERAL LVL 02,850.0,357.0,229.5,833.0,30
CDM,2775567,CATH URETERAL LVL 03,1888.0,792.96,509.76,1850.24,30
CDM,2775575,CATH URETERAL LVL 04,2827.0,1187.34,763.29,2770.46,30
CDM,2775583,CATH THROMBECTOMY/EMBOLECTMY LVL 02,594.0,249.48,160.38,582.12,30
CDM,2775591,CATH THROMBECTOMY/EMBOLECTMY LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2775609,CATH THROMBECTOMY/EMBOLECTMY LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2775617,IMP PROSTH SPHINCTR URIN LVL 01,11580.0,4863.6,3126.6,11348.4,30
CDM,2775641,IMP PUMP INF NONPRG PERM LVL 01,26284.0,11039.28,7096.68,25758.32,30
CDM,2775658,IMP PUMP INF NONPRG TMP LVL 01,594.0,249.48,160.38,582.12,30
CDM,2775666,IMP PUMP INF PRG LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,2775674,PUNCH LVL 01,313.0,131.46,84.51,306.74,30
CDM,2775682,REAMER LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2775690,IMP STENT COAT W DEL LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,2775708,IMP STENT NONCOAT W DEL LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2775716,IMP NEUROSTIM RECVR&/TRANS LVL 01,21904.0,9199.68,5914.08,21465.92,30
CDM,2775724,IMP CARDIAC EVENT REC LVL 04,24970.0,10487.4,6741.9,24470.6,30
CDM,2775732,RESERVOIR OTHER LVL 01,594.0,249.48,160.38,582.12,30
CDM,2775740,RESERVOIR THORACIC LVL 01,313.0,131.46,84.51,306.74,30
CDM,2775757,RESERVOIR THORACIC REINFUSN LVL 01,594.0,249.48,160.38,582.12,30
CDM,2775781,DEVICE INSERT RETRV LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,2775799,RETRIEVER BASKET LVL 01,313.0,131.46,84.51,306.74,30
CDM,2775807,RETRIEVER SUTURE LVL 01,594.0,249.48,160.38,582.12,30
CDM,2775815,RETRIEVER VASCULAR LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,2775823,RETRIEVER VASCULAR LVL 02,2157.0,905.94,582.39,2113.86,30
CDM,2775831,IMP RING FALLOPE LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2775849,IMP RING LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2775856,IMP STENT NONCOAT W DEL LVL 03,3083.0,1294.86,832.41,3021.34,30
CDM,2775864,IMP STENT NONCOAT W DEL LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2775872,IMP ROD/NAIL LVL 01,313.0,131.46,84.51,306.74,30
CDM,2775880,IMP ROD/NAIL LVL 02,850.0,357.0,229.5,833.0,30
CDM,2775898,IMP ROD/NAIL LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,2775906,IMP ROD/NAIL LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2775914,IMP ROD/NAIL LVL 05,3909.0,1641.78,1055.43,3830.82,30
CDM,2775922,IMP ROD/NAIL LVL 06,5373.0,2256.66,1450.71,5265.54,30
CDM,2775930,SCALPEL HARMONIC LVL 02,2426.0,1018.92,655.02,2377.48,30
CDM,2776094,IMP STENT NONCOAT W DEL LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,2776102,IMP STENT NONCOAT W DEL LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,2776110,IMP STENT NONCOAT W DEL LVL 07,11580.0,4863.6,3126.6,11348.4,30
CDM,2776136,SEAL PROXIMAL SYS LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2776144,IMP SEALANT PULMONARY LIQUID LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2776151,IMP SEPTAL DEFECT INTRACARD LVL 01,15334.0,6440.28,4140.18,15027.32,30
CDM,2776169,IMP SHUNT LVL 01,313.0,131.46,84.51,306.74,30
CDM,2776177,IMP SHUNT LVL 02,594.0,249.48,160.38,582.12,30
CDM,2776185,IMP SHUNT LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2776193,IMP SHUNT LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2776201,IMP SHUNT LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2776250,SLEEVE SCD LVL 01,166.0,69.72,44.82,162.68,30
CDM,2776268,SLEEVE SCD LVL 02,535.0,224.7,144.45,524.3,30
CDM,2776276,SLEEVE SCD LVL 03,850.0,357.0,229.5,833.0,30
CDM,2776284,IMP STENT NONCOAT W DEL LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,2776292,IMP STENT NONCOAT WO DEL LVL 02,850.0,357.0,229.5,833.0,30
CDM,2776300,SNARE LVL 01,313.0,131.46,84.51,306.74,30
CDM,2776318,SNARE LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2776326,SNARE LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2776334,IMP EMBOLIZATION SPHERE LVL 01,1619.0,679.98,437.13,1586.62,30
CDM,2776342,IMP STAPLE BONE LVL 01,166.0,69.72,44.82,162.68,30
CDM,2776359,IMP STAPLE BONE LVL 02,447.0,187.74,120.69,438.06,30
CDM,2776367,IMP STAPLE BONE LVL 03,709.0,297.78,191.43,694.82,30
CDM,2776375,STAPLE RELOAD LVL 01,166.0,69.72,44.82,162.68,30
CDM,2776383,STAPLE RELOAD LVL 02,447.0,187.74,120.69,438.06,30
CDM,2776391,STAPLE RELOAD LVL 03,850.0,357.0,229.5,833.0,30
CDM,2776409,STAPLER LVL 01,313.0,131.46,84.51,306.74,30
CDM,2776417,STAPLER LVL 02,594.0,249.48,160.38,582.12,30
CDM,2776425,STAPLER LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2776433,STAPLER LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2776441,STAPLER LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2776458,IMP STENT COAT W DEL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2776474,IMP STENT NOS LVL 01,594.0,249.48,160.38,582.12,30
CDM,2776482,IMP STENT NOS LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2776490,IMP STENT NOS LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2776508,IMP STENT NOS LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2776516,IMP STENT NONCOAT WO DEL LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2776524,IMP STENT NOS LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,2776532,IMP STENT NOS LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,2776540,IMP STENT NOS LVL 07,11580.0,4863.6,3126.6,11348.4,30
CDM,2776557,IMP STENT NOS LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,2776565,IMP STENT NONCOAT WO DEL LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2776573,IMP STENT NONCOAT W DEL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2776581,IMP STENT NONCOAT WO DEL LVL 01,447.0,187.74,120.69,438.06,30
CDM,2776599,IMP STENT NONCOR TEMP W DEL LVL 01,850.0,357.0,229.5,833.0,30
CDM,2776607,IMP STENT NONCOR TEMP WO DEL LVL 01,166.0,69.72,44.82,162.68,30
CDM,2776623,STYLET LVL 01,313.0,131.46,84.51,306.74,30
CDM,2776631,STYLET LVL 02,594.0,249.48,160.38,582.12,30
CDM,2776649,STYLET LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2776763,TIPS LVL 01,313.0,131.46,84.51,306.74,30
CDM,2776771,TIPS LVL 02,594.0,249.48,160.38,582.12,30
CDM,2776789,TIPS LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2776797,IMP TISSUE CONNECT HUMAN LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,2776805,IMP TISSUE CONNECT HUMAN LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,2776813,IMP STENT NONCOAT WO DEL LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2776821,IMP STENT NONCOAT WO DEL LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,2776854,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 02,594.0,249.48,160.38,582.12,30
CDM,2776862,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2776870,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2776888,IMP TISSUE CONNECT NONHUMAN LVL 01,850.0,357.0,229.5,833.0,30
CDM,2776896,IMP TISSUE CONNECT NONHUMAN LVL 02,2157.0,905.94,582.39,2113.86,30
CDM,2776904,IMP TISSUE CONNECT NONHUMAN LVL 03,3083.0,1294.86,832.41,3021.34,30
CDM,2776912,IMP TISSUE CONNECT NONHUMAN LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2776979,TRANSDUCER LVL 01,313.0,131.46,84.51,306.74,30
CDM,2776987,TREPHINE LVL 01,594.0,249.48,160.38,582.12,30
CDM,2776995,TREPHINE LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2777001,TROCAR LVL 01,313.0,131.46,84.51,306.74,30
CDM,2777019,TROCAR LVL 02,594.0,249.48,160.38,582.12,30
CDM,2777027,TROCAR LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2777035,TROCAR LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2777043,TROCAR LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2777050,TUBE CHEST LVL 01,102.0,42.84,27.54,99.96,30
CDM,2777068,IMP TUBE EAR LVL 01,166.0,69.72,44.82,162.68,30
CDM,2777076,TUBE ENDOBRONCHIAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,2777084,TUBE SPECIALTY LVL 01,32.0,13.44,8.64,31.36,30
CDM,2777092,TUBE SPECIALTY LVL 03,313.0,131.46,84.51,306.74,30
CDM,2777100,TUBE SPECIALTY LVL 02,166.0,69.72,44.82,162.68,30
CDM,2777118,TUBE SPECIALTY LVL 04,447.0,187.74,120.69,438.06,30
CDM,2777126,TUBE SPECIALTY LVL 09,1619.0,679.98,437.13,1586.62,30
CDM,2777134,TUBE SPECIALTY LVL 05,594.0,249.48,160.38,582.12,30
CDM,2777142,TUBE SPECIALTY LVL 06,709.0,297.78,191.43,694.82,30
CDM,2777159,TUBE SPECIALTY LVL 07,850.0,357.0,229.5,833.0,30
CDM,2777167,TUBE SPECIALTY LVL 08,1132.0,475.44,305.64,1109.36,30
CDM,2777175,TUBE SPECIALTY LVL 10,2695.0,1131.9,727.65,2641.1,30
CDM,2777258,IMP BAND LVL 02,850.0,357.0,229.5,833.0,30
CDM,2777266,BIT LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2777274,BIT LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,2777282,BIT LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2777290,BLADE LVL 01,166.0,69.72,44.82,162.68,30
CDM,2777308,BLADE LVL 02,313.0,131.46,84.51,306.74,30
CDM,2777316,BLADE LVL 03,447.0,187.74,120.69,438.06,30
CDM,2777324,BLADE LVL 04,594.0,249.48,160.38,582.12,30
CDM,2777332,BLADE LVL 09,4397.0,1846.74,1187.19,4309.06,30
CDM,2777340,BLADE LVL 05,850.0,357.0,229.5,833.0,30
CDM,2777357,BLADE LVL 06,1132.0,475.44,305.64,1109.36,30
CDM,2777365,BLADE LVL 08,3083.0,1294.86,832.41,3021.34,30
CDM,2777373,BLADE LVL 10,5861.0,2461.62,1582.47,5743.78,30
CDM,2777381,MASK AIRWAY LARYNGEAL LVL 01,166.0,69.72,44.82,162.68,30
CDM,2777399,CLIP APPLIER LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2777407,BAG DRAINAGE LVL 02,190.0,79.8,51.3,186.2,30
CDM,2777415,BAG DRAINAGE LVL 03,359.0,150.78,96.93,351.82,30
CDM,2777423,IMP BAND LVL 01,313.0,131.46,84.51,306.74,30
CDM,2777431,IMP BAND LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,2777449,BIT LVL 01,313.0,131.46,84.51,306.74,30
CDM,2777456,BIT LVL 02,594.0,249.48,160.38,582.12,30
CDM,2777464,BAG DRAINAGE LVL 01,102.0,42.84,27.54,99.96,30
CDM,2777621,CATH GLANDULAR LVL 01,166.0,69.72,44.82,162.68,30
CDM,2777639,CATH INTRAUTERN/HYST LVL 01,594.0,249.48,160.38,582.12,30
CDM,2777647,RESERVOIR NEURO LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,2777654,KIT/SET NON ROUTINE SURG LVL 01,166.0,69.72,44.82,162.68,30
CDM,2777662,INSERTS LVL 01,166.0,69.72,44.82,162.68,30
CDM,2777670,KIT/SET NON ROUTINE CARDIAC LVL 01,313.0,131.46,84.51,306.74,30
CDM,2777688,KIT/SET NON ROUTINE ORTH LVL 01,594.0,249.48,160.38,582.12,30
CDM,2777696,KIT/SET NON ROUTINE GI LVL 01,594.0,249.48,160.38,582.12,30
CDM,2777738,TAPS LVL 01,594.0,249.48,160.38,582.12,30
CDM,2777803,CATH ANGIO TRANSL LASER LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,2777886,MASK AIRWAY LARYNGEAL LVL 02,594.0,249.48,160.38,582.12,30
CDM,2777894,MASK AIRWAY LARYNGEAL LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,2777944,BLADE LVL 11,7413.0,3113.46,2001.51,7264.74,30
CDM,2777951,MASK AIRWAY LARYNGEAL LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2777969,BLADE LVL 12,9265.0,3891.3,2501.55,9079.7,30
CDM,2777977,IMP BAND LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2777985,IMP BAND LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2777993,IMP BAND LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,2778009,HYPO-HYPER THERMAL LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778017,CATH ERCP LVL 01,594.0,249.48,160.38,582.12,30
CDM,2778025,CEMENT ACCESSORIES LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778041,CLIP LVL 02,313.0,131.46,84.51,306.74,30
CDM,2778058,IMP COIL EMBOLIZATION LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778066,IMP COIL EMBOLIZATION LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2778074,IMP COIL EMBOLIZATION LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,2778082,IMP COIL EMBOLIZATION LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2778090,IMP COIL EMBOLIZATION LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,2778108,IMP COIL EMBOLIZATION LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,2778116,IMP COIL EMBOLIZATION LVL 08,11580.0,4863.6,3126.6,11348.4,30
CDM,2778124,IMP COIL EMBOLIZATION LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,2778132,DRAIN REINFUSION LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2778140,DRAIN REINFUSION LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2778157,DRAIN W ACCESSORIES LVL 02,476.0,199.92,128.52,466.48,30
CDM,2778165,DRAIN W ACCESSORIES LVL 03,850.0,357.0,229.5,833.0,30
CDM,2778173,DRAIN W ACCESSORIES LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,2778181,IMP FILTER VENA CAVA LVL 04,6950.0,2919.0,1876.5,6811.0,30
CDM,2778199,IMP FILTER VENA CAVA LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2778249,IMP GRAFT VASCULAR LVL 11,11580.0,4863.6,3126.6,11348.4,30
CDM,2778256,IMP GRAFT VASCULAR LVL 12,21904.0,9199.68,5914.08,21465.92,30
CDM,2778264,IMP GRAFT VASCULAR LVL 13,32854.0,13798.68,8870.58,32196.92,30
CDM,2778272,IMP GRAFT VASCULAR LVL 14,43804.0,18397.68,11827.08,42927.92,30
CDM,2778280,WIRE GUIDE LVL 04,850.0,357.0,229.5,833.0,30
CDM,2778298,WIRE GUIDE LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,2778306,WIRE GUIDE LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2778314,IMP ICD CHAMBER DUAL LVL 03,87604.0,36793.68,23653.08,85851.92,30
CDM,2778322,IMP ICD CHAMBER SGL LVL 03,87604.0,36793.68,23653.08,85851.92,30
CDM,2778330,INSERTS LVL 02,313.0,131.46,84.51,306.74,30
CDM,2778348,INSTRUMENT DISP SINGLE LVL 06,3083.0,1294.86,832.41,3021.34,30
CDM,2778355,INSTRUMENT DISP MULTIPLE LVL 06,3909.0,1641.78,1055.43,3830.82,30
CDM,2778363,INSTRUMENT DISP MULTIPLE LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2778371,IRRIGATOR/ACCESSORY LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2778389,IRRIGATOR/ACCESSORY LVL 05,3596.0,1510.32,970.92,3524.08,30
CDM,2778397,KIT/SET NON ROUTINE CARDIAC LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778405,KIT/SET NON ROUTINE CARDIAC LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2778413,KIT/SET NON ROUTINE CARDIAC LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,2778421,KIT/SET NON ROUTINE CARDIAC LVL 05,3909.0,1641.78,1055.43,3830.82,30
CDM,2778439,KIT/SET NON ROUTINE CARDIAC LVL 06,5373.0,2256.66,1450.71,5265.54,30
CDM,2778447,KNOT PUSHER LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,2778454,KNOT PUSHER LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2778462,TIPS LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2778470,IMP MARKER TISSUE LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778488,NEEDLE BIOPSY LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2778496,NEEDLE BIOPSY LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2778504,NEEDLE BIOPSY LVL 06,5861.0,2461.62,1582.47,5743.78,30
CDM,2778512,CEMENT ACCESSORIES LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2778520,SUPPLY NEURO LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,2778538,IMP CEMENT LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2778546,IMP CEMENT LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,2778561,OBTURATOR DISPOSABLE LVL 02,850.0,357.0,229.5,833.0,30
CDM,2778579,OCCLUDER LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,2778587,OCCLUDER LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,2778611,IMP DEV CLOSURE VASCULAR LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778629,WIRE GUIDE LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2778637,WIRE GUIDE LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,2778645,HEMOSTATIC AGENT LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2778652,IMP DEV CLOSURE VASCULAR LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2778660,INSTRUMENT DISP MULTIPLE LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,2778678,INTRO LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2778686,INTRO LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,2778694,IMP DEV CLOSURE VASCULAR LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2778702,KIT/SET NON ROUTINE SURG LVL 02,313.0,131.46,84.51,306.74,30
CDM,2778710,KIT/SET NON ROUTINE SURG LVL 03,594.0,249.48,160.38,582.12,30
CDM,2778728,KIT/SET NON ROUTINE SURG LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2778736,KIT/SET NON ROUTINE SURG LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,2778744,KIT/SET NON ROUTINE SURG LVL 06,2157.0,905.94,582.39,2113.86,30
CDM,2778751,KIT/SET NON ROUTINE SURG LVL 07,2695.0,1131.9,727.65,2641.1,30
CDM,2778769,KIT/SET NON ROUTINE SURG LVL 08,3853.0,1618.26,1040.31,3775.94,30
CDM,2778777,KIT/SET NON ROUTINE SURG LVL 09,4885.0,2051.7,1318.95,4787.3,30
CDM,2778785,IMP DEV CLOSURE VASCULAR LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,2778793,IMP LD PCMKR/ICD COMBO LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2778801,IMP LD PCMKR/ICD COMBO LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2778819,IMP LD PCMKR/ICD COMBO LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2778827,IMP LD PCMKR/ICD COMBO LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2778835,IMP LD PCMKR/ICD COMBO LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2778843,IMP LD PCMKR/ICD COMBO LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,2778850,IMP LD PCMKR/ICD COMBO LVL 08,21904.0,9199.68,5914.08,21465.92,30
CDM,2778868,IMP LD PCMKR/ICD COMBO LVL 09,26284.0,11039.28,7096.68,25758.32,30
CDM,2778876,SUPPLY NEURO LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2778884,SUPPLY NEURO LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,2778892,SUPPLY NEURO LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,2778900,SUPPLY NEURO LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,2778918,BRUSH LVL 03,850.0,357.0,229.5,833.0,30
CDM,2778926,BURR LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2778934,IMP CABLE LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,2778942,IMP DEV CLOSURE VASCULAR LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2778959,IMP COIL EMBOLIZATION LVL 10,15334.0,6440.28,4140.18,15027.32,30
CDM,2778967,COIL IMAGING MAGNETIC RESON LVL 02,594.0,249.48,160.38,582.12,30
CDM,2778975,THERAPY COLD LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,2778983,IMP ACCESS SYSTEM DIALYS LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2778991,IMP ACCESS SYSTEM DIALYS LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2779007,DIALYSIS ACCESSORIES LVL 02,313.0,131.46,84.51,306.74,30
CDM,2779015,DIALYSIS ACCESSORIES LVL 03,594.0,249.48,160.38,582.12,30
CDM,2779023,DIALYSIS ACCESSORIES LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2779031,DRAIN REINFUSION LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,2779049,DRAIN REINFUSION LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2779056,CATH ABL EP 3D/VECTOR LVL 02,3083.0,1294.86,832.41,3021.34,30
CDM,2779064,CATH ABL EP 3D/VECTOR LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2779072,CATH ABL EP 3D/VECTOR LVL 04,11580.0,4863.6,3126.6,11348.4,30
CDM,2779080,CATH ABL EP 3D/VECTOR LVL 05,17524.0,7360.08,4731.48,17173.52,30
CDM,2779098,CATH ABL EP 3D/VECTOR LVL 06,21904.0,9199.68,5914.08,21465.92,30
CDM,2779106,CATH ATHERECT TRANSL DIRECT LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2779114,CATH ATHERECT TRANSL ROTAT LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,2779122,CATH BALLOON LVL 02,313.0,131.46,84.51,306.74,30
CDM,2779130,CATH BALLOON LVL 03,594.0,249.48,160.38,582.12,30
CDM,2779148,CATH BALLOON LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,2779155,CATH BALLOON LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,2779163,CATH BALLOON LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2779171,CATH BALLOON LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2779189,CATH BALLOON DILAT NONVASC LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2779197,CATH BALLOON DILAT NONVASC LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2779205,CATH BALLOON DILAT NONVASC LVL 04,6950.0,2919.0,1876.5,6811.0,30
CDM,2779213,CATH BALLOON DILAT NONVASC LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2779239,IMP CATH BRACHY SEED ADM LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2779247,CATH CHOLANGIOGRAM LVL 02,850.0,357.0,229.5,833.0,30
CDM,2779254,CATH CHOLANGIOGRAM LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,2779262,CATH CHOLANGIOGRAM LVL 04,1888.0,792.96,509.76,1850.24,30
CDM,2779270,CATH DIAGNOSTIC LVL 02,134.0,56.28,36.18,131.32,30
CDM,2779288,CATH DIAGNOSTIC LVL 03,251.0,105.42,67.77,245.98,30
CDM,2779296,CATH DIAGNOSTIC LVL 04,313.0,131.46,84.51,306.74,30
CDM,2779304,CATH DIAGNOSTIC LVL 05,594.0,249.48,160.38,582.12,30
CDM,2779312,CATH DIAGNOSTIC LVL 06,1132.0,475.44,305.64,1109.36,30
CDM,2779320,CATH DIAGNOSTIC LVL 07,2157.0,905.94,582.39,2113.86,30
CDM,2779338,CATH DIAGNOSTIC LVL 08,3596.0,1510.32,970.92,3524.08,30
CDM,2779346,CATH DIAGNOSTIC LVL 09,5861.0,2461.62,1582.47,5743.78,30
CDM,2779353,CATH EP NON 3D 1-19 LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,2779361,CATH EP NON 3D 1-19 LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,2779379,CATH EP NON 3D 1-19 LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,2779387,CATH EP NON 3D 1-19 LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,2779395,CATH EP NON 3D 1-19 LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,2779403,CATH GUIDE LVL 02,313.0,131.46,84.51,306.74,30
CDM,2779411,CATH GUIDE LVL 03,447.0,187.74,120.69,438.06,30
CDM,2779429,CATH GUIDE LVL 04,594.0,249.48,160.38,582.12,30
CDM,2779437,CATH GUIDE LVL 05,850.0,357.0,229.5,833.0,30
CDM,2779445,CATH GUIDE LVL 06,1413.0,593.46,381.51,1384.74,30
CDM,2779452,CATH GUIDE LVL 07,2827.0,1187.34,763.29,2770.46,30
CDM,2779460,CATH HEM/PER SHORT TERM LVL 02,594.0,249.48,160.38,582.12,30
CDM,2779478,CATH HEM/PER SHORT TERM LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2779486,CATH HEM/PER SHORT TERM LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2779494,IMP CATH HEM/PER LONG TERM LVL 02,594.0,249.48,160.38,582.12,30
CDM,2779502,IMP CATH HEM/PER LONG TERM LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,2779510,IMP CATH HEM/PER LONG TERM LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2779528,IMP CATH HEM/PER LONG TERM LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,2779536,IMP CATH HEM/PER LONG TERM LVL 06,3596.0,1510.32,970.92,3524.08,30
CDM,2779544,IMP CATH HEM/PER LONG TERM LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2779551,IMP CATH HEM/PER LONG TERM LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,2779569,DRESSING SPECIALTY LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2779577,IMP GRAFT VASCULAR LVL 15,54754.0,22996.68,14783.58,53658.92,30
CDM,2779585,HANDPIECE LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2779593,HANDPIECE LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2779601,HANDPIECE LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2779619,HARVESTER LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2779627,HARVESTER LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2779635,IMP NEURO LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,2779643,IMP NEURO LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,2779650,IMP NEURO LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,2779668,IMP NEURO LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,2779676,IMP NEURO LVL 06,21904.0,9199.68,5914.08,21465.92,30
CDM,2779684,IMP NEURO LVL 07,43804.0,18397.68,11827.08,42927.92,30
CDM,2779692,KIT/SET NON ROUTINE GI LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2779700,KIT/SET NON ROUTINE GI LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2779718,KIT/SET NON ROUTINE GI LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2779726,KIT/SET NON ROUTINE GI LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2779734,KIT/SET NON ROUTINE ORTH LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,2779742,KIT/SET NON ROUTINE ORTH LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2779759,KIT/SET NON ROUTINE ORTH LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,2779767,KIT/SET NON ROUTINE ORTH LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,2779775,KIT/SET NON ROUTINE ORTH LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,2779783,MAMMOTOME LVL 02,594.0,249.48,160.38,582.12,30
CDM,2779791,MAMMOTOME LVL 03,1126.0,472.92,304.02,1103.48,30
CDM,2779809,MAMMOTOME LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,2779817,IMP PCMKR DUAL RR LVL 03,26284.0,11039.28,7096.68,25758.32,30
CDM,2779825,IMP PCMKR DUAL RR LVL 04,43804.0,18397.68,11827.08,42927.92,30
CDM,2779833,SUPPLY PERFUSION/ECMO LVL 06,2426.0,1018.92,655.02,2377.48,30
CDM,2779841,SUPPLY PERFUSION/ECMO LVL 07,3340.0,1402.8,901.8,3273.2,30
CDM,2779858,SUPPLY PERFUSION/ECMO LVL 08,4153.0,1744.26,1121.31,4069.94,30
CDM,2779866,IMP CATH PORT INDWELLING LVL 02,447.0,187.74,120.69,438.06,30
CDM,2779874,IMP CATH PORT INDWELLING LVL 03,850.0,357.0,229.5,833.0,30
CDM,2779882,IMP PCMKR SGL RR LVL 04,26284.0,11039.28,7096.68,25758.32,30
CDM,2779890,CATH/WIRE/SUTURE PASSER LVL 02,594.0,249.48,160.38,582.12,30
CDM,2779908,IMP CATH PORT INDWELLING LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,2779916,IMP CATH PORT INDWELLING LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,2779924,IMP CATH PORT INDWELLING LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2779932,IMP CATH PORT INDWELLING LVL 07,3340.0,1402.8,901.8,3273.2,30
CDM,2779940,PROBE LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,2779957,PROBE LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,2779965,PROBE LVL 06,3909.0,1641.78,1055.43,3830.82,30
CDM,2779973,PROBE LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,2779981,IMP VALVE LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,2779999,IMP DEV JT TOE LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,2783801,CATH CHOLANGIOGRAM LVL 05,2426.0,1018.92,655.02,2377.48,30
CDM,2783819,CATH CHOLANGIOGRAM LVL 06,2827.0,1187.34,763.29,2770.46,30
CDM,2784411,HEMOSTATIC AGENT LVL 08,8107.0,3404.94,2188.89,7944.86,30
CDM,2784973,IMP FIX LW/UP/PELVIC LVL 09,30664.0,12878.88,8279.28,30050.72,30
CDM,2785129,CATH ENDOBRONCHIAL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,2785137,MAGGOTS MEDICAL/VIAL LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,2785145,MAGGOTS MEDICAL/VIAL LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2785186,CATH INTRACARDIAC ECHO LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,2792398,IMP CATH BRACHY SEED ADM LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,2792406,IMP STENT NONCOR TEMP W DEL LVL 06,6487.0,2724.54,1751.49,6357.26,30
CDM,2792976,IMP LD NEUROSTIM LVL 08,35044.0,14718.48,9461.88,34343.12,30
CDM,2792984,HEMOSTATIC AGENT LVL 09,11580.0,4863.6,3126.6,11348.4,30
CDM,2793552,FIX EXTRNL LW/UP/PELVIC LVL 01,102.0,42.84,27.54,99.96,30
CDM,2793560,FIX EXTRNL LW/UP/PELVIC LVL 02,190.0,79.8,51.3,186.2,30
CDM,2793578,FIX EXTRNL LW/UP/PELVIC LVL 03,313.0,131.46,84.51,306.74,30
CDM,2793586,FIX EXTRNL LW/UP/PELVIC LVL 04,594.0,249.48,160.38,582.12,30
CDM,2793594,FIX EXTRNL LW/UP/PELVIC LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,2793602,FIX EXTRNL LW/UP/PELVIC LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,2793610,FIX EXTRNL LW/UP/PELVIC LVL 07,3853.0,1618.26,1040.31,3775.94,30
CDM,2793628,FIX EXTRNL LW/UP/PELVIC LVL 08,4885.0,2051.7,1318.95,4787.3,30
CDM,2793636,FIX EXTRNL LW/UP/PELVIC LVL 09,6950.0,2919.0,1876.5,6811.0,30
CDM,2793644,FIX EXTRNL LW/UP/PELVIC LVL 10,9265.0,3891.3,2501.55,9079.7,30
CDM,2793651,FIX EXTRNL LW/UP/PELVIC LVL 11,11580.0,4863.6,3126.6,11348.4,30
CDM,2793669,FIX EXTRNL LW/UP/PELVIC LVL 12,13895.0,5835.9,3751.65,13617.1,30
CDM,2793677,FIX EXTRNL LW/UP/PELVIC LVL 13,17524.0,7360.08,4731.48,17173.52,30
CDM,2793685,FIX EXTRNL LW/UP/PELVIC LVL 14,21904.0,9199.68,5914.08,21465.92,30
CDM,2793693,FIX EXTRNL LW/UP/PELVIC LVL 15,26284.0,11039.28,7096.68,25758.32,30
CDM,2793701,FIX EXTRNL LW/UP/PELVIC LVL 16,30664.0,12878.88,8279.28,30050.72,30
CDM,2793719,FIX EXTRNL LW/UP/PELVIC LVL 17,35044.0,14718.48,9461.88,34343.12,30
CDM,2793727,FIX EXTRNL LW/UP/PELVIC LVL 18,43804.0,18397.68,11827.08,42927.92,30
CDM,2793735,FIX EXTRNL LW/UP/PELVIC LVL 19,52564.0,22076.88,14192.28,51512.72,30
CDM,2793743,FIX EXTRNL LW/UP/PELVIC LVL 20,61324.0,25756.08,16557.48,60097.52,30
CDM,2793750,FIX EXTRNL LW/UP/PELVIC LVL 21,70084.0,29435.28,18922.68,68682.32,30
CDM,2793768,FIX EXTRNL LW/UP/PELVIC LVL 22,78844.0,33114.48,21287.88,77267.12,30
CDM,2793776,FIX EXTRNL LW/UP/PELVIC LVL 23,87604.0,36793.68,23653.08,85851.92,30
CDM,2793784,FIX EXTRNL LW/UP/PELVIC LVL 24,96364.0,40472.88,26018.28,94436.72,30
CDM,2793875,DEVICE HEART ARTIFICIAL 70CC,744600.0,312732.0,201042.0,729708.0,30
CDM,2794030,IMP FASTENERS W DEV DELIVERY LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,2794048,IMP FASTENERS W DEV DELIVERY LVL 02,6105.0,2564.1,1648.35,5982.9,30
CDM,2794055,IMP FASTENERS W DEV DELIVERY LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,2794063,IMP FASTENERS W DEV DELIVERY LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,2794071,IMP FASTENERS W DEV DELIVERY LVL 05,17524.0,7360.08,4731.48,17173.52,30
CDM,2794089,IMP FASTENERS W DEV DELIVERY LVL 06,21904.0,9199.68,5914.08,21465.92,30
CDM,2794097,IMP FASTENERS W DEV DELIVERY LVL 07,26284.0,11039.28,7096.68,25758.32,30
CDM,2799443,IMP PROSTH PENILE NONINF LVL 07,41614.0,17477.88,11235.78,40781.72,30
CDM,3000007,LAB IG FREE LIGHT CHAIN SERUM EA,61.0,25.62,16.47,59.78,37
CDM,3000015,LAB IG FREE LIGHT CHAIN URINE EA,69.0,28.98,17.27,67.62,37
CDM,3020112,LAB SUSCPT ETEST AGENT EA NS,66.0,27.72,4.75,64.68,37
CDM,3020120,LAB SUGARS SINGLE QL STOOL NS,64.0,26.88,5.5,62.72,37
CDM,3020922,LAB LEUKOCYTE HISTAMINE RELEASE,64.0,26.88,12.46,62.72,37
CDM,3021243,LAB SCR AB SYPHILIS,53.0,22.26,13.24,51.94,37
CDM,3021284,LAB DET IA FLU REV T&PRB AMP 3+ NS,88.0,36.96,23.76,86.24,37
CDM,3022209,LAB SCR AB NEUROMYOTONIA FL,37.0,15.54,9.99,36.26,37
CDM,3022373,LAB CHOLINESTERASE SERUM NS,61.0,25.62,7.87,59.78,37
CDM,3022472,LAB EVEROLIMUS,60.0,25.2,13.73,58.8,37
CDM,3022720,LAB HORMONE ANTIMULLERIAN,116.0,48.72,31.32,113.68,37
CDM,3022746,LAB AB HEPATITIS C NS,255.0,107.1,14.27,249.9,37
CDM,3022779,POC AGGREGATION PLT EA AGENT,75.0,31.5,20.25,73.5,37
CDM,3022787,POC FIBRINOGEN ACTIVITY,30.0,12.6,8.1,29.4,37
CDM,3022795,POC SCR FIBRINOLYSINS/COAG,47.0,19.74,12.69,46.06,37
CDM,3022878,LAB AB ID ANTI-NEUTROPHIL,46.0,19.32,12.42,45.08,37
CDM,3022886,LAB MCG IN SITU INT 25-99 CELL NS,128.0,53.76,34.56,125.44,37
CDM,3023199,LAB DET IA HIV-1 PRB AMP NS,108.0,45.36,29.16,105.84,37
CDM,3023348,LAB DET IA ENTEROVRS PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3023355,LAB DET IA ENTEROVRS PRB AMP NS,139.0,58.38,35.09,136.22,37
CDM,3023462,LAB FETAL CONGENITAL ABNORMALITIES,260.0,109.2,54.3,254.8,37
CDM,3024049,LAB DET IA RESP MLTPLX 12-25 TGT NS,1251.0,525.42,337.77,1225.98,37
CDM,3024114,LAB DET IA FLU REV T&PRB AMP 1-2,288.0,120.96,77.76,282.24,37
CDM,3024270,LAB SCR AG BLD TYPE SERUM PT U NS,153.0,64.26,16.34,149.94,37
CDM,3024387,LAB DET IA HEP C PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3024395,LAB DET IA HEP C QN,129.0,54.18,34.83,126.42,37
CDM,3024403,LAB DET IA HIV-1 QN,256.0,107.52,69.12,250.88,37
CDM,3024411,LAB DET IA HEP C QN NS,147.0,61.74,39.69,144.06,37
CDM,3025087,LAB GENOTYPE IA CYTOMEGALOVIRUS,773.0,324.66,208.71,757.54,37
CDM,3025111,LAB GENE F2 VAR 20210G>A,198.0,83.16,53.46,194.04,37
CDM,3025426,LAB DET IA RESP MLTPLX 6-11 TGT,655.0,275.1,176.85,641.9,37
CDM,3025558,LAB DET IA VZV PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3025889,LAB DET IA RESP MLTPLX 3-5 TGT,428.0,179.76,115.56,419.44,37
CDM,3025905,LAB GENE SEQ MUTATION FAM TARGETED,401.0,168.42,108.27,392.98,30
CDM,3026051,LAB AB HISTOPLASMA COMP FIXATION,63.0,26.46,13.79,61.74,37
CDM,3026077,LAB SCR AB CHAGAS,62.0,26.04,12.39,60.76,37
CDM,3026085,LAB AB CHAGAS RIPA,38.0,15.96,10.26,37.24,37
CDM,3026184,LAB BACLOFEN,132.0,55.44,18.64,129.36,37
CDM,3026234,LAB GENE ANLYS MUT C-KIT,989.0,415.38,267.03,969.22,37
CDM,3026473,LAB THYROXINE T-4 ELUTION,20.0,8.4,5.4,19.6,37
CDM,3026663,LAB GENE BCR/ABL1 REFLEX P210 NS,492.0,206.64,132.84,482.16,37
CDM,3026671,LAB GENE EGFR VAR COMMON NS,974.0,409.08,262.98,954.52,37
CDM,3026689,LAB IBD SGI DIAGNOSTIC,292.0,122.64,78.84,286.16,30
CDM,3026994,LAB SCR HEMOGLOBIN UNSTABLE,126.0,52.92,9.47,123.48,37
CDM,30270,R&B NURSERY LEVEL 4,11493.0,4827.06,9769.05,11263.14,13
CDM,3027018,LAB RNA NOROVIRUS AMP PROBE,109.0,45.78,29.43,106.82,37
CDM,3027554,LAB PRETREAT SERUM RBC AB DILUTION,170.0,71.4,29.55,166.6,37
CDM,3027612,LAB DET IA HIV-2 REV T&PRB AMP,122.0,51.24,32.94,119.56,37
CDM,3027729,LAB MICRODISSECTION LASER,909.0,381.78,245.43,890.82,30
CDM,3027752,LAB DET IA RESP MLTPLX 12-25 TGT,1251.0,525.42,337.77,1225.98,37
CDM,3027778,LAB DET IA MYCOPLAS PNEU PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3027786,LAB AB CYTOMEGALOVIRUS NS,56.0,23.52,14.39,54.88,37
CDM,3028024,LAB OXCARBAZEPINE,69.0,28.98,13.25,67.62,37
CDM,3028164,LAB COPPER SERUM,63.0,26.46,12.41,61.74,37
CDM,3028172,LAB ZINC,61.0,25.62,11.39,59.78,37
CDM,3028230,LAB ITRACONAZOLE,131.0,55.02,27.11,128.38,37
CDM,3028313,LAB GENE PDGFRA,989.0,415.38,267.03,969.22,37
CDM,3028347,LAB DET IA MUCORALES PCR PRB AMP,275.0,115.5,35.09,269.5,37
CDM,3028354,LAB DET IA NORCARDIA PCR PRB AMP,362.0,152.04,35.09,354.76,37
CDM,3028388,LAB DET IA COV19&FLU A&B PRB AMP,96.0,40.32,25.92,206.81,37
CDM,3028461,LAB THIOPURINE,160.0,67.2,18.64,156.8,37
CDM,3028487,LAB PATH GROSS ONLY LVL 1 NS,60.0,25.2,16.2,58.8,37
CDM,3028537,LAB CULT TISS NEO TMR SOLID NS,443.0,186.06,119.61,434.14,37
CDM,3028669,LAB ESTRADIOL TOTAL,84.0,35.28,22.68,82.32,37
CDM,3028677,LAB ESTRADIOL TOTAL NS,84.0,35.28,22.68,82.32,37
CDM,3028701,LAB CARBAMAZEPINE -10 11-EPOXIDE,58.0,24.36,15.66,56.84,37
CDM,3028719,LAB CARBAMAZEPINE -10 11-EPOXIDE NS,90.0,37.8,18.64,88.2,37
CDM,3028727,LAB IMM AB QL/SEMI QN SGL COVID-19,136.0,57.12,36.72,133.28,37
CDM,3028735,LAB GENE NUDT15&TPMT VAR COMMON,1399.0,587.58,377.73,1371.02,37
CDM,3028768,LAB IMM AB BP180 QN,73.0,30.66,17.27,71.54,37
CDM,3028842,LAB DRG DF ETOH BIOMRK TIS CORD 1-2,110.0,46.2,29.7,107.8,30
CDM,3028859,LAB IMM ELASTASE PANCREATIC QN,100.0,42.0,22.97,98.0,37
CDM,3029121,LAB SCR AB PHOSPHOLIPAS A2 RECPT FL,190.0,79.8,12.05,186.2,37
CDM,3029139,LAB AB FL TITER PHOSPHOLPS A2 RECPT,285.0,119.7,12.05,279.3,37
CDM,3029147,LAB DIS INFCT DNA PLASMA NGS UNTGT,6379.0,2679.18,1722.33,6251.42,37
CDM,3029162,LAB CROSS LINKS DEOXYPYRIDINOLINE,113.0,47.46,18.68,110.74,37
CDM,3029170,LAB AB ECHINOCOCCUS,71.0,29.82,13.01,69.58,37
CDM,3029188,LAB DRG DF SULFONAMIDES DAY 1-3,147.0,61.74,39.69,144.06,30
CDM,3029196,LAB ACID PHOSPHATASE TOTAL NS,63.0,26.46,7.64,61.74,37
CDM,3029253,LAB CHROMAT MS METHOXYTYRAMINE,392.0,164.64,24.09,384.16,37
CDM,3029295,LAB DET IA VARICELLA-ZOSTER PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3029402,LAB DET IA ASPERGILLUS PCR PRB AMP,115.0,48.3,31.05,112.7,37
CDM,3029428,LAB IMM ALZHEIMER EVALUATION,351.0,147.42,17.27,343.98,37
CDM,3029451,LAB TRNSPL DNA DNR DRV CELL-FREE QN,8260.0,3469.2,2230.2,8094.8,37
CDM,3029477,LAB DRG SC INST ALYZ MECON DAY,187.0,78.54,50.49,183.26,37
CDM,3029519,LAB BLOOD OCCULT FECES 1-3 IMM NS,62.0,26.04,15.92,60.76,37
CDM,30296,R&B PEDIATRICS PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,3029642,LAB PROT FRCTN ELECTRO&QN SERUM NS,56.0,23.52,10.74,54.88,37
CDM,3029725,LAB ESTRADIOL FREE MEASURE DIRECT,84.0,35.28,22.68,82.32,37
CDM,3029733,LAB DET AG IA IMM ENZ SEMI QN,147.0,61.74,11.98,144.06,37
CDM,3029790,LAB GENE ATXN1 DET ALLELES ABNORMAL,625.0,262.5,137.0,612.5,37
CDM,3029808,LAB GENE ATXN3 DET ALLELES ABNORMAL,640.0,268.8,137.0,627.2,37
CDM,3029816,LAB GENE CACNA1A DET ALLELES ABNORM,650.0,273.0,137.0,637.0,37
CDM,3029824,LAB GENE FXN DET ALLELES ABNORMAL,465.0,195.3,125.55,455.7,37
CDM,3029865,LAB AB ENA MYOSITIS,77.0,32.34,17.93,75.46,37
CDM,3029873,LAB PROT WB W INTRP ID MYOSITIS,88.0,36.96,23.76,86.24,37
CDM,3029907,LAB HLA CLASS I PHENOTYPE QL NS,287.0,120.54,77.49,281.26,37
CDM,3029923,LAB IMMUNOFIXATION EP TRANSFRN BETA,89.0,37.38,24.03,87.22,37
CDM,3029949,LAB GENE TYPING HLA 1 LR AG 1 EA NS,223.0,93.66,60.21,218.54,37
CDM,3029964,LAB IMM AB LDL OXIDIZED,100.0,42.0,17.27,98.0,37
CDM,3029998,LAB AB CHAGAS IGG,72.0,30.24,12.39,70.56,37
CDM,3030111,LAB IMM MS PHOSPHAT/PROTHROMBIN NS,59.0,24.78,11.53,57.82,37
CDM,3030152,LAB HORMONE ANTIMULLERIAN NS,116.0,48.72,31.32,113.68,37
CDM,3030178,LAB DET IA PLASMODIUM PCR PRB AMP,518.0,217.56,35.09,507.64,37
CDM,3030186,LAB SMEAR INCL BODIES/PARAS MYO NS,287.0,120.54,5.99,281.26,37
CDM,3030285,LAB IMM NEURO AMYLD 1-42&1-40 CSF,785.0,329.7,211.95,769.3,37
CDM,3030301,LAB DRG DF BENZ DAY 1-12 NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030319,LAB DRG DF BUPRENORPHINE DAY NON UR,56.0,23.52,15.12,54.88,30
CDM,3030327,LAB DRG DF COCAINE DAY NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030335,LAB DRG DF OPIATE DAY 1+ NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030350,LAB DRG DF OXYCODONE DAY NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030368,LAB DRG DF TRAMADOL NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030376,LAB DRG DF FENTANYL DAY NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030384,LAB DRG DF METHYLENEDIOXYAMP NON UR,56.0,23.52,15.12,54.88,30
CDM,3030400,LAB DRG DF AMPH/METH DAY 1-2 NON UR,56.0,23.52,15.12,54.88,30
CDM,3030418,LAB DRG DF BARB PHENOBARB NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030434,LAB DRG DF METHADONE DAY NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030442,LAB DRG DF PHENCYCLDN NON URINE,56.0,23.52,15.12,54.88,30
CDM,3030459,LAB DRG DF CANNABINOIDS DAY NON UR,56.0,23.52,15.12,54.88,30
CDM,3030491,LAB AG CARCINOEMBRYONIC ARUP NS,68.0,28.56,18.36,66.64,37
CDM,3030509,LAB AG CARCINOEMBRYONIC MAYO NS,329.0,138.18,18.96,322.42,37
CDM,3030517,LAB MOPATH LVL2 CARDIO IQ APOE GENO,411.0,172.62,110.97,402.78,37
CDM,3030533,LAB MOPATH LVL2 EML4-ALK,411.0,172.62,110.97,402.78,37
CDM,3030608,LAB DET IA ORGANISMS FNGL MULT PRB,638.0,267.96,70.2,625.24,37
CDM,3030632,LAB DET IA FUNGAL MULT PRB AMP,1372.0,576.24,70.2,1344.56,37
CDM,3030657,LAB DET IA PNEUM JIROVECII RFLX PRB,421.0,176.82,35.09,412.58,37
CDM,3030665,LAB DET IA TOXOPLASMA RFLX PCR PRB,421.0,176.82,35.09,412.58,37
CDM,3030715,LAB SYPHILIS VDRL/RPR QL DNR TESTNG,134.0,56.28,4.27,131.32,37
CDM,3030889,LAB ONC BIOCHEMICAL PROT 4 SRM/PLSM,2280.0,957.6,615.6,2234.4,37
CDM,3031754,LAB BIOTINIDASE SPEC EA,112.0,47.04,16.87,109.76,37
CDM,3032208,LAB DRG DF PHENCYCLIDINE,94.0,39.48,25.38,92.12,30
CDM,3032281,LAB DRG DF ANLG OPIOID&OPIAT UR 5+,97.0,40.74,26.19,95.06,30
CDM,30619,R&B PEDIATRICS PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,3062015,LAB COUNT CELL W DIFF FLUID BODY,17.0,7.14,4.59,16.66,37
CDM,3062023,LAB COUNT CELL FLUID BODY,15.0,6.3,4.05,14.7,37
CDM,3062031,LAB COUNT CELL CSF,15.0,6.3,4.05,14.7,37
CDM,3062049,LAB COUNT CELL W DIFF CSF,17.0,7.14,4.59,16.66,37
CDM,3062056,LAB ID CRYSTAL MICROSCOPY LIGHT,22.0,9.24,5.94,21.56,37
CDM,3062080,LAB ASSESSMENT LEUKOCYTE FECAL,13.0,5.46,3.51,12.74,37
CDM,3062130,LAB SEMEN MOTILITY&CT WO HUHNER,26.0,10.92,7.02,25.48,37
CDM,3062189,LAB STAIN FAT/FECES/URINE/SPUTUM,18.0,7.56,4.86,17.64,37
CDM,3062205,LAB COLLECTION SWEAT IONTOPHORESIS,107.0,44.94,28.89,104.86,37
CDM,3062288,LAB KETONES ACETONE QN,25.0,10.5,6.75,24.5,37
CDM,3062312,LAB PANEL HEPATITIS ACUTE,143.0,60.06,38.61,140.14,37
CDM,3062338,LAB HORMONE ADRENOCORTICOTROPIC,116.0,48.72,31.32,113.68,37
CDM,3062346,LAB ALBUMIN SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CDM,3062379,LAB ALCOHOL BREATH,90.0,37.8,24.3,88.2,37
CDM,3062387,LAB ALDOLASE,53.0,22.26,9.71,51.94,37
CDM,3062395,LAB ALDOSTERONE NS,123.0,51.66,33.21,120.54,37
CDM,3062403,LAB ALDOSTERONE URINE,123.0,51.66,33.21,120.54,37
CDM,3062429,LAB AFP SERUM,51.0,21.42,13.77,49.98,37
CDM,3062445,LAB ALPHA-1-ANTITRYPSIN TOTAL NS,59.0,24.78,13.44,57.82,37
CDM,3062452,LAB ALPHA-1-ANTITRYPSIN PHENOTYPE,63.0,26.46,14.46,61.74,37
CDM,3062460,LAB TRANSFERASE AMINO ALANINE,16.0,6.72,4.32,15.68,37
CDM,3062478,LAB ALUMINUM,77.0,32.34,20.79,75.46,37
CDM,3062536,LAB ACIDS AMINO SGL QN SPEC EA,91.0,38.22,22.98,89.18,37
CDM,3062551,LAB ACIDS AMINO 6+ QN SPEC EA,141.0,59.22,16.87,138.18,37
CDM,3062569,LAB ACIDS AMINO 6+ QN URINE SPEC EA,141.0,59.22,16.87,138.18,37
CDM,3062585,LAB ACID AMINOLEVULINIC DELTA URINE,75.0,31.5,16.45,73.5,37
CDM,3062593,LAB AMIODARONE,90.0,37.8,18.64,88.2,37
CDM,3062619,LAB AMMONIA,44.0,18.48,11.88,43.12,37
CDM,3062650,LAB AMYLASE,20.0,8.4,5.4,19.6,37
CDM,3062668,LAB AMYLASE FLUID BODY,52.0,21.84,6.48,50.96,37
CDM,3062676,LAB AMYLASE TOTAL,54.0,22.68,6.48,52.92,37
CDM,3062684,LAB AMYLASE URINE,53.0,22.26,6.48,51.94,37
CDM,3062718,LAB ANDROSTENEDIONE,88.0,36.96,23.76,86.24,37
CDM,3062734,LAB ANGIOTENSIN I CONVERTING ENZYME,61.0,25.62,14.6,59.78,37
CDM,3062759,LAB APOLIPOPROTEIN EA,64.0,26.88,17.28,62.72,37
CDM,3062767,LAB APOLIPOPROTEIN A1 EA,77.0,32.34,20.79,75.46,37
CDM,3062775,LAB APOLIPOPROTEIN B EA,64.0,26.88,17.28,62.72,37
CDM,3062783,LAB ARSENIC BLOOD NS,63.0,26.46,17.01,61.74,37
CDM,3062791,LAB ARSENIC NON BLOOD,95.0,39.9,18.97,93.1,37
CDM,3062809,LAB TRANSFERASE AMINO ASPARTATE,16.0,6.72,4.32,15.68,37
CDM,3062866,LAB PANEL METAB BASIC W CA TOTAL,26.0,10.92,7.02,25.48,37
CDM,3062882,LAB MICROGLOBULIN BETA-2,58.0,24.36,15.66,56.84,37
CDM,3062916,LAB KETONES BETA-HYDROXYBUTYRATE QN,60.0,25.2,8.17,58.8,37
CDM,3062932,LAB ACIDS BILE TOTAL,63.0,26.46,17.01,61.74,37
CDM,3062957,LAB BILIRUBIN DIRECT,16.0,6.72,4.32,15.68,37
CDM,3062965,LAB BILIRUBIN DIRECT FLUID BODY,16.0,6.72,4.32,15.68,37
CDM,3062973,LAB BILIRUBIN TOTAL,16.0,6.72,4.32,15.68,37
CDM,3062981,LAB BILIRUBIN TOTAL FLUID BODY,57.0,23.94,5.02,55.86,37
CDM,3063005,LAB GASES BLD ANY COMBO ARTERIAL,79.0,33.18,21.33,77.42,37
CDM,3063021,LAB GASES BLD ANY COMBO W SAT O2,237.0,99.54,63.99,232.26,37
CDM,3063039,LAB GASES BLD SAT O2 ONLY,98.0,41.16,9.77,96.04,37
CDM,3063047,LAB GASES BLD ANY COMBO VENOUS,79.0,33.18,21.33,77.42,37
CDM,3063070,LAB CADMIUM,71.0,29.82,19.17,69.58,37
CDM,3063088,LAB CAFFEINE,116.0,48.72,31.32,113.68,37
CDM,3063096,LAB CALCITONIN,81.0,34.02,21.87,79.38,37
CDM,3063104,LAB CALCIUM IONIZED,54.0,22.68,13.68,52.92,37
CDM,3063112,LAB CALCIUM TOTAL,16.0,6.72,4.32,15.68,37
CDM,3063120,LAB CALCIUM TOTAL URINE,56.0,23.52,5.16,54.88,37
CDM,3063138,LAB CALCIUM URINE QN TIMED,56.0,23.52,6.03,54.88,37
CDM,3063146,LAB CALCULUS SPECTROSCOPY INFRARED,74.0,31.08,12.9,72.52,37
CDM,3063179,LAB CARBAMAZEPINE TOTAL,52.0,21.84,14.04,50.96,37
CDM,3063187,LAB CARBON DIOXIDE HCO3,15.0,6.3,4.05,14.7,37
CDM,3063195,LAB CARBOXYHEMOGLOBIN QN NS,75.0,31.5,12.32,73.5,37
CDM,3063203,LAB AG CARCINOEMBRYONIC,57.0,23.94,15.39,55.86,37
CDM,3063237,LAB CARNITINE TOTAL&FREE QN,78.0,32.76,16.87,76.44,37
CDM,3063252,LAB CAROTENE,67.0,28.14,9.22,65.66,37
CDM,3063278,LAB CATECHOLAMINES FRACTIONATED,76.0,31.92,20.52,74.48,37
CDM,3063302,LAB CERULOPLASMIN,53.0,22.26,10.74,51.94,37
CDM,3063328,LAB CHEMILUMINESCENT,70.0,29.4,14.12,68.6,37
CDM,3063351,LAB CHLORIDE BLOOD,14.0,5.88,3.78,13.72,37
CDM,3063369,LAB CHLORIDE FLUID BODY,51.0,21.42,5.0,49.98,37
CDM,3063401,LAB CHLORIDE URINE,18.0,7.56,4.86,17.64,37
CDM,3063419,LAB CHOLESTEROL SRM/BLD WHL TTL,55.0,23.1,4.35,53.9,37
CDM,3063427,LAB LIPOPROTEIN CHOLESTEROL HDL,60.0,25.2,8.19,58.8,37
CDM,3063450,LAB CHOLINESTERASE RBC,59.0,24.78,9.81,57.82,37
CDM,3063559,LAB CITRATE,84.0,35.28,22.68,82.32,37
CDM,3063641,LAB PANEL METAB COMP,32.0,13.44,8.64,31.36,37
CDM,3063674,LAB COPPER TISSUE NS,211.0,88.62,12.41,206.78,37
CDM,3063682,LAB COPPER URINE,65.0,27.3,12.41,63.7,37
CDM,3063690,LAB CORTICOSTERONE,83.0,34.86,22.41,81.34,37
CDM,3063708,LAB CORTISOL FREE,55.0,23.1,14.85,53.9,37
CDM,3063716,LAB CORTISOL TOTAL,58.0,24.36,15.66,56.84,37
CDM,3063724,LAB CORTISOL TOTAL NS,323.0,135.66,16.3,316.54,37
CDM,3063732,LAB C-PEPTIDE,63.0,26.46,17.01,61.74,37
CDM,3063740,LAB CREATINE KINASE ISOENZYMES,59.0,24.78,13.39,57.82,37
CDM,3063765,LAB CREATINE KINASE MB ONLY QN,35.0,14.7,9.45,34.3,37
CDM,3063781,LAB CREATINE URINE,60.0,25.2,4.64,58.8,37
CDM,3063799,LAB CREATININE BLOOD,16.0,6.72,4.32,15.68,37
CDM,3063807,LAB CREATININE FLUID BODY,56.0,23.52,5.18,54.88,37
CDM,3063815,LAB CREATININE CLEARANCE,29.0,12.18,7.83,28.42,37
CDM,3063823,LAB CREATINE KINASE TOTAL,20.0,8.4,5.4,19.6,37
CDM,3063831,LAB CREATININE OTHER SOURCE,80.0,33.6,5.18,78.4,37
CDM,3063849,LAB CREATININE URINE,16.0,6.72,4.32,15.68,37
CDM,3063864,LAB CRYOGLOBULIN QL/SEMI QN,63.0,26.46,6.47,61.74,37
CDM,3063872,LAB CYANIDE,78.0,32.76,19.4,76.44,37
CDM,3063880,LAB CYCLOSPORINE,55.0,23.1,14.85,53.9,37
CDM,3063898,LAB CYCLOSPORINE A,58.0,24.36,15.66,56.84,37
CDM,3063922,LAB DEOXYCORTISOL 11-,88.0,36.96,23.76,86.24,37
CDM,3063948,LAB DESOXYCORTICOSTERONE,93.0,39.06,25.11,91.14,37
CDM,3063955,LAB DEHYDROEPIANDROSTERONE,76.0,31.92,20.52,74.48,37
CDM,3063963,LAB DEHYDROEPIANDROSTERONE-SULFATE,67.0,28.14,18.09,65.66,37
CDM,3064482,LAB PANEL ELECTROLYTE,22.0,9.24,5.94,21.56,37
CDM,3064490,LAB PROT FRCTN ELECTRO&QN SERUM,57.0,23.94,10.74,55.86,37
CDM,3064516,LAB ELECTRO,185.0,77.7,49.95,181.3,37
CDM,3064532,LAB ACTIVITY ENZYME NONRADIOACTIVE,121.0,50.82,22.17,118.58,37
CDM,3064540,LAB ERYTHROPOIETIN,57.0,23.94,15.39,55.86,37
CDM,3064565,LAB ESTRIOL SERUM NS,73.0,30.66,19.71,71.54,37
CDM,3064599,LAB ESTROGENS FRACTIONATED,98.0,41.16,26.46,96.04,37
CDM,3064607,LAB ESTRONE,75.0,31.5,20.25,73.5,37
CDM,3064631,LAB ETHOSUXIMIDE,107.0,44.94,16.34,104.86,37
CDM,3064649,LAB ETHYLENE GLYCOL,81.0,34.02,14.9,79.38,37
CDM,3064763,LAB FAT/LIPIDS FECES QN,51.0,21.42,13.77,49.98,37
CDM,3064771,LAB ACIDS FATTY NONESTERIFIED,69.0,28.98,18.63,67.62,37
CDM,3064789,LAB FELBAMATE,74.0,31.08,18.64,72.52,37
CDM,3064797,LAB FERRITIN,60.0,25.2,13.63,58.8,37
CDM,3064805,LAB FIBRONECTIN FETAL SEMI QL,194.0,81.48,52.38,190.12,37
CDM,3064813,LAB FLECAINIDE,68.0,28.56,18.36,66.64,37
CDM,3064888,LAB ACID FOLIC RBC,55.0,23.1,14.85,53.9,37
CDM,3064896,LAB ACID FOLIC SERUM,45.0,18.9,12.15,44.1,37
CDM,3064904,LAB GONADOTROPIN FSH SERUM,56.0,23.52,15.12,54.88,37
CDM,3064946,LAB GABAPENTIN SRM/PLASMA/BLD WHL,77.0,32.34,20.79,75.46,37
CDM,3064961,LAB SCR TRANSFERASE GALACTOSE-1,36.0,15.12,9.72,35.28,37
CDM,3064979,LAB IG IGE,58.0,24.36,15.66,56.84,37
CDM,3064987,LAB GASES BLD PH ONLY,33.0,13.86,8.91,32.34,37
CDM,3065000,LAB SCR AB ANCA FL EA AB,54.0,22.68,12.05,52.92,37
CDM,3065018,LAB AB CHANNEL CA VOLTAGE-GATED,444.0,186.48,12.05,435.12,37
CDM,3065026,LAB AB CYTOM FLOW MOG,211.0,88.62,37.73,206.78,37
CDM,3065448,LAB IMM AB ADALIMUMAB ANTIDRUG,286.0,120.12,17.27,280.28,37
CDM,3065455,LAB AMYLASE FLUID CYST PANCREATIC,341.0,143.22,6.48,334.18,37
CDM,3071321,LAB AFP SERUM MATERNAL,51.0,21.42,13.77,49.98,37
CDM,3071370,LAB PROTHROMBIN TIME NS,63.0,26.46,4.29,61.74,37
CDM,3071560,LAB GONADOTROPIN FSH SERUM NS,58.0,24.36,15.66,56.84,37
CDM,3072196,LAB DET IA HEP B PRB AMP,135.0,56.7,35.09,132.3,37
CDM,3072360,LAB IMM MS TRANSGLUTAMINASE NS,35.0,14.7,9.45,34.3,37
CDM,3072626,LAB PHENOTYPE IA HIV 1 DRUGS 1-10,1466.0,615.72,395.82,1436.68,37
CDM,3072634,LAB PHENOTYPE IA HIV 1 DRUGS ADDL,91.0,38.22,24.57,89.18,37
CDM,3072808,LAB GENOTYPE IA HIV-1 REV T NS,773.0,324.66,208.71,757.54,37
CDM,3073004,LAB GASTRIN,58.0,24.36,15.66,56.84,37
CDM,3073038,LAB GENTAMICIN PEAK,82.0,34.44,16.38,80.36,37
CDM,3073046,LAB GENTAMICIN RANDOM,82.0,34.44,16.38,80.36,37
CDM,3073053,LAB GENTAMICIN TROUGH,82.0,34.44,16.38,80.36,37
CDM,3073061,LAB TRANSFERASE GAMMA-GLUTAMYL,22.0,9.24,5.94,21.56,37
CDM,3073079,LAB GLUCAGON,67.0,28.14,14.29,65.66,37
CDM,3073137,LAB GLUCOSE FLUID BODY,56.0,23.52,3.93,54.88,37
CDM,3073152,LAB GLUCOSE CSF,55.0,23.1,3.93,53.9,37
CDM,3073160,LAB GLUCOSE POST DOSE,15.0,6.3,4.05,14.7,37
CDM,3073186,LAB GLUCOSE TOLERANCE SPEC 1ST 3,39.0,16.38,10.53,38.22,37
CDM,3073194,LAB GLUCOSE TOLERANCE SPEC EA ADDL,12.0,5.04,3.24,11.76,37
CDM,3073202,LAB GLUCOSE URINE RANDOM,55.0,23.1,3.93,53.9,37
CDM,3073210,LAB GLUCOSE URINE TIMED,56.0,23.52,3.93,54.88,37
CDM,3073236,LAB PROT GLYCATED,53.0,22.26,14.31,51.94,37
CDM,3073251,LAB HORMONE HUMAN GROWTH,51.0,21.42,13.77,49.98,37
CDM,3073269,LAB H PYLORI UREASE NONRADIOACT,203.0,85.26,54.81,198.94,37
CDM,3073277,LAB HALOPERIDOL,99.0,41.58,15.78,97.02,37
CDM,3073285,LAB HAPTOGLOBIN QN,53.0,22.26,12.58,51.94,37
CDM,3073293,LAB HCG QL,23.0,9.66,6.21,22.54,37
CDM,3073301,LAB HCG QN,46.0,19.32,12.42,45.08,37
CDM,3073319,LAB HCG TUMOR MARKER QN,57.0,23.94,15.05,55.86,37
CDM,3073400,LAB HEAVY METAL QN EA,106.0,44.52,21.96,103.88,37
CDM,3073541,LAB HEMOGLOBIN FETAL QL,123.0,51.66,8.0,120.54,37
CDM,3073558,LAB HEMOGLOBIN PLASMA,59.0,24.78,7.31,57.82,37
CDM,3073574,LAB HEMOSIDERIN QL,67.0,28.14,4.75,65.66,37
CDM,3073582,LAB PANEL FUNCTION HEPATIC,25.0,10.5,6.75,24.5,37
CDM,3073624,LAB HEMOGLOBIN A1C,30.0,12.6,8.1,29.4,37
CDM,3073632,LAB HISTAMINE,89.0,37.38,24.03,87.22,37
CDM,3073657,LAB HOMOCYSTEINE SERUM,58.0,24.36,15.66,56.84,37
CDM,3073665,LAB ACID HOMOVANILLIC,68.0,28.56,18.36,66.64,37
CDM,3073681,LAB ACID HYDROXYINDOLACETIC 5-,61.0,25.62,12.9,59.78,37
CDM,3073699,LAB HYDROXYPROGESTERONE 17-D NS,82.0,34.44,22.14,80.36,37
CDM,3073707,LAB HYDROXYPROLINE FREE,112.0,47.04,22.65,109.76,37
CDM,3073749,LAB IG IGA IGD IGG IGM SERUM EA,52.0,21.84,9.3,50.96,37
CDM,3073764,LAB IMM MS QL/SEMI QN NS,57.0,23.94,11.53,55.86,37
CDM,3073772,LAB IMM SGL STEP QL/SEMI QN NS,524.0,220.08,9.64,513.52,37
CDM,3073780,LAB IMM MS GLIADIN IGA QL,37.0,15.54,9.99,36.26,37
CDM,3073798,LAB IMM MS GLIADIN IGG QL,37.0,15.54,9.99,36.26,37
CDM,3073814,LAB IMM AB NEURONAL QN,52.0,21.84,14.04,50.96,37
CDM,3073830,LAB IMM ANALYTE OTHER QN,80.0,33.6,17.27,78.4,37
CDM,3073848,LAB IMM POLY PANCREATIC QN,91.0,38.22,17.27,89.18,37
CDM,3073863,LAB IMM RIA QN,94.0,39.48,18.4,92.12,37
CDM,3073871,LAB IMM RIA TRYPSIN QN,82.0,34.44,18.4,80.36,37
CDM,3073897,LAB IG SUBCLASSES EA,59.0,24.78,8.02,57.82,37
CDM,3073905,LAB INSULIN FREE,79.0,33.18,12.95,77.42,37
CDM,3073913,LAB INSULIN TOTAL,57.0,23.94,11.43,55.86,37
CDM,3073921,LAB IRON,20.0,8.4,5.4,19.6,37
CDM,3073939,LAB CAPACITY IRON BINDING,27.0,11.34,7.29,26.46,37
CDM,3074036,LAB LACTATE/LACTIC ACID,35.0,14.7,9.45,34.3,37
CDM,3074077,LAB LAMOTRIGINE,61.0,25.62,13.25,59.78,37
CDM,3074085,LAB LDH,19.0,7.98,5.13,18.62,37
CDM,3074093,LAB LDH FLUID BODY,57.0,23.94,6.04,55.86,37
CDM,3074101,LAB LDH CSF,56.0,23.52,6.04,54.88,37
CDM,3074119,LAB LDH ISOENZYMES,59.0,24.78,12.79,57.82,37
CDM,3074127,LAB LEAD BLOOD,59.0,24.78,12.11,57.82,37
CDM,3074135,LAB LEAD NON BLOOD,79.0,33.18,12.11,77.42,37
CDM,3074168,LAB LIDOCAINE,62.0,26.04,14.69,60.76,37
CDM,3074176,LAB LIPASE,21.0,8.82,5.67,20.58,37
CDM,3074184,LAB LIPASE FLUID BODY,52.0,21.84,6.89,50.96,37
CDM,3074192,LAB PANEL LIPID,54.0,22.68,13.39,52.92,37
CDM,3074200,LAB LIPOPROTEIN A,57.0,23.94,14.32,55.86,37
CDM,3074218,LAB LIPOPROTEIN ELECTRO,64.0,26.88,11.26,62.72,37
CDM,3074226,LAB LIPOPROTEIN FRCTN HR,102.0,42.84,27.54,99.96,37
CDM,3074234,LAB LITHIUM,52.0,21.84,6.61,50.96,37
CDM,3074259,LAB GONADOTROPIN LH,58.0,24.36,15.66,56.84,37
CDM,3074283,LAB MAGNESIUM,21.0,8.82,5.67,20.58,37
CDM,3074291,LAB MAGNESIUM STOOL,21.0,8.82,5.67,20.58,37
CDM,3074309,LAB MAGNESIUM URINE,52.0,21.84,6.7,50.96,37
CDM,3074325,LAB MANGANESE,80.0,33.6,21.6,78.4,37
CDM,3074390,LAB MERCURY BLOOD QN,49.0,20.58,13.23,48.02,37
CDM,3074408,LAB MERCURY NON BLOOD QN,88.0,36.96,16.26,86.24,37
CDM,3074416,LAB METANEPHRINES,66.0,27.72,16.94,64.68,37
CDM,3074507,LAB MEXILETINE,141.0,59.22,18.64,138.18,37
CDM,3074515,LAB MICROALBUMIN URINE QN,56.0,23.52,5.78,54.88,37
CDM,3074770,LAB PROT MYELIN BASIC CSF,63.0,26.46,17.01,61.74,37
CDM,3074788,LAB MYOGLOBIN,59.0,24.78,12.92,57.82,37
CDM,3074796,LAB MYOGLOBIN URINE,59.0,24.78,12.92,57.82,37
CDM,3074820,LAB NEPHELOMETRY ANALYTE EA,41.0,17.22,11.07,40.18,37
CDM,3074861,LAB NUCLEOTIDASE 5-,99.0,41.58,11.15,97.02,37
CDM,3074887,LAB BLOOD OCCULT FECES SINGLE QL,14.0,5.88,3.78,13.72,37
CDM,3074903,LAB BLOOD OCCULT OTHER SOURCE QL,16.0,6.72,4.32,15.68,37
CDM,3074937,LAB BANDS OLIGOCLONAL CSF,83.0,34.86,22.41,81.34,37
CDM,3074952,LAB ACID ORGANIC SINGLE QN,195.0,81.9,21.21,191.1,37
CDM,3074960,LAB ACID ORGANIC SINGLE METHY QN NS,64.0,26.88,17.28,62.72,37
CDM,3074978,LAB ACIDS ORGANIC EA QL,50.0,21.0,13.5,49.0,37
CDM,3074986,LAB ACIDS ORGANIC URINE EA QL,50.0,21.0,13.5,49.0,37
CDM,3075009,LAB ACIDS ORGANIC TOTAL URINE EA QN,101.0,42.42,23.6,98.98,37
CDM,3075017,LAB OSMOLALITY BLOOD,56.0,23.52,6.61,54.88,37
CDM,3075033,LAB OSMOLALITY STOOL,68.0,28.56,18.36,66.64,30
CDM,3075041,LAB OSMOLALITY URINE,56.0,23.52,6.82,54.88,37
CDM,3075058,LAB OSTEOCALCIN,90.0,37.8,24.3,88.2,37
CDM,3075066,LAB OXALATE,109.0,45.78,14.45,106.82,37
CDM,3075074,LAB OXALATE URINE,67.0,28.14,14.45,65.66,37
CDM,3075132,LAB PH FLUID BODY NOS,51.0,21.42,3.58,49.98,37
CDM,3075165,LAB PHENOBARBITAL,54.0,22.68,14.58,52.92,37
CDM,3075181,LAB PHENYLALANINE BLOOD,17.0,7.14,4.59,16.66,37
CDM,3075215,LAB PHENYTOIN FREE,63.0,26.46,13.76,61.74,37
CDM,3075223,LAB PHENYTOIN TOTAL,54.0,22.68,13.25,52.92,37
CDM,3075249,LAB ACID PHOSPHATASE PROSTATIC,60.0,25.2,9.66,58.8,37
CDM,3075264,LAB ALKALINE PHOSPHATASE ISOENZYMES,57.0,23.94,14.78,55.86,37
CDM,3075272,LAB ALKALINE PHOSPHATASE,16.0,6.72,4.32,15.68,37
CDM,3075298,LAB PHOSPHORUS INORGANIC,15.0,6.3,4.05,14.7,37
CDM,3075306,LAB PHOSPHORUS INORGANIC URINE,52.0,21.84,5.78,50.96,37
CDM,3075322,LAB PORPHOBILINOGEN URINE QN,62.0,26.04,8.44,60.76,37
CDM,3075330,LAB PORPHYRINS URINE QN&FRCTN,62.0,26.04,14.71,60.76,37
CDM,3075355,LAB POTASS SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CDM,3075363,LAB POTASS FLUID BODY,56.0,23.52,15.12,54.88,30
CDM,3075389,LAB POTASS URINE,55.0,23.1,4.73,53.9,37
CDM,3075397,LAB PREALBUMIN,54.0,22.68,14.58,52.92,37
CDM,3075421,LAB PREGNENOLONE,63.0,26.46,17.01,61.74,37
CDM,3075439,LAB 17-HYDROXYPREGNENOLONE,69.0,28.98,18.63,67.62,37
CDM,3075454,LAB PEPTIDE NATRIURETIC PB,118.0,49.56,31.86,115.64,37
CDM,3075462,LAB PROCAINAMIDE W NAPA,51.0,21.42,13.77,49.98,37
CDM,3075470,LAB PROGESTERONE,63.0,26.46,17.01,61.74,37
CDM,3075488,LAB PROINSULIN,81.0,34.02,21.87,79.38,37
CDM,3075496,LAB PROLACTIN,59.0,24.78,15.93,57.82,37
CDM,3075553,LAB PROT FLUID BODY,12.0,5.04,3.24,11.76,37
CDM,3075561,LAB PROT FLUID CEREBROSPINAL,56.0,23.52,4.0,54.88,37
CDM,3075579,LAB PROT TTL SRM/PLASMA/BLD WHL,56.0,23.52,3.67,54.88,37
CDM,3075587,LAB PROT URINE,56.0,23.52,3.67,54.88,37
CDM,3075595,LAB PROT URINE TIMED,12.0,5.04,3.24,11.76,37
CDM,3075603,LAB PROTOPORPHYRIN RBC QN,111.0,46.62,14.35,108.78,37
CDM,3075645,LAB PSA FREE,56.0,23.52,15.12,54.88,37
CDM,3075652,LAB PSA TOTAL,56.0,23.52,15.12,54.88,37
CDM,3075660,LAB PARATHORMONE,124.0,52.08,33.48,121.52,37
CDM,3075678,LAB PARATHORMONE C-TERMINAL,124.0,52.08,33.48,121.52,37
CDM,3075694,LAB PARATHORMONE INTRAOP POST 10 MN,124.0,52.08,33.48,121.52,37
CDM,3075702,LAB PARATHORMONE INTRAOP POST 5 MN,124.0,52.08,33.48,121.52,37
CDM,3075710,LAB PARATHORMONE INTRAOP BASELINE 1,124.0,52.08,33.48,121.52,37
CDM,3075728,LAB PARATHORMONE INTRAOP BASELINE 2,124.0,52.08,33.48,121.52,37
CDM,3075736,LAB PARATHORMONE INTRAOP EA ADDL,124.0,52.08,33.48,121.52,37
CDM,3075751,LAB PYRUVATE,44.0,18.48,11.88,43.12,37
CDM,3075777,LAB QUININE,136.0,57.12,11.63,133.28,37
CDM,3075819,LAB RECEPTOR ACETYLCHOLINE NON-ENDO,110.0,46.2,29.7,107.8,37
CDM,3075843,LAB PANEL FUNCTION RENAL,27.0,11.34,7.29,26.46,37
CDM,3075884,LAB SELENIUM,77.0,32.34,20.79,75.46,37
CDM,3075892,LAB SEROTONIN,93.0,39.06,25.11,91.14,37
CDM,3075900,LAB HORMONE SEX BINDING GLOBULIN,66.0,27.72,17.82,64.68,37
CDM,3075934,LAB SODIUM SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CDM,3075942,LAB SODIUM FLUID BODY,15.0,6.3,4.05,14.7,37
CDM,3075975,LAB SODIUM URINE,16.0,6.72,4.32,15.68,37
CDM,3075983,LAB SODIUM URINE TIMED,16.0,6.72,4.32,15.68,37
CDM,3075991,LAB SODIUM OTHER SOURCE,15.0,6.3,4.05,14.7,37
CDM,3076015,LAB SOMATOSTATIN,82.0,34.44,18.28,80.36,37
CDM,3076031,LAB GRAVITY SPECIFIC FLUID BODY,10.0,4.2,2.7,9.8,37
CDM,3076056,LAB SPCTPHOT ANALYTE NS,58.0,24.36,8.1,56.84,37
CDM,3076072,LAB SUGARS MULTIPLE QL EA,229.0,96.18,5.5,224.42,37
CDM,3076080,LAB SULFATE URINE,17.0,7.14,4.59,16.66,37
CDM,3076098,LAB HEMOGLOBIN SULFHEMOGLOBIN QN,172.0,72.24,8.8,168.56,37
CDM,3076114,LAB UPTAKE HORMONE T3,56.0,23.52,6.47,54.88,37
CDM,3076122,LAB TACROLIMUS FK-506,57.0,23.94,13.73,55.86,37
CDM,3076148,LAB TESTOSTERONE TOTAL,78.0,32.76,21.06,76.44,37
CDM,3076155,LAB TESTOSTERONE FREE,77.0,32.34,20.79,75.46,37
CDM,3076189,LAB THEOPHYLLINE,43.0,18.06,11.61,42.14,37
CDM,3076221,LAB THYROGLOBULIN,58.0,24.36,15.66,56.84,37
CDM,3076239,LAB THYROXINE BINDING GLOBULIN,45.0,18.9,12.15,44.1,37
CDM,3076247,LAB THYROID STIMULATING IMMUN GLOB,153.0,64.26,41.31,149.94,37
CDM,3076254,LAB THYROXINE T4 FREE,28.0,11.76,7.56,27.44,37
CDM,3076262,LAB THYROXINE T4 TOTAL,56.0,23.52,6.87,54.88,37
CDM,3076288,LAB TOBRAMYCIN PEAK,49.0,20.58,13.23,48.02,37
CDM,3076296,LAB TOBRAMYCIN RANDOM,49.0,20.58,13.23,48.02,37
CDM,3076304,LAB TOBRAMYCIN TROUGH,49.0,20.58,13.23,48.02,37
CDM,3076338,LAB TOPIRAMATE,36.0,15.12,9.72,35.28,37
CDM,3076353,LAB TRANSFERRIN,39.0,16.38,10.53,38.22,37
CDM,3076361,LAB DRG DF TRAZODONE DAY,70.0,29.4,18.9,68.6,30
CDM,3076395,LAB TRIGLYCERIDES,18.0,7.56,4.86,17.64,37
CDM,3076403,LAB TRIGLYCERIDES FLUID BODY,18.0,7.56,4.86,17.64,37
CDM,3076411,LAB TRIIODOTHYRONINE T3 FREE,54.0,22.68,14.58,52.92,37
CDM,3076429,LAB TRIIODOTHYRONINE T3 REVERSE,59.0,24.78,15.76,57.82,37
CDM,3076437,LAB TRIIODOTHYRONINE T3 TOTAL,43.0,18.06,11.61,42.14,37
CDM,3076460,LAB TROPONIN QN,38.0,15.96,10.26,37.24,37
CDM,3076486,LAB THYROID STIMULATING HORMONE,54.0,22.68,14.58,52.92,37
CDM,3076494,LAB TYROSINE,100.0,42.0,10.63,98.0,37
CDM,3076510,LAB NITROGEN UREA QN,12.0,5.04,3.24,11.76,37
CDM,3076536,LAB NITROGEN UREA URINE,52.0,21.84,5.56,50.96,37
CDM,3076544,LAB ACID URIC BLOOD,14.0,5.88,3.78,13.72,37
CDM,3076551,LAB ACID URIC FLUID BODY,56.0,23.52,5.08,54.88,37
CDM,3076577,LAB ACID URIC URINE,56.0,23.52,5.08,54.88,37
CDM,3076619,LAB VANCOMYCIN PEAK,41.0,17.22,11.07,40.18,37
CDM,3076627,LAB VANCOMYCIN RANDOM,41.0,17.22,11.07,40.18,37
CDM,3076635,LAB VANCOMYCIN TROUGH,41.0,17.22,11.07,40.18,37
CDM,3076643,LAB ACID VANILLYLMANDELIC URINE,82.0,34.44,15.5,80.36,37
CDM,3076650,LAB VASOACTIVE INTS PEPTIDE NS,160.0,67.2,35.33,156.8,37
CDM,3076668,LAB VASOPRESSIN,102.0,42.84,27.54,99.96,37
CDM,3076700,LAB RIBOFLAVIN,74.0,31.08,19.98,72.52,37
CDM,3076718,LAB PYRIDOXAL PHOSPHATE,85.0,35.7,22.95,83.3,37
CDM,3076726,LAB ACID ASCORBIC BLOOD,59.0,24.78,9.89,57.82,37
CDM,3076734,LAB VITAMIN D 1 25 DIHYDROXY FRAC,116.0,48.72,31.32,113.68,37
CDM,3076759,LAB VITAMIN D 25 HYDROXY W FRAC NS,89.0,37.38,24.03,87.22,37
CDM,3076767,LAB TOCOPHEROL ALPHA,62.0,26.04,14.18,60.76,37
CDM,3076775,LAB VITAMIN A,62.0,26.04,11.61,60.76,37
CDM,3076783,LAB THIAMINE,64.0,26.88,17.28,62.72,37
CDM,3076791,LAB CYANOCOBALAMIN,54.0,22.68,14.58,52.92,37
CDM,3076809,LAB VITAMIN K,85.0,35.7,13.72,83.3,37
CDM,3076833,LAB PROT WB W INTRP ID BAND,139.0,58.38,29.21,136.22,37
CDM,3076841,LAB PROT WB W INTRP,104.0,43.68,17.03,101.92,37
CDM,3076874,LAB ZINC NS,35.0,14.7,9.45,34.3,37
CDM,3076924,LAB AB ADENOVIRUS,61.0,25.62,12.87,59.78,37
CDM,3076940,LAB AGGLUTININS FEBRILE AG EA,21.0,8.82,5.67,20.58,37
CDM,3076965,LAB AB AMOEBIC,65.0,27.3,12.39,63.7,37
CDM,3076973,LAB SCR ANA,53.0,22.26,12.09,51.94,37
CDM,3076981,LAB ANA TITER,59.0,24.78,11.16,57.82,37
CDM,3077005,LAB ANTISTREPTOLYSIN O TITER,57.0,23.94,7.3,55.86,37
CDM,3077013,LAB AB ASPERGILLUS,55.0,23.1,14.85,53.9,37
CDM,3077039,LAB AB BARTONELLA,62.0,26.04,10.18,60.76,37
CDM,3077047,LAB AB BETA 2 GLYCOPROTEIN I,77.0,32.34,20.79,75.46,37
CDM,3077054,LAB DET AB BLASTOMYCES NS,78.0,32.76,12.9,76.44,37
CDM,3077070,LAB BLOOD TYPE ABO,272.0,114.24,2.99,266.56,37
CDM,3077088,LAB BLOOD TYPE RHD,77.0,32.34,2.99,75.46,37
CDM,3077104,LAB AB BORDETELLA,70.0,29.4,13.19,68.6,37
CDM,3077112,LAB AB BRUCELLA,67.0,28.14,8.93,65.66,37
CDM,3077138,LAB AB CANDIDA,71.0,29.82,12.01,69.58,37
CDM,3077146,LAB AB CARDIOLIPIN IG EA,80.0,33.6,21.6,78.4,37
CDM,3077153,LAB AB CHLAMYDIA,81.0,34.02,11.82,79.38,37
CDM,3077179,LAB AB CHLAMYDIA PNEU IGG IGA,61.0,25.62,11.82,59.78,37
CDM,3077187,LAB AB CHLAMYDIA PNEUM IGM,61.0,25.62,12.68,59.78,37
CDM,3077195,LAB AB CHLAMYDIA PSITTACI IGG IGA,61.0,25.62,11.82,59.78,37
CDM,3077203,LAB AB CHLAMYDIA PSITTACI IGM,61.0,25.62,12.68,59.78,37
CDM,3077211,LAB AB CHLAMYDIA TRAC IGM,61.0,25.62,12.68,59.78,37
CDM,3077229,LAB AB CYTOMEGALOVIRUS,60.0,25.2,14.39,58.8,37
CDM,3077237,LAB AB CYTOMEGALOVIRUS IGM,61.0,25.62,16.47,59.78,37
CDM,3077245,LAB AB CYTOMEGALOVIRUS IGM NS,51.0,21.42,13.77,49.98,37
CDM,3077252,LAB AB COCCIDIOIDES,55.0,23.1,11.47,53.9,37
CDM,3077260,LAB AB COCCIDIOIDES IGG,63.0,26.46,11.47,61.74,37
CDM,3077278,LAB AB COCCIDIOIDES IGM,63.0,26.46,11.47,61.74,37
CDM,3077286,LAB SCR AGGLUTININ COLD,25.0,10.5,6.75,24.5,37
CDM,3077294,LAB AGGLUTININ COLD TITER,58.0,24.36,8.06,56.84,37
CDM,3077377,LAB COMPLEMENT ACT FUNC C1 ESTER,66.0,27.72,12.0,64.68,37
CDM,3077385,LAB COMPLEMENT AG C1Q COMP EA,76.0,31.92,12.0,74.48,37
CDM,3077393,LAB COMPLEMENT AG C2 COMP EA,36.0,15.12,9.72,35.28,37
CDM,3077401,LAB COMPLEMENT AG C3 COMP EA,36.0,15.12,9.72,35.28,37
CDM,3077419,LAB COMPLEMENT AG C4 COMP EA,53.0,22.26,12.0,51.94,37
CDM,3077427,LAB COMPLEMENT AG C5 COMP EA,77.0,32.34,12.0,75.46,37
CDM,3077468,LAB COMPLEMENT ACT FUNC,66.0,27.72,12.0,64.68,37
CDM,3077484,LAB COMPLEMENT TOTAL HEMOLYTIC,61.0,25.62,16.47,59.78,37
CDM,3077492,LAB COOMBS INDIRECT TITER AB EA NS,348.0,146.16,5.18,341.04,37
CDM,3077500,LAB COOMBS INDIRECT TITER AB EA,348.0,146.16,5.18,341.04,37
CDM,3077526,LAB AB COXIELLA BRUNETII,57.0,23.94,12.12,55.86,37
CDM,3077534,LAB AB COXSACKIE,53.0,22.26,13.03,51.94,37
CDM,3077542,LAB PROT C-REACTIVE SENS HIGH,57.0,23.94,12.95,55.86,37
CDM,3077559,LAB PROT C-REACTIVE,16.0,6.72,4.32,15.68,37
CDM,3077567,LAB CROSSMATCH ANTIGLOBULIN,348.0,146.16,93.96,341.04,37
CDM,3077575,LAB CROSSMATCH SPIN IMMEDIATE,348.0,146.16,93.96,341.04,37
CDM,3077583,LAB CROSSMATCH INCUBATION,348.0,146.16,93.96,341.04,37
CDM,3077609,LAB SCR SERUM PRA CYTOTOXIC QUICK,90.0,37.8,24.3,88.2,37
CDM,3077617,LAB AB DEOXYRIBONUCLEASE,40.0,16.8,10.8,39.2,37
CDM,3077625,LAB AB DIPTHERIA,63.0,26.46,15.21,61.74,37
CDM,3077633,LAB AB DNA STRANDED NATVE/DOUBLE,42.0,17.64,11.34,41.16,37
CDM,3077658,LAB AB EBV EARLY AG,55.0,23.1,13.12,53.9,37
CDM,3077666,LAB AB EBV EBNA,46.0,19.32,12.42,45.08,37
CDM,3077674,LAB AB EBV VCA IGG,55.0,23.1,14.85,53.9,37
CDM,3077682,LAB AB EBV VCA IGM,62.0,26.04,16.74,60.76,37
CDM,3077690,LAB AB EBV VCA,55.0,23.1,14.85,53.9,37
CDM,3077716,LAB AB EHRLICHIA,80.0,33.6,10.18,78.4,37
CDM,3077732,LAB AB ENA RNP,55.0,23.1,14.85,53.9,37
CDM,3077757,LAB AB ENA SCLERODERMA,123.0,51.66,17.93,120.54,37
CDM,3077765,LAB AB ENA SMITH,55.0,23.1,14.85,53.9,37
CDM,3077773,LAB AB ENA SS-A/RO,55.0,23.1,14.85,53.9,37
CDM,3077781,LAB AB ENA SS-B/LA,55.0,23.1,14.85,53.9,37
CDM,3077799,LAB AB ENCEPHALITIS CALIFORNIA,65.0,27.3,13.19,63.7,37
CDM,3077807,LAB AB ENCEPHALITIS EQUINE EASTERN,65.0,27.3,13.19,63.7,37
CDM,3077815,LAB AB ENCEPHALITIS SAINT LOUIS NS,65.0,27.3,13.19,63.7,37
CDM,3077823,LAB AB ENCEPHALITIS EQUINE WEST NS,65.0,27.3,13.19,63.7,37
CDM,3077831,LAB AB ENTEROVIRUS,40.0,16.8,10.8,39.2,37
CDM,3077849,LAB THAWING PLASMA FRESH FROZEN,348.0,146.16,93.96,341.04,37
CDM,3077856,LAB SCR AB FL NS,55.0,23.1,12.05,53.9,37
CDM,3077906,LAB SCR AB ENDOMYSIAL FL,61.0,25.62,12.09,59.78,37
CDM,3077948,LAB SCR AB PARIETAL FL,55.0,23.1,12.05,53.9,37
CDM,3077955,LAB SCR AB RETICULUM FL,54.0,22.68,12.05,52.92,37
CDM,3077963,LAB SCR AB MUSCLE SMOOTH FL,60.0,25.2,12.05,58.8,37
CDM,3077971,LAB SCR AB MUSCLE STRIATED FL,56.0,23.52,12.05,54.88,37
CDM,3077989,LAB AB FL TITER,37.0,15.54,9.99,36.26,37
CDM,3078011,LAB AB FL TITER HU,55.0,23.1,12.05,53.9,37
CDM,3078029,LAB AB FL TITER MITOCHONDRIA,60.0,25.2,12.05,58.8,37
CDM,3078045,LAB AB FL TITER PARIETAL,55.0,23.1,12.05,53.9,37
CDM,3078052,LAB AB FL TITER PURKINJE,190.0,79.8,12.05,186.2,37
CDM,3078060,LAB AB FL TITER MUSCLE SMOOTH,65.0,27.3,12.05,63.7,37
CDM,3078078,LAB AB FL TITER MUSCLE STRIATED,65.0,27.3,12.05,63.7,37
CDM,3078086,LAB SCR AB FL,128.0,53.76,12.05,125.44,37
CDM,3078094,LAB AB FRANCISELLA TULARENSIS,100.0,42.0,14.16,98.0,37
CDM,3078110,LAB AB FUNGUS NOT SPECIFIED,55.0,23.1,12.25,53.9,37
CDM,3078128,LAB AB GIARDIA LAMBLIA,67.0,28.14,14.72,65.66,37
CDM,3078136,LAB AB HELICOBACTER PYLORI,78.0,32.76,16.85,76.44,37
CDM,3078144,LAB AB HELMINTH NONSPECIFIED,65.0,27.3,13.01,63.7,37
CDM,3078169,LAB AB HAEMOPHILUS INFLUENZA IGG,62.0,26.04,15.84,60.76,37
CDM,3078185,LAB AB HEPATITIS A IGM,55.0,23.1,11.26,53.9,37
CDM,3078201,LAB AB HEPATITIS B CORE IGM,55.0,23.1,11.77,53.9,37
CDM,3078219,LAB AB HEPATITIS B CORE TOTAL,55.0,23.1,12.05,53.9,37
CDM,3078227,LAB AB HEPATITIS B SURFACE,55.0,23.1,10.74,53.9,37
CDM,3078235,LAB AB HEPATITIS BE,59.0,24.78,11.57,57.82,37
CDM,3078243,LAB AB HEPATITIS C,43.0,18.06,11.61,42.14,37
CDM,3078250,LAB AB HEPATITIS C CONFIRMATORY,239.0,100.38,15.49,234.22,37
CDM,3078268,LAB AB HEPATITIS DELTA AGENT,85.0,35.7,17.16,83.3,37
CDM,3078276,LAB AB HERPES SIMPLEX NONSPECIFIC,44.0,18.48,11.88,43.12,37
CDM,3078284,LAB AB HERPES SIMPLEX TYPE 1,40.0,16.8,10.8,39.2,37
CDM,3078292,LAB AB HERPES SIMPLEX TYPE 2,59.0,24.78,15.93,57.82,37
CDM,3078300,LAB SCR AB HETEROPHILE,16.0,6.72,4.32,15.68,37
CDM,3078326,LAB AB HISTOPLASMA IMMUNODIFFUSION,68.0,28.56,13.79,66.64,37
CDM,3078334,LAB AB HIV-1,76.0,31.92,8.89,74.48,37
CDM,3078342,LAB AB HIV-1&HIV-2 RESULT SGL,42.0,17.64,11.34,41.16,37
CDM,3078359,LAB AB HIV-2,87.0,36.54,13.52,85.26,37
CDM,3078375,LAB BLOOD TYPE HLA B-27 AG SINGLE,78.0,32.76,21.06,76.44,37
CDM,3078425,LAB AB HTLV-I,28.0,11.76,7.56,27.44,37
CDM,3078466,LAB IMMUNE COMPLEX C1Q BINDING,74.0,31.08,19.98,72.52,37
CDM,3078508,LAB IMM AG TUMOR CA 125,63.0,26.46,17.01,61.74,37
CDM,3078516,LAB IMM AG TUMOR CA 15-3,63.0,26.46,17.01,61.74,37
CDM,3078524,LAB IMM AG TUMOR CA 19-9,63.0,26.46,17.01,61.74,37
CDM,3078532,LAB IMM AG TUMOR CA 27-29,63.0,26.46,17.01,61.74,37
CDM,3078540,LAB IMM AG TUMOR OTHER QN NS,75.0,31.5,20.25,73.5,37
CDM,3078565,LAB IMDF,55.0,23.1,14.05,53.9,37
CDM,3078573,LAB IMDF GEL AB/AG QL,56.0,23.52,11.98,54.88,37
CDM,3078599,LAB IMMUNOELECTROPHORESIS SERUM,90.0,37.8,24.3,88.2,37
CDM,3078615,LAB IMMUNOFIXATION EP URINE/CSF,89.0,37.38,24.03,87.22,37
CDM,3078631,LAB AB INFLUENZA A,68.0,28.56,13.55,66.64,37
CDM,3078656,LAB AB INFLUENZA B,68.0,28.56,13.55,66.64,37
CDM,3078664,LAB INHIBIN A NS,77.0,32.34,15.59,75.46,37
CDM,3078672,LAB AB INSULIN,66.0,27.72,17.82,64.68,37
CDM,3078680,LAB AB INTRINSIC FACTOR,59.0,24.78,15.08,57.82,37
CDM,3078698,LAB AB ISLET CELL NS,71.0,29.82,19.17,69.58,37
CDM,3078714,LAB AB LEGIONELLA,72.0,30.24,15.3,70.56,37
CDM,3078722,LAB AB LEISHMANIA,37.0,15.54,9.99,36.26,37
CDM,3078748,LAB AB ID LEUKOCYTE,55.0,23.1,14.85,53.9,37
CDM,3078755,LAB AB ID LEUKOCYTE NS,54.0,22.68,14.58,52.92,37
CDM,3078813,LAB TRANSFORM LYMPHOCYTE MITOGEN,205.0,86.1,49.03,200.9,37
CDM,3078839,LAB AB CHORIOMENINGITIS LYMPHOCYTIC,62.0,26.04,12.87,60.76,37
CDM,3078854,LAB AB MICROSOMAL EA,44.0,18.48,11.88,43.12,37
CDM,3078862,LAB AB MICROSOMAL LIVER-KIDNEY EA,63.0,26.46,14.55,61.74,37
CDM,3078888,LAB AB MUMPS,61.0,25.62,13.05,59.78,37
CDM,3078896,LAB AB MUMPS IGG,56.0,23.52,13.05,54.88,37
CDM,3078904,LAB AB MUMPS IGM,62.0,26.04,13.05,60.76,37
CDM,3078938,LAB AB MYCOPLASMA IGM,55.0,23.1,13.24,53.9,37
CDM,3078953,LAB NEUTRALIZATION VIRAL,69.0,28.98,16.91,67.62,37
CDM,3078995,LAB SCR AB CRYPTO AGG PARTICLE,59.0,24.78,11.54,57.82,37
CDM,3079019,LAB SCR AB NEISS AGG PARTICLE,74.0,31.08,11.54,72.52,37
CDM,3079027,LAB SCR AB NEISS GRP A AGG PARTICLE,53.0,22.26,11.54,51.94,37
CDM,3079043,LAB SCR AB NEISS GRP C AGG PARTICLE,53.0,22.26,11.54,51.94,37
CDM,3079050,LAB SCR AB STREP PNEUMO AGGPARTICLE,53.0,22.26,11.54,51.94,37
CDM,3079076,LAB AGG PARTICLE TITER,59.0,24.78,10.64,57.82,37
CDM,3079092,LAB AB PARVOVIRUS B19 IGG,62.0,26.04,15.03,60.76,37
CDM,3079100,LAB AB PARVOVIRUS B19 IGM,62.0,26.04,15.03,60.76,37
CDM,3079118,LAB AB ANTIPHOSPHATIDYLSERINE,57.0,23.94,15.39,55.86,37
CDM,3079134,LAB AB ID PLATELET PATIENT SERUM,56.0,23.52,15.12,54.88,37
CDM,3079175,LAB SCR ALLG IGE QL MULTI,56.0,23.52,7.97,54.88,37
CDM,3079183,LAB ELUTION AB RBC EA,348.0,146.16,93.96,341.04,37
CDM,3079209,LAB FACTOR RHEUMATOID QL,70.0,29.4,6.14,68.6,37
CDM,3079217,LAB FACTOR RHEUMATOID QN,18.0,7.56,4.86,17.64,37
CDM,3079225,LAB AB RICKETTSIA,71.0,29.82,19.17,69.58,37
CDM,3079258,LAB AB RSV,72.0,30.24,15.89,70.56,37
CDM,3079274,LAB AB RUBELLA IGG,56.0,23.52,14.39,54.88,37
CDM,3079282,LAB AB RUBELLA IGM NS,56.0,23.52,14.39,54.88,37
CDM,3079308,LAB AB RUBEOLA IGG,60.0,25.2,12.88,58.8,37
CDM,3079316,LAB AB RUBEOLA IGM,56.0,23.52,12.88,54.88,37
CDM,3079340,LAB AB SALMONELLA,73.0,30.66,13.19,71.54,37
CDM,3079373,LAB SYPHILIS VDRL/RPR QL,52.0,21.84,4.27,50.96,37
CDM,3079381,LAB SYPHILIS VDRL/RPR QL CSF,62.0,26.04,4.27,60.76,37
CDM,3079399,LAB SYPHILIS VDRL/RPR QN,52.0,21.84,4.4,50.96,37
CDM,3079407,LAB COUNT CELLS T CD4&CD8 RATIO,141.0,59.22,38.07,138.18,37
CDM,3079415,LAB COUNT TOTAL CELLS T,114.0,47.88,30.78,111.72,37
CDM,3079431,LAB AB TETANUS,63.0,26.46,14.8,61.74,37
CDM,3079449,LAB AB THYROGLOBULIN,57.0,23.94,15.39,55.86,37
CDM,3079464,LAB AB TOXOPLASMA IGG NS,63.0,26.46,14.39,61.74,37
CDM,3079472,LAB AB TOXOPLASMA IGM NS,63.0,26.46,14.41,61.74,37
CDM,3079514,LAB AB VARICELLA-ZOSTER IGG,39.0,16.38,10.53,38.22,37
CDM,3079522,LAB AB VARICELLA-ZOSTER IGM,39.0,16.38,10.53,38.22,37
CDM,3079530,LAB AB VIRUS NONSPECIFIED,65.0,27.3,12.88,63.7,37
CDM,3079548,LAB PROT C ACT RESISTANCE,66.0,27.72,15.32,64.68,37
CDM,3079555,LAB ANTIPLASMIN ALPHA-2,24.0,10.08,6.48,23.52,37
CDM,3079563,LAB CLOTTING ACT ANTITHROM 3,63.0,26.46,11.85,61.74,37
CDM,3079589,LAB COUNT BLD LEUKO AUTO,8.0,3.36,2.16,7.84,37
CDM,3079605,LAB COUNT BLD PLATELET AUTOMATED,14.0,5.88,3.78,13.72,37
CDM,3079613,LAB COUNT BLD RBC AUTO,62.0,26.04,3.02,60.76,37
CDM,3079639,LAB COUNT BLD RETIC MANUAL,13.0,5.46,3.51,12.74,37
CDM,3079654,LAB COUNT BLD DIFF MANUAL WBC,54.0,22.68,3.8,52.92,37
CDM,3079688,LAB CBC AUTO W AUTO DIFF,24.0,10.08,6.48,23.52,37
CDM,3079696,LAB CBC AUTO WO DIFF,20.0,8.4,5.4,19.6,37
CDM,3079720,LAB CLOTTING FACTOR 2 PROTHROM,64.0,26.88,12.98,62.72,37
CDM,3079738,LAB LYSIS EUGLOBULIN,26.0,10.92,7.02,25.48,37
CDM,3079746,LAB CLOTTING FACTOR 8 1-STG,66.0,27.72,17.82,64.68,37
CDM,3079761,LAB INHIBITOR FACTOR 9,39.0,16.38,10.53,38.22,37
CDM,3079779,LAB INHIBITOR FACTOR 8,97.0,40.74,12.87,95.06,37
CDM,3079787,LAB CLOTTING FACTOR 9 PTC/XMAS,79.0,33.18,19.04,77.42,37
CDM,3079795,LAB CLOTTING FACTOR 5 LABILE,75.0,31.5,17.65,73.5,37
CDM,3079803,LAB CLOTTING FACTOR 7,76.0,31.92,17.9,74.48,37
CDM,3079829,LAB CLOTTING FACTOR 8 VWF AG,74.0,31.08,19.98,72.52,37
CDM,3079837,LAB CLOTTING FACTOR 8 VWF MULTI,69.0,28.98,18.63,67.62,37
CDM,3079845,LAB CLOTTING FACTOR 8 VWF RIST,74.0,31.08,19.98,72.52,37
CDM,3079852,LAB CLOTTING FACTOR 10 STUART-PROWR,76.0,31.92,17.9,74.48,37
CDM,3079860,LAB CLOTTING FACTOR 11 PTA,76.0,31.92,17.9,74.48,37
CDM,3079878,LAB CLOTTING FACTOR 12 HAGEMAN,76.0,31.92,19.35,74.48,37
CDM,3079894,LAB CLOTTING FACTOR 13 SCR SOL,28.0,11.76,7.56,27.44,37
CDM,3079902,LAB FDP FSP AGG SEMI QN,21.0,8.82,5.67,20.58,37
CDM,3079928,LAB TRIIODOTHYRONINE T3 FREE TR DIA,71.0,29.82,16.94,69.58,37
CDM,3079944,LAB SCR ALLG IGE QL MULTI NS,59.0,24.78,7.97,57.82,37
CDM,3079951,LAB SCR AB MOG FL,86.0,36.12,12.05,84.28,37
CDM,3079969,LAB AB FL TITER MOG,837.0,351.54,12.05,820.26,37
CDM,3079977,LAB IG IGA SERUM NS,56.0,23.52,9.3,54.88,37
CDM,3080041,LAB SCR AB LRP4 AUTO FL,850.0,357.0,12.05,833.0,37
CDM,3080074,LAB RECEPTOR INTERLEUK 2 SOL N-END,500.0,210.0,36.57,490.0,37
CDM,3080124,LAB POTASS BLD WHL RBC,82.0,34.44,4.76,80.36,37
CDM,3080132,LAB POTASS PLASMA,59.0,24.78,4.76,57.82,37
CDM,3086014,LAB HGB FETAL KLEIHAUER-BETKE,59.0,24.78,7.73,57.82,37
CDM,3086022,LAB HGB FETAL ROSETTE,29.0,12.18,7.83,28.42,37
CDM,3086055,LAB FDP D-DIMER QN,31.0,13.02,8.37,30.38,37
CDM,3086063,LAB FIBRINOGEN ACTIVITY,30.0,12.6,8.1,29.4,37
CDM,3086071,LAB FIBRINOGEN ANTIGEN,44.0,18.48,11.88,43.12,37
CDM,3086097,LAB COUNT BLD HEMATOCRIT,8.0,3.36,2.16,7.84,37
CDM,3086113,LAB HEMO PLT AUTO W AUTO SCAN,24.0,10.08,6.48,23.52,37
CDM,3086121,LAB COUNT BLD HEMOGLOBIN,8.0,3.36,2.16,7.84,37
CDM,3086147,LAB ASSAY HEPARIN,65.0,27.3,13.09,63.7,37
CDM,3086188,LAB MURAMIDASE,57.0,23.94,15.39,55.86,37
CDM,3086196,LAB FRAGILITY OSMOTIC RBC INCUB,57.0,23.94,13.36,55.86,37
CDM,3086238,LAB PLASMINOGEN NON-ANTIGENIC,57.0,23.94,6.53,55.86,37
CDM,3086261,LAB CLOTTING ACT PROTEIN C,42.0,17.64,11.34,41.16,37
CDM,3086279,LAB CLOTTING AG PROTEIN C,65.0,27.3,12.01,63.7,37
CDM,3086287,LAB CLOTTING PROTEIN S FREE,66.0,27.72,15.32,64.68,37
CDM,3086303,LAB PROTHROMBIN TIME,51.0,21.42,4.29,49.98,37
CDM,3086311,LAB PROTHROMBIN TIME SUB,58.0,24.36,3.94,56.84,37
CDM,3086329,LAB PTT SUBSTITUTION FRAC PLASMA,103.0,43.26,6.47,100.94,37
CDM,3086337,LAB REPTILASE,80.0,33.6,9.85,78.4,37
CDM,3086345,LAB VENOM TIME RUSSELL VIPER DLT,60.0,25.2,9.58,58.8,37
CDM,3086360,LAB RATE SEDIMENTATION RBC AUTO,9.0,3.78,2.43,8.82,37
CDM,3086378,LAB RATE SEDIMENTATION RBC NONAUTO,13.0,5.46,3.51,12.74,37
CDM,3086402,LAB THROMBIN TIME PLASMA,56.0,23.52,5.77,54.88,37
CDM,3086428,LAB PTT PLASMA/BLD WHL,19.0,7.98,5.13,18.62,37
CDM,3086444,LAB VISCOSITY,57.0,23.94,11.67,55.86,37
CDM,3086469,LAB DET IA BARTONELLA PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3086493,LAB DET IA CHLAMYD TRAC PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3086519,LAB DET IA CMV PRB AMP NS,106.0,44.52,28.62,103.88,37
CDM,3086527,LAB DET IA CMV QN NS,129.0,54.18,34.83,126.42,37
CDM,3086535,LAB CONCENTRATION AFB IA,58.0,24.36,6.68,56.84,37
CDM,3086543,LAB CONCENTRATION ANY TYPE IA,21.0,8.82,5.67,20.58,37
CDM,3086550,LAB CULT BACT AEROBIC ID DF,25.0,10.5,6.75,24.5,37
CDM,3086568,LAB CULT BACT AEROBIC OTHER QN,61.0,25.62,9.89,59.78,37
CDM,3086576,LAB CULT AFB ID ISOLATES,63.0,26.46,10.8,61.74,37
CDM,3086584,LAB CULT AFB ID ISOLATES BLOOD,33.0,13.86,8.91,32.34,37
CDM,3086592,LAB CULT BACT ANAEROBIC OTHER,29.0,12.18,7.83,28.42,37
CDM,3086600,LAB CULT BACT ANAEROBIC ID DF,25.0,10.5,6.75,24.5,37
CDM,3086618,LAB CULT BACT AEROBIC BLOOD,31.0,13.02,8.37,30.38,37
CDM,3086626,LAB CULT BACT AEROBIC CATHETER TIP,26.0,10.92,7.02,25.48,37
CDM,3086634,LAB CULT CHLAMYDIA,71.0,29.82,19.17,69.58,37
CDM,3086642,LAB CULT BACT AEROBIC CSF,26.0,10.92,7.02,25.48,37
CDM,3086659,LAB ISO VIRUS SHELL VIAL ID W IF,64.0,26.88,17.28,62.72,37
CDM,3086667,LAB CULT BACT AEROBIC EAR,26.0,10.92,7.02,25.48,37
CDM,3086683,LAB CULT BACT AEROBIC EYE,61.0,25.62,8.62,59.78,37
CDM,3086691,LAB CULT FUNGI ID ISOLATES BLOOD,69.0,28.98,18.63,67.62,37
CDM,3086709,LAB CULT FUNGI ID DERMATOPHYTE,59.0,24.78,7.71,57.82,37
CDM,3086717,LAB CULT FUNGI ID DF MOLD,62.0,26.04,10.32,60.76,37
CDM,3086725,LAB CULT FUNGI ID DF YEAST,62.0,26.04,10.32,60.76,37
CDM,3086733,LAB CULT FUNGI ID ISOLATES,78.0,32.76,8.41,76.44,37
CDM,3086741,LAB CULT BACT AEROBIC GENITAL,26.0,10.92,7.02,25.48,37
CDM,3086758,LAB CULT BACT AEROBIC RESP LOWER,26.0,10.92,7.02,25.48,37
CDM,3086766,LAB CULT MYCOPLASMA/UREAPLASMA,63.0,26.46,15.39,61.74,37
CDM,3086774,LAB CULT MYCOBACTERIAL ID DF,64.0,26.88,14.61,62.72,37
CDM,3086790,LAB CULT BACT AEROBIC ID DF NOCARD,25.0,10.5,6.75,24.5,37
CDM,3086808,LAB CULT BACT AEROBIC OTHER,75.0,31.5,8.62,73.5,37
CDM,3086824,LAB SCR CULT BORDETELLA,20.0,8.4,5.4,19.6,37
CDM,3086840,LAB SCR CULT GONORRHEA,58.0,24.36,6.63,56.84,37
CDM,3086857,LAB SCR CULT LEGIONELLA,20.0,8.4,5.4,19.6,37
CDM,3086865,LAB SCR CULT ORGANISMS SGL,59.0,24.78,6.63,57.82,37
CDM,3086873,LAB SCR CULT STAPH MRSA,20.0,8.4,5.4,19.6,37
CDM,3086881,LAB SCR CULT STREP GROUP B,20.0,8.4,5.4,19.6,37
CDM,3086899,LAB SCR CULT VRE,58.0,24.36,6.63,56.84,37
CDM,3086915,LAB CULT BACT FLUID BODY STERILE,26.0,10.92,7.02,25.48,37
CDM,3086931,LAB CULT BACT AEROBIC STOOL CAMPY,29.0,12.18,7.83,28.42,37
CDM,3086949,LAB CULT BACT AEROBIC STOOL E COLI,29.0,12.18,7.83,28.42,37
CDM,3086956,LAB CULT BACT AEROBIC STOOL PATH,79.0,33.18,9.44,77.42,37
CDM,3086964,LAB CULT BACT AEROBIC STOOL,29.0,12.18,7.83,28.42,37
CDM,3086972,LAB CULT BACT AEROBIC STOOL VIBRO,29.0,12.18,7.83,28.42,37
CDM,3086980,LAB CULT BACT AEROBIC STOOL YERSNIA,29.0,12.18,7.83,28.42,37
CDM,3086998,LAB CULT BACT AEROBIC TISSUE,112.0,47.04,8.62,109.76,37
CDM,3087004,LAB CULT TYPING ID NUC ACID PRB DIR,73.0,30.66,19.71,71.54,37
CDM,3087012,LAB CULT TYPING GLC/HPLC,38.0,15.96,10.26,37.24,37
CDM,3087020,LAB CULT TYPING IF ANTISERUM EA,57.0,23.94,5.57,55.86,37
CDM,3087046,LAB CULT TYPING SEROLOGICAL,16.0,6.72,4.32,15.68,37
CDM,3087053,LAB CULT BACT AEROBIC RESP UPPER,26.0,10.92,7.02,25.48,37
CDM,3087061,LAB CULT BACT ID ISOLATE URINE,25.0,10.5,6.75,24.5,37
CDM,3087079,LAB CULT BACT COLONY COUNT URINE,25.0,10.5,6.75,24.5,37
CDM,3087087,LAB ISO VIRUS ID ACT ENZYMATIC,102.0,42.84,27.54,99.96,37
CDM,3087095,LAB ISO VIRUS INOC TISSUE ADDL,65.0,27.3,17.55,63.7,37
CDM,3087103,LAB ISO VIRUS INOC TISSUE,79.0,33.18,21.33,77.42,37
CDM,3087129,LAB CULT BACT AEROBIC WOUND,26.0,10.92,7.02,25.48,37
CDM,3087137,LAB CULT FUNGI YEAST ID ISOLATES,60.0,25.2,8.41,58.8,37
CDM,3087160,LAB DET AG IA IMM ENZ TOXIN C DIFF,60.0,25.2,11.98,58.8,37
CDM,3087210,LAB DET AG IA IMM H PYLORI STOOL,75.0,31.5,14.38,73.5,37
CDM,3087228,LAB DET AG IA HBSAG QL/SEMI QN,31.0,13.02,8.37,30.38,37
CDM,3087236,LAB DET AG IA IMM ENZ HEP BE,59.0,24.78,11.53,57.82,37
CDM,3087244,LAB DET AG IA IMM ENZ HISTOPLASMA,152.0,63.84,13.25,148.96,37
CDM,3087301,LAB DET AG IA IMM ENZ ROTAVIRUS,36.0,15.12,9.72,35.28,37
CDM,3087319,LAB DET AG IA IMM ENZ RSV,42.0,17.64,11.34,41.16,37
CDM,3087327,LAB DET AG IA IMM ENZ TOX SHIGA,64.0,26.88,11.98,62.72,37
CDM,3087343,LAB DET AG IA IMM ENZ STREP GROUP A,51.0,21.42,13.77,49.98,37
CDM,3087350,LAB DET AG IA IMM ENZ QL,36.0,15.12,9.72,35.28,37
CDM,3087368,LAB DET IA GC PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3087459,LAB DET IA HERPES 6 PRB AMP,120.0,50.4,32.4,117.6,37
CDM,3087467,LAB DET IA HSV PRB AMP NS,106.0,44.52,28.62,103.88,37
CDM,3087491,LAB HOMOGENIZATION TISSUE,57.0,23.94,5.88,55.86,37
CDM,3087517,LAB DET AG IA IF ADENOVIRUS,44.0,18.48,11.88,43.12,37
CDM,3087533,LAB DET AG IA IF BORDETELLA,36.0,15.12,9.72,35.28,37
CDM,3087566,LAB DET AG IA IF CRYPTOSPORIDIUM,61.0,25.62,11.98,59.78,37
CDM,3087582,LAB DET AG IA IF HSV TYPE 1,60.0,25.2,11.98,58.8,37
CDM,3087590,LAB DET AG IA IF HSV TYPE 2,60.0,25.2,11.98,58.8,37
CDM,3087608,LAB DET AG IA IF INFLUENZA A VIRUS,60.0,25.2,16.07,58.8,37
CDM,3087616,LAB DET AG IA IF INFLUENZA B VIRUS,60.0,25.2,12.25,58.8,37
CDM,3087632,LAB DET AG IA IF PARAINFLUENZA,50.0,21.0,13.5,49.0,37
CDM,3087640,LAB DET AG IA IF PNEUMOCYSTIS,36.0,15.12,9.72,35.28,37
CDM,3087657,LAB DET AG IA IF PLYVLT ORG MULT,60.0,25.2,11.98,58.8,37
CDM,3087665,LAB DET AG IA IF RSV,60.0,25.2,13.42,58.8,37
CDM,3087673,LAB DET AG IA IF VARICELLA-ZOSTER,60.0,25.2,13.42,58.8,37
CDM,3087681,LAB DET AG IA IMM OPTICAL,65.0,27.3,16.07,63.7,37
CDM,3087715,LAB DET AG IA INFLUENZA IMM OPT,50.0,21.0,13.5,49.0,37
CDM,3087749,LAB DET IA MYCOBCT TB PRB AMP NS,126.0,52.92,34.02,123.48,37
CDM,3087764,LAB EXAM MACROSCOPIC ARTHROPOD,13.0,5.46,3.51,12.74,37
CDM,3087772,LAB EXAM MACROSCOPIC PARASITE,58.0,24.36,4.31,56.84,37
CDM,3087798,LAB DET IA ORGANISMS MULT PRB AMP,211.0,88.62,56.97,206.78,37
CDM,3087806,LAB DET IA MYCOPLAS PNEU PRB AMP NS,106.0,44.52,28.62,103.88,37
CDM,3087822,LAB EXAM PINWORM,13.0,5.46,3.51,12.74,37
CDM,3087830,LAB SMEAR INCL BODIES/PARASITE,18.0,7.56,4.86,17.64,37
CDM,3087848,LAB SMEAR STAIN ACID FAST AFB,58.0,24.36,5.39,56.84,37
CDM,3087863,LAB SMEAR STAIN FL AFB,57.0,23.94,5.39,55.86,37
CDM,3087889,LAB SMEAR STAIN FL FUNGI,58.0,24.36,5.39,56.84,37
CDM,3087897,LAB SMEAR GRAM/GIEMSA,13.0,5.46,3.51,12.74,37
CDM,3087905,LAB SMEAR IA INDIA INK,18.0,7.56,4.86,17.64,37
CDM,3087913,LAB SMEARS DIRECT OVA&PARASITES,27.0,11.34,7.29,26.46,37
CDM,3087947,LAB SUSCPT DISK KIRBY BAUER,23.0,9.66,6.21,22.54,37
CDM,3087954,LAB SUSCPT DETECTION ENZYME EA,56.0,23.52,4.75,54.88,37
CDM,3087962,LAB SUSCPT ETEST AGENT EA,255.0,107.1,4.75,249.9,37
CDM,3087970,LAB SUSCPT DILUTION MACROBROTH,58.0,24.36,6.64,56.84,37
CDM,3087988,LAB SUSCPT MIC PLATE EA,26.0,10.92,7.02,25.48,37
CDM,3088002,LAB TISSUE KOH SKIN/HAIR/NAIL FUNGI,64.0,26.88,4.27,62.72,37
CDM,3088010,LAB TOXIN CULT TISSUE C DIFF NS,79.0,33.18,19.74,77.42,37
CDM,3088028,LAB SMEAR GRAM/GIEMSA URINE EOSNPHL,13.0,5.46,3.51,12.74,37
CDM,3088036,LAB SMEAR IA WET MOUNT,53.0,22.26,5.82,51.94,37
CDM,3088069,LAB UA REDUCING SUBSTANCE,11.0,4.62,2.97,10.78,37
CDM,3088085,LAB UA KETONES AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CDM,3088093,LAB UA PH AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CDM,3088101,LAB UA GRAVITY SPCFC AUTO WO MICRO,53.0,22.26,2.25,51.94,37
CDM,3088119,LAB UA AUTO W MICRO,10.0,4.2,2.7,9.8,37
CDM,3088127,LAB UA AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CDM,3088135,LAB UA MICROSCOPIC ONLY,10.0,4.2,2.7,9.8,37
CDM,3088143,LAB UA NONAUTO WO MICRO,11.0,4.62,2.97,10.78,37
CDM,3088168,LAB UA QL/SEMI QN,7.0,2.94,1.89,6.86,37
CDM,3088192,LAB PREGNANCY URINE,58.0,24.36,8.61,56.84,37
CDM,3088200,LAB MEASUREMENT VOL COLL TIMED EA,11.0,4.62,2.97,10.78,37
CDM,3088226,COLLECT SPEC BLD CAPILLARY,34.0,14.28,9.18,33.32,30
CDM,3088283,LAB PROT FRCTN ELECTRO&QN URINE,54.0,22.68,14.58,52.92,37
CDM,3088861,LAB ALPHA-1-ANTITRYPSIN TOTAL,41.0,17.22,11.07,40.18,37
CDM,3088879,POC UA NONAUTO WO MICRO DIPSTICK,11.0,4.62,2.97,10.78,37
CDM,3088937,LAB STAIN SPECIAL 2 NS,272.0,114.24,73.44,266.56,37
CDM,3088945,LAB CONSULT SLIDES REFERRED NS,77.0,32.34,20.79,75.46,37
CDM,3088978,LAB MICROSCOPY ELECTRON DIAG NS,1612.0,677.04,435.24,1579.76,37
CDM,3089000,LAB SCR AB AGG PARTICLE EA,74.0,31.08,11.54,72.52,37
CDM,3094034,LAB DET AG IA IF GIARDIA,61.0,25.62,13.61,59.78,37
CDM,3094042,LAB DET AG IA IMM ENZ GIARDIA NS,66.0,27.72,11.98,64.68,37
CDM,3094059,POC COLLECT SPEC SPUTUM AEROSOL,348.0,146.16,93.96,341.04,37
CDM,3094091,LAB SMEAR STAIN CMPLX OVA&PARASITES,71.0,29.82,17.98,69.58,37
CDM,3094109,LAB CULT BACT ANAEROBIC OTHER QN,392.0,164.64,9.66,384.16,37
CDM,3094125,LAB SCR CULT STREP GROUP A,20.0,8.4,5.4,19.6,37
CDM,3094182,LAB AGGREGATION PLT EA AGENT,75.0,31.5,20.25,73.5,37
CDM,3094265,PHLEBOTOMY THERAPEUTIC,326.0,136.92,88.02,319.48,37
CDM,3094497,POC COAGULATION TIME ACTIVATED,13.0,5.46,3.51,12.74,37
CDM,3094539,POC PREGNANCY URINE,26.0,10.92,7.02,25.48,37
CDM,3094638,POC GASES BLD ANY COMBO,79.0,33.18,21.33,77.42,37
CDM,3094646,LAB LEVETIRACETAM NS,63.0,26.46,13.25,61.74,37
CDM,3094661,LAB DET IA STREP GROUP A PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3094778,POC BLOOD OCCULT FECES 1-3 TESTS QL,13.0,5.46,3.51,12.74,37
CDM,3094786,POC SODIUM SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CDM,3094794,POC POTASS SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CDM,3094802,POC NITROGEN UREA QN,12.0,5.04,3.24,11.76,37
CDM,3094810,POC CHLORIDE BLOOD,14.0,5.88,3.78,13.72,37
CDM,3094844,POC CULT BACT H PYLORI FAST,25.0,10.5,6.75,24.5,37
CDM,3094968,POC CALCIUM IONIZED,42.0,17.64,11.34,41.16,37
CDM,3094976,LAB CYTOP SLD LIQ NONGYN,107.0,44.94,28.89,104.86,37
CDM,3095015,LAB ALKALINE PHOSPHATASE NS,57.0,23.94,5.18,55.86,37
CDM,3095049,LAB COUNT TOTAL CELLS CD56 NK,114.0,47.88,30.78,111.72,37
CDM,3095056,LAB B CELLS CD19 COUNT TOTAL,114.0,47.88,30.78,111.72,37
CDM,3095064,LAB CYTOM FLOW TECH MARKER 1ST,727.0,305.34,196.29,712.46,37
CDM,3095114,LAB PROT FRCTN ELECTRO&QN OTHER,54.0,22.68,14.58,52.92,37
CDM,3095122,LAB COUNT CELLS T CD4 ABSOLUTE,111.0,46.62,26.78,108.78,37
CDM,3095130,LAB CYTOM FLOW TECH MARKER ADDL,119.0,49.98,32.13,116.62,30
CDM,3095205,POC PROTHROMBIN TIME,13.0,5.46,3.51,12.74,37
CDM,3102852,LAB NEUTRALIZATION VIRAL RABIES,127.0,53.34,16.91,124.46,37
CDM,3102894,LAB CHROM W BND 15-20 CLL 2 KRTY NS,532.0,223.44,125.49,521.36,37
CDM,3102902,LAB CHROM W BND 15-20 CLL 2 KRTY,377.0,158.34,101.79,369.46,37
CDM,3102910,LAB CHROM W BND 45 CLL 2 KRTY,451.0,189.42,121.77,441.98,37
CDM,3102928,LAB CHROM W BND AF 6-12 COL 1 K,521.0,218.82,140.67,510.58,37
CDM,3102936,LAB MCG IN SITU CHROM 10-30 CELL,335.0,140.7,34.81,328.3,37
CDM,3102969,LAB MCG IN SITU INT 25-99 CELL,128.0,53.76,34.56,125.44,37
CDM,3102977,LAB MCG IN SITU INT 100-300 CELL,154.0,64.68,41.58,150.92,37
CDM,3102985,LAB CULT TISS NON-NEO AF/CELL CV,451.0,189.42,121.77,441.98,37
CDM,3102993,LAB CHROM STUDY CELLS COUNTED ADDL,81.0,34.02,21.87,79.38,37
CDM,3103009,LAB CHROM STUDY RES HIGH ADDL,104.0,43.68,28.08,101.92,37
CDM,3103017,LAB CHROM KARYOTYPES ADDL EA,101.0,42.42,27.27,98.98,37
CDM,3103025,LAB CHROM W BND 5 CLL 1 KRTY,794.0,333.48,214.38,778.12,37
CDM,3103066,LAB CULT TISS NON-NEO LYMPHOCYTE,350.0,147.0,94.5,343.0,37
CDM,3103090,LAB CYTOPATH CONCENTRATION,77.0,32.34,20.79,75.46,37
CDM,3103108,LAB CYTOPATH FLUIDS SMEARS,77.0,32.34,20.79,75.46,37
CDM,3103157,LAB CYTOPATH EVAL FNA INTRP&RPT,107.0,44.94,28.89,104.86,37
CDM,3103199,LAB MCG PROBE DNA PROBE EA,65.0,27.3,17.55,63.7,37
CDM,3103223,LAB SCR MANUAL CYTOPATH CERV/VAG,61.0,25.62,16.47,59.78,37
CDM,3103264,LAB CYTOPATH SMEARS OTH SC&IN,71.0,29.82,19.17,69.58,37
CDM,3103272,LAB CYTOPATH OTH SRCE SMEARS SC&IN,68.0,28.56,18.36,66.64,37
CDM,3103355,LAB CONSULT PATH SURG BLOCK EA ADDL,59.0,24.78,15.93,57.82,30
CDM,3103363,LAB CONSULT PATH SURG BLOCK 1ST,348.0,146.16,93.96,341.04,37
CDM,3103371,LAB DECALCIFICATION,38.0,15.96,10.26,37.24,30
CDM,3103397,LAB PATH GROSS&MICRO LVL 2,77.0,32.34,20.79,75.46,37
CDM,3103405,LAB PATH GROSS&MICRO LVL 3,107.0,44.94,28.89,104.86,37
CDM,3103421,LAB PATH GROSS&MICRO LVL 5,727.0,305.34,196.29,712.46,37
CDM,3103439,LAB PATH GROSS&MICRO LVL 6,1612.0,677.04,435.24,1579.76,37
CDM,3103447,LAB PATH GROSS ONLY LVL 1,60.0,25.2,16.2,58.8,37
CDM,3103462,LAB STAIN HISTOCHEM W BLOCK FROZEN,750.0,315.0,202.5,735.0,30
CDM,3103538,LAB CONSULT SLIDES PREP REQ,107.0,44.94,28.89,104.86,37
CDM,3103546,LAB STAIN SPECIAL 1,107.0,44.94,28.89,104.86,37
CDM,3103595,LAB AB MYCOPLASMA IGG NS,55.0,23.1,13.24,53.9,37
CDM,3103637,LAB CLOZAPINE/NORCLOZAPINE,68.0,28.56,18.36,66.64,37
CDM,3103652,LAB CARBAMAZEPINE FREE,90.0,37.8,13.25,88.2,37
CDM,3103686,LAB TACROLIMUS FK-506 NS,64.0,26.88,13.73,62.72,37
CDM,3103728,LAB CALCIUM TOTAL NS,65.0,27.3,5.16,63.7,37
CDM,3103736,LAB CHLORIDE STOOL NS,58.0,24.36,5.0,56.84,37
CDM,3103744,LAB CHOLESTEROL SRM/BLD WHL TTL NS,56.0,23.52,4.35,54.88,37
CDM,3103777,LAB CREATINE KINASE TOTAL NS,55.0,23.1,6.51,53.9,37
CDM,3103785,LAB CREATININE URINE NS,52.0,21.84,5.18,50.96,37
CDM,3103793,LAB CRYOGLOBULIN QL/SEMI QN NS,63.0,26.46,6.47,61.74,37
CDM,3103801,LAB TRANSFERASE GALACTOSE-1 QN,173.0,72.66,21.07,169.54,37
CDM,3103819,LAB IG IGA IGD IGG IGM CSF EA,63.0,26.46,9.3,61.74,37
CDM,3103850,LAB IMM ACHR BINDING QN,70.0,29.4,18.4,68.6,37
CDM,3103884,LAB IMM GANGLIOSIDE GM TRIPLE QN,70.0,29.4,17.27,68.6,37
CDM,3103918,LAB IMM GLYCPROT MYELIN ASSC IGM,69.0,28.98,17.27,67.62,37
CDM,3103942,LAB LDH NS,55.0,23.1,6.04,53.9,37
CDM,3103967,LAB LIPASE FLUID BODY NS,58.0,24.36,6.89,56.84,37
CDM,3104122,LAB SODIUM STOOL NS,58.0,24.36,4.86,56.84,37
CDM,3104130,LAB SPCTPHOT PORPHYRINS SERUM,70.0,29.4,8.1,68.6,37
CDM,3104148,LAB TESTOSTERONE TOTAL NS,78.0,32.76,21.06,76.44,37
CDM,3104155,LAB THYROXINE T4 FREE NS,66.0,27.72,9.02,64.68,37
CDM,3104163,LAB TRIGLYCERIDES NS,57.0,23.94,5.74,55.86,37
CDM,3104205,LAB CLOTTING ACT ANTITHROM 3 NS,56.0,23.52,11.85,54.88,37
CDM,3104213,LAB CLOTTING AG ANTITHROMBIN 3 NS,69.0,28.98,10.81,67.62,37
CDM,3104239,LAB AB ID PLATELET PATIENT SERUM NS,145.0,60.9,18.37,142.1,37
CDM,3104262,LAB COMPLEMENT AG C6 COMP EA,36.0,15.12,9.72,35.28,37
CDM,3104304,LAB SCR AB ANTIMYOCARDIAL FL,76.0,31.92,12.05,74.48,37
CDM,3104338,LAB SCR AB H INFLUENZA AGG PARTICLE,53.0,22.26,11.54,51.94,37
CDM,3104353,LAB AB CHLAMYDIA TRAC IGG IGA,61.0,25.62,11.82,59.78,37
CDM,3104361,LAB SCR AB RBC SERUM EA NS,158.0,66.36,9.77,154.84,37
CDM,3104379,LAB ELUTION AB RBC EA NS,348.0,146.16,93.96,341.04,37
CDM,3104395,LAB PANEL AB RBC EA TECH SERUM NS,727.0,305.34,196.29,712.46,37
CDM,3104403,LAB COOMBS DIR ANTISERUM EA NS,121.0,50.82,5.39,118.58,37
CDM,3104411,LAB BLOOD TYPE ABO NS,272.0,114.24,2.99,266.56,37
CDM,3104429,LAB BLOOD TYPE ABO DISCREPANCY,272.0,114.24,2.99,266.56,37
CDM,3104437,LAB BLOOD TYPE RHD NS,77.0,32.34,2.99,75.46,37
CDM,3104452,LAB BLOOD TYPE AG RBC PT EA,727.0,305.34,3.83,712.46,37
CDM,3104460,LAB BLOOD TYPE PHENOTYPING RH COMP,122.0,51.24,7.75,119.56,37
CDM,3104486,LAB PRETREAT RBC AB CHEMICAL NS,150.0,63.0,40.5,147.0,37
CDM,3104494,LAB PRETREAT SERUM ABSORP NS,277.0,116.34,60.27,271.46,37
CDM,3104502,LAB HLA SEARCH,230.0,96.6,29.55,225.4,37
CDM,3104544,LAB ISO VIRUS SHELL VIAL ID W IF NS,106.0,44.52,19.56,103.88,37
CDM,3104551,LAB DET AG IA IMM ENZ LEGN URINE NS,66.0,27.72,11.98,64.68,37
CDM,3104569,LAB DET IA HSV QN,129.0,54.18,34.83,126.42,37
CDM,3104577,LAB DET IA PRB AMP NS,106.0,44.52,28.62,103.88,37
CDM,3104585,LAB GENOTYPE IA HEPATITIS C NS,773.0,324.66,208.71,757.54,37
CDM,3104593,LAB CULT TISS NON-NEO LYMPHOCYTE NS,350.0,147.0,94.5,343.0,37
CDM,3104619,LAB INHIBIN A,57.0,23.94,15.39,55.86,37
CDM,3104643,LAB ESTRIOL SERUM,73.0,30.66,19.71,71.54,37
CDM,3104650,LAB SIROLIMUS,57.0,23.94,13.73,55.86,37
CDM,3104692,LAB DET AG IA RSV IMM OPT,40.0,16.8,10.8,39.2,37
CDM,31047,R&B ICU,8046.0,3379.32,6839.1,7885.08,13
CDM,3104700,POC GASES BLD PH ONLY,33.0,13.86,8.91,32.34,37
CDM,3104718,POC CREATININE BLOOD,16.0,6.72,4.32,15.68,37
CDM,3104726,POC TROPONIN QN,38.0,15.96,10.26,37.24,37
CDM,3105020,POC AG EIA STREP GROUP A QL,51.0,21.42,13.77,49.98,37
CDM,3105046,LAB GENOTYPE IA HIV-1 REV T,773.0,324.66,208.71,757.54,37
CDM,3105129,LAB SICKLING RBC REDUCTION,56.0,23.52,5.51,54.88,37
CDM,3105178,LAB CHROM 20-25 CELLS,434.0,182.28,117.18,425.32,37
CDM,3105194,POC CARBOXYHEMOGLOBIN QN,37.0,15.54,9.99,36.26,37
CDM,3105210,POC GASES BLD ANY COMBO W SAT O2,237.0,99.54,63.99,232.26,37
CDM,3105244,LAB DET AG IA IMM ENZ HEP B SURF,58.0,24.36,10.33,56.84,37
CDM,3105343,LAB AMIKACIN PEAK,59.0,24.78,15.08,57.82,37
CDM,3105350,LAB AMIKACIN RANDOM,62.0,26.04,15.08,60.76,37
CDM,3105368,LAB AMIKACIN TROUGH,62.0,26.04,15.08,60.76,37
CDM,3105392,LAB IMM AB GBM QN NS,52.0,21.84,14.04,50.96,37
CDM,3105400,LAB IMM AG ANTI-SOLUBLE LIVER QN,71.0,29.82,17.27,69.58,37
CDM,3105434,LAB ACIDS FATTY VERY LONG CHAIN,205.0,86.1,19.75,200.9,37
CDM,3105467,LAB IMM AB QN NS,142.0,59.64,14.99,139.16,37
CDM,3105475,LAB DET IA PARVOVIRUS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3105509,LAB ALBUMIN SRM/PLASMA/BLD WHL NS,63.0,26.46,4.95,61.74,37
CDM,3105525,LAB HEMOGLOBIN FRCTN&QN ELECTRO NS,71.0,29.82,12.87,69.58,37
CDM,3105533,LAB ISO VIRUS INOC TISSUE NS,100.0,42.0,26.07,98.0,37
CDM,3105558,POC BILIRUBIN TOTAL TRANSQ,16.0,6.72,4.32,15.68,37
CDM,3105608,LAB ACYLCARNITINES QN EA,115.0,48.3,16.87,112.7,37
CDM,3105616,LAB AB ENA CENTROMERE B,60.0,25.2,16.2,58.8,37
CDM,3105657,LAB LACTOFERRIN FECAL QL,73.0,30.66,19.7,71.54,37
CDM,3105681,LAB DET AG IA STREP GROUP A IMM OPT,50.0,21.0,13.5,49.0,37
CDM,3105756,POC GASES BLD PH ONLY,33.0,13.86,8.91,32.34,37
CDM,3105772,LAB CROSS LINKS N-TELOPEPTIDE,68.0,28.56,18.36,66.64,37
CDM,3105855,LAB LEAD BLOOD NS,37.0,15.54,9.99,36.26,37
CDM,3105871,LAB SCR METABOLIC NEWBORN,157.0,65.94,42.39,153.86,30
CDM,3106036,LAB AB LYME DISEASE CONFIRMATORY,61.0,25.62,15.49,59.78,37
CDM,3106051,LAB CULT TISS NON-NEO SKIN/BX NS,423.0,177.66,114.21,414.54,37
CDM,3106168,LAB CROSSMATCH ELECTRONIC,348.0,146.16,93.96,341.04,37
CDM,3106176,LAB AB PEPTIDE CYCLIC CITRUL,60.0,25.2,12.95,58.8,37
CDM,31062,R&B ICU,8046.0,3379.32,6839.1,7885.08,13
CDM,3106390,LAB NIACIN,94.0,39.48,17.06,92.12,37
CDM,3106440,LAB ALLG IGG QN/SEMI QN EA,109.0,45.78,7.82,106.82,37
CDM,3106481,LAB CONSULT PATH SURG CYTO INITIAL,1612.0,677.04,435.24,1579.76,37
CDM,3106499,LAB CONSULT PATH SURG CYTO EA ADDL,65.0,27.3,17.55,63.7,30
CDM,3106531,LAB RENIN NS,66.0,27.72,17.82,64.68,37
CDM,3106556,LAB SUSCPT PHENOTYPE IA DRUG,392.0,164.64,105.84,384.16,37
CDM,3106572,LAB CULT BACT AEROBIC OTHER NS,68.0,28.56,8.62,66.64,37
CDM,3106622,LAB DET AG IA IMM ENZ GIARDIA,36.0,15.12,9.72,35.28,37
CDM,3106689,LAB IMM TRYPTASE QN,77.0,32.34,17.27,75.46,37
CDM,3106721,LAB IMMUNOFIXATION EP SERUM,68.0,28.56,18.36,66.64,37
CDM,3106911,LAB TRANSFERASE AMINO ALANINE NS,59.0,24.78,5.3,57.82,37
CDM,3107026,LAB VITAMIN D 25 HYDROXY W FRAC,89.0,37.38,24.03,87.22,37
CDM,3107133,LAB AB BACTERIUM NONSPECIFIED NS,153.0,64.26,12.88,149.94,37
CDM,3107141,LAB AB ENA NS,65.0,27.3,17.55,63.7,37
CDM,3107166,LAB DET AG IA IMM ENZ INFLUENZA A/B,43.0,18.06,11.61,42.14,37
CDM,3107224,LAB DET IA CANDIDA PRB DIR,90.0,37.8,20.05,88.2,37
CDM,3107232,LAB DET IA GARDNERELLA VAG PRB DIR,90.0,37.8,20.05,88.2,37
CDM,3107240,LAB DET IA TRICHOMONAS VAG PRB DIR,61.0,25.62,16.47,59.78,37
CDM,3107265,LAB IMM RIA PTH REL PROT QN,72.0,30.24,18.4,70.56,37
CDM,3107273,LAB CYTOPATH CERV/VAG AUTO&MANUAL,162.0,68.04,26.61,158.76,37
CDM,3107356,LAB AFP-L3 ISOFORM FRAC&AFP TOTAL,194.0,81.48,52.38,190.12,37
CDM,3107364,LAB LIPOPROTEIN PHOSPHOLIPASE A2,139.0,58.38,37.53,136.22,37
CDM,3107422,LAB DET IA MRSA PRB AMP NS,106.0,44.52,28.62,103.88,37
CDM,3107430,LAB DET IA STREP GROUP B PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3107489,LAB AB WEST NILE VIRUS IGM NS,72.0,30.24,16.85,70.56,37
CDM,3107497,LAB AB WEST NILE VIRUS NS,72.0,30.24,14.39,70.56,37
CDM,3107505,LAB DET AG IA IMM ENZ ASPRGLS NS,152.0,63.84,11.98,148.96,37
CDM,3107596,LAB LIPOPROTEIN CHOLESTEROL LDL,32.0,13.44,8.64,31.36,37
CDM,3107612,LAB HCG QN NS,67.0,28.14,15.05,65.66,37
CDM,3107638,LAB PROT TTL SRM/PLASMA/BLD WHL NS,53.0,22.26,3.67,51.94,37
CDM,3107646,LAB PROT URINE NS,59.0,24.78,3.67,57.82,37
CDM,3107661,LAB PTT PLASMA/BLD WHL NS,54.0,22.68,6.01,52.92,37
CDM,3107687,LAB SUSCPT MIC PLATE EA NS,152.0,63.84,8.65,148.96,37
CDM,3107695,POC UA AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CDM,3107745,LAB SCR PSA,56.0,23.52,15.12,54.88,37
CDM,3107786,POC BLOOD OCCULT OTHER SOURCE QL,16.0,6.72,4.32,15.68,37
CDM,3107828,LAB DET IA EBV PCR QN,129.0,54.18,34.83,126.42,37
CDM,3107836,LAB IRON TISSUE LIVER,208.0,87.36,6.47,203.84,37
CDM,3107851,LAB PRETREAT RBC SEP DENS GRD,455.0,191.1,122.85,445.9,37
CDM,3107877,LAB SMEAR STAIN FL AFB NS,68.0,28.56,5.39,66.64,37
CDM,3107893,LAB INHIBITOR VWF PROTEASE,225.0,94.5,12.87,220.5,37
CDM,3107919,LAB COUNT BLD RETIC AUTO W PARAM,17.0,7.14,4.59,16.66,37
CDM,3108016,LAB DET IA BK VIRUS PCR QN,129.0,54.18,34.83,126.42,37
CDM,3108032,LAB CLOTTING PROTEIN S TOTAL NS,58.0,24.36,11.61,56.84,37
CDM,3108040,LAB CLOTTING PROTEIN S FREE NS,60.0,25.2,15.32,58.8,37
CDM,3108081,LAB THYROID STIMULATING HORMONE NS,51.0,21.42,13.77,49.98,37
CDM,3108123,LAB LACTOFERRIN FECAL QL NS,98.0,41.16,19.7,96.04,37
CDM,3108149,PUNCT ARTERIAL FOR DIAGNOSIS,204.0,85.68,55.08,199.92,37
CDM,3108180,LAB PATH GROSS&MICRO LVL 5 NS,727.0,305.34,196.29,712.46,37
CDM,3108198,LAB STAIN SPECIAL 1 NS,107.0,44.94,28.89,104.86,37
CDM,3108271,LAB PATH GROSS&MICRO LVL 4 NS,107.0,44.94,28.89,104.86,37
CDM,3108305,LAB CYTOM FLOW TECH MARKER 1ST NS,727.0,305.34,196.29,712.46,37
CDM,3108313,LAB CYTOM FLOW TECH MARKER ADDL NS,126.0,52.92,34.02,123.48,30
CDM,3108404,LAB LIPOPROTEIN PART NO/S&SBCLS QN,103.0,43.26,27.81,100.94,37
CDM,3108487,LAB SCR AB MICRO AGG PARTICLE,62.0,26.04,11.54,60.76,37
CDM,3108552,LAB SEMEN SPERM PRESENCE MOTILITY,37.0,15.54,9.99,36.26,37
CDM,3108586,LAB PANEL METAB BASIC W CA IONIZED,60.0,25.2,13.73,58.8,37
CDM,3108628,POC HEMOGLOBIN METHEMOGLOBIN QN,25.0,10.5,6.75,24.5,37
CDM,3108651,LAB CALPROTECTIN FECAL,250.0,105.0,19.63,245.0,37
CDM,3108719,LAB BILIRUBIN TOTAL FLUID BODY NS,136.0,57.12,5.02,133.28,37
CDM,3108735,LAB IMM ACHR BLOCKING QN,99.0,41.58,18.4,97.02,37
CDM,3108768,LAB AB PROTOZOA BABESIA,58.0,24.36,12.39,56.84,37
CDM,3108792,LAB ACID MYCOPHENOLIC NS,55.0,23.1,14.85,53.9,37
CDM,3108859,LAB ACYLCARNITINES QL EA,50.0,21.0,13.5,49.0,37
CDM,3108891,LAB DET IA HERPES 6 PCR QN,126.0,52.92,34.02,123.48,37
CDM,3108909,LAB DET IA JC VIRUS PCR PRB AMP,123.0,51.66,33.21,120.54,37
CDM,3108917,LAB DET IA JC VIRUS PCR QN,129.0,54.18,34.83,126.42,37
CDM,3108925,LAB DET IA BK VIRUS PCR QN NS,129.0,54.18,34.83,126.42,37
CDM,3108933,LAB VORICONAZOLE,127.0,53.34,27.11,124.46,37
CDM,3109022,LAB CYSTATIN C,56.0,23.52,15.12,54.88,37
CDM,3109097,LAB SCR CULT H PYLORI SGL,20.0,8.4,5.4,19.6,37
CDM,3109154,LAB IMM CYSTIC FIBROSIS QN,52.0,21.84,14.04,50.96,37
CDM,3109204,LAB INTRP MARROW BONE SMEAR,1612.0,677.04,435.24,1579.76,37
CDM,3109212,LAB AB DNA STRANDED NATVE/DOUBLE NS,62.0,26.04,13.74,60.76,37
CDM,3109287,LAB IG IGE NS,58.0,24.36,15.66,56.84,37
CDM,3109303,LAB GONADOTROPIN LH NS,57.0,23.94,15.39,55.86,37
CDM,3109311,LAB DEHYDROGENASE G6PD QN NS,56.0,23.52,9.7,54.88,37
CDM,3109352,LAB ANA TITER NS,115.0,48.3,11.16,112.7,37
CDM,3109378,LAB AB COCCIDIOIDES NS,66.0,27.72,11.47,64.68,37
CDM,3109394,LAB CULT TISS NON-NEO MARROW BLD NS,432.0,181.44,116.64,423.36,37
CDM,3109428,LAB SOMATOMEDIN NS,64.0,26.88,17.28,62.72,37
CDM,3109444,LAB AB HERPES SIMPLEX TYPE 1 NS,53.0,22.26,13.19,51.94,37
CDM,3109485,LAB FAT/LIPIDS FECES QL NS,68.0,28.56,5.1,66.64,37
CDM,3109493,LAB ETHYLENE GLYCOL NS,94.0,39.48,14.9,92.12,37
CDM,3109501,LAB DET AG IA IMM ENZ HEP DELTA AGT,175.0,73.5,18.36,171.5,37
CDM,3109527,LAB AB HEPATITIS B CORE TOTAL NS,55.0,23.1,12.05,53.9,37
CDM,3109576,LAB CLOTTING FACTOR 8 1-STG NS,114.0,47.88,17.9,111.72,37
CDM,3109584,LAB CLOTTING FACTOR 9 PTC/XMAS NS,75.0,31.5,19.04,73.5,37
CDM,3109600,LAB CLOTTING FACTOR 11 PTA NS,89.0,37.38,17.9,87.22,37
CDM,3109626,LAB AB EBV EBNA NS,54.0,22.68,14.58,52.92,37
CDM,3109642,LAB AB EBV VCA IGM NS,55.0,23.1,14.85,53.9,37
CDM,3109659,LAB AB VARICELLA-ZOSTER IGM NS,39.0,16.38,10.53,38.22,37
CDM,3109667,LAB AB VARICELLA-ZOSTER IGG NS,53.0,22.26,12.88,51.94,37
CDM,3109675,LAB CLOTTING FACTOR 8 VWF RIST NS,87.0,36.54,22.94,85.26,37
CDM,3109709,LAB PHOSPHORUS INORGANIC URINE NS,18.0,7.56,4.86,17.64,37
CDM,3109717,LAB MAGNESIUM URINE NS,21.0,8.82,5.67,20.58,37
CDM,3109758,LAB FACTOR RHEUMATOID QN NS,55.0,23.1,5.67,53.9,37
CDM,3109766,LAB LIPOPROTEIN A NS,58.0,24.36,14.32,56.84,37
CDM,3109832,LAB LIPOPROTEIN FRCTN HR NS,102.0,42.84,27.54,99.96,37
CDM,3109956,LAB ESTROGEN TOTAL NS,66.0,27.72,17.82,64.68,37
CDM,3109980,LAB THYROGLOBULIN NS,57.0,23.94,15.39,55.86,37
CDM,3110038,LAB CLOTTING FACTOR 13 STB FBR NS,98.0,41.16,16.34,96.04,37
CDM,3110053,LAB PRIMIDONE NS,59.0,24.78,15.93,57.82,37
CDM,3110103,LAB CRYOFIBRINOGEN NS,69.0,28.98,14.14,67.62,37
CDM,3110137,LAB AB THYROGLOBULIN NS,96.0,40.32,15.91,94.08,37
CDM,3110210,LAB NEUTRAL PHOSPHO PLT NS,54.0,22.68,14.58,52.92,37
CDM,3110285,POC NEUTRALIZATION HEPARIN,36.0,15.12,9.72,35.28,37
CDM,3110293,POC TOLERANCE HEPARIN-PROTAMINE,40.0,16.8,10.8,39.2,37
CDM,3110301,LAB IMM MUSK QN,56.0,23.52,15.12,54.88,37
CDM,3110319,LAB SCR AB MUSCLE SMOOTH FL NS,56.0,23.52,12.05,54.88,37
CDM,3110327,LAB AB CRYPTOCOCCUS IFA,44.0,18.48,11.88,43.12,37
CDM,3110517,LAB CHROMIUM,61.0,25.62,16.47,59.78,37
CDM,3110574,LAB CHROM W BND 5 CLL 1 K CVS DIR,794.0,333.48,214.38,778.12,37
CDM,3110582,LAB ALPHA2-MACROGLOBULIN QN,72.0,30.24,13.6,70.56,37
CDM,3110590,LAB IMM ACHR MODULATING QN,78.0,32.76,12.05,76.44,37
CDM,3110608,LAB ACID MYCOPHENOLIC,55.0,23.1,14.85,53.9,37
CDM,3110715,LAB SUSCPT DILUTION MACROBROTH NS,115.0,48.3,6.64,112.7,37
CDM,3110723,LAB CULT FUNGI ID DF YEAST NS,136.0,57.12,10.32,133.28,37
CDM,3110731,LAB CULT FUNGI ID DF MOLD NS,138.0,57.96,10.32,135.24,37
CDM,3110756,LAB SUSCPT AFB PROPORTION EA NS,63.0,26.46,7.31,61.74,37
CDM,3110764,LAB ELASTASE PANCREATIC FECAL,104.0,43.68,11.53,101.92,37
CDM,3110772,LAB DET IA EBV PCR QN NS,129.0,54.18,34.83,126.42,37
CDM,3110780,LAB VITAMIN E BETA/GAMMA TOCOPHER,52.0,21.84,14.04,50.96,37
CDM,3110798,LAB DET IA ADENOVIRUS PCR QN,129.0,54.18,34.83,126.42,37
CDM,3110806,LAB DET IA HHV NON 6 PCR QN,129.0,54.18,34.83,126.42,37
CDM,3110814,LAB DET IA HHV-8 PCR PRB AMP,124.0,52.08,33.48,121.52,37
CDM,3110822,LAB DET IA EBV PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3110830,LAB AB HERPES SIMPLEX TYPE 2 NS,59.0,24.78,15.93,57.82,37
CDM,3110863,LAB COAGULATION&FIBRINOLYSIS,164.0,68.88,30.86,160.72,37
CDM,3110871,LAB AB ENA JO1,123.0,51.66,17.93,120.54,37
CDM,3110889,LAB IMM MS RIBO P PROTEIN QL,35.0,14.7,9.45,34.3,37
CDM,3110897,LAB AB ENA CHROMATIN,124.0,52.08,17.93,121.52,37
CDM,3110905,LAB AB ENA SM/RNP,124.0,52.08,17.93,121.52,37
CDM,3110921,LAB AB LYME DISEASE IGG IGM,66.0,27.72,17.03,64.68,37
CDM,3110996,LAB KAPPA/LAMBDA LIGHT NS,55.0,23.1,13.6,53.9,37
CDM,3111002,LAB DET IA BK VIRUS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3111028,LAB DET IA CHLAMYD TRAC PRB AMP NS,115.0,48.3,31.05,112.7,37
CDM,3111036,LAB DET IA GC PRB AMP NS,106.0,44.52,28.62,103.88,37
CDM,3111069,LAB AB TOXOPLASMA IGM,60.0,25.2,14.41,58.8,37
CDM,3111077,LAB AB TOXOPLASMA IGG,60.0,25.2,14.39,58.8,37
CDM,3111093,LAB AB PARAINFLUENZA,66.0,27.72,12.88,64.68,37
CDM,3111119,LAB AB STRONGYLOIDES,69.0,28.98,13.01,67.62,37
CDM,3111168,LAB TRIIODOTHYRONINE T3 TOTAL NS,43.0,18.06,11.61,42.14,37
CDM,3111176,LAB HEMOGLOBIN FRCTN&QN CHROMAT NS,55.0,23.1,14.85,53.9,37
CDM,3111283,LAB IMM RIA RECEPTOR TSH QN,101.0,42.42,18.4,98.98,37
CDM,3111341,LAB IMM MS HISTONE QL,62.0,26.04,11.53,60.76,37
CDM,3111358,LAB CHROM BRK STRS CLASTGN 100 CELL,520.0,218.4,140.4,509.6,37
CDM,3111390,LAB SCR AB PURKINJE FL,64.0,26.88,12.05,62.72,37
CDM,3111416,LAB AGG PARTICLE TITER STREPTOZYME,81.0,34.02,10.64,79.38,37
CDM,3111432,LAB DET IA VZV PCR QN,129.0,54.18,34.83,126.42,37
CDM,3111630,LAB PROCALCITONIN,141.0,59.22,27.22,138.18,37
CDM,3111648,LAB FNCT CELL W STIM&DET BIOMARK,408.0,171.36,110.16,399.84,37
CDM,3111655,LAB AG CELL MONONUC QN EA AG,93.0,39.06,25.11,91.14,37
CDM,3111671,LAB AB ID IG PLATELET ASSOCIATED,236.0,99.12,12.46,231.28,37
CDM,3111713,LAB LACTOFERRIN FECAL QN,204.0,85.68,19.63,199.92,37
CDM,3111804,LAB MCG PROBE DNA PROBE EA NS,272.0,114.24,21.42,266.56,37
CDM,3111812,LAB MCG IN SITU INT 100-300 CELL NS,154.0,64.68,41.58,150.92,37
CDM,3111838,LAB CULT AFB ID ISOLATES NS,65.0,27.3,10.8,63.7,37
CDM,3111911,LAB BLOOD OCCULT FECES 1-3 IMM QL,62.0,26.04,15.92,60.76,37
CDM,3111929,LAB IMM RECEPTOR TSH QN,52.0,21.84,14.04,50.96,37
CDM,3111952,LAB STAIN CONSTITUENTS ENZYME NS,1612.0,677.04,435.24,1579.76,37
CDM,3112026,LAB AB LEPTOSPIRA TITER,154.0,64.68,16.2,150.92,37
CDM,3112034,LAB AB FL TITER ANTIMYOCARDIAL,37.0,15.54,9.99,36.26,37
CDM,3112075,LAB COUNT TOTAL CELLS CD56 NK NS,114.0,47.88,30.78,111.72,37
CDM,3112182,LAB IMM AB QN PNEUMOCOCCAL,51.0,21.42,13.77,49.98,37
CDM,3112208,LAB SCR HEMOLYSINS&AGGLUTININS AUTO,490.0,205.8,8.77,480.2,37
CDM,3112224,LAB TB MEAS IMMUNITY GAMMA INTERFRN,186.0,78.12,50.22,182.28,37
CDM,3112232,LAB VITAMIN B-12 CAPACITY BNDG NS,66.0,27.72,14.32,64.68,37
CDM,3112240,LAB DET IA HEP B QN,129.0,54.18,34.83,126.42,37
CDM,3112331,LAB CARBOXYHEMOGLOBIN QN,56.0,23.52,12.32,54.88,37
CDM,3112356,LAB CULT TYPING ID SEQ NUC ACID,347.0,145.74,93.69,340.06,37
CDM,3112372,LAB DET IA CHLAMYD PNEU PRB AMP NS,328.0,137.76,35.09,321.44,37
CDM,3112448,LAB BLOOD TYPE DONOR SERUM RGT,727.0,305.34,6.35,712.46,37
CDM,3112505,LAB CYTOPATH EVAL FNA IMMED 1ST,348.0,146.16,93.96,341.04,37
CDM,3112521,LAB CYTOPATH EVAL FNA IMMED ADDL,90.0,37.8,24.3,88.2,30
CDM,3112646,LAB TRANSFERASE GAMMA-GLUTAMYL NS,62.0,26.04,7.2,60.76,37
CDM,3112661,LAB PROT 4 HUMAN EPIDIDYMIS,97.0,40.74,20.81,95.06,37
CDM,3112679,POC PAMG-1 CERVICOVAGINAL QL,295.0,123.9,79.65,289.1,37
CDM,3112695,LAB IMM AB GBM QN,60.0,25.2,16.2,58.8,37
CDM,3112703,LAB GENOTYPE IA HIV-1 TROPISM CORCP,387.0,162.54,104.49,379.26,37
CDM,3112711,LAB ZONISAMIDE,79.0,33.18,13.25,77.42,37
CDM,3112737,LAB PH FLUID BODY NOS NS,104.0,43.68,3.58,101.92,37
CDM,3112786,LAB HEAVY METAL QN COBALT,288.0,120.96,21.96,282.24,37
CDM,3112802,POC COAGULATION TIME ACTIVAT TELCOR,13.0,5.46,3.51,12.74,37
CDM,3112810,POC NITROGEN UREA QN TELCOR,12.0,5.04,3.24,11.76,37
CDM,3112828,POC CREATININE BLOOD TELCOR,16.0,6.72,4.32,15.68,37
CDM,3112836,POC PROTHROMBIN TIME TELCOR,13.0,5.46,3.51,12.74,37
CDM,3112869,POC SODIUM SRM/PLASMA/BLD WHL TLCR,15.0,6.3,4.05,14.7,37
CDM,3112877,POC POTASS SRM/PLASMA/BLD WHL TLCR,15.0,6.3,4.05,14.7,37
CDM,3112885,POC CHLORIDE BLOOD TELCOR,14.0,5.88,3.78,13.72,37
CDM,3112893,POC GASES BLD ANY COMBO TELCOR,79.0,33.18,21.33,77.42,37
CDM,3112919,POC CALCIUM IONIZED TELCOR,42.0,17.64,11.34,41.16,37
CDM,3112927,POC GASES BLD PH ONLY TELCOR,33.0,13.86,8.91,32.34,37
CDM,3112935,POC PANEL ELECTROLYTE TELCOR,22.0,9.24,5.94,21.56,37
CDM,3112950,LAB SEPARATION RED CELL,268.0,112.56,29.55,262.64,37
CDM,3112976,LAB DET AG IA IMM ENZ CRYPTOSPOR NS,74.0,31.08,13.82,72.52,37
CDM,3112992,LAB AGGREGATION PLT CLOPIDOGREL,75.0,31.5,20.25,73.5,37
CDM,3113008,LAB AGGREGATION PLT ASPIRIN,75.0,31.5,20.25,73.5,37
CDM,3113016,LAB SCR FIBRINOLYSINS/COAG,65.0,27.3,15.48,63.7,37
CDM,3113032,LAB PHENOBARBITAL NS,59.0,24.78,15.3,57.82,37
CDM,3113040,LAB PEPTIDE NATRIURETIC PB NS,121.0,50.82,32.67,118.58,37
CDM,3113057,LAB PHOSPHORUS INORGANIC NS,15.0,6.3,4.05,14.7,37
CDM,3113073,LAB CULT BACT AEROBIC STOOL PATH NS,63.0,26.46,9.44,61.74,37
CDM,3113081,LAB CULT TYPING ID NUC ACID PRB AMP,137.0,57.54,35.09,134.26,37
CDM,3113115,LAB DET IA BK VIRUS PCR QN URINE,129.0,54.18,34.83,126.42,37
CDM,3113131,LAB PROT WB W INTRP ID CREUTZ-JAKOB,89.0,37.38,24.03,87.22,37
CDM,3113149,LAB IMM AB QN CREUTZFELDT-JAKOB,83.0,34.86,14.99,81.34,37
CDM,3113156,LAB SPCTPHOT 1-3-BETA-D-GLUCAN,157.0,65.94,8.1,153.86,37
CDM,3113214,LAB HEMOGLOBIN METHEMOGLOBIN QN,59.0,24.78,8.2,57.82,37
CDM,3113222,LAB DET IA TOXOPLASMA PCR QN,130.0,54.6,35.1,127.4,37
CDM,3113230,LAB DET IA PNEUMOCYSTIS PCR QN,275.0,115.5,42.84,269.5,37
CDM,3113248,LAB IMM MS NEUROMYLTS OPT IGG QL,35.0,14.7,9.45,34.3,37
CDM,3113255,LAB DET AG IA IMM ENZ ENTAM HIST NS,73.0,30.66,11.98,71.54,37
CDM,3113362,LAB TB MEAS IMMUNITY T-CELL SUSP,300.0,126.0,81.0,294.0,37
CDM,3113370,LAB PRETREAT SERUM INCUB INHIB,348.0,146.16,93.96,341.04,37
CDM,3113420,LAB DET IA PARVOVIRUS PCR QN,141.0,59.22,38.07,138.18,37
CDM,3113446,LAB DET AG IA IMM ENZ STREP PNEU QL,65.0,27.3,11.98,63.7,37
CDM,3113461,LAB DET IA TOXIN C DIFF PRB AMP,112.0,47.04,30.24,109.76,37
CDM,3113479,LAB IMM MS GLIADIN QL,59.0,24.78,12.05,57.82,37
CDM,3113487,LAB IMM MS TRANSGLUTAMINASE QL,59.0,24.78,11.53,57.82,37
CDM,3113495,LAB AB FL TITER NS,78.0,32.76,12.05,76.44,37
CDM,3113511,LAB CYTOPATH URIN MANUAL PRB 3-5 EA,1181.0,496.02,174.06,1157.38,37
CDM,3113537,LAB PYRUVATE KINASE NS,187.0,78.54,9.44,183.26,37
CDM,3113545,LAB COUNT TOTAL CELLS T NS,114.0,47.88,30.78,111.72,37
CDM,3113552,LAB COUNT CELLS T CD4&CD8 RATIO NS,141.0,59.22,38.07,138.18,37
CDM,3113610,LAB BLOOD TYPE IMMUNOPHENOTYPE,727.0,305.34,3.83,712.46,37
CDM,3113628,LAB BLOOD TYPE DONOR SERUM RGT NS,727.0,305.34,6.35,712.46,37
CDM,3113644,LAB MICRODISSECTION MANUAL,230.0,96.6,62.1,225.4,30
CDM,3113685,LAB PLATELET RETICULATED,108.0,45.36,29.16,105.84,37
CDM,3113727,LAB PRETREAT SERUM INCUB W DRUGS,911.0,382.62,245.97,892.78,37
CDM,3113735,LAB SCR AGGLUTININ COLD NS,25.0,10.5,6.75,24.5,37
CDM,3113750,LAB KAPPA/LAMBDA LIGHT,69.0,28.98,13.6,67.62,37
CDM,3113784,LAB GENE BCR/ABL1 BREAKPOINT MAJOR,492.0,206.64,132.84,482.16,37
CDM,3113792,LAB GENE BCR/ABL1 BREAKPOINT MIN NS,435.0,182.7,117.45,426.3,37
CDM,3113800,LAB GENE BCR/ABL1 BREAKPOINT OTHER,644.0,270.48,173.88,631.12,37
CDM,3113826,LAB GENE BRAF VAR V600E NS,527.0,221.34,142.29,516.46,37
CDM,3113909,LAB GENE CFTR VAR COMMON,1670.0,701.4,450.9,1636.6,37
CDM,3113925,LAB GENE CFTR VAR DUP/DEL,1306.0,548.52,352.62,1279.88,37
CDM,3113933,LAB GENE CFTR SEQ FULL,1497.0,628.74,404.19,1467.06,37
CDM,3113941,LAB GENE CFTR INTRON 8 POLY-T,507.0,212.94,136.89,496.86,37
CDM,3113958,LAB GENE CYP2C19 VAR COMMON NS,875.0,367.5,236.25,857.5,37
CDM,3114006,LAB GENE F2 VAR 20210G>A NS,198.0,83.16,53.46,194.04,37
CDM,3114014,LAB GENE F5 VAR LEIDEN,221.0,92.82,59.67,216.58,37
CDM,3114030,LAB GENE FMR1 DET ALLELES ABNORMAL,172.0,72.24,46.44,168.56,37
CDM,3114055,LAB GENE FLT3 VAR ITD,497.0,208.74,134.19,487.06,37
CDM,3114097,LAB GENE HFE VAR COMMON NS,197.0,82.74,53.19,193.06,37
CDM,3114105,LAB GENE HBA1/HBA2 DEL/VAR COMMON,307.0,128.94,82.89,300.86,37
CDM,3114121,LAB GENE IGH REARRANGEMENT AMP,594.0,249.48,160.38,582.12,37
CDM,3114147,LAB GENE IGH MUT VARIABLE REGION,884.0,371.28,238.68,866.32,37
CDM,3114154,LAB GENE IGK REARRANGEMENT CLONAL,519.0,217.98,140.13,508.62,37
CDM,3114162,LAB GENE MARKERS STR SPEC PT&CMP,700.0,294.0,189.0,686.0,37
CDM,3114188,LAB GENE CHIMERISM WO CELL SLCT NS,1139.0,478.38,207.46,1116.22,37
CDM,3114196,LAB GENE CHIMERISM W CELL SLCT EA,783.0,328.86,211.41,767.34,37
CDM,3114204,LAB GENE JAK2 VAR V617F NS,275.0,115.5,74.25,269.5,37
CDM,3114212,LAB GENE KRAS VAR CODONS 12&13 NS,580.0,243.6,156.6,568.4,37
CDM,3114261,LAB GENE MTHFR VAR COMMON NS,197.0,82.74,53.19,193.06,37
CDM,3114360,LAB GENE INSTABILITY MICROSATELLITE,1046.0,439.32,282.42,1025.08,37
CDM,3114402,LAB GENE NPM1 VAR EXON 12,740.0,310.8,199.8,725.2,37
CDM,3114410,LAB GENE PML/RARALPHA BREAKPOINTS,622.0,261.24,167.94,609.56,37
CDM,3114477,LAB GENE SNRPN/UBE3A METHYLATION,198.0,83.16,51.07,194.04,37
CDM,3114485,LAB GENE SERPINA1 VAR COMMON,346.0,145.32,43.65,339.08,37
CDM,3114493,LAB GENE TRB REARRANGEMENT AMP,627.0,263.34,169.29,614.46,37
CDM,3114519,LAB GENE TRG REARRANGEMENT CLONAL,605.0,254.1,163.35,592.9,37
CDM,3114527,LAB GENE UGT1A1 VAR COMMON NS,702.0,294.84,189.54,687.96,37
CDM,3114543,LAB GENE TYPING HLA 1&2 LR,1207.0,506.94,325.89,1182.86,37
CDM,3114568,LAB GENE TYPING HLA 1 LR CMP,1211.0,508.62,326.97,1186.78,37
CDM,3114584,LAB GENE TYPING HLA 1 LR AG 1 EA,223.0,93.66,60.21,218.54,37
CDM,3114618,LAB GENE TYPING HLA 2 LR AG 1 EA,285.0,119.7,76.95,279.3,37
CDM,3114634,LAB GENE TYPING HLA 1 HR CMP,1007.0,422.94,271.89,986.86,37
CDM,3114642,LAB GENE TYPING HLA 1 HR LOCUS EA,532.0,223.44,143.64,521.36,37
CDM,3114659,LAB GENE TYPING HLA 1 HR ALLE 1/GRP,510.0,214.2,137.7,499.8,37
CDM,3114667,LAB GENE TYPING HLA 2 HR LOCUS EA,372.0,156.24,100.44,364.56,37
CDM,3114675,LAB GENE TYPING HLA 2 HR ALLE 1/GRP,328.0,137.76,88.56,321.44,37
CDM,3114683,LAB PROC PATHOLOGY MOLEC LEVEL 1,192.0,80.64,51.84,188.16,37
CDM,3114709,LAB PROC PATHOLOGY MOLEC LEVEL 3,451.0,189.42,121.77,441.98,37
CDM,3114717,LAB PROC PATHOLOGY MOLEC LEVEL 4 NS,617.0,259.14,166.59,604.66,37
CDM,3114725,LAB PROC PATHOLOGY MOLEC LEVEL 5,825.0,346.5,222.75,808.5,37
CDM,3114733,LAB PROC PATHOLOGY MOLEC LEVEL 6,905.0,380.1,244.35,886.9,37
CDM,3114741,LAB PROC PATHOLOGY MOLEC LEVEL 7,849.0,356.58,229.23,832.02,37
CDM,3114758,LAB PROC PATHOLOGY MOLEC LEVEL 8,2539.0,1066.38,685.53,2488.22,37
CDM,3114766,LAB PROC PATHOLOGY MOLEC LEVEL 9,6000.0,2520.0,1620.0,5880.0,37
CDM,3114824,LAB SCR AB NMDA RECEPTOR FL,167.0,70.14,12.05,163.66,37
CDM,3114832,LAB NEUTRAL PHOSPHO HEXAGONAL NS,64.0,26.88,17.28,62.72,37
CDM,3114840,LAB THROMBIN TIME PLASMA NS,18.0,7.56,4.86,17.64,37
CDM,3114931,LAB GENE MA CYTO COPY NO&SNP BLD NS,3480.0,1461.6,939.6,3410.4,37
CDM,3114949,LAB GENE MA CYTO COPY NO&SNP POC,3480.0,1461.6,939.6,3410.4,37
CDM,3114956,LAB COUNT BLD RBC AUTO NS,63.0,26.46,3.02,61.74,37
CDM,3114964,LAB COUNT BLD HEMATOCRIT NS,69.0,28.98,2.37,67.62,37
CDM,3114972,LAB COUNT BLD HEMOGLOBIN NS,60.0,25.2,2.37,58.8,37
CDM,3114980,LAB GENE MGMT ANLYS METHYLATION,374.0,157.08,100.98,366.52,37
CDM,3114998,LAB DEXAMETHASONE,60.0,25.2,16.2,58.8,37
CDM,3115003,LAB FLUCONAZOLE,111.0,46.62,18.64,108.78,37
CDM,3115011,LAB SCR AB SYPHILIS NS,40.0,16.8,10.8,39.2,37
CDM,3115029,LAB GENE MA CYTO COPY NO&SNP BLD,3480.0,1461.6,939.6,3410.4,37
CDM,3115060,LAB DET IA TRICHOMONAS VAG PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3115169,LAB DET IA B PERTUSSIS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3115193,LAB B CELLS CD19 COUNT TOTAL NS,114.0,47.88,30.78,111.72,37
CDM,3115649,LAB DET IA LEGIONELL PNEUM PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3115664,LAB POSACONAZOLE,118.0,49.56,27.11,115.64,37
CDM,3115672,LAB DIGOXIN TOTAL,53.0,22.26,13.28,51.94,37
CDM,3115680,LAB DIGOXIN FREE,40.0,16.8,10.8,39.2,37
CDM,3115698,LAB ACID VALPROIC TOTAL,53.0,22.26,13.54,51.94,37
CDM,3115730,LAB IMHST/IMCYT MLTPLX PER SPEC NS,1023.0,429.66,276.21,1002.54,37
CDM,3115748,LAB MORPHO HER2 MANUAL PER SPEC NS,374.0,157.08,100.98,366.52,37
CDM,3115755,LAB MORPHO HER2 COMP PER SPEC,727.0,305.34,196.29,712.46,37
CDM,3115763,LAB ISH PRB STAIN PER SPEC ADDL,136.0,57.12,36.72,133.28,30
CDM,3115771,LAB ISH PRB STAIN PER SPEC ADDL NS,124.0,52.08,33.48,121.52,30
CDM,3115789,LAB ISH 1ST PRB STAIN PER SPEC NS,348.0,146.16,93.96,341.04,37
CDM,3115797,LAB ISH 1ST PRB STAIN PER SPEC,348.0,146.16,93.96,341.04,37
CDM,3115805,LAB MORPHO ISH COMP 1ST SPEC NS,727.0,305.34,196.29,712.46,37
CDM,3115813,LAB MORPHO ISH MANUAL 1ST SPEC,727.0,305.34,196.29,712.46,37
CDM,3115821,LAB MORPHO ISH MANUAL 1ST SPEC NS,727.0,305.34,196.29,712.46,37
CDM,3115839,LAB MORPHO ISH MANUAL ADDL SPEC,196.0,82.32,52.92,192.08,30
CDM,3115847,LAB MORPHO ISH MANUAL ADDL SPEC NS,101.0,42.42,27.27,98.98,30
CDM,3115854,LAB MORPHO ISH COMP ADDL SPEC NS,86.0,36.12,23.22,84.28,30
CDM,3115862,LAB PATH GROSS&MICRO BX PROS NDL,546.0,229.32,147.42,535.08,37
CDM,3115888,LAB VOLATILE,52.0,21.84,14.04,50.96,37
CDM,3115896,LAB SCR VOLATILE,52.0,21.84,14.04,50.96,37
CDM,3115904,LAB IMHST/IMCYT AB 1ST PER SPEC NS,348.0,146.16,93.96,341.04,37
CDM,3115912,LAB IMHST/IMCYT AB PER SPEC NS ADDL,137.0,57.54,36.99,134.26,30
CDM,3115961,LAB DET IA HPV TYPES 16&18,122.0,51.24,32.94,119.56,37
CDM,3115987,LAB ISH MLTPLX PER SPEC,517.0,217.14,139.59,506.66,37
CDM,3115995,LAB DET IA GI MULT PRB AMP 3-5 TGT,385.0,161.7,103.95,377.3,37
CDM,3116001,LAB MORPHO ISH COMP MULT SPEC NS,553.0,232.26,149.31,541.94,37
CDM,3116035,LAB FDP FSP AGG SEMI QN NS,80.0,33.6,6.89,78.4,37
CDM,3116043,LAB MORPHO ISH MAN MULT PER SPEC NS,348.0,146.16,93.96,341.04,37
CDM,3116126,LAB ACID VALPROIC TOTAL NS,66.0,27.72,13.54,64.68,37
CDM,3116134,LAB ACID VALPROIC FREE,66.0,27.72,13.54,64.68,37
CDM,3116142,LAB GENE TPMT NS,525.0,220.5,141.75,514.5,37
CDM,3116159,LAB DET IA CANDIDA PRB AMP,237.0,99.54,35.09,232.26,37
CDM,3116241,LAB SMEAR INCL BODIES/PARASITE NS,64.0,26.88,5.99,62.72,37
CDM,3116316,LAB DET AG IA IMM HIV1 W HIV 1&2,87.0,36.54,23.49,85.26,37
CDM,3116332,LAB DET IA HIV-1 QN NS,256.0,107.52,69.12,250.88,37
CDM,3116357,LAB PH STOOL NS,72.0,30.24,3.58,70.56,37
CDM,3116365,LAB SCR AB PARANEOPLASTIC FL,93.0,39.06,12.05,91.14,37
CDM,3116373,LAB ARIPIPRAZOLE,62.0,26.04,16.74,60.76,37
CDM,3116381,LAB HSP 70 WB W INTRP,174.0,73.08,17.03,170.52,37
CDM,3116399,LAB GENE BCR/ABL1 BREAKPOINT MIN,435.0,182.7,117.45,426.3,37
CDM,3116407,LAB GENE BCR/ABL1 REFLEX P210,492.0,206.64,132.84,482.16,37
CDM,3116423,LAB CONCENTRATION ANY TYPE IA NS,128.0,53.76,6.68,125.44,37
CDM,3116431,LAB DET AG IA IF PNEUMOCYSTIS NS,76.0,31.92,11.98,74.48,37
CDM,3116472,LAB GENE ANLYS MUT CALRETICULIN,365.0,153.3,98.55,357.7,37
CDM,3116506,LAB GENE MLH1 METHYLATION,577.0,242.34,155.79,565.46,37
CDM,3116514,LAB CHROMAT MS NON-DRUG QL/QN NS,73.0,30.66,19.71,71.54,37
CDM,3116522,LAB MS&MS TNDM NON-DRUG QL/QN,73.0,30.66,19.71,71.54,37
CDM,3116530,LAB AB HEPATITIS A,55.0,23.1,12.39,53.9,37
CDM,3116571,LAB CLOMIPRAMINE,62.0,26.04,16.74,60.76,37
CDM,3116597,LAB GENE ABL1 VAR KD,900.0,378.0,243.0,882.0,37
CDM,3116605,LAB GENE CEBPA SEQ FULL,726.0,304.92,196.02,711.48,37
CDM,3116613,LAB BUSULFAN,56.0,23.52,15.12,54.88,37
CDM,3116662,LAB GENE FLT3 VAR TKD,249.0,104.58,67.23,244.02,37
CDM,3116670,LAB DRG DF ANTD CYCL AMIT DAY 1-2,62.0,26.04,16.74,60.76,30
CDM,3116704,LAB DRG DF BENZ DAY 1-12,84.0,35.28,22.68,82.32,30
CDM,3116720,LAB DRG DF BENZ CLONAZEPM DAY 1-12,67.0,28.14,18.09,65.66,30
CDM,3116837,LAB DRG DF ANTD CYCL DESI DAY 1-2NS,62.0,26.04,16.74,60.76,30
CDM,3116860,LAB DRG DF ANTD CYCL DOXE DAY 1-2,74.0,31.08,19.98,72.52,30
CDM,3116894,LAB DRG DF GOLD DAY 1-3,170.0,71.4,45.9,166.6,30
CDM,3116928,LAB DRG DF ANTD CYCL IMIPRM DAY 1-2,62.0,26.04,16.74,60.76,30
CDM,3116951,LAB DRG DF ANTD CYCL NORT DAY 1-2,68.0,28.56,18.36,66.64,30
CDM,3117017,LAB DRG DF ANLG SALICYLATE DAY 1-2,178.0,74.76,48.06,174.44,30
CDM,3117041,LAB DRG DF ANLG ACETAMINPHN DAY 1-2,178.0,74.76,48.06,174.44,30
CDM,3117074,LAB DRG DF ETOH EXCEPT BR DAY,132.0,55.44,35.64,129.36,30
CDM,3117082,LAB DRG DF ETOH EXCEPT BR DAY NS,61.0,25.62,16.47,59.78,30
CDM,3117108,LAB DRG DF AMPH/METH DAY 1-2 NS,73.0,30.66,19.71,71.54,30
CDM,3117132,LAB DRG DF BARB PHENOBARB DAY,164.0,68.88,44.28,160.72,30
CDM,3117181,LAB DRG DF BARB URINE DAY,67.0,28.14,18.09,65.66,30
CDM,3117199,LAB DRG DF COCAINE DAY,67.0,28.14,18.09,65.66,30
CDM,3117256,LAB DRG DF MSCL RELAX DAY 1-2,154.0,64.68,41.58,150.92,30
CDM,3117280,LAB DRG DF METHADONE DAY NS,67.0,28.14,18.09,65.66,30
CDM,3117298,LAB DRG DF ALKALOIDS NICOTINE DAY,182.0,76.44,49.14,178.36,30
CDM,3117306,LAB DRG DF OPIATE DAY 1+,104.0,43.68,28.08,101.92,30
CDM,3117314,LAB DRG DF OXYCODONE DAY,104.0,43.68,28.08,101.92,30
CDM,3117405,LAB DRG DF CNFRM AMPH DAY 1-2,73.0,30.66,19.71,71.54,30
CDM,3117462,LAB DRG DF CNFRM PHENCYCLDN/PCP DAY,67.0,28.14,18.09,65.66,30
CDM,3117488,LAB DRG SCR DIRECT OPT OBS ONLY DAY,38.0,15.96,10.26,37.24,37
CDM,3117496,LAB DRG SC DIRECT OPT INST ASST DAY,52.0,21.84,14.04,50.96,37
CDM,3117512,LAB DRG DF SULFONYLUREAS DAY 7+,178.0,74.76,48.06,174.44,30
CDM,3117538,LAB DRG DF CANNABINOIDS DAY,84.0,35.28,22.68,82.32,30
CDM,3117561,LAB GENE NRAS VAR EXON 2&3 NS,888.0,372.96,239.76,870.24,37
CDM,3117611,LAB COMPLEMENT AG COMP EA NS,222.0,93.24,12.0,217.56,37
CDM,3117645,LAB DRG DF ANTIEPILEPTICS DAY 1-3,176.0,73.92,47.52,172.48,30
CDM,3117652,LAB IMM MS MYOSITIS,67.0,28.14,11.53,65.66,37
CDM,3117660,LAB DET IA GI MULT PRB 12-25TGT NS,1251.0,525.42,337.77,1225.98,37
CDM,3117686,LAB GENE MTHFR VAR COMMON,197.0,82.74,53.19,193.06,37
CDM,3117694,LAB IF AB STAIN PER SPEC ADDL NS,189.0,79.38,51.03,185.22,30
CDM,3117702,LAB IF AB STAIN INITIAL PER SPEC NS,348.0,146.16,93.96,341.04,37
CDM,3117710,LAB INTERLEUKIN 2 RECEPTOR,144.0,60.48,36.57,141.12,37
CDM,3117728,LAB DRG DF FENTANYL DAY,67.0,28.14,18.09,65.66,30
CDM,3117736,LAB DET IA MYCOBCT TB PRB AMP,126.0,52.92,34.02,123.48,37
CDM,3117744,LAB GENE BRCA1&2 SEQ&DUP/DEL FULL,5475.0,2299.5,1478.25,5365.5,37
CDM,3117769,LAB IMM INTERLEUKIN 6 QN,109.0,45.78,17.27,106.82,37
CDM,3117777,LAB GENE KIT VAR D816,375.0,157.5,101.25,367.5,37
CDM,3117785,LAB AB JOHN CUNNINGHAM VIRUS,51.0,21.42,13.77,49.98,37
CDM,3117819,LAB DRG DF METHYLENEDIOXYAMPH NS,70.0,29.4,18.9,68.6,30
CDM,3117827,LAB DET IA GI MULT PRB AMP 6-11 TGT,789.0,331.38,213.03,773.22,37
CDM,3117835,LAB GENOMIC ANLY SEQ SO/HL 51+ NS,8759.0,3678.78,2364.93,8583.82,37
CDM,3117868,LAB DET IA HSV PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3117876,LAB MORPHO ISH COMP MULT PER SPEC,348.0,146.16,93.96,341.04,37
CDM,3117892,LAB DET IA HEP E PCR QN,251.0,105.42,42.84,245.98,37
CDM,3117918,LAB DRG DF ANTD SEROTONERG DAY 3-5,97.0,40.74,26.19,95.06,30
CDM,3117926,LAB DRG DF ANTD CYCL DAY 6+,87.0,36.54,23.49,85.26,30
CDM,3118031,LAB FETAL CHROMOSOMAL ANEUPLOIDY,2278.0,956.76,615.06,2232.44,37
CDM,3118064,LAB GENOMIC ANLY SEQ HL 5-50 NS,2395.0,1005.9,646.65,2347.1,37
CDM,3118080,LAB MORPHO TMR IHC MNL PER SPEC NS,348.0,146.16,93.96,341.04,37
CDM,3118106,LAB DET IA MYCOBCT PRB AMP,450.0,189.0,48.24,441.0,37
CDM,3118254,LAB PARATHORMONE NS,124.0,52.08,33.48,121.52,37
CDM,3118262,LAB COAGULATION TIME ACTIVATED,55.0,23.1,4.28,53.9,37
CDM,3118270,LAB IMM PHOS TAU/TTL TAU/BETA42,650.0,273.0,17.27,637.0,37
CDM,3118288,LAB DET IA LEGIONELL MULT PRB AMP,211.0,88.62,56.97,206.78,37
CDM,3118320,LAB GENE EGFR VAR COMMON,974.0,409.08,262.98,954.52,37
CDM,3118361,LAB GENOMIC ANLY SEQ SO 5-50 NS,1794.0,753.48,484.38,1758.12,37
CDM,3118379,LAB IMM IGFBP 3 QN,64.0,26.88,17.27,62.72,37
CDM,3118387,LAB DRG DF HEROIN METABOLITE DAY,56.0,23.52,15.12,54.88,30
CDM,3118403,LAB CHROMAT MS BILE ACIDS FRAC/TTL,259.0,108.78,24.09,253.82,37
CDM,3118502,LAB DET AG IA HBSAG QL/SEMI QN NS,231.0,97.02,10.33,226.38,37
CDM,3118551,LAB AB HIV-1&HIV-2 RESULT SGL NS,70.0,29.4,13.71,68.6,37
CDM,3118601,LAB DRG DF ETOH BIOMRK URINE 1-2,158.0,66.36,42.66,154.84,30
CDM,3118619,LAB DRG DF METHYLPHENIDATE DAY,67.0,28.14,18.09,65.66,30
CDM,3118684,LAB GLUCOSE FLUID BODY NS,131.0,55.02,3.93,128.38,37
CDM,3118759,LAB SCR CULT ACANTHAMOEBA,20.0,8.4,5.4,19.6,37
CDM,3118767,LAB DRG DF TRAMADOL,67.0,28.14,18.09,65.66,30
CDM,3118775,LAB DET IA CNS PRB AMP 12-25 TGT,1251.0,525.42,337.77,1225.98,37
CDM,3118791,LAB DET IA CMV QN,129.0,54.18,34.83,126.42,37
CDM,3118809,LAB DET IA PERTUSSIS MULT PRB AMP,211.0,88.62,56.97,206.78,37
CDM,3118890,LAB GENOMIC ANLY SEQ SO 5-50,1794.0,753.48,484.38,1758.12,37
CDM,3118999,LAB PROC PATHOLOGY MOLEC LEVEL 4,556.0,233.52,150.12,544.88,37
CDM,3119047,LAB ALBUMIN OTHER SOURCE QN EA,58.0,24.36,7.78,56.84,37
CDM,3119054,LAB ALBUMIN OTHER SOURCE QN EA NS,24.0,10.08,6.48,23.52,37
CDM,3119062,LAB ALLG IGE QN/SEMI QN CRUDE EA,56.0,23.52,5.22,54.88,37
CDM,3119070,LAB ALLG IGE QN/SEMI QN CRUDE EA NS,55.0,23.1,5.22,53.9,37
CDM,3119120,LAB DRG DF PREGABALIN,95.0,39.9,25.65,93.1,30
CDM,3119146,LAB CHROMAT/MS METHYLTETRAHYDOFOLAT,266.0,111.72,24.09,260.68,37
CDM,3119153,LAB CHROMAT/MS NEOPTERIN,275.0,115.5,24.09,269.5,37
CDM,3119179,LAB SCR AB LG1 FL,565.0,237.3,12.05,553.7,37
CDM,3119211,LAB DET IA TRICHOMON VAG PRB AMP NS,111.0,46.62,29.97,108.78,37
CDM,3119260,LAB DRG DF BUPRENORPHINE DAY NS,109.0,45.78,29.43,106.82,30
CDM,3119286,LAB DRG DF GABAPENTN NON BLD DAY,56.0,23.52,15.12,54.88,30
CDM,3119294,LAB DRG DF KETAMN&NORKETMN DAY,145.0,60.9,39.15,142.1,30
CDM,3119302,LAB DRG DF HYPNOTICS SED DAY,56.0,23.52,15.12,54.88,30
CDM,3119310,LAB DRG DF STIMULANTS SYN DAY,160.0,67.2,43.2,156.8,30
CDM,3119328,LAB DRG DF TAPENTADOL DAY,56.0,23.52,15.12,54.88,30
CDM,3119377,LAB ALLG IGE QN/SEMI QN EA,64.0,26.88,17.28,62.72,37
CDM,3119385,LAB USTEKINUMAB,226.0,94.92,18.64,221.48,37
CDM,3119492,LAB DRG DF CANNABINOIDS SYN DAY 7+,175.0,73.5,47.25,171.5,30
CDM,3119518,LAB IMM GROWTH DIFFER FACTOR 15,295.0,123.9,17.27,289.1,37
CDM,3119526,LAB IG IGD SERUM EA,63.0,26.46,9.3,61.74,37
CDM,3119534,LAB IMMUNOFIXATION EP CRYOGLOBULIN,68.0,28.56,18.36,66.64,37
CDM,3119542,LAB IG IGG SERUM EA,56.0,23.52,9.3,54.88,37
CDM,3119559,LAB PROC PATHOLOGY MOLEC HEA RBC,556.0,233.52,150.12,544.88,37
CDM,3119575,LAB HANTAVIRUS,102.0,42.84,12.88,99.96,37
CDM,3119583,LAB THYROGLOBULIN FNA,82.0,34.44,16.06,80.36,37
CDM,3119617,LAB MORPHO ISH COMP 1ST SPEC,727.0,305.34,196.29,712.46,37
CDM,3119625,LAB MORPHO ISH COMP ADDL SPEC,303.0,127.26,81.81,296.94,30
CDM,3119658,LAB CHROMAT MS LEUKOTRIENE,325.0,136.5,24.09,318.5,37
CDM,3119666,LAB AB TREPONEMA PALLIDUM CONF,74.0,31.08,13.24,72.52,37
CDM,3119674,LAB DRG DF THIOPURINE DAY 1-3,160.0,67.2,43.2,156.8,30
CDM,3119682,LAB DET IA VIRUS ZIKA PRB AMP,200.0,84.0,51.31,196.0,37
CDM,3119708,LAB GENE HBA1/HBA2 VAR DUP/DEL,608.0,255.36,164.16,595.84,37
CDM,3119716,LAB PANEL LIPID NS,69.0,28.98,13.39,67.62,37
CDM,3119773,LAB DET IA LEGIONELL PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3119781,LAB GROWTH STIMULATION GENE 2,227.0,95.34,61.29,222.46,37
CDM,3119799,LAB CULT TYPING IF ANTISERUM EA NS,56.0,23.52,5.57,54.88,37
CDM,3119807,LAB HAPTOGLOBIN QN NS,59.0,24.78,12.58,57.82,37
CDM,3119815,LAB APOLIPOPROTEIN A1 EA NS,77.0,32.34,20.79,75.46,37
CDM,3119823,LAB BILIRUBIN TOTAL NS,58.0,24.36,5.02,56.84,37
CDM,3119849,LAB AB ZINC TRANSPORTER,240.0,100.8,23.57,235.2,37
CDM,3119864,LAB GENOMIC ANLY SEQ SO/HL 51+,8759.0,3678.78,2364.93,8583.82,37
CDM,3119872,LAB GENOMIC ANLY SEQ HL 5-50,2279.0,957.18,615.33,2233.42,37
CDM,3119880,LAB VEDOLIZUMAB,317.0,133.14,38.57,310.66,37
CDM,3119898,LAB DET AG IA IMM ENZ FUNGITELL NS,157.0,65.94,11.98,153.86,37
CDM,3119930,LAB CULT TYPING ID SEQ NUC ACID NS,347.0,145.74,93.69,340.06,37
CDM,3119948,LAB ISH MLTPLX PER SPEC NS,348.0,146.16,93.96,341.04,37
CDM,3120300,LAB CHROMAT MS IODINE QL/QN,73.0,30.66,19.71,71.54,37
CDM,3120318,LAB GENE HBA1/HBA2 SEQ FULL,1800.0,756.0,486.0,1764.0,37
CDM,3120326,LAB GENE DPYD VAR COMMON NS,525.0,220.5,141.75,514.5,37
CDM,3120342,LAB GENE HBB SEQ FULL,974.0,409.08,262.98,954.52,37
CDM,3120391,LAB AB VIRUS HEPATITIS E IGG,71.0,29.82,12.88,69.58,37
CDM,3120417,LAB DRG DF AMPH/METH MCNIUM DAY 1-2,83.0,34.86,22.41,81.34,30
CDM,3120425,LAB DRG DF COCAINE MECONIUM,149.0,62.58,40.23,146.02,30
CDM,3120433,LAB DRG DF METHADONE MECONIUM DAY,165.0,69.3,44.55,161.7,30
CDM,3120441,LAB DRG DF OPIATE MECONIUM DAY 1+,70.0,29.4,18.9,68.6,30
CDM,3120516,LAB GENE NUDT15 VAR COMMON NS,875.0,367.5,236.25,857.5,37
CDM,3120524,LAB GENE SMN1 ANALYSIS DOSAGE/DEL,525.0,220.5,137.0,514.5,37
CDM,3120540,POC DET IA FLU REV T&PRB AMP 1-2,288.0,120.96,77.76,282.24,37
CDM,3120557,POC DET AG IA STREP GROUP A IMM OPT,50.0,21.0,13.5,49.0,37
CDM,3120573,LAB HCV INFCT DIS CHRNC 6 ASSAYS,217.0,91.14,58.59,212.66,37
CDM,3120581,LAB TEST GENETIC COND SEVERE INHRTD,7346.0,3085.32,1983.42,7199.08,37
CDM,3120607,LAB INFLIXIMAB,266.0,111.72,38.57,260.68,37
CDM,3120656,LAB DIHYDROTESTOSTERONE,88.0,36.96,23.76,86.24,37
CDM,3120664,LAB GENE MYD88 VAR L265P,527.0,221.34,142.29,516.46,37
CDM,3120714,LAB COMPLEMENT ACT FUNC NS,185.0,77.7,12.0,181.3,37
CDM,3120755,LAB SCR AB PARANEOPLASTIC CSF FL,200.0,84.0,12.05,196.0,37
CDM,3120763,LAB CSF3R MUTATION EXONS 14&17,300.0,126.0,81.0,294.0,30
CDM,3120771,LAB DET IA PNEUMOCYSTIS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3120821,LAB DET IA GI MULT PRB AMP 12-25TGT,1251.0,525.42,337.77,1225.98,37
CDM,3120839,LAB NEURO CSF PRION PROT QUAL,1623.0,681.66,438.21,1590.54,37
CDM,3120847,LAB SCR AB COPEPTIN FL,300.0,126.0,12.05,294.0,37
CDM,3120854,LAB CHROMAT MS ORGANIC ACIDS,153.0,64.26,24.09,149.94,37
CDM,3120888,LAB DET AG IA IMM ENZ CAMPY,78.0,32.76,11.98,76.44,37
CDM,3120896,LAB GENE CYP2C19 VAR COMMON,875.0,367.5,236.25,857.5,37
CDM,3120904,LAB GENE CYP2D6 VAR COMMON,1353.0,568.26,365.31,1325.94,37
CDM,3120912,LAB GENE CYP2C9 VAR COMMON,525.0,220.5,141.75,514.5,37
CDM,3120920,LAB GENE CYP3A4 VAR COMMON,525.0,220.5,141.75,514.5,37
CDM,3120938,LAB GENE CYP3A5 VAR COMMON,525.0,220.5,141.75,514.5,37
CDM,3120946,LAB GENE DPYD VAR COMMON,525.0,220.5,141.75,514.5,37
CDM,3120953,LAB GENE IFNL3,221.0,92.82,59.67,216.58,37
CDM,3120979,LAB GENE SLCO1B1 VAR COMMON,525.0,220.5,141.75,514.5,37
CDM,3120987,LAB GENE TPMT,525.0,220.5,141.75,514.5,37
CDM,3120995,LAB GENE UGT1A1 VAR COMMON,702.0,294.84,189.54,687.96,37
CDM,3121001,LAB GENE VKORC1 VAR COMMON,265.0,111.3,71.55,259.7,37
CDM,3121019,LAB GENE PHARMOCOGENOMICS PANEL,51.0,21.42,13.77,49.98,30
CDM,3121035,LAB ACTIVITY ENZYME ALPHA GALACTOS,375.0,157.5,22.17,367.5,37
CDM,3121050,LAB AMMONIA STONE RISK,115.0,48.3,14.57,112.7,37
CDM,3121068,LAB CALCIUM STONE RISK,77.0,32.34,6.03,75.46,37
CDM,3121076,LAB CITRATE STONE RISK,174.0,73.08,27.8,170.52,37
CDM,3121084,LAB CREATININE STONE RISK,73.0,30.66,5.18,71.54,37
CDM,3121092,LAB MAGNESIUM NS,88.0,36.96,6.7,86.24,37
CDM,3121100,LAB OXALATE STONE RISK,108.0,45.36,14.45,105.84,37
CDM,3121118,LAB PH STONE RISK,66.0,27.72,3.58,64.68,37
CDM,3121126,LAB PHOSPHORUS STONE RISK,74.0,31.08,5.78,72.52,37
CDM,3121134,LAB POTASSIUM STONE RISK,70.0,29.4,4.73,68.6,37
CDM,3121142,LAB SODIUM STONE RISK,72.0,30.24,5.06,70.56,37
CDM,3121159,LAB SULFATE STONE RISK,72.0,30.24,5.49,70.56,37
CDM,3121167,LAB URIC ACID STONE RISK,72.0,30.24,5.08,70.56,37
CDM,3121183,LAB IMM AB HMGCR IGG,315.0,132.3,17.27,308.7,37
CDM,3121209,LAB LIVER DISEASE 10 ASSAYS,1511.0,634.62,407.97,1480.78,37
CDM,3121225,LAB DET IA IGM PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3121274,LAB DET AG IA IMM OPTICAL NS,75.0,31.5,16.07,73.5,37
CDM,3121290,LAB HLA CLASS II AB HIGH DEF QL NS,978.0,410.76,264.06,958.44,37
CDM,3121308,LAB GENE TYPING HLA 1 LR LOCUS NS,383.0,160.86,103.41,375.34,37
CDM,3121316,LAB GENE TYPING HLA 2 LR LOCUS NS,367.0,154.14,99.09,359.66,37
CDM,3121332,LAB HLA CLASS I AB HIGH DEF QL NS,972.0,408.24,262.44,952.56,37
CDM,3121340,LAB GENE TYPING HLA 1&2 HR NS,1037.0,435.54,279.99,1016.26,37
CDM,3121357,LAB IMM NEUTRPHL GEL-ASSC LIPOCALIN,52.0,21.84,14.04,50.96,37
CDM,3121365,LAB HLA CLASS I&II AB QL NS,330.0,138.6,64.19,323.4,37
CDM,3121456,LAB ADALIMUMAB,300.0,126.0,38.57,294.0,37
CDM,3121464,LAB LACOSAMIDE,82.0,34.44,22.14,80.36,37
CDM,3121480,LAB GENE HTT DET ALLELES ABNORMAL,411.0,172.62,110.97,402.78,37
CDM,3121498,LAB DRG DF CONF PROPOXYPHENE DAY NS,56.0,23.52,15.12,54.88,30
CDM,3121514,LAB FRAGILITY OSMOTIC RBC INCUB NS,187.0,78.54,13.36,183.26,37
CDM,3121530,LAB ONC BIOCHEMICAL PROT 2 SERUM,782.0,328.44,211.14,766.36,37
CDM,3121563,LAB GENE TYPING HLA 2 HR LOCUS NS,372.0,156.24,100.44,364.56,37
CDM,3121571,LAB DRG DF BARB PHENOBARB DAY NS,158.0,66.36,42.66,154.84,30
CDM,3121589,LAB IMM MS 21-HYDROXYLASE QL,114.0,47.88,11.53,111.72,37
CDM,3121597,LAB GENE FLT3 VAR ITD QN,2340.0,982.8,407.43,2293.2,37
CDM,3121621,LAB DET IA MYCOPLAS GEN PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3121647,LAB SCR AB ENCEPHALITIS FL,98.0,41.16,12.05,96.04,37
CDM,3121654,LAB NPM1 GENE ANALYSIS QUAN,2275.0,955.5,407.43,2229.5,37
CDM,3121688,LAB NGS MI PROFILE,3550.0,1491.0,958.5,3479.0,30
CDM,3121696,LAB LIPOPROTEIN CHOLESTEROL LDL SD,103.0,43.26,27.81,100.94,37
CDM,3121746,LAB DET IA RESP NA 18 VIRAL&2 BACT,827.0,347.34,223.29,810.46,37
CDM,3121803,LAB ONC AML DNA DET/NONDET,746.0,313.32,201.42,731.08,37
CDM,3121811,LAB DET IA COV19 PRB AMP NS,154.0,64.68,41.58,150.92,37
CDM,3121829,LAB DET IA COV19 PRB AMP,154.0,64.68,41.58,150.92,37
CDM,3121845,LAB GENE SO NEOPLSM DNA TGT SEQ 324,10500.0,4410.0,2835.0,10290.0,37
CDM,3121910,LAB AB SARS-COV-2 COVID-19,127.0,53.34,34.29,124.46,37
CDM,3121928,LAB AB SARS-COV-2 COVID-19 NS,127.0,53.34,34.29,124.46,37
CDM,3121944,LAB ABNORM FETAL CONGENITAL ANLYL 4,490.0,205.8,132.3,480.2,37
CDM,3121951,LAB DET IA FLU REV T&PRB AMP 1-2 NS,288.0,120.96,77.76,282.24,37
CDM,3121977,LAB HLA CLASS II PHENOTYPE QL NS,246.0,103.32,66.42,241.08,37
CDM,3121985,LAB HLA X-MATCH NON-CYTOTOXIC NS,329.0,138.18,88.83,322.42,37
CDM,3121993,LAB DIS INFCT ID FUNGAL DNA TGT 15,471.0,197.82,127.17,461.58,37
CDM,3122058,LAB CHROMAT MS OMEGA FATTY ACIDS,100.0,42.0,24.09,98.0,37
CDM,3122108,LAB GENE F5 VAR LEIDEN NS,221.0,92.82,59.67,216.58,37
CDM,3122165,LAB GENE TYPING HLA 1&2 LR VERIF NS,1214.0,509.88,327.78,1189.72,37
CDM,3122173,LAB GENE PIK3CA ANLYS SEQ TARGETED,825.0,346.5,222.75,808.5,37
CDM,3122181,LAB GENE G6PD ANLYS SEQ FULL,1800.0,756.0,486.0,1764.0,37
CDM,3122199,LAB GENE MPL MUTATION EXON 10 ANLYS,556.0,233.52,150.12,544.88,37
CDM,3122207,LAB GENE JAK2 EXON TGT SEQ 12,556.0,233.52,150.12,544.88,37
CDM,3122215,LAB IMM MS SP100 IGG,104.0,43.68,11.53,101.92,37
CDM,3122249,LAB DRG SC INST ALYZ URINE DAY,187.0,78.54,50.49,183.26,37
CDM,3122256,LAB DRG SC INST ALYZ SERUM DAY,187.0,78.54,50.49,183.26,37
CDM,3122264,LAB DRG SC INST ALYZ URINE ETOH DAY,187.0,78.54,50.49,183.26,37
CDM,3122272,LAB DRG SC INST ALYZ URINE DAY NS,187.0,78.54,50.49,183.26,37
CDM,3122280,LAB DRG SC INST ALYZ SERUM DAY NS,187.0,78.54,50.49,183.26,37
CDM,3122298,LAB DRG SC INST ALYZ URINE PMGT DAY,449.0,188.58,62.14,440.02,37
CDM,3122306,LAB DRG SC INST ALYZ MECON DAY NS,187.0,78.54,50.49,183.26,37
CDM,3122314,LAB DRG SC INST ALYZ CORD BLOOD DAY,248.0,104.16,62.14,243.04,37
CDM,3122322,LAB DRG DF BUPRENORPHINE MECON DAY,129.0,54.18,34.83,126.42,30
CDM,3122330,LAB DRG SC INST ALYZ CORD TIS DAYNS,187.0,78.54,50.49,183.26,37
CDM,3122389,LAB CULT BACT AEROBIC ID DF NS,96.0,40.32,8.08,94.08,37
CDM,3122397,LAB ISO VIRUS ID ACT ENZYMATIC NS,102.0,42.84,27.54,99.96,37
CDM,3122496,LAB AB ISLET ENCEPHALITIS,144.0,60.48,23.57,141.12,37
CDM,3122520,LAB PROT WB W INTRP ENCEPHALITIS,155.0,65.1,29.21,151.9,37
CDM,3122546,LAB DIS INFCT SARS-COV-2 TGT 22,1251.0,525.42,337.77,1225.98,37
CDM,3122553,LAB CONSULT PATH LTD,107.0,44.94,28.89,104.86,37
CDM,3122561,LAB CONSULT PATH MOD,348.0,146.16,93.96,341.04,37
CDM,3122579,LAB CONSULT PATH COMP,348.0,146.16,93.96,341.04,37
CDM,3122587,LAB CONSULT PATH PROLONG ADDL 30MIN,100.0,42.0,27.0,98.0,30
CDM,3122702,LAB DET IA HEP D PCR QN,690.0,289.8,42.84,676.2,37
CDM,3122710,LAB DIS INFCT ID BAC&FNG GRM+ RXRST,471.0,197.82,127.17,461.58,37
CDM,3122728,LAB DIS INFCT ID BAC&FNG GRM- RXRST,471.0,197.82,127.17,461.58,37
CDM,3122736,LAB DET IA MRSA PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3122744,LAB SCR AB MITOCHONDRIAL,77.0,32.34,20.79,75.46,37
CDM,3122751,LAB SCR AQUAPORIN 4 AB IGG CSF,350.0,147.0,12.05,343.0,37
CDM,3122769,LAB SCR AQUAPORIN 4 AB IGG SERUM,225.0,94.5,12.05,220.5,37
CDM,3122777,LAB AQUAPORIN AB,268.0,112.56,11.53,262.64,37
CDM,3122793,LAB AQUAPORIN 4 AB FLOW CYTOMETRY,118.0,49.56,31.86,115.64,37
CDM,3122835,LAB GLUCOSE BLOOD REAGENT STRIP,16.0,6.72,4.32,15.68,37
CDM,3122876,LAB GENE TP53 SEQ TARGETED,989.0,415.38,267.03,969.22,37
CDM,3122926,LAB IMM MS GP210 IGG,148.0,62.16,11.53,145.04,37
CDM,3122983,LAB IMM AB ADAMTS 13,300.0,126.0,17.27,294.0,37
CDM,3123056,LAB AB TOXOPLASMA IGA,166.0,69.72,14.39,162.68,37
CDM,3123064,LAB IGH/BCL2 TRAN MBR&MCR REG ANLYS,622.0,261.24,167.94,609.56,37
CDM,3123072,LAB AB ENA PM/SC1-100,115.0,48.3,17.93,112.7,37
CDM,3123080,LAB IMM MS POLYMERASE III AB,107.0,44.94,11.53,104.86,37
CDM,3123122,LAB DET IA ORTHOPOXVIRUS PRB AMP,154.0,64.68,41.58,150.92,37
CDM,3123148,LAB ALLG IGE QN/SEMI QN EA NS,80.0,33.6,17.93,78.4,37
CDM,3123155,LAB IMM VWF BINDING ASSAY,145.0,60.9,17.27,142.1,37
CDM,3123171,LAB CHLORDIAZEPOXIDE,169.0,70.98,18.64,165.62,37
CDM,3123197,LAB METHOTREXATE NS,116.0,48.72,31.32,113.68,37
CDM,3123221,LAB SEMEN VOL COUNT MOT&DIF W MORPH,418.0,175.56,15.5,409.64,37
CDM,3123247,LAB AB HTLV/HIV CONFIRM DONOR NS,503.0,211.26,19.35,492.94,37
CDM,3123254,LAB PLASMINOGEN NON-ANTIGENIC NS,71.0,29.82,6.53,69.58,37
CDM,3123270,LAB IG PARAPROT IMPRC&MS BLD/UR QL,211.0,88.62,43.43,206.78,37
CDM,3123288,LAB TB MEAS IMMUNITY T-CELL SUSP NS,300.0,126.0,81.0,294.0,37
CDM,3123296,LAB IMM ANALYTE CYTOKINES QN,135.0,56.7,17.27,132.3,37
CDM,3123320,LAB COMPLEMENT AG SC5B-9 COMP EA,292.0,122.64,12.0,286.16,37
CDM,3123361,LAB DIS INFCT BAC VAG RNA VG FLU QN,428.0,179.76,115.56,419.44,37
CDM,3123395,LAB AB M FAENI,153.0,64.26,12.88,149.94,37
CDM,3123403,LAB AB S VIRIDIS,153.0,64.26,12.88,149.94,37
CDM,3123411,LAB AB T CANDIDUS,153.0,64.26,12.88,149.94,37
CDM,3123429,LAB AB T VULGARIS,153.0,64.26,12.88,149.94,37
CDM,3123437,LAB AB LISTERIA,153.0,64.26,12.88,149.94,37
CDM,3123445,LAB AB CYSTICERCUS CSF,65.0,27.3,13.01,63.7,37
CDM,3123452,LAB AB CYSTICERCUS SERUM,65.0,27.3,13.01,63.7,37
CDM,3123460,LAB AB SCHISTOSOMA SERUM,65.0,27.3,13.01,63.7,37
CDM,3123478,LAB DRG DF FUROSEMIDE DAY 1-3,181.0,76.02,48.87,177.38,30
CDM,3123486,LAB DRG DF MITOTANE DAY 1-3,187.0,78.54,50.49,183.26,30
CDM,3123494,LAB DRG DF TPMT ACTIVITY DAY 1-3,181.0,76.02,48.87,177.38,30
CDM,3123544,LAB DIS INFCT BAC VAG RNA VG FLU QN,428.0,179.76,115.56,419.44,37
CDM,3123569,LAB THIOPURINE S-METHYLTRANSFERASE,112.0,47.04,22.17,109.76,37
CDM,3123577,LAB COMPLEMENT ACT FUNC C3NEF,300.0,126.0,12.0,294.0,37
CDM,3123767,LAB GSAP METAB RX >=6,2752.0,1155.84,743.04,2696.96,37
CDM,3123775,LAB CRYOFIBRINOGEN MAYO NS,153.0,64.26,14.14,149.94,37
CDM,3123817,LAB DET AG IA IMM ENZ FUNGITELL,97.0,40.74,11.98,95.06,37
CDM,3123825,LAB SUSCPT MIC PLATE EA LSI NS,200.0,84.0,8.65,196.0,37
CDM,3123833,LAB ANTI-CD19 CAR T-CELL,500.0,210.0,18.64,490.0,37
CDM,3123841,LAB GENOMIC ANLY SEQ SO/HL RNA 51+,8759.0,3678.78,2364.93,8583.82,37
CDM,3123874,LAB DIS INFCT SARS-COV-2 TGT 21,1251.0,525.42,337.77,1225.98,37
CDM,3123882,POC FERN,66.0,27.72,9.74,64.68,37
CDM,3123981,LAB IMM AB BP230 QN,90.0,37.8,17.27,88.2,37
CDM,3124021,LAB DET IA LEPTOSPIRA PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3124047,LAB DRG DF OPIOID DAY 1-2 TISSUE,56.0,23.52,15.12,54.88,30
CDM,3124054,LAB ANLY MUTATION KRAS,190.0,79.8,51.3,186.2,30
CDM,3124062,LAB ANLY MUTATION NRAS,659.0,276.78,177.93,645.82,30
CDM,3124070,LAB ANLY TRANSLOCATION NTRK,1555.0,653.1,419.85,1523.9,37
CDM,3124229,LAB HCV INFCT DIS CHRNC 6 ASSAYS NS,217.0,91.14,58.59,212.66,37
CDM,3124245,LAB LIVER DIS ANYL 3BIOMARK ALG SRM,529.0,222.18,142.83,518.42,37
CDM,3124252,LAB NORTRIPTYLINE,68.0,28.56,18.36,66.64,37
CDM,3124286,LAB IMM INHIBIN B QN,104.0,43.68,17.27,101.92,37
CDM,3124294,LAB SCR AB MOG TITER,837.0,351.54,12.05,820.26,37
CDM,3124302,LAB SCR ANCA TITER AB EA,62.0,26.04,12.05,60.76,37
CDM,3124476,LAB CHROMAT MS APOE ISOFORM,550.0,231.0,24.09,539.0,37
CDM,3124484,LAB CHROMAT MS BETA AMYLOID RATIO,1409.0,591.78,24.09,1380.82,37
CDM,3124492,LAB DET IA RUBELLA PCR PRB AMP,106.0,44.52,28.62,103.88,37
CDM,3124518,LAB RBC DNA HEA 35 AG 11 BLD GRP NS,2160.0,907.2,583.2,2116.8,37
CDM,3124526,LAB SCR AB CIDP/NP EVALUATION FL,376.0,157.92,12.05,368.48,37
CDM,3124542,LAB DET IA ENTEROBACTR MULT PRB AMP,411.0,172.62,70.2,402.78,37
CDM,3124559,LAB DET IA BACTERIAL MULT PRB AMP,1309.0,549.78,70.2,1282.82,37
CDM,3124567,LAB CLONAZEPAM,67.0,28.14,18.09,65.66,37
CDM,3124583,LAB GENE B-CELL CLONALITY PCR,51.0,21.42,13.77,49.98,30
CDM,3124625,LAB GENE HFE VAR COMMON,197.0,82.74,53.19,193.06,37
CDM,3124690,LAB DET IA HPV TYPE RISK HIGH POOL,106.0,44.52,28.62,103.88,37
CDM,3124708,LAB DIS INFCT BV&VAGINITIS DNA AMP,789.0,331.38,213.03,773.22,37
CDM,3124781,LAB GENE MARKERS STR SPEC PT&CMP NS,1427.0,599.34,233.07,1398.46,37
CDM,3124864,LAB BETA AMYLOID 1-42,387.0,162.54,104.49,379.26,37
CDM,3124872,LAB TAU TOTAL,387.0,162.54,104.49,379.26,37
CDM,3124906,LAB GENE SEPT9 ANLYS METHYLATION,576.0,241.92,155.52,564.48,37
CDM,3124914,LAB AB STREP PNEU SEROT IA,372.0,156.24,92.03,364.56,37
CDM,3124930,LAB AB ID PLATELET BLOOD PRODUCT,238.0,99.96,18.37,233.24,37
CDM,3124971,LAB CYTOPATH EVAL FNA INTRP&RPT NS,107.0,44.94,28.89,104.86,37
CDM,3125010,LAB ONC SEQ NEXT GEN DNA&RNA FFPE,25365.0,10653.3,6848.55,24857.7,37
CDM,3125044,LAB BETA AMYLOID 1-40,387.0,162.54,104.49,379.26,37
CDM,3125051,LAB MOPATH LVL2 CBFB/MYH11 DET QN,411.0,172.62,110.97,402.78,37
CDM,3125101,LAB TAU217 PHOSPHORYLATED EA,387.0,162.54,104.49,379.26,37
CDM,3125119,LAB TAU181 PHOSPHORYLATED EA,387.0,162.54,104.49,379.26,37
CDM,3125135,LAB DET IA RUBEOLA PCR PRB AMP,416.0,174.72,35.09,407.68,37
CDM,3125143,LAB DET IA RUBEOLA PCR PRB AMP URIN,517.0,217.14,35.09,506.66,37
CDM,3125168,LAB ONC SEQ NEXT GEN DNA&MRNA 74,10800.0,4536.0,2916.0,10584.0,37
CDM,3125200,LAB ANLY GEN SEQ PANEL XLID 60+,3480.0,1461.6,914.0,3410.4,37
CDM,3125226,LAB NEUROFILAMENT LC PLASMA,350.0,147.0,94.5,343.0,37
CDM,3125275,LAB GENE TRNSLOC T9-22 BCR-ABL1,275.0,115.5,74.25,269.5,30
CDM,3125283,LAB MOPATH LVL2 ADMARK APOE GENO,671.0,281.82,137.0,657.58,37
CDM,3125309,LAB AB HTLV/HIV CONFIRM SRM/PLASMA,472.0,198.24,19.35,462.56,37
CDM,3125317,LAB DET IA C BURNETII PCR PRB AMP,744.0,312.48,35.09,729.12,37
CDM,3125341,LAB ACTIVITY ENZYME CHITOTRIOSIDASE,362.0,152.04,22.17,354.76,37
CDM,3125358,LAB IMM MS ANTI TH/TO AB,135.0,56.7,11.53,132.3,37
CDM,3125713,LAB DET IA SYPHILIS PCR PRB AMP,371.0,155.82,35.09,363.58,37
CDM,3125721,LAB IMM ANALYTE SFIT-1,72.0,30.24,17.27,70.56,37
CDM,3125739,LAB IMM ANALYTE PIGF,72.0,30.24,17.27,70.56,37
CDM,3125846,LAB PROC PATHOLOGY MOLEC LVL7 NOTCH,3185.0,1337.7,282.88,3121.3,37
CDM,3125887,LAB RISANKIZUMAB,396.0,166.32,18.64,388.08,37
CDM,3125911,LAB DRG SC INST ALYZ CORD TIS DAY,187.0,78.54,50.49,183.26,37
CDM,3125945,LAB SUSCPT CARBAPENEMASE DET ENZ,56.0,23.52,15.12,54.88,30
CDM,3126034,LAB DET IA CT&NG PRB AMP MULTIPLEX,211.0,88.62,56.97,206.78,37
CDM,3126067,LAB NEURO AM BETA&PROT TAU BLD QN,2250.0,945.0,607.5,2205.0,37
CDM,3126117,LAB DET IA PATH JT&GENE RXRST 26+,2040.0,856.8,550.8,1999.2,37
CDM,3126331,LAB AB LEPTOSPIRA IGM DOT BLOT,102.0,42.84,16.2,99.96,37
CDM,3126349,LAB CHROMAT MS GLUTARIC ACID,400.0,168.0,24.09,392.0,37
CDM,3126372,LAB PROSTAGLANDIN EA ARP,335.0,140.7,41.77,328.3,37
CDM,3126430,LAB NEURO PLAM ISP 3DSTNCT CHROM MS,350.0,147.0,94.5,343.0,30
CDM,3126448,LAB CULT TISS NON-NEO LYMPHOCYT MYO,1148.0,482.16,116.49,1125.04,37
CDM,3126463,LAB SEMEN MOTILITY&CT WO HUHNER NS,271.0,113.82,8.61,265.58,37
CDM,3126489,LAB MORPHO SEMEN SPERM STRICT CRIT,275.0,115.5,53.24,269.5,37
CDM,3126513,LAB DRG DF MITRAGYNINE URINE QN,67.0,28.14,18.09,65.66,30
CDM,3200367,PLC STNT/S ART INM/INTRATH CAR S&I,9327.0,3917.34,2518.29,9140.46,30
CDM,3200995,INJ ANES PLEXUS HYPOGASTRIC,2239.0,940.38,604.53,3186.0,37
CDM,3202140,REM CALCULI BILI DUCT&/GALLBLDR S&I,5625.0,2362.5,1518.75,5512.5,29
CDM,3202546,INJ NEPH&/URETERGRM ACC NEW RT S&I,2379.0,999.18,642.33,3186.0,30
CDM,3202553,INJ NEPH&/URETERGRM ACC NEW LT S&I,2379.0,999.18,642.33,3186.0,30
CDM,3202561,INJ NEPH&/URETERGRM ACC NEW BI S&I,3569.0,1498.98,963.63,3497.62,30
CDM,3202645,CT LTD/FOLLOWUP,585.0,245.7,88.91,573.3,37
CDM,3202728,INJ NEPH&/URETERGRM ACC EXST RT S&I,1791.0,752.22,483.57,3186.0,30
CDM,3202736,INJ NEPH&/URETERGRM ACC EXST LT S&I,1791.0,752.22,483.57,3186.0,30
CDM,3202744,INJ NEPH&/URETERGRM ACC EXST BI S&I,2687.0,1128.54,725.49,3186.0,30
CDM,3202751,INSTILL AGENT FIBRIN TB/CTH 1ST DAY,1519.0,637.98,410.13,3186.0,37
CDM,3202876,PLC CATH NEPHROSTOMY PERC RT S&I,4781.0,2008.02,1290.87,10412.0,30
CDM,3202884,PLC CATH NEPHROSTOMY PERC LT S&I,4781.0,2008.02,1290.87,10412.0,30
CDM,3202892,PLC CATH NEPHROSTOMY PERC BI S&I,7172.0,3012.24,1936.44,10412.0,30
CDM,3202900,EXCHG CATH NEPH PERC RT S&I,2996.0,1258.32,808.92,3186.0,30
CDM,3202918,EXCHG CATH NEPH PERC LT S&I,2996.0,1258.32,808.92,3186.0,30
CDM,3202926,EXCHG CATH NEPH PERC BI S&I,4494.0,1887.48,1213.38,4404.12,30
CDM,3203114,PLC STNT URTR NEPH PREEXIST RT S&I,4931.0,2071.02,1331.37,14009.0,30
CDM,3203122,PLC STNT URTR NEPH PREEXIST LT S&I,4931.0,2071.02,1331.37,14009.0,30
CDM,3203130,PLC STNT URTR NEPH PREEXIST BI S&I,7397.0,3106.74,1997.19,14009.0,30
CDM,3203148,PLC STNT URTR WO NEPH CATH RT S&I,5335.0,2240.7,1440.45,14009.0,30
CDM,3203155,PLC STNT URTR WO NEPH CATH LT S&I,5335.0,2240.7,1440.45,14009.0,30
CDM,3203163,PLC STNT URTR WO NEPH CATH BI S&I,8003.0,3361.26,2160.81,14009.0,30
CDM,3203213,PLC STNT URTR W NEPH CATH RT S&I,6803.0,2857.26,1836.81,14009.0,30
CDM,3203221,PLC STNT URTR W NEPH CATH LT S&I,6803.0,2857.26,1836.81,14009.0,30
CDM,3203239,PLC STNT URTR W NEPH CATH BI S&I,10205.0,4286.1,2755.35,14009.0,30
CDM,3203403,PVB THORACIC INJ SINGLE W IMG GD BI,2924.0,1228.08,789.48,3186.0,30
CDM,3203411,PVB THORACIC INJ SINGLE W IMG GD LT,1949.0,818.58,526.23,3186.0,30
CDM,3203429,PVB THORACIC INJ SINGLE W IMG GD RT,1949.0,818.58,526.23,3186.0,30
CDM,3204179,US INTRAVASCULAR NONCORNRY INIT S&I,6493.0,2727.06,1753.11,6363.14,29
CDM,3204187,US INTRAVASCULAR NONCORNRY ADDL S&I,1957.0,821.94,528.39,1917.86,29
CDM,3204195,INJ CHOLANGIOGRAM ACCESS EXIST S&I,1680.0,705.6,453.6,14009.0,37
CDM,3204203,INJ CHOLANGIOGRAM ACCESS NEW S&I,3300.0,1386.0,891.0,14009.0,37
CDM,3204211,PLC CATH DRN BILIARY PERC EXT S&I,6138.0,2577.96,1657.26,14009.0,37
CDM,3204229,PLC CATH DRN BILIARY INT-EXT S&I,6343.0,2664.06,1712.61,14009.0,37
CDM,3204237,CONVERSION CATH DRN BILIARY EXT S&I,5445.0,2286.9,1470.15,14009.0,37
CDM,3204245,EXCHG CATH DRN BILIARY PERC S&I,6359.0,2670.78,1716.93,14009.0,37
CDM,3204252,REM CATH DRN BILIARY PERC S&I,2004.0,841.68,541.08,5367.0,37
CDM,3204260,PLC STNT/S DUCT BILE EXIST S&I,8707.0,3656.94,2350.89,25370.0,37
CDM,3204278,PLC STNT/S DUCT BILE NEW S&I,12301.0,5166.42,3321.27,25370.0,37
CDM,3204286,PLC STNT/S DUCT BILE NEW W DRN S&I,12641.0,5309.22,3413.07,25370.0,37
CDM,3204294,PLC ACCS BILI TREE SM BOWEL NEW S&I,8532.0,3583.44,2303.64,14009.0,37
CDM,3204559,ADM PRLNG AGNT RX INTRACRN EV INIT,2941.0,1235.22,794.07,3101.0,30
CDM,3204575,XR SPINE ENTIRE THOR&LUMB 1 VW,155.0,65.1,41.85,151.9,37
CDM,3204583,XR SPINE ENTIRE THOR&LUMB 2-3 VW,303.0,127.26,81.81,296.94,37
CDM,3204591,XR SPINE ENTIRE THOR&LUMB 4-5 VW,341.0,143.22,92.07,334.18,37
CDM,3204609,XR SPINE ENTIRE THOR&LUMB 6+ VW,342.0,143.64,92.34,335.16,37
CDM,3204617,XR HIP W PELVIS 1 VW RT,201.0,84.42,54.27,196.98,30
CDM,3204625,XR HIP W PELVIS 1 VW LT,201.0,84.42,54.27,196.98,30
CDM,3204641,XR HIP W PELVIS 2-3 VW RT,358.0,150.36,96.66,350.84,30
CDM,3204658,XR HIP W PELVIS 2-3 VW LT,358.0,150.36,96.66,350.84,30
CDM,3204674,XR HIP W PELVIS 4+ VW RT,535.0,224.7,144.45,524.3,30
CDM,3204682,XR HIP W PELVIS 4+ VW LT,535.0,224.7,144.45,524.3,30
CDM,3204708,XR HIPS W PELVIS 2 VW BI,269.0,112.98,72.63,263.62,37
CDM,3204716,XR HIPS W PELVIS 3-4 VW BI,359.0,150.78,96.93,351.82,37
CDM,3204724,XR HIPS W PELVIS 5+ VW BI,431.0,181.02,106.81,422.38,37
CDM,3204732,XR FEMUR 1 VW RT,194.0,81.48,52.38,190.12,30
CDM,3204740,XR FEMUR 1 VW LT,194.0,81.48,52.38,190.12,30
CDM,3204765,XR FEMUR 2+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3204773,XR FEMUR 2+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3205655,PLC CATH NEPHROURET PERC NEW BI S&I,7397.0,3106.74,1997.19,10412.0,30
CDM,3205663,PLC CATH NEPHROURET PERC NEW LT S&I,4931.0,2071.02,1331.37,10412.0,30
CDM,3205671,PLC CATH NEPHROURET PERC NEW RT S&I,4931.0,2071.02,1331.37,10412.0,30
CDM,3205689,CNV CATH NEPH PERC PRE EXIST BI S&I,5139.0,2158.38,1387.53,5036.22,30
CDM,3205697,CNV CATH NEPH PERC PRE EXIST LT S&I,3426.0,1438.92,925.02,3357.48,30
CDM,3205705,CNV CATH NEPH PERC PRE EXIST RT S&I,3426.0,1438.92,925.02,3357.48,30
CDM,3205713,DIL BLN DUCT BILIARY PERC EA S&I,6464.0,2714.88,1745.28,6334.72,29
CDM,3205721,BX/S ENDOLMNL BILI TREE PERC S&I,3399.0,1427.58,917.73,3331.02,29
CDM,3205739,COLL FLUID SCLEROTX W IMG GD S&I,2677.0,1124.34,722.79,3186.0,37
CDM,3205747,EMB/OCCL URETERAL BI S&I,3582.0,1504.44,967.14,3510.36,29
CDM,3205754,DIL BLN STRICTURE URETERAL BI S&I,6362.0,2672.04,1717.74,6234.76,29
CDM,3205762,THROMBECTOMY&/INF TRNSL ART PERC BI,6549.0,2750.58,1768.23,6418.02,30
CDM,3205770,EMB/OCCL URETERAL LT S&I,2388.0,1002.96,644.76,2340.24,29
CDM,3205788,EMB/OCCL URETERAL RT S&I,2388.0,1002.96,644.76,2340.24,29
CDM,3205796,DIL BLN STRICTURE URETERAL LT S&I,4241.0,1781.22,1145.07,4156.18,29
CDM,3205804,DIL BLN STRICTURE URETERAL RT S&I,4241.0,1781.22,1145.07,4156.18,29
CDM,3205812,THROMBECTOMY&/INF TRNSL ART PERC LT,4366.0,1833.72,1178.82,4278.68,30
CDM,3205820,THROMBECTOMY&/INF TRNSL ART PERC RT,4366.0,1833.72,1178.82,4278.68,30
CDM,3206265,INJ/S EPID/SUB C/T W IMG,3930.0,1650.6,721.17,3851.4,37
CDM,3206273,INJ/S EPID/SUB L/S WO IMG,1352.0,567.84,365.04,3186.0,37
CDM,3206281,INJ/S EPID/SUB L/S W IMG,3000.0,1260.0,721.17,3186.0,37
CDM,3206331,SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3206349,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3206356,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,3206398,INTRO NDL&/CTH DIAL W DX ANG S&I,2676.0,1123.92,722.52,5367.0,37
CDM,3206406,INTRO NDL&/CTH DIAL W TBA S&I,13437.0,5643.54,3627.99,25370.0,37
CDM,3206414,INTRO NDL&/CTH DIAL W PLC STNT/S IV,20869.0,8764.98,5634.63,26759.0,37
CDM,3206422,THROMBECT&/INF PERC IMG ANG S&I,15360.0,6451.2,4147.2,25370.0,37
CDM,3206430,THROMBECT&/INF PERC MECH W TBA S&I,14039.0,5896.38,3790.53,26759.0,37
CDM,3206448,THROMBECT&/INF PERC W PLC STNT/S IV,33068.0,13888.56,8928.36,32969.0,37
CDM,3206455,TBA DIAL CENTRAL SEG W IMG SI,8829.0,3708.18,2383.83,8652.42,29
CDM,3206463,TBA OPN/PRC ART INT BI S&I,16851.0,7077.42,4549.77,25370.0,30
CDM,3206471,TBA OPN/PRC ART ADL BI S&I,13410.0,5632.2,3620.7,13141.8,29
CDM,3206489,TBA OPN/PRC VEIN INT BI S&I,25925.0,10888.5,6999.75,25406.5,30
CDM,3206497,TBA OPN/PRC VEIN ADL BI S&I,17210.0,7228.2,4646.7,16865.8,29
CDM,3206737,CHEMODENERV GLANDS PAR&SUBMAND BI,466.0,195.72,125.82,456.68,36
CDM,3206877,PLC TRANSCTH STNT/S IVASC CDS S&I,12029.0,5052.18,3247.83,11788.42,29
CDM,3206885,EMB/OCCL PERM CIRCUIT DIALYSIS S&I,13225.0,5554.5,3570.75,12960.5,29
CDM,3207172,TBA OPN/PRC ART INT NONPAIR/UNI S&I,11234.0,4718.28,3033.18,25370.0,37
CDM,3207198,TBA OPN/PRC ART ADL NONPAIR/UNI S&I,8940.0,3754.8,2413.8,8761.2,29
CDM,3207214,TBA OPN/PRC VEIN INT NONPAIR/UNIS&I,17283.0,7258.86,4666.41,25370.0,37
CDM,3207230,TBA OPN/PRC VEIN ADL NONPAIR/UNIS&I,11473.0,4818.66,3097.71,11243.54,29
CDM,3207248,ANGIO PELVIC S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,3207255,CT REND 3D W I&R W PP DIFF WRKST,354.0,148.68,95.58,346.92,30
CDM,3207453,RUPTURE CYST SYNOVIAL INJ,623.0,261.66,168.21,610.54,36
CDM,3220001,XR ABSCESS/SINUS/FISTULA S&I,1112.0,467.04,300.24,1089.76,37
CDM,3220019,XR ABDOMEN CMP 2+VW W CHEST 1 VW,420.0,176.4,106.81,411.6,37
CDM,3220050,XR JTS ACROMIOCLAVICULAR BI,179.0,75.18,48.33,175.42,37
CDM,3220092,XR ANKLE CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3220100,XR ANKLE CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3220126,XR ANKLE 2 VW LT,237.0,99.54,63.99,232.26,30
CDM,3220134,XR ANKLE 2 VW RT,237.0,99.54,63.99,232.26,30
CDM,3220183,ASP PUNCT ABSCESS/CYST,623.0,261.66,168.21,610.54,36
CDM,3220217,ASP&/INJ CYST THYROID,979.0,411.18,264.33,3186.0,37
CDM,3220233,ASP&/INJ CYST/PELVIS RENAL BI,3258.0,1368.36,879.66,3192.84,30
CDM,3220241,ASP&/INJ CYST/PELVIS RENAL LT,2172.0,912.24,586.44,3186.0,30
CDM,3220258,ASP&/INJ CYST/PELVIS RENAL RT,2172.0,912.24,586.44,3186.0,30
CDM,3220316,ENDO BILI W DIL DCT&STNT PERC,13236.0,5559.12,3573.72,25370.0,37
CDM,3220332,BX TRANSCATHETER,7097.0,2980.74,1916.19,25370.0,37
CDM,3220340,BX TRANSCATHETER S&I,3304.0,1387.68,892.08,3237.92,30
CDM,3220357,STUDIES AGE BONE,161.0,67.62,43.47,157.78,37
CDM,3220365,STUDIES LENGTH BONE,216.0,90.72,58.32,211.68,37
CDM,3220373,XR SURVEY OSSEOUS CMP,420.0,176.4,106.81,411.6,37
CDM,3220381,XR SURVEY OSSEOUS INFANT,244.0,102.48,65.88,239.12,37
CDM,3220399,XR SURVEY OSSEOUS LTD,216.0,90.72,58.32,211.68,37
CDM,3220431,BX MASS ABD/RETRO NDL PERC,2707.0,1136.94,730.89,5367.0,37
CDM,3220449,BX BONE TROCAR/NDL DEEP,3327.0,1397.34,898.29,5367.0,37
CDM,3220456,BX BONE TROCAR/NDL SUPERFICIAL,2065.0,867.3,557.55,3186.0,37
CDM,3220464,BX LIVER NDL PERC,3384.0,1421.28,913.68,5367.0,37
CDM,3220506,BX MUSCLE NDL PERC,3161.0,1327.62,853.47,5367.0,37
CDM,3220530,BX THYROID NDL CORE PERC,979.0,411.18,264.33,3186.0,37
CDM,3220555,XR CALCANEUS 2+ VW LT,233.0,97.86,62.91,228.34,30
CDM,3220563,XR CALCANEUS 2+ VW RT,233.0,97.86,62.91,228.34,30
CDM,3220613,CHG TUBE CYSTO SIMPLE,374.0,157.08,100.98,370.13,36
CDM,3220662,CHG CATH DRN/TUBE PERC S&I,631.0,265.02,170.37,618.38,30
CDM,3220696,CHOLANGIO&/PANCREATOGRAM OR ADD S&I,344.0,144.48,92.88,337.12,30
CDM,3220704,CHOLANGIO&/PANCREATOGRAM OR S&I,843.0,354.06,227.61,826.14,30
CDM,3220803,XR CLAVICLE CMP LT,254.0,106.68,68.58,248.92,30
CDM,3220811,XR CLAVICLE CMP RT,254.0,106.68,68.58,248.92,30
CDM,3220860,INS CVC CENTRAL NONTUN 5+YRS,4040.0,1696.8,1090.8,4677.51,37
CDM,3220878,INS CVC CENTRAL NONTUN 0-4YRS,3451.0,1449.42,931.77,4677.51,37
CDM,3220886,INS CVC CENTRAL TUN WO P/P 0-4YRS,7097.0,2980.74,1916.19,25370.0,37
CDM,3220894,INS CVC CENTRAL TUN WO P/P 5+YRS,4040.0,1696.8,1090.8,14009.0,37
CDM,3220936,INS CVD CENTRAL TUN W PORT 5+YRS,8995.0,3777.9,2428.65,14009.0,37
CDM,3220944,INS CAD CENTRAL TUN W PORT,7452.0,3129.84,2012.04,25370.0,37
CDM,3220951,CYSTOGRAM 3+ VW S&I,710.0,298.2,191.7,695.8,37
CDM,3221009,DECLOT CATH/VAD W AGENT THROMB,492.0,206.64,132.84,489.32,36
CDM,3221132,ENDO BILI W DIL DCT WO STNT PERC,10158.0,4266.36,2742.66,14009.0,37
CDM,3221140,DIL STRICT&/OBSTRUCT INTRALUM S&I,777.0,326.34,209.79,761.46,30
CDM,3221157,DISCOGRAM LUMBAR S&I,3200.0,1344.0,864.0,3136.0,37
CDM,3221231,XR ELBOW CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3221249,XR ELBOW CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3221264,XR ELBOW 2 VW LT,229.0,96.18,61.83,224.42,30
CDM,3221272,XR ELBOW 2 VW RT,229.0,96.18,61.83,224.42,30
CDM,3221306,CATH ENDO DUCT BILIARY S&I,1112.0,467.04,300.24,1089.76,30
CDM,3221314,CATH ENDO DUCT PANCREAS S&I,984.0,413.28,265.68,964.32,30
CDM,3221330,ENEMA THERAPEUTIC,446.0,187.32,120.42,437.08,37
CDM,3221371,CATH ENDO DUCT BILIARY&PANCREAS S&I,1743.0,732.06,470.61,1708.14,30
CDM,3221421,EXCHG CATH DRN ABSC/CYST,3795.0,1593.9,1024.65,5367.0,37
CDM,3221470,XR BONES FACIAL 0-2 VW,179.0,75.18,48.33,175.42,37
CDM,3221488,XR BONES FACIAL CMP 3+ VW,216.0,90.72,58.32,211.68,37
CDM,3221496,XR FB NOSE TO RECTUM CHILD 1 VW,179.0,75.18,48.33,175.42,37
CDM,3221538,XR FINGER/S 2+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3221546,XR FINGER/S 2+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3221553,FLUORO GD PLC/REPL/REM CVAD,481.0,202.02,129.87,471.38,30
CDM,3221561,GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,30
CDM,3221579,FLUORO GD&LOC NEEDLE SPINE,794.0,333.48,214.38,778.12,30
CDM,3221603,FLUORO GD PLCMT NEEDLE,559.0,234.78,150.93,547.82,30
CDM,3221611,FLUORO 0-1HR TIME PHYS/QHCP,1055.0,443.1,243.77,1033.9,37
CDM,3221645,XR FOOT CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3221652,XR FOOT CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3221678,XR FOOT 2 VW LT,219.0,91.98,59.13,214.62,30
CDM,3221686,XR FOOT 2 VW RT,219.0,91.98,59.13,214.62,30
CDM,3221702,XR FOREARM 2 VW LT,229.0,96.18,61.83,224.42,30
CDM,3221710,XR FOREARM 2 VW RT,229.0,96.18,61.83,224.42,30
CDM,3221744,XR HAND 3+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3221751,XR HAND 3+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3221777,XR HAND 2 VW LT,222.0,93.24,59.94,217.56,30
CDM,3221785,XR HAND 2 VW RT,222.0,93.24,59.94,217.56,30
CDM,3221876,XR HUMERUS 2+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3221884,XR HUMERUS 2+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3221892,HYSTEROSALPINGOGRAM S&I,750.0,315.0,202.5,735.0,37
CDM,3221942,INJ CNT ABSC/CYST VIA PREV CATH/TB,819.0,343.98,221.13,802.62,29
CDM,3222239,INJ CYSTOGRAM,517.0,217.14,139.59,506.66,29
CDM,3222247,INJ DISCOGRAM CERVICAL/THORACIC,1676.0,703.92,452.52,1642.48,29
CDM,3222254,INJ DISCOGRAM LUMBAR,2164.0,908.88,584.28,2120.72,29
CDM,3222288,INJ EPID PATCH BLOOD/CLOT,1571.0,659.82,424.17,3186.0,37
CDM,3222536,INJ/S TRIGGER PT/S MUSC/S 1-2,470.0,197.4,126.9,460.6,36
CDM,3222601,INJ/S TRIGGER PT/S MUSC/S 3+,694.0,291.48,187.38,680.12,36
CDM,3222619,INJ PSEUDOANEURYSM EXT LT,1211.0,508.62,326.97,3186.0,30
CDM,3222627,INJ PSEUDOANEURYSM EXT RT,1211.0,508.62,326.97,3186.0,30
CDM,3222643,INJ URETHROCYSTOGRAM RETROGRADE,295.0,123.9,79.65,289.1,29
CDM,3222650,INJ VENOGRAM NON EXTREMITY,1036.0,435.12,279.72,1015.28,29
CDM,3222692,INJ VISUAL ILEAL CONDUIT,1165.0,489.3,314.55,1141.7,29
CDM,3222759,ASP BLADDER W INS CATH SUPRAPUBIC,2996.0,1258.32,808.92,10412.0,37
CDM,3222775,INS TIPS,19581.0,8224.02,5286.87,27156.6,37
CDM,3222783,INS CATH BLADDER INDWL SMPL,204.0,85.68,55.08,199.92,36
CDM,3222841,INTRO TUBE GI LONG W FLUORO S&I,677.0,284.34,182.79,663.46,30
CDM,3222866,INTRO CATH AORTA,1878.0,788.76,507.06,1840.44,29
CDM,3222908,INTRO CATH RT HEART/ART PULM MAIN,423.0,177.66,114.21,414.54,29
CDM,3222916,INTRO CATH SVC/IVC,2425.0,1018.5,654.75,2376.5,29
CDM,3222957,INTRO TUBE GI LONG,2237.0,939.54,603.99,5367.0,37
CDM,3223005,INTRO NDL/CATH ARTERY EXTREMITY LT,1206.0,506.52,325.62,1181.88,29
CDM,3223013,INTRO NDL/CATH ARTERY EXTREMITY RT,1206.0,506.52,325.62,1181.88,29
CDM,3223039,UROGRAPHY INF&/BOLUS W NEPHRO,1292.0,542.64,179.2,1266.16,37
CDM,3223047,UROGRAPHY IV W/WO KUB,915.0,384.3,179.2,896.7,37
CDM,3223096,APPLY MANUAL STRESS JOINT UNI/BI,237.0,99.54,63.99,232.26,37
CDM,3223104,SURVEY JOINT SGL VW 2+ JTS,189.0,79.38,51.03,185.22,37
CDM,3223120,XR KNEE CMP 4+ VW LT,281.0,118.02,75.87,275.38,30
CDM,3223138,XR KNEE CMP 4+ VW RT,281.0,118.02,75.87,275.38,30
CDM,3223153,XR KNEE 1-2 VW LT,179.0,75.18,48.33,175.42,30
CDM,3223161,XR KNEE 1-2 VW RT,179.0,75.18,48.33,175.42,30
CDM,3223187,XR KNEE 3 VW LT,254.0,106.68,68.58,248.92,30
CDM,3223195,XR KNEE 3 VW RT,254.0,106.68,68.58,248.92,30
CDM,3223203,XR KNEES STANDING AP BI,241.0,101.22,65.07,236.18,37
CDM,3223229,XR EXT LOWER INFANT 2+ VW LT,139.0,58.38,37.53,136.22,30
CDM,3223237,XR EXT LOWER INFANT 2+ VW RT,139.0,58.38,37.53,136.22,30
CDM,3223252,PUNCT LUMBAR DIAGNOSTIC,1728.0,725.76,466.56,3186.0,37
CDM,3223336,XR MANDIBLE CMP 4+ VW,254.0,106.68,68.58,248.92,37
CDM,3223344,XR MANDIBLE PARTIAL 1-3 VW,179.0,75.18,48.33,175.42,37
CDM,3223377,MYELOGRAPHY CERVICAL S&I,1651.0,693.42,445.77,1617.98,37
CDM,3223385,MYELOGRAPHY LUMBOSACRAL S&I,1961.0,823.62,529.47,1921.78,37
CDM,3223401,MYELOGRAPHY THORACIC S&I,2059.0,864.78,555.93,2017.82,37
CDM,3223419,MYELOGRAPHY 2+ REGIONS S&I,1993.0,837.06,538.11,1953.14,37
CDM,3223427,XR BONES NASAL CMP 3+ VW,254.0,106.68,68.58,248.92,37
CDM,3223435,XR TISSUE SOFT NECK,254.0,106.68,68.58,248.92,37
CDM,3223534,XR FORAMINA OPTIC LT,134.0,56.28,36.18,131.32,30
CDM,3223542,XR FORAMINA OPTIC RT,134.0,56.28,36.18,131.32,30
CDM,3223567,XR ORBITS CMP 4+ VW,254.0,106.68,68.58,248.92,37
CDM,3223575,ORTHOPANTOGRAM,172.0,72.24,46.44,168.56,37
CDM,3223591,XR PELVIS CMP 3+ VW,304.0,127.68,82.08,297.92,37
CDM,3223609,XR PELVIS 1-2 VW,254.0,106.68,68.58,248.92,37
CDM,3223724,INS PICD WO P/P 0-4YRS,8475.0,3559.5,2288.25,14009.0,37
CDM,3223732,INS PICD WO P/P 5+YRS,10458.0,4392.36,2823.66,14009.0,37
CDM,3223773,PLC G-TUBE NASO/ORO PHYS W FL GD,683.0,286.86,184.41,669.34,36
CDM,3223781,PLC DEV/S OCCLUSIVE,936.0,393.12,252.72,917.28,29
CDM,3223815,CATH VEIN PORTAL PERC ANY METHOD,2043.0,858.06,551.61,2002.14,29
CDM,3223823,PORTOGRAM W EVAL HEMO S&I,4131.0,1735.02,1115.37,4677.51,37
CDM,3223831,PORTOGRAM WO EVAL HEMO S&I,4085.0,1715.7,1102.95,4677.51,37
CDM,3224003,PUNCT SHUNT TUBE/RESV ASP/INJ,1127.0,473.34,304.29,3186.0,37
CDM,3224052,REM OBSTRUCT CVD INTRALUMINAL S&I,344.0,144.48,92.88,337.12,30
CDM,3224060,REM OBSTRUCT MECH CVD PERICATHETER,4040.0,1696.8,1090.8,14009.0,37
CDM,3224078,REM OBSTRUCT CVD PERICATHETER S&I,910.0,382.2,245.7,891.8,30
CDM,3224102,REM CVC TUN WO P/P,1788.0,750.96,482.76,3186.0,37
CDM,3224110,REM CVD TUN W P/P,3303.0,1387.26,891.81,5367.0,37
CDM,3224144,RPR CVD W P/P,7492.0,3146.64,1608.25,7342.16,37
CDM,3224169,REPOSITION CVC PREVIOUS W FLUORO,2922.0,1227.24,788.94,3186.0,37
CDM,3224219,REV TIPS,18883.0,7930.86,5098.41,26759.0,37
CDM,3224227,XR RIBS 2 VW LT,183.0,76.86,49.41,179.34,30
CDM,3224235,XR RIBS 2 VW RT,183.0,76.86,49.41,179.34,30
CDM,3224243,XR RIBS 3+ VW BI,276.0,115.92,74.52,270.48,37
CDM,3224276,XR RIBS W CXR 4+ VW BI,339.0,142.38,91.53,332.22,37
CDM,3224284,RPLC CATH CVD W P/P,4040.0,1696.8,1090.8,14009.0,37
CDM,3224292,RPLC CICVC NONTUN WO P/P,2004.0,841.68,541.08,3186.0,37
CDM,3224318,RPLC PICVD W PORT,7269.0,3052.98,1962.63,14009.0,37
CDM,3224326,RPLC CICVC TUN WO P/P,5611.0,2356.62,1514.97,14009.0,37
CDM,3224334,RPLC CICVC TUN W PORT,6051.0,2541.42,1633.77,14009.0,37
CDM,3224342,RPLC CICVC TUN W PUMP,7097.0,2980.74,1916.19,25370.0,37
CDM,3224359,XR SACRUM&COCCYX 2+ VW,254.0,106.68,68.58,248.92,37
CDM,3224383,XR SCAPULA CMP LT,203.0,85.26,54.81,198.94,30
CDM,3224391,XR SCAPULA CMP RT,203.0,85.26,54.81,198.94,30
CDM,3224409,PLC CATH SEL ART PULM BI,587.0,246.54,158.49,575.26,29
CDM,3224417,PLC CATH SEL ART PULM LT,391.0,164.22,105.57,383.18,29
CDM,3224425,PLC CATH SEL ART PULM RT,391.0,164.22,105.57,383.18,29
CDM,3224433,PLC CATH SEL ART ABD/EXT 1ST ORD,2768.0,1162.56,747.36,2712.64,29
CDM,3224441,PLC CATH SEL ART ABD/EXT 2ND ORD,2815.0,1182.3,760.05,2758.7,29
CDM,3224458,PLC CATH SEL ART ABD/EXT 3RD ORD,3178.0,1334.76,858.06,3114.44,29
CDM,3224466,PLC CATH SEL ART ABD/EXT ADDL,1953.0,820.26,527.31,1913.94,29
CDM,3224474,PLC CATH SEL ART PULM 2ND ORD LT,445.0,186.9,120.15,436.1,29
CDM,3224482,PLC CATH SEL ART PULM 2ND ORD RT,445.0,186.9,120.15,436.1,29
CDM,3224490,PLC CATH SEL ART THOR/BRACH 1ST ORD,1884.0,791.28,508.68,1846.32,29
CDM,3224508,PLC CATH SEL ART THOR/BRACH 2ND ORD,1885.0,791.7,508.95,1847.3,29
CDM,3224516,PLC CATH SEL ART THOR/BRACH 3RD ORD,2750.0,1155.0,742.5,2695.0,29
CDM,3224524,PLC CATH SEL ART THOR/BRACH ADDL,364.0,152.88,98.28,356.72,29
CDM,3224532,PLC CATH SEL VENOUS BRANCH 1ST ORD,1806.0,758.52,487.62,1769.88,29
CDM,3224540,PLC CATH SEL VENOUS BRANCH 2+ ORD,2007.0,842.94,541.89,1966.86,29
CDM,3224565,XR SHOULDER CMP 2+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3224573,XR SHOULDER CMP 2+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3224599,XR SHOULDER 1 VW LT,185.0,77.7,49.95,181.3,30
CDM,3224607,XR SHOULDER 1 VW RT,185.0,77.7,49.95,181.3,30
CDM,3224623,SHUNTOGRAM NONVASCULAR S&I,442.0,185.64,106.81,433.16,37
CDM,3224631,XR JTS SACROILIAC 1-2 VW,161.0,67.62,43.47,157.78,37
CDM,3224649,XR JTS SACROILIAC 3+ VW,215.0,90.3,58.05,210.7,37
CDM,3224672,XR SINUSES PARANASAL 0-2 VW,179.0,75.18,48.33,175.42,37
CDM,3224680,XR SINUSES PARANASAL CMP 3+ VW,216.0,90.72,58.32,211.68,37
CDM,3224698,XR SKULL 0-3 VW,188.0,78.96,50.76,184.24,37
CDM,3224706,XR SKULL CMP 4+ VW,265.0,111.3,71.55,259.7,37
CDM,3224730,EVAL SPEECH COMPLEX CINE/VIDEO,366.0,153.72,98.82,358.68,37
CDM,3224748,XR SPINE 1 VW,161.0,67.62,43.47,157.78,37
CDM,3224771,XR SPINE CERVICAL 2-3 VW,254.0,106.68,68.58,248.92,37
CDM,3224797,XR SPINE LS 4+ VW,357.0,149.94,96.39,349.86,37
CDM,3224805,XR SPINE LS 2-3 VW,254.0,106.68,68.58,248.92,37
CDM,3224854,XR SPINE THORACIC 4+ VW,297.0,124.74,80.19,291.06,37
CDM,3224862,XR SPINE THORACIC 2 VW,254.0,106.68,68.58,248.92,37
CDM,3224870,XR SPINE THORACIC 3 VW,270.0,113.4,72.9,264.6,37
CDM,3224888,XR SPINE THORACOLUMBAR => 2 VW,214.0,89.88,57.78,209.72,37
CDM,3224896,SPLENOPORTOGRAPHY S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3224920,XR JT/S STERNOCLAVICULAR 3+ VW,215.0,90.3,58.05,210.7,37
CDM,3224938,XR STERNUM 2+ VW,188.0,78.96,50.76,184.24,37
CDM,3224995,OCC EV ART BLN TEMP CNS W ANG,11118.0,4669.56,3001.86,26759.0,37
CDM,3225091,XR TIBIA&FIBULA 2 VW LT,254.0,106.68,68.58,248.92,30
CDM,3225109,XR TIBIA&FIBULA 2 VW RT,254.0,106.68,68.58,248.92,30
CDM,3225117,INTRO NDL AORTA TRANSLUMBAR,1000.0,420.0,270.0,980.0,29
CDM,3225125,XR TMJ MOUTH OPEN&CLOSE BI,301.0,126.42,81.27,294.98,37
CDM,3225133,XR TMJ MOUTH OPEN&CLOSE LT,134.0,56.28,36.18,131.32,30
CDM,3225141,XR TMJ MOUTH OPEN&CLOSE RT,134.0,56.28,36.18,131.32,30
CDM,3225158,TOMOGRAPHY SGL EXCEPT URO,184.0,77.28,49.68,180.32,37
CDM,3225190,THERAPY TRANSCATH EMB S&I,1776.0,745.92,479.52,1740.48,30
CDM,3225216,DIL STRICT DUCT BILI TRANSHEP S&I,962.0,404.04,259.74,942.76,30
CDM,3225299,XR EXT UPPER INFANT 2+ VW LT,247.0,103.74,66.69,242.06,30
CDM,3225307,XR EXT UPPER INFANT 2+ VW RT,247.0,103.74,66.69,242.06,30
CDM,3225323,URETHROCYSTOGRAM RETROGRADE S&I,491.0,206.22,132.57,481.18,37
CDM,3225331,URETHROCYSTOGRAM VOIDING S&I,515.0,216.3,139.05,504.7,37
CDM,3225356,UROGRAPHY INF&/BOLUS,1107.0,464.94,179.2,1084.86,37
CDM,3225364,UROGRAPHY RETROGRADE W/WO KUB,680.0,285.6,183.6,666.4,37
CDM,3225414,VENOGRAM EPIDURAL S&I,5814.0,2441.88,640.89,5697.72,37
CDM,3225455,VENOGRAM HEPATIC W EVAL HEMO S&I,6981.0,2932.02,1884.87,6841.38,37
CDM,3225463,VENOGRAM HEPATIC WO EVAL HEMO S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3225471,VENOGRAM IVC SERIAL S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3225489,VENOGRAM SINUS VEN/JUG S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3225497,VENOGRAM ORBITAL S&I,5457.0,2291.94,640.89,5347.86,37
CDM,3225505,VENOGRAM RENAL SEL BI S&I,8596.0,3610.32,2320.92,8424.08,37
CDM,3225513,VENOGRAM RENAL SEL LT S&I,6971.0,2927.82,1882.17,6831.58,30
CDM,3225521,VENOGRAM RENAL SEL RT S&I,6971.0,2927.82,1882.17,6831.58,30
CDM,3225539,VENOGRAM SINUS SAGITTAL SUP S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3225554,VENOGRAM ADRENAL SEL LT S&I,4040.0,1696.8,1090.8,3959.2,30
CDM,3225562,VENOGRAM ADRENAL SEL RT S&I,4040.0,1696.8,1090.8,3959.2,30
CDM,3225570,CATH VENOUS SAMPLE BLOOD ORGAN,880.0,369.6,237.6,862.4,29
CDM,3225588,SAMPLE VENOUS CATH W/WO ANG S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,3225620,XR WRIST CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3225638,XR WRIST CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3225653,XR WRIST 2 VW LT,222.0,93.24,59.94,217.56,30
CDM,3225661,XR WRIST 2 VW RT,222.0,93.24,59.94,217.56,30
CDM,3225687,XR ARTHRO SHOULDER LT S&I,1329.0,558.18,358.83,1302.42,30
CDM,3225695,XR ARTHRO SHOULDER RT S&I,1329.0,558.18,358.83,1302.42,30
CDM,3225703,XR ARTHRO ANKLE LT S&I,671.0,281.82,181.17,657.58,30
CDM,3225711,XR ARTHRO ANKLE RT S&I,671.0,281.82,181.17,657.58,30
CDM,3225729,XR ARTHRO ELBOW LT S&I,549.0,230.58,148.23,538.02,30
CDM,3225737,XR ARTHRO ELBOW RT S&I,549.0,230.58,148.23,538.02,30
CDM,3225745,XR ARTHRO HIP LT S&I,742.0,311.64,200.34,727.16,30
CDM,3225752,XR ARTHRO HIP RT S&I,742.0,311.64,200.34,727.16,30
CDM,3225760,XR ARTHRO KNEE LT S&I,549.0,230.58,148.23,538.02,30
CDM,3225778,XR ARTHRO KNEE RT S&I,549.0,230.58,148.23,538.02,30
CDM,3225802,XR ARTHRO WRIST LT S&I,761.0,319.62,205.47,745.78,30
CDM,3225810,XR ARTHRO WRIST RT S&I,761.0,319.62,205.47,745.78,30
CDM,3225828,ARTHRO TMJ LT S&I,366.0,153.72,98.82,358.68,30
CDM,3225836,ARTHRO TMJ RT S&I,366.0,153.72,98.82,358.68,30
CDM,3225844,ANGIO ADRENAL SEL LT S&I,4040.0,1696.8,1090.8,3959.2,30
CDM,3225851,ANGIO ADRENAL SEL RT S&I,4040.0,1696.8,1090.8,3959.2,30
CDM,3225869,ANGIO ADRENAL SEL BI S&I,5700.0,2394.0,1539.0,5586.0,37
CDM,3225992,ANGIO EXTREMITY BI S&I,6723.0,2823.66,1815.21,6588.54,37
CDM,3226008,ANGIO EXTREMITY LT S&I,6382.0,2680.44,1723.14,6254.36,30
CDM,3226016,ANGIO EXTREMITY RT S&I,6382.0,2680.44,1723.14,6254.36,30
CDM,3226024,ANGIO MAMMARY INTERNAL S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3226057,ANGIO PULMONARY NONSEL S&I,5272.0,2214.24,1423.44,5166.56,37
CDM,3226065,ANGIO PULMONARY SEL BI S&I,10489.0,4405.38,2832.03,10279.22,37
CDM,3226073,ANGIO PULMONARY SEL LT S&I,5213.0,2189.46,1407.51,5108.74,30
CDM,3226081,ANGIO PULMONARY SEL RT S&I,5213.0,2189.46,1407.51,5108.74,30
CDM,3226123,ANGIO SEL VESSEL ADDL S&I,3737.0,1569.54,1008.99,3662.26,30
CDM,3226131,ANGIO SPINAL SEL S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,3226156,ANGIO VISCERAL SEL S&I,9235.0,3878.7,2493.45,9050.3,37
CDM,3226164,AORTO ABD SERIAL S&I,6178.0,2594.76,1668.06,6054.44,37
CDM,3226172,AORTO ABD ILIOFEM BI SERIAL S&I,7198.0,3023.16,1943.46,7054.04,37
CDM,3226180,AORTO THORACIC SERIAL S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,3226198,AORTO THORACIC WO SERIAL S&I,7092.0,2978.64,1914.84,6950.16,37
CDM,3226479,XR TOE/S 2+ VW LT,254.0,106.68,68.58,248.92,30
CDM,3226487,XR TOE/S 2+ VW RT,254.0,106.68,68.58,248.92,30
CDM,3228004,REPOS G-TUBE NASO/ORO,1159.0,486.78,255.26,1135.82,36
CDM,3228012,INTRO TUBE GI LONG,2237.0,939.54,603.99,5367.0,37
CDM,3228103,INJ CYSTOGRAM,517.0,217.14,139.59,506.66,29
CDM,3228111,INJ URETHROCYSTOGRAM RETROGRADE,295.0,123.9,79.65,289.1,29
CDM,3228186,PUNCT LUMBAR DIAGNOSTIC,1728.0,725.76,466.56,3186.0,37
CDM,3228194,PUNCT SPINE THER DRN CSF,1080.0,453.6,291.6,3186.0,37
CDM,3228459,CHEMO CNS REQ PUNCTURE SPINAL,1086.0,456.12,293.22,1064.28,37
CDM,3228467,INJ ARTHRO HIP WO ANES LT,671.0,281.82,181.17,657.58,29
CDM,3228475,INJ ARTHRO HIP WO ANES RT,671.0,281.82,181.17,657.58,29
CDM,3228541,INSTILL AGENT PLEURODESIS W TB/CATH,1501.0,630.42,405.27,3186.0,37
CDM,3228558,INJ VENOGRAPHY EXTREMITY BI,1197.0,502.74,323.19,1173.06,29
CDM,3228566,INJ VENOGRAPHY EXTREMITY LT,798.0,335.16,215.46,782.04,29
CDM,3228574,INJ VENOGRAPHY EXTREMITY RT,798.0,335.16,215.46,782.04,29
CDM,3228616,IMP/REV/REPOS CATH IT/EPIDURAL,8495.0,3567.9,2293.65,17965.0,37
CDM,3228632,XR SPINE 1 VW,161.0,67.62,43.47,157.78,37
CDM,3228640,XR ARTHRO HIP LT S&I,742.0,311.64,200.34,727.16,30
CDM,3228657,XR ARTHRO HIP RT S&I,742.0,311.64,200.34,727.16,30
CDM,3228699,CATH ENDO DUCT BILIARY S&I,1112.0,467.04,300.24,1089.76,30
CDM,3228715,CATH ENDO DUCT BILIARY&PANCREAS S&I,1743.0,732.06,470.61,1708.14,30
CDM,3228723,INTRO TUBE GI LONG W FLUORO S&I,677.0,284.34,182.79,663.46,30
CDM,3228731,PLC TUBE ENTEROCLYSIS PERC S&I,564.0,236.88,152.28,552.72,30
CDM,3228749,UROGRAPHY RETROGRADE W/WO KUB,680.0,285.6,183.6,666.4,37
CDM,3228756,UROGRAPHY ANTEGRADE S&I,686.0,288.12,185.22,672.28,37
CDM,3228764,CYSTOGRAM 3+ VW S&I,710.0,298.2,191.7,695.8,37
CDM,3228780,URETHROCYSTOGRAM RETROGRADE S&I,491.0,206.22,132.57,481.18,37
CDM,3228798,HYSTEROSALPINGOGRAM S&I,750.0,315.0,202.5,735.0,37
CDM,3228814,VENOGRAM EXTREMITY LT S&I,2925.0,1228.5,789.75,2866.5,30
CDM,3228822,VENOGRAM EXTREMITY RT S&I,2925.0,1228.5,789.75,2866.5,30
CDM,3228830,VENOGRAM EXTREMITY BI S&I,3721.0,1562.82,1004.67,3646.58,37
CDM,3228848,VENOGRAM SVC SERIAL S&I,2362.0,992.04,637.74,2331.96,37
CDM,3228913,FLUORO 0-1HR TIME PHYS/QHCP,1055.0,443.1,243.77,1033.9,37
CDM,3228939,FLUORO GD PLCMT NEEDLE,559.0,234.78,150.93,547.82,30
CDM,3228947,FLUORO GD&LOC NEEDLE SPINE,794.0,333.48,214.38,778.12,30
CDM,3228954,XR ABSCESS/SINUS/FISTULA S&I,1112.0,467.04,300.24,1089.76,37
CDM,3228962,US GD ABLATION TISSUE,670.0,281.4,180.9,656.6,30
CDM,3228996,CHEMO PUSH INTRAARTERIAL,507.0,212.94,136.89,496.86,37
CDM,3229002,CHEMO CNS REQ PUNCTURE SPINAL,1086.0,456.12,293.22,1064.28,37
CDM,3229028,FLUORO GD PLC/REPL/REM CVAD,481.0,202.02,129.87,471.38,30
CDM,3229036,PLC G-TUBE NASO/ORO PHYS W FL GD,683.0,286.86,184.41,669.34,36
CDM,3229267,INS CATH PLEURAL INDWL W CUFF,5619.0,2359.98,1517.13,14009.0,37
CDM,3229390,DIL STRICT&/OBSTRUCT INTRALUM S&I,777.0,326.34,209.79,761.46,30
CDM,3229507,PHLEBECTOMY VEIN EXT 10-20 LT,4040.0,1696.8,1090.8,14009.0,30
CDM,3229515,PHLEBECTOMY VEIN EXT 10-20 RT,4040.0,1696.8,1090.8,14009.0,30
CDM,3229523,PHLEBECTOMY VEIN EXT 10-20 BI,6060.0,2545.2,1636.2,14009.0,30
CDM,3229531,PHLEBECTOMY VEIN EXT 21+ LT,4091.0,1718.22,1104.57,14009.0,30
CDM,3229549,PHLEBECTOMY VEIN EXT 21+ RT,4091.0,1718.22,1104.57,14009.0,30
CDM,3229556,PHLEBECTOMY VEIN EXT 21+ BI,6137.0,2577.54,1656.99,14009.0,30
CDM,3229622,IMP/RPLC DEV INF PUMP PROGRAMMABLE,7574.0,3181.08,2044.98,32969.0,37
CDM,3229820,INJ/S CNT EVAL CVD FLUORO S&I,1016.0,426.72,217.31,995.68,36
CDM,3229846,THROMBECT MECH PRIM ART SUBSQ W FL,4736.0,1989.12,1278.72,4641.28,29
CDM,3229853,THROMBECT MECH SEC ART W FL,9113.0,3827.46,2460.51,8930.74,29
CDM,3229861,THROMBECT MECH VEIN W FL,11118.0,4669.56,3001.86,25370.0,37
CDM,3229879,THROMBECT MECH VEIN SUBSQ W FL,6777.0,2846.34,1829.79,14009.0,37
CDM,3229895,RPLC STENT URETER INT PERC LT S&I,5143.0,2160.06,1388.61,10412.0,30
CDM,3229903,RPLC STENT URETER INT PERC RT S&I,5143.0,2160.06,1388.61,10412.0,30
CDM,3229911,RPLC STENT URETER INT PERC BI S&I,7715.0,3240.3,2083.05,10412.0,30
CDM,3229929,REM STENT URETER INT PERC LT S&I,3967.0,1666.14,1071.09,10412.0,30
CDM,3229937,REM STENT URETER INT PERC RT S&I,3967.0,1666.14,1071.09,10412.0,30
CDM,3229945,REM STENT URETER INT PERC BI S&I,5951.0,2499.42,1606.77,10412.0,30
CDM,3229952,RPLC CATH NEPHROURETER FL GD LT S&I,4022.0,1689.24,1085.94,5367.0,30
CDM,3229960,RPLC CATH NEPHROURETER FL GD RT S&I,4022.0,1689.24,1085.94,5367.0,30
CDM,3229978,RPLC CATH NEPHROURETER FL GD BI S&I,6033.0,2533.86,1628.91,5912.34,30
CDM,3229986,REM TUBE NEPHRO W FLUORO LT S&I,1515.0,636.3,409.05,3186.0,30
CDM,3229994,REM TUBE NEPHRO W FLUORO RT S&I,1515.0,636.3,409.05,3186.0,30
CDM,3230000,REM TUBE NEPHRO W FLUORO BI S&I,2273.0,954.66,613.71,3186.0,30
CDM,3230018,PTA INTRACRANIAL PERC,14072.0,5910.24,3101.0,13790.56,30
CDM,3230026,PLC STNT/S INTRAVASC INTRACRN,27059.0,11364.78,3101.0,26517.82,30
CDM,3230133,CHG TB/STNT URETER CONDUIT ILEAL,3238.0,1359.96,874.26,5367.0,37
CDM,3230810,GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,30
CDM,3231123,PHLEBECTOMY VEIN EXT 1-9,755.0,317.1,203.85,3186.0,37
CDM,3231198,XR TURCICA SELLA,134.0,56.28,36.18,131.32,37
CDM,3234622,INJ VISUAL ILEAL CONDUIT,1165.0,489.3,314.55,1141.7,29
CDM,3234630,ASP&/INJ CYST GANGLION,603.0,253.26,162.81,590.94,36
CDM,3234705,I&R FB TISSUE SUBQ SIMPLE,623.0,261.66,168.21,610.54,36
CDM,3234754,INS TUBE GASTRO PERC S&I,3435.0,1442.7,927.45,5367.0,37
CDM,3234762,INS TUBE DUO/JEJUNOSTOMY PERC S&I,2896.0,1216.32,781.92,5367.0,37
CDM,3234770,INS TUBE CECOSTOMY PERC S&I,1819.0,763.98,491.13,5367.0,37
CDM,3234788,CHG G-TUBE TO G-J TUBE PERC S&I,3282.0,1378.44,886.14,5367.0,37
CDM,3234796,RPLC TUBE GASTRO/CECOSTOMY PERC S&I,1478.0,620.76,399.06,5367.0,37
CDM,3234804,RPLC TUBE DUO/JEJUNOSTOMY PERC S&I,1846.0,775.32,498.42,5367.0,37
CDM,3234812,RPLC TUBE G-J PERC S&I,2570.0,1079.4,693.9,5367.0,37
CDM,3234820,REM OBSTRUCT MECH TUBE G/COLON S&I,955.0,401.1,257.85,5367.0,37
CDM,3234838,INJ CNT TUBE G/COLON PERC S&I,573.0,240.66,154.71,561.54,36
CDM,3234994,INJ CNT TUBE G/COLON PERC S&I,573.0,240.66,154.71,561.54,36
CDM,3235058,CHEMO INF INTRAARTERIAL 1ST HR,727.0,305.34,196.29,712.46,37
CDM,3235249,DISCOGRAM CERVICAL/THORACIC S&I,5582.0,2344.44,1507.14,5470.36,37
CDM,3235256,PERITONEOGRAM S&I,838.0,351.96,226.26,821.24,37
CDM,32367,R&B PEDIATRICS PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,3241551,INJ/S JT FCT C/T IMG 1 LVL BI,3948.0,1658.16,1065.96,3869.04,30
CDM,3241569,INJ/S JT FCT C/T IMG 1 LVL LT,2632.0,1105.44,710.64,3186.0,30
CDM,3241577,INJ/S JT FCT C/T IMG 1 LVL RT,2632.0,1105.44,710.64,3186.0,30
CDM,3241585,INJ/S JT FCT C/T IMG 2 LVL BI,2213.0,929.46,597.51,2168.74,29
CDM,3241593,INJ/S JT FCT C/T IMG 2 LVL LT,1475.0,619.5,398.25,1445.5,29
CDM,3241601,INJ/S JT FCT C/T IMG 2 LVL RT,1475.0,619.5,398.25,1445.5,29
CDM,3241619,INJ/S JT FCT C/T IMG 3+ LVL BI,1776.0,745.92,479.52,1740.48,29
CDM,3241627,INJ/S JT FCT C/T IMG 3+ LVL LT,1184.0,497.28,319.68,1160.32,29
CDM,3241635,INJ/S JT FCT C/T IMG 3+ LVL RT,1184.0,497.28,319.68,1160.32,29
CDM,3241643,INJ/S JT FCT L/S IMG 1 LVL BI,4442.0,1865.64,1199.34,4353.16,30
CDM,3241650,INJ/S JT FCT L/S IMG 1 LVL LT,2961.0,1243.62,799.47,3186.0,30
CDM,3241668,INJ/S JT FCT L/S IMG 1 LVL RT,2961.0,1243.62,799.47,3186.0,30
CDM,3241676,INJ/S JT FCT L/S IMG 2 LVL BI,2532.0,1063.44,683.64,2481.36,29
CDM,3241684,INJ/S JT FCT L/S IMG 2 LVL LT,1688.0,708.96,455.76,1654.24,29
CDM,3241692,INJ/S JT FCT L/S IMG 2 LVL RT,1688.0,708.96,455.76,1654.24,29
CDM,3241700,INJ/S JT FCT L/S IMG 3+ LVL BI,1665.0,699.3,449.55,1631.7,29
CDM,3241718,INJ/S JT FCT L/S IMG 3+ LVL LT,1110.0,466.2,299.7,1087.8,29
CDM,3241726,INJ/S JT FCT L/S IMG 3+ LVL RT,1110.0,466.2,299.7,1087.8,29
CDM,3241916,REM CATH PLEURAL INDWL W CUFF,993.0,417.06,268.11,3186.0,37
CDM,3241973,XR SPECIMEN SURGICAL,540.0,226.8,145.8,809.46,37
CDM,3242237,XR EYE FOREIGN BODY LT,254.0,106.68,68.58,248.92,30
CDM,3242245,XR EYE FOREIGN BODY RT,254.0,106.68,68.58,248.92,30
CDM,32433,R&B ICU,8046.0,3379.32,6839.1,7885.08,13
CDM,3243326,XR RIBS W CXR 3+ VW,264.0,110.88,71.28,258.72,37
CDM,3243342,BX PANCREAS NDL PERC,2567.0,1078.14,693.09,5367.0,37
CDM,3243359,CT GD PLCMT NEEDLE S&I,2584.0,1085.28,697.68,2532.32,30
CDM,3243979,XR MASTOIDS CMP 3+ VW PER SIDE LT,238.0,99.96,64.26,233.24,30
CDM,3243987,XR MASTOIDS CMP 3+ VW PER SIDE RT,238.0,99.96,64.26,233.24,30
CDM,3244100,RPR ENDOVAS AORTA THOR WO LSA,20206.0,8486.52,3101.0,19801.88,30
CDM,3244118,RPR ENDOVAS AORTA THOR W LSA,23522.0,9879.24,3101.0,23051.56,30
CDM,3244886,INJ SCLEROSANT VEIN INCMPT SGL BI,935.0,392.7,252.45,916.3,29
CDM,3244894,INJ SCLEROSANT VEIN INCMPT SGL LT,623.0,261.66,168.21,610.54,29
CDM,3244902,INJ SCLEROSANT VEIN INCMPT SGL RT,623.0,261.66,168.21,610.54,29
CDM,3244910,INJ SCLEROSANT VEIN INCMPT MULTI BI,1832.0,769.44,494.64,1795.36,29
CDM,3244928,INJ SCLEROSANT VEIN INCMPT MULTI LT,1221.0,512.82,329.67,1196.58,29
CDM,3244936,INJ SCLEROSANT VEIN INCMPT MULTI RT,1221.0,512.82,329.67,1196.58,29
CDM,3244969,BX/S MARROW BONE DX NP/UNI,1386.0,582.12,374.22,3186.0,37
CDM,3244977,BX/S MARROW BONE DX BI,2079.0,873.18,561.33,3186.0,30
CDM,3244985,ASP/S&BX/S MARROW BONE DX BI,2219.0,931.98,599.13,5367.0,30
CDM,3244993,XR CHEST 1 VW,254.0,106.68,68.58,248.92,37
CDM,3245016,XR CHEST 2 VW,322.0,135.24,86.94,315.56,37
CDM,3245032,XR CHEST 3 VW,397.0,166.74,88.91,389.06,37
CDM,3245057,XR CHEST 4+ VW,426.0,178.92,106.81,417.48,37
CDM,3245297,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,621.18,399.33,5367.0,37
CDM,3245479,XR ABDOMEN 1 VW,231.0,97.02,62.37,226.38,37
CDM,3245495,XR ABDOMEN 2 VW,276.0,115.92,74.52,270.48,37
CDM,3245511,XR ABDOMEN 3+ VW,322.0,135.24,86.94,315.56,37
CDM,3245677,BX GLAND SALIVARY NDL,1263.0,530.46,341.01,3186.0,37
CDM,3246139,BX/EXCISE NODE NDL SUPERFICIAL BI,4134.0,1736.28,1116.18,5367.0,30
CDM,3246147,BX/EXCISE NODE NDL SUPERFICIAL LT,2756.0,1157.52,744.12,5367.0,30
CDM,3246154,BX/EXCISE NODE NDL SUPERFICIAL RT,2756.0,1157.52,744.12,5367.0,30
CDM,3246253,STUDY MANOMETRIC RENAL TB/CATH BI,1601.0,672.42,432.27,3186.0,30
CDM,3246261,STUDY MANOMETRIC RENAL TB/CATH LT,1067.0,448.14,288.09,3186.0,30
CDM,3246279,STUDY MANOMETRIC RENAL TB/CATH RT,1067.0,448.14,288.09,3186.0,30
CDM,3246287,INJ CATH URETERAL BI,782.0,328.44,211.14,766.36,29
CDM,3246295,INJ CATH URETERAL LT,521.0,218.82,140.67,510.58,29
CDM,3246303,INJ CATH URETERAL RT,521.0,218.82,140.67,510.58,29
CDM,3247038,INJ ARTHRO HIP WO ANES BI,1007.0,422.94,271.89,986.86,29
CDM,3248259,CHOLECYSTOSTOMY PERC W IMG GD S&I,4887.0,2052.54,1319.49,14009.0,37
CDM,3248283,REM CATH INTRAPERIT,4570.0,1919.4,1233.9,14009.0,37
CDM,3248291,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,4466.0,1875.72,1205.82,4376.68,30
CDM,3248309,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2977.0,1250.34,803.79,3186.0,30
CDM,3248317,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2977.0,1250.34,803.79,3186.0,30
CDM,3248325,INJ/S EPID TRFR C/T FL/CT GD ADD BI,1469.0,616.98,396.63,1439.62,29
CDM,3248333,INJ/S EPID TRFR C/T FL/CT GD ADD LT,979.0,411.18,264.33,959.42,29
CDM,3248341,INJ/S EPID TRFR C/T FL/CT GD ADD RT,979.0,411.18,264.33,959.42,29
CDM,3248358,INJ/S EPID TRFR L/S FL/CT GD 1LV BI,2103.0,883.26,567.81,3186.0,30
CDM,3248366,INJ/S EPID TRFR L/S FL/CT GD 1LV LT,1402.0,588.84,378.54,3186.0,30
CDM,3248374,INJ/S EPID TRFR L/S FL/CT GD 1LV RT,1402.0,588.84,378.54,3186.0,30
CDM,3248382,INJ/S EPID TRFR L/S FL/CT GD ADD BI,920.0,386.4,248.4,901.6,29
CDM,3248390,INJ/S EPID TRFR L/S FL/CT GD ADD LT,613.0,257.46,165.51,600.74,29
CDM,3248408,INJ/S EPID TRFR L/S FL/CT GD ADD RT,613.0,257.46,165.51,600.74,29
CDM,3248416,ART PHYS 1-2 LEVEL LTD BI,798.0,335.16,135.93,782.04,37
CDM,3248432,ATHERECT PERIPH ART RENAL W S&I,11118.0,4669.56,3001.86,26759.0,37
CDM,3248440,ATHERECT PERIPH ART VISC W S&I,10766.0,4521.72,2906.82,10550.68,30
CDM,3248457,ATHERECT PERIPH AORTA ABD W S&I,11118.0,4669.56,3001.86,26759.0,37
CDM,3248465,ATHERECT PERIPH TR&BR BRACH W S&I,11118.0,4669.56,3001.86,26759.0,37
CDM,3248473,ATHERECT PERIPH ART ILIAC W S&I,13309.0,5589.78,3593.43,27156.6,37
CDM,3248630,INS CATH INTRAPERIT TUN W IMG,8828.0,3707.76,2383.56,14009.0,37
CDM,3248846,RPLC STENT URETER TRANSURETH LT S&I,2996.0,1258.32,808.92,10412.0,30
CDM,3248853,RPLC STENT URETER TRANSURETH RT S&I,2996.0,1258.32,808.92,10412.0,30
CDM,3248861,RPLC STENT URETER TRANSURETH BI S&I,4494.0,1887.48,1213.38,10412.0,30
CDM,3248879,INS SHUNT PERITONEAL-VENOUS,7493.0,3147.06,2023.11,7343.14,30
CDM,3249307,XR SPINE LS CMP W BEND 6+ VW,410.0,172.2,106.81,401.8,37
CDM,3249315,XR SPINE LS BEND 2-3 VW,166.0,69.72,44.82,162.68,37
CDM,3249414,INJ JT SI ANES/STRD FL/CT GD BI,2720.0,1142.4,734.4,2665.6,29
CDM,3249422,INJ JT SI ANES/STRD FL/CT GD LT,1813.0,761.46,489.51,1776.74,29
CDM,3249430,INJ JT SI ANES/STRD FL/CT GD RT,1813.0,761.46,489.51,1776.74,29
CDM,3249448,INJ JT SI ARTHO FL/CT GD BI,2720.0,1142.4,734.4,2665.6,29
CDM,3249455,INJ JT SI ARTHO FL/CT GD LT,1813.0,761.46,489.51,1776.74,29
CDM,3249463,INJ JT SI ARTHO FL/CT GD RT,1813.0,761.46,489.51,1776.74,29
CDM,3249471,PLC CATH SEL 1ST ART RENAL UNI S&I,6273.0,2634.66,1693.71,14009.0,37
CDM,3249489,PLC CATH SEL 1ST ART RENAL BI S&I,7705.0,3236.1,2080.35,14009.0,37
CDM,3249497,PLC CATH SEL 2ND+ ART RENAL UNI S&I,11041.0,4637.22,2981.07,25370.0,37
CDM,3249505,PLC CATH SEL 2ND+ ART RENAL BI S&I,11777.0,4946.34,3179.79,14009.0,37
CDM,3249513,INS FILTER VENA CAVA ENDV S&I,9168.0,3850.56,2475.36,25370.0,37
CDM,3249521,REPOS FILTER VENA CAVA ENDV S&I,7251.0,3045.42,1957.77,14009.0,37
CDM,3249539,REM FILTER VENA CAVA ENDV S&I,5136.0,2157.12,1386.72,14009.0,37
CDM,3249554,PARACENTESIS ABDOMINAL WO IMG,1846.0,775.32,498.42,5367.0,37
CDM,3249562,PARACENTESIS ABDOMINAL W IMG,2677.0,1124.34,722.79,5367.0,37
CDM,3249620,DST NRV CERV/THOR FL/CT GD SGL BI,4442.0,1865.64,1199.34,10412.0,30
CDM,3249638,DST NRV CERV/THOR FL/CT GD SGL LT,2961.0,1243.62,799.47,10412.0,30
CDM,3249646,DST NRV CERV/THOR FL/CT GD SGL RT,2961.0,1243.62,799.47,10412.0,30
CDM,3249687,DST NRV LUMB/SAC FL/CT GD SGL BI,6237.0,2619.54,1683.99,10412.0,30
CDM,3249695,DST NRV LUMB/SAC FL/CT GD SGL LT,4158.0,1746.36,1122.66,10412.0,30
CDM,3249703,DST NRV LUMB/SAC FL/CT GD SGL RT,4158.0,1746.36,1122.66,10412.0,30
CDM,3249711,DST NRV LUMB/SAC FL/CT GD ADDL BI,2279.0,957.18,615.33,2233.42,29
CDM,3249729,DST NRV LUMB/SAC FL/CT GD ADDL LT,1519.0,637.98,410.13,1488.62,29
CDM,3249737,DST NRV LUMB/SAC FL/CT GD ADDL RT,1519.0,637.98,410.13,1488.62,29
CDM,3249760,BX RENAL TROCAR/NDL PERC LT,3084.0,1295.28,832.68,5367.0,30
CDM,3249778,BX RENAL TROCAR/NDL PERC RT,3084.0,1295.28,832.68,5367.0,30
CDM,3249786,BX RENAL TROCAR/NDL PERC BI,4626.0,1942.92,1249.02,5367.0,30
CDM,3249836,INTRO NDL/INTRACATHETER VEIN,357.0,149.94,96.39,349.86,29
CDM,3249851,LYMPHANGIOGRAPHY PLVC/ABD UNI S&I,3062.0,1286.04,826.74,4677.51,37
CDM,3249869,LYMPHANGIOGRAPHY PLVC/ABD BI S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,3249984,THERAPY RRX INTRAARTERIAL PARTICUL,630.0,264.6,170.1,617.4,37
CDM,3250628,INJ/S ANES NRV ILIOING ILIOHYGAS LT,1080.0,453.6,291.6,3186.0,30
CDM,3250636,INJ/S ANES NRV ILIOING ILIOHYGAS RT,1080.0,453.6,291.6,3186.0,30
CDM,3250677,INJ/S ANES NRV ILIOING ILIOHYGAS BI,1620.0,680.4,437.4,3186.0,30
CDM,3250693,ASP INTERDISCAL DX PERC,1560.0,655.2,421.2,3186.0,37
CDM,3250941,INJ ANES GANGLION SPHENO LT,604.0,253.68,163.08,591.92,29
CDM,3250958,INJ ANES GANGLION SPHENO RT,604.0,253.68,163.08,591.92,29
CDM,3250966,INJ ANES GANGLION SPHENO BI,906.0,380.52,244.62,887.88,29
CDM,3251089,INJ/S ANES NRV TRIGEMINAL BR LT,753.0,316.26,203.31,737.94,29
CDM,3251097,INJ/S ANES NRV TRIGEMINAL BR RT,753.0,316.26,203.31,737.94,29
CDM,3251113,INJ/S ANES NRV TRIGEMINAL BR BI,1130.0,474.6,305.1,1107.4,29
CDM,3251246,LYMPHANGIOGRAPHY EXT LT S&I,1680.0,705.6,453.6,1646.4,30
CDM,3251253,LYMPHANGIOGRAPHY EXT RT S&I,1680.0,705.6,453.6,1646.4,30
CDM,3251261,LYMPHANGIOGRAPHY EXT BIL S&I,3553.0,1492.26,959.31,3481.94,37
CDM,3252160,THORACENTESIS ASP WO IMG LT,930.0,390.6,251.1,3186.0,30
CDM,3252178,THORACENTESIS ASP WO IMG RT,930.0,390.6,251.1,3186.0,30
CDM,3252186,THORACENTESIS ASP WO IMG BI,1395.0,585.9,376.65,3186.0,30
CDM,3252194,THORACENTESIS ASP W IMG LT,1726.0,724.92,466.02,3186.0,30
CDM,3252202,THORACENTESIS ASP W IMG RT,1726.0,724.92,466.02,3186.0,30
CDM,3252210,THORACENTESIS ASP W IMG BI,2589.0,1087.38,699.03,3186.0,30
CDM,3252293,XR SPINE CERVICAL 4-5 VW,349.0,146.58,94.23,342.02,37
CDM,3252301,XR SPINE CERVICAL 6+ VW,402.0,168.84,106.81,393.96,37
CDM,3252418,CT REND 3D W I&R W PP DIFF WRKST,354.0,148.68,95.58,346.92,30
CDM,3252434,ANGIO SUBSQ THRPY EMB/INF NONTHROMB,2981.0,1252.02,804.87,4677.51,37
CDM,3252509,THORACENTESIS ASP W IMG LT,1726.0,724.92,466.02,3186.0,30
CDM,3252517,THORACENTESIS ASP W IMG RT,1726.0,724.92,466.02,3186.0,30
CDM,3252525,THORACENTESIS ASP W IMG BI,2589.0,1087.38,699.03,3186.0,30
CDM,3252590,DRN PLEURA INS CATH INDWL WO IMG LT,2620.0,1100.4,707.4,5367.0,30
CDM,3252608,DRN PLEURA INS CATH INDWL WO IMG RT,2620.0,1100.4,707.4,5367.0,30
CDM,3252616,DRN PLEURA INS CATH INDWL WO IMG BI,3930.0,1650.6,1061.1,5367.0,30
CDM,3252624,DRN PLEURA INS CATH INDWL W IMG LT,2983.0,1252.86,805.41,3186.0,30
CDM,3252632,DRN PLEURA INS CATH INDWL W IMG RT,2983.0,1252.86,805.41,3186.0,30
CDM,3252640,DRN PLEURA INS CATH INDWL W IMG BI,4475.0,1879.5,1208.25,4385.5,30
CDM,3252830,DIL URETER(S)/URETHRA S&I,2071.0,869.82,559.17,3096.71,37
CDM,3252962,REM FB INTRAVASC W IMG S&I,8624.0,3622.08,2328.48,14009.0,37
CDM,3252970,THROMBOLYSIS INF ART INIT DAY S&I,10375.0,4357.5,2801.25,25370.0,37
CDM,3252988,THROMBOLYSIS INF VEN INIT S&I,9087.0,3816.54,2453.49,14009.0,37
CDM,3252996,THROMBOLYSIS INF ART/VEN SUBSQ S&I,8633.0,3625.86,2330.91,8460.34,37
CDM,3253002,CESSAT THROMBOLYSIS&REM CATH S&I,9863.0,4142.46,2663.01,9665.74,37
CDM,3253010,PLC CATH AORTA THOR ANG EC&/IC S&I,8780.0,3687.6,2370.6,14009.0,37
CDM,3253044,PLC CATH SEL CAR/INM ANG EC LT S&I,10163.0,4268.46,2744.01,14009.0,30
CDM,3253051,PLC CATH SEL CAR/INM ANG EC RT S&I,10163.0,4268.46,2744.01,14009.0,30
CDM,3253069,PLC CATH SEL CAR/INM ANG EC BI S&I,15245.0,6402.9,4116.15,14940.1,30
CDM,3253077,PLC CATH SEL CAR/INM ANG IC LT S&I,13057.0,5483.94,3525.39,25370.0,30
CDM,3253085,PLC CATH SEL CAR/INM ANG IC RT S&I,13057.0,5483.94,3525.39,25370.0,30
CDM,3253093,PLC CATH SEL CAR/INM ANG IC BI S&I,19586.0,8226.12,5288.22,25370.0,30
CDM,3253101,PLC CATH SEL ART CAR ANG IC LT S&I,15124.0,6352.08,4083.48,25370.0,30
CDM,3253119,PLC CATH SEL ART CAR ANG IC RT S&I,15124.0,6352.08,4083.48,25370.0,30
CDM,3253127,PLC CATH SEL ART CAR ANG IC BI S&I,22686.0,9528.12,6125.22,25370.0,30
CDM,3253135,PLC CATH SEL ART SUB/INM ANG LT S&I,10712.0,4499.04,2892.24,14009.0,30
CDM,3253143,PLC CATH SEL ART SUB/INM ANG RT S&I,10712.0,4499.04,2892.24,14009.0,30
CDM,3253150,PLC CATH SEL ART SUB/INM ANG BI S&I,16068.0,6748.56,4338.36,15746.64,30
CDM,3253168,PLC CATH SEL ART VERT ANG LT S&I,14859.0,6240.78,4011.93,25370.0,30
CDM,3253176,PLC CATH SEL ART VERT ANG RT S&I,14859.0,6240.78,4011.93,25370.0,30
CDM,3253184,PLC CATH SEL ART VERT ANG BI S&I,22289.0,9361.38,6018.03,25370.0,30
CDM,3253192,PLC CATH SEL ART CAR EXT ANG LT S&I,6628.0,2783.76,1789.56,6495.44,29
CDM,3253200,PLC CATH SEL ART CAR EXT ANG RT S&I,6628.0,2783.76,1789.56,6495.44,29
CDM,3253218,PLC CATH SEL ART CAR EXT ANG BI S&I,9942.0,4175.64,2684.34,9743.16,29
CDM,3253226,PLC CATH SEL BR INTRACRN ANG LT S&I,1847.0,775.74,498.69,1810.06,29
CDM,3253234,PLC CATH SEL BR INTRACRN ANG RT S&I,1847.0,775.74,498.69,1810.06,29
CDM,3253242,PLC CATH SEL BR INTRACRN ANG BI S&I,2771.0,1163.82,748.17,2715.58,29
CDM,3253283,DST NRV PERIPH/BRANCH BI,2079.0,873.18,561.33,3186.0,30
CDM,3253291,DST NRV PERIPH/BRANCH LT,1386.0,582.12,374.22,3186.0,30
CDM,3253309,DST NRV PERIPH/BRANCH RT,1386.0,582.12,374.22,3186.0,30
CDM,3253358,PLC STNT/S ART OPEN/PERC INIT S&I,15917.0,6685.14,4297.59,26759.0,37
CDM,3253366,PLC STNT/S ART OPEN/PERC ADDL S&I,6947.0,2917.74,1875.69,25370.0,30
CDM,3253374,PLC STNT/S VEIN OPEN/PERC INIT S&I,19417.0,8155.14,5242.59,26759.0,37
CDM,3253382,PLC STNT/S VEIN OPEN/PERC ADDL S&I,7307.0,3068.94,1972.89,25370.0,30
CDM,3253390,EMB/OCCL VASC VENOUS S&I,19494.0,8187.48,5263.38,26759.0,37
CDM,3253408,EMB/OCCL VASC ARTERIAL S&I,19798.0,8315.16,5345.46,27156.6,37
CDM,3253416,EMB/OCCL VASC TMRS/ORG S&I,20635.0,8666.7,5571.45,26759.0,37
CDM,3253424,EMB/OCCL VASC HEMORRHAGE S&I,19494.0,8187.48,5263.38,26759.0,37
CDM,3253432,DRN CATH FLUID VISCERAL IMG GD,2535.0,1064.7,684.45,5367.0,37
CDM,3253440,DRN CATH FLUID PERI PERC IMG GD,6013.0,2525.46,1623.51,5892.74,37
CDM,3253457,DRN CATH FLUID TRNSVAG/REC IMG GD,2528.0,1061.76,682.56,5367.0,37
CDM,3253465,DRN CATH FLUID TISSUE SOFT IMG GD,2511.0,1054.62,677.97,3186.0,37
CDM,3253523,INJ PSEUDOANEURYSM EXT BI,1817.0,763.14,490.59,3186.0,30
CDM,3253606,BX BRST W/WO DEV/IMG SG LSN 1ST LT,3925.0,1648.5,1059.75,5367.0,30
CDM,3253614,BX BRST W/WO DEV/IMG SG LSN 1ST RT,3925.0,1648.5,1059.75,5367.0,30
CDM,3253655,BX BRST W/WO DEV/IMG SG LSN ADD,1367.0,574.14,369.09,1339.66,29
CDM,3253671,PLC DEV/S BRST MAMMO GD LSN ADD,734.0,308.28,198.18,719.32,29
CDM,3253739,DUCTO/GALACTOGRAM MAMMARY SGL RTS&I,419.0,175.98,113.13,410.62,30
CDM,3253754,DUCTO/GALACTOGRAM MAMMARY SGL LTS&I,419.0,175.98,113.13,410.62,30
CDM,3253770,DUCTO/GALACTOGRAM MAMMARY MULTI S&I,551.0,231.42,148.77,539.98,37
CDM,3253903,PLC DEV/S BRST MAMMO GD LSN 1ST LT,2434.0,1022.28,657.18,5367.0,30
CDM,3253911,PLC DEV/S BRST MAMMO GD LSN 1ST RT,2434.0,1022.28,657.18,5367.0,30
CDM,3254257,INJ MYELOGRAM&/CT LUMBAR,1474.0,619.08,397.98,1444.52,29
CDM,3261989,ASP&/INJ JT/BUR SM WO US GD LT,523.0,219.66,141.21,512.54,29
CDM,3261997,ASP&/INJ JT/BUR SM WO US GD RT,523.0,219.66,141.21,512.54,29
CDM,3262003,ASP&/INJ JT/BUR SM WO US GD BI,785.0,329.7,211.95,769.3,29
CDM,3262011,ASP&/INJ JT/BUR INTR WO US GD RT,557.0,233.94,150.39,545.86,29
CDM,3262029,ASP&/INJ JT/BUR INTR WO US GD BI,836.0,351.12,225.72,819.28,29
CDM,3262037,ASP&/INJ JT/BUR INTR WO US GD LT,557.0,233.94,150.39,545.86,29
CDM,3262045,ASP&/INJ JT/BUR MAJ WO US GD RT,750.0,315.0,202.5,735.0,29
CDM,3262052,ASP&/INJ JT/BUR MAJ WO US GD BI,1125.0,472.5,303.75,1102.5,29
CDM,3262060,ASP&/INJ JT/BUR MAJ WO US GD LT,750.0,315.0,202.5,735.0,29
CDM,3262078,ABL RF TUMOR/S BONE PERC IMG GD,11294.0,4743.48,3049.38,25974.71,37
CDM,3262086,PLC STNT/S ART CRV CAR W EMB S&I,17102.0,7182.84,3101.0,16759.96,30
CDM,3262094,PLC STNT/S ART CRV CAR WO EMB S&I,10410.0,4372.2,2810.7,10201.8,30
CDM,3262128,VERTEBROPLASTY LUMBOSACRAL PERC,9261.0,3889.62,2500.47,14009.0,37
CDM,3262136,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4730.0,1986.6,1277.1,4635.4,29
CDM,3262144,AUG VERTEBRAL THORACIC PERC,18013.0,7565.46,4863.51,25370.0,37
CDM,3262169,AUG VERTEBRAL LUMBAR PERC,17548.0,7370.16,4737.96,25370.0,37
CDM,3263415,INJ LUMB MYELOGRPHY CERVICAL S&I,2054.0,862.68,554.58,3186.0,37
CDM,3263431,INJ LUMB MYELOGRPHY THORACIC S&I,2859.0,1200.78,771.93,3186.0,37
CDM,3263456,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,2885.0,1211.7,778.95,3186.0,37
CDM,3264389,ASP&/INJ JT/BUR INTR W US GD BI,2100.0,882.0,567.0,3186.0,30
CDM,3264587,ASP&/INJ JT/BUR MAJ W US GD BI,2279.0,957.18,615.33,2233.42,29
CDM,3264595,ASP&/INJ JT/BUR MAJ W US GD LT,1519.0,637.98,410.13,1488.62,29
CDM,3264603,ASP&/INJ JT/BUR MAJ W US GD RT,1519.0,637.98,410.13,1488.62,29
CDM,3264611,INJ LUMB MYELOGRPHY CERVICAL S&I,2054.0,862.68,554.58,3186.0,37
CDM,3264629,INJ LUMB MYELOGRPHY THORACIC S&I,2859.0,1200.78,771.93,3186.0,37
CDM,3264637,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,2885.0,1211.7,778.95,3186.0,37
CDM,3264645,INJ LUMB MYELOGRPHY 2+ S&I,3393.0,1425.06,800.9,3325.14,37
CDM,3264652,ASP&/INJ JT/BUR INTR W US GD LT,1400.0,588.0,378.0,3186.0,30
CDM,3264660,ASP&/INJ JT/BUR INTR W US GD RT,1400.0,588.0,378.0,3186.0,30
CDM,3264678,ASP&/INJ JT/BUR SM W US GD BI,1178.0,494.76,318.06,1154.44,29
CDM,3264686,ASP&/INJ JT/BUR SM W US GD LT,785.0,329.7,211.95,769.3,29
CDM,3264694,ASP&/INJ JT/BUR SM W US GD RT,785.0,329.7,211.95,769.3,29
CDM,3264751,INJ SUBQ/IM,228.0,95.76,61.56,223.44,37
CDM,3265121,THERAPY TRANSCATH EMB S&I,1776.0,745.92,479.52,1740.48,30
CDM,3265162,INJ SUBQ/IM,228.0,95.76,61.56,223.44,37
CDM,3265287,INJ ARTHRO SHOULDER BI,707.0,296.94,190.89,692.86,29
CDM,3265295,INJ ARTHRO SHOULDER LT,471.0,197.82,127.17,461.58,29
CDM,3265303,INJ ARTHRO SHOULDER RT,471.0,197.82,127.17,461.58,29
CDM,3265337,XR HUMERUS 2 VW RT RDC,254.0,106.68,68.58,248.92,30
CDM,3265345,XR HUMERUS 2 VW LT RDC,254.0,106.68,68.58,248.92,30
CDM,3265352,XR ELBOW 2 VW RT RDC,229.0,96.18,61.83,224.42,30
CDM,3265360,XR ELBOW 2 VW LT RDC,229.0,96.18,61.83,224.42,30
CDM,3265386,XR FOREARM 2 VW RT RDC,229.0,96.18,61.83,224.42,30
CDM,3265394,XR FOREARM 2 VW LT RDC,229.0,96.18,61.83,224.42,30
CDM,3265410,XR WRIST 2 VW RT RDC,222.0,93.24,59.94,217.56,30
CDM,3265428,XR WRIST 2 VW LT RDC,222.0,93.24,59.94,217.56,30
CDM,3265444,XR HAND 2 VW RT RDC,222.0,93.24,59.94,217.56,30
CDM,3265451,XR HAND 2 VW LT RDC,222.0,93.24,59.94,217.56,30
CDM,3265477,XR TIBIA&FIBULA 2 VW RT RDC,254.0,106.68,68.58,248.92,30
CDM,3265485,XR TIBIA&FIBULA 2 VW LT RDC,254.0,106.68,68.58,248.92,30
CDM,3265501,XR ANKLE 2 VW RT RDC,237.0,99.54,63.99,232.26,30
CDM,3265519,XR ANKLE 2 VW LT RDC,237.0,99.54,63.99,232.26,30
CDM,3265535,XR FOOT 2 VW RT RDC,219.0,91.98,59.13,214.62,30
CDM,3265543,XR FOOT 2 VW LT RDC,219.0,91.98,59.13,214.62,30
CDM,3265600,ASP NEEDLE FINE BX US GD LSN 1ST,2616.0,1098.72,706.32,3186.0,37
CDM,3265618,ASP NEEDLE FINE BX US GD LSN ADDL,1644.0,690.48,443.88,1611.12,29
CDM,3265626,ASP NEEDLE FINE BX FL GD LSN 1ST,2953.0,1240.26,723.47,3186.0,37
CDM,3265667,INS PICC WO P/P W IMG 0-4YRS,2506.0,1052.52,640.89,3186.0,37
CDM,3265675,INS PICC WO P/P W IMG 5+YRS,4693.0,1971.06,1267.11,5367.0,37
CDM,3265683,DIL TRACT EXIST PERC BI S&I,7397.0,3106.74,1997.19,10412.0,30
CDM,3265691,DIL TRACT EXIST PERC LT S&I,4931.0,2071.02,1331.37,10412.0,30
CDM,3265709,DIL TRACT EXIST PERC RT S&I,4931.0,2071.02,1331.37,10412.0,30
CDM,3265717,DIL TRACT EXIST PERC NEW ACC BI S&I,7397.0,3106.74,1997.19,14009.0,30
CDM,3265725,DIL TRACT EXIST PERC NEW ACC LT S&I,4931.0,2071.02,1331.37,14009.0,30
CDM,3265733,DIL TRACT EXIST PERC NEW ACC RT S&I,4931.0,2071.02,1331.37,14009.0,30
CDM,3265741,INS PICC WO P/P WO IMG 0-4YRS,2004.0,841.68,541.08,3186.0,37
CDM,3265758,INS PICC WO P/P WO IMG 5+YRS,4462.0,1874.04,1204.74,4372.76,37
CDM,3265766,RPLC PICC WO P/P SA S&I,4056.0,1703.52,1095.12,3974.88,37
CDM,3265790,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,2235.0,938.7,603.45,3186.0,37
CDM,3265808,PLC DEV/S LOC TIS SOFT PERC LSN ADD,828.0,347.76,223.56,811.44,29
CDM,3266020,XR ESOPHAGUS STUDY CNT SINGLE,461.0,193.62,124.47,451.78,37
CDM,3266038,FNCT SWALLOW W CINE/VIDEO STUDY CNT,584.0,245.28,157.68,572.32,37
CDM,3266046,XR UGI STUDY CNT SINGLE,478.0,200.76,129.06,468.44,37
CDM,3266053,XR UGI STUDY CNT DOUBLE,645.0,270.9,174.15,632.1,37
CDM,3266061,XR INTESTINE SM STUDY FOLLOW THRU,216.0,90.72,58.32,211.68,30
CDM,3266079,XR INTESTINE SM STUDY CNT SINGLE,432.0,181.44,116.64,423.36,37
CDM,3266087,XR INTESTINE SM STUDY CNT DOUBLE,983.0,412.86,179.2,963.34,37
CDM,3266095,XR COLON STUDY CNT SINGLE,584.0,245.28,157.68,572.32,37
CDM,3266103,XR COLON STUDY CNT DOUBLE,607.0,254.94,163.89,594.86,37
CDM,3266210,INJ/S ANES NRV OCCIPITAL GREAT BI,1992.0,836.64,537.84,1952.16,29
CDM,3266228,INJ/S ANES NRV OCCIPITAL GREAT LT,1328.0,557.76,358.56,1301.44,29
CDM,3266236,INJ/S ANES NRV OCCIPITAL GREAT RT,1328.0,557.76,358.56,1301.44,29
CDM,3266269,INJ/S ANES NRV/BR PERPH OTHER BI,2100.0,882.0,567.0,3186.0,30
CDM,3266277,INJ/S ANES NRV/BR PERPH OTHER LT,1400.0,588.0,378.0,3186.0,30
CDM,3266285,INJ/S ANES NRV/BR PERPH OTHER RT,1400.0,588.0,378.0,3186.0,30
CDM,3266293,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,2773.0,1164.66,721.17,3186.0,37
CDM,3266301,PUNCT SPINE THER DRN CSF W FL/CT GD,1884.0,791.28,508.68,3186.0,37
CDM,3266319,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,2773.0,1164.66,721.17,3186.0,37
CDM,3266327,PUNCT SPINE THER DRN CSF W FL/CT GD,1884.0,791.28,508.68,3186.0,37
CDM,3266335,XR ESOPHAGUS STUDY CNT DOUBLE,485.0,203.7,130.95,475.3,37
CDM,3266376,INJ/S ANES NRV GENICULAR INCL IMGBI,2100.0,882.0,567.0,3186.0,30
CDM,3266418,ABL RF JOINT SI INCL IMG GD BI,6300.0,2646.0,1701.0,10412.0,30
CDM,3266426,ABL RF JOINT SI INCL IMG GD LT,4200.0,1764.0,1134.0,10412.0,30
CDM,3266434,ABL RF JOINT SI INCL IMG GD RT,4200.0,1764.0,1134.0,10412.0,30
CDM,3266459,INJ/S ANES NRV GENICULAR INCL IMGLT,1400.0,588.0,378.0,3186.0,30
CDM,3266467,INJ/S ANES NRV GENICULAR INCL IMGRT,1400.0,588.0,378.0,3186.0,30
CDM,3266566,DRN PERICARD PERC WO CONG CARD 6+Y,5629.0,2364.18,1519.83,5516.42,30
CDM,3266582,DRN PERICARD PERC WO CONG CARD 0-5Y,6576.0,2761.92,1775.52,6444.48,30
CDM,3266822,ASP&/INJ JT/BUR SM W US GD NP/UNI,785.0,329.7,211.95,769.3,36
CDM,3267010,INJ/S ANES NRV FEMORAL W IMG BI,1779.0,747.18,480.33,3186.0,30
CDM,3267028,INJ/S ANES NRV FEMORAL W IMG LT,1186.0,498.12,320.22,3186.0,30
CDM,3267036,INJ/S ANES NRV FEMORAL W IMG RT,1186.0,498.12,320.22,3186.0,30
CDM,3267085,CREATE AVF UE ACCESS SEP IMG GD S&I,17585.0,7385.7,4747.95,27156.6,37
CDM,3267242,INJ/S ANES NRV INTRCST LVL SGL BI,2208.0,927.36,596.16,3186.0,30
CDM,3267259,INJ/S ANES NRV INTRCST LVL SGL RT,1472.0,618.24,397.44,3186.0,30
CDM,3267267,INJ/S ANES NRV INTRCST LVL SGL LT,1472.0,618.24,397.44,3186.0,30
CDM,3267275,INJ/S ANES NRV INTRCST LVL ADD BI,2724.0,1144.08,735.48,3186.0,30
CDM,3267283,INJ/S ANES NRV INTRCST LVL ADD RT,1816.0,762.72,490.32,3186.0,30
CDM,3267291,INJ/S ANES NRV INTRCST LVL ADD LT,1816.0,762.72,490.32,3186.0,30
CDM,3267309,INJ/S ANES NRV INTRCST LVL SGL BI,2208.0,927.36,596.16,3186.0,30
CDM,3267317,INJ/S ANES NRV INTRCST LVL SGL RT,1472.0,618.24,397.44,3186.0,30
CDM,3267325,INJ/S ANES NRV INTRCST LVL SGL LT,1472.0,618.24,397.44,3186.0,30
CDM,3267333,INJ/S ANES NRV INTRCST LVL ADD BI,2724.0,1144.08,735.48,3186.0,30
CDM,3267341,INJ/S ANES NRV INTRCST LVL ADD RT,1816.0,762.72,490.32,3186.0,30
CDM,3267358,INJ/S ANES NRV INTRCST LVL ADD LT,1816.0,762.72,490.32,3186.0,30
CDM,3271806,REVSC IVT ANGIO SF VSL INIT BI,23813.0,10001.46,6429.51,25370.0,30
CDM,3271814,REVSC IVT ANGIO SF VSL INIT LT,15875.0,6667.5,4286.25,25370.0,30
CDM,3271822,REVSC IVT ANGIO SF VSL INIT RT,15875.0,6667.5,4286.25,25370.0,30
CDM,3271830,REVSC IVT ANGIO SF VSL ADD BI,9741.0,4091.22,2630.07,9546.18,29
CDM,3271848,REVSC IVT ANGIO SF VSL ADD LT,6494.0,2727.48,1753.38,6364.12,29
CDM,3271855,REVSC IVT ANGIO SF VSL ADD RT,6494.0,2727.48,1753.38,6364.12,29
CDM,3271863,REVSC IVT ANGIO CMPLX VSL INIT BI,34902.0,14658.84,9423.54,34203.96,30
CDM,3271871,REVSC IVT ANGIO CMPLX VSL INIT LT,23268.0,9772.56,6282.36,25370.0,30
CDM,3271889,REVSC IVT ANGIO CMPLX VSL INIT RT,23268.0,9772.56,6282.36,25370.0,30
CDM,3271897,REVSC IVT ANGIO CMPLX VSL ADD BI,12590.0,5287.8,3399.3,12338.2,29
CDM,3271905,REVSC IVT ANGIO CMPLX VSL ADD LT,8393.0,3525.06,2266.11,8225.14,29
CDM,3271913,REVSC IVT ANGIO CMPLX VSL ADD RT,8393.0,3525.06,2266.11,8225.14,29
CDM,3271921,REVSC IVT STNT SF VSL INIT BI,33071.0,13889.82,8929.17,32409.58,30
CDM,3271939,REVSC IVT STNT SF VSL INIT LT,22047.0,9259.74,5952.69,26759.0,30
CDM,3271947,REVSC IVT STNT SF VSL INIT RT,22047.0,9259.74,5952.69,26759.0,30
CDM,3271954,REVSC IVT STNT SF VSL ADD BI,9674.0,4063.08,2611.98,9480.52,29
CDM,3271962,REVSC IVT STNT SF VSL ADD LT,6449.0,2708.58,1741.23,6320.02,29
CDM,3271970,REVSC IVT STNT SF VSL ADD RT,6449.0,2708.58,1741.23,6320.02,29
CDM,3271988,REVSC IVT STNT CMPLX VSL INIT BI,47802.0,20076.84,12906.54,46845.96,30
CDM,3271996,REVSC IVT STNT CMPLX VSL INIT LT,31868.0,13384.56,8604.36,31230.64,30
CDM,3272002,REVSC IVT STNT CMPLX VSL INIT RT,31868.0,13384.56,8604.36,31230.64,30
CDM,3272010,REVSC IVT STNT CMPLX VSL ADD BI,10280.0,4317.6,2775.6,10074.4,29
CDM,3272028,REVSC IVT STNT CMPLX VSL ADD LT,6853.0,2878.26,1850.31,6715.94,29
CDM,3272036,REVSC IVT STNT CMPLX VSL ADD RT,6853.0,2878.26,1850.31,6715.94,29
CDM,3272044,REVSC F&P VT ANG SF VSL INIT BI,24023.0,10089.66,6486.21,25370.0,30
CDM,3272051,REVSC F&P VT ANG SF VSL INIT LT,16015.0,6726.3,4324.05,25370.0,30
CDM,3272069,REVSC F&P VT ANG SF VSL INIT RT,16015.0,6726.3,4324.05,25370.0,30
CDM,3272077,REVSC F&P VT ANG SF VSL ADD BI,9194.0,3861.48,2482.38,9010.12,29
CDM,3272085,REVSC F&P VT ANG SF VSL ADD LT,6129.0,2574.18,1654.83,6006.42,29
CDM,3272093,REVSC F&P VT ANG SF VSL ADD RT,6129.0,2574.18,1654.83,6006.42,29
CDM,3272101,REVSC F&P VT ANG CMPLX VSL INIT BI,32472.0,13638.24,8767.44,31822.56,30
CDM,3272119,REVSC F&P VT ANG CMPLX VSL INIT LT,21648.0,9092.16,5844.96,25370.0,30
CDM,3272127,REVSC F&P VT ANG CMPLX VSL INIT RT,21648.0,9092.16,5844.96,25370.0,30
CDM,3272135,REVSC F&P VT ANG CMPLX VSL ADD BI,12237.0,5139.54,3303.99,11992.26,29
CDM,3272143,REVSC F&P VT ANG CMPLX VSL ADD LT,8158.0,3426.36,2202.66,7994.84,29
CDM,3272150,REVSC F&P VT ANG CMPLX VSL ADD RT,8158.0,3426.36,2202.66,7994.84,29
CDM,3272168,REVSC F&P VT STNT SF VSL INIT BI,30194.0,12681.48,8152.38,29590.12,30
CDM,3272176,REVSC F&P VT STNT SF VSL INIT LT,20129.0,8454.18,5434.83,26759.0,30
CDM,3272184,REVSC F&P VT STNT SF VSL INIT RT,20129.0,8454.18,5434.83,26759.0,30
CDM,3272192,REVSC F&P VT STNT SF VSL ADD BI,12761.0,5359.62,3445.47,12505.78,29
CDM,3272200,REVSC F&P VT STNT SF VSL ADD LT,8507.0,3572.94,2296.89,8336.86,29
CDM,3272218,REVSC F&P VT STNT SF VSL ADD RT,8507.0,3572.94,2296.89,8336.86,29
CDM,3272226,REVSC F&P VT STNT CMPLX VSL INIT BI,50717.0,21301.14,13693.59,49702.66,30
CDM,3272234,REVSC F&P VT STNT CMPLX VSL INIT LT,33811.0,14200.62,9128.97,33134.78,30
CDM,3272242,REVSC F&P VT STNT CMPLX VSL INIT RT,33811.0,14200.62,9128.97,33134.78,30
CDM,3272259,REVSC F&P VT STNT CMPLX VSL ADD BI,17132.0,7195.44,4625.64,16789.36,29
CDM,3272267,REVSC F&P VT STNT CMPLX VSL ADD LT,11421.0,4796.82,3083.67,11192.58,29
CDM,3272275,REVSC F&P VT STNT CMPLX VSL ADD RT,11421.0,4796.82,3083.67,11192.58,29
CDM,3272283,REVSC F&P VT ATHR SF VSL INIT BI,28778.0,12086.76,7770.06,28202.44,30
CDM,3272291,REVSC F&P VT ATHR SF VSL INIT LT,19185.0,8057.7,5179.95,26759.0,30
CDM,3272309,REVSC F&P VT ATHR SF VSL INIT RT,19185.0,8057.7,5179.95,26759.0,30
CDM,3272317,REVSC F&P VT ATHR SF VSL ADD BI,12684.0,5327.28,3424.68,12430.32,29
CDM,3272325,REVSC F&P VT ATHR SF VSL ADD LT,8456.0,3551.52,2283.12,8286.88,29
CDM,3272333,REVSC F&P VT ATHR SF VSL ADD RT,8456.0,3551.52,2283.12,8286.88,29
CDM,3272341,REVSC F&P VT ATHR CMPLX VSL INIT BI,40269.0,16912.98,10872.63,39463.62,30
CDM,3272358,REVSC F&P VT ATHR CMPLX VSL INIT LT,26846.0,11275.32,7248.42,26759.0,30
CDM,3272366,REVSC F&P VT ATHR CMPLX VSL INIT RT,26846.0,11275.32,7248.42,26759.0,30
CDM,3272374,REVSC F&P VT ATHR CMPLX VSL ADD BI,17448.0,7328.16,4710.96,17099.04,29
CDM,3272382,REVSC F&P VT ATHR CMPLX VSL ADD LT,11632.0,4885.44,3140.64,11399.36,29
CDM,3272390,REVSC F&P VT ATHR CMPLX VSL ADD RT,11632.0,4885.44,3140.64,11399.36,29
CDM,3272408,REVSC F&P VT ST&AT SF VSL INIT BI,40902.0,17178.84,11043.54,40083.96,30
CDM,3272416,REVSC F&P VT ST&AT SF VSL INIT LT,27268.0,11452.56,7362.36,26759.0,30
CDM,3272424,REVSC F&P VT ST&AT SF VSL INIT RT,27268.0,11452.56,7362.36,26759.0,30
CDM,3272432,REVSC F&P VT ST&AT SF VSL ADD BI,15696.0,6592.32,4237.92,15382.08,29
CDM,3272440,REVSC F&P VT ST&AT SF VSL ADD LT,10464.0,4394.88,2825.28,10254.72,29
CDM,3272457,REVSC F&P VT ST&AT SF VSL ADD RT,10464.0,4394.88,2825.28,10254.72,29
CDM,3272465,REVSC F&P VT ST&AT CMPLX VSL INITBI,55617.0,23359.14,15016.59,54504.66,30
CDM,3272473,REVSC F&P VT ST&AT CMPLX VSL INITLT,37078.0,15572.76,10011.06,36336.44,30
CDM,3272481,REVSC F&P VT ST&AT CMPLX VSL INITRT,37078.0,15572.76,10011.06,36336.44,30
CDM,3272499,REVSC F&P VT ST&AT CMPLX VSL ADD BI,22100.0,9282.0,5967.0,21658.0,29
CDM,3272507,REVSC F&P VT ST&AT CMPLX VSL ADD LT,14733.0,6187.86,3977.91,14438.34,29
CDM,3272515,REVSC F&P VT ST&AT CMPLX VSL ADD RT,14733.0,6187.86,3977.91,14438.34,29
CDM,3272523,REVSC T&P VT ANG SF VSL INIT BI,26687.0,11208.54,7205.49,26759.0,30
CDM,3272531,REVSC T&P VT ANG SF VSL INIT LT,17791.0,7472.22,4803.57,26759.0,30
CDM,3272549,REVSC T&P VT ANG SF VSL INIT RT,17791.0,7472.22,4803.57,26759.0,30
CDM,3272556,REVSC T&P VT ANG SF VSL ADD BI,6413.0,2693.46,1731.51,6284.74,29
CDM,3272564,REVSC T&P VT ANG SF VSL ADD LT,4275.0,1795.5,1154.25,4189.5,29
CDM,3272572,REVSC T&P VT ANG SF VSL ADD RT,4275.0,1795.5,1154.25,4189.5,29
CDM,3272580,REVSC T&P VT ANG CMPLX VSL INIT BI,33438.0,14043.96,9028.26,32769.24,30
CDM,3272598,REVSC T&P VT ANG CMPLX VSL INIT LT,22292.0,9362.64,6018.84,26759.0,30
CDM,3272606,REVSC T&P VT ANG CMPLX VSL INIT RT,22292.0,9362.64,6018.84,26759.0,30
CDM,3272614,REVSC T&P VT ANG CMPLX VSL ADD BI,9119.0,3829.98,2462.13,8936.62,29
CDM,3272622,REVSC T&P VT ANG CMPLX VSL ADD LT,6079.0,2553.18,1641.33,5957.42,29
CDM,3272630,REVSC T&P VT ANG CMPLX VSL ADD RT,6079.0,2553.18,1641.33,5957.42,29
CDM,3272648,REVSC T&P VT STNT SF VSL INIT BI,21923.0,9207.66,5919.21,26759.0,30
CDM,3272655,REVSC T&P VT STNT SF VSL INIT LT,14615.0,6138.3,3946.05,26759.0,30
CDM,3272663,REVSC T&P VT STNT SF VSL INIT RT,14615.0,6138.3,3946.05,26759.0,30
CDM,3272671,REVSC T&P VT STNT SF VSL ADD BI,7343.0,3084.06,1982.61,7196.14,29
CDM,3272689,REVSC T&P VT STNT SF VSL ADD LT,4895.0,2055.9,1321.65,4797.1,29
CDM,3272697,REVSC T&P VT STNT SF VSL ADD RT,4895.0,2055.9,1321.65,4797.1,29
CDM,3272705,REVSC T&P VT STNT CMPLX VSL INIT BI,29415.0,12354.3,7942.05,28826.7,30
CDM,3272713,REVSC T&P VT STNT CMPLX VSL INIT LT,19610.0,8236.2,5294.7,26759.0,30
CDM,3272721,REVSC T&P VT STNT CMPLX VSL INIT RT,19610.0,8236.2,5294.7,26759.0,30
CDM,3272739,REVSC T&P VT STNT CMPLX VSL ADD BI,11048.0,4640.16,2982.96,10827.04,29
CDM,3272747,REVSC T&P VT STNT CMPLX VSL ADD LT,7365.0,3093.3,1988.55,7217.7,29
CDM,3272754,REVSC T&P VT STNT CMPLX VSL ADD RT,7365.0,3093.3,1988.55,7217.7,29
CDM,3272762,REVSC T&P VT ATH SF VSL INIT BI,29295.0,12303.9,7909.65,28709.1,30
CDM,3272770,REVSC T&P VT ATH SF VSL INIT LT,19530.0,8202.6,5273.1,26759.0,30
CDM,3272788,REVSC T&P VT ATH SF VSL INIT RT,19530.0,8202.6,5273.1,26759.0,30
CDM,3272796,REVSC T&P VT ATH SF VSL ADD BI,10250.0,4305.0,2767.5,10045.0,29
CDM,3272804,REVSC T&P VT ATH SF VSL ADD LT,6833.0,2869.86,1844.91,6696.34,29
CDM,3272812,REVSC T&P VT ATH SF VSL ADD RT,6833.0,2869.86,1844.91,6696.34,29
CDM,3272820,REVSC T&P VT ATH CMPLX VSL INIT BI,36876.0,15487.92,9956.52,36138.48,30
CDM,3272838,REVSC T&P VT ATH CMPLX VSL INIT LT,24584.0,10325.28,6637.68,26759.0,30
CDM,3272846,REVSC T&P VT ATH CMPLX VSL INIT RT,24584.0,10325.28,6637.68,26759.0,30
CDM,3272853,REVSC T&P VT ATH CMPLX VSL ADD BI,13964.0,5864.88,3770.28,13684.72,29
CDM,3272861,REVSC T&P VT ATH CMPLX VSL ADD LT,9309.0,3909.78,2513.43,9122.82,29
CDM,3272879,REVSC T&P VT ATH CMPLX VSL ADD RT,9309.0,3909.78,2513.43,9122.82,29
CDM,3272887,REVSC T&P VT ST&AT SF VSL INIT BI,32868.0,13804.56,8874.36,32210.64,30
CDM,3272895,REVSC T&P VT ST&AT SF VSL INIT LT,21912.0,9203.04,5916.24,26759.0,30
CDM,3272903,REVSC T&P VT ST&AT SF VSL INIT RT,21912.0,9203.04,5916.24,26759.0,30
CDM,3272911,REVSC T&P VT ST&AT SF VSL ADD BI,15153.0,6364.26,4091.31,14849.94,29
CDM,3272929,REVSC T&P VT ST&AT SF VSL ADD LT,10102.0,4242.84,2727.54,9899.96,29
CDM,3272937,REVSC T&P VT ST&AT SF VSL ADD RT,10102.0,4242.84,2727.54,9899.96,29
CDM,3272945,REVSC T&P VT ST&AT CMPLX VSL INITBI,39401.0,16548.42,10638.27,38612.98,30
CDM,3272952,REVSC T&P VT ST&AT CMPLX VSL INITLT,26267.0,11032.14,7092.09,26759.0,30
CDM,3272960,REVSC T&P VT ST&AT CMPLX VSL INITRT,26267.0,11032.14,7092.09,26759.0,30
CDM,3272978,REVSC T&P VT ST&AT CMPLX VSL ADD BI,19103.0,8023.26,5157.81,18720.94,29
CDM,3272986,REVSC T&P VT ST&AT CMPLX VSL ADD LT,12735.0,5348.7,3438.45,12480.3,29
CDM,3272994,REVSC T&P VT ST&AT CMPLX VSL ADD RT,12735.0,5348.7,3438.45,12480.3,29
CDM,3283330,EXCHG TUBE CHEST VIA WIRE,727.0,305.34,196.29,3186.0,37
CDM,3305026,INSTILL BLADDER ANTICARCINOGENIC,1067.0,448.14,288.09,1045.66,37
CDM,3305372,CHEMO SUBQ/IM NONHORMONAL,560.0,235.2,73.56,548.8,37
CDM,3305380,CHEMO SUBQ/IM HORMONAL,205.0,86.1,55.35,200.9,37
CDM,3305398,CHEMO IVP DRUG INITIAL,507.0,212.94,136.89,496.86,37
CDM,3305406,CHEMO IVP DRUG ADDL,277.0,116.34,73.56,271.46,37
CDM,3305414,CHEMO INF IV 1ST HR,851.0,357.42,229.77,833.98,37
CDM,3305422,CHEMO INF IV ADDL HR,183.0,76.86,49.41,179.34,37
CDM,3305430,CHEMO INF IV SEQ 1ST HR,310.0,130.2,73.56,303.8,37
CDM,3305570,CHEMO INTRALESIONAL LSN 1-7,270.0,113.4,72.9,264.6,37
CDM,3305588,CHEMO INTRALESIONAL LSN 8+,648.0,272.16,174.96,635.04,37
CDM,33274,R&B ICU,8046.0,3379.32,6839.1,7885.08,13
CDM,3330529,PLAN PORT TELETHRPY SPEC,1086.0,456.12,293.22,1064.28,37
CDM,3332061,RAD THER FIELD SIMULAT LVL 01 SMPL,1106.0,464.52,137.32,1083.88,37
CDM,3332079,RAD THER FIELD SIMULAT LVL 02 INTRM,1859.0,780.78,382.54,1821.82,37
CDM,3332087,RAD THER FIELD SIMULAT LVL 03 CMPLX,1923.0,807.66,382.54,1884.54,37
CDM,3332111,CALC DOSIMETRY RAD BASIC,657.0,275.94,137.32,643.86,37
CDM,3332129,PLAN IMRT HISTOGRAMS DOSE-VOLUME,7241.0,3041.22,1414.11,7096.18,37
CDM,3332228,CALC DOSIMETRY SPEC,591.0,248.22,137.32,579.18,37
CDM,3332236,CALC DOSIMETRY SPEC DIODE,591.0,248.22,137.32,579.18,37
CDM,3332244,CALC DOSIMETRY SPEC TLD,591.0,248.22,137.32,579.18,37
CDM,3332251,DEVICE TX DESIGN&CONST LVL 01 SMPL,554.0,232.68,137.32,542.92,37
CDM,3332269,DEVICE TX DESIGN&CONST LVL 02 INTRM,759.0,318.78,137.32,743.82,37
CDM,3332277,DEVICE TX DESIGN&CONST LVL 03 CMPLX,1304.0,547.68,352.08,1277.92,37
CDM,3332285,CONSULT PHYSICS MEDICAL CONTINUING,666.0,279.72,137.32,652.68,37
CDM,3332293,CONSULT PHYSICS RAD MEDICAL SPECIAL,913.0,383.46,137.32,894.74,37
CDM,3332343,RAD THER IMG/S PORT,329.0,138.18,88.83,322.42,30
CDM,3332376,PROCEDURE TX SPECIAL THRPY RAD,1938.0,813.96,523.26,1899.24,37
CDM,3332392,APPL BRACHY INTRACAV LVL 01 SMPL,1420.0,596.4,383.4,1391.6,37
CDM,3332400,APPL BRACHY INTRACAV LVL 02 INTRM,1875.0,787.5,506.25,1837.5,37
CDM,3332418,APPL BRACHY INTRACAV LVL 03 CMPLX,2679.0,1125.18,711.56,2625.42,37
CDM,3332442,APPL SOURCE RAD INTERSTITIAL CMPLX,3968.0,1666.56,711.56,3888.64,37
CDM,3332491,SPVN/HANDLING/LOAD RADIOELEMENT,475.0,199.5,128.25,465.5,30
CDM,3332756,INS TANDEM UTERI&/OVOID VAG BRACHY,3907.0,1640.94,1054.89,7410.66,37
CDM,3332913,BRACHY STRND P-103/SRCE,208.0,87.36,56.16,203.84,37
CDM,3333101,DEVICE MLC DESIGN&CONST PER IMRT,1477.0,620.34,382.54,1447.46,37
CDM,3333135,SRS CRANIAL COURSE 1 SESSN,15044.0,6318.48,4061.88,14743.12,36
CDM,3333150,SRS/SBRT LINEAR COURSE MAX 5 SESSNS,7291.0,3062.22,1826.78,7145.18,37
CDM,3333358,PLAN RADTHRPY 3D W HISTGMS DOSE-VOL,6622.0,2781.24,1414.11,6489.56,37
CDM,3333366,SIMULAT MGMT MOTION RESPIRATORY,1435.0,602.7,387.45,1406.3,30
CDM,3333374,NASOPHARYNGOSCOPY W ENDOSCOPE,395.0,165.9,106.65,387.1,36
CDM,3333382,GD LOC VOL TARGET DELIVERY TX RAD,234.0,98.28,63.18,229.32,30
CDM,3333390,PLAN ISODOSE TELETHRPY LVL 01 SMPL,661.0,277.62,178.47,647.78,37
CDM,3333408,PLAN ISODOSE TELETHRPY LVL 02 CMPLX,1590.0,667.8,382.54,1558.2,37
CDM,3333416,PLAN ISODOSE BRACHY LVL 01 SMPL,1589.0,667.38,382.54,1557.22,37
CDM,3333424,PLAN ISODOSE BRACHY LVL 02 INTRM,2086.0,876.12,382.54,2044.28,37
CDM,3333432,PLAN ISODOSE BRACHY LVL 03 CMPLX,2212.0,929.04,382.54,2167.76,37
CDM,3333523,BRACHY HDR RDNCL ICAV/ISTL 1 CH,3950.0,1659.0,711.56,3871.0,37
CDM,3333531,BRACHY HDR RDNCL ICAV/ISTL 2-12 CH,5441.0,2285.22,711.56,5332.18,37
CDM,3333549,BRACHY HDR RDNCL ICAV/ISTL 13+CH,5659.0,2376.78,711.56,5545.82,37
CDM,3336864,TX RAD LVL 1 E-SGL/MULTI 2D IMG GD,785.0,329.7,104.24,769.3,37
CDM,3336880,TX RAD LVL 2 ISOCNTR SGL IMG GD,2525.0,1060.5,394.05,2474.5,37
CDM,3336906,TX RAD LVL 3 ISOCNTRS MULTI IMG GD,2860.0,1201.2,564.51,2802.8,37
CDM,3411238,NM BONE&/JOINT PHASE 3,3615.0,1518.3,408.43,3542.7,37
CDM,3411246,NM BONE&/JOINT LTD,2031.0,853.02,408.43,1990.38,37
CDM,3411253,NM MARROW BONE LTD,819.0,343.98,221.13,802.62,37
CDM,3411261,NM MARROW BONE MULTIPLE,1048.0,440.16,282.96,1027.04,37
CDM,3411279,NM MARROW BONE BODY WHOLE,1195.0,501.9,322.65,1171.1,37
CDM,3411287,NM BONE&/JOINT MULTIPLE,2427.0,1019.34,408.43,2378.46,37
CDM,3411303,NM BONE&/JOINT BODY WHOLE,3328.0,1397.76,408.43,3261.44,37
CDM,3411360,NM POOL BLOOD CARDIAC 1ST PASS SGL,1735.0,728.7,468.45,1700.3,37
CDM,3411378,NM DETECTION SHUNT CARDIAC,1515.0,636.3,408.43,1484.7,37
CDM,3411394,NM FLOW CSF CISTERNOGRAM,1424.0,598.08,384.48,1395.52,37
CDM,3411410,NM DETECTION&LOC LEAK CSF,1984.0,833.28,535.68,1944.32,37
CDM,3411428,NM FLOW CSF EVAL SHUNT,1183.0,496.86,319.41,1159.34,37
CDM,3411436,NM REFLEX URETERAL,613.0,257.46,165.51,600.74,37
CDM,3411469,NM EMPTYING GASTRIC,2874.0,1207.08,408.43,2816.52,37
CDM,3411485,NM REFLUX GASTROESOPHAGEAL,1045.0,438.9,282.15,1024.1,37
CDM,3411493,NM LOSS BLOOD GI ACUTE,1583.0,664.86,408.43,1551.34,37
CDM,3411592,NM LIVER&SPLEEN STATIC,1328.0,557.76,358.56,1301.44,37
CDM,3411600,NM LIVER&SPLEEN W FLOW VASCULAR,621.0,260.82,167.67,608.58,37
CDM,3411626,NM PERF PULMONARY,1415.0,594.3,382.05,1386.7,37
CDM,3411683,NM LYMPH SYSTEM,2928.0,1229.76,554.73,2869.44,37
CDM,3411691,NM INTESTINE,1335.0,560.7,360.45,1308.3,37
CDM,3411717,NM MUGA REST/STRESS PLANAR SGL,1744.0,732.48,408.43,1709.12,37
CDM,3411741,NM MYOCARDIAL INFARCT PLANAR,1077.0,452.34,290.79,1055.46,37
CDM,3411881,NM KIDNEY FUNCTION&FLOW,1994.0,837.48,538.38,1954.12,37
CDM,3411899,NM KIDNEY FUNCTION&FLOW PHARM MULTI,2067.0,868.14,554.73,2025.66,37
CDM,3411907,NM KIDNEY FUNCTION&FLOW PHARM SGL,1882.0,790.44,508.14,1844.36,37
CDM,3412004,NM SPLEEN W/WO FLOW VASCULAR,851.0,357.42,229.77,833.98,37
CDM,3412020,NM TESTICULAR W FLOW VASCULAR,613.0,257.46,165.51,600.74,37
CDM,3412038,NM METS CA THYROID LTD,962.0,404.04,259.74,942.76,37
CDM,3412053,NM METS CA THYROID WHOLE BODY,3045.0,1278.9,554.73,2984.1,37
CDM,3412160,NM LOC RRX TMR PLNR WHL BODY 2D IMG,4836.0,2031.12,554.73,4739.28,37
CDM,3412178,NM LOC RRX TMR PLNR WHL BODY 1D IMG,1959.0,822.78,528.93,1919.82,37
CDM,3412186,NM TEST BREATH UREA C14 ACQ,598.0,251.16,11.06,586.04,37
CDM,3412194,NM TEST BREATH UREA C14 ANALYSIS,4975.0,2089.5,94.41,4875.5,37
CDM,3412244,THERAPY RRX PO HYPTHYROID INIT,3317.0,1393.14,238.39,3250.66,37
CDM,3412251,THERAPY RRX PO HYPTHYROID ADDL,3317.0,1393.14,238.39,3250.66,37
CDM,3412269,THERAPY RRX INTRAARTICULAR,436.0,183.12,117.72,427.28,37
CDM,3412301,THERAPY RRX PO THYROID CA ABL,3317.0,1393.14,238.39,3250.66,37
CDM,3412319,THERAPY RRX PO THYROID CA METS,3317.0,1393.14,238.39,3250.66,37
CDM,3412327,THERAPY RRX PO THYROID SUPPRESSION,3317.0,1393.14,238.39,3250.66,37
CDM,3412343,RRX DISOFENIN DX/0-15MCI DOSE,253.0,106.26,68.31,247.94,30
CDM,3412400,RRX I-123 IOBENG DX/0-15MCI DOSE,6208.0,2607.36,1676.16,6083.84,37
CDM,3412434,RRX TC99 MEDRONATE/0-30MCI DOSE,354.3,148.81,95.66,347.21,30
CDM,3412483,SPVN/HANDLING/LOAD RADIOELEMENT,475.0,199.5,128.25,465.5,30
CDM,3412608,RRX INDIUM 111 PENTETATE DX/0.5MCI,1865.0,783.3,503.55,1827.7,37
CDM,3412624,RRX INDIUM 111 OXYQ DX/0.5MCI,1749.0,734.58,472.23,1787.64,37
CDM,3412657,RRX TETROFOSMIN DX/DOSE,275.0,115.5,74.25,269.5,30
CDM,3412707,RRX TC-99 SESTAMIBI DX/DOSE,277.9,116.72,75.03,968.75,30
CDM,3412731,BRACHY N-STRND YTTR 90 SIRSP/SRCE,75774.0,31825.08,17771.01,74258.52,37
CDM,3412780,RRX I-131 IOD NA DX/MCI CAP,85.0,35.7,22.95,209.69,30
CDM,3412798,RRX I-131 IOD NA THPY/MCI CAP,160.0,67.2,24.07,156.8,37
CDM,3412814,RRX PERTECHNETATE DX/MCI,13.0,5.46,3.51,23.69,30
CDM,3412863,RRX EXAMETAZIME DX/0-25MCI DOSE,1813.0,761.46,489.51,3445.55,30
CDM,3412889,THERAPY RRX INF IV RMA,1350.0,567.0,238.39,1323.0,37
CDM,3413101,RRX MERTIATIDE DX/0-15MCI DOSE,619.0,259.98,167.13,1705.53,30
CDM,3413143,RRX PYROPHOSPHATE DX/0-25MCI DOSE,463.2,194.54,97.67,453.94,30
CDM,3413168,RRX MEBROFENIN DX/0-15MCI DOSE,413.0,173.46,111.51,404.74,30
CDM,3413200,RRX MAA DX/0-10MCI DOSE,513.0,215.46,65.34,502.74,30
CDM,3413218,RRX BICISATE DX/0-25MCI DOSE,3395.0,1425.9,775.52,3327.1,37
CDM,3413226,RRX SULFUR COLLOID DX/0-20MCI DOSE,608.0,255.36,164.16,1615.51,30
CDM,3413234,RRX RBC LABELED DX/0-30MCI DOSE,614.0,257.88,165.78,601.72,30
CDM,3413259,RRX YTTR90 ZEV THR/0-40MCI DOSE,59939.5,25174.59,16183.67,122172.8,37
CDM,3413382,NM BRAIN 1-3 VW STATIC,781.0,328.02,210.87,765.38,37
CDM,3413390,NM BRAIN 1-3 VW STATIC W FLOW,917.0,385.14,247.59,898.66,37
CDM,3413408,NM BRAIN 4+ VW STATIC,832.0,349.44,224.64,815.36,37
CDM,3413416,NM BRAIN 4+ VW STATIC W FLOW,1390.0,583.8,375.3,1362.2,37
CDM,3413440,RRX I-123 IOD NA DX/1MCI,1542.5,647.85,374.14,1511.65,30
CDM,3413457,RRX I-123 IOD NA DX/100UCI <1MCI,381.0,160.02,102.87,373.38,30
CDM,3413465,RRX INDIUM-111 PENTET DX/0-6MCI,12397.0,5206.74,2000.94,12149.06,37
CDM,3413473,RRX EXAMETAZIME WBC LABELED DX/DOSE,6434.0,2702.28,934.13,6305.32,37
CDM,3413481,RRX INDIUM-111 WBC LABELED DX/DOSE,4609.0,1935.78,1103.19,4516.82,37
CDM,3413515,INJ RRX LOC STDY PROBE NON-IMG IV,613.0,257.46,165.51,600.74,37
CDM,3413572,NM PERF MYOC SPECT WM/EF SGL,1789.0,751.38,483.03,1917.9,37
CDM,3413580,NM PERF MYOC SPEC WM/EF MULT,2158.0,906.36,582.66,2114.84,37
CDM,3413598,NM PERF MYOC PLANAR WM/EF SGL,1789.0,751.38,483.03,1917.9,37
CDM,3413606,NM PERF MYOC PLANAR WM/EF MULT,1984.0,833.28,535.68,1944.32,37
CDM,3413762,INJ RRX NODE SENTINEL ID BI,1094.0,459.48,295.38,1072.12,29
CDM,3413770,INJ RRX NODE SENTINEL ID LT,729.0,306.18,196.83,714.42,29
CDM,3413788,INJ RRX NODE SENTINEL ID RT,729.0,306.18,196.83,714.42,29
CDM,3413796,NM HEPATOBILIARY W/WO GB,2437.0,1023.54,408.43,2388.26,37
CDM,3413804,NM HEPATOBILIARY W PHARM W/WO GB,3446.0,1447.32,554.73,3377.08,37
CDM,3413812,NM VENT PULMONARY,1386.0,582.12,374.22,1358.28,37
CDM,3413820,NM VENT&PERF PULMONARY,2500.0,1050.0,554.73,2450.0,37
CDM,3413838,NM PERF PULM DIFF QN W/WO IMG,1165.0,489.3,314.55,1141.7,37
CDM,3413846,NM PERF&VENT PULM DIFF QN W/WO IMG,1830.0,768.6,494.1,1793.4,37
CDM,3413960,NM THYROID UPTAKE MEAS QN SGL/MULT,853.0,358.26,230.31,835.94,37
CDM,3413978,NM THYROID W/WO FLOW VASCULAR,834.0,350.28,225.18,817.32,37
CDM,3413986,NM THYROID UPTAKE MEAS W/WO FLW STM,2462.0,1034.04,408.43,2412.76,37
CDM,3413994,NM PLANAR PARATHYROID,1282.0,538.44,346.14,1256.36,37
CDM,3414000,NM PLANAR PARATHYROID W SPECT,1336.0,561.12,360.72,1309.28,37
CDM,3414018,NM PLANAR PARATHYROID W SPECT/CT,2578.0,1082.76,554.73,2526.44,37
CDM,3414067,RRX DTPA AEROSOL DOSE 0-75MCI,581.0,244.02,45.24,569.38,30
CDM,3414075,RRX TC-99 TILMANOCEPT/0.5MCI INJ,2399.5,1007.79,647.87,2351.51,29
CDM,3414356,NM LOC RRX TMR PLNR 1 AREA 1D IMG,924.0,388.08,249.48,905.52,37
CDM,3414364,NM LOC RRX TMR PLNR 2+AREA 1+D IMG,1298.0,545.16,350.46,1272.04,37
CDM,3414372,NM LOC RRX TMR SPECT 1AREA 1ACQ 1D,4396.0,1846.32,554.73,4308.08,37
CDM,3414380,NM LOC RRX TMR SPECT CT 1AREA 1ACQ,3284.0,1379.28,886.68,3218.32,37
CDM,3414398,NM LOC RRX TMR SPECT 2+AREA 2ACQ,3508.0,1473.36,947.16,3437.84,37
CDM,3414406,NM LOC RRX TMR SPECT CT 2+AREA 2ACQ,3633.0,1525.86,980.91,3560.34,37
CDM,3502515,AUG SACRAL PERC INJ UNI,8278.0,3476.76,2235.06,14009.0,37
CDM,3502523,AUG SACRAL PERC INJ BI,12326.0,5176.92,3328.02,14009.0,37
CDM,3502531,ASP&/INJ JT/BUR SM WO US GD RT,523.0,219.66,141.21,512.54,29
CDM,3502549,ASP&/INJ JT/BUR SM WO US GD BI,785.0,329.7,211.95,769.3,29
CDM,3502556,ASP&/INJ JT/BUR SM WO US GD LT,523.0,219.66,141.21,512.54,29
CDM,3502564,ASP&/INJ JT/BUR INTR WO US GD LT,557.0,233.94,150.39,545.86,29
CDM,3502572,ASP&/INJ JT/BUR INTR WO US GD BI,836.0,351.12,225.72,819.28,29
CDM,3502580,ASP&/INJ JT/BUR INTR WO US GD RT,557.0,233.94,150.39,545.86,29
CDM,3502598,ASP&/INJ JT/BUR MAJ WO US GD RT,750.0,315.0,202.5,735.0,29
CDM,3502606,ASP&/INJ JT/BUR MAJ WO US GD BI,1125.0,472.5,303.75,1102.5,29
CDM,3502614,ASP&/INJ JT/BUR MAJ WO US GD LT,750.0,315.0,202.5,735.0,29
CDM,3502622,ABL RF TUMOR/S BONE PERC IMG GD,11294.0,4743.48,3049.38,25974.71,37
CDM,3502648,VERTEBROPLASTY CRVTHOR PERC,9853.0,4138.26,2660.31,14009.0,37
CDM,3502655,VERTEBROPLASTY LUMBOSACRAL PERC,9261.0,3889.62,2500.47,14009.0,37
CDM,3502663,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4730.0,1986.6,1277.1,4635.4,29
CDM,3503232,INJ/S TRIGGER PT/S MUSC/S 3+,694.0,291.48,187.38,680.12,36
CDM,3503364,PLC CATH NEPHROSTOMY PERC RT S&I,4781.0,2008.02,1290.87,10412.0,30
CDM,3503372,PLC CATH NEPHROSTOMY PERC LT S&I,4781.0,2008.02,1290.87,10412.0,30
CDM,3503380,PLC CATH NEPHROSTOMY PERC BI S&I,7172.0,3012.24,1936.44,10412.0,30
CDM,3503737,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,2235.0,938.7,603.45,3186.0,37
CDM,3503745,PLC DEV/S LOC TIS SOFT PERC LSN ADD,828.0,347.76,223.56,811.44,29
CDM,3503869,ABL CRYO PLEXUS/TRUNCAL NRV PERC,8495.0,3567.9,2293.65,17965.0,37
CDM,3504040,INJ THROMBIN PSEUDOANEU ART SPLENIC,1211.0,508.62,326.97,3186.0,37
CDM,3504107,INJ/S EPID/SUB C/T W IMG,3930.0,1650.6,721.17,3851.4,37
CDM,3504149,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3504156,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,3521903,ABL RF TUMOR/S LIVER PERC,10632.0,4465.44,2870.64,25370.0,37
CDM,3521929,ASP BLADDER TROCAR/CATH,1527.0,641.34,412.29,5367.0,37
CDM,3521945,ASP PUNCT ABSCESS/CYST,623.0,261.66,168.21,610.54,36
CDM,3521994,ASP&/INJ CYST/PELVIS RENAL LT,2172.0,912.24,586.44,3186.0,30
CDM,3522000,ASP&/INJ CYST/PELVIS RENAL RT,2172.0,912.24,586.44,3186.0,30
CDM,3522026,BX MASS ABD/RETRO NDL PERC,2707.0,1136.94,730.89,5367.0,37
CDM,3522034,BX BONE TROCAR/NDL DEEP,3327.0,1397.34,898.29,5367.0,37
CDM,3522042,BX BONE TROCAR/NDL SUPERFICIAL,2065.0,867.3,557.55,3186.0,37
CDM,3522067,BX LIVER NDL PERC,3384.0,1421.28,913.68,5367.0,37
CDM,3522109,BX MUSCLE NDL PERC,3161.0,1327.62,853.47,5367.0,37
CDM,3522125,BX PANCREAS NDL PERC,2567.0,1078.14,693.09,5367.0,37
CDM,3522133,BX PLEURA NDL PERC,2434.0,1022.28,657.18,5367.0,37
CDM,3522141,BX RENAL TROCAR/NDL PERC LT,3084.0,1295.28,832.68,5367.0,30
CDM,3522158,BX RENAL TROCAR/NDL PERC RT,3084.0,1295.28,832.68,5367.0,30
CDM,3522174,EXCHG CATH DRN ABSC/CYST,3795.0,1593.9,1024.65,5367.0,37
CDM,3522182,CT LTD/FOLLOWUP,585.0,245.7,88.91,573.3,37
CDM,3522208,CT GD ABLATION TISSUE,1897.0,796.74,512.19,1859.06,30
CDM,3522216,CT GD PLCMT NEEDLE S&I,2584.0,1085.28,697.68,2532.32,30
CDM,3522224,CT GD LOC STEREOTACTIC,1895.0,795.9,511.65,1857.1,30
CDM,3522240,CT GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,30
CDM,3522307,CTA AORTA ABD RUNOFF W CNT,2042.0,857.64,179.2,2001.16,37
CDM,3522687,CT HEAD W CNT,1933.0,811.86,179.2,1894.34,37
CDM,3522695,CT HEAD WO CNT,1546.0,649.32,106.81,1515.08,37
CDM,3522703,CT HEAD W&WO CNT,2319.0,973.98,179.2,2272.62,37
CDM,3522711,CT MAXFACIAL WO CNT,1933.0,811.86,106.81,1894.34,37
CDM,3522729,CT MAXFACIAL W CNT,2417.0,1015.14,179.2,2368.66,37
CDM,3522737,CT MAXFACIAL W&WO CNT,2900.0,1218.0,179.2,2842.0,37
CDM,3522745,CT NECK ST W CNT,1938.0,813.96,179.2,1899.24,37
CDM,3522752,CT NECK ST WO CNT,1550.0,651.0,106.81,1519.0,37
CDM,3522760,CT NECK ST W&WO CNT,2325.0,976.5,179.2,2278.5,37
CDM,3522778,CT ORB/PF/SEL/IAC W CNT,2417.0,1015.14,179.2,2368.66,37
CDM,3522786,CT ORB/PF/SEL/IAC WO CNT,1933.0,811.86,106.81,1894.34,37
CDM,3522794,CT ORB/PF/SEL/IAC W&WO CNT,2900.0,1218.0,179.2,2842.0,37
CDM,3522810,CTA HEAD W CNT&PP,2435.0,1022.7,179.2,2386.3,37
CDM,3522836,CTA NECK W CNT&PP,2442.0,1025.64,179.2,2393.16,37
CDM,3522844,CT ABDOMEN W CNT,1459.0,612.78,179.2,1429.82,37
CDM,3522851,CT ABDOMEN WO CNT,1167.0,490.14,106.81,1143.66,37
CDM,3522869,CT ABDOMEN W&WO CNT,1751.0,735.42,179.2,1715.98,37
CDM,3522893,CT CHEST DX W CNT,1448.0,608.16,179.2,1419.04,37
CDM,3522901,CT CHEST DX WO CNT,1158.0,486.36,106.81,1134.84,37
CDM,3522919,CT CHEST DX W&WO CNT,1737.0,729.54,179.2,1702.26,37
CDM,3522927,CT SPINE CERVICAL W CNT,2417.0,1015.14,356.43,2368.66,37
CDM,3522935,CT SPINE CERVICAL WO CNT,1933.0,811.86,106.81,1894.34,37
CDM,3522943,CT SPINE CERVICAL W&WO CNT,2900.0,1218.0,179.2,2842.0,37
CDM,3522950,CT EXT LOWER W CNT LT,2417.0,1015.14,652.59,2368.66,30
CDM,3522968,CT EXT LOWER W CNT RT,2417.0,1015.14,652.59,2368.66,30
CDM,3522976,CT EXT LOWER WO CNT LT,1933.0,811.86,521.91,1894.34,30
CDM,3522984,CT EXT LOWER WO CNT RT,1933.0,811.86,521.91,1894.34,30
CDM,3523024,CT EXT LOWER W&WO CNT LT,2900.0,1218.0,783.0,2842.0,30
CDM,3523032,CT EXT LOWER W&WO CNT RT,2900.0,1218.0,783.0,2842.0,30
CDM,3523040,CT SPINE LUMBAR W CNT,2390.0,1003.8,356.43,2342.2,37
CDM,3523057,CT SPINE LUMBAR WO CNT,1912.0,803.04,106.81,1873.76,37
CDM,3523065,CT SPINE LUMBAR W&WO CNT,2868.0,1204.56,179.2,2810.64,37
CDM,3523073,CT PELVIS W CNT,1434.0,602.28,179.2,1405.32,37
CDM,3523081,CT PELVIS WO CNT,1147.0,481.74,106.81,1124.06,37
CDM,3523099,CT PELVIS W&WO CNT,1721.0,722.82,179.2,1686.58,37
CDM,3523107,CT SPINE THORACIC W CNT,2409.0,1011.78,179.2,2360.82,37
CDM,3523115,CT SPINE THORACIC WO CNT,1927.0,809.34,106.81,1888.46,37
CDM,3523123,CT SPINE THORACIC W&WO CNT,2891.0,1214.22,179.2,2833.18,37
CDM,3523156,CT EXT UPPER W CNT LT,1374.0,577.08,370.98,1346.52,30
CDM,3523164,CT EXT UPPER W CNT RT,1374.0,577.08,370.98,1346.52,30
CDM,3523180,CT EXT UPPER WO CNT LT,1099.0,461.58,296.73,1077.02,30
CDM,3523198,CT EXT UPPER WO CNT RT,1099.0,461.58,296.73,1077.02,30
CDM,3523206,CT EXT UPPER W&WO CNT LT,1649.0,692.58,445.23,1616.02,30
CDM,3523214,CT EXT UPPER W&WO CNT RT,1649.0,692.58,445.23,1616.02,30
CDM,3523230,CTA ABDOMEN W CNT&PP,1839.0,772.38,179.2,1802.22,37
CDM,3523255,CTA CHEST W CNT&PP,1824.0,766.08,179.2,1787.52,37
CDM,3523289,CTA EXT LOWER W CNT&PP LT,3045.0,1278.9,822.15,2984.1,30
CDM,3523297,CTA EXT LOWER W CNT&PP RT,3045.0,1278.9,822.15,2984.1,30
CDM,3523313,CTA PELVIS W CNT&PP,1808.0,759.36,179.2,1771.84,37
CDM,3523321,CTA EXT UPPER W CNT&PP LT,1732.0,727.44,467.64,1697.36,30
CDM,3523339,CTA EXT UPPER W CNT&PP RT,1732.0,727.44,467.64,1697.36,30
CDM,3523578,ABL RF TUMOR/S KIDNEY PERC RT,8707.0,3656.94,2350.89,25370.0,30
CDM,3523586,ABL RF TUMOR/S KIDNEY PERC LT,8707.0,3656.94,2350.89,25370.0,30
CDM,3523610,DISCOGRAM LUMBAR S&I,3200.0,1344.0,864.0,3136.0,37
CDM,3523651,CT LOC NDL LUNG/PLEURA,1655.0,695.1,446.85,3186.0,37
CDM,3523693,ASP BLADDER W INS CATH SUPRAPUBIC,2996.0,1258.32,808.92,10412.0,37
CDM,3523958,ABL CRYO TUMOR/S KIDNEY PERC LT,14821.0,6224.82,4001.67,25370.0,30
CDM,3523966,ABL CRYO TUMOR/S KIDNEY PERC RT,14821.0,6224.82,4001.67,25370.0,30
CDM,3524105,INJ DISCOGRAM LUMBAR,2164.0,908.88,584.28,2120.72,29
CDM,3524113,INJ DISCOGRAM CERVICAL/THORACIC,1676.0,703.92,452.52,1642.48,29
CDM,3524121,DISCOGRAM CERVICAL/THORACIC S&I,5582.0,2344.44,1507.14,5470.36,37
CDM,3524832,CHG CATH DRN/TUBE PERC S&I,631.0,265.02,170.37,618.38,30
CDM,3525599,INJ ANES PLEXUS CELIAC,1352.0,567.84,365.04,3186.0,37
CDM,3525607,DRN ABSCESS PERI/PREVESICAL SPACE,4350.0,1827.0,1174.5,5367.0,37
CDM,3526365,BX RENAL TROCAR/NDL PERC BI,4626.0,1942.92,1249.02,5367.0,30
CDM,3526597,CT SCREEN COLONOGRAPHY,1715.0,720.3,243.77,1680.7,37
CDM,3526605,CT EVAL QN CALCIUM HRT WO CNT,174.0,73.08,46.98,170.52,37
CDM,3526613,CT EVAL STRUC&MORPH HRT W CNT,1237.0,519.54,333.99,1212.26,37
CDM,3526621,CT EVAL STRUC&MORPH CONG HRT W CNT,1187.0,498.54,320.49,1163.26,37
CDM,3526639,CTA ART&GRAFTS HEART W CNT,1247.0,523.74,336.69,1222.06,37
CDM,3526647,INJ/S JT FCT C/T IMG 1 LVL BI,3948.0,1658.16,1065.96,3869.04,30
CDM,3526654,INJ/S JT FCT C/T IMG 1 LVL LT,2632.0,1105.44,710.64,3186.0,30
CDM,3526662,INJ/S JT FCT C/T IMG 1 LVL RT,2632.0,1105.44,710.64,3186.0,30
CDM,3526670,INJ/S JT FCT C/T IMG 2 LVL BI,2213.0,929.46,597.51,2168.74,29
CDM,3526688,INJ/S JT FCT C/T IMG 2 LVL LT,1475.0,619.5,398.25,1445.5,29
CDM,3526696,INJ/S JT FCT C/T IMG 2 LVL RT,1475.0,619.5,398.25,1445.5,29
CDM,3526704,INJ/S JT FCT C/T IMG 3+ LVL BI,1776.0,745.92,479.52,1740.48,29
CDM,3526712,INJ/S JT FCT C/T IMG 3+ LVL LT,1184.0,497.28,319.68,1160.32,29
CDM,3526720,INJ/S JT FCT C/T IMG 3+ LVL RT,1184.0,497.28,319.68,1160.32,29
CDM,3526738,INJ/S JT FCT L/S IMG 1 LVL BI,4442.0,1865.64,1199.34,4353.16,30
CDM,3526746,INJ/S JT FCT L/S IMG 1 LVL LT,2961.0,1243.62,799.47,3186.0,30
CDM,3526753,INJ/S JT FCT L/S IMG 1 LVL RT,2961.0,1243.62,799.47,3186.0,30
CDM,3526829,CT COLONOGRAPHY DX WO CNT,1025.0,430.5,106.81,1004.5,37
CDM,3526837,CT COLONOGRAPHY DX W CNT,1282.0,538.44,179.2,1256.36,37
CDM,3527546,INJ/S SHTH TNDN SGL/LIG/AP BI,705.0,296.1,190.35,690.9,29
CDM,3527553,INJ/S SHTH TNDN SGL/LIG/AP LT,470.0,197.4,126.9,460.6,29
CDM,3527561,INJ/S SHTH TNDN SGL/LIG/AP RT,470.0,197.4,126.9,460.6,29
CDM,3527686,INJ/S ANES&/STRD BLOCK HARDWARE,2961.0,1243.62,313.6,2901.78,36
CDM,3527777,ABL RF TUMOR/S PULM PERC IMG GD LT,8707.0,3656.94,2350.89,25370.0,30
CDM,3527785,ABL RF TUMOR/S PULM PERC IMG GD RT,8707.0,3656.94,2350.89,25370.0,30
CDM,3527793,ABL RF TUMOR/S PULM PERC IMG GD BI,13061.0,5485.62,3526.47,25370.0,30
CDM,3527835,BX/EXCISE NODE NDL SUPERFICIAL BI,4134.0,1736.28,1116.18,5367.0,30
CDM,3527843,BX/EXCISE NODE NDL SUPERFICIAL LT,2756.0,1157.52,744.12,5367.0,30
CDM,3527850,BX/EXCISE NODE NDL SUPERFICIAL RT,2756.0,1157.52,744.12,5367.0,30
CDM,3528577,ASP&/INJ CYST/PELVIS RENAL BI,3258.0,1368.36,879.66,3192.84,30
CDM,3528775,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,4466.0,1875.72,1205.82,4376.68,30
CDM,3528783,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2977.0,1250.34,803.79,3186.0,30
CDM,3528791,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2977.0,1250.34,803.79,3186.0,30
CDM,3528809,INJ/S EPID TRFR C/T FL/CT GD ADD BI,1469.0,616.98,396.63,1439.62,29
CDM,3528817,INJ/S EPID TRFR C/T FL/CT GD ADD LT,979.0,411.18,264.33,959.42,29
CDM,3528825,INJ/S EPID TRFR C/T FL/CT GD ADD RT,979.0,411.18,264.33,959.42,29
CDM,3528833,INJ/S EPID TRFR L/S FL/CT GD 1LV BI,2103.0,883.26,567.81,3186.0,30
CDM,3528841,INJ/S EPID TRFR L/S FL/CT GD 1LV LT,1402.0,588.84,378.54,3186.0,30
CDM,3528858,INJ/S EPID TRFR L/S FL/CT GD 1LV RT,1402.0,588.84,378.54,3186.0,30
CDM,3528866,INJ/S EPID TRFR L/S FL/CT GD ADD BI,920.0,386.4,248.4,901.6,29
CDM,3528874,INJ/S EPID TRFR L/S FL/CT GD ADD LT,613.0,257.46,165.51,600.74,29
CDM,3528882,INJ/S EPID TRFR L/S FL/CT GD ADD RT,613.0,257.46,165.51,600.74,29
CDM,3528957,CT ABDOMEN&PELVIS WO CNT,2532.0,1063.44,243.77,2481.36,37
CDM,3528965,CT ABDOMEN&PELVIS W CNT,3165.0,1329.3,356.43,3101.7,37
CDM,3528973,CT ABDOMEN&PELVIS W&WO CNT,3798.0,1595.16,356.43,3722.04,37
CDM,3528999,CHOLECYSTOSTOMY PERC W IMG GD S&I,4887.0,2052.54,1319.49,14009.0,37
CDM,3529435,INJ JT SI ANES/STRD FL/CT GD BI,2720.0,1142.4,734.4,2665.6,29
CDM,3529443,INJ JT SI ANES/STRD FL/CT GD LT,1813.0,761.46,489.51,1776.74,29
CDM,3529450,INJ JT SI ANES/STRD FL/CT GD RT,1813.0,761.46,489.51,1776.74,29
CDM,3529492,PARACENTESIS ABDOMINAL WO IMG,1846.0,775.32,498.42,5367.0,37
CDM,3529500,PARACENTESIS ABDOMINAL W IMG,2677.0,1124.34,722.79,5367.0,37
CDM,3529542,CTA ABDOMEN&PELVIS W CNT&PP,3988.0,1674.96,356.43,3908.24,37
CDM,3529864,CT ABDOMEN&PELVIS W CNT RDC,3165.0,1329.3,854.55,3101.7,30
CDM,3530060,DST NRV PLEXUS CELIAC,2069.0,868.98,558.63,3186.0,37
CDM,3530078,CT REND 3D W I&R W PP SAME WRKST,144.0,60.48,38.88,141.12,30
CDM,3530086,CT REND 3D W I&R W PP DIFF WRKST,354.0,148.68,95.58,346.92,30
CDM,3530128,THORACENTESIS ASP W IMG LT,1726.0,724.92,466.02,3186.0,30
CDM,3530136,THORACENTESIS ASP W IMG RT,1726.0,724.92,466.02,3186.0,30
CDM,3530144,THORACENTESIS ASP W IMG BI,2589.0,1087.38,699.03,3186.0,30
CDM,3530185,DRN PLEURA INS CATH INDWL W IMG LT,2983.0,1252.86,805.41,3186.0,30
CDM,3530193,DRN PLEURA INS CATH INDWL W IMG RT,2983.0,1252.86,805.41,3186.0,30
CDM,3530201,DRN PLEURA INS CATH INDWL W IMG BI,4475.0,1879.5,1208.25,4385.5,30
CDM,3530573,DRN CATH FLUID VISCERAL IMG GD,2535.0,1064.7,684.45,5367.0,37
CDM,3530581,DRN CATH FLUID PERI PERC IMG GD,6013.0,2525.46,1623.51,5892.74,37
CDM,3530631,DRN CATH FLUID TISSUE SOFT IMG GD,2511.0,1054.62,677.97,3186.0,37
CDM,3530649,DRN CATH FLUID TRNSVAG/REC IMG GD,2528.0,1061.76,682.56,5367.0,37
CDM,3530839,ASP INTERDISCAL DX PERC,1560.0,655.2,421.2,3186.0,37
CDM,3531027,COLL FLUID SCLEROTX W IMG GD S&I,2677.0,1124.34,722.79,3186.0,37
CDM,3531068,BX/S MARROW BONE DX NP/UNI,1386.0,582.12,374.22,3186.0,37
CDM,3531092,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,621.18,399.33,5367.0,37
CDM,3531225,ASP NEEDLE FINE BX CT GD LSN 1ST,3564.0,1496.88,723.47,3492.72,37
CDM,3531233,ASP NEEDLE FINE BX CT GD LSN ADDL,1552.0,651.84,419.04,1520.96,29
CDM,3531274,INJ ANES PLEXUS HYPOGASTRIC,2239.0,940.38,604.53,3186.0,37
CDM,3531415,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,2452.0,1029.84,662.04,3186.0,37
CDM,3531530,DST NRV INTERCOSTAL,2030.0,852.6,548.1,3186.0,37
CDM,3531605,ASP PUNCT CYST BREAST INIT LT,979.0,411.18,264.33,3186.0,30
CDM,3531613,ASP PUNCT CYST BREAST INIT RT,979.0,411.18,264.33,3186.0,30
CDM,3531647,REPOS CATH DIALYSIS PERIT W FL GD,2273.0,954.66,613.71,5367.0,37
CDM,3531662,EXCHG TUBE CHEST VIA WIRE,727.0,305.34,196.29,3186.0,37
CDM,3531738,ABL RF TUMOR/S KIDNEY PERC BI,13061.0,5485.62,3526.47,25370.0,30
CDM,3531837,ABL CRYO TUMOR/S KIDNEY PERC BI,22232.0,9337.44,6002.64,25370.0,30
CDM,3531910,INJ ANES GANGLION STELLA LT,1722.0,723.24,464.94,3186.0,30
CDM,3531928,INJ ANES GANGLION STELLA RT,1722.0,723.24,464.94,3186.0,30
CDM,3531936,INJ ANES GANGLION STELLA BI,2583.0,1084.86,697.41,3186.0,30
CDM,3532009,DISRUPTION FIBRIN SHEATH BALLOON,4040.0,1696.8,640.89,3959.2,37
CDM,3532223,INJ/S ANES NRV PUDENDAL BI,2028.0,851.76,547.56,3186.0,30
CDM,3532231,INJ/S ANES NRV PUDENDAL LT,1352.0,567.84,365.04,3186.0,30
CDM,3532249,INJ/S ANES NRV PUDENDAL RT,1352.0,567.84,365.04,3186.0,30
CDM,3532322,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3078.0,1292.76,831.06,5367.0,37
CDM,3532348,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3078.0,1292.76,831.06,5367.0,37
CDM,3532439,THROMBECT MECH PRIM ART INIT BI,24351.0,10227.42,6574.77,25370.0,30
CDM,3532454,THROMBECT MECH PRIM ART INIT LT,16234.0,6818.28,4383.18,25370.0,30
CDM,3532462,THROMBECT MECH PRIM ART INIT RT,16234.0,6818.28,4383.18,25370.0,30
CDM,3532520,THROMBECT MECH PRIM ART INIT NP/UNI,16234.0,6818.28,4383.18,27156.6,37
CDM,3532561,CHEMO INTRALESIONAL LSN 1-7,270.0,113.4,72.9,264.6,37
CDM,3532959,RPR EV DPLMNT A BIILAC NDGFT NO RUP,9482.0,3982.44,2560.14,9292.36,30
CDM,3532975,ASP PUNCT CYST BREAST ADDL LT,367.0,154.14,99.09,359.66,29
CDM,3532983,ASP PUNCT CYST BREAST ADDL RT,367.0,154.14,99.09,359.66,29
CDM,3533023,PLC G-TUBE NASO/ORO PHYS W FL GD,683.0,286.86,184.41,669.34,36
CDM,3533122,BX FAT PAD ABDOMINAL NDL PERC,2341.0,983.22,204.98,2294.18,36
CDM,3533213,REVASC LITH INTRAV INCL ANGIOPLSTY,16067.0,6748.14,4338.09,25370.0,37
CDM,3533221,REVASC LITH INTRAV STNT ANGIOPLSTY,23343.0,9804.06,6302.61,27156.6,37
CDM,3533239,REVASC LITH INTRAV ATHR ANGIOPLSTY,33257.0,13967.94,8979.39,32591.86,37
CDM,3533247,REVASC LITH INTRAV STNT ATHR ANGIO,28438.0,11943.96,7678.26,27869.24,37
CDM,3533254,REVASC LITH INTRAV TIB/PER INCL ANG,21999.0,9239.58,5939.73,26759.0,37
CDM,3533262,REVASC LITH INTRAV TIB/PER STNT ANG,22524.0,9460.08,6081.48,27156.6,37
CDM,3533346,BX FAT PAD ABDOMINAL NDL PERC,2341.0,983.22,204.98,2294.18,36
CDM,3533536,INJ/S ANES NRV PLEX BRACH SGL W IMG,1352.0,567.84,365.04,3186.0,37
CDM,3533742,RPR EV ILIAC DPLMNT A ILIAC NDGFT,13964.0,5864.88,3101.0,13684.72,30
CDM,3533908,ABL CRYO NEUROMA,10632.0,4465.44,204.98,10419.36,36
CDM,3533916,INJ ANES SPG TRANSCTH NOSE,604.0,253.68,163.08,591.92,36
CDM,3534211,CT PERFUSION CEREBRAL W CNT ADD-ON,1289.0,541.38,348.03,1263.22,30
CDM,3534229,CT PERFUSION CEREBRAL W CNT,1991.0,836.22,179.2,1951.18,37
CDM,3534237,GD LOC VOL TARGET DELIVERY TX RAD,234.0,98.28,63.18,229.32,30
CDM,3534252,RPR EV DPLMNT ILIAC NDGFT RUP BI,17063.0,7166.46,3101.0,16721.74,30
CDM,3534260,RPR EV DPLMNT ILIAC NDGFT RUP LT,11375.0,4777.5,3071.25,11147.5,30
CDM,3534278,RPR EV DPLMNT ILIAC NDGFT RUP RT,11375.0,4777.5,3071.25,11147.5,30
CDM,3534302,ABL IRE TUMOR/S LIVER PERC W IMG GD,14821.0,6224.82,4001.67,25370.0,37
CDM,3534328,CTA HEAD&NECK W&WO CNT&PP,4877.0,2048.34,356.43,4779.46,37
CDM,3534476,ABL RF MASS RETROPERITONEAL,8229.0,3456.18,926.63,8064.42,37
CDM,3602000,OR LEVEL 1 FIRST 30MIN,4090.0,1717.8,1104.3,4008.2,29
CDM,3602018,OR LEVEL 1 ADDL 15MIN,1220.0,512.4,329.4,1195.6,29
CDM,3602026,OR LEVEL 2 FIRST 30MIN,5590.0,2347.8,1509.3,5478.2,29
CDM,3602034,OR LEVEL 2 ADDL 15MIN,1720.0,722.4,464.4,1685.6,29
CDM,3602042,OR LEVEL 3 FIRST 30MIN,7090.0,2977.8,1914.3,6948.2,29
CDM,3602059,OR LEVEL 3 ADDL 15MIN,2220.0,932.4,599.4,2175.6,29
CDM,3602067,OR LEVEL 4 FIRST 30MIN,7930.0,3330.6,2141.1,7771.4,29
CDM,3602075,OR LEVEL 4 ADDL 15MIN,2550.0,1071.0,688.5,2499.0,29
CDM,3602083,OR LEVEL 5 FIRST 30MIN,10930.0,4590.6,2951.1,10711.4,29
CDM,3602091,OR LEVEL 5 ADDL 15MIN,3050.0,1281.0,823.5,2989.0,29
CDM,3602109,OR LEVEL 6 FIRST 30MIN,13930.0,5850.6,3761.1,13651.4,29
CDM,3602117,OR LEVEL 6 ADDL 15MIN,3550.0,1491.0,958.5,3479.0,29
CDM,3603321,LAVAGE BRONCH ALVEO WO SCOPE,2329.0,978.18,203.93,2282.42,36
CDM,3604048,ESWT/ESWL FIRST 30MIN,8915.0,3744.3,2407.05,8736.7,29
CDM,3604055,ESWT/ESWL ADDL 15MIN,2855.0,1199.1,770.85,2797.9,29
CDM,3690047,BRONCHOSCOPY DIAGNOSTIC,2708.0,1137.36,731.16,2653.84,29
CDM,3701000,SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701018,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701026,SED MOD ENDO SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701034,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,3701075,SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701083,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701091,SED MOD ENDO SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701109,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,3701208,SED MOD DIFF 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701216,SED MOD DIFF 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701224,SED MOD DIFF ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,3701232,SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701240,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,3701257,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,3702107,ANESTHESIA LEVEL 1 FIRST 30MIN,835.0,350.7,225.45,818.3,30
CDM,3702115,ANESTHESIA LEVEL 2 FIRST 30MIN,1335.0,560.7,360.45,1308.3,30
CDM,3702123,ANESTHESIA LEVEL 3 FIRST 30MIN,1835.0,770.7,495.45,1798.3,30
CDM,3702131,ANESTHESIA LEVEL 4 FIRST 30MIN,2335.0,980.7,630.45,2288.3,30
CDM,3705100,ANESTHESIA LEVEL 1 ADDL 15MIN,280.0,117.6,75.6,274.4,30
CDM,3705118,ANESTHESIA LEVEL 2 ADDL 15MIN,380.0,159.6,102.6,372.4,30
CDM,3705126,ANESTHESIA LEVEL 3 ADDL 15MIN,480.0,201.6,129.6,470.4,30
CDM,3705134,ANESTHESIA LEVEL 4 ADDL 15MIN,680.0,285.6,183.6,666.4,30
CDM,3900040,PLATELETS PATHOGEN RDC VOL RDC EA,1752.0,735.84,473.04,1716.96,37
CDM,3900297,TRANSFUSION BLOOD/COMP 1 UNIT,1419.0,595.98,383.13,1390.62,37
CDM,3900305,TRANSFUSION BLOOD/COMP 2 UNITS,1774.0,745.08,450.73,1738.52,37
CDM,3900313,TRANSFUSION BLOOD/COMP 3+ UNITS,2129.0,894.18,450.73,2086.42,37
CDM,3900321,THAWING WO WASH CELLS ALLOGEN,1107.0,464.94,298.89,1084.86,35
CDM,3900339,THAWING WO WASH CELLS AUTOLOG,1107.0,464.94,298.89,1084.86,37
CDM,3900347,THAWING W WASH CELLS ALLOGEN,1149.0,482.58,310.23,1126.02,35
CDM,3900354,THAWING W WASH CELLS AUTOLOG,1149.0,482.58,310.23,1126.02,37
CDM,3902020,LAB POOLING PLATELETS/BLOOD PROD,348.0,146.16,93.96,341.04,37
CDM,3902038,LAB COOMBS DIR ANTISERUM EA,121.0,50.82,5.39,118.58,37
CDM,3902046,LAB COOMBS INDIRECT REAGENT EA,348.0,146.16,5.72,341.04,37
CDM,3902053,CRYOPRECIPITATE EA UNIT,89.0,37.38,24.03,104.33,37
CDM,3902087,FFP FRZ WITHIN 8 HRS COLL EA UNIT,93.0,39.06,25.11,124.67,37
CDM,3902103,LAB HEMOLYSINS&AGGLUTININS INCUBATE,137.0,57.54,12.11,134.26,37
CDM,3902111,PLASMA CRYOPRECIPITATE RDC EA UNIT,442.0,185.64,119.34,433.16,37
CDM,3902129,FFP FRZ 8-24 HRS AFTER COLL EA UNIT,93.0,39.06,25.11,106.97,37
CDM,3902277,PLATELETS PHER LR EA UNIT,731.0,307.02,197.37,741.81,37
CDM,3902285,PLATELETS PHER LR IRRD EA UNIT,787.0,330.54,212.49,986.88,37
CDM,3902319,LAB BLOOD TYPE AG RBC EA,727.0,305.34,3.83,712.46,37
CDM,3902327,LAB PANEL AB RBC EA TECH SERUM,727.0,305.34,196.29,712.46,37
CDM,3902335,LAB SCR AB RBC SERUM EA,107.0,44.94,9.77,104.86,37
CDM,3902384,RBC LR AUTO EA UNIT,714.0,299.88,184.91,699.72,37
CDM,3902418,RBC LR IRRD EA UNIT,350.0,147.0,94.5,384.84,37
CDM,3902442,LAB PRETREAT RBC INCUB ENZYME,348.0,146.16,93.96,341.04,37
CDM,3902483,LAB SPLITTING BLOOD/BLOOD PROD EA,348.0,146.16,93.96,341.04,37
CDM,3902525,TRANSFUSION BLOOD/COMP 1 UNIT,1419.0,595.98,383.13,1390.62,37
CDM,3902533,TRANSFUSION BLOOD/COMP 2 UNITS,1774.0,745.08,450.73,1738.52,37
CDM,3902541,TRANSFUSION BLOOD/COMP 3+ UNITS,2129.0,894.18,450.73,2086.42,37
CDM,3902632,RBC LR EA UNIT,294.0,123.48,79.38,288.12,37
CDM,3902681,RBC WASHED EA UNIT,441.0,185.22,119.07,534.44,37
CDM,3902707,FFP FRZ WITHIN 8 HRS COLL PHER EA,93.0,39.06,25.11,124.67,37
CDM,3902715,BLOOD WHOLE LR EA UNIT,650.0,273.0,175.5,637.0,37
CDM,3902749,HLA MATCH,250.0,105.0,29.55,245.0,37
CDM,3902780,RBC WASHED IRRD LR EA UNIT,497.0,208.74,134.19,534.44,37
CDM,3902830,GRANULOCYTES PHER IRRD EA UNIT,5385.0,2261.7,1453.95,5277.3,30
CDM,3902848,RBC DGLC LR EA UNIT,891.0,374.22,240.57,873.18,37
CDM,3902855,BLOOD WHOLE LR IRRD EA UNIT,706.0,296.52,84.55,691.88,37
CDM,3902871,RBC LR IRRD DGLC EA UNIT,700.0,294.0,189.0,686.0,37
CDM,3903234,BLOOD UNIT SPLIT RBC LR,135.0,56.7,36.45,225.97,37
CDM,3903242,BLOOD UNIT SPLIT PLASMA FROZEN,54.0,22.68,14.58,225.97,37
CDM,3903515,PLATELETS PHER LR IRRD WASHED EA,934.0,392.28,252.18,986.88,37
CDM,3903564,TEST PATHOGENS PLATELETS,240.0,100.8,60.27,235.2,37
CDM,3903572,PLATELETS PATHOGEN RDC EA UNIT,1875.0,787.5,506.25,1837.5,37
CDM,3903580,BLOOD UNIT SPLIT PLATELET ALIQUOTS,379.0,159.18,102.33,371.42,37
CDM,3903598,BLOOD UNIT SPLIT PLATELET PTHGN RDC,379.0,159.18,102.33,371.42,37
CDM,3903606,BLOOD UNIT SPLIT DEGLYCEROLIZED,404.0,169.68,109.08,395.92,37
CDM,3903614,PLATELETS PATHOGEN RDC WASHED EA,1752.0,735.84,473.04,1716.96,37
CDM,3903630,LAB DET IA RSV PRB AMP,211.0,88.62,56.97,206.78,37
CDM,3903689,LAB CHROMAT MS NON-DRUG QL/QN,75.0,31.5,20.25,73.5,37
CDM,3903713,LAB STAIN SPECIAL 2 PROT AMYLOID,272.0,114.24,73.44,266.56,37
CDM,3903721,LAB MICRODISSECTION LASER PROT AMYL,202.0,84.84,54.54,197.96,30
CDM,3903739,LAB CHROMAT MS PROT AMYLOID QN,909.0,381.78,24.09,890.82,37
CDM,3903788,LAB IMM MS ALPHA 2 MACROGLOBULIN,59.0,24.78,11.53,57.82,37
CDM,3903820,LAB DET IA ANPLSM PHGCYTPHL PRB QNI,189.0,79.38,35.09,185.22,37
CDM,3903838,LAB SCR AB THSD7A W REFLEX FL,453.0,190.26,12.05,443.94,37
CDM,3903887,LAB THYROGLOBULIN MYO,215.0,90.3,16.06,210.7,37
CDM,3903895,LAB AB THYROGLOBULIN MYO,214.0,89.88,15.91,209.72,37
CDM,3903978,LAB DRG DF ETOH BIOMRK 1-2,130.0,54.6,35.1,127.4,30
CDM,3904067,LAB SUSCPT MICRODILUTION PLATE EA,60.0,25.2,8.65,58.8,37
CDM,3904091,LAB DRG DF VENLAFAXINE DAY,350.0,147.0,94.5,343.0,30
CDM,3904109,LAB DET IA DENGUE TYPES 1-4 PRB AMP,290.0,121.8,35.09,284.2,37
CDM,3904117,LAB AB VIRUS DENGUE,70.0,29.4,12.88,68.6,37
CDM,3904166,LAB AB ID PLATELET IGG FLOW CYTO,236.0,99.12,18.37,231.28,37
CDM,3904190,LAB IMM NEOPTERIN,202.0,84.84,17.27,197.96,37
CDM,3904216,LAB EOSINOPHILS URINE/OTHER,57.0,23.94,15.39,55.86,30
CDM,3904331,LAB PANEL INFCT FLUID SYNOVIAL PCR,856.0,359.52,231.12,838.88,30
CDM,3904422,LAB CHOLESTEROL FLUID BODY,55.0,23.1,14.85,53.9,30
CDM,3904430,LAB IMM AB QN HAEMOPHILUS INFLU B,63.0,26.46,14.99,61.74,37
CDM,3904513,LAB ACTIVITY ENZYME L-ASPARAGNSE,325.0,136.5,22.17,318.5,37
CDM,3904646,LAB NEPHELOMETRY RETINL BIND PROT,365.0,153.3,13.6,357.7,37
CDM,3904661,LAB AB ENA SCLERODERMA PANEL,161.0,67.62,17.93,157.78,37
CDM,3904729,PLATELETS PATHOGEN RDC LOW YIELD EA,1875.0,787.5,506.25,1837.5,37
CDM,3904737,PLATELETS PATHOGEN PHER LOW YIELDEA,1875.0,787.5,506.25,1837.5,37
CDM,3904745,PLATELETS PHER LR IRRD LOW YIELD EA,2042.0,857.64,551.34,2001.16,37
CDM,3904760,PLATELETS PHER LR LOW YIELD EA,1875.0,787.5,506.25,1837.5,37
CDM,39263,R&B ICU,8046.0,3379.32,6839.1,7885.08,13
CDM,4002069,US BREAST CMP LT,408.0,171.36,110.16,399.84,30
CDM,4002077,US BREAST CMP RT,408.0,171.36,110.16,399.84,30
CDM,4002085,US BREAST LTD LT,334.0,140.28,90.18,327.32,30
CDM,4002093,US BREAST LTD RT,334.0,140.28,90.18,327.32,30
CDM,4002226,ASP&/INJ JT/BUR MAJ W US GD BI,2279.0,957.18,615.33,2233.42,29
CDM,4002234,ASP&/INJ JT/BUR MAJ W US GD LT,1519.0,637.98,410.13,1488.62,29
CDM,4002242,ASP&/INJ JT/BUR MAJ W US GD RT,1519.0,637.98,410.13,1488.62,29
CDM,4002267,ASP&/INJ JT/BUR INTR W US GD BI,2100.0,882.0,567.0,3186.0,30
CDM,4002275,ASP&/INJ JT/BUR INTR W US GD LT,1400.0,588.0,378.0,3186.0,30
CDM,4002283,ASP&/INJ JT/BUR INTR W US GD RT,1400.0,588.0,378.0,3186.0,30
CDM,4002291,ASP&/INJ JT/BUR SM W US GD BI,1178.0,494.76,318.06,1154.44,29
CDM,4002309,ASP&/INJ JT/BUR SM W US GD LT,785.0,329.7,211.95,769.3,29
CDM,4002317,ASP&/INJ JT/BUR SM W US GD RT,785.0,329.7,211.95,769.3,29
CDM,4002382,US BREAST LTD BI,501.0,210.42,135.27,490.98,30
CDM,4002416,US BREAST CMP BI,612.0,257.04,165.24,599.76,30
CDM,4002556,BX/EXCISE NODE OPEN SUPERFICIAL RT,5908.0,2481.36,1595.16,10412.0,30
CDM,4002564,BX/EXCISE NODE OPEN SUPERFICIAL LT,5908.0,2481.36,1595.16,10412.0,30
CDM,4002572,BX/EXCISE NODE OPEN SUPERFICIAL BI,8862.0,3722.04,2392.74,10412.0,30
CDM,4002598,ASP INTERDISCAL DX PERC,1560.0,655.2,421.2,3186.0,37
CDM,40279,R&B NURSERY LEVEL 2 LOWER ACUITY,6385.0,2681.7,5427.25,6257.3,13
CDM,4030060,ASP PUNCT CYST BREAST ADDL LT,367.0,154.14,99.09,359.66,29
CDM,4030078,ASP PUNCT CYST BREAST ADDL RT,367.0,154.14,99.09,359.66,29
CDM,4030094,ASP PUNCT CYST BREAST INIT LT,979.0,411.18,264.33,3186.0,30
CDM,4030102,ASP PUNCT CYST BREAST INIT RT,979.0,411.18,264.33,3186.0,30
CDM,4030128,ASP PUNCT ABSCESS/CYST,623.0,261.66,168.21,610.54,36
CDM,4030268,BX MASS ABD/RETRO NDL PERC,2707.0,1136.94,730.89,5367.0,37
CDM,4030383,BX LIVER NDL PERC,3384.0,1421.28,913.68,5367.0,37
CDM,4030409,BX MUSCLE NDL PERC,3161.0,1327.62,853.47,5367.0,37
CDM,4030458,BX RENAL TROCAR/NDL PERC LT,3084.0,1295.28,832.68,5367.0,30
CDM,4030466,BX RENAL TROCAR/NDL PERC RT,3084.0,1295.28,832.68,5367.0,30
CDM,4030474,BX THYROID NDL CORE PERC,979.0,411.18,264.33,3186.0,37
CDM,4030557,I&D HEMATOMA/SEROMA/FLUID,3176.0,1333.92,857.52,5367.0,37
CDM,4030664,INJ PSEUDOANEURYSM EXT RT,1211.0,508.62,326.97,3186.0,30
CDM,4030847,US UTERUS PREG DETAIL GEST ADDL,954.0,400.68,257.58,934.92,30
CDM,4030854,US ABDOMEN CMP,1213.0,509.46,106.81,1188.74,37
CDM,4030862,US ABDOMEN LTD,905.0,380.1,106.81,886.9,37
CDM,4030870,US PROFILE BIO FETAL W NST ADDL,729.0,306.18,196.83,714.42,30
CDM,4030888,US PROFILE BIO FETAL WO NST,523.0,219.66,106.81,512.54,37
CDM,4030896,US PROFILE BIO FETAL WO NST ADDL,523.0,219.66,141.21,512.54,30
CDM,4030904,US PROFILE BIO FETAL W NST,729.0,306.18,106.81,714.42,37
CDM,4030953,US CHEST,408.0,171.36,106.81,399.84,37
CDM,4031084,US GD VA EVAL SITE W REC PERM,349.0,146.58,94.23,342.02,30
CDM,4031092,US GD INTRAOPERATIVE,815.0,342.3,220.05,798.7,30
CDM,4031100,US GD AMNIOCENTESIS S&I,439.0,184.38,118.53,430.22,30
CDM,4031142,US GD PLCMT NEEDLE S&I,1641.0,689.22,443.07,1608.18,30
CDM,4031167,US GD ABLATION TISSUE,670.0,281.4,180.9,656.6,30
CDM,4031175,US HIPS INFANT DYNAMIC,347.0,145.74,88.91,340.06,37
CDM,4031183,US HIPS INFANT STATIC,172.0,72.24,46.44,168.56,37
CDM,4031225,US HEAD NEONATAL,347.0,145.74,93.69,340.06,37
CDM,4031241,US UTERUS PREG 0-13WK GEST ADDL,280.0,117.6,75.6,274.4,30
CDM,4031258,US UTERUS PREG 0-13WK GEST SGL,905.0,380.1,106.81,886.9,37
CDM,4031266,US UTERUS PREG 14+WK GEST ADDL,408.0,171.36,110.16,399.84,30
CDM,4031274,US UTERUS PREG 14+WK GEST SGL,1041.0,437.22,106.81,1020.18,37
CDM,4031282,US UTERUS PREG DETAIL GEST SGL,852.0,357.84,230.04,834.96,37
CDM,4031290,US UTERUS PREG RE-EVAL FETUS,418.0,175.56,106.81,409.64,37
CDM,4031308,US UTERUS PREG RE-EVAL FETUS ADDL,418.0,175.56,112.86,409.64,30
CDM,4031316,US UTERUS PREG LTD 1+ FETUS,520.0,218.4,106.81,509.6,37
CDM,4031324,US UTERUS PREG TRANSVAGINAL,599.0,251.58,106.81,587.02,37
CDM,4031332,US PELVIS NON OB CMP,905.0,380.1,106.81,886.9,37
CDM,4031340,US PELVIS NON OB LTD,724.0,304.08,106.81,709.52,37
CDM,4031357,US GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,30
CDM,4031399,US GD RPR PSEUDOAN ART/FISTULA AV,1055.0,443.1,220.6,1033.9,37
CDM,4031407,US RETROPERITONEAL LTD,403.0,169.26,106.81,394.94,37
CDM,4031415,US RETROPERITONEAL CMP,670.0,281.4,106.81,656.6,37
CDM,4031423,US SCROTUM&CONTENTS,905.0,380.1,106.81,886.9,37
CDM,4031431,US TISSUE SOFT HEAD&NECK,545.0,228.9,106.81,534.1,37
CDM,4031449,US SPINAL CANAL&CONTENTS,510.0,214.2,106.81,499.8,37
CDM,4031456,US TRANSRECTAL STDY VOL PROSTATE,544.0,228.48,106.81,533.12,37
CDM,4031464,US TRANSRECTAL,418.0,175.56,106.81,409.64,37
CDM,4031472,US TRANSVAGINAL,905.0,380.1,106.81,886.9,37
CDM,4032405,US DUPLEX ART EXT UPR UNI/LTD LT,753.0,316.26,203.31,737.94,30
CDM,4032413,US DUPLEX ART EXT LWR UNI/LTD RT,826.0,346.92,223.02,809.48,30
CDM,4032421,US DUPLEX ART EXT LWR UNI/LTD LT,826.0,346.92,223.02,809.48,30
CDM,4032439,US DUPLEX ART EXT UPR UNI/LTD RT,753.0,316.26,203.31,737.94,30
CDM,4032447,US DUPLEX ART EXT LWR BI,1157.0,485.94,243.77,1133.86,37
CDM,4032454,US DUPLEX ART EXT UPR CMP BI,1929.0,810.18,243.77,1890.42,37
CDM,4032496,US DUPLEX EXTRACRANIAL CMP BI,1691.0,710.22,243.77,1657.18,37
CDM,4032504,US DUPLEX EXTRACRANIAL UNI/LTD,533.0,223.86,106.81,522.34,37
CDM,4032520,US DUPLEX ABD/PEL/SCR&/RETRO CMP,2013.0,845.46,243.77,1972.74,37
CDM,4032538,US DUPLEX ABD/PEL/SCR&/RETRO LTD,1205.0,506.1,106.81,1180.9,37
CDM,4032546,US DUPLEX AO/IVC/ILIAC/GRFT LTD,734.0,308.28,106.81,719.32,37
CDM,4032553,US DUPLEX AO/IVC/ILIAC/GRFT CMP,1058.0,444.36,243.77,1036.84,37
CDM,4032561,US DUPLEX PENILE CMP,1086.0,456.12,106.81,1064.28,37
CDM,4032587,US DUPLEX VEIN EXT CMP BI,2466.0,1035.72,243.77,2416.68,37
CDM,4032595,US DUPLEX VEIN EXT LTD/UNI,1481.0,622.02,106.81,1451.38,37
CDM,4032603,US DUPLEX HEMODIALYSIS,600.0,252.0,106.81,588.0,37
CDM,4032611,US TCD INTRACRANIAL CMP,841.0,353.22,227.07,824.18,37
CDM,4032629,US TCD INTRACRANIAL LTD,366.0,153.72,98.82,358.68,37
CDM,4032652,US TRANSRECTAL STDY VOL PROSTATE,544.0,228.48,106.81,533.12,37
CDM,4032678,US GD APP RADIOELEMENT INTERSTITIAL,944.0,396.48,254.88,925.12,30
CDM,4032751,US TRANSRECTAL,418.0,175.56,106.81,409.64,37
CDM,4032835,US UTERUS PREG LTD 1+ FETUS,520.0,218.4,106.81,509.6,37
CDM,4032991,US GD AMNIOCENTESIS S&I,439.0,184.38,118.53,430.22,30
CDM,4033197,US GD PLCMT NEEDLE ADDL S&I,1641.0,689.22,443.07,1608.18,30
CDM,4033221,MEAS URINE&/CAPACITY BLADDER US,107.0,44.94,28.89,104.86,36
CDM,4033254,US GD VA EVAL SITE W REC PERM,349.0,146.58,94.23,342.02,30
CDM,4033262,US GD PLCMT NEEDLE S&I,1641.0,689.22,443.07,1608.18,30
CDM,4033544,INJ PSEUDOANEURYSM EXT LT,1211.0,508.62,326.97,3186.0,30
CDM,4033759,ECHO 2D CMP WO CNT,822.0,345.24,221.94,805.56,37
CDM,4033767,ECHO 2D LTD WO CNT,893.0,375.06,241.11,875.14,37
CDM,4035002,US KIDNEY TRANSPLANTED W DOPPLER,905.0,380.1,106.81,886.9,37
CDM,4035895,ECHO 2D CMP W CNT,1028.0,431.76,277.56,1161.31,37
CDM,4035903,ECHO 2D LTD W CNT,1117.0,469.14,301.59,1094.66,37
CDM,4036554,US TRANSVAGINAL RDC,905.0,380.1,244.35,886.9,30
CDM,4037081,US GD PLCMT NEEDLE ADDL S&I,1641.0,689.22,443.07,1608.18,30
CDM,4037222,BX/EXCISE NODE NDL SUPERFICIAL BI,4134.0,1736.28,1116.18,5367.0,30
CDM,4037230,BX/EXCISE NODE NDL SUPERFICIAL LT,2756.0,1157.52,744.12,5367.0,30
CDM,4037248,BX/EXCISE NODE NDL SUPERFICIAL RT,2756.0,1157.52,744.12,5367.0,30
CDM,4037453,BX/S MARROW BONE DX BI,2079.0,873.18,561.33,3186.0,30
CDM,4037461,BX/S MARROW BONE DX NP/UNI,1386.0,582.12,374.22,3186.0,37
CDM,4037727,BX RENAL TROCAR/NDL PERC BI,4626.0,1942.92,1249.02,5367.0,30
CDM,4037792,ART PHYS 1-2 LEVEL LTD BI,798.0,335.16,135.93,782.04,37
CDM,4037800,ART PHYS 3+ LEVEL CMP BI,1023.0,429.66,220.6,1002.54,37
CDM,4037826,CHOLECYSTOSTOMY PERC W IMG GD S&I,4887.0,2052.54,1319.49,14009.0,37
CDM,4037982,US GD VA EVAL SITE W REC PERM,349.0,146.58,94.23,342.02,30
CDM,4037990,ART PHYS 1-2 LEVEL LTD UNI,532.0,223.44,143.64,521.36,30
CDM,4038006,ART PHYS 3+ LEVEL CMP UNI,682.0,286.44,184.14,668.36,30
CDM,4038063,ECHO 2D TEE CMP WO CNT W I&R,1630.0,684.6,440.1,1597.4,37
CDM,4038071,ECHO 2D TEE CMP W CNT W I&R,2038.0,855.96,550.26,1997.24,37
CDM,4038089,INS CVC CENTRAL NONTUN 5+YRS,4040.0,1696.8,1090.8,4677.51,37
CDM,4038600,PARACENTESIS ABDOMINAL WO IMG,1846.0,775.32,498.42,5367.0,37
CDM,4038618,PARACENTESIS ABDOMINAL W IMG,2677.0,1124.34,722.79,5367.0,37
CDM,4038832,THORACENTESIS ASP W IMG LT,1726.0,724.92,466.02,3186.0,30
CDM,4038840,THORACENTESIS ASP W IMG RT,1726.0,724.92,466.02,3186.0,30
CDM,4038857,THORACENTESIS ASP W IMG BI,2589.0,1087.38,699.03,3186.0,30
CDM,4039269,DRN CATH FLUID VISCERAL IMG GD,2535.0,1064.7,684.45,5367.0,37
CDM,4039277,DRN CATH FLUID PERI PERC IMG GD,6013.0,2525.46,1623.51,5892.74,37
CDM,4039285,DRN CATH FLUID TRNSVAG/REC IMG GD,2528.0,1061.76,682.56,5367.0,37
CDM,4039319,BX BRST W/WO DEV/IMG US LSN ADD,1496.0,628.32,403.92,1466.08,29
CDM,4039350,PLC DEV/S BRST US GD LSN ADD,442.0,185.64,119.34,433.16,29
CDM,4039368,DRN CATH FLUID TISSUE SOFT IMG GD,2511.0,1054.62,677.97,3186.0,37
CDM,4039541,US ABDOMEN LTD,905.0,380.1,106.81,886.9,37
CDM,4039558,US CHEST,408.0,171.36,106.81,399.84,37
CDM,4039624,PLC DEV/S BRST US GD LSN 1ST LT,979.0,411.18,264.33,3186.0,30
CDM,4039632,PLC DEV/S BRST US GD LSN 1ST RT,979.0,411.18,264.33,3186.0,30
CDM,4039707,BX BRST W/WO DEV/IMG US LSN 1ST LT,2808.0,1179.36,758.16,5367.0,30
CDM,4039715,BX BRST W/WO DEV/IMG US LSN 1ST RT,2808.0,1179.36,758.16,5367.0,30
CDM,4039913,INJ PSEUDOANEURYSM EXT BI,1817.0,763.14,490.59,3186.0,30
CDM,4040036,US JOINT CMP REALTIME,909.0,381.78,106.81,890.82,37
CDM,4040069,US JT/EVAL FOCAL EXT NONVASC LTD,586.0,246.12,106.81,574.28,37
CDM,4040135,ASP NEEDLE FINE BX US GD LSN 1ST,2616.0,1098.72,706.32,3186.0,37
CDM,4040143,ASP NEEDLE FINE BX US GD LSN ADDL,1644.0,690.48,443.88,1611.12,29
CDM,4040622,US DUPLEX ART&VEN B4 HEMO CMP BI,877.0,368.34,236.79,859.46,37
CDM,4040630,US DUPLEX ART&VEN B4 HEMO CMP UNI,654.0,274.68,106.81,640.92,37
CDM,4040754,ACCS&CLSR ART FEM NDGFT PERC UNI,693.0,291.06,187.11,679.14,29
CDM,4041968,RRX F18 FDG DX/0-45MCI DOSE,1131.0,475.02,305.37,1108.38,30
CDM,4042420,PET/CT SKULL-THIGH ONC FDG INIT,5138.0,2157.96,1387.26,5035.24,30
CDM,4042438,PET/CT SKULL-THIGH ONC FDG SUB 1-3,5138.0,2157.96,1387.26,5035.24,30
CDM,4042735,PET/CT SKULL-THIGH ONC FDG SUB 4+,5138.0,2157.96,1387.26,5035.24,30
CDM,4109096,RX NITRIC OXIDE 10 MIN,142.4,59.81,38.45,139.55,30
CDM,4109112,RX NITRIC OXIDE PER DAY,13966.4,5865.89,3770.93,13687.07,30
CDM,4109120,INTUBATION ENDOTRACHEAL EMERG,736.0,309.12,198.72,721.28,37
CDM,4109237,CHG TUBE TRACH PRIOR TRACT FISTULA,924.0,388.08,241.98,905.52,36
CDM,4109245,CPR,1485.0,623.7,220.6,1455.3,37
CDM,4109351,DEMO&/EVAL PT AEROSOL/NEB/MDI/IPPB,276.0,115.92,74.52,324.39,37
CDM,4109385,BIPAP INITIAL DAY,1031.0,433.02,223.72,1010.38,37
CDM,4109393,BIPAP SUBSQ DAY,1031.0,433.02,223.72,1010.38,37
CDM,4109401,PHYSIOTHERAPY CHEST INITIAL,204.0,85.68,55.08,199.92,37
CDM,4109419,PHYSIOTHERAPY CHEST SUBSQ,262.0,110.04,70.74,256.76,37
CDM,4109435,CPAP INITIAL DAY,1031.0,433.02,223.72,1010.38,37
CDM,4109443,CPAP SUBSQ DAY,1031.0,433.02,223.72,1010.38,37
CDM,4109468,CLEARANCE AIRWAY INITIAL,204.0,85.68,55.08,199.92,37
CDM,4109476,CLEARANCE AIRWAY SUBSQ,262.0,110.04,70.74,256.76,37
CDM,4109583,VENT INITIAL DAY,2531.0,1063.02,631.17,2480.38,37
CDM,4109591,VENT SUBSQ DAY,1823.0,765.66,492.21,1786.54,37
CDM,4109765,INHALATION AEROSOL PENTAMIDINE,555.0,233.1,149.85,543.9,37
CDM,4109823,PUNCT ARTERIAL FOR DIAGNOSIS,204.0,85.68,55.08,199.92,37
CDM,4109880,CAPACITY VITAL TOTAL,256.0,107.52,69.12,250.88,37
CDM,4109963,SPIROMETRY W VITAL CAP W/WO VENT,432.0,181.44,116.64,423.36,37
CDM,4109971,PHYSIOTHERAPY CHEST COMP INITIAL,204.0,85.68,55.08,199.92,37
CDM,4110094,BRONCHDLTN PRE&POST SPIROMETRY W VC,778.0,326.76,210.06,762.44,37
CDM,4110144,ADMIN SURFACTANT INTRAPULMONARY,292.0,122.64,78.84,324.39,37
CDM,4110151,EVAL BRONCHSPSM SPIRO W AGENTS,576.0,241.92,155.52,564.48,37
CDM,4110458,DECLOT CATH/VAD W AGENT THROMB,492.0,206.64,132.84,489.32,36
CDM,4110615,PLETHYSMOGRAPHY VOLUMES LUNG,572.0,240.24,154.44,560.56,37
CDM,4110623,DILUT GAS/WASHOUT VOLUMES LUNG,374.0,157.08,100.98,366.52,37
CDM,4110649,CAPACITY DIFFUSING,512.0,215.04,138.24,501.76,30
CDM,4110672,HAST W REPORT&TITRATE OXYGEN SUPP,267.0,112.14,72.09,261.66,37
CDM,4110698,OSCILLATION CHEST WALL MECH SESSN,348.0,146.16,93.96,341.04,37
CDM,4110870,INS PICC WO P/P W IMG 0-4YRS,2506.0,1052.52,640.89,3186.0,37
CDM,4110888,INS PICC WO P/P W IMG 5+YRS,4693.0,1971.06,1267.11,5367.0,37
CDM,4110896,INS PICC WO P/P WO IMG 0-4YRS,2004.0,841.68,541.08,3186.0,37
CDM,4110904,INS PICC WO P/P WO IMG 5+YRS,4462.0,1874.04,1204.74,4372.76,37
CDM,4110912,RPLC PICC WO P/P SA S&I,4056.0,1703.52,1095.12,3974.88,37
CDM,4110979,LARYNGOSCOPY W STROBOSCOPY,600.0,252.0,162.0,588.0,36
CDM,4130647,HBOT CHAMBER FULL BODY 30MIN,717.0,301.14,140.59,702.66,37
CDM,4200218,PT CONF TEAM PHY WO PT&/FM 30+MN,117.0,49.14,31.59,114.66,30
CDM,4200515,PT EVAL THERAPY LOW,246.0,103.32,66.42,241.08,30
CDM,4200564,PT EVAL THERAPY MOD,392.0,164.64,105.84,384.16,30
CDM,4200614,PT EVAL THERAPY HIGH,392.0,164.64,105.84,384.16,30
CDM,4200663,PT RE-EVAL THERAPY,170.0,71.4,45.9,166.6,30
CDM,4209102,PT MODALITY APPL TRACTION MECHANIC,71.0,29.82,19.17,69.58,30
CDM,4209250,PT MODALITY APPL E-STIM MAN 15MN,95.0,39.9,25.65,93.1,30
CDM,4209268,PT MODALITY APPL IONTOPHORES 15MN,119.0,49.98,32.13,116.62,30
CDM,4209284,PT MODALITY APPL ULTRASOUND 15MN,99.0,41.58,26.73,97.02,30
CDM,4209318,PT THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CDM,4209334,PT THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CDM,4209359,PT THER TRAIN GAIT 15MN,86.0,36.12,23.22,84.28,30
CDM,4209375,PT THER MASSAGE 15MN,87.0,36.54,23.49,85.26,30
CDM,4209391,PT THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CDM,4209409,PT THER GROUP,62.0,26.04,16.74,60.76,30
CDM,4209433,PT THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CDM,4209474,PT MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CDM,4209490,PT MANAGEMENT WHEELCHAIR 15MN,78.0,32.76,21.06,76.44,30
CDM,4209557,PT MEAS/TEST PERFORMANCE 15MIN,105.0,44.1,28.35,102.9,30
CDM,4209706,PT CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CDM,4209714,PT CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CDM,4212056,PT REPOSITIONING CANALITH PER DAY,90.0,37.8,24.3,88.2,30
CDM,4214144,PT TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CDM,4214177,PT TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CDM,4214227,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CDM,4214714,PTA REPOSITIONING CANALITH PER DAY,90.0,37.8,24.3,88.2,30
CDM,4214821,PTA THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CDM,4214839,PTA THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CDM,4214854,PTA THER TRAIN GAIT 15MN,86.0,36.12,23.22,84.28,30
CDM,4214870,PTA THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CDM,4214888,PTA THER GROUP,62.0,26.04,16.74,60.76,30
CDM,4214896,PTA THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CDM,4214912,PTA MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CDM,4214938,PTA MANAGEMENT WHEELCHAIR 15MN,78.0,32.76,21.06,76.44,30
CDM,4215067,PTA TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CDM,4215075,PTA TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CDM,4215083,PTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CDM,4219796,OTA CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CDM,4219804,PTA CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CDM,4219812,OTA CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CDM,4219820,PTA CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CDM,4307930,OT MODALITY APPL IONTOPHORES 15MN,119.0,49.98,32.13,116.62,30
CDM,4307955,OT MODALITY APPL ULTRASOUND 15MN,99.0,41.58,26.73,97.02,30
CDM,4307989,OT THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CDM,4307997,OT THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CDM,4308045,OT THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CDM,4308086,OT THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CDM,4308110,OT TECHNIQUES SENSORY 15MN,153.0,64.26,41.31,149.94,30
CDM,4308128,OT MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CDM,4308144,OT MANAGEMENT WHEELCHAIR 15MN,78.0,32.76,21.06,76.44,30
CDM,4308276,OT MODALITY APPL E-STIM MAN 15MN,95.0,39.9,25.65,93.1,30
CDM,4308300,OT CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CDM,4308318,OT CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CDM,4312138,OT CONF TEAM PHY WO PT&/FM 30+MN,117.0,49.14,31.59,114.66,30
CDM,4312401,OT EVAL THERAPY LOW,246.0,103.32,66.42,241.08,30
CDM,4312427,OT EVAL THERAPY MOD,392.0,164.64,105.84,384.16,30
CDM,4312443,OT EVAL THERAPY HIGH,392.0,164.64,105.84,384.16,30
CDM,4312468,OT RE-EVAL THERAPY,170.0,71.4,45.9,166.6,30
CDM,4313011,OT TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CDM,4313052,OT TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CDM,4313086,OT TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CDM,4313805,OTA THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CDM,4313813,OTA THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CDM,4313862,OTA THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CDM,4313888,OTA THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CDM,4313896,OTA TECHNIQUES SENSORY 15MN,153.0,64.26,41.31,149.94,30
CDM,4313904,OTA MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CDM,4314035,OTA TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CDM,4314043,OTA TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CDM,4314050,OTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CDM,4400370,ST EVAL SWALLOW ENDOSCOPIC FLEX,295.0,123.9,79.65,289.1,30
CDM,4403283,ST LARYNGOSCOPY DIAGNOSTIC FLEX,347.0,145.74,93.69,340.06,36
CDM,4405924,ST TX SPEECH/LANG/VOICE/COM IND,192.0,80.64,51.84,188.16,30
CDM,4405932,ST TX SPEECH/LANG/VOICE/COM GROUP,94.0,39.48,25.38,92.12,30
CDM,4405940,ST TX DYSFNCT SWALLOW FNCT FEED,244.0,102.48,65.88,239.12,30
CDM,4405957,ST EVAL DEVICE VOICE PROSTHETIC,375.0,157.5,101.25,367.5,30
CDM,4406013,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,296.0,124.32,79.92,290.08,30
CDM,4406021,ST EVAL FNCT SWALLOW FLUOROSCOPIC,749.0,314.58,202.23,734.02,30
CDM,4406252,ST CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CDM,4406260,ST CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CDM,4409140,ST EVAL PROD SOUND SP,281.0,118.02,75.87,275.38,30
CDM,4409157,ST EVAL PROD SOUND SP W LANG&EXPRSN,738.0,309.96,199.26,723.24,30
CDM,4409165,ST ANALYSIS VOICE&RESON BEH&QUAL,275.0,115.5,74.25,269.5,30
CDM,4409421,ST CONF TEAM PHY WO PT&/FM 30+MN,117.0,49.14,31.59,114.66,30
CDM,4409645,ST SKILLS DEVLPMT COGNITIVE 15MN,195.0,81.9,52.65,191.1,30
CDM,4409652,ST SKILLS DEVLPMT COGNITIVE AD 15MN,178.0,74.76,48.06,174.44,30
CDM,4500062,ED US ABDOMEN LTD,905.0,380.1,106.81,886.9,37
CDM,4500385,ED TRAUMA ACT LVL2 EVAL/GREEN WO CC,3795.0,1593.9,1024.65,3719.1,30
CDM,4500393,ED TRAUMA ACT LVL2 EVAL/GREEN W CC,5060.0,2125.2,1361.78,4958.8,37
CDM,4504502,ED AMPUTATION DIGIT,4701.0,1974.42,1269.27,4606.98,29
CDM,4504510,ED ANOSCOPY,291.0,122.22,78.57,285.18,29
CDM,4504528,ED ASP/INJECT JOINT/BURSA,435.0,182.7,117.45,426.3,29
CDM,4504544,ED TREATMENT BURN LVL 01 SMALL,467.0,196.14,126.09,457.66,29
CDM,4504551,ED CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,36
CDM,4504569,ED CASTING EXTREMITY LOWER,214.0,89.88,57.78,209.72,29
CDM,4504577,ED CASTING EXTREMITY UPPER,319.0,133.98,86.13,312.62,29
CDM,4504585,ED ASP BLADDER CATH SUPRAPUB,2996.0,1258.32,808.92,2936.08,29
CDM,4504593,ED INS CATH BLADDER INDWL CMPLX,404.0,169.68,109.08,395.92,29
CDM,4504650,ED CPR,1485.0,623.7,220.6,1455.3,36
CDM,4504668,ED VISIT CRITICAL CARE ADDL 30MIN,3885.0,1631.7,1048.95,3807.3,29
CDM,4504676,ED VISIT CRITICAL CARE 1ST 30-74MIN,7775.0,3265.5,843.92,7619.5,36
CDM,4504684,ED CHG TUBE CYSTO,626.0,262.92,169.02,613.48,29
CDM,4504692,ED DEBRIDE TISSUE SKIN/SUBQ,1294.0,543.48,349.38,1268.12,29
CDM,4504700,ED DELIVERY PLACENTA,2705.0,1136.1,730.35,4795.5,36
CDM,4504718,ED DELIVERY VAGINAL ONLY,2585.0,1085.7,697.95,2533.3,29
CDM,4504726,ED INTUBATION ENDOTRACHEAL,736.0,309.12,198.72,721.28,29
CDM,4504734,ED INJ EPID PATCH BLOOD/CLOT,1571.0,659.82,424.17,1539.58,36
CDM,4504742,ED EXPLORATION WOUND/TRAUMA,312.0,131.04,84.24,305.76,29
CDM,4504775,ED I&D HEMATOMA/SEROMA/FLUID,3176.0,1333.92,857.52,3112.48,29
CDM,4504783,ED I&R FB SUBCUTANEOUS,235.0,98.7,63.45,230.3,29
CDM,4504809,ED IMMUNIZATION 1ST VACCINE,131.0,55.02,35.37,128.38,37
CDM,4504817,ED IMMUNIZATION ADDL VACCINE,59.0,24.78,15.93,57.82,30
CDM,4504833,ED INJ SUBQ/IM,228.0,95.76,61.56,223.44,36
CDM,4504841,ED INJ SHTH TNDN SGL/LIG/AP,470.0,197.4,126.9,460.6,29
CDM,4504858,ED INJ TRIGGER PT/S MUSCLE,599.0,251.58,161.73,587.02,29
CDM,4504866,ED PROCEDURE IRRG BLADDER,374.0,157.08,100.98,370.13,36
CDM,4504890,ED LARYNGOSCOPY,306.0,128.52,82.62,299.88,29
CDM,4504908,ED VISIT LEVEL 1,670.0,281.4,86.15,656.6,36
CDM,4504916,ED VISIT LEVEL 2,1185.0,497.7,156.87,1161.3,36
CDM,4504924,ED VISIT LEVEL 3,1705.0,716.1,278.89,1670.9,36
CDM,4504932,ED VISIT LEVEL 4,2490.0,1045.8,426.3,2440.2,36
CDM,4504940,ED VISIT LEVEL 5,3511.0,1474.62,608.43,3440.78,36
CDM,4504965,ED PUNCT LUMBAR,1728.0,725.76,466.56,1693.44,29
CDM,4504973,ED MONITOR PRESS SYND COMPART MUSC,979.0,411.18,264.33,1049.03,36
CDM,4504981,ED PROCEDURE NAIL,362.0,152.04,97.74,354.76,29
CDM,4504999,ED PLC NEEDLE INF INTRAOSSEOUS,806.0,338.52,217.62,789.88,36
CDM,4505038,ED LAVAGE PERITONEAL/PARACENTESIS,1846.0,775.32,498.42,1809.08,29
CDM,4505046,ED PLC CATHETER CENTRAL VENOUS,4040.0,1696.8,1090.8,3959.2,29
CDM,4505053,ED REDUCTION FX/DISLOCATION OTHER,994.0,417.48,268.38,974.12,29
CDM,4505061,ED REDUCTION FX/DISLOCATION DIGIT,457.0,191.94,123.39,447.86,29
CDM,4505087,ED REM/BIVALVE CAST,429.0,180.18,115.83,420.42,29
CDM,4505095,ED REM IUD,496.0,208.32,133.92,486.08,36
CDM,4505103,ED REM FB NASAL,352.0,147.84,95.04,344.96,29
CDM,4505129,ED REM FB EYE EMBEDDED,683.0,286.86,184.41,669.34,29
CDM,4505137,ED REM FB EYE RUSTRING (METAL),354.0,148.68,95.58,346.92,29
CDM,4505145,ED REM FB EYE SUPERFICIAL,420.0,176.4,113.4,411.6,29
CDM,4505152,ED REM FB PHARYNX,683.0,286.86,184.41,669.34,29
CDM,4505194,ED SPLINT/STRAP EXTREMITY LOWER,218.0,91.56,58.86,213.64,29
CDM,4505202,ED SPLINT/STRAP EXTREMITY UPPER,344.0,144.48,92.88,337.12,29
CDM,4505210,ED PACING TRANSCUTANEOUS TEMP,1013.0,425.46,273.51,992.74,36
CDM,4505228,ED THORACENT/TUBE CHEST/DRN PLEURAL,2004.0,841.68,541.08,1963.92,29
CDM,4505236,ED THORACOTOMY MASSAGE CARDIAC,1873.0,786.66,505.71,1835.54,29
CDM,4505244,ED TRACH/CRICOTHYROID,890.0,373.8,240.3,872.2,29
CDM,4505269,ED TRAUMA ACT LVL2 FULL/RED WO CC,9505.0,3992.1,2566.35,9314.9,30
CDM,4505301,ED TRAUMA ACT LVL2 LTD/YELLOW WO CC,6320.0,2654.4,1706.4,6193.6,30
CDM,4505335,ED TREATMENT INCOMPLETE ABORTION,4805.0,2018.1,1297.35,4708.9,29
CDM,4505343,ED VENIPUNCTURE CUTDOWN,856.0,359.52,231.12,838.88,29
CDM,4505350,ED CLOSURE WOUND W TISSUE ADHESIVE,453.0,190.26,122.31,443.94,29
CDM,4505368,ED RPR WOUND LVL 03 COMPLEX,849.0,356.58,229.23,832.02,29
CDM,4505392,ED EKG TRACING ROUTINE 12+ LEADS,474.0,199.08,60.27,464.52,37
CDM,4505400,ED EKG TRACING RHYTHM 1-3 LEADS,108.0,45.36,29.16,105.84,37
CDM,4505491,ED INS CATH BLADDER INDWL SMPL,204.0,85.68,55.08,199.92,36
CDM,4505590,ED INF IV HYDRATION 31-60MIN,675.0,283.5,182.25,661.5,36
CDM,4505608,ED INF IV HYDRATION ADDL HR,237.0,99.54,47.84,232.26,36
CDM,4505616,ED INF IV THRPY 1ST HR,640.0,268.8,172.8,627.2,36
CDM,4505624,ED INF IV THRPY ADDL HR,234.0,98.28,47.84,229.32,36
CDM,4505640,ED INF IV THRPY CONCURRENT,426.0,178.92,115.02,417.48,29
CDM,4505657,ED INJ IVP DRUG INITIAL,378.0,158.76,102.06,370.44,36
CDM,4505665,ED INJ IVP SEQ DRUG ADDL NEW,236.0,99.12,47.84,231.28,36
CDM,4505681,ED CHEMO SUBQ/IM NONHORMONAL,560.0,235.2,73.56,548.8,37
CDM,4505871,ED INJ IVP SEQ DRUG ADDL SAME,192.0,80.64,51.84,188.16,29
CDM,4505889,ED CHG TUBE GASTRO WO GD IMG/ENDO,879.0,369.18,237.33,861.42,29
CDM,4505913,ED PROCEDURE IRRG NOT BLADDER,618.0,259.56,166.86,605.64,29
CDM,4505954,ED INJ/S ANES NRV BLOCK OTHER,1400.0,588.0,378.0,1372.0,29
CDM,4506135,ED PROCEDURE UNLIST LVL 01 SMPL,996.0,418.32,268.92,976.08,29
CDM,4506143,ED PROCEDURE UNLIST LVL 02 INTRM,2082.0,874.44,562.14,2040.36,29
CDM,4506150,ED PROCEDURE UNLIST LVL 03 CMPLX,4162.0,1748.04,1123.74,4078.76,29
CDM,4506168,ED TRANSFUSION BLOOD/COMP 1 UNIT,1419.0,595.98,383.13,1390.62,37
CDM,4506176,ED TRANSFUSION BLOOD/COMP 2 UNITS,1774.0,745.08,450.73,1738.52,37
CDM,4506184,ED TRANSFUSION BLOOD/COMP 3+ UNITS,2129.0,894.18,450.73,2086.42,37
CDM,4506192,ED I&D/ASP PUNCT LVL 01 SIMPLE,428.0,179.76,115.56,419.44,29
CDM,4506200,ED I&D LVL 02 INTRM,592.0,248.64,159.84,580.16,29
CDM,4506218,ED I&D LVL 03 COMPLEX,889.0,373.38,240.03,871.22,29
CDM,4506226,ED REM FB CANL AUD EXT LVL 01 SMPL,320.0,134.4,86.4,313.6,29
CDM,4506234,ED REM FB CANL AUD EXT LVL 02 CMPLX,445.0,186.9,120.15,436.1,29
CDM,4506242,ED REM FB MUSCLE/TNDN LVL 01 SIMPLE,2718.0,1141.56,733.86,2663.64,29
CDM,4506259,ED REM FB MUSCLE/TNDN LVL 02 CMPLX,4350.0,1827.0,1174.5,4263.0,29
CDM,4506267,ED RPR TENDON FOOT LVL 01 SIMPLE,2928.0,1229.76,790.56,2869.44,29
CDM,4506275,ED RPR TENDON FOOT LVL 02 CMPLX,4235.0,1778.7,1143.45,4150.3,29
CDM,4506283,ED RPR TENDON HAND/FNG LVL 01 SMPL,4358.0,1830.36,1176.66,4270.84,29
CDM,4506291,ED RPR TENDON HAND/FNG LVL 02 CMPLX,5919.0,2485.98,1598.13,5800.62,29
CDM,4506317,ED INTUBATION/ASPIRATION GASTRIC,966.0,405.72,260.82,946.68,29
CDM,4506325,ED CATH COLLECT SPEC URINE,37.0,15.54,9.34,36.26,37
CDM,4506333,ED INS CATH BLADDER NONINDWL,262.0,110.04,70.74,256.76,36
CDM,4506341,ED PROCEDURE UNLIST ADD-ON,203.0,85.26,54.81,198.94,29
CDM,4506408,ED INF IV THRPY SEQ DRUG NEW 1ST HR,472.0,198.24,73.56,462.56,36
CDM,4506424,ED TREATMENT BURN LVL 02 MEDIUM,520.0,218.4,140.4,509.6,29
CDM,4506432,ED TREATMENT BURN LVL 03 LARGE,788.0,330.96,212.76,772.24,29
CDM,4506440,ED RPR WOUND LVL 02 INTERMEDIATE,720.0,302.4,194.4,705.6,29
CDM,4506457,ED RPR WOUND LVL 01 SIMPLE,558.0,234.36,150.66,546.84,29
CDM,4506572,ED HEM NASAL CNTRL ANT LVL 02 BI,624.0,262.08,168.48,611.52,29
CDM,4506580,ED HEM NASAL CNTRL POST LVL 02 BI,624.0,262.08,168.48,611.52,29
CDM,4506598,ED HEM NASAL CNTRL ANT LVL 01 UNI,312.0,131.04,84.24,305.76,29
CDM,4506606,ED HEM NASAL CNTRL POST LVL 01 UNI,312.0,131.04,84.24,305.76,29
CDM,4506630,ED TRAUMA ACT LVL2 FULL/RED W CC,12670.0,5321.4,1361.78,12416.6,37
CDM,4506648,ED TRAUMA ACT LVL2 LTD/YELLOW W CC,8425.0,3538.5,1361.78,8256.5,37
CDM,4506697,ED REM CERUMEN IMPACTED W INST UNI,329.0,138.18,88.83,322.42,29
CDM,4506705,ED REM CERUMEN IMPACTED W INST BI,494.0,207.48,133.38,484.12,29
CDM,4506721,ED REM CERUMEN IMPACTED W IRRG UNI,299.0,125.58,80.73,293.02,29
CDM,4506739,ED REM CERUMEN IMPACTED W IRRG BI,449.0,188.58,121.23,440.02,29
CDM,4506804,ED SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4506812,ED SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4506820,ED SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,4506838,ED SED MOD DIFF 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4506846,ED SED MOD DIFF 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4506853,ED SED MOD DIFF ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,4506861,ED SED MOD ENDO SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4506929,ED PERICARDIOCENTESIS INCL IMG GD,4288.0,1800.96,1157.76,4202.24,36
CDM,4506960,ED INJ/S ANES NRV TRIGEMINAL BR BI,1130.0,474.6,305.1,1107.4,29
CDM,4506978,ED INJ/S ANES NRV TRIGEMINAL BR LT,753.0,316.26,203.31,737.94,29
CDM,4506986,ED INJ/S ANES NRV TRIGEMINAL BR RT,753.0,316.26,203.31,737.94,29
CDM,4507026,ED CATH/CANN ART SMP/MNTR/TRNS PERC,898.0,377.16,242.46,880.04,29
CDM,4507034,ED REM SUTURE/STAPLE NO ANESTH,167.0,70.14,45.09,163.66,29
CDM,4507042,ED REM SUTURE&STAPLE NO ANESTH,168.0,70.56,45.36,164.64,29
CDM,4507091,ED INJ/S ANES NRV INTRCST LVL SGLBI,2208.0,927.36,596.16,2163.84,29
CDM,4507109,ED INJ/S ANES NRV INTRCST LVL SGLRT,1472.0,618.24,397.44,1442.56,29
CDM,4507117,ED INJ/S ANES NRV INTRCST LVL SGLLT,1472.0,618.24,397.44,1442.56,29
CDM,4507125,ED INJ/S ANES NRV INTRCST LVL ADDBI,2724.0,1144.08,735.48,2669.52,29
CDM,4507133,ED INJ/S ANES NRV INTRCST LVL ADDRT,1816.0,762.72,490.32,1779.68,29
CDM,4507141,ED INJ/S ANES NRV INTRCST LVL ADDLT,1816.0,762.72,490.32,1779.68,29
CDM,4601407,IMPRV RESP STRENGTH MUSC/S 15MIN,122.0,51.24,29.55,119.56,37
CDM,4601415,IMPRV RESP FNCT/STRENGTH MUSC/S GRP,267.0,112.14,38.16,261.66,37
CDM,4601696,TEST EXERCISE BRONCHOSPASMS W REC,1051.0,441.42,135.93,1029.98,37
CDM,4601704,TEST STRESS PULMONARY,1051.0,441.42,135.93,1029.98,37
CDM,4601712,TEST EXERCISE CARDIOPULMONARY,1495.0,627.9,381.24,1465.1,37
CDM,4601746,TEST STRESS PULMONARY,1051.0,441.42,135.93,1029.98,37
CDM,4601753,REHAB PULM OP WO CONT OX SESSN,195.0,81.9,52.65,191.1,37
CDM,4601761,REHAB PULM OP W CONT OX SESSN,251.0,105.42,60.27,245.98,37
CDM,4601779,REHAB PULM OP WO CONT OX 36+ SESSN,195.0,81.9,52.65,191.1,30
CDM,4601787,REHAB PULM OP W CONT OX 36+ SESSN,251.0,105.42,67.77,245.98,30
CDM,4800322,TX DEHISCENCE WOUND CLSR SMPL,1133.0,475.86,305.91,1110.34,36
CDM,4800702,EVAL DEV PROG ICD TV SGL IN PERSON,238.0,99.96,38.13,233.24,37
CDM,4800728,EVAL DEV PROG ICD TV DUAL IN PERSON,278.0,116.76,38.13,272.44,37
CDM,4800744,EVAL DEV PROG ICD TV MULT IN PERSON,300.0,126.0,38.13,294.0,37
CDM,4800769,EVAL DEV PERIPRO PROG ICD IN PERSON,209.0,87.78,56.43,204.82,30
CDM,4800801,EVAL EP ICD TV CHAMBER SGL/DUAL,5624.0,2362.08,1243.91,5511.52,37
CDM,4800827,INS/RPL DEFIB SUBQ PERM W ELCTRD,51894.0,21795.48,14011.38,91723.0,37
CDM,4800835,INS DEFIB SUBQ ELCTRD,12702.0,5334.84,3429.54,91723.0,37
CDM,4800843,REM DEFIB SUBQ ELCTRD,6398.0,2687.16,1727.46,91723.0,37
CDM,4800850,REPOS DEFIB SUBQ PREV ELCTRD,6398.0,2687.16,1727.46,14009.0,37
CDM,4800868,EVAL DEV PROG DEV SUBQ IN PERSON,135.0,56.7,36.45,132.3,37
CDM,4800876,EVAL DEV INTRGTN DEV SUBQ IN PERSON,135.0,56.7,36.45,132.3,37
CDM,4800884,EVAL EP DEFIBRILLATOR SUBQ,127.0,53.34,34.29,124.46,30
CDM,4801015,REM DEV IAB PERC,104.0,43.68,28.08,32969.0,30
CDM,4801064,PLC CATH SEL VENOUS BRANCH 1ST ORD,1806.0,758.52,487.62,1769.88,29
CDM,4801098,CATH VENOUS SAMPLE BLOOD ORGAN,880.0,369.6,237.6,862.4,29
CDM,4801106,THROMBOLYSIS CEREBRAL INF IV,823.0,345.66,222.21,806.54,36
CDM,4801114,BX TRANSCATHETER,7097.0,2980.74,1916.19,25370.0,37
CDM,4801122,BX TRANSCATHETER S&I,3304.0,1387.68,892.08,3237.92,30
CDM,4801189,ANGIO ILIAC/FEMORAL DURING HRT CATH,3363.0,1412.46,908.01,3295.74,29
CDM,4801205,RECORDING BUNDLE OF HIS,6881.0,2890.02,1857.87,11554.47,37
CDM,4801213,EVAL EP COMP PACING&REC ATRIAL LT,14442.0,6065.64,3899.34,14153.16,30
CDM,4801221,EVAL EP COMP PACING&REC VENT LT,21229.0,8916.18,5731.83,20804.42,30
CDM,4801239,EVAL EP LEADS W TEST ICD INITIAL,4162.0,1748.04,1123.74,4078.76,30
CDM,4801254,STUDY EP FLWUP PACING&REC,6881.0,2890.02,1857.87,11554.47,37
CDM,4801270,RECORDING INTRA-ATRIAL,6881.0,2890.02,1857.87,11554.47,37
CDM,4801288,MAP 3D EP INTRACARDIAC,12656.0,5315.52,3417.12,12402.88,30
CDM,4801296,PACING INTRAVENTRICULAR,6007.0,2522.94,1621.89,11554.47,37
CDM,4801304,STIMULATION&PACING INF IV DRUG,7297.0,3064.74,1970.19,7151.06,30
CDM,4801312,MAP TACHYCARDIA INTRAVENT&/ATRIAL,5305.0,2228.1,1432.35,5198.9,30
CDM,4801320,RECORDING VENTRICULAR RT,2636.0,1107.12,711.72,2583.28,37
CDM,4801338,ABL CATH IC NODE A/V W/WO PM TEMP,16948.0,7118.16,4575.96,16609.04,37
CDM,4801445,INS ELCTRD LV PREVIOUS PM/ICD,23971.0,10067.82,6472.17,29702.0,37
CDM,4801452,INS ELCTRD LV PM/ICD ADD ON,23927.0,10049.34,6460.29,29702.0,30
CDM,4801460,INS ELCTRD PM/ICD TRANSVENOUS DUAL,7462.0,3134.04,2014.74,25370.0,37
CDM,4801478,INS ELCTRD PM/ICD TRANSVENOUS SGL,6401.0,2688.42,1728.27,25370.0,37
CDM,4801528,INS/RPLC ELCTRD/CATH PM TEMP SGL,8765.0,3681.3,2366.55,25370.0,37
CDM,4801536,INS DEV IAB PERC,7743.0,3252.06,2090.61,32969.0,30
CDM,4801551,VEL&/FLW DOPP INTRAV VSL ADDL,2155.0,905.1,581.85,2111.9,29
CDM,4801569,VEL&/FLW DOPP INTRAV VSL INIT,4667.0,1960.14,1260.09,4573.66,29
CDM,4801577,INTRO CATH SVC/IVC,2425.0,1018.5,654.75,2376.5,29
CDM,4801593,INTRO NDL/CATH ARTERY EXTREMITY LT,1206.0,506.52,325.62,1181.88,29
CDM,4801627,PLC DEV/S OCCLUSIVE,936.0,393.12,252.72,917.28,29
CDM,4801668,REM ELCTRD ICD SGL/DUAL EXTRACT TV,14571.0,6119.82,3817.9,14279.58,37
CDM,4801692,REPOSITION ELCTRD LV PREVIOUS,5204.0,2185.68,1405.08,14009.0,37
CDM,4801700,REPOSITION ELCTRD PM/ICD PREV A/V,7745.0,3252.9,2091.15,14009.0,37
CDM,4801742,PLC CATH SEL ART ABD/EXT 1ST ORD,2768.0,1162.56,747.36,2712.64,29
CDM,4801759,PLC CATH SEL ART ABD/EXT 2ND ORD,2815.0,1182.3,760.05,2758.7,29
CDM,4801767,PLC CATH SEL ART ABD/EXT 3RD ORD,3178.0,1334.76,858.06,3114.44,29
CDM,4801775,PLC CATH SEL ART ABD/EXT ADDL,1953.0,820.26,527.31,1913.94,29
CDM,4801783,PLC CATH SEL ART THOR/BRACH 1ST ORD,1884.0,791.28,508.68,1846.32,29
CDM,4801791,PLC CATH SEL ART THOR/BRACH 2ND ORD,1885.0,791.7,508.95,1847.3,29
CDM,4801809,PLC CATH SEL ART THOR/BRACH 3RD ORD,2750.0,1155.0,742.5,2695.0,29
CDM,4801817,PLC CATH SEL ART THOR/BRACH ADDL,364.0,152.88,98.28,356.72,29
CDM,4801866,UPGRADE SYS PM IMP SGL TO DUAL,18451.0,7749.42,4981.77,29702.0,37
CDM,4801940,ANGIO EXTREMITY BI S&I,6723.0,2823.66,1815.21,6588.54,37
CDM,4801965,ANGIO PULMONARY SEL BI S&I,10489.0,4405.38,2832.03,10279.22,37
CDM,4802013,ANGIO VISCERAL SEL S&I,9235.0,3878.7,2493.45,9050.3,37
CDM,4802021,AORTO ABD SERIAL S&I,6178.0,2594.76,1668.06,6054.44,37
CDM,4802039,AORTO ABD ILIOFEM BI SERIAL S&I,7198.0,3023.16,1943.46,7054.04,37
CDM,4802047,AORTO THORACIC SERIAL S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,4802112,CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,37
CDM,4802385,VENOGRAM EXTREMITY BI S&I,3721.0,1562.82,1004.67,3646.58,37
CDM,4802401,VENOGRAM IVC SERIAL S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,4802419,VENOGRAM SVC SERIAL S&I,2362.0,992.04,637.74,2331.96,37
CDM,4802427,EVAL EP COMP W ARRHYTHMIA,51816.0,21762.72,7968.6,50779.68,37
CDM,4802435,EVAL EP COMP WO ARRHYTHMIA,16063.0,6746.46,4337.01,15741.74,37
CDM,4802450,PACING INTRA-ATRIAL,6881.0,2890.02,1857.87,11554.47,37
CDM,4802526,ANGIO MAMMARY INTERNAL S&I,4040.0,1696.8,1090.8,4677.51,37
CDM,4802575,VALVULOPLASTY BLN PULMONARY PERC,11118.0,4669.56,3001.86,25370.0,37
CDM,4802591,PTA BLN ART PULMONARY VSL SGL,11118.0,4669.56,3001.86,17101.63,37
CDM,4802609,PTA BLN ART PULMONARY VSL ADDL,5389.0,2263.38,1455.03,5281.22,30
CDM,4802807,ECHO ICRD INTRV THER/DX,10209.0,4287.78,2756.43,10004.82,30
CDM,4802971,ANGIO SEL VESSEL ADDL S&I,3737.0,1569.54,1008.99,3662.26,30
CDM,4802997,BX ENDOMYOCARDIAL,6032.0,2533.44,1628.64,14009.0,37
CDM,4803003,EVAL EP LEADS ICD INITIAL,3342.0,1403.64,902.34,3275.16,30
CDM,4803029,INDUCTION ARRTHYMIA BY PACING,1809.0,759.78,488.43,1803.67,37
CDM,4803037,INS&PLC CATH DIRECTED FLOW,2463.0,1034.46,665.01,3186.0,37
CDM,4803094,CLOSE TRANSCATH PFO/ASD CONG W IMP,36422.0,15297.24,9833.94,35693.56,37
CDM,4803144,FLUORO 0-1HR TIME PHYS/QHCP,1055.0,443.1,243.77,1033.9,37
CDM,4803177,I&D HEMATOMA/SEROMA/FLUID,3176.0,1333.92,857.52,5367.0,37
CDM,4803227,THERAPY TRANSCATH EMB S&I,1776.0,745.92,479.52,1740.48,30
CDM,4803235,CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,37
CDM,4803243,ECHO 2D CMP WO CNT,822.0,345.24,221.94,805.56,37
CDM,4803250,ECHO 2D LTD WO CNT,893.0,375.06,241.11,875.14,37
CDM,4803268,ECHO DOPP MAP VELOCITY COLOR FLOW,852.0,357.84,230.04,834.96,30
CDM,4803276,ECHO CONG ANM CMP WO CNT,1823.0,765.66,492.21,1786.54,37
CDM,4803284,ECHO CONG ANM LTD WO CNT,838.0,351.96,226.26,821.24,37
CDM,4803292,ECHO DOPP CMP,684.0,287.28,184.68,670.32,30
CDM,4803300,ECHO DOPP LTD,608.0,255.36,164.16,595.84,30
CDM,4803318,ECHO 2D REST&STRESS WO CNT W I&R,2200.0,924.0,558.25,2156.0,37
CDM,4803326,ECHO 2D TEE CMP WO CNT W I&R,1630.0,684.6,440.1,1597.4,37
CDM,4803359,TEST CV STRESS TREAD/BIKE&/RX TRACE,1396.0,586.32,220.6,1368.08,37
CDM,4803474,REM ELCTRD PM LEAD A/V DUAL,9926.0,4168.92,2680.02,14009.0,37
CDM,4803482,REM ELCTRD PM LEAD A/V SGL,8632.0,3625.44,2330.64,14009.0,37
CDM,4803490,VALVULOPLASTY BLN MITRAL PERC,11788.0,4950.96,3182.76,25370.0,37
CDM,4803508,CPR,1485.0,623.7,220.6,1455.3,37
CDM,4803516,INTRO CATH AORTA,1878.0,788.76,507.06,1840.44,29
CDM,4803524,VALVULOPLASTY BLN AORTA PERC,11463.0,4814.46,3095.01,25370.0,37
CDM,4803797,INJ VENOGRAPHY EXTREMITY BI,1197.0,502.74,323.19,1173.06,29
CDM,4804142,INJ VENOGRAPHY EXTREMITY LT,798.0,335.16,215.46,782.04,29
CDM,4804159,INJ VENOGRAPHY EXTREMITY RT,798.0,335.16,215.46,782.04,29
CDM,4804167,VENOGRAM RENAL SEL LT S&I,6971.0,2927.82,1882.17,6831.58,30
CDM,4804175,VENOGRAM RENAL SEL RT S&I,6971.0,2927.82,1882.17,6831.58,30
CDM,4804209,VENOGRAM EXTREMITY LT S&I,2925.0,1228.5,789.75,2866.5,30
CDM,4804217,VENOGRAM EXTREMITY RT S&I,2925.0,1228.5,789.75,2866.5,30
CDM,4804266,ANGIO PULMONARY SEL LT S&I,5213.0,2189.46,1407.51,5108.74,30
CDM,4804274,ANGIO PULMONARY SEL RT S&I,5213.0,2189.46,1407.51,5108.74,30
CDM,4804282,ANGIO EXTREMITY LT S&I,6382.0,2680.44,1723.14,6254.36,30
CDM,4804290,ANGIO EXTREMITY RT S&I,6382.0,2680.44,1723.14,6254.36,30
CDM,4804522,INTRO NDL/CATH ARTERY EXTREMITY RT,1206.0,506.52,325.62,1181.88,29
CDM,4804589,CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,37
CDM,4804621,INS CVC CENTRAL NONTUN 5+YRS,4040.0,1696.8,1090.8,4677.51,37
CDM,4804811,INS CVC CENTRAL TUN WO P/P 5+YRS,4040.0,1696.8,1090.8,14009.0,37
CDM,4804837,PLC CATH SEL ART PULM BI,587.0,246.54,158.49,575.26,29
CDM,4804845,PLC CATH SEL ART PULM LT,391.0,164.22,105.57,383.18,29
CDM,4804852,PLC CATH SEL ART PULM RT,391.0,164.22,105.57,383.18,29
CDM,4804860,THROMBECT MECH SEC ART W FL,9113.0,3827.46,2460.51,8930.74,29
CDM,4805503,CATH/CANN ART SMP/MNTR/TRNS PERC,898.0,377.16,242.46,880.04,29
CDM,4805545,THROMBECT MECH PRIM ART SUBSQ W FL,4736.0,1989.12,1278.72,4641.28,29
CDM,4805784,EVAL FNCT CARDIO W TILT TABLE/EKG,1627.0,683.34,381.24,1594.46,37
CDM,4805792,CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,37
CDM,4805800,THROMBECT MECH VEIN W FL,11118.0,4669.56,3001.86,25370.0,37
CDM,4805818,THROMBECT MECH VEIN SUBSQ W FL,6777.0,2846.34,1829.79,14009.0,37
CDM,4806014,US GD PLCMT NEEDLE S&I,1641.0,689.22,443.07,1608.18,30
CDM,4807640,ECHO 2D DOPP&CLR FLW CMP WO CNT,2676.0,1123.92,558.25,2622.48,37
CDM,4807673,ECHO 2D DOPP&CLR FLW CMP W CNT,3345.0,1404.9,800.9,3278.1,37
CDM,4809042,SAMPLE VENOUS CATH W/WO ANG S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,4809174,CARDIOVERSION ICD INTERNAL,1192.0,500.64,131.46,1168.16,37
CDM,4809315,PLC STNT/S ART INM/INTRATH CAR S&I,9327.0,3917.34,2518.29,9140.46,30
CDM,4809711,RPR ENDOVAS AORTA THOR WO LSA,20206.0,8486.52,3101.0,19801.88,30
CDM,4809836,VELOCITY/FLW DOPP STAND ALONE,3681.0,1546.02,131.46,3607.38,37
CDM,4811204,US INTRAVASCULAR NONCORNRY INIT S&I,6493.0,2727.06,1753.11,6363.14,29
CDM,4811212,US INTRAVASCULAR NONCORNRY ADDL S&I,1957.0,821.94,528.39,1917.86,29
CDM,4811642,INS CRM SUBQ W PROGRAMMING,7740.0,3250.8,2089.8,26759.0,37
CDM,4811667,INS VAD LH ACC ART ONLY PERC S&I,7592.0,3188.64,2049.84,7440.16,30
CDM,4811683,REM VAD LH PERC ART/ART&VEN SEP,2653.0,1114.26,716.31,3101.0,30
CDM,4811691,REM VAD RH PERC ART/ART&VEN SEP,2653.0,1114.26,716.31,3101.0,30
CDM,4811717,INS VAD RH ACC ART ONLY PERC S&I,5527.0,2321.34,1492.29,5416.46,30
CDM,4812350,ATHERECT PERIPH TR&BR BRACH W S&I,11118.0,4669.56,3001.86,26759.0,37
CDM,4812368,ATHERECT PERIPH ART ILIAC W S&I,13309.0,5589.78,3593.43,27156.6,37
CDM,4812400,ADMIN DRUG&MEAS HEMODYNAMIC,4481.0,1882.02,1209.87,4391.38,29
CDM,4812988,RHC O2 SAT&CARDIAC OUTPUT,12342.0,5183.64,3312.15,17965.0,37
CDM,4812996,LHC W INJ/S VENTRCLGRPHY LT S&I,11291.0,4742.22,3048.57,17965.0,37
CDM,4813002,RHC&LHC W INJ/S VENTRCLGRPHY LT S&I,13524.0,5680.08,3312.15,17965.0,37
CDM,4813010,PLC CATH&INJ/S CAG S&I,19602.0,8232.84,3312.15,19209.96,37
CDM,4813028,PLC CATH&INJ/S CAG&GRF S&I,21511.0,9034.62,3312.15,21080.78,37
CDM,4813036,PLC CATH&INJ/S CAG W RHC S&I,24040.0,10096.8,3312.15,23559.2,37
CDM,4813044,PLC CATH&INJ/S CAG&GRF W RHC S&I,25919.0,10885.98,3312.15,25400.62,37
CDM,4813051,PLC CATH&INJ/S CAG&LV W LHC S&I,21978.0,9230.76,3312.15,21538.44,37
CDM,4813069,PLC CATH CAG&GRF&LV W LHC S&I,23157.0,9725.94,3312.15,22693.86,37
CDM,4813077,PLC CATH CAG&LV W RHC&LHC S&I,25604.0,10753.68,3312.15,25091.92,37
CDM,4813085,PLC CATH CAG&GRF&LV W RHC&LHC S&I,28194.0,11841.48,3312.15,27630.12,37
CDM,4813093,LHC PUNCT TRANSSEPTAL/TRANSAPICAL,9654.0,4054.68,2606.58,9460.92,29
CDM,4813135,INJ ANGIO RV/RA HRT CATH S&I,698.0,293.16,188.46,684.04,29
CDM,4813143,INJ AORTO SUPRVLV HRT CATH S&I,1647.0,691.74,444.69,1614.06,29
CDM,4813481,US GD VA EVAL SITE W REC PERM,349.0,146.58,94.23,342.02,30
CDM,4813697,INS NEW/RPLC PPM W ELCTRD ATRIAL,13340.0,5602.8,3601.8,26759.0,37
CDM,4813713,INS NEW/RPLC PPM W ELCTRD VENT,14033.0,5893.86,3788.91,26759.0,37
CDM,4813739,INS NEW/RPLC PPM W ELCTRD A&V,20456.0,8591.52,5523.12,29702.0,37
CDM,4813754,INS GEN PPM ONLY W LD EXIST SGL,10538.0,4425.96,2845.26,26759.0,37
CDM,4813770,INS GEN PPM ONLY W LD EXIST DUAL,11786.0,4950.12,3182.22,26759.0,37
CDM,4813796,RPR ELCTRD PM/ICD TRANSVENOUS SGL,7274.0,3055.08,1963.98,14009.0,37
CDM,4813838,INS GEN PPM ONLY W LD EXIST MULTI,20938.0,8793.96,5653.26,28534.39,37
CDM,4813853,REM&RPL GEN PPM SGL,14251.0,5985.42,3847.77,26759.0,37
CDM,4813879,REM&RPL GEN PPM DUAL,14882.0,6250.44,4018.14,26759.0,37
CDM,4813895,REM&RPL GEN PPM MULTI,27207.0,11426.94,7345.89,28534.39,37
CDM,4813911,INS GEN ICD ONLY W LD EXIST DUAL,57152.0,24003.84,15431.04,91723.0,37
CDM,4813929,INS GEN ICD ONLY W LD EXIST MULTI,42733.0,17947.86,11537.91,91723.0,37
CDM,4813937,REM GENERATOR PPM ONLY,4253.0,1786.26,1148.31,14009.0,37
CDM,4813960,INS GEN ICD ONLY W LD EXIST SGL,29915.0,12564.3,8077.05,91723.0,37
CDM,4813978,REM GEN ICD ONLY,5555.0,2333.1,1499.85,14009.0,37
CDM,4814000,INS/RPL ICD W LEAD SGL/DUAL,90195.0,37881.9,24352.65,91723.0,37
CDM,4814018,REM&RPL GEN ICD SGL,36864.0,15482.88,9953.28,91723.0,37
CDM,4814026,REM&RPL GEN ICD DUAL,51840.0,21772.8,13996.8,91723.0,37
CDM,4814034,REM&RPL GEN ICD MULTI,54013.0,22685.46,14583.51,91723.0,37
CDM,4814042,PLC CATH SEL 1ST ART RENAL UNI S&I,6273.0,2634.66,1693.71,14009.0,37
CDM,4814067,PLC CATH SEL 1ST ART RENAL BI S&I,7705.0,3236.1,2080.35,14009.0,37
CDM,4814083,PLC CATH SEL 2ND+ ART RENAL UNI S&I,11041.0,4637.22,2981.07,25370.0,37
CDM,4814109,PLC CATH SEL 2ND+ ART RENAL BI S&I,11777.0,4946.34,3179.79,14009.0,37
CDM,4814125,INS FILTER VENA CAVA ENDV S&I,9168.0,3850.56,2475.36,25370.0,37
CDM,4814166,REM FILTER VENA CAVA ENDV S&I,5136.0,2157.12,1386.72,14009.0,37
CDM,4814372,STUDY EXERCISE&MEAS HEMODYNAMIC,1210.0,508.2,326.7,1185.8,29
CDM,4814778,THORACENTESIS ASP W IMG LT,1726.0,724.92,466.02,3186.0,30
CDM,4814786,THORACENTESIS ASP W IMG RT,1726.0,724.92,466.02,3186.0,30
CDM,4814794,THORACENTESIS ASP W IMG BI,2589.0,1087.38,699.03,3186.0,30
CDM,4814877,EVAL EP&ABL ARRHYTHMIA SV,44753.0,18796.26,12083.31,43857.94,37
CDM,4814885,EVAL EP&ABL ARRHYTHMIA VT,36176.0,15193.92,9767.52,38720.79,37
CDM,4814893,ABL ARRHYTHMIA ADDL,11718.0,4921.56,3163.86,11483.64,30
CDM,4814919,ABL FIB ATRIAL ADDL,11555.0,4853.1,3119.85,11323.9,30
CDM,4814927,TAVR/TAVI VIA ARTERY FEMORAL PERC,8332.0,3499.44,2249.64,8165.36,30
CDM,4814968,REPOS VAD PERC W IMG SESSN DIFF,1228.0,515.76,331.56,3101.0,30
CDM,4814976,REM FB INTRAVASC W IMG S&I,8624.0,3622.08,2328.48,14009.0,37
CDM,4814984,THROMBOLYSIS INF ART INIT DAY S&I,10375.0,4357.5,2801.25,25370.0,37
CDM,4814992,THROMBOLYSIS INF VEN INIT S&I,9087.0,3816.54,2453.49,14009.0,37
CDM,4815007,THROMBOLYSIS INF ART/VEN SUBSQ S&I,8633.0,3625.86,2330.91,8460.34,37
CDM,4815015,CESSAT THROMBOLYSIS&REM CATH S&I,9863.0,4142.46,2663.01,9665.74,37
CDM,4815023,PLC CATH AORTA THOR ANG EC&/IC S&I,8780.0,3687.6,2370.6,14009.0,37
CDM,4815031,TAVR/TAVI VIA ARTERY FEMORAL OPEN,8951.0,3759.42,2416.77,8771.98,30
CDM,4815049,TAVR/TAVI VIA ARTERY AXILLA OPEN,9276.0,3895.92,2504.52,9090.48,30
CDM,4815056,PLC CATH SEL CAR/INM ANG EC LT S&I,10163.0,4268.46,2744.01,14009.0,30
CDM,4815064,PLC CATH SEL CAR/INM ANG EC RT S&I,10163.0,4268.46,2744.01,14009.0,30
CDM,4815072,PLC CATH SEL CAR/INM ANG EC BI S&I,15245.0,6402.9,4116.15,14940.1,30
CDM,4815080,PLC CATH SEL CAR/INM ANG IC LT S&I,13057.0,5483.94,3525.39,25370.0,30
CDM,4815098,PLC CATH SEL CAR/INM ANG IC RT S&I,13057.0,5483.94,3525.39,25370.0,30
CDM,4815106,PLC CATH SEL CAR/INM ANG IC BI S&I,19586.0,8226.12,5288.22,25370.0,30
CDM,4815114,PLC CATH SEL ART CAR ANG IC LT S&I,15124.0,6352.08,4083.48,25370.0,30
CDM,4815122,PLC CATH SEL ART CAR ANG IC RT S&I,15124.0,6352.08,4083.48,25370.0,30
CDM,4815130,PLC CATH SEL ART CAR ANG IC BI S&I,22686.0,9528.12,6125.22,25370.0,30
CDM,4815148,PLC CATH SEL ART SUB/INM ANG LT S&I,10712.0,4499.04,2892.24,14009.0,30
CDM,4815155,PLC CATH SEL ART SUB/INM ANG RT S&I,10712.0,4499.04,2892.24,14009.0,30
CDM,4815163,PLC CATH SEL ART SUB/INM ANG BI S&I,16068.0,6748.56,4338.36,15746.64,30
CDM,4815171,PLC CATH SEL ART VERT ANG LT S&I,14859.0,6240.78,4011.93,25370.0,30
CDM,4815189,PLC CATH SEL ART VERT ANG RT S&I,14859.0,6240.78,4011.93,25370.0,30
CDM,4815197,PLC CATH SEL ART VERT ANG BI S&I,22289.0,9361.38,6018.03,25370.0,30
CDM,4815205,PLC CATH SEL ART CAR EXT ANG LT S&I,6628.0,2783.76,1789.56,6495.44,29
CDM,4815213,PLC CATH SEL ART CAR EXT ANG RT S&I,6628.0,2783.76,1789.56,6495.44,29
CDM,4815221,PLC CATH SEL ART CAR EXT ANG BI S&I,9942.0,4175.64,2684.34,9743.16,29
CDM,4815239,PLC CATH SEL BR INTRACRN ANG LT S&I,1847.0,775.74,498.69,1810.06,29
CDM,4815247,PLC CATH SEL BR INTRACRN ANG RT S&I,1847.0,775.74,498.69,1810.06,29
CDM,4815254,PLC CATH SEL BR INTRACRN ANG BI S&I,2771.0,1163.82,748.17,2715.58,29
CDM,4815262,PTCA ART COR MAJ SGL&/BR,15180.0,6375.6,4098.6,25370.0,37
CDM,4815288,ATHER W ANGIO COR ART MAJ SGL&/BR,18500.0,7770.0,4995.0,26759.0,37
CDM,4815320,ATHER W STENT ANGIO ART MAJ SGL&/BR,21819.0,9163.98,5891.13,27156.6,37
CDM,4815452,PLC STENT/S DE SGL COR ART/BR SGL,19708.0,8277.36,5321.16,26759.0,37
CDM,4815460,PLC STENT/S DE COR ART/BR ADDL,14783.0,6208.86,3991.41,14487.34,29
CDM,4815478,ATHERECT&STENT/PTCA DE ART COR SGL,27274.0,11455.08,7363.98,27156.6,37
CDM,4815486,ATHERECT&STENT/PTCA DE ART COR ADD,20457.0,8591.94,5523.39,20047.86,29
CDM,4815494,REVASC DE GRFT BYPASS COR VSL SGL,15160.0,6367.2,4093.2,26759.0,37
CDM,4815502,REVASC DE GRFT BYPASS COR VSL ADDL,11371.0,4775.82,3070.17,11143.58,29
CDM,4815510,REVASC DE OCC MI ACUTE COR VSL SGL,29872.0,12546.24,3101.0,29274.56,30
CDM,4815528,REVASC DE OCC CHRONIC COR VSL SGL,32123.0,13491.66,8673.21,31480.54,37
CDM,4815536,REVASC DE OCC CHRONIC COR VSL ADDL,24093.0,10119.06,6505.11,23611.14,29
CDM,4815635,TAVR/TAVI VIA ARTERY ILIAC OPEN,8593.0,3609.06,2320.11,8421.14,30
CDM,4815643,TAVR/TAVI VIA TRANSAORTIC,10253.0,4306.26,2768.31,10047.94,30
CDM,4815676,THORACOSTOMY TUBE OPEN BI,3006.0,1262.52,811.62,3186.0,30
CDM,4815684,THORACOSTOMY TUBE OPEN LT,2004.0,841.68,541.08,3186.0,30
CDM,4815692,THORACOSTOMY TUBE OPEN RT,2004.0,841.68,541.08,3186.0,30
CDM,4815809,RELOCATION POCKET SKIN PM,3320.0,1394.4,896.4,5367.0,37
CDM,4815825,RELOCATION POCKET SKIN ICD,6583.0,2764.86,1777.41,6451.34,37
CDM,4815841,PLC STNT/S ART OPEN/PERC INIT S&I,15917.0,6685.14,4297.59,26759.0,37
CDM,4815858,PLC STNT/S ART OPEN/PERC ADDL S&I,6947.0,2917.74,1875.69,25370.0,30
CDM,4815866,PLC STNT/S VEIN OPEN/PERC INIT S&I,19417.0,8155.14,5242.59,26759.0,37
CDM,4815874,PLC STNT/S VEIN OPEN/PERC ADDL S&I,7307.0,3068.94,1972.89,25370.0,30
CDM,4815890,EMB/OCCL VASC ARTERIAL S&I,19798.0,8315.16,5345.46,27156.6,37
CDM,4815940,THERAPY RDC SEPTAL TRANSCATH PERC,8277.0,3476.34,2234.79,8111.46,30
CDM,4816179,INSR/RPLC SYS CCM GEN PULS&ELCRD TV,14691.0,6170.22,3966.57,46499.66,37
CDM,4816211,TAVR/TAVI VIA TRANSAPICAL,10578.0,4442.76,2856.06,10366.44,30
CDM,4816518,CLOSE LAA PERC W IMP ENDOCARD,7001.0,2940.42,1890.27,17965.0,30
CDM,4816617,TBA OPN/PRC ART INT BI S&I,16851.0,7077.42,4549.77,25370.0,30
CDM,4816641,TBA OPN/PRC ART ADL BI S&I,13410.0,5632.2,3620.7,13141.8,29
CDM,4816757,TBA OPN/PRC VEIN INT BI S&I,25925.0,10888.5,6999.75,25406.5,30
CDM,4816765,TBA OPN/PRC VEIN ADL BI S&I,17210.0,7228.2,4646.7,16865.8,29
CDM,4816773,IMG ENDOLMNL IVUS/OCT COR VSL INIT,7899.0,3317.58,2132.73,7741.02,29
CDM,4816781,IMG ENDOLMNL IVUS/OCT COR VSL ADDL,2596.0,1090.32,700.92,2544.08,29
CDM,4816799,SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4816807,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4816815,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,4817086,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4817094,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,4817110,SED MOD DIFF 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CDM,4817128,SED MOD DIFF ADDL 15MN,205.0,86.1,55.35,200.9,30
CDM,4817250,TBA OPN/PRC ART INT NONPAIR/UNI S&I,11234.0,4718.28,3033.18,25370.0,37
CDM,4817383,TBA OPN/PRC ART ADL NONPAIR/UNI S&I,8940.0,3754.8,2413.8,8761.2,29
CDM,4817409,TBA OPN/PRC VEIN INT NONPAIR/UNIS&I,17283.0,7258.86,4666.41,25370.0,37
CDM,4817425,TBA OPN/PRC VEIN ADL NONPAIR/UNIS&I,11473.0,4818.66,3097.71,11243.54,29
CDM,4817433,ANGIO PELVIC S&I,7097.0,2980.74,1916.19,8243.26,37
CDM,4817797,RPR EV DPLMNT AA NDGFT NO RUP,7696.0,3232.32,2077.92,7542.08,30
CDM,4817813,RPR EV DPLMNT A BIILAC NDGFT NO RUP,9482.0,3982.44,2560.14,9292.36,30
CDM,4817821,RPR EV DPLMNT ILIO ILAC NDGFT BI,10871.0,4565.82,2935.17,10653.58,30
CDM,4817839,RPR EV DPLMNT ILIO ILAC NDGFT LT,7247.0,3043.74,1956.69,7102.06,30
CDM,4817847,RPR EV DPLMNT ILIO ILAC NDGFT RT,7247.0,3043.74,1956.69,7102.06,30
CDM,4817896,ACCS&CLSR ART FEM NDGFT PERC UNI,693.0,291.06,187.11,679.14,29
CDM,4818613,INS/RPL PM PERM LDLS RV W IMG GD,28877.0,12128.34,7796.79,32969.0,37
CDM,4818639,INS CRM SUBQ W PROGRAMMING,7740.0,3250.8,2089.8,26759.0,37
CDM,4818647,REM CRM SUBQ,1209.0,507.78,326.43,3186.0,37
CDM,4818670,EVAL DEV PERIPRO PM/PM LDLS,164.0,68.88,44.28,160.72,30
CDM,4818878,PERICARDIOCENTESIS INCL IMG GD,4288.0,1800.96,1157.76,4202.24,37
CDM,4818886,DRN PERICARD PERC WO CONG CARD 6+Y,5629.0,2364.18,1519.83,5516.42,30
CDM,4818894,DRN PERICARD PERC WO CONG CARD 0-5Y,6576.0,2761.92,1775.52,6444.48,30
CDM,4818977,INS ELCTRD DEFIB SUBSTRNL,12702.0,5334.84,3429.54,12447.96,37
CDM,4818985,REM ELCTRD DEFIB SUBSTRNL,6398.0,2687.16,1727.46,6270.04,37
CDM,4818993,REPOS ELCTR DEFIB-PAC SS IP,4460.0,1873.2,1204.2,5535.95,37
CDM,4819009,EVAL DEV PRG ICD ELCTRD SS IN PER,100.0,42.0,27.0,98.0,37
CDM,4819017,EVAL DEV INTRG ICD ELCTRD SS IN PER,100.0,42.0,27.0,98.0,37
CDM,4819181,ASSESS STRAIN MYOCARDIAL W IMG,377.0,158.34,101.79,369.46,30
CDM,4819223,REVASC LITH INTRAV INCL ANGIOPLSTY,16067.0,6748.14,4338.09,25370.0,37
CDM,4819306,REVASC LITH INTRAV STNT ANGIOPLSTY,23343.0,9804.06,6302.61,27156.6,37
CDM,4819322,THROMBECT MECH PRIM ART INIT BI,24351.0,10227.42,6574.77,25370.0,30
CDM,4819330,THROMBECT MECH PRIM ART INIT LT,16234.0,6818.28,4383.18,25370.0,30
CDM,4819348,THROMBECT MECH PRIM ART INIT RT,16234.0,6818.28,4383.18,25370.0,30
CDM,4819355,VEL&/FLW DOPP INTRAV VSL INIT RDC,4667.0,1960.14,1260.09,4573.66,29
CDM,4819363,VEL&/FLW DOPP INTRAV VSL ADDL RDC,2155.0,905.1,581.85,2111.9,29
CDM,4819769,REVASC LITH INTRAV ATHR ANGIOPLSTY,33257.0,13967.94,8979.39,32591.86,37
CDM,4819785,RPR EV ILIAC DPLMNT A ILIAC NDGFT,13964.0,5864.88,3101.0,13684.72,30
CDM,4819819,REVASC LITH INTRAV STNT ATHR ANGIO,28438.0,11943.96,7678.26,27869.24,37
CDM,4819827,REVASC LITH INTRAV TIB/PER ATHR ANG,22699.0,9533.58,6128.73,27156.6,37
CDM,4819892,REVASC LITH INTRAV TIB/PER INCL ANG,21999.0,9239.58,5939.73,26759.0,37
CDM,4820213,INJ ANGIO PULM NONSEL HRT CATH S&I,893.0,375.06,241.11,875.14,29
CDM,4820221,INJ ANGIO PULM SEL HRT CATH UNI S&I,87.0,36.54,23.49,85.26,29
CDM,4820239,INJ ANGIO PULM SEL HRT CATH BI S&I,1071.0,449.82,289.17,1049.58,29
CDM,4820346,RPR EV DPLMNT ILIO ILAC NDGFT LT,7247.0,3043.74,1956.69,7102.06,30
CDM,4820353,RPR EV DPLMNT ILIO ILAC NDGFT RT,7247.0,3043.74,1956.69,7102.06,30
CDM,4820361,RPR EV DPLMNT ILIO ILAC NDGFT BI,10871.0,4565.82,2935.17,10653.58,30
CDM,4820544,EVAL FNCT CARDIO W TILT TABLE/EKG,1627.0,683.34,381.24,1594.46,37
CDM,4820551,INS CRM SUBQ W PROGRAMMING,7740.0,3250.8,2089.8,26759.0,37
CDM,4820643,VEL&/FLW DOPP IVAS VSL WO DRUG INT,2945.0,1236.9,131.46,2886.1,36
CDM,4820650,VEL&/FLW DOPP IVAS VSL WO DRUG MULT,6626.0,2782.92,131.46,6493.48,36
CDM,4820692,DEBRIDE MUSCLE&/FASCIA 1ST 20CM,1133.0,475.86,305.91,1110.34,36
CDM,4820700,DEBRIDE MUSCLE&/FASCIA ADDL 20CM,621.0,260.82,167.67,608.58,29
CDM,4820726,EVAL EP&ABL FIB ATRIAL VEIN PULM,73071.0,30689.82,19729.17,71609.58,37
CDM,4820759,RPLC LEAD PORT GEN PCMKR,4249.0,1784.58,640.89,4164.02,37
CDM,4820767,THER RX TRNSCTH PERC BLN IC S&I,8149.0,3422.58,2200.23,25370.0,37
CDM,4820775,THER RX TRNSCTH PERC BLN IC SEP,4527.0,1901.34,1222.29,4436.46,29
CDM,4820973,PLC PROS DLYD EXT RPR EV VES INIT,1780.0,747.6,480.6,3101.0,30
CDM,4820981,PLC PROS DLYD EXT RPR EV VES ADD,653.0,274.26,176.31,3101.0,30
CDM,4850491,ANLYS ELECT SYSTEM PM ANTITACHYCARD,598.0,251.16,161.46,586.04,37
CDM,4850657,LITHOTRIPSY CORONARY PERC TRANSL,15305.0,6428.1,4132.35,14998.9,29
CDM,4850707,BYPASS ART RETROG-ANT FEM-FEM PERC,4081.0,1714.02,640.89,3999.38,37
CDM,4850822,RECORDING ESOPH EGM ATR W/WO VENT,2636.0,1107.12,711.72,2583.28,37
CDM,4850905,INS SYS STM NRV PHRENIC INCL IM GD,67501.0,28350.42,18225.27,66150.98,37
CDM,4851135,EXPOSE ART BRACH OPN W PROSTH EV BI,3305.0,1388.1,892.35,3238.9,30
CDM,4851143,EXPOSE ART BRACH OPN W PROSTH EV RT,2203.0,925.26,594.81,3101.0,30
CDM,4851150,EXPOSE ART BRACH OPN W PROSTH EV LT,2203.0,925.26,594.81,3101.0,30
CDM,4851283,INS SYS PPM DUAL LDLS TRANSCTH,38503.0,16171.26,10395.81,37732.94,37
CDM,4851432,REVSC IVT ANGIO SF VSL INIT BI,23813.0,10001.46,6429.51,25370.0,30
CDM,4851440,REVSC IVT ANGIO SF VSL INIT LT,15875.0,6667.5,4286.25,25370.0,30
CDM,4851457,REVSC IVT ANGIO SF VSL INIT RT,15875.0,6667.5,4286.25,25370.0,30
CDM,4851465,REVSC IVT ANGIO SF VSL ADD BI,9741.0,4091.22,2630.07,9546.18,29
CDM,4851473,REVSC IVT ANGIO SF VSL ADD LT,6494.0,2727.48,1753.38,6364.12,29
CDM,4851481,REVSC IVT ANGIO SF VSL ADD RT,6494.0,2727.48,1753.38,6364.12,29
CDM,4851499,REVSC IVT ANGIO CMPLX VSL INIT BI,34902.0,14658.84,9423.54,34203.96,30
CDM,4851507,REVSC IVT ANGIO CMPLX VSL INIT LT,23268.0,9772.56,6282.36,25370.0,30
CDM,4851515,REVSC IVT ANGIO CMPLX VSL INIT RT,23268.0,9772.56,6282.36,25370.0,30
CDM,4851523,REVSC IVT ANGIO CMPLX VSL ADD BI,12590.0,5287.8,3399.3,12338.2,29
CDM,4851531,REVSC IVT ANGIO CMPLX VSL ADD LT,8393.0,3525.06,2266.11,8225.14,29
CDM,4851549,REVSC IVT ANGIO CMPLX VSL ADD RT,8393.0,3525.06,2266.11,8225.14,29
CDM,4851556,REVSC IVT STNT SF VSL INIT BI,33071.0,13889.82,8929.17,32409.58,30
CDM,4851564,REVSC IVT STNT SF VSL INIT LT,22047.0,9259.74,5952.69,26759.0,30
CDM,4851572,REVSC IVT STNT SF VSL INIT RT,22047.0,9259.74,5952.69,26759.0,30
CDM,4851580,REVSC IVT STNT SF VSL ADD BI,9674.0,4063.08,2611.98,9480.52,29
CDM,4851598,REVSC IVT STNT SF VSL ADD LT,6449.0,2708.58,1741.23,6320.02,29
CDM,4851606,REVSC IVT STNT SF VSL ADD RT,6449.0,2708.58,1741.23,6320.02,29
CDM,4851614,REVSC IVT STNT CMPLX VSL INIT BI,47802.0,20076.84,12906.54,46845.96,30
CDM,4851622,REVSC IVT STNT CMPLX VSL INIT LT,31868.0,13384.56,8604.36,31230.64,30
CDM,4851630,REVSC IVT STNT CMPLX VSL INIT RT,31868.0,13384.56,8604.36,31230.64,30
CDM,4851648,REVSC IVT STNT CMPLX VSL ADD BI,10280.0,4317.6,2775.6,10074.4,29
CDM,4851655,REVSC IVT STNT CMPLX VSL ADD LT,6853.0,2878.26,1850.31,6715.94,29
CDM,4851663,REVSC IVT STNT CMPLX VSL ADD RT,6853.0,2878.26,1850.31,6715.94,29
CDM,4851671,REVSC F&P VT ANG SF VSL INIT BI,24023.0,10089.66,6486.21,25370.0,30
CDM,4851689,REVSC F&P VT ANG SF VSL INIT LT,16015.0,6726.3,4324.05,25370.0,30
CDM,4851697,REVSC F&P VT ANG SF VSL INIT RT,16015.0,6726.3,4324.05,25370.0,30
CDM,4851705,REVSC F&P VT ANG SF VSL ADD BI,9194.0,3861.48,2482.38,9010.12,29
CDM,4851713,REVSC F&P VT ANG SF VSL ADD LT,6129.0,2574.18,1654.83,6006.42,29
CDM,4851721,REVSC F&P VT ANG SF VSL ADD RT,6129.0,2574.18,1654.83,6006.42,29
CDM,4851739,REVSC F&P VT ANG CMPLX VSL INIT BI,32472.0,13638.24,8767.44,31822.56,30
CDM,4851747,REVSC F&P VT ANG CMPLX VSL INIT LT,21648.0,9092.16,5844.96,25370.0,30
CDM,4851754,REVSC F&P VT ANG CMPLX VSL INIT RT,21648.0,9092.16,5844.96,25370.0,30
CDM,4851762,REVSC F&P VT ANG CMPLX VSL ADD BI,12237.0,5139.54,3303.99,11992.26,29
CDM,4851770,REVSC F&P VT ANG CMPLX VSL ADD LT,8158.0,3426.36,2202.66,7994.84,29
CDM,4851788,REVSC F&P VT ANG CMPLX VSL ADD RT,8158.0,3426.36,2202.66,7994.84,29
CDM,4851796,REVSC F&P VT STNT SF VSL INIT BI,30194.0,12681.48,8152.38,29590.12,30
CDM,4851804,REVSC F&P VT STNT SF VSL INIT LT,20129.0,8454.18,5434.83,26759.0,30
CDM,4851812,REVSC F&P VT STNT SF VSL INIT RT,20129.0,8454.18,5434.83,26759.0,30
CDM,4851820,REVSC F&P VT STNT SF VSL ADD BI,12761.0,5359.62,3445.47,12505.78,29
CDM,4851838,REVSC F&P VT STNT SF VSL ADD LT,8507.0,3572.94,2296.89,8336.86,29
CDM,4851846,REVSC F&P VT STNT SF VSL ADD RT,8507.0,3572.94,2296.89,8336.86,29
CDM,4851853,REVSC F&P VT STNT CMPLX VSL INIT BI,50717.0,21301.14,13693.59,49702.66,30
CDM,4851861,REVSC F&P VT STNT CMPLX VSL INIT LT,33811.0,14200.62,9128.97,33134.78,30
CDM,4851879,REVSC F&P VT STNT CMPLX VSL INIT RT,33811.0,14200.62,9128.97,33134.78,30
CDM,4851887,REVSC F&P VT STNT CMPLX VSL ADD BI,17132.0,7195.44,4625.64,16789.36,29
CDM,4851895,REVSC F&P VT STNT CMPLX VSL ADD LT,11421.0,4796.82,3083.67,11192.58,29
CDM,4851903,REVSC F&P VT STNT CMPLX VSL ADD RT,11421.0,4796.82,3083.67,11192.58,29
CDM,4851911,REVSC F&P VT ATHR SF VSL INIT BI,28778.0,12086.76,7770.06,28202.44,30
CDM,4851929,REVSC F&P VT ATHR SF VSL INIT LT,19185.0,8057.7,5179.95,26759.0,30
CDM,4851937,REVSC F&P VT ATHR SF VSL INIT RT,19185.0,8057.7,5179.95,26759.0,30
CDM,4851945,REVSC F&P VT ATHR SF VSL ADD BI,12684.0,5327.28,3424.68,12430.32,29
CDM,4851952,REVSC F&P VT ATHR SF VSL ADD LT,8456.0,3551.52,2283.12,8286.88,29
CDM,4851960,REVSC F&P VT ATHR SF VSL ADD RT,8456.0,3551.52,2283.12,8286.88,29
CDM,4851978,REVSC F&P VT ATHR CMPLX VSL INIT BI,40269.0,16912.98,10872.63,39463.62,30
CDM,4851986,REVSC F&P VT ATHR CMPLX VSL INIT LT,26846.0,11275.32,7248.42,26759.0,30
CDM,4851994,REVSC F&P VT ATHR CMPLX VSL INIT RT,26846.0,11275.32,7248.42,26759.0,30
CDM,4852000,REVSC F&P VT ATHR CMPLX VSL ADD BI,17448.0,7328.16,4710.96,17099.04,29
CDM,4852018,REVSC F&P VT ATHR CMPLX VSL ADD LT,11632.0,4885.44,3140.64,11399.36,29
CDM,4852026,REVSC F&P VT ATHR CMPLX VSL ADD RT,11632.0,4885.44,3140.64,11399.36,29
CDM,4852034,REVSC F&P VT ST&AT SF VSL INIT BI,40902.0,17178.84,11043.54,40083.96,30
CDM,4852042,REVSC F&P VT ST&AT SF VSL INIT LT,27268.0,11452.56,7362.36,26759.0,30
CDM,4852059,REVSC F&P VT ST&AT SF VSL INIT RT,27268.0,11452.56,7362.36,26759.0,30
CDM,4852067,REVSC F&P VT ST&AT SF VSL ADD BI,15696.0,6592.32,4237.92,15382.08,29
CDM,4852075,REVSC F&P VT ST&AT SF VSL ADD LT,10464.0,4394.88,2825.28,10254.72,29
CDM,4852083,REVSC F&P VT ST&AT SF VSL ADD RT,10464.0,4394.88,2825.28,10254.72,29
CDM,4852091,REVSC F&P VT ST&AT CMPLX VSL INITBI,55617.0,23359.14,15016.59,54504.66,30
CDM,4852109,REVSC F&P VT ST&AT CMPLX VSL INITLT,37078.0,15572.76,10011.06,36336.44,30
CDM,4852117,REVSC F&P VT ST&AT CMPLX VSL INITRT,37078.0,15572.76,10011.06,36336.44,30
CDM,4852125,REVSC F&P VT ST&AT CMPLX VSL ADD BI,22100.0,9282.0,5967.0,21658.0,29
CDM,4852133,REVSC F&P VT ST&AT CMPLX VSL ADD LT,14733.0,6187.86,3977.91,14438.34,29
CDM,4852141,REVSC F&P VT ST&AT CMPLX VSL ADD RT,14733.0,6187.86,3977.91,14438.34,29
CDM,4852158,REVSC T&P VT ANG SF VSL INIT BI,26687.0,11208.54,7205.49,26759.0,30
CDM,4852166,REVSC T&P VT ANG SF VSL INIT LT,17791.0,7472.22,4803.57,26759.0,30
CDM,4852174,REVSC T&P VT ANG SF VSL INIT RT,17791.0,7472.22,4803.57,26759.0,30
CDM,4852182,REVSC T&P VT ANG SF VSL ADD BI,6413.0,2693.46,1731.51,6284.74,29
CDM,4852190,REVSC T&P VT ANG SF VSL ADD LT,4275.0,1795.5,1154.25,4189.5,29
CDM,4852208,REVSC T&P VT ANG SF VSL ADD RT,4275.0,1795.5,1154.25,4189.5,29
CDM,4852216,REVSC T&P VT ANG CMPLX VSL INIT BI,33438.0,14043.96,9028.26,32769.24,30
CDM,4852224,REVSC T&P VT ANG CMPLX VSL INIT LT,22292.0,9362.64,6018.84,26759.0,30
CDM,4852232,REVSC T&P VT ANG CMPLX VSL INIT RT,22292.0,9362.64,6018.84,26759.0,30
CDM,4852240,REVSC T&P VT ANG CMPLX VSL ADD BI,9119.0,3829.98,2462.13,8936.62,29
CDM,4852257,REVSC T&P VT ANG CMPLX VSL ADD LT,6079.0,2553.18,1641.33,5957.42,29
CDM,4852265,REVSC T&P VT ANG CMPLX VSL ADD RT,6079.0,2553.18,1641.33,5957.42,29
CDM,4852273,REVSC T&P VT STNT SF VSL INIT BI,21923.0,9207.66,5919.21,26759.0,30
CDM,4852281,REVSC T&P VT STNT SF VSL INIT LT,14615.0,6138.3,3946.05,26759.0,30
CDM,4852299,REVSC T&P VT STNT SF VSL INIT RT,14615.0,6138.3,3946.05,26759.0,30
CDM,4852307,REVSC T&P VT STNT SF VSL ADD BI,7343.0,3084.06,1982.61,7196.14,29
CDM,4852315,REVSC T&P VT STNT SF VSL ADD LT,4895.0,2055.9,1321.65,4797.1,29
CDM,4852323,REVSC T&P VT STNT SF VSL ADD RT,4895.0,2055.9,1321.65,4797.1,29
CDM,4852331,REVSC T&P VT STNT CMPLX VSL INIT BI,29415.0,12354.3,7942.05,28826.7,30
CDM,4852349,REVSC T&P VT STNT CMPLX VSL INIT LT,19610.0,8236.2,5294.7,26759.0,30
CDM,4852356,REVSC T&P VT STNT CMPLX VSL INIT RT,19610.0,8236.2,5294.7,26759.0,30
CDM,4852364,REVSC T&P VT STNT CMPLX VSL ADD BI,11048.0,4640.16,2982.96,10827.04,29
CDM,4852372,REVSC T&P VT STNT CMPLX VSL ADD LT,7365.0,3093.3,1988.55,7217.7,29
CDM,4852380,REVSC T&P VT STNT CMPLX VSL ADD RT,7365.0,3093.3,1988.55,7217.7,29
CDM,4852398,REVSC T&P VT ATH SF VSL INIT BI,29295.0,12303.9,7909.65,28709.1,30
CDM,4852406,REVSC T&P VT ATH SF VSL INIT LT,19530.0,8202.6,5273.1,26759.0,30
CDM,4852414,REVSC T&P VT ATH SF VSL INIT RT,19530.0,8202.6,5273.1,26759.0,30
CDM,4852422,REVSC T&P VT ATH SF VSL ADD BI,10250.0,4305.0,2767.5,10045.0,29
CDM,4852430,REVSC T&P VT ATH SF VSL ADD LT,6833.0,2869.86,1844.91,6696.34,29
CDM,4852448,REVSC T&P VT ATH SF VSL ADD RT,6833.0,2869.86,1844.91,6696.34,29
CDM,4852455,REVSC T&P VT ATH CMPLX VSL INIT BI,36876.0,15487.92,9956.52,36138.48,30
CDM,4852463,REVSC T&P VT ATH CMPLX VSL INIT LT,24584.0,10325.28,6637.68,26759.0,30
CDM,4852471,REVSC T&P VT ATH CMPLX VSL INIT RT,24584.0,10325.28,6637.68,26759.0,30
CDM,4852489,REVSC T&P VT ATH CMPLX VSL ADD BI,13964.0,5864.88,3770.28,13684.72,29
CDM,4852497,REVSC T&P VT ATH CMPLX VSL ADD LT,9309.0,3909.78,2513.43,9122.82,29
CDM,4852505,REVSC T&P VT ATH CMPLX VSL ADD RT,9309.0,3909.78,2513.43,9122.82,29
CDM,4852513,REVSC T&P VT ST&AT SF VSL INIT BI,32868.0,13804.56,8874.36,32210.64,30
CDM,4852521,REVSC T&P VT ST&AT SF VSL INIT LT,21912.0,9203.04,5916.24,26759.0,30
CDM,4852539,REVSC T&P VT ST&AT SF VSL INIT RT,21912.0,9203.04,5916.24,26759.0,30
CDM,4852547,REVSC T&P VT ST&AT SF VSL ADD BI,15153.0,6364.26,4091.31,14849.94,29
CDM,4852554,REVSC T&P VT ST&AT SF VSL ADD LT,10102.0,4242.84,2727.54,9899.96,29
CDM,4852562,REVSC T&P VT ST&AT SF VSL ADD RT,10102.0,4242.84,2727.54,9899.96,29
CDM,4852570,REVSC T&P VT ST&AT CMPLX VSL INITBI,39401.0,16548.42,10638.27,38612.98,30
CDM,4852588,REVSC T&P VT ST&AT CMPLX VSL INITLT,26267.0,11032.14,7092.09,26759.0,30
CDM,4852596,REVSC T&P VT ST&AT CMPLX VSL INITRT,26267.0,11032.14,7092.09,26759.0,30
CDM,4852604,REVSC T&P VT ST&AT CMPLX VSL ADD BI,19103.0,8023.26,5157.81,18720.94,29
CDM,4852612,REVSC T&P VT ST&AT CMPLX VSL ADD LT,12735.0,5348.7,3438.45,12480.3,29
CDM,4852620,REVSC T&P VT ST&AT CMPLX VSL ADD RT,12735.0,5348.7,3438.45,12480.3,29
CDM,4852679,PLC STNT/S W ANGIO SGL&/BR 1 LSN,15766.0,6621.72,4256.82,25370.0,37
CDM,4852687,PLC STNT/S W ANGIO SGL&/BR 2+ LSN,17198.0,7223.16,4643.46,27156.6,37
CDM,4852695,REVASC GRFT BYPASS ART COR SGL&/BR,12128.0,5093.76,3274.56,25370.0,37
CDM,4852711,REVASC OCC MI ACUTE ART COR SGL&/BR,23897.0,10036.74,6452.19,25370.0,30
CDM,4852729,REVASC OCC CHRONIC ART/BR/GRFT COR,25698.0,10793.16,6938.46,25370.0,37
CDM,4852737,THROMBECT ASP MECH COR PERC,6480.0,2721.6,1749.6,6350.4,29
CDM,4852794,LITHOTRIPSY INTRAV IVT ART SAME BI,37077.0,15572.34,10010.79,36335.46,29
CDM,4852802,LITHOTRIPSY INTRAV IVT ART SAME RT,24718.0,10381.56,6673.86,24223.64,29
CDM,4852810,LITHOTRIPSY INTRAV IVT ART SAME LT,24718.0,10381.56,6673.86,24223.64,29
CDM,4852919,LITHOTRIPSY INTRAV FPVT ART SAME BI,37077.0,15572.34,10010.79,36335.46,29
CDM,4852927,LITHOTRIPSY INTRAV FPVT ART SAME LT,24718.0,10381.56,6673.86,24223.64,29
CDM,4852935,LITHOTRIPSY INTRAV FPVT ART SAME RT,24718.0,10381.56,6673.86,24223.64,29
CDM,50278,R&B NURSERY LEVEL 1,3193.0,1341.06,2714.05,3129.14,13
CDM,52365,R&B HOSPICE PVT,2554.0,1072.68,2170.9,2502.92,12
CDM,5405469,TRNSPRT NONEMR AMB ALS LEVEL 1,2153.0,904.26,400.0,2109.94,31
CDM,5405543,TRNSPRT EMERG AMB ALS LEVEL 1,2492.0,1046.64,400.0,2442.16,31
CDM,5405550,TRNSPRT EMERG AMB BLS,1814.0,761.88,400.0,1777.72,31
CDM,5405568,TRNSPRT NONEMR AMB BLS,1525.0,640.5,400.0,1494.5,31
CDM,5405576,MILEAGE GROUND MILE 1.00,27.0,11.34,7.29,400.0,31
CDM,5405592,TRNSPRT SPECIALTY CARE,2716.0,1140.72,400.0,2661.68,31
CDM,5405600,TRNSPRT AMB ALS LEVEL 2,3322.0,1395.24,400.0,3255.56,31
CDM,5405618,RESPONSE/TREATMENT AMB WO TRNSPRT,222.0,93.24,59.94,400.0,31
CDM,5405626,MILEAGE GROUND MILE 0.10,2.7,1.13,0.729,400.0,31
CDM,5405642,MILEAGE NONCOVERED MILE 0.10,2.7,1.13,0.729,400.0,31
CDM,60277,R&B NURSERY LEVEL 2 HIGHER ACUITY,6385.0,2681.7,5427.25,6257.3,13
CDM,6104087,MRI GD PLC NDL S&I,2984.0,1253.28,805.68,2924.32,30
CDM,6104137,MRI ABDOMEN W CNT,2339.0,982.38,356.43,2292.22,37
CDM,6104145,MRI ABDOMEN WO CNT,1871.0,785.82,243.77,1833.58,37
CDM,6104152,MRI ABDOMEN W&WO CNT,2807.0,1178.94,356.43,2750.86,37
CDM,6104160,MRI BONE MARROW,1525.0,640.5,243.77,1494.5,37
CDM,6104319,MRI CHEST W CNT,2509.0,1053.78,677.43,2458.82,37
CDM,6104327,MRI CHEST WO CNT,2007.0,842.94,243.77,1966.86,37
CDM,6104335,MRI CHEST W&WO CNT,3011.0,1264.62,356.43,2950.78,37
CDM,6104376,MRI EXT LOWER JT W CNT LT,2383.0,1000.86,643.41,2335.34,30
CDM,6104384,MRI EXT LOWER JT W CNT RT,2383.0,1000.86,643.41,2335.34,30
CDM,6104400,MRI EXT LOWER JT WO CNT LT,1906.0,800.52,514.62,1867.88,30
CDM,6104418,MRI EXT LOWER JT WO CNT RT,1906.0,800.52,514.62,1867.88,30
CDM,6104434,MRI EXT LOWER JT W&WO CNT LT,2859.0,1200.78,771.93,2801.82,30
CDM,6104442,MRI EXT LOWER JT W&WO CNT RT,2859.0,1200.78,771.93,2801.82,30
CDM,6104467,MRI EXT LOWER NONJT W CNT LT,2383.0,1000.86,643.41,2335.34,30
CDM,6104475,MRI EXT LOWER NONJT W CNT RT,2383.0,1000.86,643.41,2335.34,30
CDM,6104491,MRI EXT LOWER NONJT WO CNT LT,1906.0,800.52,514.62,1867.88,30
CDM,6104509,MRI EXT LOWER NONJT WO CNT RT,1906.0,800.52,514.62,1867.88,30
CDM,6104525,MRI EXT LOWER NONJT W&WO CNT LT,2859.0,1200.78,771.93,2801.82,30
CDM,6104533,MRI EXT LOWER NONJT W&WO CNT RT,2859.0,1200.78,771.93,2801.82,30
CDM,6104574,MRI JOINT TEMPOROMANDIBULAR BI,2691.0,1130.22,243.77,2637.18,37
CDM,6104582,MRI JOINT TEMPOROMANDIBULAR LT,1794.0,753.48,484.38,1758.12,30
CDM,6104590,MRI JOINT TEMPOROMANDIBULAR RT,1794.0,753.48,484.38,1758.12,30
CDM,6104616,MRI EXT UPPER JT W CNT LT,2383.0,1000.86,643.41,2335.34,30
CDM,6104624,MRI EXT UPPER JT W CNT RT,2383.0,1000.86,643.41,2335.34,30
CDM,6104640,MRI EXT UPPER JT WO CNT LT,1906.0,800.52,514.62,1867.88,30
CDM,6104657,MRI EXT UPPER JT WO CNT RT,1906.0,800.52,514.62,1867.88,30
CDM,6104673,MRI EXT UPPER JT W&WO CNT LT,2859.0,1200.78,771.93,2801.82,30
CDM,6104681,MRI EXT UPPER JT W&WO CNT RT,2859.0,1200.78,771.93,2801.82,30
CDM,6104707,MRI EXT UPPER NONJT W&WO CNT LT,2205.0,926.1,595.35,2160.9,30
CDM,6104715,MRI EXT UPPER NONJT W&WO CNT RT,2205.0,926.1,595.35,2160.9,30
CDM,6104731,MRI EXT UPPER NONJT W CNT LT,1838.0,771.96,496.26,1801.24,30
CDM,6104749,MRI EXT UPPER NONJT W CNT RT,1838.0,771.96,496.26,1801.24,30
CDM,6104764,MRI EXT UPPER NONJT WO CNT LT,1470.0,617.4,396.9,1440.6,30
CDM,6104848,MRI BRAIN W CNT,2979.0,1251.18,356.43,2919.42,37
CDM,6104855,MRI BRAIN WO CNT,2383.0,1000.86,243.77,2335.34,37
CDM,6104863,MRI BRAIN W&WO CNT,3575.0,1501.5,356.43,3503.5,37
CDM,6104871,MRI ORBIT FACE&/NECK W&WO CNT,2441.0,1025.22,356.43,2392.18,37
CDM,6104889,MRI ORBIT FACE&/NECK W CNT,2034.0,854.28,356.43,1993.32,37
CDM,6104897,MRI ORBIT FACE&/NECK WO CNT,1627.0,683.34,243.77,1594.46,37
CDM,6104905,MRI SPINE CERVICAL W CNT,2377.0,998.34,356.43,2329.46,37
CDM,6104913,MRI SPINE CERVICAL WO CNT,1901.0,798.42,243.77,1862.98,37
CDM,6104921,MRI SPINE CERVICAL W&WO CNT,2852.0,1197.84,356.43,2794.96,37
CDM,6104939,MRI SPINE LUMBAR W CNT,2383.0,1000.86,356.43,2335.34,37
CDM,6104947,MRI SPINE LUMBAR WO CNT,1906.0,800.52,243.77,1867.88,37
CDM,6104954,MRI SPINE LUMBAR W&WO CNT,2859.0,1200.78,356.43,2801.82,37
CDM,6104962,MRI PELVIS W CNT,2367.0,994.14,356.43,2319.66,37
CDM,6104970,MRI PELVIS WO CNT,1893.0,795.06,243.77,1855.14,37
CDM,6104988,MRI PELVIS W&WO CNT,2840.0,1192.8,356.43,2783.2,37
CDM,6104996,MRI SPINE THORACIC W CNT,2370.0,995.4,356.43,2322.6,37
CDM,6105001,MRI SPINE THORACIC WO CNT,1896.0,796.32,243.77,1858.08,37
CDM,6105019,MRI SPINE THORACIC W&WO CNT,2844.0,1194.48,356.43,2787.12,37
CDM,6105555,MRI EXT UPPER NONJT WO CNT RT,1470.0,617.4,396.9,1440.6,30
CDM,6105662,MRI BREAST WO CNT LT,1141.0,479.22,308.07,1118.18,30
CDM,6105670,MRI BREAST WO CNT RT,1141.0,479.22,308.07,1118.18,30
CDM,6105688,MRI BREAST WO CNT BI,1591.0,668.22,243.77,1559.18,37
CDM,6105696,MRI BREAST W&WO CNT LT,1712.0,719.04,462.24,1677.76,30
CDM,6105704,MRI BREAST W&WO CNT RT,1712.0,719.04,462.24,1677.76,30
CDM,6105712,MRI BREAST W&WO CNT BI,2387.0,1002.54,644.49,2339.26,30
CDM,6105829,MRI BODY WHOLE,2975.0,1249.5,88.91,2915.5,37
CDM,6111538,MRI CAD BREAST,79.0,33.18,21.33,77.42,30
CDM,6111827,MRCP WO CNT,1871.0,785.82,243.77,1833.58,37
CDM,6111835,MRCP W CNT,2339.0,982.38,356.43,2292.22,37
CDM,6111843,MRCP W&WO CNT,2807.0,1178.94,356.43,2750.86,37
CDM,6111918,MRI CARD MOR&FUNC WO CNT,1307.0,548.94,243.77,1280.86,37
CDM,6111959,MRI CARD MOR&FUNC W&WO CNT,1961.0,823.62,356.43,1921.78,37
CDM,6113484,MRI PELVIS WO CNT RDC,1893.0,795.06,511.11,1855.14,30
CDM,6113500,MRI CARDIAC VELOCITY FLW MAP ADD-ON,889.0,373.38,240.03,871.22,30
CDM,6113682,MR ASSESS IMP&/FB CLIN INIT 15MIN,45.0,18.9,12.15,44.1,37
CDM,6113690,MR ASSESS IMP&/FB CLIN EA ADD 30MIN,183.0,76.86,49.41,179.34,30
CDM,6113708,MR DETERMIN SAFETY PHYS/QHCP,134.0,56.28,36.18,131.32,37
CDM,6113716,MR CUST EXAM MED PHYSICS SAFETY PLN,469.0,196.98,126.63,459.62,37
CDM,6113724,MR PREP ELECT IMP SAFETY PHYS/QHCP,203.0,85.26,54.81,198.94,37
CDM,6113732,MR POS IMP SAFETY&/IMMOB PHYS/QHCP,315.0,132.3,60.27,308.7,37
CDM,6114201,BX BRST W/WO DEV/IMG MR LSN ADD,3485.0,1463.7,940.95,3415.3,29
CDM,6114433,BX BRST W/WO DEV/IMG MR LSN 1ST LT,4531.0,1903.02,1223.37,5367.0,30
CDM,6114441,BX BRST W/WO DEV/IMG MR LSN 1ST RT,4531.0,1903.02,1223.37,5367.0,30
CDM,612,R&B PEDIATRICS SEMI-PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,6152003,MRA HEAD W CNT,1705.0,716.1,356.43,1670.9,37
CDM,6152011,MRA HEAD WO CNT,1364.0,572.88,243.77,1336.72,37
CDM,6152029,MRA HEAD W&WO CNT,2046.0,859.32,356.43,2005.08,37
CDM,6152037,MRA EXT LOWER W CNT LT,2503.0,1051.26,675.81,2452.94,30
CDM,6152045,MRA EXT LOWER W CNT RT,2503.0,1051.26,675.81,2452.94,30
CDM,6152052,MRA EXT LOWER WO CNT LT,2002.0,840.84,540.54,1961.96,30
CDM,6152060,MRA EXT LOWER WO CNT RT,2002.0,840.84,540.54,1961.96,30
CDM,6152078,MRA EXT LOWER W/WO CNT LT,3002.0,1260.84,810.54,2941.96,30
CDM,6152086,MRA EXT LOWER W/WO CNT RT,3002.0,1260.84,810.54,2941.96,30
CDM,6152094,MRA ABDOMEN W CNT,2456.0,1031.52,663.12,2406.88,30
CDM,6152102,MRA ABDOMEN WO CNT,1965.0,825.3,530.55,1925.7,30
CDM,6152110,MRA ABDOMEN W/WO CNT,2948.0,1238.16,795.96,2889.04,30
CDM,6152128,MRA CHEST W CNT,2635.0,1106.7,711.45,2582.3,30
CDM,6152136,MRA CHEST WO CNT,2108.0,885.36,569.16,2065.84,30
CDM,6152144,MRA CHEST W/WO CNT,3162.0,1328.04,853.74,3098.76,30
CDM,6152151,MRA PELVIS W CNT,2486.0,1044.12,671.22,2436.28,30
CDM,6152169,MRA PELVIS WO CNT,1988.0,834.96,536.76,1948.24,30
CDM,6152177,MRA PELVIS W/WO CNT,2982.0,1252.44,805.14,2922.36,30
CDM,6152185,MRA SPINE W CNT,2496.0,1048.32,673.92,2446.08,30
CDM,6152193,MRA SPINE WO CNT,1997.0,838.74,539.19,1957.06,30
CDM,6152201,MRA SPINE W/WO CNT,2995.0,1257.9,808.65,2935.1,30
CDM,6152219,MRA EXT UPPER W CNT LT,2503.0,1051.26,675.81,2452.94,30
CDM,6152227,MRA EXT UPPER W CNT RT,2503.0,1051.26,675.81,2452.94,30
CDM,6152235,MRA EXT UPPER WO CNT LT,2002.0,840.84,540.54,1961.96,30
CDM,6152243,MRA EXT UPPER WO CNT RT,2002.0,840.84,540.54,1961.96,30
CDM,6152250,MRA EXT UPPER W/WO CNT LT,3002.0,1260.84,810.54,2941.96,30
CDM,6152268,MRA EXT UPPER W/WO CNT RT,3002.0,1260.84,810.54,2941.96,30
CDM,6152276,MRA NECK W CNT,1852.0,777.84,356.43,1814.96,37
CDM,6152284,MRA NECK WO CNT,1481.0,622.02,243.77,1451.38,37
CDM,6152292,MRA NECK W&WO CNT,2222.0,933.24,356.43,2177.56,37
CDM,6271142,BIT LVL 07,3596.0,1510.32,970.92,3524.08,30
CDM,6271159,BIT LVL 08,4880.0,2049.6,1317.6,4782.4,30
CDM,6271167,IMP BOLT LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6271175,IMP BOLT LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6271183,IMP BOLT LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6271191,IMP BONE HUMAN/SYNTHETIC LVL 11,26284.0,11039.28,7096.68,25758.32,30
CDM,6271217,CANNULA LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6271225,CANNULA LVL 07,3596.0,1510.32,970.92,3524.08,30
CDM,6271233,CANNULA LVL 08,4397.0,1846.74,1187.19,4309.06,30
CDM,6271241,CATH ANGIO TRANSL NONLASER LVL 10,12969.0,5446.98,3501.63,12709.62,30
CDM,6271258,CATH EP NON 3D 1-19 LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6271266,CATH EP NON 3D 1-19 LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6271274,CATH GUIDE LVL 08,3596.0,1510.32,970.92,3524.08,30
CDM,6271282,CATH GUIDE LVL 09,4885.0,2051.7,1318.95,4787.3,30
CDM,6271290,ELECTRODE ELECTROSURGICAL LVL 10,5861.0,2461.62,1582.47,5743.78,30
CDM,6271308,ELECTRODE ELECTROSURGICAL LVL 11,9265.0,3891.3,2501.55,9079.7,30
CDM,6271316,ELECTRODE ELECTROSURGICAL LVL 12,12506.0,5252.52,3376.62,12255.88,30
CDM,6271324,ELECTRODE ELECTROSURGICAL LVL 09,3596.0,1510.32,970.92,3524.08,30
CDM,6271332,CEMENT ACCESSORIES LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6271340,CEMENT ACCESSORIES LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6271357,CEMENT ACCESSORIES LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6271365,CLIP LVL 03,594.0,249.48,160.38,582.12,30
CDM,6271373,EMBOLIZATION SYS PROTECT LVL 02,6950.0,2919.0,1876.5,6811.0,30
CDM,6271381,IMP GENERATOR NEUROSTIM LVL 02,43800.0,18396.0,11826.0,42924.0,30
CDM,6271399,IMP GENERATOR NEUROSTIM LVL 03,65704.0,27595.68,17740.08,64389.92,30
CDM,6271407,IMP GENERATOR NEUROSTIM LVL 04,87604.0,36793.68,23653.08,85851.92,30
CDM,6271415,WIRE GUIDE LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6271423,IMP ICD CHAMBER DUAL LVL 04,109504.0,45991.68,29566.08,107313.92,30
CDM,6271431,IMP ICD CHAMBER DUAL LVL 05,131404.0,55189.68,35479.08,128775.92,30
CDM,6271449,INSTRUMENT DISP SINGLE LVL 07,3596.0,1510.32,970.92,3524.08,30
CDM,6271456,INTRO LVL 06,3596.0,1510.32,970.92,3524.08,30
CDM,6271464,INTRO LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,6271472,INTRO NON GD/EP/LASER LVL 02,313.0,131.46,84.51,306.74,30
CDM,6271480,INTRO NON GD/EP/LASER LVL 03,594.0,249.48,160.38,582.12,30
CDM,6271498,INTRO NON GD/EP/LASER LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,6271506,INTRO NON GD/EP/LASER LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6271514,INTRO NON GD/EP/LASER LVL 06,3596.0,1510.32,970.92,3524.08,30
CDM,6271522,INTRO NON GD/EP/LASER LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,6271530,INTRO NON GD/EP/LASER LVL 08,7876.0,3307.92,2126.52,7718.48,30
CDM,6271548,KIT/SET NON ROUTINE SURG LVL 10,6950.0,2919.0,1876.5,6811.0,30
CDM,6271555,KIT/SET NON ROUTINE SURG LVL 11,9265.0,3891.3,2501.55,9079.7,30
CDM,6271563,KIT/SET NON ROUTINE SURG LVL 12,11580.0,4863.6,3126.6,11348.4,30
CDM,6271571,KIT/SET NON ROUTINE SURG LVL 13,13895.0,5835.9,3751.65,13617.1,30
CDM,6271589,MANIPULATOR LVL 01,313.0,131.46,84.51,306.74,30
CDM,6271597,MANIPULATOR LVL 02,594.0,249.48,160.38,582.12,30
CDM,6271605,IMP MESH LVL 11,19714.0,8279.88,5322.78,19319.72,30
CDM,6271613,IMP MESH LVL 12,24094.0,10119.48,6505.38,23612.12,30
CDM,6271621,IMP MESH LVL 13,28474.0,11959.08,7687.98,27904.52,30
CDM,6271639,NEEDLE SPECIALTY LVL 06,2157.0,905.94,582.39,2113.86,30
CDM,6271647,NEEDLE SPECIALTY LVL 07,2426.0,1018.92,655.02,2377.48,30
CDM,6271662,IMP PCMKR SGL RR LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6271670,IMP PCMKR SGL RR LVL 06,35044.0,14718.48,9461.88,34343.12,30
CDM,6271688,SUPPLY PERFUSION/ECMO LVL 10,6105.0,2564.1,1648.35,5982.9,30
CDM,6271696,SUPPLY PERFUSION/ECMO LVL 09,5129.0,2154.18,1384.83,5026.42,30
CDM,6271704,IMP PIN/WIRE LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6271712,IMP PIN/WIRE LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6271720,IMP PIN/WIRE LVL 06,1619.0,679.98,437.13,1586.62,30
CDM,6271738,IMP PIN/WIRE LVL 07,1888.0,792.96,509.76,1850.24,30
CDM,6271746,IMP PLATE LVL 11,9265.0,3891.3,2501.55,9079.7,30
CDM,6271753,IMP PLATE LVL 12,11580.0,4863.6,3126.6,11348.4,30
CDM,6271761,IMP PLATE LVL 13,13895.0,5835.9,3751.65,13617.1,30
CDM,6271779,IMP PLATE LVL 14,15334.0,6440.28,4140.18,15027.32,30
CDM,6271787,POUCH LVL 01,166.0,69.72,44.82,162.68,30
CDM,6271795,POUCH LVL 02,447.0,187.74,120.69,438.06,30
CDM,6271803,POUCH LVL 03,850.0,357.0,229.5,833.0,30
CDM,6271811,PROBE LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6271829,PROBE LVL 08,5861.0,2461.62,1582.47,5743.78,30
CDM,6271837,PROBE LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6271845,IMP DEV JT KNEE TOTAL LVL 20,96364.0,40472.88,26018.28,94436.72,30
CDM,6271852,REAMER LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,6271860,REAMER LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,6271878,IMP RING LVL 02,3596.0,1510.32,970.92,3524.08,30
CDM,6271886,IMP RING LVL 03,4397.0,1846.74,1187.19,4309.06,30
CDM,6271894,IMP ROD/NAIL LVL 08,7876.0,3307.92,2126.52,7718.48,30
CDM,6271902,IMP ROD/NAIL LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6271910,IMP STAPLE BONE LVL 05,1490.0,625.8,402.3,1460.2,30
CDM,6271928,IMP STAPLE BONE LVL 06,2157.0,905.94,582.39,2113.86,30
CDM,6271936,IMP STAPLE BONE LVL 07,3083.0,1294.86,832.41,3021.34,30
CDM,6271944,IMP STAPLE BONE LVL 08,3909.0,1641.78,1055.43,3830.82,30
CDM,6271951,IMP STAPLE BONE LVL 09,4885.0,2051.7,1318.95,4787.3,30
CDM,6271969,IMP STAPLE BONE LVL 10,5861.0,2461.62,1582.47,5743.78,30
CDM,6271977,IMP STAPLE BONE LVL 11,6487.0,2724.54,1751.49,6357.26,30
CDM,6271985,STAPLER LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,6271993,IMP STENT NOS LVL 10,21904.0,9199.68,5914.08,21465.92,30
CDM,6272009,IMP STENT NOS LVL 11,26284.0,11039.28,7096.68,25758.32,30
CDM,6272017,IMP STENT NOS LVL 12,30664.0,12878.88,8279.28,30050.72,30
CDM,6272025,IMP STENT NOS LVL 13,35044.0,14718.48,9461.88,34343.12,30
CDM,6272033,IMP STENT NOS LVL 14,39424.0,16558.08,10644.48,38635.52,30
CDM,6272041,IMP STENT NOS LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,6272058,IMP STENT NONCOAT W DEL LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6272066,IMP STENT NONCOAT W DEL LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,6272074,IMP STENT NONCOAT W DEL LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,6272082,IMP STENT NONCOAT W DEL LVL 12,35044.0,14718.48,9461.88,34343.12,30
CDM,6272090,IMP STENT NONCOAT WO DEL LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6272108,IMP STENT NONCOAT WO DEL LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6272116,IMP STENT NONCOAT WO DEL LVL 12,26284.0,11039.28,7096.68,25758.32,30
CDM,6272124,IMP STENT NONCOAT WO DEL LVL 13,30664.0,12878.88,8279.28,30050.72,30
CDM,6272132,IMP STENT NONCOAT WO DEL LVL 14,35044.0,14718.48,9461.88,34343.12,30
CDM,6272140,IMP STENT NONCOAT WO DEL LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6272165,IMP TISSUE CONNECT HUMAN LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6272173,IMP TISSUE CONNECT HUMAN LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6272181,IMP TISSUE CONNECT HUMAN LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6272199,IMP TISSUE CONNECT HUMAN LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6272207,IMP TISSUE CONNECT HUMAN LVL 07,15334.0,6440.28,4140.18,15027.32,30
CDM,6272215,IMP TISSUE CONNECT HUMAN LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6272231,WIRE PACING TEMP LVL 01,313.0,131.46,84.51,306.74,30
CDM,6272249,WIRE PACING TEMP LVL 02,594.0,249.48,160.38,582.12,30
CDM,6272256,PACER ACCESSORY LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6272389,IMP CEMENT ACCESSORY LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6272397,IMP CEMENT ACCESSORY LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6272405,CATH BALLOON LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6272413,CATH BALLOON LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6272421,CATH BALLOON LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6272439,CATH BALLOON LVL 11,13895.0,5835.9,3751.65,13617.1,30
CDM,6272462,INSTRUMENT DISP SINGLE LVL 08,5861.0,2461.62,1582.47,5743.78,30
CDM,6272470,INSTRUMENT DISP SINGLE LVL 09,6950.0,2919.0,1876.5,6811.0,30
CDM,6272488,IMP PROSTH ANKLE LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6272496,IMP PROSTH ANKLE LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,6272504,IMP PROSTH ANKLE LVL 08,35044.0,14718.48,9461.88,34343.12,30
CDM,6272512,IMP CONNECTOR SPINAL LVL 01,313.0,131.46,84.51,306.74,30
CDM,6272520,IMP CONNECTOR SPINAL LVL 02,594.0,249.48,160.38,582.12,30
CDM,6272538,IMP CONNECTOR SPINAL LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6272546,IMP CONNECTOR SPINAL LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6272553,IMP CONNECTOR SPINAL LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6272561,IMP CONNECTOR SPINAL LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6272579,IMP CONNECTOR SPINAL LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6272587,IMP STENT COAT W DEL LVL 10,21904.0,9199.68,5914.08,21465.92,30
CDM,6272595,IMP STENT COAT W DEL LVL 11,26284.0,11039.28,7096.68,25758.32,30
CDM,6272603,IMP STENT COAT W DEL LVL 12,30664.0,12878.88,8279.28,30050.72,30
CDM,6272611,IMP STENT COAT W DEL LVL 13,35044.0,14718.48,9461.88,34343.12,30
CDM,6272629,PUNCH LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6272637,PUNCH LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6272645,PROBE LVL 11,17524.0,7360.08,4731.48,17173.52,30
CDM,6272652,IMP BAND LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6272660,IMP BAND LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6272678,IMP MESH LVL 14,32854.0,13798.68,8870.58,32196.92,30
CDM,6272686,INSTRUMENT DISP SINGLE LVL 10,9265.0,3891.3,2501.55,9079.7,30
CDM,6272694,INSTRUMENT DISP SINGLE LVL 11,11580.0,4863.6,3126.6,11348.4,30
CDM,6272702,INSTRUMENT DISP SINGLE LVL 12,13895.0,5835.9,3751.65,13617.1,30
CDM,6272710,IMP DEV JT ELBOW TOTAL LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6272728,IMP DEV JT ELBOW TOTAL LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,6272736,IMP DEV JT ELBOW TOTAL LVL 08,35044.0,14718.48,9461.88,34343.12,30
CDM,6272744,IMP DEV JT ELBOW TOTAL LVL 09,39424.0,16558.08,10644.48,38635.52,30
CDM,6272751,IMP DEV JT ELBOW TOTAL LVL 10,43804.0,18397.68,11827.08,42927.92,30
CDM,6272769,IMP DEV JT ELBOW TOTAL LVL 11,48184.0,20237.28,13009.68,47220.32,30
CDM,6272777,IMP DEV JT ELBOW TOTAL LVL 12,52564.0,22076.88,14192.28,51512.72,30
CDM,6272785,IMP DEV JT ELBOW TOTAL LVL 13,56944.0,23916.48,15374.88,55805.12,30
CDM,6272793,IMP DEV JT ELBOW TOTAL LVL 14,61324.0,25756.08,16557.48,60097.52,30
CDM,6272801,IMP DEV JT ELBOW TOTAL LVL 15,65704.0,27595.68,17740.08,64389.92,30
CDM,6272819,IMP TISSUE CONNECT HUMAN LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6272827,IMP TISSUE CONNECT HUMAN LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,6272835,IMP TISSUE CONNECT HUMAN LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,6272926,PAIN MGMT ACCESSORY LVL 01,313.0,131.46,84.51,306.74,30
CDM,6272934,PAIN MGMT ACCESSORY LVL 02,594.0,249.48,160.38,582.12,30
CDM,6272942,PAIN MGMT ACCESSORY LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6273171,IMP ACCESS SYSTEM DIALYS LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6273189,IMP ACCESS SYSTEM DIALYS LVL 05,5861.0,2461.62,1582.47,5743.78,30
CDM,6273197,IMP ACCESS SYSTEM DIALYS LVL 06,8107.0,3404.94,2188.89,7944.86,30
CDM,6273205,INTRO EP FIX CRV PEEL LVL 02,594.0,249.48,160.38,582.12,30
CDM,6273213,INTRO EP LASER LVL 01,313.0,131.46,84.51,306.74,30
CDM,6273221,INTRO EP LASER LVL 02,594.0,249.48,160.38,582.12,30
CDM,6273247,IMP DEV URINARY W SLING LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6273254,IMP DEV URINARY W SLING LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6273288,IMP ORTHOPEDIC CAGE LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,6273296,IMP ORTHOPEDIC CAGE LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6273304,IMP ORTHOPEDIC CAGE LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,6273312,IMP ORTHOPEDIC CAGE LVL 05,17524.0,7360.08,4731.48,17173.52,30
CDM,6273320,IMP ORTHOPEDIC CAGE LVL 06,21904.0,9199.68,5914.08,21465.92,30
CDM,6273338,IMP ORTHOPEDIC CAGE LVL 07,26284.0,11039.28,7096.68,25758.32,30
CDM,6273346,IMP ORTHOPEDIC CAGE LVL 08,30664.0,12878.88,8279.28,30050.72,30
CDM,6273353,IMP ORTHOPEDIC CAGE LVL 09,35044.0,14718.48,9461.88,34343.12,30
CDM,6273361,IMP LD PCMKR NON VDD LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,6273379,IMP STENT NONCOR TEMP WO DEL LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6273387,IMP STENT NONCOR TEMP WO DEL LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6273395,IMP STENT NONCOR TEMP WO DEL LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6273403,IMP STENT NONCOR TEMP WO DEL LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6273494,CEMENT ACCESSORIES LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6273502,CEMENT ACCESSORIES LVL 08,15334.0,6440.28,4140.18,15027.32,30
CDM,6273510,PROGRAMMER PT NEUROSTIM LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6273528,IMP PROSTH PENILE INFLT LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6273585,CLIP APPLIER LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,6273627,IMP DEV JT KNEE TOTAL LVL 21,109504.0,45991.68,29566.08,107313.92,30
CDM,6273635,IMP DEV JT KNEE TOTAL LVL 22,122644.0,51510.48,33113.88,120191.12,30
CDM,6273643,IMP DEV JT KNEE TOTAL LVL 23,135784.0,57029.28,36661.68,133068.32,30
CDM,6273668,KIT/SET NON ROUTINE ORTH LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6273676,KIT/SET NON ROUTINE SURG LVL 14,17524.0,7360.08,4731.48,17173.52,30
CDM,6273684,KIT/SET NON ROUTINE SURG LVL 15,21904.0,9199.68,5914.08,21465.92,30
CDM,6273692,IMP CLIP ANEURYSM LVL 02,3596.0,1510.32,970.92,3524.08,30
CDM,6273700,IMP LD NEUROSTIM LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,6273718,IMP LD NEUROSTIM LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6273726,IMP LD NEUROSTIM LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6273734,IMP RING CARDIAC LVL 03,17524.0,7360.08,4731.48,17173.52,30
CDM,6273742,IMP LD ICD COIL SGL LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,6273759,IMP LD ICD COIL SGL LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6273767,IMP LD ICD COIL SGL LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6273775,IMP LD ICD COIL SGL LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6273783,IMP LD ICD COIL SGL LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6273791,IMP LD ICD COIL SGL LVL 07,15334.0,6440.28,4140.18,15027.32,30
CDM,6273809,IMP LD ICD COIL SGL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6273817,IMP LD ICD COIL SGL LVL 09,19714.0,8279.88,5322.78,19319.72,30
CDM,6273825,IMP LD ICD COIL DUAL LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,6273833,IMP LD ICD COIL DUAL LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6273841,IMP LD ICD COIL DUAL LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6273858,IMP LD ICD COIL DUAL LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6273866,IMP LD ICD COIL DUAL LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6273874,IMP LD ICD COIL DUAL LVL 07,15334.0,6440.28,4140.18,15027.32,30
CDM,6273882,IMP LD ICD COIL DUAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6273890,IMP LD ICD COIL DUAL LVL 09,19714.0,8279.88,5322.78,19319.72,30
CDM,6273908,INTRO EP FIX CRV PEEL LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,6273916,INTRO EP FIX CRV PEEL LVL 04,2023.0,849.66,546.21,1982.54,30
CDM,6273924,IMP DEV JT SHDR TOTAL LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,6273932,IMP DEV JT SHDR TOTAL LVL 12,35044.0,14718.48,9461.88,34343.12,30
CDM,6273940,IMP PROSTH ENT LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6273957,IMP PROSTH ENT LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6273965,IMP PROSTH ENT LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6273973,IMP PROSTH ENT LVL 08,11580.0,4863.6,3126.6,11348.4,30
CDM,6274005,IMP PROSTH SPHINCTR ANAL LVL 02,11580.0,4863.6,3126.6,11348.4,30
CDM,6274013,CLIP LVL 04,850.0,357.0,229.5,833.0,30
CDM,6274021,IMP FIX SPINE LVL 09,27160.0,11407.2,7333.2,26616.8,30
CDM,6274039,CATH EP NON 3D 20+ LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6274047,CATH EP NON 3D 20+ LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,6274054,CATH EP NON 3D 20+ LVL 05,17524.0,7360.08,4731.48,17173.52,30
CDM,6274062,IMP LD VENOUS COR LV LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6274070,IMP LD VENOUS COR LV LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6274088,IMP LD VENOUS COR LV LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6274096,IMP LD VENOUS COR LV LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6274104,IMP LD VENOUS COR LV LVL 08,26284.0,11039.28,7096.68,25758.32,30
CDM,6274112,IMP LD VENOUS COR LV LVL 09,30664.0,12878.88,8279.28,30050.72,30
CDM,6274260,IMP PCMKR DUAL RR LVL 05,65704.0,27595.68,17740.08,64389.92,30
CDM,6274278,IMP PCMKR DUAL RR LVL 06,87604.0,36793.68,23653.08,85851.92,30
CDM,6274286,IMP PCMKR DUAL RR LVL 07,109504.0,45991.68,29566.08,107313.92,30
CDM,6274294,IMP LD PCMKR NON VDD LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6274302,IMP LD PCMKR NON VDD LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,6274310,IMP LD PCMKR NON VDD LVL 05,17524.0,7360.08,4731.48,17173.52,30
CDM,6274328,IMP LD PCMKR NON VDD LVL 06,21904.0,9199.68,5914.08,21465.92,30
CDM,6274336,IMP LD PCMKR NON VDD LVL 07,26284.0,11039.28,7096.68,25758.32,30
CDM,6274344,IMP LD PCMKR NON VDD LVL 08,30664.0,12878.88,8279.28,30050.72,30
CDM,6274351,IMP ICD CHAMBER NON SGL/DUAL LVL 05,109504.0,45991.68,29566.08,107313.92,30
CDM,6274369,IMP DEV CLOSURE VASCULAR LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6274377,IMP PLATE LVL 15,18400.0,7728.0,4968.0,18032.0,30
CDM,6274393,TAPE MARKING RADIOPAQUE LVL 01,166.0,69.72,44.82,162.68,30
CDM,6274401,DEVICE INSERT RETRV LVL 02,2157.0,905.94,582.39,2113.86,30
CDM,6274419,DEVICE INSERT RETRV LVL 03,3596.0,1510.32,970.92,3524.08,30
CDM,6274427,IMP LD ICD COIL DUAL LVL 10,24094.0,10119.48,6505.38,23612.12,30
CDM,6274435,IMP PCMKR NONSGL OR DUAL LVL 04,35040.0,14716.8,9460.8,34339.2,30
CDM,6274468,CATH ANGIO TRANSL LASER LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6274476,IMP PROSTH ENT LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6274484,IMP PROSTH ENT LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6274492,IMP PROSTH ENT LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6274500,IMP PROSTH ENT LVL 12,26284.0,11039.28,7096.68,25758.32,30
CDM,6274518,CATH ATHERECT TRANSL ROTAT LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6274526,IMP FILTER VENA CAVA LVL 02,2690.0,1129.8,726.3,2636.2,30
CDM,6274575,DIALYSIS ACCESSORIES LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,6274617,IMP LD PCMKR VDD LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6274625,IMP LD PCMKR VDD LVL 04,11580.0,4863.6,3126.6,11348.4,30
CDM,6274633,IMP LD PCMKR VDD LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6274641,IMP LD PCMKR VDD LVL 06,15334.0,6440.28,4140.18,15027.32,30
CDM,6274658,IMP LD PCMKR VDD LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6274666,IMP LD PCMKR VDD LVL 08,19714.0,8279.88,5322.78,19319.72,30
CDM,6274682,CATH DIAGNOSTIC LVL 10,6950.0,2919.0,1876.5,6811.0,30
CDM,6274690,REAMER LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6274708,IMP PUMP INF PRG LVL 02,8112.0,3407.04,2190.24,7949.76,30
CDM,6274716,IMP PUMP INF PRG LVL 03,10431.0,4381.02,2816.37,10222.38,30
CDM,6274724,IMP PUMP INF PRG LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,6274732,IMP PUMP INF PRG LVL 05,19714.0,8279.88,5322.78,19319.72,30
CDM,6274740,IMP PUMP INF PRG LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6274757,IMP PUMP INF PRG LVL 07,32854.0,13798.68,8870.58,32196.92,30
CDM,6274765,IMP PUMP INF PRG LVL 08,39424.0,16558.08,10644.48,38635.52,30
CDM,6274773,IMP PUMP INF PRG LVL 09,46870.0,19685.4,12654.9,45932.6,30
CDM,6274781,IMP PROSTH TESTICULAR LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6274799,IMP PROSTH TESTICULAR LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,6274807,IMP PROSTH TESTICULAR LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6274815,IMP PROSTH TESTICULAR LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,6274823,IMP PROSTH TESTICULAR LVL 08,35044.0,14718.48,9461.88,34343.12,30
CDM,6274864,IMP PLATE LVL 16,21904.0,9199.68,5914.08,21465.92,30
CDM,6274872,IMP PLATE LVL 17,24094.0,10119.48,6505.38,23612.12,30
CDM,6275028,CATH INTRASPINAL LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6275036,CATH INTRASPINAL LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6275044,IMP DEV URINARY WO SLNG LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6275051,IMP DEV URINARY WO SLNG LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6275077,IMP ICD CHAMBER NON SGL/DUAL LVL 06,122644.0,51510.48,33113.88,120191.12,30
CDM,6275085,CATH INTRAVASCULAR US LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,6275101,SUPPLY OSTOMY LVL 01,32.0,13.44,8.64,31.36,30
CDM,6275135,CANNULA LVL 09,6105.0,2564.1,1648.35,5982.9,30
CDM,6275143,IMP PUMP VALVE BLOOD LVL 06,87604.0,36793.68,23653.08,85851.92,30
CDM,6275184,IMP BONE HUMAN/SYNTHETIC LVL 12,30664.0,12878.88,8279.28,30050.72,30
CDM,6275192,IMP BONE HUMAN/SYNTHETIC LVL 13,35482.0,14902.44,9580.14,34772.36,30
CDM,6275200,IMP PROSTH ORTHOPEDIC LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6275218,IMP PROSTH ORTHOPEDIC LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,6275226,DILATOR LVL 06,3340.0,1402.8,901.8,3273.2,30
CDM,6275259,INTRO EP FIX CRV NONPEEL LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6275275,VEST AIRWAY DISPOSABLE LVL 01,594.0,249.48,160.38,582.12,30
CDM,6275291,PAIN MGMT ACCESSORY LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,6275309,PAIN MGMT ACCESSORY LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6275317,IMP FIX SPINE LVL 10,32854.0,13798.68,8870.58,32196.92,30
CDM,6275325,CATH ANGIO TRANSL LASER LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6275374,IMP DEV COCHLEAR INT&EXT CMP LVL 04,96364.0,40472.88,26018.28,94436.72,30
CDM,6275390,IMP PROSTH ANKLE LVL 09,39424.0,16558.08,10644.48,38635.52,30
CDM,6275408,KIT/SET NON ROUTINE CARDIAC LVL 07,6487.0,2724.54,1751.49,6357.26,30
CDM,6275416,KIT/SET NON ROUTINE CARDIAC LVL 08,7876.0,3307.92,2126.52,7718.48,30
CDM,6275531,CATH INTRACARDIAC ECHO LVL 03,6487.0,2724.54,1751.49,6357.26,30
CDM,6275580,IMP DEV URINARY W SLING LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6275622,IMP STAPLE BONE LVL 12,7413.0,3113.46,2001.51,7264.74,30
CDM,6275671,IMP PROSTH MAXILLOFACIAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6275689,IMP PROSTH MAXILLOFACIAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6275697,IMP PROSTH MAXILLOFACIAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6275705,IMP PROSTH MAXILLOFACIAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6275762,CATH ABL COOL-TIP LVL 06,6487.0,2724.54,1751.49,6357.26,30
CDM,6275770,CATH ABL COOL-TIP LVL 07,7413.0,3113.46,2001.51,7264.74,30
CDM,6275788,IMP NRSTM BAT RECHG SYS LVL 05,43800.0,18396.0,11826.0,42924.0,30
CDM,6275796,IMP NRSTM BAT RECHG SYS LVL 06,65704.0,27595.68,17740.08,64389.92,30
CDM,6275804,IMP NRSTM BAT RECHG SYS LVL 07,87604.0,36793.68,23653.08,85851.92,30
CDM,6275820,INTRO EP FIX CRV PEEL LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6275853,HEMOSTATIC AGENT LVL 05,3083.0,1294.86,832.41,3021.34,30
CDM,6275861,IMP PUMP INF PRG LVL 10,51250.0,21525.0,13837.5,50225.0,30
CDM,6275879,IMP MATERIAL CORD VOCAL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6275895,STYLET LVL 04,1888.0,792.96,509.76,1850.24,30
CDM,6275903,EMBOLIZATION SYS PROTECT LVL 03,8339.0,3502.38,2251.53,8172.22,30
CDM,6275911,CATH ABL NONCARDIAC LVL 01,1619.0,679.98,437.13,1586.62,30
CDM,6275929,CATH ABL NONCARDIAC LVL 02,3083.0,1294.86,832.41,3021.34,30
CDM,6275937,IMP DEV JT KNEE TOTAL LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,6275945,IMP DEV JT KNEE TOTAL LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6275952,IMP DEV JT KNEE TOTAL LVL 03,4880.0,2049.6,1317.6,4782.4,30
CDM,6275986,IMP TISSUE CONNECT HUMAN LVL 12,35044.0,14718.48,9461.88,34343.12,30
CDM,6276034,BIT LVL 09,6024.0,2530.08,1626.48,5903.52,30
CDM,6276042,IMP DEV URINARY WO SLNG LVL 01,2421.0,1016.82,653.67,2372.58,30
CDM,6276083,CATH ATHERECT TRANSL DIRECT LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6276117,IMP EMBOLIZATION AGENT LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6276125,IMP EMBOLIZATION AGENT LVL 03,3596.0,1510.32,970.92,3524.08,30
CDM,6276133,IMP EMBOLIZATION AGENT LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,6276141,IMP EMBOLIZATION AGENT LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,6276158,IMP EMBOLIZATION AGENT LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6276166,IMP EMBOLIZATION AGENT LVL 07,11580.0,4863.6,3126.6,11348.4,30
CDM,6276174,IMP EMBOLIZATION AGENT LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,6276182,IMP EMBOLIZATION AGENT LVL 09,15334.0,6440.28,4140.18,15027.32,30
CDM,6276190,IMP PROSTH ORTHOPEDIC LVL 01,1614.0,677.88,435.78,1581.72,30
CDM,6276208,IMP PROSTH ORTHOPEDIC LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6276216,IMP TISSUE CONNECT HUMAN LVL 13,39424.0,16558.08,10644.48,38635.52,30
CDM,6276224,IMP TISSUE CONNECT HUMAN LVL 14,43804.0,18397.68,11827.08,42927.92,30
CDM,6276232,IMP BOLT LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6276240,IMP LD PCMKR VDD LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6276257,HYPO-HYPER THERMAL LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,6276273,IMP DEV JT SHDR TOTAL LVL 13,39424.0,16558.08,10644.48,38635.52,30
CDM,6276281,IMP DEV JT SHDR TOTAL LVL 14,43804.0,18397.68,11827.08,42927.92,30
CDM,6276299,IMP DEV JT SHDR TOTAL LVL 15,48184.0,20237.28,13009.68,47220.32,30
CDM,6276315,PIN GUIDE LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6276323,IMP LD NEUROSTIM LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,6276331,IMP LD NEUROSTIM LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6276356,RETRIEVER SUTURE LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6276364,RETRIEVER SUTURE LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,6276372,RETRIEVER SUTURE LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6276398,INTRO EP LASER LVL 03,1888.0,792.96,509.76,1850.24,30
CDM,6276406,INTRO EP LASER LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,6276414,INTRO EP LASER LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6276422,INTRO EP LASER LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6276430,INTRO EP LASER LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6276455,IMP AGENT SYNTHETIC BULK 1ML LVL 02,447.0,187.74,120.69,438.06,30
CDM,6276463,IMP AGENT SYNTHETIC BULK 1ML LVL 03,709.0,297.78,191.43,694.82,30
CDM,6276471,IMP AGENT SYNTHETIC BULK 1ML LVL 04,1272.0,534.24,343.44,1246.56,30
CDM,6276497,IMP SEPTAL DEFECT INTRACARD LVL 02,19714.0,8279.88,5322.78,19319.72,30
CDM,6276505,IMP SEPTAL DEFECT INTRACARD LVL 03,24094.0,10119.48,6505.38,23612.12,30
CDM,6276513,IMP DEV URINARY W SLING LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6276521,IMP DEV URINARY WO SLNG LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6276604,MORCELLATOR LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6276612,MORCELLATOR LVL 02,4880.0,2049.6,1317.6,4782.4,30
CDM,6276620,MORCELLATOR LVL 03,9260.0,3889.2,2500.2,9074.8,30
CDM,6276638,CATH THROMBECTOMY/EMBOLECTMY LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6276646,INTRO LVL 08,7876.0,3307.92,2126.52,7718.48,30
CDM,6276653,INTRO LVL 09,10191.0,4280.22,2751.57,9987.18,30
CDM,6276661,CATH INTRACARDIAC ECHO LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6276679,IMP TISSUE CONNECT NONHUMAN LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6276687,IMP LD ICD COIL DUAL LVL 11,32854.0,13798.68,8870.58,32196.92,30
CDM,6276729,IMP AGENT SYNTHETIC BULK 1ML LVL 05,2690.0,1129.8,726.3,2636.2,30
CDM,6276737,IMP AGENT SYNTHETIC BULK 1ML LVL 06,3078.0,1292.76,831.06,3016.44,30
CDM,6276794,IMP ROD/NAIL LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6276802,HANDPIECE LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6276810,HANDPIECE LVL 08,21904.0,9199.68,5914.08,21465.92,30
CDM,6276828,HANDPIECE LVL 09,26284.0,11039.28,7096.68,25758.32,30
CDM,6276836,HANDPIECE LVL 10,30664.0,12878.88,8279.28,30050.72,30
CDM,6276844,HANDPIECE LVL 11,35044.0,14718.48,9461.88,34343.12,30
CDM,6276851,HANDPIECE LVL 12,39424.0,16558.08,10644.48,38635.52,30
CDM,6276885,SUPPLY PERFUSION/ECMO LVL 11,7181.0,3016.02,1938.87,7037.38,30
CDM,6276893,INTRO NON GD/EP/LASER LVL 01,96.0,40.32,25.92,94.08,30
CDM,6276927,CATH INTRACARDIAC ECHO LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6276935,CATH INTRACARDIAC ECHO LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6276943,IMP PCMKR SGL RR LVL 02,17520.0,7358.4,4730.4,17169.6,30
CDM,6276968,IMP DEV CLOSURE VASCULAR LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6276976,IMP DEV CLOSURE VASCULAR LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6276984,IMP DEV CLOSURE VASCULAR LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6276992,IMP DEV CLOSURE VASCULAR LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6277008,DILATOR LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,6277016,IMP DEV JT HIP TOTAL LVL 17,109504.0,45991.68,29566.08,107313.92,30
CDM,6277024,IMP MEMBRANE AMNIO OCULAR LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6277032,IMP MEMBRANE AMNIO OCULAR LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6277057,IMP CEMENT LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6277065,IMP CEMENT LVL 07,11580.0,4863.6,3126.6,11348.4,30
CDM,6277099,IMP PLATE CUST LVL 01,65704.0,27595.68,17740.08,64389.92,30
CDM,6277107,IMP PLATE CUST LVL 02,87604.0,36793.68,23653.08,85851.92,30
CDM,6277115,IMP PLATE CUST LVL 03,109504.0,45991.68,29566.08,107313.92,30
CDM,6277123,IMP PLATE CUST LVL 04,131404.0,55189.68,35479.08,128775.92,30
CDM,6277131,IMP BONE HUMAN/SYNTHETIC LVL 14,39862.0,16742.04,10762.74,39064.76,30
CDM,6277149,IMP BONE HUMAN/SYNTHETIC LVL 15,44242.0,18581.64,11945.34,43357.16,30
CDM,6277156,IMP BONE HUMAN/SYNTHETIC LVL 16,48622.0,20421.24,13127.94,47649.56,30
CDM,6277164,IMP BONE HUMAN/SYNTHETIC LVL 17,53002.0,22260.84,14310.54,51941.96,30
CDM,6277172,IMP SPINE KYPHX LVL 01,594.0,249.48,160.38,582.12,30
CDM,6277180,IMP SPINE KYPHX LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6277198,IMP SPINE KYPHX LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6277206,IMP SPINE KYPHX LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,6277214,IMP SPINE KYPHX LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6277222,IMP SPINE KYPHX LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6277230,IMP SPINE KYPHX LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6277248,IMP SPINE KYPHX LVL 08,21904.0,9199.68,5914.08,21465.92,30
CDM,6277545,NEEDLE SPECIALTY LVL 08,2827.0,1187.34,763.29,2770.46,30
CDM,6277552,NEEDLE SPECIALTY LVL 09,3340.0,1402.8,901.8,3273.2,30
CDM,6277560,NEEDLE SPECIALTY LVL 10,3853.0,1618.26,1040.31,3775.94,30
CDM,6277578,LASER FIBER LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,6277669,IMP PROSTH SPHINCTR URIN LVL 02,14020.0,5888.4,3785.4,13739.6,30
CDM,6277818,IMP TISSUE CONNECT NONHUMAN LVL 08,30664.0,12878.88,8279.28,30050.72,30
CDM,6277842,IMP PROSTH SPHINCTR URIN LVL 03,19714.0,8279.88,5322.78,19319.72,30
CDM,6277859,IMP PROSTH SPHINCTR URIN LVL 04,25408.0,10671.36,6860.16,24899.84,30
CDM,6277875,SENSOR ENDOSURE AAA LVL 01,13895.0,5835.9,3751.65,13617.1,30
CDM,6277917,DRESSING SPECIALTY LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6277925,IMP MARKER TISSUE LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6277933,INTRO EP FIX CRV NONPEEL LVL 03,1888.0,792.96,509.76,1850.24,30
CDM,6277941,INTRO EP FIX CRV NONPEEL LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6277958,INTRO EP FIX CRV NONPEEL LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6277982,IMP PCMKR DUAL RR LVL 01,17520.0,7358.4,4730.4,17169.6,30
CDM,6278014,IMP DEV URINARY W SLING LVL 06,14020.0,5888.4,3785.4,13739.6,30
CDM,6278113,CATH INTRAVASCULAR US LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,6278121,CATH INTRAVASCULAR US LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6278139,CATH INTRAVASCULAR US LVL 07,11580.0,4863.6,3126.6,11348.4,30
CDM,6278147,IMP PIN/WIRE LVL 08,2426.0,1018.92,655.02,2377.48,30
CDM,6278154,IMP PIN/WIRE LVL 09,2827.0,1187.34,763.29,2770.46,30
CDM,6278162,IMP PIN/WIRE LVL 10,3340.0,1402.8,901.8,3273.2,30
CDM,6278170,IMP PIN/WIRE LVL 11,3853.0,1618.26,1040.31,3775.94,30
CDM,6278188,CATH GUIDE LVL 10,6105.0,2564.1,1648.35,5982.9,30
CDM,6278196,CATH GUIDE LVL 11,9265.0,3891.3,2501.55,9079.7,30
CDM,6278204,CATH GUIDE LVL 12,11580.0,4863.6,3126.6,11348.4,30
CDM,6278220,IMP SHUNT LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6278238,IMP ICD CHAMBER NON SGL/DUAL LVL 03,78840.0,33112.8,21286.8,77263.2,30
CDM,6278246,CATH INTRACARDIAC ECHO LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6278253,IMP ROD/NAIL LVL 11,15334.0,6440.28,4140.18,15027.32,30
CDM,6278261,IMP ROD/NAIL LVL 12,19714.0,8279.88,5322.78,19319.72,30
CDM,6278279,IMP ROD/NAIL LVL 13,24094.0,10119.48,6505.38,23612.12,30
CDM,6278329,IMP PIN/WIRE LVL 12,6105.0,2564.1,1648.35,5982.9,30
CDM,6278337,IMP CABLE LVL 07,6950.0,2919.0,1876.5,6811.0,30
CDM,6278345,IMP CABLE LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6278352,IMP CABLE LVL 09,11580.0,4863.6,3126.6,11348.4,30
CDM,6278360,IMP PCMKR DUAL NON RR LVL 01,19714.0,8279.88,5322.78,19319.72,30
CDM,6278378,IMP PCMKR DUAL NON RR LVL 02,24090.0,10117.8,6504.3,23608.2,30
CDM,6278386,IMP PCMKR SGL NON RR LVL 02,19714.0,8279.88,5322.78,19319.72,30
CDM,6278394,IMP PCMKR SGL NON RR LVL 03,22776.0,9565.92,6149.52,22320.48,30
CDM,6278410,IMP CARDIAC EVENT REC LVL 03,14892.0,6254.64,4020.84,14594.16,30
CDM,6278444,CANNULA LVL 10,7181.0,3016.02,1938.87,7037.38,30
CDM,6278451,CANNULA LVL 11,10654.0,4474.68,2876.58,10440.92,30
CDM,6278469,IMP PROSTH SPHINCTR ANAL LVL 01,5368.0,2254.56,1449.36,5260.64,30
CDM,6278519,IMP CEMENT LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,6278584,STAPLE RELOAD LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6278600,STAPLE RELOAD LVL 08,8107.0,3404.94,2188.89,7944.86,30
CDM,6278634,IMP DEV COCHLEAR INT&EXT CMP LVL 06,131404.0,55189.68,35479.08,128775.92,30
CDM,6278642,IMP DEV COCHLEAR INT&EXT CMP LVL 07,153304.0,64387.68,41392.08,150237.92,30
CDM,6278659,IMP DEV COCHLEAR INT&EXT CMP LVL 08,175204.0,73585.68,47305.08,171699.92,30
CDM,6278667,IMP DEV COCHLEAR INT&EXT CMP LVL 09,197104.0,82783.68,53218.08,193161.92,30
CDM,6278675,IMP DEV COCHLEAR INT&EXT CMP LVL 10,219004.0,91981.68,59131.08,214623.92,30
CDM,6278683,DEVICE INSERT RETRV LVL 04,4397.0,1846.74,1187.19,4309.06,30
CDM,6278709,IMP DEV JT SHDR TOTAL LVL 16,55630.0,23364.6,15020.1,54517.4,30
CDM,6278717,CATH ABL EP NON 3D/VECTOR LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6278741,SUPPLY NEURO LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,6278758,IMP MESH LVL 15,37234.0,15638.28,10053.18,36489.32,30
CDM,6278766,BAG DRAINAGE LVL 04,535.0,224.7,144.45,524.3,30
CDM,6278774,BAG DRAINAGE LVL 05,766.0,321.72,206.82,750.68,30
CDM,6278857,LENS INTRAOCULAR CHAM POST LVL 01,594.0,249.48,160.38,582.12,30
CDM,6278865,LENS INTRAOCULAR CHAM POST LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6278873,LENS INTRAOCULAR CHAM POST LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6278881,LENS INTRAOCULAR CHAM ANT LVL 01,594.0,249.48,160.38,582.12,30
CDM,6278899,LENS INTRAOCULAR CHAM ANT LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6278907,LENS INTRAOCULAR CHAM ANT LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6278915,INTRO EP FIX CRV PEEL LVL 06,3596.0,1510.32,970.92,3524.08,30
CDM,6278931,IMP PIN/WIRE LVL 13,8107.0,3404.94,2188.89,7944.86,30
CDM,6278949,IMP LD ICD NON SGL/DUAL LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6278956,IMP STENT NOS LVL 15,43804.0,18397.68,11827.08,42927.92,30
CDM,6278972,IMP ADPT/EXT LD PACING/NEURO LVL 03,7413.0,3113.46,2001.51,7264.74,30
CDM,6278980,IMP NRSTM BAT RECHG SYS LVL 03,14892.0,6254.64,4020.84,14594.16,30
CDM,6278998,IMP NRSTM BAT RECHG SYS LVL 04,28470.0,11957.4,7686.9,27900.6,30
CDM,6279004,IMP LD NEUROSTIM LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,6279020,IMP NRSTM BAT RECHG SYS LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,6279038,IMP NRSTM BAT RECHG SYS LVL 02,6945.0,2916.9,1875.15,6806.1,30
CDM,6279046,PAIN MGMT ACCESSORY LVL 06,3340.0,1402.8,901.8,3273.2,30
CDM,6279111,REAMER LVL 02,588.0,246.96,158.76,576.24,30
CDM,6279152,IMP FIX SPINE LVL 11,39424.0,16558.08,10644.48,38635.52,30
CDM,6279160,RETRIEVER BASKET LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6279178,REAMER LVL 01,159.0,66.78,42.93,155.82,30
CDM,6279194,IMP ICD CHAMBER SGL LVL 01,43800.0,18396.0,11826.0,42924.0,30
CDM,6279202,CATH ABL COOL-TIP LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6279210,CATH ABL COOL-TIP LVL 09,11575.0,4861.5,3125.25,11343.5,30
CDM,6279228,CATH ABL COOL-TIP LVL 10,13432.0,5641.44,3626.64,13163.36,30
CDM,6279236,IMP PROSTH ORTHOPEDIC LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6279269,IMP DEV INTERSPINOUS LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,6279277,IMP DEV INTERSPINOUS LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,6279285,IMP DEV INTERSPINOUS LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6279293,IMP DEV INTERSPINOUS LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6279301,IMP DEV INTERSPINOUS LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,6279319,IMP DEV INTERSPINOUS LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6279327,IMP DEV INTERSPINOUS LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,6279335,IMP DEV INTERSPINOUS LVL 08,35044.0,14718.48,9461.88,34343.12,30
CDM,6279343,HYPO-HYPER THERMAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6279376,IMP ORTHOPEDIC CAGE LVL 10,39424.0,16558.08,10644.48,38635.52,30
CDM,6279384,IMP STAPLE BONE LVL 13,8339.0,3502.38,2251.53,8172.22,30
CDM,6279392,IMP BONE HUMAN/SYNTHETIC LVL 18,61324.0,25756.08,16557.48,60097.52,30
CDM,6279400,IMP BONE HUMAN/SYNTHETIC LVL 19,70084.0,29435.28,18922.68,68682.32,30
CDM,6279418,IMP BONE HUMAN/SYNTHETIC LVL 20,78844.0,33114.48,21287.88,77267.12,30
CDM,6279426,IMP BONE HUMAN/SYNTHETIC LVL 21,87604.0,36793.68,23653.08,85851.92,30
CDM,6279434,IMP ORTHOPEDIC CAGE LVL 11,52564.0,22076.88,14192.28,51512.72,30
CDM,6279442,IMP ORTHOPEDIC CAGE LVL 12,65704.0,27595.68,17740.08,64389.92,30
CDM,6279459,IMP FIX SPINE LVL 12,52564.0,22076.88,14192.28,51512.72,30
CDM,6279467,IMP FIX SPINE LVL 13,65704.0,27595.68,17740.08,64389.92,30
CDM,6279475,IMP ORTHOPEDIC CAGE LVL 13,78844.0,33114.48,21287.88,77267.12,30
CDM,6279483,IMP FIX SPINE LVL 14,78844.0,33114.48,21287.88,77267.12,30
CDM,6279491,IMP BONE HUMAN/SYNTHETIC LVL 22,96364.0,40472.88,26018.28,94436.72,30
CDM,6279509,IMP GENERATOR NEUROSTIM LVL 05,109504.0,45991.68,29566.08,107313.92,30
CDM,6279525,IMP TUBE EAR LVL 02,447.0,187.74,120.69,438.06,30
CDM,6279533,IMP TUBE EAR LVL 03,709.0,297.78,191.43,694.82,30
CDM,6279541,IMP ORTHOTIC CAP END LVL 01,159.0,66.78,42.93,155.82,30
CDM,6279558,IMP ORTHOTIC CAP END LVL 02,313.0,131.46,84.51,306.74,30
CDM,6279566,IMP ORTHOTIC CAP END LVL 03,850.0,357.0,229.5,833.0,30
CDM,6279574,IMP ORTHOTIC CAP END LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6279582,IMP ORTHOTIC CAP END LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,6279590,IMP ORTHOTIC CAP END LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6279608,IMP STENT NONCOR TEMP W DEL LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6279624,INSERTS LVL 03,594.0,249.48,160.38,582.12,30
CDM,6279632,INSERTS LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6279640,IMP DEV URINARY W SLING LVL 07,17962.0,7544.04,4849.74,17602.76,30
CDM,6279665,CATH INTRAVASCULAR US LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,6279673,CATH INTRAVASCULAR US LVL 09,15334.0,6440.28,4140.18,15027.32,30
CDM,6279699,DRESSING SPECIALTY LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6279707,DRESSING SPECIALTY LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6279715,IMP SPINE FUSION LVL 03,7413.0,3113.46,2001.51,7264.74,30
CDM,6279723,IMP SPINE FUSION LVL 04,8339.0,3502.38,2251.53,8172.22,30
CDM,6279731,IMP SPINE FUSION LVL 05,9728.0,4085.76,2626.56,9533.44,30
CDM,6279749,IMP SPINE FUSION LVL 06,11117.0,4669.14,3001.59,10894.66,30
CDM,6279756,IMP SPINE FUSION LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6279764,IMP SPINE FUSION LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6279772,IMP SPINE FUSION LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6279780,IMP SPINE FUSION LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,6279798,IMP SPINE FUSION LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,6279806,IMP SPINE FUSION LVL 12,35044.0,14718.48,9461.88,34343.12,30
CDM,6279814,IMP SPINE FUSION LVL 13,39424.0,16558.08,10644.48,38635.52,30
CDM,6279830,IMP CEMENT ACCESSORY LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6279848,IMP CEMENT ACCESSORY LVL 06,4880.0,2049.6,1317.6,4782.4,30
CDM,6279855,IMP PLATE LVL 18,26284.0,11039.28,7096.68,25758.32,30
CDM,6279863,IMP PLATE LVL 19,28474.0,11959.08,7687.98,27904.52,30
CDM,6279871,IMP PLATE LVL 20,30664.0,12878.88,8279.28,30050.72,30
CDM,6279889,IMP PLATE LVL 21,32854.0,13798.68,8870.58,32196.92,30
CDM,6279897,IMP PLATE LVL 22,35044.0,14718.48,9461.88,34343.12,30
CDM,6279996,IMP SPINE FUSION LVL 14,43804.0,18397.68,11827.08,42927.92,30
CDM,6280002,IMP SPINE FUSION LVL 15,48184.0,20237.28,13009.68,47220.32,30
CDM,6280010,IMP SPINE FUSION LVL 16,52564.0,22076.88,14192.28,51512.72,30
CDM,6280028,IMP SPINE FUSION LVL 17,56944.0,23916.48,15374.88,55805.12,30
CDM,6280036,IMP SPINE FUSION LVL 18,61324.0,25756.08,16557.48,60097.52,30
CDM,6280044,IMP PROSTH ANKLE LVL 10,43804.0,18397.68,11827.08,42927.92,30
CDM,6280051,STAPLE RELOAD LVL 09,10422.0,4377.24,2813.94,10213.56,30
CDM,6280101,IMP TISSUE CONNECT NONHUMAN LVL 09,39424.0,16558.08,10644.48,38635.52,30
CDM,6280119,IMP TISSUE CONNECT NONHUMAN LVL 10,43804.0,18397.68,11827.08,42927.92,30
CDM,6280200,INSTRUMENT DISP SINGLE LVL 13,15334.0,6440.28,4140.18,15027.32,30
CDM,6280234,IMP SPINE FUSION LVL 19,65704.0,27595.68,17740.08,64389.92,30
CDM,6280242,IMP SPINE FUSION LVL 20,70084.0,29435.28,18922.68,68682.32,30
CDM,6280259,IMP SPINE FUSION LVL 21,74464.0,31274.88,20105.28,72974.72,30
CDM,6280267,IMP SPINE FUSION LVL 22,78844.0,33114.48,21287.88,77267.12,30
CDM,6280275,IMP SPINE FUSION LVL 23,83224.0,34954.08,22470.48,81559.52,30
CDM,6280283,CATH/WIRE/SUTURE PASSER LVL 03,850.0,357.0,229.5,833.0,30
CDM,6280291,BRA SURG POSTOP LVL 01,159.0,66.78,42.93,155.82,30
CDM,6280309,IMP SPINE FUSION LVL 24,111694.0,46911.48,30157.38,109460.12,30
CDM,6280317,SENSOR CEREBRAL OXIMETER LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,6280325,IMP BOLT LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6280333,IMP BOLT LVL 08,12506.0,5252.52,3376.62,12255.88,30
CDM,6280341,CLIP LVL 05,1485.0,623.7,400.95,1455.3,30
CDM,6280358,CLIP LVL 06,2028.0,851.76,547.56,1987.44,30
CDM,6280366,NEEDLE BRACHYTHERAPY LVL 02,588.0,246.96,158.76,576.24,30
CDM,6280374,IMP PROSTH PENILE INFLT LVL 06,43804.0,18397.68,11827.08,42927.92,30
CDM,6280382,IMP PROSTH PENILE INFLT LVL 07,56944.0,23916.48,15374.88,55805.12,30
CDM,6280390,IMP PROSTH PENILE INFLT LVL 08,65704.0,27595.68,17740.08,64389.92,30
CDM,6280408,EMBOLIZATION SYS PROTECT LVL 04,11580.0,4863.6,3126.6,11348.4,30
CDM,6280416,TAPS LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6280424,THERAPY COLD LVL 04,2426.0,1018.92,655.02,2377.48,30
CDM,6280432,THERAPY COLD LVL 05,3909.0,1641.78,1055.43,3830.82,30
CDM,6280440,IMP TISSUE CONNECT NONHUMAN LVL 11,48184.0,20237.28,13009.68,47220.32,30
CDM,6280523,IMP ADPT/EXT LD PACING/NEURO LVL 01,1126.0,472.92,304.02,1103.48,30
CDM,6280572,IMP STAPLE REINFORCEMENT LVL 01,313.0,131.46,84.51,306.74,30
CDM,6280580,IMP STAPLE REINFORCEMENT LVL 02,594.0,249.48,160.38,582.12,30
CDM,6280598,IMP STAPLE REINFORCEMENT LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6280606,IMP STAPLE REINFORCEMENT LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,6280614,IMP STAPLE REINFORCEMENT LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,6280655,IMP LD NEUROSTIM TEST KIT LVL 07,3909.0,1641.78,1055.43,3830.82,30
CDM,6280671,IMP PROSTH SPHINCTR ANAL LVL 03,15334.0,6440.28,4140.18,15027.32,30
CDM,6280689,IMP PROSTH SPHINCTR ANAL LVL 04,19714.0,8279.88,5322.78,19319.72,30
CDM,6280721,IMP NEURO LVL 08,65704.0,27595.68,17740.08,64389.92,30
CDM,6280739,IMP STENT NONCOR TEMP W DEL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6280747,IMP STENT NONCOR TEMP W DEL LVL 04,3909.0,1641.78,1055.43,3830.82,30
CDM,6280754,IMP STENT NONCOR TEMP W DEL LVL 05,5373.0,2256.66,1450.71,5265.54,30
CDM,6280762,WIRE PACING TEMP LVL 03,850.0,357.0,229.5,833.0,30
CDM,6280770,WIRE PACING TEMP LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6280788,WIRE PACING TEMP LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6280796,MANIPULATOR LVL 03,850.0,357.0,229.5,833.0,30
CDM,6280804,IMP MATERIAL CORD VOCAL LVL 02,1614.0,677.88,435.78,1581.72,30
CDM,6280812,IMP LD NEUROSTIM TEST KIT LVL 08,6105.0,2564.1,1648.35,5982.9,30
CDM,6280820,IMP LD NEUROSTIM TEST KIT LVL 09,7644.0,3210.48,2063.88,7491.12,30
CDM,6280838,DEVICE CLOSURE TISSUE LVL 01,313.0,131.46,84.51,306.74,30
CDM,6280846,DEVICE CLOSURE TISSUE LVL 02,594.0,249.48,160.38,582.12,30
CDM,6280853,DEVICE CLOSURE TISSUE LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6280861,DEVICE CLOSURE TISSUE LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,6280879,DEVICE CLOSURE TISSUE LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,6280887,DEVICE CLOSURE TISSUE LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6280895,DEVICE CLOSURE TISSUE LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6280903,DEVICE CLOSURE TISSUE LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6280911,DEVICE CLOSURE TISSUE LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6280929,DEVICE CLOSURE TISSUE LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6280937,DEVICE CLOSURE TISSUE LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6280945,IMP HOOK LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6280952,IMP HOOK LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,6280960,IMP HOOK LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6280978,IMP HOOK LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6280986,WIRE GUIDE LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6280994,WIRE GUIDE LVL 11,13895.0,5835.9,3751.65,13617.1,30
CDM,6281000,IMP STENT COAT W DEL LVL 14,39424.0,16558.08,10644.48,38635.52,30
CDM,6281018,IMP STENT COAT W DEL LVL 15,43804.0,18397.68,11827.08,42927.92,30
CDM,6281026,IMP SPINAL BAR/RG/CLR LVL 01,594.0,249.48,160.38,582.12,30
CDM,6281034,IMP SPINAL BAR/RG/CLR LVL 02,850.0,357.0,229.5,833.0,30
CDM,6281042,IMP SPINAL BAR/RG/CLR LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6281059,IMP SPINAL BAR/RG/CLR LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6281067,IMP SPINAL BAR/RG/CLR LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,6281075,IMP SPINAL BAR/RG/CLR LVL 06,1888.0,792.96,509.76,1850.24,30
CDM,6281083,IMP SPINAL BAR/RG/CLR LVL 07,2426.0,1018.92,655.02,2377.48,30
CDM,6281091,IMP SPINAL BAR/RG/CLR LVL 08,2827.0,1187.34,763.29,2770.46,30
CDM,6281109,IMP SPINAL BAR/RG/CLR LVL 09,3340.0,1402.8,901.8,3273.2,30
CDM,6281117,DEVICE INFLATION DISP LVL 01,313.0,131.46,84.51,306.74,30
CDM,6281125,DEVICE INFLATION DISP LVL 02,594.0,249.48,160.38,582.12,30
CDM,6281133,DEVICE INFLATION DISP LVL 03,850.0,357.0,229.5,833.0,30
CDM,6281141,DEVICE INFLATION DISP LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6281158,DEVICE INFLATION DISP LVL 05,1619.0,679.98,437.13,1586.62,30
CDM,6281166,DEVICE INFLATION DISP LVL 06,2157.0,905.94,582.39,2113.86,30
CDM,6281174,DEVICE INFLATION DISP LVL 07,2695.0,1131.9,727.65,2641.1,30
CDM,6281182,IMP TISSUE CONNECT HUMAN LVL 15,48184.0,20237.28,13009.68,47220.32,30
CDM,6281208,DEVICE FIXATION DISP LVL 01,313.0,131.46,84.51,306.74,30
CDM,6281216,DEVICE FIXATION DISP LVL 02,594.0,249.48,160.38,582.12,30
CDM,6281224,DEVICE FIXATION DISP LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6281232,DEVICE FIXATION DISP LVL 04,1619.0,679.98,437.13,1586.62,30
CDM,6281240,DEVICE FIXATION DISP LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,6281257,DEVICE FIXATION DISP LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6281265,DEVICE FIXATION DISP LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6281273,IMP SPINAL BAR/RG/CLR LVL 10,3853.0,1618.26,1040.31,3775.94,30
CDM,6281281,IMP SPINAL BAR/RG/CLR LVL 11,4153.0,1744.26,1121.31,4069.94,30
CDM,6281299,IMP CATH PORT INDWELLING LVL 08,4153.0,1744.26,1121.31,4069.94,30
CDM,6281307,IMP CATH PORT INDWELLING LVL 09,4641.0,1949.22,1253.07,4548.18,30
CDM,6281323,DEVICE FIXATION DISP LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6281349,IMP STENT NOS LVL 16,50374.0,21157.08,13600.98,49366.52,30
CDM,6281356,IMP SPINAL BAR/RG/CLR LVL 12,4885.0,2051.7,1318.95,4787.3,30
CDM,6281364,IMP SPINAL BAR/RG/CLR LVL 13,6105.0,2564.1,1648.35,5982.9,30
CDM,6281372,EMBOLIZATION SYS PROTECT LVL 01,5861.0,2461.62,1582.47,5743.78,30
CDM,6281380,DEVICE ABLATION LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6281398,DEVICE ABLATION LVL 03,3083.0,1294.86,832.41,3021.34,30
CDM,6281406,DEVICE ABLATION LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,6281414,DEVICE ABLATION LVL 05,6950.0,2919.0,1876.5,6811.0,30
CDM,6281422,DEVICE ABLATION LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6281430,DEVICE ABLATION LVL 07,11580.0,4863.6,3126.6,11348.4,30
CDM,6281448,DEVICE ABLATION LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,6281455,VEST AIRWAY DISPOSABLE LVL 02,850.0,357.0,229.5,833.0,30
CDM,6281463,VEST AIRWAY DISPOSABLE LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6281471,SENSOR CEREBRAL OXIMETER LVL 01,588.0,246.96,158.76,576.24,30
CDM,6281489,DEVICE INSERT RETRV LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6281497,DEVICE INSERT RETRV LVL 06,8107.0,3404.94,2188.89,7944.86,30
CDM,6281505,DEVICE INSERT RETRV LVL 07,10422.0,4377.24,2813.94,10213.56,30
CDM,6281513,DEVICE INSERT RETRV LVL 08,12737.0,5349.54,3438.99,12482.26,30
CDM,6281521,DEVICE INSERT RETRV LVL 09,14239.0,5980.38,3844.53,13954.22,30
CDM,6281539,DEVICE INSERT RETRV LVL 10,16429.0,6900.18,4435.83,16100.42,30
CDM,6281547,DEVICE INSERT RETRV LVL 11,18619.0,7819.98,5027.13,18246.62,30
CDM,6281554,DEVICE INSERT RETRV LVL 12,20809.0,8739.78,5618.43,20392.82,30
CDM,6281562,DEVICE INSERT RETRV LVL 13,22999.0,9659.58,6209.73,22539.02,30
CDM,6281570,DEVICE INSERT RETRV LVL 14,25189.0,10579.38,6801.03,24685.22,30
CDM,6281588,DEVICE INSERT RETRV LVL 15,27379.0,11499.18,7392.33,26831.42,30
CDM,6281596,DEVICE INSERT RETRV LVL 16,29569.0,12418.98,7983.63,28977.62,30
CDM,6281604,DEVICE INSERT RETRV LVL 17,31759.0,13338.78,8574.93,31123.82,30
CDM,6281646,CATH/WIRE/SUTURE PASSER LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6281653,CATH/WIRE/SUTURE PASSER LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,6281661,CATH/WIRE/SUTURE PASSER LVL 06,2426.0,1018.92,655.02,2377.48,30
CDM,6281679,INTRO EP FIX CRV PEEL LVL 07,4397.0,1846.74,1187.19,4309.06,30
CDM,6281745,TREPHINE LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6281752,TREPHINE LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,6281760,TREPHINE LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6281778,IMP TISSUE CONNECT NONHUMAN LVL 12,52564.0,22076.88,14192.28,51512.72,30
CDM,6281786,IMP TISSUE CONNECT NONHUMAN LVL 13,56944.0,23916.48,15374.88,55805.12,30
CDM,6281794,IMP DEV COCHLEAR INT&EXT CMP LVL 01,50370.0,21155.4,13599.9,49362.6,30
CDM,6281802,IMP DEV COCHLEAR INT&EXT CMP LVL 02,63510.0,26674.2,17147.7,62239.8,30
CDM,6281810,IMP DEV COCHLEAR INT&EXT CMP LVL 03,76650.0,32193.0,20695.5,75117.0,30
CDM,6281828,PACER ACCESSORY LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6281836,BOWL CELL SAVER LVL 02,2157.0,905.94,582.39,2113.86,30
CDM,6281844,BOWL CELL SAVER LVL 03,3083.0,1294.86,832.41,3021.34,30
CDM,6281851,BOWL CELL SAVER LVL 04,3909.0,1641.78,1055.43,3830.82,30
CDM,6281869,IMP CEMENT ACCESSORY LVL 07,5861.0,2461.62,1582.47,5743.78,30
CDM,6281877,IMP CEMENT ACCESSORY LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6281885,IMP CEMENT ACCESSORY LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6281893,IMP CEMENT ACCESSORY LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6281901,IMP CEMENT ACCESSORY LVL 11,13895.0,5835.9,3751.65,13617.1,30
CDM,6282172,IMP NEURAWRAP NRV PROTEC/CM LVL 04,6718.0,2821.56,1813.86,6583.64,30
CDM,6282180,IMP COVER BURR HOLE LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6282198,IMP PUMP VALVE BLOOD LVL 05,78844.0,33114.48,21287.88,77267.12,30
CDM,6282206,IMP SEPTAL DEFECT INTRACARD LVL 04,28474.0,11959.08,7687.98,27904.52,30
CDM,6282248,IMP SPINE FUSION LVL 02,4880.0,2049.6,1317.6,4782.4,30
CDM,6282255,IMP TISSUE CONNECT HUMAN LVL 16,54754.0,22996.68,14783.58,53658.92,30
CDM,6282289,IMP GENERATOR NEUROSTIM LVL 01,28470.0,11957.4,7686.9,27900.6,30
CDM,6282313,CATH HEM/PER SHORT TERM LVL 05,2157.0,905.94,582.39,2113.86,30
CDM,6282347,OBTURATOR DISPOSABLE LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,6282396,CATH ANGIO TRANSL LASER LVL 05,11580.0,4863.6,3126.6,11348.4,30
CDM,6282438,IMP MATERIAL CORD VOCAL LVL 01,588.0,246.96,158.76,576.24,30
CDM,6282479,IMP COVER BURR HOLE LVL 01,588.0,246.96,158.76,576.24,30
CDM,6282685,DRAIN LVL 06,1619.0,679.98,437.13,1586.62,30
CDM,6282859,IMP RV/AD/RP HIP FEMORAL HD LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6282867,IMP RV/AD/RP HIP FEMORAL HD LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6282875,IMP RV/AD/RP HIP FEMORAL HD LVL 05,4397.0,1846.74,1187.19,4309.06,30
CDM,6282883,IMP RV/AD/RP HIP FEMORAL HD LVL 06,5373.0,2256.66,1450.71,5265.54,30
CDM,6282891,IMP RV/AD/RP HIP STEM LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6282909,IMP RV/AD/RP HIP STEM LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,6282917,IMP RV/AD/RP HIP STEM LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6282925,IMP RV/AD/RP HIP SHELL LVL 03,4397.0,1846.74,1187.19,4309.06,30
CDM,6282933,IMP RV/AD/RP HIP SHELL LVL 04,5373.0,2256.66,1450.71,5265.54,30
CDM,6282941,IMP RV/AD/RP HIP SHELL LVL 05,6487.0,2724.54,1751.49,6357.26,30
CDM,6282958,IMP RV/AD/RP HIP SHELL LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6282966,IMP RV/AD/RP HIP LINER LVL 04,5373.0,2256.66,1450.71,5265.54,30
CDM,6282974,IMP RV/AD/RP HIP LINER LVL 05,6487.0,2724.54,1751.49,6357.26,30
CDM,6282982,IMP RV/AD/RP HIP LINER LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6282990,IMP RV/AD/RP HIP CUP LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6283006,IMP RV/AD/RP HIP CUP LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6283014,IMP RV/AD/RP HIP CUP LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6283022,IMP RV/AD/RP HIP CUP LVL 08,21904.0,9199.68,5914.08,21465.92,30
CDM,6283030,IMP RV/AD/RP KN FEMORAL LVL 01,3596.0,1510.32,970.92,3524.08,30
CDM,6283048,IMP RV/AD/RP KN FEMORAL LVL 02,4885.0,2051.7,1318.95,4787.3,30
CDM,6283055,IMP RV/AD/RP KN FEMORAL LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6283063,IMP RV/AD/RP KN FEMORAL LVL 04,26284.0,11039.28,7096.68,25758.32,30
CDM,6283071,IMP RV/AD/RP KN TIBIAL LVL 01,3596.0,1510.32,970.92,3524.08,30
CDM,6283089,IMP RV/AD/RP KN TIBIAL LVL 02,5373.0,2256.66,1450.71,5265.54,30
CDM,6283097,IMP RV/AD/RP KN TIBIAL LVL 03,6950.0,2919.0,1876.5,6811.0,30
CDM,6283105,IMP RV/AD/RP KN TIBIAL LVL 04,8802.0,3696.84,2376.54,8625.96,30
CDM,6283113,IMP RV/AD/RP KN TIBIAL LVL 05,10654.0,4474.68,2876.58,10440.92,30
CDM,6283121,IMP RV/AD/RP KN TIBIAL LVL 06,12506.0,5252.52,3376.62,12255.88,30
CDM,6283139,IMP RV/AD/RP KN TIBIAL LVL 07,13582.0,5704.44,3667.14,13310.36,30
CDM,6283147,IMP RV/AD/RP KN TIBIAL LVL 08,15334.0,6440.28,4140.18,15027.32,30
CDM,6283154,IMP RV/AD/RP KN TIBIAL LVL 09,17086.0,7176.12,4613.22,16744.28,30
CDM,6283162,IMP RV/AD/RP KN STEM LVL 02,3596.0,1510.32,970.92,3524.08,30
CDM,6283170,IMP RV/AD/RP KN STEM LVL 03,4397.0,1846.74,1187.19,4309.06,30
CDM,6283188,IMP RV/AD/RP KN STEM LVL 04,5373.0,2256.66,1450.71,5265.54,30
CDM,6283196,IMP RV/AD/RP KN STEM LVL 05,6024.0,2530.08,1626.48,5903.52,30
CDM,6283204,IMP RV/AD/RP KN INSR/SLV/LN LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6283212,IMP RV/AD/RP KN INSR/SLV/LN LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6283220,IMP RV/AD/RP KN INSR/SLV/LN LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6283238,IMP RV/AD/RP KN PATELLA LVL 03,3083.0,1294.86,832.41,3021.34,30
CDM,6283246,IMP RV/AD/RP KN PATELLA LVL 04,3909.0,1641.78,1055.43,3830.82,30
CDM,6283253,IMP RV/AD/RP KN PATELLA LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6283261,IMP RV/AD/RP KN PATELLA LVL 06,5861.0,2461.62,1582.47,5743.78,30
CDM,6283279,IMP RV/AD/RP KN PATELLA LVL 07,6024.0,2530.08,1626.48,5903.52,30
CDM,6283287,IMP RV/AD/RP SHDR HEAD LVL 05,6487.0,2724.54,1751.49,6357.26,30
CDM,6283295,IMP RV/AD/RP SHDR HEAD LVL 06,7413.0,3113.46,2001.51,7264.74,30
CDM,6283303,IMP RV/AD/RP SHDR HEAD LVL 07,8339.0,3502.38,2251.53,8172.22,30
CDM,6283311,IMP RV/AD/RP SHDR STEM LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,6283329,IMP RV/AD/RP SHDR STEM LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6283337,IMP RV/AD/RP SHDR STEM LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6283345,IMP RV/AD/RP SHDR GLEN CMP LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,6283352,IMP RV/AD/RP SHDR GLEN CMP LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6283360,IMP RV/AD/RP SHDR GLEN CMP LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6283402,IMP RV/AD/RP SHDR SHELL LVL 01,9265.0,3891.3,2501.55,9079.7,30
CDM,6283410,IMP RV/AD/RP SHDR SHELL LVL 02,13895.0,5835.9,3751.65,13617.1,30
CDM,6283428,IMP RV/AD/RP SHDR SHELL LVL 03,17524.0,7360.08,4731.48,17173.52,30
CDM,6283436,IMP RV/AD/RP SHDR INSERT LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6283444,IMP RV/AD/RP SHDR INSERT LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,6283451,IMP RV/AD/RP SHDR INSERT LVL 05,17524.0,7360.08,4731.48,17173.52,30
CDM,6283477,IMP MARKER TISSUE LVL 04,1894.0,795.48,511.38,1856.12,30
CDM,6283485,IMP MARKER TISSUE LVL 05,2580.0,1083.6,696.6,2528.4,30
CDM,6283493,IMP MARKER TISSUE LVL 06,3355.0,1409.1,905.85,3287.9,30
CDM,6283501,IMP RV/AD/RP HIP FEMORAL HD LVL 07,6024.0,2530.08,1626.48,5903.52,30
CDM,6283519,IMP RV/AD/RP HIP FEMORAL HD LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6283527,IMP RV/AD/RP HIP FEMORAL HD LVL 09,12506.0,5252.52,3376.62,12255.88,30
CDM,6283568,IMP RV/AD/RP HIP LINER LVL 07,7876.0,3307.92,2126.52,7718.48,30
CDM,6283576,IMP RV/AD/RP HIP LINER LVL 08,8802.0,3696.84,2376.54,8625.96,30
CDM,6283584,IMP STENT NOS LVL 17,56944.0,23916.48,15374.88,55805.12,30
CDM,6283626,IMP ROD/NAIL LVL 14,28474.0,11959.08,7687.98,27904.52,30
CDM,6283667,IMP RV/AD/RP HIP SHELL LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6283675,IMP RV/AD/RP HIP SHELL LVL 08,11580.0,4863.6,3126.6,11348.4,30
CDM,6283683,IMP RV/AD/RP HIP SHELL LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6283709,CATH ATHERECT TRANSL ROTAT LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6283725,IMP RING FALLOPE LVL 01,166.0,69.72,44.82,162.68,30
CDM,6283733,IMP RING FALLOPE LVL 02,588.0,246.96,158.76,576.24,30
CDM,6283782,CATH ATHERECT TRANSL DIRECT LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6283808,IMP RV/AD/RP HIP FEMORAL HD LVL 10,14896.0,6256.32,4021.92,14598.08,30
CDM,6283816,IMP RV/AD/RP HIP FEMORAL HD LVL 11,17962.0,7544.04,4849.74,17602.76,30
CDM,6283840,IMP RV/AD/RP KN INSR/SLV/LN LVL 04,4880.0,2049.6,1317.6,4782.4,30
CDM,6283881,THERAPY COLD LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6283923,CATH THROMBECTOMY/EMBOLECTMY LVL 09,11580.0,4863.6,3126.6,11348.4,30
CDM,6283949,BRUSH LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6283980,IMP VALVE LVL 12,61324.0,25756.08,16557.48,60097.52,30
CDM,6283998,IMP VALVE LVL 13,70084.0,29435.28,18922.68,68682.32,30
CDM,6284020,IMP PCMKR SGL NON RR LVL 01,15330.0,6438.6,4139.1,15023.4,30
CDM,6284038,IMP DEV OSSEO AUD INT&EXT LVL 01,594.0,249.48,160.38,582.12,30
CDM,6284046,IMP DEV OSSEO AUD INT&EXT LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6284053,IMP DEV OSSEO AUD INT&EXT LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6284061,IMP DEV OSSEO AUD INT&EXT LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6284079,IMP DEV OSSEO AUD INT&EXT LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6284087,IMP DEV OSSEO AUD INT&EXT LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6284095,IMP DEV OSSEO AUD INT&EXT LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6284103,IMP DEV OSSEO AUD INT&EXT LVL 08,11580.0,4863.6,3126.6,11348.4,30
CDM,6284111,IMP DEV OSSEO AUD INT&EXT LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6284129,IMP DEV OSSEO AUD INT&EXT LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6284137,IMP DEV OSSEO AUD INT&EXT LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6284145,IMP DEV OSSEO AUD INT&EXT LVL 12,26284.0,11039.28,7096.68,25758.32,30
CDM,6284228,IMP RV/AD/RP HIP INSR/EX/RNG LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6284236,IMP RV/AD/RP HIP INSR/EX/RNG LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6284244,IMP RV/AD/RP HIP INSR/EX/RNG LVL 05,4397.0,1846.74,1187.19,4309.06,30
CDM,6284251,IMP RV/AD/RP HIP INSR/EX/RNG LVL 06,5373.0,2256.66,1450.71,5265.54,30
CDM,6284269,IMP RV/AD/RP HIP INSR/EX/RNG LVL 07,6024.0,2530.08,1626.48,5903.52,30
CDM,6284277,IMP RV/AD/RP HIP INSR/EX/RNG LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6284285,IMP RV/AD/RP HIP INSR/EX/RNG LVL 09,12506.0,5252.52,3376.62,12255.88,30
CDM,6284368,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6284376,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 03,1619.0,679.98,437.13,1586.62,30
CDM,6284384,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,6284392,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 05,3596.0,1510.32,970.92,3524.08,30
CDM,6284400,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 06,4397.0,1846.74,1187.19,4309.06,30
CDM,6284418,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 07,5373.0,2256.66,1450.71,5265.54,30
CDM,6284426,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 08,6024.0,2530.08,1626.48,5903.52,30
CDM,6284434,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6284483,IMP RV/AD/RP KN DIS/POS AUG LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,6284491,IMP RV/AD/RP KN DIS/POS AUG LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6284509,IMP RV/AD/RP KN DIS/POS AUG LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6284517,IMP RV/AD/RP KN DIS/POS AUG LVL 05,4397.0,1846.74,1187.19,4309.06,30
CDM,6284525,IMP RV/AD/RP KN DIS/POS AUG LVL 06,5373.0,2256.66,1450.71,5265.54,30
CDM,6284533,IMP RV/AD/RP KN DIS/POS AUG LVL 07,6024.0,2530.08,1626.48,5903.52,30
CDM,6284541,IMP RV/AD/RP KN DIS/POS AUG LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6284558,IMP RV/AD/RP KN DIS/POS AUG LVL 09,12506.0,5252.52,3376.62,12255.88,30
CDM,6284566,IMP RV/AD/RP KN DIS/POS AUG LVL 10,13582.0,5704.44,3667.14,13310.36,30
CDM,6284608,IMP RV/AD/RP KN TIB/FM TRIAL LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,6284616,IMP RV/AD/RP KN TIB/FM TRIAL LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6284624,IMP RV/AD/RP KN TIB/FM TRIAL LVL 04,3596.0,1510.32,970.92,3524.08,30
CDM,6284632,IMP RV/AD/RP KN TIB/FM TRIAL LVL 05,4397.0,1846.74,1187.19,4309.06,30
CDM,6284640,IMP RV/AD/RP KN TIB/FM TRIAL LVL 06,5373.0,2256.66,1450.71,5265.54,30
CDM,6284657,IMP RV/AD/RP KN TIB/FM TRIAL LVL 07,6024.0,2530.08,1626.48,5903.52,30
CDM,6284665,IMP RV/AD/RP KN TIB/FM TRIAL LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6284673,IMP RV/AD/RP KN TIB/FM TRIAL LVL 09,12506.0,5252.52,3376.62,12255.88,30
CDM,6284681,IMP RV/AD/RP KN TIB/FM TRIAL LVL 10,13582.0,5704.44,3667.14,13310.36,30
CDM,6284699,IMP RV/AD/RP KN TIB/FM TRIAL LVL 11,15334.0,6440.28,4140.18,15027.32,30
CDM,6284707,IMP RV/AD/RP KN TIB/FM TRIAL LVL 12,17524.0,7360.08,4731.48,17173.52,30
CDM,6284715,IMP RV/AD/RP KN TIB/FM TRIAL LVL 13,19714.0,8279.88,5322.78,19319.72,30
CDM,6284806,IMP RV/AD/RP HIP INSR/EX/RNG LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6284814,IMP RV/AD/RP HIP TR/CNT/SL LVL 03,1413.0,593.46,381.51,1384.74,30
CDM,6284822,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 01,588.0,246.96,158.76,576.24,30
CDM,6284830,IMP RV/AD/RP KN DIS/POS AUG LVL 01,1126.0,472.92,304.02,1103.48,30
CDM,6284848,IMP RV/AD/RP KN TIB/FM TRIAL LVL 01,1126.0,472.92,304.02,1103.48,30
CDM,6284863,DRESSING SPECIALTY LVL 01,32.0,13.44,8.64,31.36,30
CDM,6284871,IMP RV/AD/RP HIP LINER LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6284889,IMP RV/AD/RP HIP LINER LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6284996,CATH URETHRAL LVL 01,32.0,13.44,8.64,31.36,30
CDM,6285001,DRAIN LVL 01,32.0,13.44,8.64,31.36,30
CDM,6285068,SPACER/GUIDE LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6285076,SPACER/GUIDE LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6285084,SPACER/GUIDE LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6285092,SPACER/GUIDE LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6285142,LASER FIBER LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6285159,IMP PROSTH PENILE INFLT LVL 01,844.0,354.48,227.88,827.12,30
CDM,6285167,IMP DEV OSSEO AUD INT&EXT LVL 13,30664.0,12878.88,8279.28,30050.72,30
CDM,6285175,IMP DEV OSSEO AUD INT&EXT LVL 14,35044.0,14718.48,9461.88,34343.12,30
CDM,6285217,IMP RV/AD/RP SHDR HEAD LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6285225,IMP RV/AD/RP SHDR HEAD LVL 04,5856.0,2459.52,1581.12,5738.88,30
CDM,6285233,IMP RV/AD/RP SHDR INSERT LVL 02,4880.0,2049.6,1317.6,4782.4,30
CDM,6285290,IMP ACCESS SYSTEM DIALYS LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6285324,IMP PROSTH PENILE NONINF LVL 04,28474.0,11959.08,7687.98,27904.52,30
CDM,6285399,IMP RV/AD/RP KN STEM LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6285407,IMP RV/AD/RP KN STEM LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6285415,IMP RV/AD/RP HIP INSR/EX/RNG LVL 01,594.0,249.48,160.38,582.12,30
CDM,6285423,IMP RV/AD/RP HIP SYS MODULAR LVL 02,13895.0,5835.9,3751.65,13617.1,30
CDM,6285431,IMP RV/AD/RP HIP SYS MODULAR LVL 03,17524.0,7360.08,4731.48,17173.52,30
CDM,6285449,IMP RV/AD/RP HIP SYS MODULAR LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,6285456,IMP RV/AD/RP HIP SYS MODULAR LVL 05,26284.0,11039.28,7096.68,25758.32,30
CDM,6285464,IMP RV/AD/RP HIP SYS MODULAR LVL 06,30664.0,12878.88,8279.28,30050.72,30
CDM,6285472,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 01,594.0,249.48,160.38,582.12,30
CDM,6285480,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6285498,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6285506,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6285514,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6285522,IMP RV/AD/RP KN ROTATING HNG LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6285530,IMP RV/AD/RP KN ROTATING HNG LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6285548,IMP RV/AD/RP KN ROTATING HNG LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6285555,IMP RV/AD/RP KN ROTATING HNG LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6285563,IMP RV/AD/RP KN ROTATING HNG LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6285571,IMP RV/AD/RP KN ROTATING HNG LVL 06,19714.0,8279.88,5322.78,19319.72,30
CDM,6285589,IMP RV/AD/RP KN EX/CONNECT LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6285597,IMP RV/AD/RP KN EX/CONNECT LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6285605,IMP RV/AD/RP KN EX/CONNECT LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6285647,IMP RV/AD/RP HIP SHELL LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6285654,IMP TISSUE CONNECT NONHUMAN LVL 14,65704.0,27595.68,17740.08,64389.92,30
CDM,6285712,IMP RV/AD/RP KN BR/AX/YK/BH LVL 01,594.0,249.48,160.38,582.12,30
CDM,6285720,IMP RV/AD/RP KN BR/AX/YK/BH LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6285738,IMP RV/AD/RP KN BR/AX/YK/BH LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6285746,IMP RV/AD/RP KN BR/AX/YK/BH LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6285753,IMP RV/AD/RP KN BR/AX/YK/BH LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6285761,IMP RV/AD/RP SHDR HEAD LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6285811,IMP RV/AD/RP HIP SHELL LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6286017,HYPO-HYPER THERMAL LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6286041,BLADE LVL 13,15334.0,6440.28,4140.18,15027.32,30
CDM,6286058,IMP AGENT COLLAGN BULK 2.5ML LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6286066,IMP AGENT COLLAGN BULK 2.5ML LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6286074,IMP AGENT COLLAGN BULK 2.5ML LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6286082,IMP AGENT COLLAGN BULK 2.5ML LVL 04,13895.0,5835.9,3751.65,13617.1,30
CDM,6286090,IMP AGENT COLLAGN BULK 2.5ML LVL 05,19272.0,8094.24,5203.44,18886.56,30
CDM,6286124,CATH ABL COOL-TIP LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6286132,CATH ABL COOL-TIP LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6286140,CATH ABL COOL-TIP LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6286157,CATH ABL COOL-TIP LVL 04,4880.0,2049.6,1317.6,4782.4,30
CDM,6286173,IMP RV/AD/RP HIP SYS SOLN LVL 01,13895.0,5835.9,3751.65,13617.1,30
CDM,6286181,IMP RV/AD/RP HIP SYS SOLN LVL 02,19714.0,8279.88,5322.78,19319.72,30
CDM,6286264,IMP RV/AD/RP HIP FEMORAL HD LVL 12,21904.0,9199.68,5914.08,21465.92,30
CDM,6286272,IMP RV/AD/RP HIP FEMORAL HD LVL 13,28474.0,11959.08,7687.98,27904.52,30
CDM,6286280,IMP CLIP ANEURYSM LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6286298,IMP CLIP ANEURYSM LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6286355,EMBOLIZATION SYS PROTECT LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6286363,EMBOLIZATION SYS PROTECT LVL 06,19714.0,8279.88,5322.78,19319.72,30
CDM,6286447,DEVICE FIXATION DISP LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6286454,DEVICE FIXATION DISP LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6286538,IMP ICD CHAMBER NON SGL/DUAL LVL 02,70080.0,29433.6,18921.6,68678.4,30
CDM,6286546,IMP CEMENT ACCESSORY LVL 12,17524.0,7360.08,4731.48,17173.52,30
CDM,6286553,IMP SPACER ORTHOPEDIC LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6286561,IMP SPACER ORTHOPEDIC LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6286579,IMP SPACER ORTHOPEDIC LVL 05,6024.0,2530.08,1626.48,5903.52,30
CDM,6286603,SUPPLY OSTOMY LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6286611,DEVICE FIXATION DISP LVL 11,17524.0,7360.08,4731.48,17173.52,30
CDM,6286637,CATH ERCP LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6286660,RESERVOIR NEURO LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6286686,IMP VALVE LVL 14,83224.0,34954.08,22470.48,81559.52,30
CDM,6286694,IMP VALVE LVL 15,96364.0,40472.88,26018.28,94436.72,30
CDM,6286702,IMP VALVE LVL 16,109504.0,45991.68,29566.08,107313.92,30
CDM,6286769,CATH ENDOBRONCHIAL LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6286892,CATH GLANDULAR LVL 02,313.0,131.46,84.51,306.74,30
CDM,6286900,CATH SPINAL/NEURO LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6286918,IMP RV/AD/RP ELBOW HEAD LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6286926,IMP RV/AD/RP ELBOW HEAD LVL 04,5856.0,2459.52,1581.12,5738.88,30
CDM,6286934,IMP RV/AD/RP ELBOW HEAD LVL 05,6487.0,2724.54,1751.49,6357.26,30
CDM,6286942,IMP RV/AD/RP ELBOW HEAD LVL 06,7413.0,3113.46,2001.51,7264.74,30
CDM,6286959,IMP RV/AD/RP ELBOW HEAD LVL 07,8339.0,3502.38,2251.53,8172.22,30
CDM,6286967,IMP RV/AD/RP ELBOW HEAD LVL 08,9265.0,3891.3,2501.55,9079.7,30
CDM,6287015,IMP RV/AD/RP ELBOW STEM LVL 01,9265.0,3891.3,2501.55,9079.7,30
CDM,6287023,IMP RV/AD/RP ELBOW STEM LVL 02,13895.0,5835.9,3751.65,13617.1,30
CDM,6287031,IMP RV/AD/RP ELBOW STEM LVL 03,17524.0,7360.08,4731.48,17173.52,30
CDM,6287049,DEVICE ABLATION LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,6287056,DRAIN LVL 07,2157.0,905.94,582.39,2113.86,30
CDM,6287064,PIN GUIDE LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,6287072,HARVESTER LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6287080,HEMOSTATIC AGENT LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6287098,IMP RV/AD/RP HIP SHELL LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6287106,IMP RV/AD/RP HIP SHELL LVL 02,3591.0,1508.22,969.57,3519.18,30
CDM,6287114,IMP RV/AD/RP HIP CUP LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6287122,IMP RV/AD/RP HIP CUP LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6287130,IMP RV/AD/RP HIP CUP LVL 04,4880.0,2049.6,1317.6,4782.4,30
CDM,6287148,IMP RV/AD/RP KN EX/CONNECT LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6287155,IMP RV/AD/RP KN EX/CONNECT LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6287163,IMP RV/AD/RP KN EX/CONNECT LVL 04,9260.0,3889.2,2500.2,9074.8,30
CDM,6287387,IMP PLATE LVL 23,37234.0,15638.28,10053.18,36489.32,30
CDM,6287437,IMP RV/AD/RP SHDR CUP LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6287478,IMP RV/AD/RP SHDR HEAD LVL 09,13895.0,5835.9,3751.65,13617.1,30
CDM,6287486,IMP RV/AD/RP SHDR HEAD LVL 10,17524.0,7360.08,4731.48,17173.52,30
CDM,6287494,IMP RV/AD/RP SHDR STEM LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,6287502,CATH INF NON HEMODIALYSIS LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6287510,TAPE MARKING RADIOPAQUE LVL 02,313.0,131.46,84.51,306.74,30
CDM,6287544,BRUSH LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6287551,IMP RV/AD/RP ELBOW HEAD LVL 09,11580.0,4863.6,3126.6,11348.4,30
CDM,6287569,IMP RV/AD/RP KN BR/AX/YK/BH LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6287577,IMP RV/AD/RP HIP FEMORAL HD LVL 02,1619.0,679.98,437.13,1586.62,30
CDM,6287585,IMP SPACER ORTHOPEDIC LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6287601,IMP NEURAWRAP NRV PROTEC/CM LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6287619,IMMOBILIZER LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6287627,IMMOBILIZER LVL 06,1888.0,792.96,509.76,1850.24,30
CDM,6287650,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6287676,IMP HOOK LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6287692,IMP RV/AD/RP SHDR INSERT LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,6287700,IMP RV/AD/RP HIP DIS/POS AUG LVL 01,594.0,249.48,160.38,582.12,30
CDM,6287718,IMP RV/AD/RP HIP DIS/POS AUG LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6287833,REAMER LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6287866,CLIP LVL 07,2695.0,1131.9,727.65,2641.1,30
CDM,6287874,CLIP LVL 08,3853.0,1618.26,1040.31,3775.94,30
CDM,6287882,CLIP LVL 09,6105.0,2564.1,1648.35,5982.9,30
CDM,6287932,IMP RV/AD/RP HIP LINER LVL 03,4392.0,1844.64,1185.84,4304.16,30
CDM,6287940,IMP RV/AD/RP HIP STEM LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,6287957,IMP RV/AD/RP HIP STEM LVL 02,4880.0,2049.6,1317.6,4782.4,30
CDM,6287965,IMP RV/AD/RP KN PATELLA LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6288005,IMP RV/AD/RP SHDR STEM LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6288088,IMP DEV JT SHDR TOTAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,6288096,IMP DEV JT SHDR TOTAL LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6288104,IMP DEV JT SHDR TOTAL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6288112,IMP DEV JT SHDR TOTAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6288120,IMP RV/AD/RP KN TIBIAL LVL 10,21466.0,9015.72,5795.82,21036.68,30
CDM,6288138,IMP RV/AD/RP KN TIBIAL LVL 11,25846.0,10855.32,6978.42,25329.08,30
CDM,6288146,IMP FIX LW/UP/PELVIC LVL 02,6105.0,2564.1,1648.35,5982.9,30
CDM,6288153,IMP FIX LW/UP/PELVIC LVL 03,7413.0,3113.46,2001.51,7264.74,30
CDM,6288161,IMP FIX LW/UP/PELVIC LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6288203,IMP RV/AD/RP KN INSR/SLV/LN LVL 01,594.0,249.48,160.38,582.12,30
CDM,6288211,IMP RV/AD/RP KN INSR/SLV/LN LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6288229,IMP RV/AD/RP KN INSR/SLV/LN LVL 03,2152.0,903.84,581.04,2108.96,30
CDM,6288260,IMP RV/AD/RP ELBOW HEAD LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6288278,IMP DEV OSSEO AUD INT&EXT LVL 15,39424.0,16558.08,10644.48,38635.52,30
CDM,6288286,IMP VALVE LVL 17,122644.0,51510.48,33113.88,120191.12,30
CDM,6288294,PIN GUIDE LVL 06,2157.0,905.94,582.39,2113.86,30
CDM,6288302,IMP PIN/WIRE LVL 14,10422.0,4377.24,2813.94,10213.56,30
CDM,6288369,IMP DEV OSSEO AUD INT&EXT LVL 16,43804.0,18397.68,11827.08,42927.92,30
CDM,6288377,IMP DEV OSSEO AUD INT&EXT LVL 17,48184.0,20237.28,13009.68,47220.32,30
CDM,6288435,IMP MARKER TISSUE LVL 07,3853.0,1618.26,1040.31,3775.94,30
CDM,6288443,IMP MARKER TISSUE LVL 08,6105.0,2564.1,1648.35,5982.9,30
CDM,6288468,CATH INTRASPINAL LVL 01,166.0,69.72,44.82,162.68,30
CDM,6288476,CATH INTRASPINAL LVL 02,313.0,131.46,84.51,306.74,30
CDM,6288484,CATH INTRASPINAL LVL 03,594.0,249.48,160.38,582.12,30
CDM,6288518,IMP RV/AD/RP KN FEMORAL LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6288559,IMP EXPANDER TISSUE LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6288583,IMP RV/AD/RP KN TIBIAL LVL 12,30226.0,12694.92,8161.02,29621.48,30
CDM,6288591,IMP RV/AD/RP KN TIBIAL LVL 13,34606.0,14534.52,9343.62,33913.88,30
CDM,6288609,IMP RV/AD/RP HIP LINER LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6288617,IMP RV/AD/RP KN PATELLA LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6288625,IMP RV/AD/RP KN PATELLA LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6288633,LENS INTRAOCULAR CHAM POST LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6288658,DEVICE ABLATION LVL 10,21904.0,9199.68,5914.08,21465.92,30
CDM,6288666,DEVICE ABLATION LVL 11,26284.0,11039.28,7096.68,25758.32,30
CDM,6288674,DEVICE ABLATION LVL 12,30664.0,12878.88,8279.28,30050.72,30
CDM,6288682,RESERVOIR OTHER LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6288724,IMP RV/AD/RP KN ROTATING HNG LVL 07,24094.0,10119.48,6505.38,23612.12,30
CDM,6288765,IMP LD ICD NON SGL/DUAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6288781,PACER ACCESSORY LVL 04,2157.0,905.94,582.39,2113.86,30
CDM,6288799,CATH BALLOON DILAT NONVASC LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6288815,CATH SPINAL/NEURO LVL 06,6105.0,2564.1,1648.35,5982.9,30
CDM,6288823,IMP PLATE LVL 24,39424.0,16558.08,10644.48,38635.52,30
CDM,6288831,IMP PLATE LVL 25,43804.0,18397.68,11827.08,42927.92,30
CDM,6288898,HYPO-HYPER THERMAL LVL 06,8107.0,3404.94,2188.89,7944.86,30
CDM,6288906,IMP ICD CHAMBER DUAL LVL 01,43800.0,18396.0,11826.0,42924.0,30
CDM,6288914,IMP ICD CHAMBER SGL LVL 04,109504.0,45991.68,29566.08,107313.92,30
CDM,6288922,SUPPLY NEURO LVL 10,21904.0,9199.68,5914.08,21465.92,30
CDM,6288930,PACER ACCESSORY LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6288948,POUCH LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6288955,IMP PROSTH PENILE NONINF LVL 05,32854.0,13798.68,8870.58,32196.92,30
CDM,6288971,IMP SHUNT LVL 11,21904.0,9199.68,5914.08,21465.92,30
CDM,6288989,IMP STENT NOS LVL 22,81034.0,34034.28,21879.18,79413.32,30
CDM,6288997,TRANSDUCER LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6289003,IMP DEV JT WRIST TOTAL LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,6289011,IMP DEV JT WRIST TOTAL LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,6289029,IMP DEV JT WRIST TOTAL LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6289037,IMP DEV JT WRIST TOTAL LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6289045,IMP DEV JT WRIST TOTAL LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,6289052,IMP DEV JT WRIST TOTAL LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6289060,IMP DEV JT WRIST TOTAL LVL 07,30664.0,12878.88,8279.28,30050.72,30
CDM,6289201,IMP PROSTH OPHTHALMIC LVL 06,6105.0,2564.1,1648.35,5982.9,30
CDM,6289219,IMP PROSTH OPHTHALMIC LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6289227,INTRO EP STEER NONPEEL LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6289235,CATH ABL EP NON 3D/VECTOR LVL 06,21028.0,8831.76,5677.56,20607.44,30
CDM,6289243,IMP SPACER ORTHOPEDIC LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6289250,IMP SPACER ORTHOPEDIC LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6289268,IMP SPACER ORTHOPEDIC LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6289276,IMP SPACER ORTHOPEDIC LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6289292,RETRIEVER SUTURE LVL 06,6105.0,2564.1,1648.35,5982.9,30
CDM,6289409,IMP VALVE LVL 18,140164.0,58868.88,37844.28,137360.72,30
CDM,6289417,NEEDLE BIOPSY MRW BONE PWR LVL 01,594.0,249.48,160.38,582.12,30
CDM,6289474,IMP RV/AD/RP ELBOW HEAD LVL 11,15334.0,6440.28,4140.18,15027.32,30
CDM,6289508,TIPS LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6289516,TIPS LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6289524,IMP RV/AD/RP ELBOW HEAD LVL 12,17524.0,7360.08,4731.48,17173.52,30
CDM,6289532,IMP RV/AD/RP ELBOW STEM LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,6289540,SCALPEL HARMONIC LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6289581,CATH ABL EP NON 3D/VECTOR LVL 07,25408.0,10671.36,6860.16,24899.84,30
CDM,6289599,CATH ABL EP NON 3D/VECTOR LVL 08,29788.0,12510.96,8042.76,29192.24,30
CDM,6289607,EMBOLIZATION SYS PROTECT LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6289615,ADHESIVE LVL 01,166.0,69.72,44.82,162.68,30
CDM,6289623,ADHESIVE LVL 02,313.0,131.46,84.51,306.74,30
CDM,6289631,ADHESIVE LVL 03,594.0,249.48,160.38,582.12,30
CDM,6289649,ADHESIVE LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6289656,ADHESIVE LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6289664,ADHESIVE LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6289672,ADHESIVE LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6289680,ADHESIVE LVL 08,6105.0,2564.1,1648.35,5982.9,30
CDM,6289797,IMP MEMBRANE AMNIO OCULAR LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6289813,IMP RING LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6289821,IMP RING LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6289839,IMP VALVE LVL 19,157684.0,66227.28,42574.68,154530.32,30
CDM,6289938,IMP RV/AD/RP KN EX/CONNECT LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6289953,IMP RV/AD/RP SHDR GLEN CMP LVL 01,4880.0,2049.6,1317.6,4782.4,30
CDM,6289961,SCALPEL HARMONIC LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6289979,CATH URETHRAL LVL 07,2695.0,1131.9,727.65,2641.1,30
CDM,6290217,IMP RV/AD/RP KN FEMORAL LVL 06,35044.0,14718.48,9461.88,34343.12,30
CDM,6290225,IMP RV/AD/RP HIP TR/CNT/SL LVL 01,313.0,131.46,84.51,306.74,30
CDM,6290233,IMP RV/AD/RP HIP TR/CNT/SL LVL 02,594.0,249.48,160.38,582.12,30
CDM,6290241,IMP SPACER ORTHOPEDIC LVL 01,594.0,249.48,160.38,582.12,30
CDM,6290290,NEEDLE SPECIALTY LVL 11,4153.0,1744.26,1121.31,4069.94,30
CDM,6290308,SCALPEL HARMONIC LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6290753,IMP RV/AD/RP ANKLE INSR/TRAY LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6290761,IMP RV/AD/RP ANKLE INSR/TRAY LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6290779,IMP RV/AD/RP ANKLE INSR/TRAY LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6290787,IMP RV/AD/RP ANKLE INSR/TRAY LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6290795,IMP RV/AD/RP ANKLE INSR/TRAY LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6290803,IMP RV/AD/RP ANKLE INSR/TRAY LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6290811,IMP RV/AD/RP ANKLE INSR/TRAY LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6290829,IMP RV/AD/RP ANKLE INSR/TRAY LVL 08,26284.0,11039.28,7096.68,25758.32,30
CDM,6290837,IMP RV/AD/RP ANKLE INSR/TRAY LVL 09,30664.0,12878.88,8279.28,30050.72,30
CDM,6290886,IMP RV/AD/RP KN FEMORAL LVL 07,39424.0,16558.08,10644.48,38635.52,30
CDM,6290894,REAMER LVL 08,6105.0,2564.1,1648.35,5982.9,30
CDM,6290902,REAMER LVL 09,6950.0,2919.0,1876.5,6811.0,30
CDM,6290910,TAPE MARKING RADIOPAQUE LVL 03,594.0,249.48,160.38,582.12,30
CDM,6291819,CATH THROMBECTOMY/EMBOLECTMY LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6291827,CATH THROMBECTOMY/EMBOLECTMY LVL 11,17524.0,7360.08,4731.48,17173.52,30
CDM,6291835,CATH THROMBECTOMY/EMBOLECTMY LVL 12,21904.0,9199.68,5914.08,21465.92,30
CDM,6291843,CATH THROMBECTOMY/EMBOLECTMY LVL 13,26284.0,11039.28,7096.68,25758.32,30
CDM,6291850,CATH THROMBECTOMY/EMBOLECTMY LVL 14,32854.0,13798.68,8870.58,32196.92,30
CDM,6291892,IMP RV/AD/RP KN BR/AX/YK/BH LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6291900,IMP RV/AD/RP KN STEM LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6291926,IMP RV/AD/RP HIP SYS MODULAR LVL 01,9260.0,3889.2,2500.2,9074.8,30
CDM,6291934,IMP RV/AD/RP ELBOW HEAD LVL 13,21904.0,9199.68,5914.08,21465.92,30
CDM,6292007,IMP RV/AD/RP SHDR LN/SL LVL 01,594.0,249.48,160.38,582.12,30
CDM,6292015,IMP RV/AD/RP SHDR LN/SL LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6292023,IMP RV/AD/RP SHDR LN/SL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6292031,IMP RV/AD/RP SHDR LN/SL LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6292049,IMP RV/AD/RP SHDR LN/SL LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6292056,IMP RV/AD/RP SHDR PROX BODY LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,6292064,IMP RV/AD/RP SHDR PROX BODY LVL 02,9265.0,3891.3,2501.55,9079.7,30
CDM,6292072,IMP RV/AD/RP SHDR PROX BODY LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6292080,IMP RV/AD/RP SHDR PROX BODY LVL 04,17524.0,7360.08,4731.48,17173.52,30
CDM,6292098,IMP RV/AD/RP SHDR PROX BODY LVL 05,21904.0,9199.68,5914.08,21465.92,30
CDM,6292106,INTRO EP STEER NONPEEL LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6292320,IMP RV/AD/RP HIP LINER LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6292338,IMP CONNECTOR NERVE LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,6292346,NEUROMATRIX 2.5CM LENGTH/0.5CM,430.5,180.81,116.23,421.89,30
CDM,6292395,LENS INTRAOCULAR NEW TECH LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6292460,IMP ICD CHAMBER NON SGL/DUAL LVL 01,61320.0,25754.4,16556.4,60093.6,30
CDM,6292494,IMP PCMKR SGL RR LVL 01,11575.0,4861.5,3125.25,11343.5,30
CDM,6292502,IMP CATH BRACHY SEED ADM LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6292510,IMP CATH BRACHY SEED ADM LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6292528,IMP CATH BRACHY SEED ADM LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6292536,IMP CATH BRACHY SEED ADM LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6292544,IMP CATH BRACHY SEED ADM LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6292551,IMP CONNECTOR NERVE LVL 02,6105.0,2564.1,1648.35,5982.9,30
CDM,6292569,IMP CONNECTOR NERVE LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6292577,IMP PUMP VALVE BLOOD LVL 07,100744.0,42312.48,27200.88,98729.12,30
CDM,6292585,IMP PUMP VALVE BLOOD LVL 08,109504.0,45991.68,29566.08,107313.92,30
CDM,6292593,CATH ABL TISSUE INSERT LVL 02,11580.0,4863.6,3126.6,11348.4,30
CDM,6292650,IMP LD ICD NON SGL/DUAL LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6292668,IMP LD ICD NON SGL/DUAL LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6292676,IMP LD ICD NON SGL/DUAL LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,6292692,THERAPY COLD LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6292700,THERAPY COLD LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6292759,IMP RV/AD/RP SHDR HEAD LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6292767,IMP RV/AD/RP SHDR HEAD LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6292775,IMP RV/AD/RP HIP FEMORAL HD LVL 14,35044.0,14718.48,9461.88,34343.12,30
CDM,6292791,CATH FEEDING LVL 03,1132.0,475.44,305.64,1109.36,30
CDM,6292809,IMP RV/AD/RP KN STEM LVL 08,21904.0,9199.68,5914.08,21465.92,30
CDM,6292817,IMP RV/AD/RP KN STEM LVL 09,26284.0,11039.28,7096.68,25758.32,30
CDM,6292841,BIT LVL 10,6718.0,2821.56,1813.86,6583.64,30
CDM,6292866,TAPS LVL 05,3909.0,1641.78,1055.43,3830.82,30
CDM,6292882,IMP PROSTH ENT LVL 13,30664.0,12878.88,8279.28,30050.72,30
CDM,6292908,IMP SPINE FUSION LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6292924,IMP STAPLE BONE LVL 14,9728.0,4085.76,2626.56,9533.44,30
CDM,6293039,MANIPULATOR LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6293120,CATH/WIRE/SUTURE PASSER LVL 07,2695.0,1131.9,727.65,2641.1,30
CDM,6293138,IMP ORTHOPEDIC CAGE LVL 01,2690.0,1129.8,726.3,2636.2,30
CDM,6293153,HEMOSTATIC AGENT LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6293179,IMP CATH PORT INDWELLING LVL 10,6105.0,2564.1,1648.35,5982.9,30
CDM,6293336,IMP NEURAWRAP NRV PROTEC/CM LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6293344,IMP NEURAWRAP NRV PROTEC/CM LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6293351,IMP NEURAWRAP NRV PROTEC/CM LVL 03,6100.0,2562.0,1647.0,5978.0,30
CDM,6293377,IMP STIMULATOR BONE LVL 01,13890.0,5833.8,3750.3,13612.2,30
CDM,6293385,IMP STIMULATOR BONE LVL 02,19714.0,8279.88,5322.78,19319.72,30
CDM,6293393,IMP STIMULATOR BONE LVL 03,24094.0,10119.48,6505.38,23612.12,30
CDM,6293401,IMP STIMULATOR BONE LVL 04,28474.0,11959.08,7687.98,27904.52,30
CDM,6293419,IMP STIMULATOR BONE LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6293435,IMP FILTER VENA CAVA LVL 01,1407.0,590.94,379.89,1378.86,30
CDM,6293443,NEEDLE BRACHYTHERAPY LVL 03,850.0,357.0,229.5,833.0,30
CDM,6293492,CLIP APPLIER LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6293526,IMP MESH LVL 16,41614.0,17477.88,11235.78,40781.72,30
CDM,6293534,IMP MESH LVL 17,45994.0,19317.48,12418.38,45074.12,30
CDM,6293542,IMP MESH LVL 18,50374.0,21157.08,13600.98,49366.52,30
CDM,6293559,IMP MESH LVL 19,54754.0,22996.68,14783.58,53658.92,30
CDM,6293567,IMP MESH LVL 20,59134.0,24836.28,15966.18,57951.32,30
CDM,6293575,IMP MESH LVL 21,63514.0,26675.88,17148.78,62243.72,30
CDM,6293583,IMP MESH LVL 22,67894.0,28515.48,18331.38,66536.12,30
CDM,6293591,IMP MESH LVL 23,72362.0,30392.04,19537.74,70914.76,30
CDM,6293641,IMP DEV TISS LOCAL/EXCISION LVL 01,594.0,249.48,160.38,582.12,30
CDM,6293658,IMP DEV TISS LOCAL/EXCISION LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6293666,IMP DEV TISS LOCAL/EXCISION LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6293674,IMP DEV TISS LOCAL/EXCISION LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6293682,IMP DEV TISS LOCAL/EXCISION LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6294128,KNOT PUSHER LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6294144,CATH ANGIO TRANSL LASER LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6294425,IMP PUMP VALVE BLOOD LVL 09,118264.0,49670.88,31931.28,115898.72,30
CDM,6294433,IMP PUMP VALVE BLOOD LVL 10,127024.0,53350.08,34296.48,124483.52,30
CDM,6294441,IMP PUMP VALVE BLOOD LVL 11,135784.0,57029.28,36661.68,133068.32,30
CDM,6294458,IMP PUMP VALVE BLOOD LVL 12,144544.0,60708.48,39026.88,141653.12,30
CDM,6294466,IMP PUMP VALVE BLOOD LVL 13,153304.0,64387.68,41392.08,150237.92,30
CDM,6294557,CATH GUIDE LVL 13,13895.0,5835.9,3751.65,13617.1,30
CDM,6294565,CATH INTRASPINAL LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6294573,IMP PROSTH SPHINCTR URIN LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6294581,IMP PROSTH SPHINCTR URIN LVL 06,35044.0,14718.48,9461.88,34343.12,30
CDM,6294599,IMP PROSTH SPHINCTR URIN LVL 07,39424.0,16558.08,10644.48,38635.52,30
CDM,6294607,IMP PROSTH SPHINCTR URIN LVL 08,43804.0,18397.68,11827.08,42927.92,30
CDM,6294615,IMP PROSTH SPHINCTR URIN LVL 09,48184.0,20237.28,13009.68,47220.32,30
CDM,6294623,IMP PROSTH SPHINCTR URIN LVL 10,52564.0,22076.88,14192.28,51512.72,30
CDM,6294631,IMP PROSTH SPHINCTR URIN LVL 11,56944.0,23916.48,15374.88,55805.12,30
CDM,6294649,IMP PROSTH SPHINCTR URIN LVL 12,61324.0,25756.08,16557.48,60097.52,30
CDM,6294656,IMP PROSTH SPHINCTR URIN LVL 13,67894.0,28515.48,18331.38,66536.12,30
CDM,6295034,IMP MEMBRANE AMNIO OCULAR LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6295042,IMP MEMBRANE AMNIO OCULAR LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6295075,PROBE/NEEDLE CRYOABLATION LVL 01,588.0,246.96,158.76,576.24,30
CDM,6295083,PROBE/NEEDLE CRYOABLATION LVL 02,2690.0,1129.8,726.3,2636.2,30
CDM,6295091,PROBE/NEEDLE CRYOABLATION LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,6295109,PROBE/NEEDLE CRYOABLATION LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6295117,PROBE/NEEDLE CRYOABLATION LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6295125,PROBE/NEEDLE CRYOABLATION LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6295133,PROBE/NEEDLE CRYOABLATION LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6295141,PROBE/NEEDLE CRYOABLATION LVL 08,26284.0,11039.28,7096.68,25758.32,30
CDM,6295240,IMP FIX LW/UP/PELVIC LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6295257,IMP FIX LW/UP/PELVIC LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,6295265,IMP FIX LW/UP/PELVIC LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6295273,IMP FIX LW/UP/PELVIC LVL 07,21904.0,9199.68,5914.08,21465.92,30
CDM,6295281,IMP BLADE LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6295299,IMP BLADE LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6295307,IMP BLADE LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6295315,WIRE PACING TEMP LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6295323,CATH FEEDING LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6295331,CATH FEEDING LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6295539,IMP RV/AD/RP KN ROTATING HNG LVL 08,28474.0,11959.08,7687.98,27904.52,30
CDM,6295547,IMP RV/AD/RP KN ROTATING HNG LVL 09,32854.0,13798.68,8870.58,32196.92,30
CDM,6295836,IMP PROSTH SPHINCTR URIN LVL 14,74464.0,31274.88,20105.28,72974.72,30
CDM,6295844,CATH ABL TISSUE INSERT LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,6295869,CATH SPINAL/NEURO LVL 07,6950.0,2919.0,1876.5,6811.0,30
CDM,6295877,IMP ORTHOPEDIC CAGE LVL 14,91984.0,38633.28,24835.68,90144.32,30
CDM,6295893,IMP CLIP/S 1-4 REPAIR MITRAL KIT,109800.0,46116.0,29646.0,107604.0,30
CDM,6295919,INSTRUMENT DISP SINGLE LVL 14,17524.0,7360.08,4731.48,17173.52,30
CDM,6295935,IMP LD VENOUS COR LV LVL 01,2695.0,1131.9,727.65,2641.1,30
CDM,6295943,IMP LD VENOUS COR LV LVL 02,3853.0,1618.26,1040.31,3775.94,30
CDM,6295950,IMP LD VENOUS COR LV LVL 03,4880.0,2049.6,1317.6,4782.4,30
CDM,6296032,IMP MEMBRANE AMNIO OCULAR LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6296081,IMP SEPTAL DEFECT INTRACARD LVL 05,32854.0,13798.68,8870.58,32196.92,30
CDM,6296149,IMP CATH PORT INDWELLING LVL 11,6950.0,2919.0,1876.5,6811.0,30
CDM,6296776,INTRO NON GD/EP/LASER LVL 09,10191.0,4280.22,2751.57,9987.18,30
CDM,6296784,INTRO NON GD/EP/LASER LVL 10,13895.0,5835.9,3751.65,13617.1,30
CDM,6296958,IMP PROSTH SPHINCTR URIN LVL 15,76654.0,32194.68,20696.58,75120.92,30
CDM,6297006,IMP RV/AD/RP SHDR STEM LVL 01,4880.0,2049.6,1317.6,4782.4,30
CDM,6297030,IMP COVER BURR HOLE LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6297154,IMP SPINE STABILIZER LVL 01,594.0,249.48,160.38,582.12,30
CDM,6297162,IMP SPINE STABILIZER LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6297170,IMP SPINE STABILIZER LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6297188,IMP SPINE STABILIZER LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6297196,IMP SPINE STABILIZER LVL 05,6024.0,2530.08,1626.48,5903.52,30
CDM,6297204,IMP SPINE STABILIZER LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6297212,IMP SPINE STABILIZER LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6297220,IMP SPINE STABILIZER LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6297238,IMP SPINE STABILIZER LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6297246,IMP SPINE STABILIZER LVL 10,24094.0,10119.48,6505.38,23612.12,30
CDM,6297303,CATH TLA NONLASER DRUG COAT LVL 01,166.0,69.72,44.82,162.68,30
CDM,6297311,CATH TLA NONLASER DRUG COAT LVL 02,313.0,131.46,84.51,306.74,30
CDM,6297329,CATH TLA NONLASER DRUG COAT LVL 03,594.0,249.48,160.38,582.12,30
CDM,6297337,CATH TLA NONLASER DRUG COAT LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6297345,CATH TLA NONLASER DRUG COAT LVL 05,1888.0,792.96,509.76,1850.24,30
CDM,6297352,CATH TLA NONLASER DRUG COAT LVL 06,2695.0,1131.9,727.65,2641.1,30
CDM,6297360,CATH TLA NONLASER DRUG COAT LVL 07,3853.0,1618.26,1040.31,3775.94,30
CDM,6297378,CATH TLA NONLASER DRUG COAT LVL 08,4397.0,1846.74,1187.19,4309.06,30
CDM,6297386,CATH TLA NONLASER DRUG COAT LVL 09,6105.0,2564.1,1648.35,5982.9,30
CDM,6297394,CATH TLA NONLASER DRUG COAT LVL 10,7413.0,3113.46,2001.51,7264.74,30
CDM,6297402,CATH TLA NONLASER DRUG COAT LVL 11,9265.0,3891.3,2501.55,9079.7,30
CDM,6297410,CATH TLA NONLASER DRUG COAT LVL 12,11580.0,4863.6,3126.6,11348.4,30
CDM,6297428,CATH BALLOON PACING LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6297436,LENS INTRAOCULAR IRIS LVL 01,594.0,249.48,160.38,582.12,30
CDM,6297444,LENS INTRAOCULAR IRIS LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6297451,LENS INTRAOCULAR IRIS LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6297469,LENS INTRAOCULAR IRIS LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6297477,LENS INTRAOCULAR IRIS LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6297485,LENS INTRAOCULAR IRIS LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6297493,LENS INTRAOCULAR IRIS LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6297501,LENS INTRAOCULAR ASTIGMATISM LVL 01,594.0,249.48,160.38,582.12,30
CDM,6297519,LENS INTRAOCULAR ASTIGMATISM LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6297527,LENS INTRAOCULAR ASTIGMATISM LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6297535,LENS INTRAOCULAR ASTIGMATISM LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6297543,LENS INTRAOCULAR ASTIGMATISM LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6297550,LENS INTRAOCULAR ASTIGMATISM LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6297568,LENS INTRAOCULAR ASTIGMATISM LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6297576,LENS INTRAOCULAR PRESBYOPIA LVL 01,594.0,249.48,160.38,582.12,30
CDM,6297584,LENS INTRAOCULAR PRESBYOPIA LVL 02,1132.0,475.44,305.64,1109.36,30
CDM,6297592,LENS INTRAOCULAR PRESBYOPIA LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6297600,LENS INTRAOCULAR PRESBYOPIA LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6297618,LENS INTRAOCULAR PRESBYOPIA LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6297626,LENS INTRAOCULAR PRESBYOPIA LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6297634,LENS INTRAOCULAR PRESBYOPIA LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6297659,DEVICE FIXATION DISP LVL 12,21904.0,9199.68,5914.08,21465.92,30
CDM,6297667,MAGGOTS MEDICAL/VIAL LVL 01,313.0,131.46,84.51,306.74,30
CDM,6297675,MAGGOTS MEDICAL/VIAL LVL 02,594.0,249.48,160.38,582.12,30
CDM,6297683,MAGGOTS MEDICAL/VIAL LVL 03,850.0,357.0,229.5,833.0,30
CDM,6297691,MAGGOTS MEDICAL/VIAL LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6297709,LENS INTRAOCULAR CHAM ANT LVL 04,2695.0,1131.9,727.65,2641.1,30
CDM,6297717,LENS INTRAOCULAR CHAM ANT LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6297725,LENS INTRAOCULAR CHAM ANT LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6297733,LENS INTRAOCULAR CHAM ANT LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6297741,LENS INTRAOCULAR CHAM ANT LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6297758,LENS INTRAOCULAR CHAM POST LVL 05,3853.0,1618.26,1040.31,3775.94,30
CDM,6297766,LENS INTRAOCULAR CHAM POST LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6297774,LENS INTRAOCULAR CHAM POST LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6297782,LENS INTRAOCULAR CHAM POST LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6297790,LENS INTRAOCULAR NEW TECH LVL 04,4885.0,2051.7,1318.95,4787.3,30
CDM,6297808,LENS INTRAOCULAR NEW TECH LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6297816,LENS INTRAOCULAR NEW TECH LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6297824,LENS INTRAOCULAR ASTIGMATISM LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6297832,LENS INTRAOCULAR IRIS LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6297840,LENS INTRAOCULAR PRESBYOPIA LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6297857,DEVICE CLOSURE TISSUE LVL 12,26284.0,11039.28,7096.68,25758.32,30
CDM,6297865,DEVICE CLOSURE TISSUE LVL 13,30664.0,12878.88,8279.28,30050.72,30
CDM,6297873,IMP RV/AD/RP KN PATELLA LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6297881,IMP RV/AD/RP KN PATELLA LVL 02,2152.0,903.84,581.04,2108.96,30
CDM,6298160,IMP FIX LW/UP/PELVIC LVL 08,26284.0,11039.28,7096.68,25758.32,30
CDM,6298475,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 01,594.0,249.48,160.38,582.12,30
CDM,6298483,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6298491,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 03,2157.0,905.94,582.39,2113.86,30
CDM,6298509,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 04,3083.0,1294.86,832.41,3021.34,30
CDM,6298517,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 05,4885.0,2051.7,1318.95,4787.3,30
CDM,6298525,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 06,6950.0,2919.0,1876.5,6811.0,30
CDM,6298533,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 07,9265.0,3891.3,2501.55,9079.7,30
CDM,6298541,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 08,13895.0,5835.9,3751.65,13617.1,30
CDM,6298558,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,6298574,OCCLUDER LVL 05,30664.0,12878.88,8279.28,30050.72,30
CDM,6298657,IMP DEV CLOSURE ATRIAL APNDG LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,6298665,IMP DEV CLOSURE ATRIAL APNDG LVL 02,13895.0,5835.9,3751.65,13617.1,30
CDM,6298673,IMP DEV CLOSURE ATRIAL APNDG LVL 03,26284.0,11039.28,7096.68,25758.32,30
CDM,6298707,IMP DEV CLOSURE ATRIAL APNDG LVL 06,78844.0,33114.48,21287.88,77267.12,30
CDM,6298806,CATH ABL NONCARDIAC LVL 03,6105.0,2564.1,1648.35,5982.9,30
CDM,6298814,IMP RV/AD/RP HIP SYS TRIFLNG LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,6298822,IMP RV/AD/RP HIP SYS TRIFLNG LVL 02,6105.0,2564.1,1648.35,5982.9,30
CDM,6298830,IMP RV/AD/RP HIP SYS TRIFLNG LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6298848,IMP RV/AD/RP HIP SYS TRIFLNG LVL 04,21904.0,9199.68,5914.08,21465.92,30
CDM,6298855,IMP RV/AD/RP HIP SYS TRIFLNG LVL 05,32854.0,13798.68,8870.58,32196.92,30
CDM,6298939,IMP CARDIAC EVENT REC LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,6298947,IMP CARDIAC EVENT REC LVL 02,11575.0,4861.5,3125.25,11343.5,30
CDM,6298954,IMP PCMKR NONSGL OR DUAL LVL 01,6105.0,2564.1,1648.35,5982.9,30
CDM,6298962,IMP PCMKR NONSGL OR DUAL LVL 02,13895.0,5835.9,3751.65,13617.1,30
CDM,6298970,IMP PCMKR NONSGL OR DUAL LVL 03,21900.0,9198.0,5913.0,21462.0,30
CDM,6299085,IMP DEV JT ANKLE TOTAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,6299093,IMP DEV JT ANKLE TOTAL LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6299101,IMP DEV JT ANKLE TOTAL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6299119,IMP DEV JT ANKLE TOTAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6299127,IMP DEV JT ANKLE TOTAL LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6299135,IMP DEV JT ANKLE TOTAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6299143,IMP DEV JT ANKLE TOTAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6299150,IMP DEV JT ANKLE TOTAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
CDM,6299168,IMP DEV JT ANKLE TOTAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6299176,IMP DEV JT ANKLE TOTAL LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,6299184,IMP DEV JT ANKLE TOTAL LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,6299192,IMP DEV JT ANKLE TOTAL LVL 12,35044.0,14718.48,9461.88,34343.12,30
CDM,6299200,IMP DEV JT ANKLE TOTAL LVL 13,39424.0,16558.08,10644.48,38635.52,30
CDM,6299218,IMP DEV JT ANKLE TOTAL LVL 14,43804.0,18397.68,11827.08,42927.92,30
CDM,6299556,ANCHOR APPLIER SYS LVL 01,313.0,131.46,84.51,306.74,30
CDM,6299564,ANCHOR APPLIER SYS LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6299572,ANCHOR APPLIER SYS LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6299580,ANCHOR APPLIER SYS LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6299820,IMP BLADE LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6299861,IMP PROSTH PENILE NONINF LVL 06,37234.0,15638.28,10053.18,36489.32,30
CDM,6299887,DEVICE SYS DELIVERY DISP LVL 01,166.0,69.72,44.82,162.68,30
CDM,6299895,DEVICE SYS DELIVERY DISP LVL 02,313.0,131.46,84.51,306.74,30
CDM,6299903,DEVICE SYS DELIVERY DISP LVL 03,594.0,249.48,160.38,582.12,30
CDM,6299911,DEVICE SYS DELIVERY DISP LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6299929,DEVICE SYS DELIVERY DISP LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6299937,DEVICE SYS DELIVERY DISP LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6299994,IMP SEPTAL DEFECT INTRACARD LVL 06,37234.0,15638.28,10053.18,36489.32,30
CDM,6300990,PLUG BIOPSY LUNG W DELIVERY LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6301030,DEVICE ABLATION LVL 13,39424.0,16558.08,10644.48,38635.52,30
CDM,6301048,DEVICE ABLATION LVL 14,48184.0,20237.28,13009.68,47220.32,30
CDM,6301055,DEVICE ABLATION LVL 15,56944.0,23916.48,15374.88,55805.12,30
CDM,6301063,IMP SEPTAL DEFECT INTRACARD LVL 07,43804.0,18397.68,11827.08,42927.92,30
CDM,6301071,IMP RV/AD/RP HIP FEMORAL HD LVL 01,1132.0,475.44,305.64,1109.36,30
CDM,6301113,IMP RV/AD/RP SHDR PROX BODY LVL 06,26284.0,11039.28,7096.68,25758.32,30
CDM,6301139,IMP STAPLE BONE LVL 15,10654.0,4474.68,2876.58,10440.92,30
CDM,6301147,IMP STAPLE BONE LVL 16,11580.0,4863.6,3126.6,11348.4,30
CDM,6301295,CATH THROMBECTOMY/EMBOLECTMY LVL 15,35044.0,14718.48,9461.88,34343.12,30
CDM,6301337,INTRO EP STEER NONPEEL LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6301345,INTRO EP STEER NONPEEL LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6301352,IMP SPACER ORTHOPEDIC LVL 10,26284.0,11039.28,7096.68,25758.32,30
CDM,6301402,IMP CEMENT LVL 09,17524.0,7360.08,4731.48,17173.52,30
CDM,6301493,IMP LD NEUROSTIM TEST KIT LVL 01,166.0,69.72,44.82,162.68,30
CDM,6301501,IMP LD NEUROSTIM TEST KIT LVL 02,313.0,131.46,84.51,306.74,30
CDM,6301519,IMP LD NEUROSTIM TEST KIT LVL 03,594.0,249.48,160.38,582.12,30
CDM,6301527,IMP LD NEUROSTIM TEST KIT LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6301535,IMP LD NEUROSTIM TEST KIT LVL 05,1883.0,790.86,508.41,1845.34,30
CDM,6301584,IMP SHUNT LVL 12,26284.0,11039.28,7096.68,25758.32,30
CDM,6301592,IMP SHUNT LVL 13,30664.0,12878.88,8279.28,30050.72,30
CDM,6301881,IMP SPACER ORTHOPEDIC LVL 11,30664.0,12878.88,8279.28,30050.72,30
CDM,6302285,STAPLER LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6302293,STAPLER LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6302426,IMP PROSTH SPHINCTR URIN LVL 16,87604.0,36793.68,23653.08,85851.92,30
CDM,6302442,CANNULA LVL 12,13895.0,5835.9,3751.65,13617.1,30
CDM,6302459,CANNULA LVL 13,19714.0,8279.88,5322.78,19319.72,30
CDM,6302467,CANNULA LVL 14,26284.0,11039.28,7096.68,25758.32,30
CDM,6302475,CANNULA LVL 15,32854.0,13798.68,8870.58,32196.92,30
CDM,6302483,CANNULA LVL 16,39424.0,16558.08,10644.48,38635.52,30
CDM,6302491,CANNULA LVL 17,45994.0,19317.48,12418.38,45074.12,30
CDM,6302509,CANNULA LVL 18,52564.0,22076.88,14192.28,51512.72,30
CDM,6302590,IMP PROSTH PENILE NONINF LVL 08,45994.0,19317.48,12418.38,45074.12,30
CDM,6302616,CATH THROMBECTOMY/EMBOLECTMY LVL 16,39424.0,16558.08,10644.48,38635.52,30
CDM,6302822,IMP GENERATOR NEUROSTIM LVL 07,153304.0,64387.68,41392.08,150237.92,30
CDM,6302905,IMP SPACER ORTHOPEDIC LVL 14,43804.0,18397.68,11827.08,42927.92,30
CDM,6303077,IMP PROSTH BREAST LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6305445,IMP PROSTH PENILE INFLT LVL 09,74464.0,31274.88,20105.28,72974.72,30
CDM,6305692,STRAVIX/STRAVPL PRIM FIX INT 3X6/SC,465.3,195.43,125.63,455.99,37
CDM,6305965,CYTAL MTRX 3LYR FIX INT 5X5/SC,109.9,46.16,29.67,184.35,37
CDM,6305973,CYTAL MTRX 3LYR FIX INT 7X10/SC,87.9,36.92,23.73,184.35,37
CDM,6306336,CATH/WIRE/SUTURE PASSER LVL 08,3853.0,1618.26,1040.31,3775.94,30
CDM,6306369,CATH GUIDE LVL 14,15334.0,6440.28,4140.18,15027.32,30
CDM,6306427,INTGR BM FIX INT 10X25/SC,118.6,49.81,32.02,184.35,37
CDM,6306450,INTGR BM FIX INT 20X25/SC,93.9,39.44,25.35,184.35,37
CDM,6306948,IMP ANCHOR/SCREW/WASHER/NUT LVL 01,70.0,29.4,18.9,68.6,30
CDM,6306955,IMP ANCHOR/SCREW/WASHER/NUT LVL 02,102.0,42.84,27.54,99.96,30
CDM,6306963,IMP ANCHOR/SCREW/WASHER/NUT LVL 03,166.0,69.72,44.82,162.68,30
CDM,6306971,IMP ANCHOR/SCREW/WASHER/NUT LVL 04,221.0,92.82,59.67,216.58,30
CDM,6306989,IMP ANCHOR/SCREW/WASHER/NUT LVL 05,313.0,131.46,84.51,306.74,30
CDM,6306997,IMP ANCHOR/SCREW/WASHER/NUT LVL 06,447.0,187.74,120.69,438.06,30
CDM,6307003,IMP ANCHOR/SCREW/WASHER/NUT LVL 07,594.0,249.48,160.38,582.12,30
CDM,6307011,IMP ANCHOR/SCREW/WASHER/NUT LVL 08,850.0,357.0,229.5,833.0,30
CDM,6307029,IMP ANCHOR/SCREW/WASHER/NUT LVL 09,1132.0,475.44,305.64,1109.36,30
CDM,6307037,IMP ANCHOR/SCREW/WASHER/NUT LVL 10,1413.0,593.46,381.51,1384.74,30
CDM,6307045,IMP ANCHOR/SCREW/WASHER/NUT LVL 11,1619.0,679.98,437.13,1586.62,30
CDM,6307052,IMP ANCHOR/SCREW/WASHER/NUT LVL 12,2695.0,1131.9,727.65,2641.1,30
CDM,6307060,IMP ANCHOR/SCREW/WASHER/NUT LVL 13,3853.0,1618.26,1040.31,3775.94,30
CDM,6307078,IMP ANCHOR/SCREW/WASHER/NUT LVL 14,4885.0,2051.7,1318.95,4787.3,30
CDM,6307086,IMP ANCHOR/SCREW/WASHER/NUT LVL 15,6105.0,2564.1,1648.35,5982.9,30
CDM,6307094,IMP ANCHOR/SCREW/WASHER/NUT LVL 16,6950.0,2919.0,1876.5,6811.0,30
CDM,6307102,IMP ANCHOR/SCREW/WASHER/NUT LVL 17,9265.0,3891.3,2501.55,9079.7,30
CDM,6307110,IMP ANCHOR/SCREW/WASHER/NUT LVL 18,11580.0,4863.6,3126.6,11348.4,30
CDM,6307128,IMP ANCHOR/SCREW/WASHER/NUT LVL 19,13895.0,5835.9,3751.65,13617.1,30
CDM,6307136,IMP ANCHOR/SCREW/WASHER/NUT LVL 20,17524.0,7360.08,4731.48,17173.52,30
CDM,6307144,IMP ANCHOR/SCREW/WASHER/NUT LVL 21,21904.0,9199.68,5914.08,21465.92,30
CDM,6307151,IMP RV/AD/RP SHDR CUP LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6307169,IMP RV/AD/RP SHDR CUP LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6307177,IMP RV/AD/RP SHDR CUP LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6307425,DURAL SLNT ADHERUS AUTOSPRAY,4621.8,1941.16,1247.89,4529.36,30
CDM,6307821,SEALANT SYS DURASEAL 5ML,2180.2,915.68,588.65,2136.6,30
CDM,6307847,SPINE SLNT DURASEAL SYS 5ML 5U,4246.5,1783.53,1146.56,4161.57,30
CDM,6307979,FBR SLNT TISSEEL W DPLJECT SYS 4ML,969.0,406.98,261.63,949.62,30
CDM,6307987,FBR SLNT TISSEEL W PRIMA 10ML SYR,2256.9,947.9,609.36,2211.76,30
CDM,6307995,FBR SLNT TISSEEL W PRIMA 4ML SYR,644.3,270.61,173.96,631.41,30
CDM,6308001,FBR SLNT TISSEEL THROMBIN FRZ 4ML,909.6,382.03,245.59,891.41,30
CDM,6308019,FBR SLNT TISSEEL VALUE PACK 2ML,969.0,406.98,261.63,949.62,30
CDM,6308688,AMNIOBAND FIX INT 4X4/SC,506.1,212.56,127.14,495.98,37
CDM,6308803,HEMOSTATIC AGENT GI TOP LVL 01,313.0,131.46,84.51,306.74,30
CDM,6308811,HEMOSTATIC AGENT GI TOP LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6308829,HEMOSTATIC AGENT GI TOP LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6308837,HEMOSTATIC AGENT GI TOP LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6308845,HEMOSTATIC AGENT GI TOP LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6309116,PROBE/WATERJET ABL ROBOTIC LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6309124,PROBE/WATERJET ABL ROBOTIC LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6309132,PROBE/WATERJET ABL ROBOTIC LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6309140,PROBE/WATERJET ABL ROBOTIC LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6309157,PROBE/WATERJET ABL ROBOTIC LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6309207,NEEDLE SPECIALTY LVL 12,4641.0,1949.22,1253.07,4548.18,30
CDM,6309215,CATH ANGIO TRANSL NONLASER LVL 11,15772.0,6624.24,4258.44,15456.56,30
CDM,6309223,CATH ANGIO TRANSL NONLASER LVL 12,19276.0,8095.92,5204.52,18890.48,30
CDM,6309231,CATH ANGIO TRANSL NONLASER LVL 13,22780.0,9567.6,6150.6,22324.4,30
CDM,6309256,IMP SEALANT PULMONARY LIQUID LVL 02,3596.0,1510.32,970.92,3524.08,30
CDM,6309264,IMP SEALANT PULMONARY LIQUID LVL 03,4397.0,1846.74,1187.19,4309.06,30
CDM,6309272,IMP SEALANT PULMONARY LIQUID LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6309330,CATH TLA NONLASER DRUG COAT LVL 13,13895.0,5835.9,3751.65,13617.1,30
CDM,6309504,CATH LITHO TRANSL INTRAVASC LVL 01,4885.0,2051.7,1318.95,4787.3,30
CDM,6309512,CATH LITHO TRANSL INTRAVASC LVL 02,6950.0,2919.0,1876.5,6811.0,30
CDM,6309520,CATH LITHO TRANSL INTRAVASC LVL 03,9265.0,3891.3,2501.55,9079.7,30
CDM,6309538,CATH LITHO TRANSL INTRAVASC LVL 04,11580.0,4863.6,3126.6,11348.4,30
CDM,6309546,CATH LITHO TRANSL INTRAVASC LVL 05,13895.0,5835.9,3751.65,13617.1,30
CDM,6309553,CATH LITHO TRANSL INTRAVASC LVL 06,15334.0,6440.28,4140.18,15027.32,30
CDM,6309561,CATH LITHO TRANSL INTRAVASC LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6309579,CATH LITHO TRANSL INTRAVASC LVL 08,19714.0,8279.88,5322.78,19319.72,30
CDM,6309587,CATH LITHO TRANSL INTRAVASC LVL 09,21904.0,9199.68,5914.08,21465.92,30
CDM,6309595,REAMER LVL 10,9265.0,3891.3,2501.55,9079.7,30
CDM,6309728,SEALANT SURG PREVELEAK 4ML,2181.2,916.1,588.92,2137.58,30
CDM,6309843,CATH THROMBECTOMY/EMBOLECTMY LVL 17,43804.0,18397.68,11827.08,42927.92,30
CDM,6309850,CATH THROMBECTOMY/EMBOLECTMY LVL 18,48184.0,20237.28,13009.68,47220.32,30
CDM,6309868,ENDOSCOPE SINGLE USE UGI LVL 01,313.0,131.46,84.51,306.74,30
CDM,6309876,ENDOSCOPE SINGLE USE UGI LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6309884,ENDOSCOPE SINGLE USE UGI LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6309892,ENDOSCOPE SINGLE USE UGI LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6309900,ENDOSCOPE SINGLE USE UGI LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6309918,ENDOSCOPE SINGLE USE UGI LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6309926,ENDOSCOPE SINGLE USE UGI LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6309934,IMP PUMP VALVE BLOOD LVL 14,162064.0,68066.88,43757.28,158822.72,30
CDM,6309942,IMP PUMP VALVE BLOOD LVL 15,170824.0,71746.08,46122.48,167407.52,30
CDM,6309959,IMP PUMP VALVE BLOOD LVL 16,179584.0,75425.28,48487.68,175992.32,30
CDM,6309967,INTRO EP FIX CRV NONPEEL LVL 06,4885.0,2051.7,1318.95,4787.3,30
CDM,6309975,INTRO EP FIX CRV NONPEEL LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6310031,CLIP LVL 10,8107.0,3404.94,2188.89,7944.86,30
CDM,6310056,IMP PUMP VALVE BLOOD LVL 01,30664.0,12878.88,8279.28,30050.72,30
CDM,6310064,IMP PUMP VALVE BLOOD LVL 02,39424.0,16558.08,10644.48,38635.52,30
CDM,6310072,IMP PUMP VALVE BLOOD LVL 03,52564.0,22076.88,14192.28,51512.72,30
CDM,6310080,IMP PUMP VALVE BLOOD LVL 04,65704.0,27595.68,17740.08,64389.92,30
CDM,6310411,IMP FILTER VENA CAVA LVL 06,11580.0,4863.6,3126.6,11348.4,30
CDM,6310429,CATH BALLOON DILAT NONVASC LVL 07,17524.0,7360.08,4731.48,17173.52,30
CDM,6310775,IMP PROS TEMP W ANCHR&STRTS LVL 01,3853.0,1618.26,1040.31,3775.94,30
CDM,6310783,IMP PROS TEMP W ANCHR&STRTS LVL 02,6105.0,2564.1,1648.35,5982.9,30
CDM,6310791,IMP PROS TEMP W ANCHR&STRTS LVL 03,13895.0,5835.9,3751.65,13617.1,30
CDM,6310874,EMBOLIZATION SYS PROTECT LVL 08,26284.0,11039.28,7096.68,25758.32,30
CDM,6310882,EMBOLIZATION SYS PROTECT LVL 09,30664.0,12878.88,8279.28,30050.72,30
CDM,6310940,IMP FIX SPINE LVL 15,91984.0,38633.28,24835.68,90144.32,30
CDM,6310957,CATH LITHO TRANSL INTRAVASC LVL 10,24094.0,10119.48,6505.38,23612.12,30
CDM,6310981,IMP RV/AD/RP ELBOW HEAD LVL 01,1413.0,593.46,381.51,1384.74,30
CDM,6310999,IMP RV/AD/RP ELBOW HEAD LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6311211,PILLOW FETAL LVL 01,594.0,249.48,160.38,582.12,30
CDM,6311229,PILLOW FETAL LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6311237,PILLOW FETAL LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6311245,PILLOW FETAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6311328,PROBE/WATERJET ABL ROBOTIC LVL 06,17524.0,7360.08,4731.48,17173.52,30
CDM,6311633,ENDOSCOPE SINGLE USE UT LVL 01,313.0,131.46,84.51,306.74,30
CDM,6311641,ENDOSCOPE SINGLE USE UT LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6311658,ENDOSCOPE SINGLE USE UT LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6311666,ENDOSCOPE SINGLE USE UT LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6311674,ENDOSCOPE SINGLE USE UT LVL 05,6105.0,2564.1,1648.35,5982.9,30
CDM,6311682,ENDOSCOPE SINGLE USE UT LVL 06,9265.0,3891.3,2501.55,9079.7,30
CDM,6311690,ENDOSCOPE SINGLE USE UT LVL 07,13895.0,5835.9,3751.65,13617.1,30
CDM,6311716,RESTRATA MESH FIX INT 10X12.5/SC,111.9,47.0,30.21,184.35,37
CDM,6311948,IMP AGENT SYNTHETIC BULK 1ML LVL 07,3591.0,1508.22,969.57,3519.18,30
CDM,6311955,IMP AGENT SYNTHETIC BULK 1ML LVL 08,6105.0,2564.1,1648.35,5982.9,30
CDM,6312227,CATH THROMBECTOMY/EMBO DVT PPP,27531.0,11563.02,7433.37,26980.38,30
CDM,6312235,INTRO NON GD/EP/LASER DVT PPP,7509.0,3153.78,2027.43,7358.82,30
CDM,6312243,CATH THROMBECTOMY/EMBO VTE PPP,37856.0,15899.52,10221.12,37098.88,30
CDM,6312250,INTRO NON GD/EP/LASER VTE PPP,10324.0,4336.08,2787.48,10117.52,30
CDM,6312359,IMP ADHSN BARRIER 30+ DAYS LVL 01,850.0,357.0,229.5,833.0,30
CDM,6312367,IMP ADHSN BARRIER 30+ DAYS LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6312375,IMP ADHSN BARRIER 30+ DAYS LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,6312383,IMP ADHSN BARRIER 30+ DAYS LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6312417,IMP CATH DRAINAGE 30+ DAYS LVL 01,594.0,249.48,160.38,582.12,30
CDM,6312425,IMP CATH DRAINAGE 30+ DAYS LVL 02,1888.0,792.96,509.76,1850.24,30
CDM,6312433,IMP CATH DRAINAGE 30+ DAYS LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6312441,IMP CATH DRAINAGE 30+ DAYS LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6312466,IMP TUBE TRACH 30+ DAYS LVL 01,313.0,131.46,84.51,306.74,30
CDM,6312474,IMP TUBE TRACH 30+ DAYS LVL 02,594.0,249.48,160.38,582.12,30
CDM,6312482,IMP TUBE TRACH 30+ DAYS LVL 03,850.0,357.0,229.5,833.0,30
CDM,6312490,IMP TUBE TRACH 30+ DAYS LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6312508,IMP TUBE TRACH 30+ DAYS LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6312516,IMP TUBE TRACH 30+ DAYS LVL 06,1619.0,679.98,437.13,1586.62,30
CDM,6312524,IMP TUBE TRACH 30+ DAYS LVL 07,2157.0,905.94,582.39,2113.86,30
CDM,6312532,IMP TUBE TRACH 30+ DAYS LVL 08,2695.0,1131.9,727.65,2641.1,30
CDM,6312540,ADHSN BARRIER IMP <30DAYS LVL 01,850.0,357.0,229.5,833.0,30
CDM,6312557,ADHSN BARRIER IMP <30DAYS LVL 02,2695.0,1131.9,727.65,2641.1,30
CDM,6312565,ADHSN BARRIER IMP <30DAYS LVL 03,4885.0,2051.7,1318.95,4787.3,30
CDM,6312573,ADHSN BARRIER IMP <30DAYS LVL 04,9265.0,3891.3,2501.55,9079.7,30
CDM,6312607,CATH DRAINAGE IMP <30DAYS LVL 01,594.0,249.48,160.38,582.12,30
CDM,6312615,CATH DRAINAGE IMP <30DAYS LVL 02,1888.0,792.96,509.76,1850.24,30
CDM,6312623,CATH DRAINAGE IMP <30DAYS LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6312631,CATH DRAINAGE IMP <30DAYS LVL 04,3853.0,1618.26,1040.31,3775.94,30
CDM,6312656,TUBE TRACH IMP <30DAYS LVL 01,313.0,131.46,84.51,306.74,30
CDM,6312664,TUBE TRACH IMP <30DAYS LVL 02,594.0,249.48,160.38,582.12,30
CDM,6312672,TUBE TRACH IMP <30DAYS LVL 03,850.0,357.0,229.5,833.0,30
CDM,6312680,TUBE TRACH IMP <30DAYS LVL 04,1132.0,475.44,305.64,1109.36,30
CDM,6312698,TUBE TRACH IMP <30DAYS LVL 05,1413.0,593.46,381.51,1384.74,30
CDM,6312706,TUBE TRACH IMP <30DAYS LVL 06,1619.0,679.98,437.13,1586.62,30
CDM,6312714,TUBE TRACH IMP <30DAYS LVL 07,2157.0,905.94,582.39,2113.86,30
CDM,6312722,TUBE TRACH IMP <30DAYS LVL 08,2695.0,1131.9,727.65,2641.1,30
CDM,6312771,CYTAL MTRX 2LYR FIX INT 5X5/SC,520.4,218.57,127.14,509.99,37
CDM,6313001,DEVICE SYS HEM CNTRL UTR VAC LVL 01,166.0,69.72,44.82,162.68,30
CDM,6313019,DEVICE SYS HEM CNTRL UTR VAC LVL 02,313.0,131.46,84.51,306.74,30
CDM,6313027,DEVICE SYS HEM CNTRL UTR VAC LVL 03,594.0,249.48,160.38,582.12,30
CDM,6313035,DEVICE SYS HEM CNTRL UTR VAC LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6313043,DEVICE SYS HEM CNTRL UTR VAC LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6313050,DEVICE SYS HEM CNTRL UTR VAC LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6313068,DEVICE SYS HEM CNTRL UTR VAC LVL 07,4885.0,2051.7,1318.95,4787.3,30
CDM,6313076,DEVICE SYS HEM CNTRL UTR VAC LVL 08,6105.0,2564.1,1648.35,5982.9,30
CDM,6313084,DEVICE SYS HEM CNTRL UTR VAC LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6313142,CATH ABL EP NON 3D/VECTOR LVL 09,34168.0,14350.56,9225.36,33484.64,30
CDM,6313159,CATH ABL EP NON 3D/VECTOR LVL 10,38548.0,16190.16,10407.96,37777.04,30
CDM,6313639,IMP CEMENT LVL 10,21904.0,9199.68,5914.08,21465.92,30
CDM,6314421,IMP RV/AD/RP KN FEMORAL LVL 08,43804.0,18397.68,11827.08,42927.92,30
CDM,6314728,CATH COR TRANSL NONLASER DRUG LVL01,313.0,131.46,84.51,306.74,30
CDM,6314736,CATH COR TRANSL NONLASER DRUG LVL02,1413.0,593.46,381.51,1384.74,30
CDM,6314744,CATH COR TRANSL NONLASER DRUG LVL03,3853.0,1618.26,1040.31,3775.94,30
CDM,6314751,CATH COR TRANSL NONLASER DRUG LVL04,6105.0,2564.1,1648.35,5982.9,30
CDM,6314769,CATH COR TRANSL NONLASER DRUG LVL05,9265.0,3891.3,2501.55,9079.7,30
CDM,6314777,CATH COR TRANSL NONLASER DRUG LVL06,13895.0,5835.9,3751.65,13617.1,30
CDM,6314785,CATH COR TRANSL NONLASER DRUG LVL07,17524.0,7360.08,4731.48,17173.52,30
CDM,6314793,CATH COR TRANSL NONLASER DRUG LVL08,21904.0,9199.68,5914.08,21465.92,30
CDM,6314801,CATH COR TRANSL NONLASER DRUG LVL09,26284.0,11039.28,7096.68,25758.32,30
CDM,6314918,CHOLEDOCHOSCOPE SINGLE USE LVL 01,313.0,131.46,84.51,306.74,30
CDM,6314926,CHOLEDOCHOSCOPE SINGLE USE LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6314934,CHOLEDOCHOSCOPE SINGLE USE LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6314942,CHOLEDOCHOSCOPE SINGLE USE LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6314959,CHOLEDOCHOSCOPE SINGLE USE LVL 05,9265.0,3891.3,2501.55,9079.7,30
CDM,6314967,CHOLEDOCHOSCOPE SINGLE USE LVL 06,13895.0,5835.9,3751.65,13617.1,30
CDM,6314975,NEUROSTIM EXTERNAL WIRELESS LVL 01,166.0,69.72,44.82,162.68,30
CDM,6314983,NEUROSTIM EXTERNAL WIRELESS LVL 02,313.0,131.46,84.51,306.74,30
CDM,6314991,NEUROSTIM EXTERNAL WIRELESS LVL 03,594.0,249.48,160.38,582.12,30
CDM,6315006,NEUROSTIM EXTERNAL WIRELESS LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6315014,NEUROSTIM EXTERNAL WIRELESS LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6315659,MYRIAD MATRIX FIX INT 5X5 THCK/SC,38.0,15.96,10.26,184.35,37
CDM,6315881,IMP POUCH ECM LVL 01,313.0,131.46,84.51,306.74,30
CDM,6315899,IMP POUCH ECM LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6315907,IMP POUCH ECM LVL 03,3853.0,1618.26,1040.31,3775.94,30
CDM,6315915,IMP POUCH ECM LVL 04,6105.0,2564.1,1648.35,5982.9,30
CDM,6316178,INTGR MESH BM FIX INT 5X5/SC,387.7,162.83,104.68,379.95,37
CDM,6316426,DURAGEN CL 2.5X2.5/SH,950.8,399.34,127.14,931.78,37
CDM,6316434,DURAGEN PL 2.5X2.5/SH,841.0,353.22,127.14,824.18,37
CDM,6317028,DURAGEN CL 2.5X2.5/SH 5/PKG,854.4,358.85,127.14,837.31,37
CDM,6317077,DURAGEN CL 7.5X7.5/SH,1823.8,766.0,127.14,1787.32,37
CDM,6317085,DURAGEN CL 7.5X7.5/SH 5/PKG,2028.5,851.97,127.14,1987.93,37
CDM,6317135,IMP SLEEVE FIXATION LVL 01,166.0,69.72,44.82,162.68,30
CDM,6317143,IMP SLEEVE FIXATION LVL 02,313.0,131.46,84.51,306.74,30
CDM,6317150,IMP SLEEVE FIXATION LVL 03,594.0,249.48,160.38,582.12,30
CDM,6317168,IMP SLEEVE FIXATION LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6317960,RESTRATA SOLID FIX INT 2.5X2.5/SC,485.8,204.04,127.14,476.08,37
CDM,6318026,TACHOSIL 9.5X4.8CM PATCH,50.4,21.17,13.61,49.39,30
CDM,6318034,TACHOSIL 4.8X4.8CM PATCH,52.5,22.05,14.18,51.45,30
CDM,6318166,SLEEVE PROTECTION NON-SCD LVL 01,166.0,69.72,44.82,162.68,30
CDM,6318174,SLEEVE PROTECTION NON-SCD LVL 02,313.0,131.46,84.51,306.74,30
CDM,6318190,SLEEVE PROTECTION NON-SCD LVL 03,594.0,249.48,160.38,582.12,30
CDM,6318208,SLEEVE PROTECTION NON-SCD LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6318216,SLEEVE PROTECTION NON-SCD LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6318364,NEEDLE BIOPSY MRW BONE PWR LVL 02,1413.0,593.46,381.51,1384.74,30
CDM,6318372,NEEDLE BIOPSY MRW BONE PWR LVL 03,2695.0,1131.9,727.65,2641.1,30
CDM,6318661,IMP DEV VALVE SHUNT LVL 01,166.0,69.72,44.82,162.68,30
CDM,6318679,IMP DEV VALVE SHUNT LVL 02,313.0,131.46,84.51,306.74,30
CDM,6318687,IMP DEV VALVE SHUNT LVL 03,594.0,249.48,160.38,582.12,30
CDM,6318695,IMP DEV VALVE SHUNT LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6318703,IMP DEV VALVE SHUNT LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6318711,IMP DEV VALVE SHUNT LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6318729,IMP DEV VALVE SHUNT LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6318737,IMP DEV VALVE SHUNT LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6318745,IMP DEV VALVE SHUNT LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6318752,IMP DEV VALVE SHUNT LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6318760,IMP DEV VALVE SHUNT LVL 11,13895.0,5835.9,3751.65,13617.1,30
CDM,6318778,IMP DEV VALVE SHUNT LVL 12,17524.0,7360.08,4731.48,17173.52,30
CDM,6318786,IMP DEV VALVE SHUNT LVL 13,21904.0,9199.68,5914.08,21465.92,30
CDM,6318794,IMP DEV VALVE SHUNT LVL 14,26284.0,11039.28,7096.68,25758.32,30
CDM,6319354,IMP SCAF EV NON COR DE W DEL LVL 01,166.0,69.72,44.82,162.68,30
CDM,6319362,IMP SCAF EV NON COR DE W DEL LVL 02,313.0,131.46,84.51,306.74,30
CDM,6319370,IMP SCAF EV NON COR DE W DEL LVL 03,594.0,249.48,160.38,582.12,30
CDM,6319388,IMP SCAF EV NON COR DE W DEL LVL 04,1413.0,593.46,381.51,1384.74,30
CDM,6319396,IMP SCAF EV NON COR DE W DEL LVL 05,2695.0,1131.9,727.65,2641.1,30
CDM,6319404,IMP SCAF EV NON COR DE W DEL LVL 06,3853.0,1618.26,1040.31,3775.94,30
CDM,6319412,IMP SCAF EV NON COR DE W DEL LVL 07,6105.0,2564.1,1648.35,5982.9,30
CDM,6319420,IMP SCAF EV NON COR DE W DEL LVL 08,6950.0,2919.0,1876.5,6811.0,30
CDM,6319438,IMP SCAF EV NON COR DE W DEL LVL 09,9265.0,3891.3,2501.55,9079.7,30
CDM,6319446,IMP SCAF EV NON COR DE W DEL LVL 10,11580.0,4863.6,3126.6,11348.4,30
CDM,6319453,IMP SCAF EV NON COR DE W DEL LVL 11,13895.0,5835.9,3751.65,13617.1,30
CDM,6319982,BRACHY STRND P-103/SRCE,349.0,146.58,88.26,342.02,37
CDM,6763601,BETAXOLOL HCL 0.5%/5ML 5ML SNOP,204.3,85.81,55.16,200.21,30
CDM,6774731,MULTIVITAMIN/ TBCW,5.7,2.39,1.54,5.59,30
CDM,6775415,FOSINOPRIL/10MG 10MG TB,4.7,1.97,1.27,4.61,30
CDM,6785216,NAPROXEN/500MG 500MG TB,4.9,2.06,1.32,4.8,30
CDM,6793368,SOD CL 0.45%/1000ML 1000ML SNIV,29.1,12.22,7.86,28.52,30
CDM,6797781,TUBERCULIN PPD/1ML 5U/0.1ML SNIJ,37.1,15.58,10.02,36.36,30
CDM,6809602,TAMSULOSIN/0.4MG 0.4MG CP,6.2,2.6,1.67,6.08,30
CDM,6824361,ADMIN FEE PNEUMOCOCCAL,131.0,55.02,35.37,128.38,37
CDM,6824379,ADMIN FEE INFLUENZA,131.0,55.02,35.37,128.38,37
CDM,6824478,ADMIN FEE HEPATITIS B,131.0,55.02,35.37,128.38,37
CDM,6835276,TRAMADOL/100MG 100MG TBER,17.8,7.48,4.81,17.44,30
CDM,6861603,RABIES IG/150IU 1500U/5ML IM,963.2,404.54,260.06,943.94,37
CDM,6864920,DIAZEPAM/2ML 10MG/2ML GLKT,438.6,184.21,118.42,429.83,30
CDM,6868269,RISPERIDONE/0.5MG 37.5MG SPIJ,30.1,12.64,8.13,29.5,37
CDM,6869325,EPO ALFA ESRD/100U 4KU SNIJ,4.9,2.06,1.32,4.8,30
CDM,6872626,EPO ALFA EPBX ESRD/100U 2KU SNIJ,3.4,1.43,0.918,3.33,30
CDM,6872634,EPO ALFA EPBX ESRD/100U 3KU SNIJ,3.4,1.43,0.918,3.33,30
CDM,6872642,EPO ALFA EPBX ESRD/100U 4KU SNIJ,3.4,1.43,0.918,3.33,30
CDM,6873616,HEPARIN/1000U 15U/30ML SNIJ,62.5,26.25,16.88,61.25,30
CDM,6874531,IOHEXOL 240MG/1ML 4.8GM/20ML SNIJ,6.1,2.56,1.65,5.98,30
CDM,6874945,MEROPENEM/100MG 500MG PWIJ,14.8,6.22,4.0,14.5,30
CDM,6875975,OXACILLIN/<=250MG 1GM PWIJ,28.1,11.8,7.59,27.54,30
CDM,6876064,PALIPERD PALM/1MG 234MG/1.5ML IJER,37.3,15.67,10.07,36.55,37
CDM,6876650,PREDNISOLN/5MG 15MG TBDS,54.7,22.97,14.77,53.61,30
CDM,6877120,TOBRMYCN SULF/<=80MG 20MG/2ML MDV,72.8,30.58,19.66,71.34,30
CDM,6877815,LIDOCAINE 2%/1ML 200MG/20ML MDV,0.5,0.21,0.135,0.49,30
CDM,6877823,LIDOCAINE 2%/1ML 500MG/50ML MDV,0.5,0.21,0.135,0.49,30
CDM,6878409,TIROFBN HCL/0.25MG 12.5MG/250MLSNIV,18.3,7.69,4.94,17.93,30
CDM,6878813,MUPIROCIN 2%/1GM 1GM ON,13.3,5.59,3.59,13.03,30
CDM,6883060,LIFILEUCEL TIL/DOSE 7.5B-72B SNIJ,3141500.0,1319430.0,848205.0,3078670.0,29
CDM,7140817,RECOVERY LEVEL 1 FIRST 1MIN,585.0,245.7,157.95,573.3,30
CDM,7140825,RECOVERY LEVEL 1 ADDL 1MIN,22.0,9.24,5.94,21.56,30
CDM,7140833,RECOVERY LEVEL 2 FIRST 1MIN,685.0,287.7,184.95,671.3,30
CDM,7140841,RECOVERY LEVEL 2 ADDL 1MIN,28.0,11.76,7.56,27.44,30
CDM,7140858,RECOVERY LEVEL 3 FIRST 1MIN,785.0,329.7,211.95,769.3,30
CDM,7140866,RECOVERY LEVEL 3 ADDL 1MIN,36.0,15.12,9.72,35.28,30
CDM,7140874,RECOVERY LEVEL 4 FIRST 1MIN,885.0,371.7,238.95,867.3,30
CDM,7140882,RECOVERY LEVEL 4 ADDL 1MIN,46.0,19.32,12.42,45.08,30
CDM,7141336,RECOVERY LEVEL 1 FIRST 1MIN,585.0,245.7,157.95,573.3,30
CDM,7141344,RECOVERY LEVEL 1 ADDL 1MIN,22.0,9.24,5.94,21.56,30
CDM,7141351,RECOVERY LEVEL 2 FIRST 1MIN,685.0,287.7,184.95,671.3,30
CDM,7141369,RECOVERY LEVEL 2 ADDL 1MIN,28.0,11.76,7.56,27.44,30
CDM,7141377,RECOVERY LEVEL 3 FIRST 1MIN,785.0,329.7,211.95,769.3,30
CDM,7141385,RECOVERY LEVEL 3 ADDL 1MIN,36.0,15.12,9.72,35.28,30
CDM,7141393,RECOVERY LEVEL 4 FIRST 1MIN,885.0,371.7,238.95,867.3,30
CDM,7141401,RECOVERY LEVEL 4 ADDL 1MIN,46.0,19.32,12.42,45.08,30
CDM,7141641,BX/S MARROW BONE DX NP/UNI,1386.0,582.12,374.22,3186.0,37
CDM,7141658,BX/S MARROW BONE DX BI,2079.0,873.18,561.33,3186.0,30
CDM,7141682,ASP/S&BX/S MARROW BONE DX BI,2219.0,931.98,599.13,5367.0,30
CDM,7141708,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,621.18,399.33,5367.0,37
CDM,7141740,PROCEDURE UNLIST ADD-ON,203.0,85.26,54.81,198.94,29
CDM,7141757,PROCEDURE UNLIST LVL 01 SMPL,996.0,418.32,268.92,976.08,29
CDM,7141765,PROCEDURE UNLIST LVL 02 INTRM,2082.0,874.44,562.14,2040.36,29
CDM,7141773,PROCEDURE UNLIST LVL 03 CMPLX,4162.0,1748.04,1123.74,4078.76,29
CDM,7201056,AMNIOCENTESIS DIAGNOSTIC,1410.0,592.2,380.7,3186.0,37
CDM,7201064,AMNIOCENTESIS THER US GD,1045.0,438.9,282.15,1024.1,36
CDM,7201072,INS DILATOR CERVICAL,617.0,259.14,166.59,604.66,37
CDM,7201080,VERSION CEPHALIC EXTERNAL,920.0,386.4,248.4,4795.5,37
CDM,7201098,INJ EPID PATCH BLOOD/CLOT,1571.0,659.82,424.17,3186.0,37
CDM,7201106,OR LEVEL 1 FIRST 30MIN,4090.0,1717.8,1104.3,4008.2,29
CDM,7201114,OR LEVEL 2 FIRST 30MIN,5590.0,2347.8,1509.3,5478.2,29
CDM,7201122,OR LEVEL 3 FIRST 30MIN,7090.0,2977.8,1914.3,6948.2,29
CDM,7201130,OR LEVEL 4 FIRST 30MIN,7930.0,3330.6,2141.1,7771.4,29
CDM,7201148,OR LEVEL 5 FIRST 30MIN,10930.0,4590.6,2951.1,10711.4,29
CDM,7201155,OR LEVEL 6 FIRST 30MIN,13930.0,5850.6,3761.1,13651.4,29
CDM,7201163,OR LEVEL 1 ADDL 15MIN,1220.0,512.4,329.4,1195.6,29
CDM,7201171,OR LEVEL 2 ADDL 15MIN,1720.0,722.4,464.4,1685.6,29
CDM,7201189,OR LEVEL 3 ADDL 15MIN,2220.0,932.4,599.4,2175.6,29
CDM,7201197,OR LEVEL 4 ADDL 15MIN,2550.0,1071.0,688.5,2499.0,29
CDM,7201205,OR LEVEL 5 ADDL 15MIN,3050.0,1281.0,823.5,2989.0,29
CDM,7201213,OR LEVEL 6 ADDL 15MIN,3550.0,1491.0,958.5,3479.0,29
CDM,7201221,EPIDURAL LABOR,1145.0,480.9,309.15,1122.1,30
CDM,7201239,ANESTHESIA LEVEL 1 FIRST 30MIN,835.0,350.7,225.45,818.3,30
CDM,7201247,ANESTHESIA LEVEL 2 FIRST 30MIN,1335.0,560.7,360.45,1308.3,30
CDM,7201254,ANESTHESIA LEVEL 3 FIRST 30MIN,1835.0,770.7,495.45,1798.3,30
CDM,7201262,ANESTHESIA LEVEL 4 FIRST 30MIN,2335.0,980.7,630.45,2288.3,30
CDM,7201270,ANESTHESIA LEVEL 1 ADDL 15MIN,280.0,117.6,75.6,274.4,30
CDM,7201288,ANESTHESIA LEVEL 2 ADDL 15MIN,380.0,159.6,102.6,372.4,30
CDM,7201296,ANESTHESIA LEVEL 3 ADDL 15MIN,480.0,201.6,129.6,470.4,30
CDM,7201304,ANESTHESIA LEVEL 4 ADDL 15MIN,680.0,285.6,183.6,666.4,30
CDM,7201429,LABOR LEVEL 1 0-12HRS,1420.0,596.4,383.4,1391.6,30
CDM,7201437,LABOR LEVEL 2 12+HRS,1925.0,808.5,519.75,1886.5,30
CDM,7201445,DELIVERY VAGINAL SINGLE,2585.0,1085.7,697.95,2533.3,30
CDM,7201452,DELIVERY VAGINAL MULTI,4475.0,1879.5,1208.25,4385.5,30
CDM,7201460,CIRCUMCISION W BLOCK REGIONAL,665.0,279.3,179.55,3096.71,37
CDM,7201528,TEST STRESS CONTRACTION FETAL,686.0,288.12,185.22,672.28,37
CDM,7201536,TEST NONSTRESS FETAL,766.0,321.72,206.55,750.68,37
CDM,7201544,INJ SUBQ/IM,228.0,95.76,61.56,223.44,37
CDM,7201601,RECOVERY WO DELIVERY VAGINAL,1625.0,682.5,438.75,1592.5,30
CDM,7202328,DELIVERY OF PLACENTA,2705.0,1136.1,730.35,4795.5,37
CDM,7202336,RECOVERY LEVEL 1 FIRST 1MIN,585.0,245.7,157.95,573.3,30
CDM,7202344,RECOVERY LEVEL 1 ADDL 1MIN,22.0,9.24,5.94,21.56,30
CDM,7202351,RECOVERY LEVEL 2 FIRST 1MIN,685.0,287.7,184.95,671.3,30
CDM,7202369,RECOVERY LEVEL 2 ADDL 1MIN,28.0,11.76,7.56,27.44,30
CDM,7202377,RECOVERY LEVEL 3 FIRST 1MIN,785.0,329.7,211.95,769.3,30
CDM,7202385,RECOVERY LEVEL 3 ADDL 1MIN,36.0,15.12,9.72,35.28,30
CDM,7202393,RECOVERY LEVEL 4 FIRST 1MIN,885.0,371.7,238.95,867.3,30
CDM,7202401,RECOVERY LEVEL 4 ADDL 1MIN,46.0,19.32,12.42,45.08,30
CDM,7202427,VISIT OB TRIAGE NEW LEVEL 1,246.0,103.32,66.42,241.08,30
CDM,7202435,VISIT OB TRIAGE NEW LEVEL 2,472.0,198.24,127.44,462.56,30
CDM,7202443,VISIT OB TRIAGE NEW LEVEL 3,707.0,296.94,190.89,692.86,30
CDM,7202450,VISIT OB TRIAGE NEW LEVEL 4,850.0,357.0,229.5,833.0,30
CDM,7202468,VISIT OB TRIAGE NEW LEVEL 5,1137.0,477.54,306.99,1114.26,30
CDM,7202476,VISIT OB TRIAGE ESTABLISHED LEVEL 1,93.0,39.06,25.11,91.14,30
CDM,7202484,VISIT OB TRIAGE ESTABLISHED LEVEL 2,236.0,99.12,63.72,231.28,30
CDM,7202492,VISIT OB TRIAGE ESTABLISHED LEVEL 3,472.0,198.24,127.44,462.56,30
CDM,7202500,VISIT OB TRIAGE ESTABLISHED LEVEL 4,728.0,305.76,196.56,713.44,30
CDM,7202518,VISIT OB TRIAGE ESTABLISHED LEVEL 5,1024.0,430.08,276.48,1003.52,30
CDM,7202526,INF IV HYDRATION 31-60MIN,675.0,283.5,182.25,661.5,37
CDM,7202534,INF IV HYDRATION ADDL HR,237.0,99.54,47.84,232.26,37
CDM,7202542,INF IV THRPY 1ST HR,640.0,268.8,172.8,627.2,37
CDM,7202559,INF IV THRPY ADDL HR,234.0,98.28,47.84,229.32,37
CDM,7202567,INF IV THRPY SEQ DRUG NEW 1ST HR,472.0,198.24,73.56,462.56,37
CDM,7202575,INF IV THRPY CONCURRENT,426.0,178.92,115.02,417.48,30
CDM,7202583,INJ IVP DRUG INITIAL,378.0,158.76,102.06,370.44,37
CDM,7202591,INJ IVP SEQ DRUG ADDL NEW,236.0,99.12,47.84,231.28,37
CDM,7202609,INJ IVP SEQ DRUG ADDL SAME,192.0,80.64,51.84,188.16,30
CDM,7202781,IMMUNIZATION 1ST VACCINE,131.0,55.02,35.37,128.38,37
CDM,7202799,IMMUNIZATION VACCINE ADDL,59.0,24.78,15.93,57.82,30
CDM,7301021,EKG TRACING ROUTINE 12+ LEADS,474.0,199.08,60.27,464.52,37
CDM,7301245,ECHO 2D CMP W CNT,1028.0,431.76,277.56,1161.31,37
CDM,7301252,ECHO TEE CONG ANM W CNT W I&R,1209.0,507.78,326.43,1184.82,37
CDM,7301260,ECHO 2D TEE MONITORING W CNT,1390.0,583.8,375.3,1362.2,37
CDM,7301278,ECHO TEE CONG ANM WO CNT W I&R,967.0,406.14,261.09,947.66,37
CDM,7301286,ECHO 2D TEE MONITORING WO CNT,1112.0,467.04,300.24,1089.76,37
CDM,7301294,EVAL FNCT CARDIO W TILT TABLE/EKG,1627.0,683.34,381.24,1594.46,37
CDM,7301302,ECHO CONG ANM CMP W CNT,2279.0,957.18,615.33,2233.42,37
CDM,7301310,ECHO CONG ANM LTD W CNT,1048.0,440.16,282.96,1161.31,37
CDM,7301328,ECHO 2D LTD W CNT,1117.0,469.14,301.59,1094.66,37
CDM,7301336,ECHO 2D TEE CMP W CNT W I&R,2038.0,855.96,550.26,1997.24,37
CDM,7301344,ECHO 2D REST&STRESS W CNT W I&R,2750.0,1155.0,742.5,2695.0,37
CDM,73270,R&B ICU PEDIATRICS,8939.0,3754.38,7598.15,8760.22,13
CDM,7400609,EEG AWAKE&ASLEEP,1442.0,605.64,220.6,1413.16,37
CDM,7400617,EEG AWAKE&DROWSY RDC,896.0,376.32,241.92,878.08,30
CDM,7400625,EEG AWAKE&ASLEEP RDC,1442.0,605.64,389.34,1413.16,30
CDM,7400633,EEG AWAKE&DROWSY,896.0,376.32,220.6,878.08,37
CDM,7400641,EEG EVAL DEATH CEREBRAL,628.0,263.76,169.56,615.44,37
CDM,7400658,EEG COMA/SLEEP ONLY,1137.0,477.54,220.6,1114.26,37
CDM,7400674,EEG EXTENDED 61-119MIN,1675.0,703.5,220.6,1641.5,37
CDM,7400682,EEG EXTENDED 41-60MIN,1482.0,622.44,220.6,1452.36,37
CDM,7400690,EEG DURING SURGERY NONINTRACRANIAL,1108.0,465.36,299.16,1085.84,30
CDM,7401318,EEG CONT SETUP ED TECH MIN CHAN 8,748.0,314.16,201.96,733.04,37
CDM,7401326,EEG CONT WO VID 2-12HR UNMNTR,1446.0,607.32,220.6,1417.08,37
CDM,7401334,EEG CONT WO VID 2-12HR W INT MNTR,1663.0,698.46,220.6,1629.74,37
CDM,7401342,EEG CONT WO VID 2-12HR W CONT MNTR,1808.0,759.36,220.6,1771.84,37
CDM,7401359,EEG CONT WO VID 12-26HR UNMNTR,2169.0,910.98,381.24,2125.62,37
CDM,7401367,EEG CONT WO VID 12-26HR W INT MNTR,2386.0,1002.12,381.24,2338.28,37
CDM,7401375,EEG CONT WO VID 12-26HR W CONT MNTR,2531.0,1063.02,381.24,2480.38,37
CDM,7401383,EEG CONT W VID 2-12HR UNMNTR,1808.0,759.36,220.6,1771.84,37
CDM,7401391,EEG CONT W VID 2-12HR W INT MNTR,2079.0,873.18,381.24,2037.42,37
CDM,7401409,EEG CONT W VID 2-12HR W CONT MNTR,2260.0,949.2,381.24,2214.8,37
CDM,7401417,EEG CONT W VID 12-26HR UNMNTR,2712.0,1139.04,381.24,2657.76,37
CDM,7401425,EEG CONT W VID 12-26HR W INT MNTR,2983.0,1252.86,381.24,2923.34,37
CDM,7401433,EEG CONT W VID 12-26HR W CONT MNTR,3164.0,1328.88,854.28,3100.72,37
CDM,7501240,CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,37
CDM,7501794,MOTILITY ESOPHAGEAL,2603.0,1093.26,381.24,2550.94,36
CDM,7501984,TEST ESOPHAGUS PH CAP,1691.0,710.22,456.57,1657.18,36
CDM,7502685,IMG GI ESOPH-ILEUM INTRALUM W I&R,3617.0,1519.14,926.63,5367.0,37
CDM,7502784,ENDO GI LEVEL 1 FIRST 15MIN,275.0,115.5,74.25,269.5,29
CDM,7502792,ENDO GI LEVEL 1 ADDL 15MIN,140.0,58.8,37.8,137.2,29
CDM,7502800,ENDO GI LEVEL 2 FIRST 15MIN,590.0,247.8,159.3,578.2,29
CDM,7502818,ENDO GI LEVEL 2 ADDL 15MIN,295.0,123.9,79.65,289.1,29
CDM,7502826,ENDO GI LEVEL 3 FIRST 15MIN,1375.0,577.5,371.25,1347.5,29
CDM,7502834,ENDO GI LEVEL 3 ADDL 15MIN,690.0,289.8,186.3,676.2,29
CDM,7502842,ENDO GI LEVEL 4 FIRST 15MIN,1900.0,798.0,513.0,1862.0,29
CDM,7502859,ENDO GI LEVEL 4 ADDL 15MIN,950.0,399.0,256.5,931.0,29
CDM,7502867,ENDO ED LEVEL 1 FIRST 15MIN,275.0,115.5,74.25,269.5,29
CDM,7502875,ENDO ED LEVEL 1 ADDL 15MIN,140.0,58.8,37.8,137.2,29
CDM,7502883,ENDO ED LEVEL 2 FIRST 15MIN,590.0,247.8,159.3,578.2,29
CDM,7502891,ENDO ED LEVEL 2 ADDL 15MIN,295.0,123.9,79.65,289.1,29
CDM,7502909,ENDO ED LEVEL 3 FIRST 15MIN,1375.0,577.5,371.25,1347.5,29
CDM,7502917,ENDO ED LEVEL 3 ADDL 15MIN,690.0,289.8,186.3,676.2,29
CDM,7502925,ENDO ED LEVEL 4 FIRST 15MIN,1900.0,798.0,513.0,1862.0,29
CDM,7502933,ENDO ED LEVEL 4 ADDL 15MIN,950.0,399.0,256.5,931.0,29
CDM,7502941,ENDO OTHER LEVEL 1 FIRST 15MIN,275.0,115.5,74.25,269.5,29
CDM,7502958,ENDO OTHER LEVEL 1 ADDL 15MIN,140.0,58.8,37.8,137.2,29
CDM,7502966,ENDO OTHER LEVEL 2 FIRST 15MIN,590.0,247.8,159.3,578.2,29
CDM,7502974,ENDO OTHER LEVEL 2 ADDL 15MIN,295.0,123.9,79.65,289.1,29
CDM,7502982,ENDO OTHER LEVEL 3 FIRST 15MIN,1375.0,577.5,371.25,1347.5,29
CDM,7502990,ENDO OTHER LEVEL 3 ADDL 15MIN,690.0,289.8,186.3,676.2,29
CDM,7503006,ENDO OTHER LEVEL 4 FIRST 15MIN,1900.0,798.0,513.0,1862.0,29
CDM,7503014,ENDO OTHER LEVEL 4 ADDL 15MIN,950.0,399.0,256.5,931.0,29
CDM,7503030,ENDO ANES MAC/GEN FIRST 15MIN,835.0,350.7,225.45,818.3,30
CDM,7503048,ENDO ANES MAC/GEN ADDL 15MIN,280.0,117.6,75.6,274.4,30
CDM,7503345,TEST ESOPHAGEAL FNCT IMPD >1HR,1337.0,561.54,360.99,1310.26,36
CDM,7503352,IMG GI ESOPHAGUS INTRALUM W I&R,2285.0,959.7,616.95,5367.0,37
CDM,7503360,INSTILL FECAL MICROB LGI EN RECT SP,654.0,274.68,135.93,640.92,36
CDM,7610991,VISIT NEW LEVEL 1,133.0,55.86,35.91,130.34,30
CDM,7611387,VISIT NEW LEVEL 1,133.0,55.86,35.91,130.34,30
CDM,7611395,VISIT NEW LEVEL 2,178.0,74.76,48.06,174.44,30
CDM,7611403,VISIT NEW LEVEL 3,235.0,98.7,63.45,230.3,30
CDM,7611411,VISIT NEW LEVEL 4,321.0,134.82,86.67,314.58,30
CDM,7611429,VISIT NEW LEVEL 5,435.0,182.7,117.45,426.3,30
CDM,7611437,VISIT ESTABLISHED LEVEL 1,84.0,35.28,22.68,82.32,30
CDM,7611445,VISIT ESTABLISHED LEVEL 2,104.0,43.68,28.08,101.92,30
CDM,7611452,VISIT ESTABLISHED LEVEL 3,130.0,54.6,35.1,127.4,30
CDM,7611460,VISIT ESTABLISHED LEVEL 4,163.0,68.46,44.01,159.74,30
CDM,7611478,VISIT ESTABLISHED LEVEL 5,203.0,85.26,54.81,198.94,30
CDM,7611858,PAR/CUT LSN HYPERKERATOTIC BGN SGL,308.0,129.36,83.16,301.84,37
CDM,7613433,APPL CMPRSS MULT BELOW KNEE LT,303.0,127.26,81.81,296.94,30
CDM,7613441,APPL CMPRSS MULT BELOW KNEE RT,303.0,127.26,81.81,296.94,30
CDM,7613458,APPL CMPRSS MULT BELOW KNEE BI,455.0,191.1,122.85,445.9,30
CDM,7613755,INF IV PROLONG 8+ HR W PUMP,498.0,209.16,134.46,488.04,37
CDM,7613904,DEBRIDE TISSUE SUBQ 1ST 20CM,855.0,359.1,230.85,837.9,37
CDM,7613912,DEBRIDE TISSUE SUBQ ADDL 20CM,418.0,175.56,112.86,409.64,30
CDM,7613920,DEBRIDE MUSCLE&/FASCIA 1ST 20CM,1133.0,475.86,305.91,1110.34,37
CDM,7613938,DEBRIDE MUSCLE&/FASCIA ADDL 20CM,621.0,260.82,167.67,608.58,30
CDM,7613946,DEBRIDE BONE 1ST 20CM,2434.0,1022.28,657.18,2446.69,37
CDM,7613953,DEBRIDE BONE ADDL 20CM,1914.0,803.88,516.78,1875.72,30
CDM,7613961,DEBRIDE SLCT WND OPEN 1ST 20CM,309.0,129.78,83.43,302.82,37
CDM,7613979,DEBRIDE SLCT WND OPEN ADDL 20CM,228.0,95.76,61.56,223.44,30
CDM,7614142,DSG&/DEBRIDE BURN PART-THICK LG,788.0,330.96,212.76,772.24,37
CDM,7614399,PAR/CUT LSN HYPERKERATOTIC BGN 2-4,435.0,182.7,117.45,426.3,37
CDM,7614407,PAR/CUT LSN HYPERKERATOTIC BGN 4+,561.0,235.62,151.47,549.78,37
CDM,7615628,ASP PUNCT ABSCESS/CYST,623.0,261.66,168.21,610.54,37
CDM,7615636,I&D WOUND POSTOP COMPLEX,4350.0,1827.0,1174.5,4303.06,37
CDM,7615743,TRIM NAILS NONDYSTROPHIC,91.0,38.22,24.57,89.18,37
CDM,7615750,DEBRIDE NAIL/S 1-5,104.0,43.68,28.08,101.92,37
CDM,7615768,DEBRIDE NAIL/S 6+,176.0,73.92,47.52,172.48,37
CDM,7615776,AVULSION PLATE NAIL SMPL SGL,349.0,146.58,94.23,342.02,37
CDM,7615784,AVULSION PLATE NAIL SMPL ADDL,67.0,28.14,18.09,65.66,30
CDM,7615792,EXC NAIL&MATRIX REM PERM,623.0,261.66,168.21,610.54,37
CDM,7615933,CAUT CHEMICAL TISSUE GRANULATION,308.0,129.36,83.16,301.84,37
CDM,7615974,APPL CAST LEG CONTACT RIGID,856.0,359.52,231.12,838.88,37
CDM,7615990,STRAPPING BOOT UNNA BI,374.0,157.08,100.98,366.52,30
CDM,7616006,STRAPPING BOOT UNNA LT,249.0,104.58,67.23,244.02,30
CDM,7616014,STRAPPING BOOT UNNA RT,249.0,104.58,67.23,244.02,30
CDM,7616030,COLLECT SPEC BLD VAD IMPLNT,283.0,118.86,76.41,277.34,37
CDM,7616105,DEBRIDE NONSELECT WO ANES SESSN,308.0,129.36,83.16,301.84,37
CDM,7616121,VISIT NEW LEVEL 1,133.0,55.86,35.91,130.34,30
CDM,7616147,VISIT NEW LEVEL 2,178.0,74.76,48.06,174.44,30
CDM,7616162,VISIT NEW LEVEL 3,235.0,98.7,63.45,230.3,30
CDM,7616188,VISIT NEW LEVEL 4,321.0,134.82,86.67,314.58,30
CDM,7616212,VISIT NEW LEVEL 5,435.0,182.7,117.45,426.3,30
CDM,7616220,VISIT ESTABLISHED LEVEL 1,84.0,35.28,22.68,82.32,30
CDM,7616246,VISIT ESTABLISHED LEVEL 2,104.0,43.68,28.08,101.92,30
CDM,7616261,VISIT ESTABLISHED LEVEL 3,130.0,54.6,35.1,127.4,30
CDM,7616287,VISIT ESTABLISHED LEVEL 4,163.0,68.46,44.01,159.74,30
CDM,7616303,VISIT ESTABLISHED LEVEL 5,203.0,85.26,54.81,198.94,30
CDM,7616329,DECLOT CATH/VAD W AGENT THROMB,492.0,206.64,132.84,489.32,37
CDM,7616642,I&D ABSCESS SIMPLE,331.0,139.02,89.37,324.38,37
CDM,7616659,I&D ABSCESS CMP/MULT,623.0,261.66,168.21,610.54,37
CDM,7616667,I&D HEMATOMA/SEROMA/FLUID,3176.0,1333.92,857.52,3112.48,37
CDM,7616675,VISIT NEW LEVEL 1,133.0,55.86,35.91,130.34,30
CDM,7616683,VISIT NEW LEVEL 2,178.0,74.76,48.06,174.44,30
CDM,7616691,VISIT NEW LEVEL 3,235.0,98.7,63.45,230.3,30
CDM,7616709,VISIT NEW LEVEL 4,321.0,134.82,86.67,314.58,30
CDM,7616717,VISIT NEW LEVEL 5,435.0,182.7,117.45,426.3,30
CDM,7616725,VISIT ESTABLISHED LEVEL 1,84.0,35.28,22.68,82.32,30
CDM,7616733,VISIT ESTABLISHED LEVEL 2,104.0,43.68,28.08,101.92,30
CDM,7616741,VISIT ESTABLISHED LEVEL 3,130.0,54.6,35.1,127.4,30
CDM,7616758,VISIT ESTABLISHED LEVEL 4,163.0,68.46,44.01,159.74,30
CDM,7616766,VISIT ESTABLISHED LEVEL 5,203.0,85.26,54.81,198.94,30
CDM,7616899,IMMUNIZATION 1ST VACCINE,131.0,55.02,35.37,128.38,37
CDM,7618515,IMMUNIZATION ADDL VACCINE,59.0,24.78,15.93,57.82,30
CDM,7618697,DSG&/DEBRIDE BURN PART-THICK MED,520.0,218.4,140.4,509.6,37
CDM,7618705,DSG&/DEBRIDE BURN PART-THICK SM,467.0,196.14,126.09,457.66,37
CDM,7619224,PREP WND T/A/L 1ST 100CM,1133.0,475.86,305.91,1110.34,37
CDM,7619232,PREP WND T/A/L ADDL 100CM,203.0,85.26,54.81,198.94,30
CDM,7619240,PREP WND F/N/H/F/G 1ST 100CM,1092.0,458.64,294.84,1070.16,37
CDM,7619257,PREP WND F/N/H/F/G ADDL 100CM,504.0,211.68,136.08,493.92,30
CDM,7619984,COLLECT SPEC BLD PICC NOS,187.0,78.54,50.49,197.1,37
CDM,7620529,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7620552,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7620594,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7621030,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7621063,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7621196,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7621261,OBSRV OB PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7621725,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7621998,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7622020,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7622541,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7622673,OBSRV NURSERY PER HOUR,107.0,44.94,28.89,104.86,29
CDM,7623077,INJ/S ANES NRV INTRCST LVL SGL BI,2208.0,927.36,596.16,3186.0,30
CDM,7623085,INJ/S ANES NRV INTRCST LVL SGL RT,1472.0,618.24,397.44,3186.0,30
CDM,7623093,INJ/S ANES NRV INTRCST LVL SGL LT,1472.0,618.24,397.44,3186.0,30
CDM,7623101,INJ/S ANES NRV INTRCST LVL ADD BI,2724.0,1144.08,735.48,3186.0,30
CDM,7623119,INJ/S ANES NRV INTRCST LVL ADD RT,1816.0,762.72,490.32,3186.0,30
CDM,7623127,INJ/S ANES NRV INTRCST LVL ADD LT,1816.0,762.72,490.32,3186.0,30
CDM,7630148,INF IV THRPY SEQ DRUG NEW 1ST HR,472.0,198.24,73.56,462.56,37
CDM,7630296,APP SKN T/A/L 0-100CM 1ST 25CM,1023.0,429.66,276.21,1094.87,37
CDM,7630304,APP SKN T/A/L 0-100CM ADDL 25CM,127.0,53.34,34.29,124.46,30
CDM,7630312,APP SKN T/A/L 100+CM/1%PEDS,1799.0,755.58,485.73,3056.56,37
CDM,7630320,APP SKN T/A/L 100+CM/1%PEDS AD,513.0,215.46,138.51,502.74,30
CDM,7630338,APP SKN F/N/H/F 0-100CM 1ST 25CM,966.0,405.72,260.82,1094.87,37
CDM,7630346,APP SKN F/N/H/F 0-100CM ADDL 25,141.0,59.22,38.07,138.18,30
CDM,7630353,APP SKN F/N/H/F 100+CM/1%PEDS,1932.0,811.44,521.64,3056.56,37
CDM,7630361,APP SKN F/N/H/F 100+CM/1%PEDS AD,577.0,242.34,155.79,565.46,30
CDM,7631286,WOUND NEG PRESS NONDME 0-50 SC,623.0,261.66,168.21,610.54,37
CDM,7631294,WOUND NEG PRESS NONDME 51+ SC,623.0,261.66,168.21,610.54,37
CDM,7631369,EVACUATION HEMATOMA SUBUNGUAL,204.0,85.68,55.08,199.92,37
CDM,7631997,REM CERUMEN IMPACTED W INST UNI,329.0,138.18,60.27,322.42,37
CDM,7632003,REM CERUMEN IMPACTED W INST BI,494.0,207.48,60.27,484.12,37
CDM,7632243,VISIT NEW LEVEL 2,178.0,74.76,48.06,174.44,30
CDM,7632250,VISIT NEW LEVEL 3,235.0,98.7,63.45,230.3,30
CDM,7632268,VISIT NEW LEVEL 4,321.0,134.82,86.67,314.58,30
CDM,7632276,VISIT NEW LEVEL 5,435.0,182.7,117.45,426.3,30
CDM,7632284,VISIT ESTABLISHED LEVEL 1,84.0,35.28,22.68,82.32,30
CDM,7632292,VISIT ESTABLISHED LEVEL 2,104.0,43.68,28.08,101.92,30
CDM,7632300,VISIT ESTABLISHED LEVEL 3,130.0,54.6,35.1,127.4,30
CDM,7632318,VISIT ESTABLISHED LEVEL 4,163.0,68.46,44.01,159.74,30
CDM,7632326,VISIT ESTABLISHED LEVEL 5,203.0,85.26,54.81,198.94,30
CDM,7632383,WOUND NEG PRESS W DME 0-50 SC,308.0,129.36,83.16,301.84,37
CDM,7632391,WOUND NEG PRESS W DME 51+ SC,623.0,261.66,168.21,610.54,37
CDM,7633282,VISIT SMK&TOB INTRM 3-10MIN,58.0,24.36,15.66,56.84,37
CDM,7633530,GRAFT EPIDERMAL T/A/L 1ST 0-100CM,3247.0,1363.74,876.69,3182.06,37
CDM,7633548,GRAFT EPIDERMAL T/A/L ADDL 100CM,571.0,239.82,154.17,559.58,30
CDM,7633563,GRAFT EPIDERMAL F/N/H/F/G 1ST 0-100,3346.0,1405.32,903.42,3279.08,37
CDM,7633571,GRAFT EPIDERMAL F/N/H/F/G ADDL 100,562.0,236.04,151.74,550.76,30
CDM,7634058,REM FB FOOT SUBQ,979.0,411.18,264.33,1049.03,37
CDM,7636483,REM FB FOOT DEEP,2707.0,1136.94,730.89,2652.86,37
CDM,7636665,BX SKIN TANGENTIAL LSN SGL,404.0,169.68,109.08,602.21,37
CDM,7636673,BX SKIN TANGENTIAL LSN ADDL,99.0,41.58,26.73,97.02,30
CDM,7638877,ART PHYS 1-2 LEVEL LTD UNI,532.0,223.44,143.64,521.36,30
CDM,7638885,ART PHYS 3+ LEVEL CMP UNI,682.0,286.44,184.14,668.36,30
CDM,7639446,REM SUTURE/STAPLE NO ANESTH,167.0,70.14,45.09,163.66,30
CDM,7639453,REM SUTURE&STAPLE NO ANESTH,168.0,70.56,45.36,164.64,30
CDM,7639487,REM SUTURE/STAPLE NO ANESTH,167.0,70.14,45.09,163.66,30
CDM,7639495,REM SUTURE&STAPLE NO ANESTH,168.0,70.56,45.36,164.64,30
CDM,7690001,CHEMO INF IV 1ST HR,851.0,357.42,229.77,833.98,37
CDM,7690019,CHEMO INF IV ADDL HR,183.0,76.86,49.41,179.34,37
CDM,7690027,CHEMO INF IV SEQ 1ST HR,310.0,130.2,73.56,303.8,37
CDM,7690035,CHEMO IVP DRUG INITIAL,507.0,212.94,136.89,496.86,37
CDM,7690043,CHEMO IVP DRUG ADDL,277.0,116.34,73.56,271.46,37
CDM,7690050,INF IV THRPY 1ST HR,640.0,268.8,172.8,627.2,37
CDM,7690068,INF IV THRPY ADDL HR,234.0,98.28,47.84,229.32,37
CDM,7690076,INF IV THRPY CONCURRENT,426.0,178.92,115.02,417.48,30
CDM,7690084,INF IV THRPY SEQ DRUG NEW 1ST HR,472.0,198.24,73.56,462.56,37
CDM,7690092,INJ IVP DRUG INITIAL,378.0,158.76,102.06,370.44,37
CDM,7690100,INJ IVP SEQ DRUG ADDL SAME,192.0,80.64,51.84,188.16,30
CDM,7690118,INJ IVP SEQ DRUG ADDL NEW,236.0,99.12,47.84,231.28,37
CDM,7690126,INF IV HYDRATION 31-60MIN,675.0,283.5,182.25,661.5,37
CDM,7690134,INF IV HYDRATION ADDL HR,237.0,99.54,47.84,232.26,37
CDM,7690142,ASP BLADDER CATH SUPRAPUB,2996.0,1258.32,808.92,2936.08,29
CDM,7690159,INS CATH BLADDER INDWL SMPL,204.0,85.68,55.08,199.92,36
CDM,7690167,INS CATH BLADDER INDWL CMP,404.0,169.68,109.08,395.92,36
CDM,7690175,INS CATH BLADDER NONINDWL,262.0,110.04,70.74,256.76,36
CDM,7690183,CATH COLLECT SPEC URINE,37.0,15.54,9.34,36.26,37
CDM,7690217,INJ EPID PATCH BLOOD/CLOT,1571.0,659.82,424.17,3186.0,37
CDM,7690225,IMMUNIZATION 1ST VACCINE,131.0,55.02,35.37,128.38,37
CDM,7690233,IMMUNIZATION ADDL VACCINE,59.0,24.78,15.93,57.82,30
CDM,7690258,CHEMO SUBQ/IM NONHORMONAL,560.0,235.2,73.56,548.8,37
CDM,7690274,INJ/S ANES NRV BLOCK OTHER,1400.0,588.0,378.0,1372.0,29
CDM,7690282,INJ SUBQ/IM,228.0,95.76,61.56,223.44,37
CDM,7690290,INJ/S SHTH TNDN SGL/LIG/AP,470.0,197.4,126.9,460.6,29
CDM,7690308,INJ/S TRIGGER PT/S MUSC/S,599.0,251.58,161.73,587.02,29
CDM,7690316,PROCEDURE IRRG BLADDER,374.0,157.08,100.98,370.13,36
CDM,7690324,PUNCT LUMBAR,1728.0,725.76,466.56,1693.44,29
CDM,7690340,LAVAGE PERITONEAL/PARACENTESIS,1846.0,775.32,498.42,1809.08,29
CDM,7690357,SPLINT/STRAP EXTREMITY LOWER,218.0,91.56,58.86,213.64,29
CDM,7690365,SPLINT/STRAP EXTREMITY UPPER,344.0,144.48,92.88,337.12,29
CDM,7690373,THORACENT/TUBE CHEST/DRN PLEURAL,2004.0,841.68,541.08,1963.92,29
CDM,7690381,TRANSFUSION BLOOD/COMP 1 UNIT,1419.0,595.98,383.13,1390.62,37
CDM,7690399,TRANSFUSION BLOOD/COMP 2 UNITS,1774.0,745.08,450.73,1738.52,37
CDM,7690407,TRANSFUSION BLOOD/COMP 3+ UNITS,2129.0,894.18,450.73,2086.42,37
CDM,7690415,ADMISSION DIRECT OBSERVATION HOSP,668.0,280.56,180.36,882.22,36
CDM,7690423,PROCEDURE UNLIST LVL 01 SMPL,996.0,418.32,268.92,976.08,29
CDM,7690431,PROCEDURE UNLIST LVL 02 INTRM,2082.0,874.44,562.14,2040.36,29
CDM,7690449,PROCEDURE UNLIST LVL 03 CMPLX,4162.0,1748.04,1123.74,4078.76,29
CDM,7690456,PROCEDURE UNLIST ADD-ON,203.0,85.26,54.81,198.94,29
CDM,7690464,I&D/ASP PUNCT LVL 01 SIMPLE,428.0,179.76,115.56,419.44,29
CDM,7690472,I&D LVL 02 INTRM,592.0,248.64,159.84,580.16,29
CDM,7690480,I&D LVL 03 COMPLEX,889.0,373.38,240.03,871.22,29
CDM,7690555,INJ/S ANES NRV TRIGEMINAL BR EA,753.0,316.26,203.31,737.94,36
CDM,7690589,CHEMO SUBQ/IM HORMONAL,205.0,86.1,55.35,200.9,37
CDM,7690647,DEBRIDE TISSUE SKIN/SUBQ,1294.0,543.48,349.38,1268.12,29
CDM,7690654,RPR WOUND LVL 01 SIMPLE,558.0,234.36,150.66,546.84,29
CDM,7690662,RPR WOUND LVL 02 INTERMEDIATE,720.0,302.4,194.4,705.6,29
CDM,7690670,RPR WOUND LVL 03 COMPLEX,849.0,356.58,229.23,832.02,29
CDM,8011058,APHERESIS PHERESIS PLASMA,5244.0,2202.48,1415.88,5139.12,37
CDM,8011082,HEMODIALYSIS IP DIALYSIS UNIT,2680.0,1125.6,701.18,2626.4,36
CDM,8011090,HEMODIALYSIS IP BEDSIDE,2680.0,1125.6,701.18,2626.4,36
CDM,8011132,DIALYSIS OP UNSCH/ER ESRD PT,2395.0,1005.9,646.65,2347.1,37
CDM,8011215,DIALYSIS CAPD INPATIENT,1350.0,567.0,364.5,1323.0,29
CDM,8011223,THERAPY RENAL REPLACEMENT CRRT/SLED,2685.0,1127.7,724.95,2631.3,29
CDM,8011660,DIALYSIS OP UNSCH/ER NON ESRD PT,2680.0,1125.6,701.18,2626.4,37
CDM,80275,R&B NURSERY LEVEL 1 BOARDER,3193.0,1341.06,2714.05,3129.14,13
CDM,82453,R&B PEDIATRICS PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,90290,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,91041,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,91066,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,9211459,ART PHYS 1-2 LEVEL LTD BI,798.0,335.16,135.93,782.04,37
CDM,9211467,ART PHYS 3+ LEVEL CMP BI,1023.0,429.66,220.6,1002.54,37
CDM,92361,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,92411,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,92452,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,93278,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,9400029,INJ SUBQ/IM,228.0,95.76,61.56,223.44,37
CDM,9400045,DSMT IND TYPE 1 30MIN,140.0,58.8,37.8,137.2,30
CDM,9400052,DSMT IND TYPE 2 30MIN,140.0,58.8,37.8,137.2,30
CDM,9400060,DSMT GROUP TYPE 2 30MIN,41.0,17.22,11.07,40.18,30
CDM,9400078,DSMT IND TYPE 2 INSULIN 30MIN,140.0,58.8,37.8,137.2,30
CDM,9400094,DSMT IND 30MIN,140.0,58.8,37.8,137.2,30
CDM,9400102,DSMT GROUP 30MIN,41.0,17.22,11.07,40.18,30
CDM,9400110,DSMT IND GESTATIONAL 30MIN,140.0,58.8,37.8,137.2,30
CDM,9400128,DSMT GROUP GESTATIONAL 30MIN,41.0,17.22,11.07,40.18,30
CDM,9400136,DSMT IND GESTATIONAL INSULIN 30MIN,140.0,58.8,37.8,137.2,30
CDM,9400177,MNT INITIAL ASSESS INDIVIDUAL 15MIN,67.0,28.14,18.09,65.66,30
CDM,9400185,MNT GROUP 30MIN,50.0,21.0,13.5,49.0,30
CDM,9400193,MNT RE-ASSESS INDIVIDUAL 15MIN,56.0,23.52,15.12,54.88,30
CDM,9400599,INJ SUBQ/IM,228.0,95.76,61.56,223.44,37
CDM,9400771,REFILL&MAINT PUMP PORTABLE,441.0,185.22,119.07,432.18,37
CDM,9400987,INJ IVP DRUG INITIAL,378.0,158.76,102.06,370.44,37
CDM,9400995,INJ IVP SEQ DRUG ADDL NEW,236.0,99.12,47.84,231.28,37
CDM,9401001,REFILL&MAINT PUMP IMPLANTABLE,343.0,144.06,92.61,336.14,37
CDM,9401019,IRRG VAD IMP DELIVERY DRUG,239.0,100.38,60.27,234.22,37
CDM,9401159,INJ INTRA-ARTERIAL,326.0,136.92,88.02,319.48,37
CDM,9401662,INJ IVP SEQ DRUG ADDL SAME,192.0,80.64,51.84,188.16,30
CDM,9424375,HEMOGLOBIN A1C DSM,30.0,12.6,8.1,29.4,37
CDM,9431149,CR II W EKG PER SESSION,336.0,141.12,90.72,329.28,37
CDM,9431198,CR II W EKG INITIAL SESSION,336.0,141.12,90.72,329.28,37
CDM,9431495,CR II W EKG 36+ SESSIONS,336.0,141.12,90.72,329.28,30
CDM,99267,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CDM,99408,R&B MEDICAL/SURGICAL PVT,2554.0,1072.68,2170.9,2502.92,13
CPT,0001U,LAB RBC DNA HEA 35 AG 11 BLD GRP NS,2160.0,907.2,583.2,2116.8,37
CPT,0003M,LAB LIVER DISEASE 10 ASSAYS,1511.0,634.62,407.97,1480.78,37
CPT,0023U,LAB ONC AML DNA DET/NONDET,746.0,313.32,201.42,731.08,37
CPT,0035U,LAB NEURO CSF PRION PROT QUAL,1623.0,681.66,438.21,1590.54,37
CPT,0037U,LAB GENE SO NEOPLSM DNA TGT SEQ 324,10500.0,4410.0,2835.0,10290.0,37
CPT,0046U,LAB GENE FLT3 VAR ITD QN,2340.0,982.8,407.43,2293.2,37
CPT,0049U,LAB NPM1 GENE ANALYSIS QUAN,2275.0,955.5,407.43,2229.5,37
CPT,0077U,LAB IG PARAPROT IMPRC&MS BLD/UR QL,211.0,88.62,43.43,206.78,37
CPT,0115U,LAB DET IA RESP NA 18 VIRAL&2 BACT,827.0,347.34,223.29,810.46,37
CPT,0118U,LAB TRNSPL DNA DNR DRV CELL-FREE QN,8260.0,3469.2,2230.2,8094.8,37
CPT,0140U,LAB DIS INFCT ID FUNGAL DNA TGT 15,471.0,197.82,127.17,461.58,37
CPT,0141U,LAB DIS INFCT ID BAC&FNG GRM+ RXRST,471.0,197.82,127.17,461.58,37
CPT,0142U,LAB DIS INFCT ID BAC&FNG GRM- RXRST,471.0,197.82,127.17,461.58,37
CPT,0152U,LAB DIS INFCT DNA PLASMA NGS UNTGT,6379.0,2679.18,1722.33,6251.42,37
CPT,0169U,LAB GENE NUDT15&TPMT VAR COMMON,1399.0,587.58,377.73,1371.02,37
CPT,0184T,"EXCISION OF RECTAL TUMOR, TRANSANAL ENDOSCOPIC MICROSURGICAL APPROACH (IE, TEMS), INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)",,,6202.39,14009.0,8
CPT,0200T,AUG SACRAL PERC INJ UNI,8278.0,3476.76,2235.06,14009.0,37
CPT,0201T,AUG SACRAL PERC INJ BI,12326.0,5176.92,3328.02,14009.0,37
CPT,0202U,LAB DIS INFCT SARS-COV-2 TGT 22,1251.0,525.42,337.77,1225.98,37
CPT,0211U,LAB ONC SEQ NEXT GEN DNA&RNA FFPE,25365.0,10653.3,6848.55,24857.7,37
CPT,0225U,LAB DIS INFCT SARS-COV-2 TGT 21,1251.0,525.42,337.77,1225.98,37
CPT,0234T,ATHERECT PERIPH ART RENAL W S&I,11118.0,4669.56,3001.86,26759.0,37
CPT,0235T,ATHERECT PERIPH ART VISC W S&I,10766.0,4521.72,2906.82,10550.68,30
CPT,0236T,ATHERECT PERIPH AORTA ABD W S&I,11118.0,4669.56,3001.86,26759.0,37
CPT,0237T,ATHERECT PERIPH TR&BR BRACH W S&I,11118.0,4669.56,3001.86,26759.0,74
CPT,0238T,ATHERECT PERIPH ART ILIAC W S&I,13309.0,5589.78,3593.43,27156.6,74
CPT,0313U,LAB ONC SEQ NEXT GEN DNA&MRNA 74,10800.0,4536.0,2916.0,10584.0,37
CPT,0358U,LAB IMM NEURO AMYLD 1-42&1-40 CSF,785.0,329.7,211.95,769.3,37
CPT,0408T,INSR/RPLC SYS CCM GEN PULS&ELCRD TV,14691.0,6170.22,3966.57,46499.66,37
CPT,0421T,"TRANSURETHRAL WATERJET ABLATION OF PROSTATE, INCLUDING CONTROL OF POST-OPERATIVE BLEEDING, INCLUDING ULTRASOUND GUIDANCE, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR",,,,,0
CPT,0442T,ABL CRYO PLEXUS/TRUNCAL NRV PERC,8495.0,3567.9,2293.65,17965.0,37
CPT,0503U,LAB NEURO AM BETA&PROT TAU BLD QN,2250.0,945.0,607.5,2205.0,37
CPT,0572T,INS ELCTRD DEFIB SUBSTRNL,12702.0,5334.84,3429.54,12447.96,37
CPT,0573T,REM ELCTRD DEFIB SUBSTRNL,6398.0,2687.16,1727.46,6270.04,37
CPT,0574T,REPOS ELCTR DEFIB-PAC SS IP,4460.0,1873.2,1204.2,5535.95,37
CPT,0575T,EVAL DEV PRG ICD ELCTRD SS IN PER,100.0,42.0,27.0,98.0,37
CPT,0576T,EVAL DEV INTRG ICD ELCTRD SS IN PER,100.0,42.0,27.0,98.0,37
CPT,0596U,LAB NEURO PLAM ISP 3DSTNCT CHROM MS,350.0,147.0,94.5,343.0,30
CPT,0780T,INSTILL FECAL MICROB LGI EN RECT SP,654.0,274.68,135.93,640.92,36
CPT,0795T,INS SYS PPM DUAL LDLS TRANSCTH,38503.0,16171.26,10395.81,37732.94,37
CPT,0913T,THER RX TRNSCTH PERC BLN IC S&I,8149.0,3422.58,2200.23,25370.0,37
CPT,0914T,THER RX TRNSCTH PERC BLN IC SEP,4527.0,1901.34,1222.29,4436.46,29
CPT,10005,ASP NEEDLE FINE BX US GD LSN 1ST,2616.0,1098.72,706.32,3186.0,74
CPT,10006,ASP NEEDLE FINE BX US GD LSN ADDL,1644.0,690.48,443.88,1611.12,58
CPT,10007,ASP NEEDLE FINE BX FL GD LSN 1ST,2953.0,1240.26,723.47,3186.0,37
CPT,10009,ASP NEEDLE FINE BX CT GD LSN 1ST,3564.0,1496.88,723.47,3492.72,37
CPT,10010,ASP NEEDLE FINE BX CT GD LSN ADDL,1552.0,651.84,419.04,1520.96,29
CPT,10030,DRN CATH FLUID TISSUE SOFT IMG GD,2511.0,1054.62,677.97,3186.0,111
CPT,10035,PLC DEV/S LOC TIS SOFT PERC LSN 1ST,2235.0,938.7,603.45,3186.0,74
CPT,10036,PLC DEV/S LOC TIS SOFT PERC LSN ADD,828.0,347.76,223.56,811.44,58
CPT,10060,I&D ABSCESS SIMPLE,331.0,139.02,89.37,324.38,37
CPT,10061,I&D ABSCESS CMP/MULT,623.0,261.66,168.21,610.54,37
CPT,10120,I&R FB TISSUE SUBQ SIMPLE,623.0,261.66,168.21,610.54,36
CPT,10120,"Incision and removal of foreign body, subcutaneous tissues; simple",,,415.32,602.21,7
CPT,10121,"INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED",,,1687.37,5367.0,8
CPT,10140,I&D HEMATOMA/SEROMA/FLUID,3176.0,1333.92,857.52,5367.0,111
CPT,10140,"Incision and drainage of hematoma, seroma or fluid collection",,,1687.37,5367.0,8
CPT,10160,ASP PUNCT ABSCESS/CYST,623.0,261.66,168.21,610.54,145
CPT,10180,I&D WOUND POSTOP COMPLEX,4350.0,1827.0,1174.5,4303.06,37
CPT,10180,"Incision and drainage, complex, postoperative wound infection",,,2967.63,10412.0,8
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",,,2967.63,4303.06,8
CPT,11042,DEBRIDE TISSUE SUBQ 1ST 20CM,855.0,359.1,230.85,837.9,37
CPT,11042,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",,,415.32,602.21,7
CPT,11043,DEBRIDE MUSCLE&/FASCIA 1ST 20CM,1133.0,475.86,305.91,1110.34,73
CPT,11043,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",,,755.08,1094.87,7
CPT,11044,DEBRIDE BONE 1ST 20CM,2434.0,1022.28,657.18,2446.69,37
CPT,11044,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",,,1687.37,3186.0,8
CPT,11045,DEBRIDE TISSUE SUBQ ADDL 20CM,418.0,175.56,112.86,409.64,30
CPT,11046,DEBRIDE MUSCLE&/FASCIA ADDL 20CM,621.0,260.82,167.67,608.58,59
CPT,11047,DEBRIDE BONE ADDL 20CM,1914.0,803.88,516.78,1875.72,30
CPT,11055,PAR/CUT LSN HYPERKERATOTIC BGN SGL,308.0,129.36,83.16,301.84,37
CPT,11056,PAR/CUT LSN HYPERKERATOTIC BGN 2-4,435.0,182.7,117.45,426.3,37
CPT,11057,PAR/CUT LSN HYPERKERATOTIC BGN 4+,561.0,235.62,151.47,549.78,37
CPT,11102,BX SKIN TANGENTIAL LSN SGL,404.0,169.68,109.08,602.21,37
CPT,11103,BX SKIN TANGENTIAL LSN ADDL,99.0,41.58,26.73,97.02,30
CPT,11200,"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions",,,204.98,297.22,7
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",,,723.47,3186.0,8
CPT,11406,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",,,1687.37,5367.0,8
CPT,11601,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm",,,723.47,3186.0,8
CPT,11606,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",,,1687.37,5367.0,8
CPT,11643,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",,,1687.37,3186.0,8
CPT,11719,TRIM NAILS NONDYSTROPHIC,91.0,38.22,24.57,89.18,37
CPT,11720,DEBRIDE NAIL/S 1-5,104.0,43.68,28.08,101.92,37
CPT,11721,DEBRIDE NAIL/S 6+,176.0,73.92,47.52,172.48,37
CPT,11730,AVULSION PLATE NAIL SMPL SGL,349.0,146.58,94.23,342.02,37
CPT,11730,"Avulsion of nail plate, partial or complete, simple; single",,,204.98,297.22,7
CPT,11732,AVULSION PLATE NAIL SMPL ADDL,67.0,28.14,18.09,65.66,30
CPT,11740,EVACUATION HEMATOMA SUBUNGUAL,204.0,85.68,55.08,199.92,37
CPT,11750,EXC NAIL&MATRIX REM PERM,623.0,261.66,168.21,610.54,37
CPT,11772,Excision of pilonidal cyst or sinus; complicated,,,2967.63,10412.0,8
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",,,204.98,297.22,7
CPT,12011,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,204.98,297.22,7
CPT,12020,TX DEHISCENCE WOUND CLSR SMPL,1133.0,475.86,305.91,1110.34,36
CPT,12020,Treatment of superficial wound dehiscence; simple closure,,,755.08,1094.87,7
CPT,12035,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm",,,415.32,602.21,7
CPT,12052,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,415.32,602.21,7
CPT,12055,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm",,,415.32,602.21,7
CPT,13152,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm",,,755.08,1094.87,7
CPT,14040,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS",,,2107.97,5367.0,8
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",,,2107.97,5367.0,8
CPT,14060,"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less",,,2107.97,5367.0,8
CPT,14061,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM",,,2107.97,5367.0,8
CPT,15002,PREP WND T/A/L 1ST 100CM,1133.0,475.86,305.91,1110.34,37
CPT,15003,PREP WND T/A/L ADDL 100CM,203.0,85.26,54.81,198.94,30
CPT,15004,PREP WND F/N/H/F/G 1ST 100CM,1092.0,458.64,294.84,1070.16,37
CPT,15005,PREP WND F/N/H/F/G ADDL 100CM,504.0,211.68,136.08,493.92,30
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)",,,2107.97,5367.0,8
CPT,15110,GRAFT EPIDERMAL T/A/L 1ST 0-100CM,3247.0,1363.74,876.69,3182.06,37
CPT,15111,GRAFT EPIDERMAL T/A/L ADDL 100CM,571.0,239.82,154.17,559.58,30
CPT,15115,GRAFT EPIDERMAL F/N/H/F/G 1ST 0-100,3346.0,1405.32,903.42,3279.08,37
CPT,15116,GRAFT EPIDERMAL F/N/H/F/G ADDL 100,562.0,236.04,151.74,550.76,30
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",,,2107.97,5367.0,8
CPT,15271,APP SKN T/A/L 0-100CM 1ST 25CM,1023.0,429.66,276.21,1094.87,37
CPT,15272,APP SKN T/A/L 0-100CM ADDL 25CM,127.0,53.34,34.29,124.46,30
CPT,15273,APP SKN T/A/L 100+CM/1%PEDS,1799.0,755.58,485.73,3056.56,37
CPT,15274,APP SKN T/A/L 100+CM/1%PEDS AD,513.0,215.46,138.51,502.74,30
CPT,15275,APP SKN F/N/H/F 0-100CM 1ST 25CM,966.0,405.72,260.82,1094.87,37
CPT,15276,APP SKN F/N/H/F 0-100CM ADDL 25,141.0,59.22,38.07,138.18,30
CPT,15277,APP SKN F/N/H/F 100+CM/1%PEDS,1932.0,811.44,521.64,3056.56,37
CPT,15278,APP SKN F/N/H/F 100+CM/1%PEDS AD,577.0,242.34,155.79,565.46,30
CPT,15853,ED REM SUTURE/STAPLE NO ANESTH,167.0,70.14,45.09,163.66,29
CPT,15853,REM SUTURE/STAPLE NO ANESTH,167.0,70.14,45.09,163.66,60
CPT,15854,ED REM SUTURE&STAPLE NO ANESTH,168.0,70.56,45.36,164.64,29
CPT,15854,REM SUTURE&STAPLE NO ANESTH,168.0,70.56,45.36,164.64,60
CPT,16020,DSG&/DEBRIDE BURN PART-THICK SM,467.0,196.14,126.09,457.66,37
CPT,16025,DSG&/DEBRIDE BURN PART-THICK MED,520.0,218.4,140.4,509.6,37
CPT,16030,DSG&/DEBRIDE BURN PART-THICK LG,788.0,330.96,212.76,772.24,37
CPT,17250,CAUT CHEMICAL TISSUE GRANULATION,308.0,129.36,83.16,301.84,37
CPT,17999,ABL CRYO NEUROMA,10632.0,4465.44,204.98,10419.36,36
CPT,17999,BX FAT PAD ABDOMINAL NDL PERC,2341.0,983.22,204.98,2294.18,72
CPT,19000,ASP PUNCT CYST BREAST INIT LT,979.0,411.18,264.33,3186.0,60
CPT,19000,ASP PUNCT CYST BREAST INIT RT,979.0,411.18,264.33,3186.0,60
CPT,19001,ASP PUNCT CYST BREAST ADDL LT,367.0,154.14,99.09,359.66,58
CPT,19001,ASP PUNCT CYST BREAST ADDL RT,367.0,154.14,99.09,359.66,58
CPT,19020,"MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP",,,1687.37,10412.0,8
CPT,19081,BX BRST W/WO DEV/IMG SG LSN 1ST LT,3925.0,1648.5,1059.75,5367.0,30
CPT,19081,BX BRST W/WO DEV/IMG SG LSN 1ST RT,3925.0,1648.5,1059.75,5367.0,30
CPT,19082,BX BRST W/WO DEV/IMG SG LSN ADD,1367.0,574.14,369.09,1339.66,29
CPT,19083,BX BRST W/WO DEV/IMG US LSN 1ST LT,2808.0,1179.36,758.16,5367.0,30
CPT,19083,BX BRST W/WO DEV/IMG US LSN 1ST RT,2808.0,1179.36,758.16,5367.0,30
CPT,19084,BX BRST W/WO DEV/IMG US LSN ADD,1496.0,628.32,403.92,1466.08,29
CPT,19085,BX BRST W/WO DEV/IMG MR LSN 1ST LT,4531.0,1903.02,1223.37,5367.0,30
CPT,19085,BX BRST W/WO DEV/IMG MR LSN 1ST RT,4531.0,1903.02,1223.37,5367.0,30
CPT,19086,BX BRST W/WO DEV/IMG MR LSN ADD,3485.0,1463.7,940.95,3415.3,29
CPT,19101,"Biopsy of breast; open, incisional",,,4000.24,10412.0,8
CPT,19281,PLC DEV/S BRST MAMMO GD LSN 1ST LT,2434.0,1022.28,657.18,5367.0,30
CPT,19281,PLC DEV/S BRST MAMMO GD LSN 1ST RT,2434.0,1022.28,657.18,5367.0,30
CPT,19282,PLC DEV/S BRST MAMMO GD LSN ADD,734.0,308.28,198.18,719.32,29
CPT,19285,PLC DEV/S BRST US GD LSN 1ST LT,979.0,411.18,264.33,3186.0,30
CPT,19285,PLC DEV/S BRST US GD LSN 1ST RT,979.0,411.18,264.33,3186.0,30
CPT,19286,PLC DEV/S BRST US GD LSN ADD,442.0,185.64,119.34,433.16,29
CPT,19301,"Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy);",,,4000.24,10412.0,8
CPT,19303,"Mastectomy, simple, complete",,,6783.99,14009.0,8
CPT,20200,"BIOPSY, MUSCLE; SUPERFICIAL",,,1687.37,5367.0,8
CPT,20205,"BIOPSY, MUSCLE; DEEP",,,2967.63,5367.0,8
CPT,20206,BX MUSCLE NDL PERC,3161.0,1327.62,853.47,5367.0,111
CPT,20220,BX BONE TROCAR/NDL SUPERFICIAL,2065.0,867.3,557.55,3186.0,74
CPT,20225,BX BONE TROCAR/NDL DEEP,3327.0,1397.34,898.29,5367.0,74
CPT,20240,"Biopsy, bone, open; superficial (e.g., sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)",,,2967.63,10412.0,8
CPT,20550,INJ/S SHTH TNDN SGL/LIG/AP BI,705.0,296.1,190.35,690.9,29
CPT,20550,INJ/S SHTH TNDN SGL/LIG/AP LT,470.0,197.4,126.9,460.6,29
CPT,20550,INJ/S SHTH TNDN SGL/LIG/AP RT,470.0,197.4,126.9,460.6,29
CPT,20552,INJ/S TRIGGER PT/S MUSC/S 1-2,470.0,197.4,126.9,460.6,36
CPT,20553,INJ/S TRIGGER PT/S MUSC/S 3+,694.0,291.48,187.38,680.12,72
CPT,20600,ASP&/INJ JT/BUR SM WO US GD BI,785.0,329.7,211.95,769.3,58
CPT,20600,ASP&/INJ JT/BUR SM WO US GD LT,523.0,219.66,141.21,512.54,58
CPT,20600,ASP&/INJ JT/BUR SM WO US GD RT,523.0,219.66,141.21,512.54,58
CPT,20604,ASP&/INJ JT/BUR SM W US GD BI,1178.0,494.76,318.06,1154.44,58
CPT,20604,ASP&/INJ JT/BUR SM W US GD LT,785.0,329.7,211.95,769.3,58
CPT,20604,ASP&/INJ JT/BUR SM W US GD NP/UNI,785.0,329.7,211.95,769.3,36
CPT,20604,ASP&/INJ JT/BUR SM W US GD RT,785.0,329.7,211.95,769.3,58
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD BI,836.0,351.12,225.72,819.28,58
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD LT,557.0,233.94,150.39,545.86,58
CPT,20605,ASP&/INJ JT/BUR INTR WO US GD RT,557.0,233.94,150.39,545.86,58
CPT,20606,ASP&/INJ JT/BUR INTR W US GD BI,2100.0,882.0,567.0,3186.0,60
CPT,20606,ASP&/INJ JT/BUR INTR W US GD LT,1400.0,588.0,378.0,3186.0,60
CPT,20606,ASP&/INJ JT/BUR INTR W US GD RT,1400.0,588.0,378.0,3186.0,60
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD BI,1125.0,472.5,303.75,1102.5,58
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD LT,750.0,315.0,202.5,735.0,58
CPT,20610,ASP&/INJ JT/BUR MAJ WO US GD RT,750.0,315.0,202.5,735.0,58
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD BI,2279.0,957.18,615.33,2233.42,58
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD LT,1519.0,637.98,410.13,1488.62,58
CPT,20611,ASP&/INJ JT/BUR MAJ W US GD RT,1519.0,637.98,410.13,1488.62,58
CPT,20612,ASP&/INJ CYST GANGLION,603.0,253.26,162.81,590.94,36
CPT,20680,"Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)",,,2967.63,10412.0,8
CPT,20900,"BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)",,,7413.38,14009.0,8
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",,,14009.0,14009.0,1
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),,,14009.0,14009.0,1
CPT,20950,ED MONITOR PRESS SYND COMPART MUSC,979.0,411.18,264.33,1049.03,36
CPT,20982,ABL RF TUMOR/S BONE PERC IMG GD,11294.0,4743.48,3049.38,25974.71,74
CPT,21315,Closed treatment of nasal bone fracture with manipulation; without stabilization,,,1585.19,5367.0,8
CPT,21320,Closed treatment of nasal bone fracture with manipulation; with stabilization,,,3387.27,5367.0,8
CPT,21422,OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE);,,,6048.05,17965.0,8
CPT,21453,Closed treatment of mandibular fracture with interdental fixation,,,6048.05,17965.0,8
CPT,21501,"INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX;",,,2967.63,10412.0,8
CPT,21554,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); 5 cm or greater",,,2967.63,10412.0,8
CPT,21931,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",,,1687.37,10412.0,8
CPT,21932,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); less than 5 cm",,,2967.63,5367.0,8
CPT,21933,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); 5 cm or greater",,,2967.63,10412.0,8
CPT,22101,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; THORACIC",,,7413.38,25370.0,8
CPT,22325,"OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APPROACH, 1 FRACTURED VERTEBRA OR DISLOCATED SEGMENT; LUMBAR",,,13116.76,25370.0,8
CPT,22510,VERTEBROPLASTY CRVTHOR PERC,9853.0,4138.26,2660.31,14009.0,37
CPT,22511,VERTEBROPLASTY LUMBOSACRAL PERC,9261.0,3889.62,2500.47,14009.0,74
CPT,22512,VERTEBROPLASTY CRVTHOR/LS PERC ADDL,4730.0,1986.6,1277.1,4635.4,58
CPT,22513,AUG VERTEBRAL THORACIC PERC,18013.0,7565.46,4863.51,25370.0,37
CPT,22514,AUG VERTEBRAL LUMBAR PERC,17548.0,7370.16,4737.96,25370.0,37
CPT,22551,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2",,,13116.76,25370.0,8
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 ",,,17965.0,17965.0,1
CPT,22558,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar",,,26759.0,40196.51,8
CPT,22610,"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; THORACIC (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)",,,17913.59,26759.0,8
CPT,22612,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)",,,17913.59,25974.71,8
CPT,22630,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;",,,26759.0,40196.51,8
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), ",,,27721.73,40196.51,8
CPT,22830,EXPLORATION OF SPINAL FUSION,,,7413.38,25370.0,8
CPT,22845,Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure),,,25370.0,25370.0,1
CPT,22846,ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,25370.0,25370.0,1
CPT,22849,REINSERTION OF SPINAL FIXATION DEVICE,,,13116.76,26759.0,8
CPT,22850,"REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD)",,,7413.38,25370.0,8
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)",,,17913.59,25974.71,8
CPT,22900,"Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); less than 5 cm",,,2967.63,10412.0,8
CPT,22902,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm",,,1687.37,5367.0,8
CPT,23075,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm",,,1687.37,5367.0,8
CPT,23350,INJ ARTHRO SHOULDER BI,707.0,296.94,190.89,692.86,29
CPT,23350,INJ ARTHRO SHOULDER LT,471.0,197.82,127.17,461.58,29
CPT,23350,INJ ARTHRO SHOULDER RT,471.0,197.82,127.17,461.58,29
CPT,23410,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE",,,7413.38,17965.0,8
CPT,23412,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; CHRONIC",,,7413.38,17965.0,8
CPT,23430,Tenodesis of long tendon of biceps,,,7413.38,17965.0,8
CPT,23472,"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (e.g., total shoulder))",,,17913.59,26759.0,8
CPT,23515,"OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,23630,"OPEN TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,23935,"INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HUMERUS OR ELBOW",,,3342.87,10412.0,8
CPT,24105,"EXCISION, OLECRANON BURSA",,,3342.87,10412.0,8
CPT,24115,"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,7413.38,14009.0,8
CPT,24535,"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction",,,1642.82,2382.09,7
CPT,24538,"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension",,,7413.38,10749.4,8
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",,,7413.38,25370.0,8
CPT,24665,"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL HEAD EXCISION, WHEN PERFORMED;",,,7413.38,25370.0,8
CPT,24685,"OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,24999,"UNLISTED PROCEDURE, HUMERUS OR ELBOW",,,252.01,365.41,7
CPT,25000,"Incision, extensor tendon sheath, wrist (e.g., de Quervains disease)",,,1642.82,10412.0,8
CPT,25130,Excision or curettage of bone cyst or benign tumor of carpal bones;,,,3342.87,14009.0,8
CPT,25240,"EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPE OR MATCHED RESECTION)",,,3342.87,14009.0,8
CPT,25320,"CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, OPEN (EG, CAPSULODESIS, LIGAMENT REPAIR, TENDON TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR CARPAL INSTABILITY",,,7413.38,17965.0,8
CPT,25405,"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,7413.38,25370.0,8
CPT,25447,"Arthroplasty, intercarpal or carpometacarpal joints; interposition (e.g., tendon)",,,3342.87,17965.0,8
CPT,25448,"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed",,,3342.87,14009.0,8
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",,,1642.82,3186.0,8
CPT,25606,PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION,,,3342.87,10412.0,8
CPT,25608,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 2 FRAGMENTS,,,7413.38,25370.0,8
CPT,25609,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 3 OR MORE FRAGMENTS,,,7413.38,25370.0,8
CPT,25820,"ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG, INTERCARPAL OR RADIOCARPAL)",,,7413.38,17965.0,8
CPT,26020,"DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH",,,3342.87,5367.0,8
CPT,26055,"Tendon sheath incision (e.g., for trigger finger)",,,1642.82,5367.0,8
CPT,26080,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each",,,1642.82,5367.0,8
CPT,26123,"FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL JOINT, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAF",,,3342.87,14009.0,8
CPT,26418,"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon",,,1642.82,5367.0,8
CPT,26455,"TENOTOMY, FLEXOR, FINGER, OPEN, EACH TENDON",,,1642.82,5367.0,8
CPT,26531,"ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT",,,7413.38,17965.0,8
CPT,26546,"REPAIR NON-UNION, METACARPAL OR PHALANX (INCLUDES OBTAINING BONE GRAFT WITH OR WITHOUT EXTERNAL OR INTERNAL FIXATION)",,,7413.38,14009.0,8
CPT,26615,"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone",,,3342.87,25370.0,8
CPT,26725,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each",,,252.01,365.41,7
CPT,26735,"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each",,,3342.87,10412.0,8
CPT,26860,"ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;",,,3342.87,14009.0,8
CPT,26951,"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; WITH DIRECT CLOSURE",,,3342.87,5367.0,8
CPT,27093,INJ ARTHRO HIP WO ANES BI,1007.0,422.94,271.89,986.86,29
CPT,27093,INJ ARTHRO HIP WO ANES LT,671.0,281.82,181.17,657.58,29
CPT,27093,INJ ARTHRO HIP WO ANES RT,671.0,281.82,181.17,657.58,29
CPT,27096,INJ JT SI ANES/STRD FL/CT GD BI,2720.0,1142.4,734.4,2665.6,58
CPT,27096,INJ JT SI ANES/STRD FL/CT GD LT,1813.0,761.46,489.51,1776.74,58
CPT,27096,INJ JT SI ANES/STRD FL/CT GD RT,1813.0,761.46,489.51,1776.74,58
CPT,27096,INJ JT SI ARTHO FL/CT GD BI,2720.0,1142.4,734.4,2665.6,29
CPT,27096,INJ JT SI ARTHO FL/CT GD LT,1813.0,761.46,489.51,1776.74,29
CPT,27096,INJ JT SI ARTHO FL/CT GD RT,1813.0,761.46,489.51,1776.74,29
CPT,27130,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft",,,13116.76,26759.0,8
CPT,27137,"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft",,,13116.76,26759.0,8
CPT,27245,"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage",,,7413.38,17965.0,8
CPT,27310,"ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTION)",,,3342.87,14009.0,8
CPT,27403,"ARTHROTOMY WITH MENISCUS REPAIR, KNEE",,,7413.38,14009.0,8
CPT,27418,"ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE)",,,7413.38,17965.0,8
CPT,27427,"Ligamentous reconstruction (augmentation), knee; extra-articular",,,7413.38,25370.0,8
CPT,27428,"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)",,,13116.76,25370.0,8
CPT,27447,"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)",,,13116.76,26759.0,8
CPT,27486,"Revision of total knee arthroplasty, with or without allograft; 1 component",,,13116.76,26759.0,8
CPT,27502,"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction",,,1642.82,5367.0,8
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",,,7413.38,17965.0,8
CPT,27507,"OPEN TREATMENT OF FEMORAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,7413.38,17965.0,8
CPT,27524,"OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR",,,7413.38,25370.0,8
CPT,27535,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,17965.0,8
CPT,27540,"OPEN TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,17965.0,8
CPT,27590,"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;",,,3342.87,26759.0,8
CPT,27650,"REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;",,,7413.38,17965.0,8
CPT,27658,"REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON",,,3342.87,10412.0,8
CPT,27687,"GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)",,,3342.87,14009.0,8
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",,,7413.38,17965.0,8
CPT,27695,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",,,7413.38,14009.0,8
CPT,27696,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; BOTH COLLATERAL LIGAMENTS",,,7413.38,14009.0,8
CPT,27698,"REPAIR, SECONDARY, DISRUPTED LIGAMENT, ANKLE, COLLATERAL (EG, WATSON-JONES PROCEDURE)",,,7413.38,14009.0,8
CPT,27702,"Arthroplasty, ankle; with implant (total ankle)",,,25370.0,40196.51,8
CPT,27703,"Arthroplasty, ankle; revision, total ankle",,,17913.59,25974.71,8
CPT,27758,"OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,13116.76,25370.0,8
CPT,27759,"TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE",,,13116.76,25370.0,8
CPT,27768,Closed treatment of posterior malleolus fracture; with manipulation,,,1642.82,2382.09,7
CPT,27769,"OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,27792,"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
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",,,7413.38,25370.0,8
CPT,27823,"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITH FIXATION OF POSTERIOR LIP",,,7413.38,25370.0,8
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",,,13116.76,25370.0,8
CPT,27829,"OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,27832,"OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, OR WITH EXCISION OF PROXIMAL FIBULA",,,7413.38,25370.0,8
CPT,27870,"ARTHRODESIS, ANKLE, OPEN",,,13116.76,25370.0,8
CPT,27884,"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; SECONDARY CLOSURE OR SCAR REVISION",,,3342.87,10412.0,8
CPT,28011,"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS",,,1642.82,10412.0,8
CPT,28120,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TALUS OR CALCANEUS",,,3342.87,10412.0,8
CPT,28122,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TARSAL OR METATARSAL BONE, EXCEPT TALUS OR CALCANEUS",,,3342.87,10412.0,8
CPT,28124,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); PHALANX OF TOE",,,3342.87,10412.0,8
CPT,28190,REM FB FOOT SUBQ,979.0,411.18,264.33,1049.03,37
CPT,28192,REM FB FOOT DEEP,2707.0,1136.94,730.89,2652.86,37
CPT,28200,"REPAIR, TENDON, FLEXOR, FOOT; PRIMARY OR SECONDARY, WITHOUT FREE GRAFT, EACH TENDON",,,3342.87,10412.0,8
CPT,28285,"Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)",,,3342.87,10412.0,8
CPT,28288,"OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, METATARSAL HEAD, EACH METATARSAL HEAD",,,3342.87,10412.0,8
CPT,28289,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant",,,3342.87,10412.0,8
CPT,28296,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method",,,3342.87,14009.0,8
CPT,28297,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method",,,13116.76,19019.3,8
CPT,28300,"OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATION",,,7413.38,25370.0,8
CPT,28306,"OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; FIRST METATARSAL",,,7413.38,10749.4,8
CPT,28308,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each",,,3342.87,10412.0,8
CPT,28310,"OSTEOTOMY, SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; PROXIMAL PHALANX, FIRST TOE (SEPARATE PROCEDURE)",,,7413.38,10749.4,8
CPT,28445,"OPEN TREATMENT OF TALUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,28615,"OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
CPT,28725,ARTHRODESIS; SUBTALAR,,,13116.76,25370.0,8
CPT,28737,"ARTHRODESIS, WITH TENDON LENGTHENING AND ADVANCEMENT, MIDTARSAL, TARSAL NAVICULAR-CUNEIFORM (EG, MILLER TYPE PROCEDURE)",,,13116.76,25370.0,8
CPT,28740,"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT",,,7413.38,25370.0,8
CPT,28750,"ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT",,,7413.38,25370.0,8
CPT,28805,"AMPUTATION, FOOT; TRANSMETATARSAL",,,3342.87,10412.0,8
CPT,28820,"AMPUTATION, TOE; METATARSOPHALANGEAL JOINT",,,3342.87,10412.0,8
CPT,28825,"Amputation, toe; interphalangeal joint",,,3342.87,10412.0,8
CPT,29445,APPL CAST LEG CONTACT RIGID,856.0,359.52,231.12,838.88,37
CPT,29580,STRAPPING BOOT UNNA BI,374.0,157.08,100.98,366.52,30
CPT,29580,STRAPPING BOOT UNNA LT,249.0,104.58,67.23,244.02,30
CPT,29580,STRAPPING BOOT UNNA RT,249.0,104.58,67.23,244.02,30
CPT,29581,APPL CMPRSS MULT BELOW KNEE BI,455.0,191.1,122.85,445.9,30
CPT,29581,APPL CMPRSS MULT BELOW KNEE LT,303.0,127.26,81.81,296.94,30
CPT,29581,APPL CMPRSS MULT BELOW KNEE RT,303.0,127.26,81.81,296.94,30
CPT,29806,"Arthroscopy, shoulder, surgical; capsulorrhaphy",,,7413.38,25370.0,8
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",,,3342.87,25370.0,8
CPT,29824,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)",,,3342.87,25370.0,8
CPT,29827,"Arthroscopy, shoulder, surgical; with rotator cuff repair",,,7413.38,25370.0,8
CPT,29828,"Arthroscopy, shoulder, surgical; biceps tenodesis",,,7413.38,25370.0,8
CPT,29840,"ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)",,,3342.87,14009.0,8
CPT,29848,"Endoscopy, wrist, surgical, with release of transverse carpal ligament",,,1642.82,14009.0,8
CPT,29870,"ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)",,,3342.87,14009.0,8
CPT,29877,"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)",,,3342.87,14009.0,8
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",,,3342.87,14009.0,8
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)",,,3342.87,14009.0,8
CPT,29882,"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)",,,3342.87,14009.0,8
CPT,29888,Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction,,,7413.38,25370.0,8
CPT,30140,"Submucous resection inferior turbinate, partial or complete, any method",,,3387.27,10412.0,8
CPT,30520,"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft",,,3387.27,10412.0,8
CPT,30802,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (e.g., electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (i.e., submucosal)",,,1585.19,5367.0,8
CPT,30905,"CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD; INITIAL",,,135.93,197.1,7
CPT,30906,"CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD; SUBSEQUENT",,,241.98,350.87,7
CPT,30930,"FRACTURE NASAL INFERIOR TURBINATE(S), THERAPEUTIC",,,3387.27,10412.0,8
CPT,31237,"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)",,,1818.45,5367.0,8
CPT,31238,"NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF NASAL HEMORRHAGE",,,1818.45,5367.0,8
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",,,7210.32,14009.0,8
CPT,31254,"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)",,,7210.32,10454.96,8
CPT,31255,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)",,,7210.32,14009.0,8
CPT,31256,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;",,,3809.1,10412.0,8
CPT,31267,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus",,,7210.32,10454.96,8
CPT,31287,"Nasal/sinus endoscopy, surgical, with sphenoidotomy;",,,7210.32,14009.0,8
CPT,31500,INTUBATION ENDOTRACHEAL EMERG,736.0,309.12,198.72,721.28,37
CPT,31502,CHG TUBE TRACH PRIOR TRACT FISTULA,924.0,388.08,241.98,905.52,36
CPT,31512,"Laryngoscopy, indirect; with removal of lesion",,,3809.1,10412.0,8
CPT,31535,"Laryngoscopy, direct, operative, with biopsy;",,,3809.1,10412.0,8
CPT,31536,"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope",,,3809.1,10412.0,8
CPT,31575,"Laryngoscopy, flexible; diagnostic",,,203.93,295.7,7
CPT,31575,ST LARYNGOSCOPY DIAGNOSTIC FLEX,347.0,145.74,93.69,340.06,36
CPT,31579,LARYNGOSCOPY W STROBOSCOPY,600.0,252.0,162.0,588.0,36
CPT,31622,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)",,,1818.45,5367.0,16
CPT,31623,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings",,,1818.45,5367.0,8
CPT,31624,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage",,,1818.45,5367.0,8
CPT,31625,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,1818.45,5367.0,8
CPT,31628,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe",,,3809.1,5523.19,8
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)",,,3809.1,14009.0,8
CPT,31635,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body",,,1818.45,5367.0,8
CPT,31645,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial",,,1818.45,5367.0,8
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",,,3809.1,10412.0,8
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",,,3809.1,10412.0,8
CPT,31899,LAVAGE BRONCH ALVEO WO SCOPE,2329.0,978.18,203.93,2282.42,36
CPT,32400,BX PLEURA NDL PERC,2434.0,1022.28,657.18,5367.0,37
CPT,32408,BX NEEDLE CORE LUNG/MEDSTRNM PERC,3078.0,1292.76,831.06,5367.0,74
CPT,32550,INS CATH PLEURAL INDWL W CUFF,5619.0,2359.98,1517.13,14009.0,37
CPT,32551,THORACOSTOMY TUBE OPEN BI,3006.0,1262.52,811.62,3186.0,30
CPT,32551,THORACOSTOMY TUBE OPEN LT,2004.0,841.68,541.08,3186.0,30
CPT,32551,THORACOSTOMY TUBE OPEN RT,2004.0,841.68,541.08,3186.0,30
CPT,32552,REM CATH PLEURAL INDWL W CUFF,993.0,417.06,268.11,3186.0,37
CPT,32554,THORACENTESIS ASP WO IMG BI,1395.0,585.9,376.65,3186.0,30
CPT,32554,THORACENTESIS ASP WO IMG LT,930.0,390.6,251.1,3186.0,30
CPT,32554,THORACENTESIS ASP WO IMG RT,930.0,390.6,251.1,3186.0,30
CPT,32555,THORACENTESIS ASP W IMG BI,2589.0,1087.38,699.03,3186.0,150
CPT,32555,THORACENTESIS ASP W IMG LT,1726.0,724.92,466.02,3186.0,150
CPT,32555,THORACENTESIS ASP W IMG RT,1726.0,724.92,466.02,3186.0,150
CPT,32556,DRN PLEURA INS CATH INDWL WO IMG BI,3930.0,1650.6,1061.1,5367.0,30
CPT,32556,DRN PLEURA INS CATH INDWL WO IMG LT,2620.0,1100.4,707.4,5367.0,30
CPT,32556,DRN PLEURA INS CATH INDWL WO IMG RT,2620.0,1100.4,707.4,5367.0,30
CPT,32557,DRN PLEURA INS CATH INDWL W IMG BI,4475.0,1879.5,1208.25,4385.5,60
CPT,32557,DRN PLEURA INS CATH INDWL W IMG LT,2983.0,1252.86,805.41,3186.0,60
CPT,32557,DRN PLEURA INS CATH INDWL W IMG RT,2983.0,1252.86,805.41,3186.0,60
CPT,32560,INSTILL AGENT PLEURODESIS W TB/CATH,1501.0,630.42,405.27,3186.0,37
CPT,32561,INSTILL AGENT FIBRIN TB/CTH 1ST DAY,1519.0,637.98,410.13,3186.0,37
CPT,32607,"THORACOSCOPY; WITH DIAGNOSTIC BIOPSY(IES) OF LUNG INFILTRATE(S) (EG, WEDGE, INCISIONAL), UNILATERAL",,,10860.07,17965.0,8
CPT,32998,ABL RF TUMOR/S PULM PERC IMG GD BI,13061.0,5485.62,3526.47,25370.0,30
CPT,32998,ABL RF TUMOR/S PULM PERC IMG GD LT,8707.0,3656.94,2350.89,25370.0,30
CPT,32998,ABL RF TUMOR/S PULM PERC IMG GD RT,8707.0,3656.94,2350.89,25370.0,30
CPT,32999,CT LOC NDL LUNG/PLEURA,1655.0,695.1,446.85,3186.0,37
CPT,32999,EXCHG TUBE CHEST VIA WIRE,727.0,305.34,196.29,3186.0,74
CPT,33016,ED PERICARDIOCENTESIS INCL IMG GD,4288.0,1800.96,1157.76,4202.24,36
CPT,33016,PERICARDIOCENTESIS INCL IMG GD,4288.0,1800.96,1157.76,4202.24,37
CPT,33017,DRN PERICARD PERC WO CONG CARD 6+Y,5629.0,2364.18,1519.83,5516.42,60
CPT,33018,DRN PERICARD PERC WO CONG CARD 0-5Y,6576.0,2761.92,1775.52,6444.48,60
CPT,33206,INS NEW/RPLC PPM W ELCTRD ATRIAL,13340.0,5602.8,3601.8,26759.0,37
CPT,33207,INS NEW/RPLC PPM W ELCTRD VENT,14033.0,5893.86,3788.91,26759.0,37
CPT,33208,INS NEW/RPLC PPM W ELCTRD A&V,20456.0,8591.52,5523.12,29702.0,37
CPT,33210,INS/RPLC ELCTRD/CATH PM TEMP SGL,8765.0,3681.3,2366.55,25370.0,37
CPT,33212,INS GEN PPM ONLY W LD EXIST SGL,10538.0,4425.96,2845.26,26759.0,37
CPT,33213,INS GEN PPM ONLY W LD EXIST DUAL,11786.0,4950.12,3182.22,26759.0,37
CPT,33214,UPGRADE SYS PM IMP SGL TO DUAL,18451.0,7749.42,4981.77,29702.0,37
CPT,33215,REPOSITION ELCTRD PM/ICD PREV A/V,7745.0,3252.9,2091.15,14009.0,37
CPT,33216,INS ELCTRD PM/ICD TRANSVENOUS SGL,6401.0,2688.42,1728.27,25370.0,37
CPT,33217,INS ELCTRD PM/ICD TRANSVENOUS DUAL,7462.0,3134.04,2014.74,25370.0,37
CPT,33218,RPR ELCTRD PM/ICD TRANSVENOUS SGL,7274.0,3055.08,1963.98,14009.0,37
CPT,33221,INS GEN PPM ONLY W LD EXIST MULTI,20938.0,8793.96,5653.26,28534.39,37
CPT,33222,RELOCATION POCKET SKIN PM,3320.0,1394.4,896.4,5367.0,37
CPT,33223,RELOCATION POCKET SKIN ICD,6583.0,2764.86,1777.41,6451.34,37
CPT,33224,INS ELCTRD LV PREVIOUS PM/ICD,23971.0,10067.82,6472.17,29702.0,37
CPT,33225,INS ELCTRD LV PM/ICD ADD ON,23927.0,10049.34,6460.29,29702.0,30
CPT,33226,REPOSITION ELCTRD LV PREVIOUS,5204.0,2185.68,1405.08,14009.0,37
CPT,33227,REM&RPL GEN PPM SGL,14251.0,5985.42,3847.77,26759.0,37
CPT,33228,REM&RPL GEN PPM DUAL,14882.0,6250.44,4018.14,26759.0,37
CPT,33229,REM&RPL GEN PPM MULTI,27207.0,11426.94,7345.89,28534.39,37
CPT,33230,INS GEN ICD ONLY W LD EXIST DUAL,57152.0,24003.84,15431.04,91723.0,37
CPT,33231,INS GEN ICD ONLY W LD EXIST MULTI,42733.0,17947.86,11537.91,91723.0,37
CPT,33233,REM GENERATOR PPM ONLY,4253.0,1786.26,1148.31,14009.0,37
CPT,33234,REM ELCTRD PM LEAD A/V SGL,8632.0,3625.44,2330.64,14009.0,37
CPT,33235,REM ELCTRD PM LEAD A/V DUAL,9926.0,4168.92,2680.02,14009.0,37
CPT,33240,INS GEN ICD ONLY W LD EXIST SGL,29915.0,12564.3,8077.05,91723.0,37
CPT,33241,REM GEN ICD ONLY,5555.0,2333.1,1499.85,14009.0,37
CPT,33244,REM ELCTRD ICD SGL/DUAL EXTRACT TV,14571.0,6119.82,3817.9,14279.58,37
CPT,33249,INS/RPL ICD W LEAD SGL/DUAL,90195.0,37881.9,24352.65,91723.0,37
CPT,33262,REM&RPL GEN ICD SGL,36864.0,15482.88,9953.28,91723.0,37
CPT,33263,REM&RPL GEN ICD DUAL,51840.0,21772.8,13996.8,91723.0,37
CPT,33264,REM&RPL GEN ICD MULTI,54013.0,22685.46,14583.51,91723.0,37
CPT,33270,INS/RPL DEFIB SUBQ PERM W ELCTRD,51894.0,21795.48,14011.38,91723.0,37
CPT,33271,INS DEFIB SUBQ ELCTRD,12702.0,5334.84,3429.54,91723.0,37
CPT,33272,REM DEFIB SUBQ ELCTRD,6398.0,2687.16,1727.46,91723.0,37
CPT,33273,REPOS DEFIB SUBQ PREV ELCTRD,6398.0,2687.16,1727.46,14009.0,37
CPT,33274,INS/RPL PM PERM LDLS RV W IMG GD,28877.0,12128.34,7796.79,32969.0,37
CPT,33276,INS SYS STM NRV PHRENIC INCL IM GD,67501.0,28350.42,18225.27,66150.98,37
CPT,33285,INS CRM SUBQ W PROGRAMMING,7740.0,3250.8,2089.8,26759.0,111
CPT,33286,REM CRM SUBQ,1209.0,507.78,326.43,3186.0,37
CPT,33340,CLOSE LAA PERC W IMP ENDOCARD,7001.0,2940.42,1890.27,17965.0,30
CPT,33361,TAVR/TAVI VIA ARTERY FEMORAL PERC,8332.0,3499.44,2249.64,8165.36,30
CPT,33362,TAVR/TAVI VIA ARTERY FEMORAL OPEN,8951.0,3759.42,2416.77,8771.98,30
CPT,33363,TAVR/TAVI VIA ARTERY AXILLA OPEN,9276.0,3895.92,2504.52,9090.48,30
CPT,33364,TAVR/TAVI VIA ARTERY ILIAC OPEN,8593.0,3609.06,2320.11,8421.14,30
CPT,33365,TAVR/TAVI VIA TRANSAORTIC,10253.0,4306.26,2768.31,10047.94,30
CPT,33366,TAVR/TAVI VIA TRANSAPICAL,10578.0,4442.76,2856.06,10366.44,30
CPT,33518,"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); 2 VENOUS GRAFTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,3101.0,3101.0,1
CPT,33533,"Coronary artery bypass, using arterial graft(s); single arterial graft",,,3101.0,3101.0,1
CPT,33880,RPR ENDOVAS AORTA THOR W LSA,23522.0,9879.24,3101.0,23051.56,30
CPT,33881,RPR ENDOVAS AORTA THOR WO LSA,20206.0,8486.52,3101.0,19801.88,60
CPT,33967,INS DEV IAB PERC,7743.0,3252.06,2090.61,32969.0,30
CPT,33968,REM DEV IAB PERC,104.0,43.68,28.08,32969.0,30
CPT,33990,INS VAD LH ACC ART ONLY PERC S&I,7592.0,3188.64,2049.84,7440.16,30
CPT,33992,REM VAD LH PERC ART/ART&VEN SEP,2653.0,1114.26,716.31,3101.0,30
CPT,33993,REPOS VAD PERC W IMG SESSN DIFF,1228.0,515.76,331.56,3101.0,30
CPT,33995,INS VAD RH ACC ART ONLY PERC S&I,5527.0,2321.34,1492.29,5416.46,30
CPT,33997,REM VAD RH PERC ART/ART&VEN SEP,2653.0,1114.26,716.31,3101.0,30
CPT,33999,RPLC LEAD PORT GEN PCMKR,4249.0,1784.58,640.89,4164.02,37
CPT,34701,RPR EV DPLMNT AA NDGFT NO RUP,7696.0,3232.32,2077.92,7542.08,30
CPT,34705,RPR EV DPLMNT A BIILAC NDGFT NO RUP,9482.0,3982.44,2560.14,9292.36,60
CPT,34707,RPR EV DPLMNT ILIO ILAC NDGFT BI,10871.0,4565.82,2935.17,10653.58,60
CPT,34707,RPR EV DPLMNT ILIO ILAC NDGFT LT,7247.0,3043.74,1956.69,7102.06,60
CPT,34707,RPR EV DPLMNT ILIO ILAC NDGFT RT,7247.0,3043.74,1956.69,7102.06,60
CPT,34708,RPR EV DPLMNT ILIAC NDGFT RUP BI,17063.0,7166.46,3101.0,16721.74,30
CPT,34708,RPR EV DPLMNT ILIAC NDGFT RUP LT,11375.0,4777.5,3071.25,11147.5,30
CPT,34708,RPR EV DPLMNT ILIAC NDGFT RUP RT,11375.0,4777.5,3071.25,11147.5,30
CPT,34710,PLC PROS DLYD EXT RPR EV VES INIT,1780.0,747.6,480.6,3101.0,30
CPT,34711,PLC PROS DLYD EXT RPR EV VES ADD,653.0,274.26,176.31,3101.0,30
CPT,34713,ACCS&CLSR ART FEM NDGFT PERC UNI,693.0,291.06,187.11,679.14,58
CPT,34717,RPR EV ILIAC DPLMNT A ILIAC NDGFT,13964.0,5864.88,3101.0,13684.72,60
CPT,34834,EXPOSE ART BRACH OPN W PROSTH EV BI,3305.0,1388.1,892.35,3238.9,30
CPT,34834,EXPOSE ART BRACH OPN W PROSTH EV LT,2203.0,925.26,594.81,3101.0,30
CPT,34834,EXPOSE ART BRACH OPN W PROSTH EV RT,2203.0,925.26,594.81,3101.0,30
CPT,35226,"REPAIR BLOOD VESSEL, DIRECT; LOWER EXTREMITY",,,723.47,3186.0,8
CPT,36000,INTRO NDL/INTRACATHETER VEIN,357.0,149.94,96.39,349.86,29
CPT,36002,INJ PSEUDOANEURYSM EXT BI,1817.0,763.14,490.59,3186.0,60
CPT,36002,INJ PSEUDOANEURYSM EXT LT,1211.0,508.62,326.97,3186.0,60
CPT,36002,INJ PSEUDOANEURYSM EXT RT,1211.0,508.62,326.97,3186.0,60
CPT,36005,INJ VENOGRAPHY EXTREMITY BI,1197.0,502.74,323.19,1173.06,58
CPT,36005,INJ VENOGRAPHY EXTREMITY LT,798.0,335.16,215.46,782.04,58
CPT,36005,INJ VENOGRAPHY EXTREMITY RT,798.0,335.16,215.46,782.04,58
CPT,36010,INTRO CATH SVC/IVC,2425.0,1018.5,654.75,2376.5,58
CPT,36011,PLC CATH SEL VENOUS BRANCH 1ST ORD,1806.0,758.52,487.62,1769.88,58
CPT,36012,PLC CATH SEL VENOUS BRANCH 2+ ORD,2007.0,842.94,541.89,1966.86,29
CPT,36013,INTRO CATH RT HEART/ART PULM MAIN,423.0,177.66,114.21,414.54,29
CPT,36014,PLC CATH SEL ART PULM BI,587.0,246.54,158.49,575.26,58
CPT,36014,PLC CATH SEL ART PULM LT,391.0,164.22,105.57,383.18,58
CPT,36014,PLC CATH SEL ART PULM RT,391.0,164.22,105.57,383.18,58
CPT,36015,PLC CATH SEL ART PULM 2ND ORD LT,445.0,186.9,120.15,436.1,29
CPT,36015,PLC CATH SEL ART PULM 2ND ORD RT,445.0,186.9,120.15,436.1,29
CPT,36140,INTRO NDL/CATH ARTERY EXTREMITY LT,1206.0,506.52,325.62,1181.88,58
CPT,36140,INTRO NDL/CATH ARTERY EXTREMITY RT,1206.0,506.52,325.62,1181.88,58
CPT,36160,INTRO NDL AORTA TRANSLUMBAR,1000.0,420.0,270.0,980.0,29
CPT,36200,INTRO CATH AORTA,1878.0,788.76,507.06,1840.44,58
CPT,36215,PLC CATH SEL ART THOR/BRACH 1ST ORD,1884.0,791.28,508.68,1846.32,58
CPT,36216,PLC CATH SEL ART THOR/BRACH 2ND ORD,1885.0,791.7,508.95,1847.3,58
CPT,36217,PLC CATH SEL ART THOR/BRACH 3RD ORD,2750.0,1155.0,742.5,2695.0,58
CPT,36218,PLC CATH SEL ART THOR/BRACH ADDL,364.0,152.88,98.28,356.72,58
CPT,36221,PLC CATH AORTA THOR ANG EC&/IC S&I,8780.0,3687.6,2370.6,14009.0,74
CPT,36222,PLC CATH SEL CAR/INM ANG EC BI S&I,15245.0,6402.9,4116.15,14940.1,60
CPT,36222,PLC CATH SEL CAR/INM ANG EC LT S&I,10163.0,4268.46,2744.01,14009.0,60
CPT,36222,PLC CATH SEL CAR/INM ANG EC RT S&I,10163.0,4268.46,2744.01,14009.0,60
CPT,36223,PLC CATH SEL CAR/INM ANG IC BI S&I,19586.0,8226.12,5288.22,25370.0,60
CPT,36223,PLC CATH SEL CAR/INM ANG IC LT S&I,13057.0,5483.94,3525.39,25370.0,60
CPT,36223,PLC CATH SEL CAR/INM ANG IC RT S&I,13057.0,5483.94,3525.39,25370.0,60
CPT,36224,PLC CATH SEL ART CAR ANG IC BI S&I,22686.0,9528.12,6125.22,25370.0,60
CPT,36224,PLC CATH SEL ART CAR ANG IC LT S&I,15124.0,6352.08,4083.48,25370.0,60
CPT,36224,PLC CATH SEL ART CAR ANG IC RT S&I,15124.0,6352.08,4083.48,25370.0,60
CPT,36225,PLC CATH SEL ART SUB/INM ANG BI S&I,16068.0,6748.56,4338.36,15746.64,60
CPT,36225,PLC CATH SEL ART SUB/INM ANG LT S&I,10712.0,4499.04,2892.24,14009.0,60
CPT,36225,PLC CATH SEL ART SUB/INM ANG RT S&I,10712.0,4499.04,2892.24,14009.0,60
CPT,36226,PLC CATH SEL ART VERT ANG BI S&I,22289.0,9361.38,6018.03,25370.0,60
CPT,36226,PLC CATH SEL ART VERT ANG LT S&I,14859.0,6240.78,4011.93,25370.0,60
CPT,36226,PLC CATH SEL ART VERT ANG RT S&I,14859.0,6240.78,4011.93,25370.0,60
CPT,36227,PLC CATH SEL ART CAR EXT ANG BI S&I,9942.0,4175.64,2684.34,9743.16,58
CPT,36227,PLC CATH SEL ART CAR EXT ANG LT S&I,6628.0,2783.76,1789.56,6495.44,58
CPT,36227,PLC CATH SEL ART CAR EXT ANG RT S&I,6628.0,2783.76,1789.56,6495.44,58
CPT,36228,PLC CATH SEL BR INTRACRN ANG BI S&I,2771.0,1163.82,748.17,2715.58,58
CPT,36228,PLC CATH SEL BR INTRACRN ANG LT S&I,1847.0,775.74,498.69,1810.06,58
CPT,36228,PLC CATH SEL BR INTRACRN ANG RT S&I,1847.0,775.74,498.69,1810.06,58
CPT,36245,PLC CATH SEL ART ABD/EXT 1ST ORD,2768.0,1162.56,747.36,2712.64,58
CPT,36246,PLC CATH SEL ART ABD/EXT 2ND ORD,2815.0,1182.3,760.05,2758.7,58
CPT,36247,PLC CATH SEL ART ABD/EXT 3RD ORD,3178.0,1334.76,858.06,3114.44,58
CPT,36248,PLC CATH SEL ART ABD/EXT ADDL,1953.0,820.26,527.31,1913.94,58
CPT,36251,PLC CATH SEL 1ST ART RENAL UNI S&I,6273.0,2634.66,1693.71,14009.0,74
CPT,36252,PLC CATH SEL 1ST ART RENAL BI S&I,7705.0,3236.1,2080.35,14009.0,74
CPT,36253,PLC CATH SEL 2ND+ ART RENAL UNI S&I,11041.0,4637.22,2981.07,25370.0,74
CPT,36254,PLC CATH SEL 2ND+ ART RENAL BI S&I,11777.0,4946.34,3179.79,14009.0,74
CPT,36299,INJ VENOGRAM NON EXTREMITY,1036.0,435.12,279.72,1015.28,29
CPT,36416,COLLECT SPEC BLD CAPILLARY,34.0,14.28,9.18,33.32,30
CPT,36430,ED TRANSFUSION BLOOD/COMP 1 UNIT,1419.0,595.98,383.13,1390.62,37
CPT,36430,ED TRANSFUSION BLOOD/COMP 2 UNITS,1774.0,745.08,450.73,1738.52,37
CPT,36430,ED TRANSFUSION BLOOD/COMP 3+ UNITS,2129.0,894.18,450.73,2086.42,37
CPT,36430,TRANSFUSION BLOOD/COMP 1 UNIT,1419.0,595.98,383.13,1390.62,111
CPT,36430,TRANSFUSION BLOOD/COMP 2 UNITS,1774.0,745.08,450.73,1738.52,111
CPT,36430,TRANSFUSION BLOOD/COMP 3+ UNITS,2129.0,894.18,450.73,2086.42,111
CPT,36470,INJ SCLEROSANT VEIN INCMPT SGL BI,935.0,392.7,252.45,916.3,29
CPT,36470,INJ SCLEROSANT VEIN INCMPT SGL LT,623.0,261.66,168.21,610.54,29
CPT,36470,INJ SCLEROSANT VEIN INCMPT SGL RT,623.0,261.66,168.21,610.54,29
CPT,36471,INJ SCLEROSANT VEIN INCMPT MULTI BI,1832.0,769.44,494.64,1795.36,29
CPT,36471,INJ SCLEROSANT VEIN INCMPT MULTI LT,1221.0,512.82,329.67,1196.58,29
CPT,36471,INJ SCLEROSANT VEIN INCMPT MULTI RT,1221.0,512.82,329.67,1196.58,29
CPT,36481,CATH VEIN PORTAL PERC ANY METHOD,2043.0,858.06,551.61,2002.14,29
CPT,36500,CATH VENOUS SAMPLE BLOOD ORGAN,880.0,369.6,237.6,862.4,58
CPT,36514,APHERESIS PHERESIS PLASMA,5244.0,2202.48,1415.88,5139.12,37
CPT,36555,INS CVC CENTRAL NONTUN 0-4YRS,3451.0,1449.42,931.77,4677.51,37
CPT,36556,INS CVC CENTRAL NONTUN 5+YRS,4040.0,1696.8,1090.8,4677.51,111
CPT,36557,INS CVC CENTRAL TUN WO P/P 0-4YRS,7097.0,2980.74,1916.19,25370.0,37
CPT,36558,INS CVC CENTRAL TUN WO P/P 5+YRS,4040.0,1696.8,1090.8,14009.0,74
CPT,36561,INS CVD CENTRAL TUN W PORT 5+YRS,8995.0,3777.9,2428.65,14009.0,37
CPT,36561,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older",,,3225.87,14009.0,8
CPT,36563,INS CAD CENTRAL TUN W PORT,7452.0,3129.84,2012.04,25370.0,37
CPT,36568,INS PICC WO P/P WO IMG 0-4YRS,2004.0,841.68,541.08,3186.0,74
CPT,36569,INS PICC WO P/P WO IMG 5+YRS,4462.0,1874.04,1204.74,4372.76,74
CPT,36570,INS PICD WO P/P 0-4YRS,8475.0,3559.5,2288.25,14009.0,37
CPT,36571,INS PICD WO P/P 5+YRS,10458.0,4392.36,2823.66,14009.0,37
CPT,36572,INS PICC WO P/P W IMG 0-4YRS,2506.0,1052.52,640.89,3186.0,74
CPT,36573,INS PICC WO P/P W IMG 5+YRS,4693.0,1971.06,1267.11,5367.0,74
CPT,36576,RPR CVD W P/P,7492.0,3146.64,1608.25,7342.16,37
CPT,36578,RPLC CATH CVD W P/P,4040.0,1696.8,1090.8,14009.0,37
CPT,36580,RPLC CICVC NONTUN WO P/P,2004.0,841.68,541.08,3186.0,37
CPT,36581,RPLC CICVC TUN WO P/P,5611.0,2356.62,1514.97,14009.0,37
CPT,36582,"REPLACEMENT, COMPLETE, OF A TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT, THROUGH SAME VENOUS ACCESS",,,3225.87,14009.0,8
CPT,36582,RPLC CICVC TUN W PORT,6051.0,2541.42,1633.77,14009.0,37
CPT,36583,RPLC CICVC TUN W PUMP,7097.0,2980.74,1916.19,25370.0,37
CPT,36584,RPLC PICC WO P/P SA S&I,4056.0,1703.52,1095.12,3974.88,74
CPT,36585,RPLC PICVD W PORT,7269.0,3052.98,1962.63,14009.0,37
CPT,36589,REM CVC TUN WO P/P,1788.0,750.96,482.76,3186.0,37
CPT,36590,REM CVD TUN W P/P,3303.0,1387.26,891.81,5367.0,37
CPT,36590,"REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION",,,1608.25,5367.0,8
CPT,36591,COLLECT SPEC BLD VAD IMPLNT,283.0,118.86,76.41,277.34,37
CPT,36592,COLLECT SPEC BLD PICC NOS,187.0,78.54,50.49,197.1,37
CPT,36593,DECLOT CATH/VAD W AGENT THROMB,492.0,206.64,132.84,489.32,109
CPT,36595,REM OBSTRUCT MECH CVD PERICATHETER,4040.0,1696.8,1090.8,14009.0,37
CPT,36597,REPOSITION CVC PREVIOUS W FLUORO,2922.0,1227.24,788.94,3186.0,37
CPT,36598,INJ/S CNT EVAL CVD FLUORO S&I,1016.0,426.72,217.31,995.68,36
CPT,36600,PUNCT ARTERIAL FOR DIAGNOSIS,204.0,85.68,55.08,199.92,74
CPT,36620,CATH/CANN ART SMP/MNTR/TRNS PERC,898.0,377.16,242.46,880.04,29
CPT,36620,ED CATH/CANN ART SMP/MNTR/TRNS PERC,898.0,377.16,242.46,880.04,29
CPT,36680,ED PLC NEEDLE INF INTRAOSSEOUS,806.0,338.52,217.62,789.88,36
CPT,36818,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION",,,5685.01,25370.0,8
CPT,36819,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION",,,5685.01,25370.0,8
CPT,36821,"Arteriovenous anastomosis, open; direct, any site (e.g., Cimino type) (separate procedure)",,,3225.87,14009.0,8
CPT,36832,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)",,,5685.01,25370.0,8
CPT,36837,CREATE AVF UE ACCESS SEP IMG GD S&I,17585.0,7385.7,4747.95,27156.6,37
CPT,36838,"DISTAL REVASCULARIZATION AND INTERVAL LIGATION (DRIL), UPPER EXTREMITY HEMODIALYSIS ACCESS (STEAL SYNDROME)",,,5685.01,25370.0,8
CPT,36901,INTRO NDL&/CTH DIAL W DX ANG S&I,2676.0,1123.92,722.52,5367.0,37
CPT,36902,INTRO NDL&/CTH DIAL W TBA S&I,13437.0,5643.54,3627.99,25370.0,37
CPT,36903,INTRO NDL&/CTH DIAL W PLC STNT/S IV,20869.0,8764.98,5634.63,26759.0,37
CPT,36904,THROMBECT&/INF PERC IMG ANG S&I,15360.0,6451.2,4147.2,25370.0,37
CPT,36905,THROMBECT&/INF PERC MECH W TBA S&I,14039.0,5896.38,3790.53,26759.0,37
CPT,36906,THROMBECT&/INF PERC W PLC STNT/S IV,33068.0,13888.56,8928.36,32969.0,37
CPT,36907,TBA DIAL CENTRAL SEG W IMG SI,8829.0,3708.18,2383.83,8652.42,29
CPT,36908,PLC TRANSCTH STNT/S IVASC CDS S&I,12029.0,5052.18,3247.83,11788.42,29
CPT,36909,EMB/OCCL PERM CIRCUIT DIALYSIS S&I,13225.0,5554.5,3570.75,12960.5,29
CPT,37182,INS TIPS,19581.0,8224.02,5286.87,27156.6,37
CPT,37183,REV TIPS,18883.0,7930.86,5098.41,26759.0,37
CPT,37184,THROMBECT MECH PRIM ART INIT BI,24351.0,10227.42,6574.77,25370.0,60
CPT,37184,THROMBECT MECH PRIM ART INIT LT,16234.0,6818.28,4383.18,25370.0,60
CPT,37184,THROMBECT MECH PRIM ART INIT NP/UNI,16234.0,6818.28,4383.18,27156.6,37
CPT,37184,THROMBECT MECH PRIM ART INIT RT,16234.0,6818.28,4383.18,25370.0,60
CPT,37185,THROMBECT MECH PRIM ART SUBSQ W FL,4736.0,1989.12,1278.72,4641.28,58
CPT,37186,THROMBECT MECH SEC ART W FL,9113.0,3827.46,2460.51,8930.74,58
CPT,37187,THROMBECT MECH VEIN W FL,11118.0,4669.56,3001.86,25370.0,74
CPT,37188,THROMBECT MECH VEIN SUBSQ W FL,6777.0,2846.34,1829.79,14009.0,74
CPT,37191,INS FILTER VENA CAVA ENDV S&I,9168.0,3850.56,2475.36,25370.0,74
CPT,37192,REPOS FILTER VENA CAVA ENDV S&I,7251.0,3045.42,1957.77,14009.0,37
CPT,37193,REM FILTER VENA CAVA ENDV S&I,5136.0,2157.12,1386.72,14009.0,74
CPT,37195,THROMBOLYSIS CEREBRAL INF IV,823.0,345.66,222.21,806.54,36
CPT,37197,REM FB INTRAVASC W IMG S&I,8624.0,3622.08,2328.48,14009.0,74
CPT,37200,BX TRANSCATHETER,7097.0,2980.74,1916.19,25370.0,74
CPT,37211,THROMBOLYSIS INF ART INIT DAY S&I,10375.0,4357.5,2801.25,25370.0,74
CPT,37212,THROMBOLYSIS INF VEN INIT S&I,9087.0,3816.54,2453.49,14009.0,74
CPT,37213,THROMBOLYSIS INF ART/VEN SUBSQ S&I,8633.0,3625.86,2330.91,8460.34,74
CPT,37214,CESSAT THROMBOLYSIS&REM CATH S&I,9863.0,4142.46,2663.01,9665.74,74
CPT,37215,PLC STNT/S ART CRV CAR W EMB S&I,17102.0,7182.84,3101.0,16759.96,30
CPT,37216,PLC STNT/S ART CRV CAR WO EMB S&I,10410.0,4372.2,2810.7,10201.8,30
CPT,37218,PLC STNT/S ART INM/INTRATH CAR S&I,9327.0,3917.34,2518.29,9140.46,60
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",,,,,0
CPT,37224,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty",,,,,0
CPT,37226,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed",,,,,0
CPT,37228,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty",,,,,0
CPT,37230,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL, PERONEAL ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL, WHEN PERF",,,,,0
CPT,37236,PLC STNT/S ART OPEN/PERC INIT S&I,15917.0,6685.14,4297.59,26759.0,74
CPT,37237,PLC STNT/S ART OPEN/PERC ADDL S&I,6947.0,2917.74,1875.69,25370.0,60
CPT,37238,PLC STNT/S VEIN OPEN/PERC INIT S&I,19417.0,8155.14,5242.59,26759.0,74
CPT,37239,PLC STNT/S VEIN OPEN/PERC ADDL S&I,7307.0,3068.94,1972.89,25370.0,60
CPT,37241,EMB/OCCL VASC VENOUS S&I,19494.0,8187.48,5263.38,26759.0,37
CPT,37242,EMB/OCCL VASC ARTERIAL S&I,19798.0,8315.16,5345.46,27156.6,74
CPT,37243,EMB/OCCL VASC TMRS/ORG S&I,20635.0,8666.7,5571.45,26759.0,37
CPT,37244,EMB/OCCL VASC HEMORRHAGE S&I,19494.0,8187.48,5263.38,26759.0,37
CPT,37246,TBA OPN/PRC ART INT BI S&I,16851.0,7077.42,4549.77,25370.0,60
CPT,37246,TBA OPN/PRC ART INT NONPAIR/UNI S&I,11234.0,4718.28,3033.18,25370.0,74
CPT,37247,TBA OPN/PRC ART ADL BI S&I,13410.0,5632.2,3620.7,13141.8,58
CPT,37247,TBA OPN/PRC ART ADL NONPAIR/UNI S&I,8940.0,3754.8,2413.8,8761.2,58
CPT,37248,TBA OPN/PRC VEIN INT BI S&I,25925.0,10888.5,6999.75,25406.5,60
CPT,37248,TBA OPN/PRC VEIN INT NONPAIR/UNIS&I,17283.0,7258.86,4666.41,25370.0,74
CPT,37249,TBA OPN/PRC VEIN ADL BI S&I,17210.0,7228.2,4646.7,16865.8,58
CPT,37249,TBA OPN/PRC VEIN ADL NONPAIR/UNIS&I,11473.0,4818.66,3097.71,11243.54,58
CPT,37252,US INTRAVASCULAR NONCORNRY INIT S&I,6493.0,2727.06,1753.11,6363.14,58
CPT,37253,US INTRAVASCULAR NONCORNRY ADDL S&I,1957.0,821.94,528.39,1917.86,58
CPT,37254,REVSC IVT ANGIO SF VSL INIT BI,23813.0,10001.46,6429.51,25370.0,60
CPT,37254,REVSC IVT ANGIO SF VSL INIT LT,15875.0,6667.5,4286.25,25370.0,60
CPT,37254,REVSC IVT ANGIO SF VSL INIT RT,15875.0,6667.5,4286.25,25370.0,60
CPT,37255,REVSC IVT ANGIO SF VSL ADD BI,9741.0,4091.22,2630.07,9546.18,58
CPT,37255,REVSC IVT ANGIO SF VSL ADD LT,6494.0,2727.48,1753.38,6364.12,58
CPT,37255,REVSC IVT ANGIO SF VSL ADD RT,6494.0,2727.48,1753.38,6364.12,58
CPT,37256,REVSC IVT ANGIO CMPLX VSL INIT BI,34902.0,14658.84,9423.54,34203.96,60
CPT,37256,REVSC IVT ANGIO CMPLX VSL INIT LT,23268.0,9772.56,6282.36,25370.0,60
CPT,37256,REVSC IVT ANGIO CMPLX VSL INIT RT,23268.0,9772.56,6282.36,25370.0,60
CPT,37257,REVSC IVT ANGIO CMPLX VSL ADD BI,12590.0,5287.8,3399.3,12338.2,58
CPT,37257,REVSC IVT ANGIO CMPLX VSL ADD LT,8393.0,3525.06,2266.11,8225.14,58
CPT,37257,REVSC IVT ANGIO CMPLX VSL ADD RT,8393.0,3525.06,2266.11,8225.14,58
CPT,37258,REVSC IVT STNT SF VSL INIT BI,33071.0,13889.82,8929.17,32409.58,60
CPT,37258,REVSC IVT STNT SF VSL INIT LT,22047.0,9259.74,5952.69,26759.0,60
CPT,37258,REVSC IVT STNT SF VSL INIT RT,22047.0,9259.74,5952.69,26759.0,60
CPT,37259,REVSC IVT STNT SF VSL ADD BI,9674.0,4063.08,2611.98,9480.52,58
CPT,37259,REVSC IVT STNT SF VSL ADD LT,6449.0,2708.58,1741.23,6320.02,58
CPT,37259,REVSC IVT STNT SF VSL ADD RT,6449.0,2708.58,1741.23,6320.02,58
CPT,37260,REVSC IVT STNT CMPLX VSL INIT BI,47802.0,20076.84,12906.54,46845.96,60
CPT,37260,REVSC IVT STNT CMPLX VSL INIT LT,31868.0,13384.56,8604.36,31230.64,60
CPT,37260,REVSC IVT STNT CMPLX VSL INIT RT,31868.0,13384.56,8604.36,31230.64,60
CPT,37261,REVSC IVT STNT CMPLX VSL ADD BI,10280.0,4317.6,2775.6,10074.4,58
CPT,37261,REVSC IVT STNT CMPLX VSL ADD LT,6853.0,2878.26,1850.31,6715.94,58
CPT,37261,REVSC IVT STNT CMPLX VSL ADD RT,6853.0,2878.26,1850.31,6715.94,58
CPT,37262,LITHOTRIPSY INTRAV IVT ART SAME BI,37077.0,15572.34,10010.79,36335.46,29
CPT,37262,LITHOTRIPSY INTRAV IVT ART SAME LT,24718.0,10381.56,6673.86,24223.64,29
CPT,37262,LITHOTRIPSY INTRAV IVT ART SAME RT,24718.0,10381.56,6673.86,24223.64,29
CPT,37263,REVSC F&P VT ANG SF VSL INIT BI,24023.0,10089.66,6486.21,25370.0,60
CPT,37263,REVSC F&P VT ANG SF VSL INIT LT,16015.0,6726.3,4324.05,25370.0,60
CPT,37263,REVSC F&P VT ANG SF VSL INIT RT,16015.0,6726.3,4324.05,25370.0,60
CPT,37264,REVSC F&P VT ANG SF VSL ADD BI,9194.0,3861.48,2482.38,9010.12,58
CPT,37264,REVSC F&P VT ANG SF VSL ADD LT,6129.0,2574.18,1654.83,6006.42,58
CPT,37264,REVSC F&P VT ANG SF VSL ADD RT,6129.0,2574.18,1654.83,6006.42,58
CPT,37265,REVSC F&P VT ANG CMPLX VSL INIT BI,32472.0,13638.24,8767.44,31822.56,60
CPT,37265,REVSC F&P VT ANG CMPLX VSL INIT LT,21648.0,9092.16,5844.96,25370.0,60
CPT,37265,REVSC F&P VT ANG CMPLX VSL INIT RT,21648.0,9092.16,5844.96,25370.0,60
CPT,37266,REVSC F&P VT ANG CMPLX VSL ADD BI,12237.0,5139.54,3303.99,11992.26,58
CPT,37266,REVSC F&P VT ANG CMPLX VSL ADD LT,8158.0,3426.36,2202.66,7994.84,58
CPT,37266,REVSC F&P VT ANG CMPLX VSL ADD RT,8158.0,3426.36,2202.66,7994.84,58
CPT,37267,REVSC F&P VT STNT SF VSL INIT BI,30194.0,12681.48,8152.38,29590.12,60
CPT,37267,REVSC F&P VT STNT SF VSL INIT LT,20129.0,8454.18,5434.83,26759.0,60
CPT,37267,REVSC F&P VT STNT SF VSL INIT RT,20129.0,8454.18,5434.83,26759.0,60
CPT,37268,REVSC F&P VT STNT SF VSL ADD BI,12761.0,5359.62,3445.47,12505.78,58
CPT,37268,REVSC F&P VT STNT SF VSL ADD LT,8507.0,3572.94,2296.89,8336.86,58
CPT,37268,REVSC F&P VT STNT SF VSL ADD RT,8507.0,3572.94,2296.89,8336.86,58
CPT,37269,REVSC F&P VT STNT CMPLX VSL INIT BI,50717.0,21301.14,13693.59,49702.66,60
CPT,37269,REVSC F&P VT STNT CMPLX VSL INIT LT,33811.0,14200.62,9128.97,33134.78,60
CPT,37269,REVSC F&P VT STNT CMPLX VSL INIT RT,33811.0,14200.62,9128.97,33134.78,60
CPT,37270,REVSC F&P VT STNT CMPLX VSL ADD BI,17132.0,7195.44,4625.64,16789.36,58
CPT,37270,REVSC F&P VT STNT CMPLX VSL ADD LT,11421.0,4796.82,3083.67,11192.58,58
CPT,37270,REVSC F&P VT STNT CMPLX VSL ADD RT,11421.0,4796.82,3083.67,11192.58,58
CPT,37271,REVSC F&P VT ATHR SF VSL INIT BI,28778.0,12086.76,7770.06,28202.44,60
CPT,37271,REVSC F&P VT ATHR SF VSL INIT LT,19185.0,8057.7,5179.95,26759.0,60
CPT,37271,REVSC F&P VT ATHR SF VSL INIT RT,19185.0,8057.7,5179.95,26759.0,60
CPT,37272,REVSC F&P VT ATHR SF VSL ADD BI,12684.0,5327.28,3424.68,12430.32,58
CPT,37272,REVSC F&P VT ATHR SF VSL ADD LT,8456.0,3551.52,2283.12,8286.88,58
CPT,37272,REVSC F&P VT ATHR SF VSL ADD RT,8456.0,3551.52,2283.12,8286.88,58
CPT,37273,REVSC F&P VT ATHR CMPLX VSL INIT BI,40269.0,16912.98,10872.63,39463.62,60
CPT,37273,REVSC F&P VT ATHR CMPLX VSL INIT LT,26846.0,11275.32,7248.42,26759.0,60
CPT,37273,REVSC F&P VT ATHR CMPLX VSL INIT RT,26846.0,11275.32,7248.42,26759.0,60
CPT,37274,REVSC F&P VT ATHR CMPLX VSL ADD BI,17448.0,7328.16,4710.96,17099.04,58
CPT,37274,REVSC F&P VT ATHR CMPLX VSL ADD LT,11632.0,4885.44,3140.64,11399.36,58
CPT,37274,REVSC F&P VT ATHR CMPLX VSL ADD RT,11632.0,4885.44,3140.64,11399.36,58
CPT,37275,REVSC F&P VT ST&AT SF VSL INIT BI,40902.0,17178.84,11043.54,40083.96,60
CPT,37275,REVSC F&P VT ST&AT SF VSL INIT LT,27268.0,11452.56,7362.36,26759.0,60
CPT,37275,REVSC F&P VT ST&AT SF VSL INIT RT,27268.0,11452.56,7362.36,26759.0,60
CPT,37276,REVSC F&P VT ST&AT SF VSL ADD BI,15696.0,6592.32,4237.92,15382.08,58
CPT,37276,REVSC F&P VT ST&AT SF VSL ADD LT,10464.0,4394.88,2825.28,10254.72,58
CPT,37276,REVSC F&P VT ST&AT SF VSL ADD RT,10464.0,4394.88,2825.28,10254.72,58
CPT,37277,REVSC F&P VT ST&AT CMPLX VSL INITBI,55617.0,23359.14,15016.59,54504.66,60
CPT,37277,REVSC F&P VT ST&AT CMPLX VSL INITLT,37078.0,15572.76,10011.06,36336.44,60
CPT,37277,REVSC F&P VT ST&AT CMPLX VSL INITRT,37078.0,15572.76,10011.06,36336.44,60
CPT,37278,REVSC F&P VT ST&AT CMPLX VSL ADD BI,22100.0,9282.0,5967.0,21658.0,58
CPT,37278,REVSC F&P VT ST&AT CMPLX VSL ADD LT,14733.0,6187.86,3977.91,14438.34,58
CPT,37278,REVSC F&P VT ST&AT CMPLX VSL ADD RT,14733.0,6187.86,3977.91,14438.34,58
CPT,37279,LITHOTRIPSY INTRAV FPVT ART SAME BI,37077.0,15572.34,10010.79,36335.46,29
CPT,37279,LITHOTRIPSY INTRAV FPVT ART SAME LT,24718.0,10381.56,6673.86,24223.64,29
CPT,37279,LITHOTRIPSY INTRAV FPVT ART SAME RT,24718.0,10381.56,6673.86,24223.64,29
CPT,37280,REVSC T&P VT ANG SF VSL INIT BI,26687.0,11208.54,7205.49,26759.0,60
CPT,37280,REVSC T&P VT ANG SF VSL INIT LT,17791.0,7472.22,4803.57,26759.0,60
CPT,37280,REVSC T&P VT ANG SF VSL INIT RT,17791.0,7472.22,4803.57,26759.0,60
CPT,37281,REVSC T&P VT ANG SF VSL ADD BI,6413.0,2693.46,1731.51,6284.74,58
CPT,37281,REVSC T&P VT ANG SF VSL ADD LT,4275.0,1795.5,1154.25,4189.5,58
CPT,37281,REVSC T&P VT ANG SF VSL ADD RT,4275.0,1795.5,1154.25,4189.5,58
CPT,37282,REVSC T&P VT ANG CMPLX VSL INIT BI,33438.0,14043.96,9028.26,32769.24,60
CPT,37282,REVSC T&P VT ANG CMPLX VSL INIT LT,22292.0,9362.64,6018.84,26759.0,60
CPT,37282,REVSC T&P VT ANG CMPLX VSL INIT RT,22292.0,9362.64,6018.84,26759.0,60
CPT,37283,REVSC T&P VT ANG CMPLX VSL ADD BI,9119.0,3829.98,2462.13,8936.62,58
CPT,37283,REVSC T&P VT ANG CMPLX VSL ADD LT,6079.0,2553.18,1641.33,5957.42,58
CPT,37283,REVSC T&P VT ANG CMPLX VSL ADD RT,6079.0,2553.18,1641.33,5957.42,58
CPT,37284,REVSC T&P VT STNT SF VSL INIT BI,21923.0,9207.66,5919.21,26759.0,60
CPT,37284,REVSC T&P VT STNT SF VSL INIT LT,14615.0,6138.3,3946.05,26759.0,60
CPT,37284,REVSC T&P VT STNT SF VSL INIT RT,14615.0,6138.3,3946.05,26759.0,60
CPT,37285,REVSC T&P VT STNT SF VSL ADD BI,7343.0,3084.06,1982.61,7196.14,58
CPT,37285,REVSC T&P VT STNT SF VSL ADD LT,4895.0,2055.9,1321.65,4797.1,58
CPT,37285,REVSC T&P VT STNT SF VSL ADD RT,4895.0,2055.9,1321.65,4797.1,58
CPT,37286,REVSC T&P VT STNT CMPLX VSL INIT BI,29415.0,12354.3,7942.05,28826.7,60
CPT,37286,REVSC T&P VT STNT CMPLX VSL INIT LT,19610.0,8236.2,5294.7,26759.0,60
CPT,37286,REVSC T&P VT STNT CMPLX VSL INIT RT,19610.0,8236.2,5294.7,26759.0,60
CPT,37287,REVSC T&P VT STNT CMPLX VSL ADD BI,11048.0,4640.16,2982.96,10827.04,58
CPT,37287,REVSC T&P VT STNT CMPLX VSL ADD LT,7365.0,3093.3,1988.55,7217.7,58
CPT,37287,REVSC T&P VT STNT CMPLX VSL ADD RT,7365.0,3093.3,1988.55,7217.7,58
CPT,37288,REVSC T&P VT ATH SF VSL INIT BI,29295.0,12303.9,7909.65,28709.1,60
CPT,37288,REVSC T&P VT ATH SF VSL INIT LT,19530.0,8202.6,5273.1,26759.0,60
CPT,37288,REVSC T&P VT ATH SF VSL INIT RT,19530.0,8202.6,5273.1,26759.0,60
CPT,37289,REVSC T&P VT ATH SF VSL ADD BI,10250.0,4305.0,2767.5,10045.0,58
CPT,37289,REVSC T&P VT ATH SF VSL ADD LT,6833.0,2869.86,1844.91,6696.34,58
CPT,37289,REVSC T&P VT ATH SF VSL ADD RT,6833.0,2869.86,1844.91,6696.34,58
CPT,37290,REVSC T&P VT ATH CMPLX VSL INIT BI,36876.0,15487.92,9956.52,36138.48,60
CPT,37290,REVSC T&P VT ATH CMPLX VSL INIT LT,24584.0,10325.28,6637.68,26759.0,60
CPT,37290,REVSC T&P VT ATH CMPLX VSL INIT RT,24584.0,10325.28,6637.68,26759.0,60
CPT,37291,REVSC T&P VT ATH CMPLX VSL ADD BI,13964.0,5864.88,3770.28,13684.72,58
CPT,37291,REVSC T&P VT ATH CMPLX VSL ADD LT,9309.0,3909.78,2513.43,9122.82,58
CPT,37291,REVSC T&P VT ATH CMPLX VSL ADD RT,9309.0,3909.78,2513.43,9122.82,58
CPT,37292,REVSC T&P VT ST&AT SF VSL INIT BI,32868.0,13804.56,8874.36,32210.64,60
CPT,37292,REVSC T&P VT ST&AT SF VSL INIT LT,21912.0,9203.04,5916.24,26759.0,60
CPT,37292,REVSC T&P VT ST&AT SF VSL INIT RT,21912.0,9203.04,5916.24,26759.0,60
CPT,37293,REVSC T&P VT ST&AT SF VSL ADD BI,15153.0,6364.26,4091.31,14849.94,58
CPT,37293,REVSC T&P VT ST&AT SF VSL ADD LT,10102.0,4242.84,2727.54,9899.96,58
CPT,37293,REVSC T&P VT ST&AT SF VSL ADD RT,10102.0,4242.84,2727.54,9899.96,58
CPT,37294,REVSC T&P VT ST&AT CMPLX VSL INITBI,39401.0,16548.42,10638.27,38612.98,60
CPT,37294,REVSC T&P VT ST&AT CMPLX VSL INITLT,26267.0,11032.14,7092.09,26759.0,60
CPT,37294,REVSC T&P VT ST&AT CMPLX VSL INITRT,26267.0,11032.14,7092.09,26759.0,60
CPT,37295,REVSC T&P VT ST&AT CMPLX VSL ADD BI,19103.0,8023.26,5157.81,18720.94,58
CPT,37295,REVSC T&P VT ST&AT CMPLX VSL ADD LT,12735.0,5348.7,3438.45,12480.3,58
CPT,37295,REVSC T&P VT ST&AT CMPLX VSL ADD RT,12735.0,5348.7,3438.45,12480.3,58
CPT,37607,LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA,,,3225.87,14009.0,8
CPT,37609,"LIGATION OR BIOPSY, TEMPORAL ARTERY",,,1687.37,5367.0,8
CPT,37765,PHLEBECTOMY VEIN EXT 10-20 BI,6060.0,2545.2,1636.2,14009.0,30
CPT,37765,PHLEBECTOMY VEIN EXT 10-20 LT,4040.0,1696.8,1090.8,14009.0,30
CPT,37765,PHLEBECTOMY VEIN EXT 10-20 RT,4040.0,1696.8,1090.8,14009.0,30
CPT,37765,"STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; 10-20 STAB INCISIONS",,,3225.87,14009.0,8
CPT,37766,PHLEBECTOMY VEIN EXT 21+ BI,6137.0,2577.54,1656.99,14009.0,30
CPT,37766,PHLEBECTOMY VEIN EXT 21+ LT,4091.0,1718.22,1104.57,14009.0,30
CPT,37766,PHLEBECTOMY VEIN EXT 21+ RT,4091.0,1718.22,1104.57,14009.0,30
CPT,37785,"LIGATION, DIVISION, AND/OR EXCISION OF VARICOSE VEIN CLUSTER(S), 1 LEG",,,3225.87,14009.0,8
CPT,37799,BYPASS ART RETROG-ANT FEM-FEM PERC,4081.0,1714.02,640.89,3999.38,37
CPT,37799,DISRUPTION FIBRIN SHEATH BALLOON,4040.0,1696.8,640.89,3959.2,37
CPT,37799,INJ THROMBIN PSEUDOANEU ART SPLENIC,1211.0,508.62,326.97,3186.0,37
CPT,37799,PHLEBECTOMY VEIN EXT 1-9,755.0,317.1,203.85,3186.0,37
CPT,37799,"UNLISTED PROCEDURE, VASCULAR SURGERY",,,640.89,3186.0,8
CPT,38208,THAWING WO WASH CELLS ALLOGEN,1107.0,464.94,298.89,1084.86,35
CPT,38208,THAWING WO WASH CELLS AUTOLOG,1107.0,464.94,298.89,1084.86,37
CPT,38209,THAWING W WASH CELLS ALLOGEN,1149.0,482.58,310.23,1126.02,35
CPT,38209,THAWING W WASH CELLS AUTOLOG,1149.0,482.58,310.23,1126.02,37
CPT,38221,BX/S MARROW BONE DX BI,2079.0,873.18,561.33,3186.0,90
CPT,38221,BX/S MARROW BONE DX NP/UNI,1386.0,582.12,374.22,3186.0,148
CPT,38222,ASP/S&BX/S MARROW BONE DX BI,2219.0,931.98,599.13,5367.0,60
CPT,38222,ASP/S&BX/S MARROW BONE DX NP/UNI,1479.0,621.18,399.33,5367.0,111
CPT,38500,BX/EXCISE NODE OPEN SUPERFICIAL BI,8862.0,3722.04,2392.74,10412.0,30
CPT,38500,BX/EXCISE NODE OPEN SUPERFICIAL LT,5908.0,2481.36,1595.16,10412.0,30
CPT,38500,BX/EXCISE NODE OPEN SUPERFICIAL RT,5908.0,2481.36,1595.16,10412.0,30
CPT,38500,"Biopsy or excision of lymph node(s); open, superficial",,,4000.24,10412.0,8
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL BI,4134.0,1736.28,1116.18,5367.0,90
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL LT,2756.0,1157.52,744.12,5367.0,90
CPT,38505,BX/EXCISE NODE NDL SUPERFICIAL RT,2756.0,1157.52,744.12,5367.0,90
CPT,38510,"Biopsy or excision of lymph node(s); open, deep cervical node(s)",,,4000.24,10412.0,8
CPT,38525,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",,,4000.24,10412.0,8
CPT,38531,"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)",,,4000.24,14009.0,8
CPT,38571,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy",,,10860.07,25370.0,8
CPT,38792,INJ RRX NODE SENTINEL ID BI,1094.0,459.48,295.38,1072.12,29
CPT,38792,INJ RRX NODE SENTINEL ID LT,729.0,306.18,196.83,714.42,29
CPT,38792,INJ RRX NODE SENTINEL ID RT,729.0,306.18,196.83,714.42,29
CPT,39402,"MEDIASTINOSCOPY; WITH LYMPH NODE BIOPSY(IES) (EG, LUNG CANCER STAGING)",,,6176.47,17965.0,8
CPT,40808,"BIOPSY, VESTIBULE OF MOUTH",,,551.01,798.96,7
CPT,40831,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX",,,551.01,798.96,7
CPT,41010,Incision of lingual frenum (frenotomy),,,1585.19,5367.0,8
CPT,42140,"UVULECTOMY, EXCISION OF UVULA",,,3387.27,5367.0,8
CPT,42330,"SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL",,,3387.27,5367.0,8
CPT,42400,BX GLAND SALIVARY NDL,1263.0,530.46,341.01,3186.0,37
CPT,42410,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection",,,6048.05,17965.0,8
CPT,42415,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve",,,6048.05,17965.0,8
CPT,42440,EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND,,,6048.05,17965.0,8
CPT,42500,"PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; PRIMARY OR SIMPLE",,,6048.05,10412.0,8
CPT,42700,INCISION AND DRAINAGE ABSCESS; PERITONSILLAR,,,241.98,350.87,7
CPT,42725,"INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR PARAPHARYNGEAL, EXTERNAL APPROACH",,,6048.05,17965.0,8
CPT,42821,Tonsillectomy and adenoidectomy; age 12 or over,,,3387.27,10412.0,8
CPT,42826,"Tonsillectomy, primary or secondary; age 12 or over",,,3387.27,10412.0,8
CPT,42830,"Adenoidectomy, primary; younger than age 12",,,3387.27,10412.0,8
CPT,42831,"Adenoidectomy, primary; age 12 or over",,,3387.27,10412.0,8
CPT,42870,"EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD (SEPARATE PROCEDURE)",,,6048.05,10412.0,8
CPT,42960,"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); SIMPLE",,,551.01,798.96,7
CPT,42962,"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); WITH SECONDARY SURGICAL INTERVENTION",,,3387.27,10412.0,8
CPT,43191,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)",,,1960.47,5367.0,8
CPT,43194,"ESOPHAGOSCOPY, RIGID, TRANSORAL; WITH REMOVAL OF FOREIGN BODY(S)",,,1960.47,5367.0,8
CPT,43235,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,926.63,5367.0,16
CPT,43236,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance",,,926.63,5367.0,8
CPT,43237,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures",,,1960.47,5367.0,8
CPT,43238,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,1960.47,5367.0,8
CPT,43239,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,926.63,5367.0,24
CPT,43242,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,1960.47,5367.0,16
CPT,43243,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH INJECTION SCLEROSIS OF ESOPHAGEAL/GASTRIC VARICES",,,1960.47,5367.0,8
CPT,43244,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices",,,1960.47,5367.0,8
CPT,43245,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (e.g., balloon, bougie)",,,1960.47,5367.0,8
CPT,43246,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube",,,1960.47,5367.0,8
CPT,43247,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)",,,926.63,5367.0,16
CPT,43248,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire",,,926.63,5367.0,16
CPT,43249,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)",,,1960.47,5367.0,16
CPT,43251,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1960.47,5367.0,16
CPT,43255,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method",,,1960.47,5367.0,8
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 ",,,1960.47,5367.0,8
CPT,43261,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple",,,3938.98,10412.0,16
CPT,43262,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy,,,3938.98,10412.0,8
CPT,43264,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s),,,3938.98,10412.0,16
CPT,43266,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,6202.39,14009.0,8
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)",,,1960.47,5367.0,8
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",,,6202.39,10412.0,16
CPT,43275,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s),,,1960.47,5367.0,16
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",,,6202.39,10412.0,16
CPT,43277,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH TRANS-ENDOSCOPIC BALLOON DILATION OF BILIARY/PANCREATIC DUCT(S) OR OF AMPULLA (SPHINCTEROPLASTY), INCLUDING SPHINCTEROTOMY, WHEN PERFORMED, ",,,3938.98,10412.0,8
CPT,43281,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh",,,10860.07,25370.0,8
CPT,43282,"LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITH IMPLANTATION OF MESH",,,10860.07,25370.0,8
CPT,43450,"DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES",,,926.63,5367.0,8
CPT,43644,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (Roux limb 150 cm or less)",,,25370.0,25370.0,1
CPT,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",,,6176.47,17965.0,8
CPT,43752,PLC G-TUBE NASO/ORO PHYS W FL GD,683.0,286.86,184.41,669.34,108
CPT,43761,REPOS G-TUBE NASO/ORO,1159.0,486.78,255.26,1135.82,36
CPT,43762,"REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT",,,255.26,370.13,14
CPT,43774,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components",,,3938.98,26759.0,8
CPT,43775,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (i.e., sleeve gastrectomy)",,,25370.0,25370.0,1
CPT,44180,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)",,,6176.47,25370.0,8
CPT,44300,"PLACEMENT, ENTEROSTOMY OR CECOSTOMY, TUBE OPEN (EG, FOR FEEDING OR DECOMPRESSION) (SEPARATE PROCEDURE)",,,1960.47,5367.0,8
CPT,44361,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE",,,1960.47,5367.0,8
CPT,44373,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH CONVERSION OF PERCUTANEOUS GASTROSTOMY TUBE TO PERCUTANEOUS JEJUNOSTOMY TUBE",,,1960.47,5367.0,8
CPT,44382,"ILEOSCOPY, THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE",,,926.63,5367.0,8
CPT,44386,"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL POUCH (EG, KOCK POUCH, ILEAL RESERVOIR [S OR J]); WITH BIOPSY, SINGLE OR MULTIPLE",,,950.1,5367.0,8
CPT,44388,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,5367.0,8
CPT,44389,"Colonoscopy through stoma; with biopsy, single or multiple",,,1222.56,5367.0,8
CPT,44394,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1222.56,5367.0,8
CPT,44500,INTRO TUBE GI LONG,2237.0,939.54,603.99,5367.0,74
CPT,44799,"UNLISTED PROCEDURE, SMALL INTESTINE",,,926.63,5367.0,8
CPT,44950,Appendectomy;,,,6614.04,14009.0,8
CPT,44970,"Laparoscopy, surgical, appendectomy",,,6176.47,25370.0,8
CPT,45171,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA (IE, PARTIAL THICKNESS)",,,2835.78,10412.0,8
CPT,45172,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)",,,2835.78,14009.0,8
CPT,45330,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,3186.0,16
CPT,45331,"Sigmoidoscopy, flexible; with biopsy, single or multiple",,,950.1,3186.0,8
CPT,45334,"SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD",,,1222.56,5367.0,8
CPT,45347,"SIGMOIDOSCOPY, FLEXIBLE; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,5367.0,8993.47,8
CPT,45378,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,5367.0,16
CPT,45379,"Colonoscopy, flexible; with removal of foreign body(s)",,,1222.56,5367.0,8
CPT,45380,"Colonoscopy, flexible; with biopsy, single or multiple",,,1222.56,5367.0,24
CPT,45381,"Colonoscopy, flexible; with directed submucosal injection(s), any substance",,,1222.56,5367.0,8
CPT,45382,"Colonoscopy, flexible; with control of bleeding, any method",,,1222.56,5367.0,8
CPT,45385,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1222.56,5367.0,24
CPT,45400,"LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE)",,,14009.0,14009.0,1
CPT,45505,PROCTOPLASTY; FOR PROLAPSE OF MUCOUS MEMBRANE,,,2835.78,14009.0,8
CPT,45999,"UNLISTED PROCEDURE, RECTUM",,,950.1,3186.0,8
CPT,46020,PLACEMENT OF SETON,,,2835.78,10412.0,8
CPT,46030,"REMOVAL OF ANAL SETON, OTHER MARKER",,,1222.56,5367.0,8
CPT,46040,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure),,,1222.56,5367.0,8
CPT,46250,"HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS",,,2835.78,10412.0,8
CPT,46255,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP;",,,2835.78,10412.0,8
CPT,46260,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;",,,2835.78,10412.0,8
CPT,46270,SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS,,,2835.78,10412.0,8
CPT,46280,"SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED",,,2835.78,10412.0,8
CPT,46320,"EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL",,,1222.56,5367.0,8
CPT,46600,"ANOSCOPY; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,135.93,197.1,7
CPT,46922,"DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION",,,2835.78,10412.0,8
CPT,46948,"HEMORRHOIDECTOMY, INTERNAL, BY TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, 2 OR MORE HEMORRHOID COLUMNS/GROUPS, INCLUDING ULTRASOUND GUIDANCE, WITH MUCOPEXY, WHEN PERFORMED",,,2835.78,10412.0,8
CPT,46999,"UNLISTED PROCEDURE, ANUS",,,950.1,3186.0,8
CPT,47000,BX LIVER NDL PERC,3384.0,1421.28,913.68,5367.0,111
CPT,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER",,,6176.47,17965.0,8
CPT,47382,ABL RF TUMOR/S LIVER PERC,10632.0,4465.44,2870.64,25370.0,37
CPT,47384,ABL IRE TUMOR/S LIVER PERC W IMG GD,14821.0,6224.82,4001.67,25370.0,37
CPT,47490,CHOLECYSTOSTOMY PERC W IMG GD S&I,4887.0,2052.54,1319.49,14009.0,111
CPT,47531,INJ CHOLANGIOGRAM ACCESS EXIST S&I,1680.0,705.6,453.6,14009.0,37
CPT,47532,INJ CHOLANGIOGRAM ACCESS NEW S&I,3300.0,1386.0,891.0,14009.0,37
CPT,47533,PLC CATH DRN BILIARY PERC EXT S&I,6138.0,2577.96,1657.26,14009.0,37
CPT,47534,PLC CATH DRN BILIARY INT-EXT S&I,6343.0,2664.06,1712.61,14009.0,37
CPT,47535,CONVERSION CATH DRN BILIARY EXT S&I,5445.0,2286.9,1470.15,14009.0,37
CPT,47536,EXCHG CATH DRN BILIARY PERC S&I,6359.0,2670.78,1716.93,14009.0,37
CPT,47537,REM CATH DRN BILIARY PERC S&I,2004.0,841.68,541.08,5367.0,37
CPT,47538,PLC STNT/S DUCT BILE EXIST S&I,8707.0,3656.94,2350.89,25370.0,37
CPT,47539,PLC STNT/S DUCT BILE NEW S&I,12301.0,5166.42,3321.27,25370.0,37
CPT,47540,PLC STNT/S DUCT BILE NEW W DRN S&I,12641.0,5309.22,3413.07,25370.0,37
CPT,47541,PLC ACCS BILI TREE SM BOWEL NEW S&I,8532.0,3583.44,2303.64,14009.0,37
CPT,47542,DIL BLN DUCT BILIARY PERC EA S&I,6464.0,2714.88,1745.28,6334.72,29
CPT,47543,BX/S ENDOLMNL BILI TREE PERC S&I,3399.0,1427.58,917.73,3331.02,29
CPT,47544,REM CALCULI BILI DUCT&/GALLBLDR S&I,5625.0,2362.5,1518.75,5512.5,29
CPT,47555,ENDO BILI W DIL DCT WO STNT PERC,10158.0,4266.36,2742.66,14009.0,37
CPT,47556,ENDO BILI W DIL DCT&STNT PERC,13236.0,5559.12,3573.72,25370.0,37
CPT,47562,"Laparoscopy, surgical; cholecystectomy",,,6176.47,25370.0,8
CPT,47563,"Laparoscopy, surgical; cholecystectomy with cholangiography",,,6176.47,25370.0,8
CPT,47600,CHOLECYSTECTOMY;,,,17965.0,17965.0,1
CPT,48102,BX PANCREAS NDL PERC,2567.0,1078.14,693.09,5367.0,74
CPT,49082,PARACENTESIS ABDOMINAL WO IMG,1846.0,775.32,498.42,5367.0,111
CPT,49083,PARACENTESIS ABDOMINAL W IMG,2677.0,1124.34,722.79,5367.0,111
CPT,49180,BX MASS ABD/RETRO NDL PERC,2707.0,1136.94,730.89,5367.0,111
CPT,49185,COLL FLUID SCLEROTX W IMG GD S&I,2677.0,1124.34,722.79,3186.0,74
CPT,49187,"EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL (IE, PERITONEAL, MESENTERIC, RETROPERITONEAL), PRIMARY OR SECONDARY TUMOR(S) OR CYST(S), SUM OF THE MAXIMUM LENGTH OF TUMOR(S) OR CYST(S); 5.1 TO 10 CM",,,10412.0,10412.0,1
CPT,49320,"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,6176.47,17965.0,8
CPT,49321,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,6176.47,17965.0,8
CPT,49324,"LAPAROSCOPY, SURGICAL; WITH INSERTION OF TUNNELED INTRAPERITONEAL CATHETER",,,6176.47,17965.0,8
CPT,49325,"LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED",,,6176.47,17965.0,8
CPT,49329,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,6176.47,17965.0,8
CPT,49405,DRN CATH FLUID VISCERAL IMG GD,2535.0,1064.7,684.45,5367.0,111
CPT,49406,DRN CATH FLUID PERI PERC IMG GD,6013.0,2525.46,1623.51,5892.74,111
CPT,49407,DRN CATH FLUID TRNSVAG/REC IMG GD,2528.0,1061.76,682.56,5367.0,111
CPT,49418,INS CATH INTRAPERIT TUN W IMG,8828.0,3707.76,2383.56,14009.0,37
CPT,49422,REM CATH INTRAPERIT,4570.0,1919.4,1233.9,14009.0,37
CPT,49422,REMOVAL OF TUNNELED INTRAPERITONEAL CATHETER,,,3225.87,14009.0,8
CPT,49423,EXCHG CATH DRN ABSC/CYST,3795.0,1593.9,1024.65,5367.0,74
CPT,49424,INJ CNT ABSC/CYST VIA PREV CATH/TB,819.0,343.98,221.13,802.62,29
CPT,49425,INS SHUNT PERITONEAL-VENOUS,7493.0,3147.06,2023.11,7343.14,30
CPT,49440,INS TUBE GASTRO PERC S&I,3435.0,1442.7,927.45,5367.0,37
CPT,49441,INS TUBE DUO/JEJUNOSTOMY PERC S&I,2896.0,1216.32,781.92,5367.0,37
CPT,49442,INS TUBE CECOSTOMY PERC S&I,1819.0,763.98,491.13,5367.0,37
CPT,49446,CHG G-TUBE TO G-J TUBE PERC S&I,3282.0,1378.44,886.14,5367.0,37
CPT,49450,RPLC TUBE GASTRO/CECOSTOMY PERC S&I,1478.0,620.76,399.06,5367.0,37
CPT,49451,RPLC TUBE DUO/JEJUNOSTOMY PERC S&I,1846.0,775.32,498.42,5367.0,37
CPT,49452,RPLC TUBE G-J PERC S&I,2570.0,1079.4,693.9,5367.0,37
CPT,49460,REM OBSTRUCT MECH TUBE G/COLON S&I,955.0,401.1,257.85,5367.0,37
CPT,49465,INJ CNT TUBE G/COLON PERC S&I,573.0,240.66,154.71,561.54,72
CPT,49501,"REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO YOUNGER THAN 5 YEARS, WITH OR WITHOUT HYDROCELECTOMY; INCARCERATED OR STRANGULATED",,,3657.95,14009.0,8
CPT,49505,"Repair initial inguinal hernia, age 5 years or older; reducible",,,3657.95,14009.0,8
CPT,49507,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated",,,3657.95,14009.0,8
CPT,49520,"Repair recurrent inguinal hernia, any age; reducible",,,3657.95,14009.0,8
CPT,49521,"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED",,,6614.04,14009.0,8
CPT,49525,"REPAIR INGUINAL HERNIA, SLIDING, ANY AGE",,,3657.95,14009.0,8
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",,,3657.95,14009.0,8
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",,,6176.47,25370.0,8
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",,,6614.04,14009.0,8
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",,,6176.47,25370.0,8
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",,,6614.04,14009.0,8
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",,,25370.0,25370.0,1
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",,,3657.95,14009.0,8
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",,,6614.04,14009.0,8
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",,,25370.0,25370.0,1
CPT,49650,"Laparoscopy, surgical; repair initial inguinal hernia",,,6176.47,25370.0,8
CPT,49651,"Laparoscopy, surgical; repair recurrent inguinal hernia",,,6176.47,25370.0,8
CPT,49659,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY",,,6176.47,17965.0,8
CPT,49999,ABL RF MASS RETROPERITONEAL,8229.0,3456.18,926.63,8064.42,37
CPT,49999,REPOS CATH DIALYSIS PERIT W FL GD,2273.0,954.66,613.71,5367.0,37
CPT,50080,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,9671.5,17965.0,8
CPT,50081,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,9671.5,17965.0,8
CPT,50200,BX RENAL TROCAR/NDL PERC BI,4626.0,1942.92,1249.02,5367.0,90
CPT,50200,BX RENAL TROCAR/NDL PERC LT,3084.0,1295.28,832.68,5367.0,90
CPT,50200,BX RENAL TROCAR/NDL PERC RT,3084.0,1295.28,832.68,5367.0,90
CPT,50382,RPLC STENT URETER INT PERC BI S&I,7715.0,3240.3,2083.05,10412.0,30
CPT,50382,RPLC STENT URETER INT PERC LT S&I,5143.0,2160.06,1388.61,10412.0,30
CPT,50382,RPLC STENT URETER INT PERC RT S&I,5143.0,2160.06,1388.61,10412.0,30
CPT,50384,REM STENT URETER INT PERC BI S&I,5951.0,2499.42,1606.77,10412.0,30
CPT,50384,REM STENT URETER INT PERC LT S&I,3967.0,1666.14,1071.09,10412.0,30
CPT,50384,REM STENT URETER INT PERC RT S&I,3967.0,1666.14,1071.09,10412.0,30
CPT,50384,"REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLING URETERAL STENT VIA PERCUTANEOUS APPROACH, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,2135.66,10412.0,8
CPT,50385,RPLC STENT URETER TRANSURETH BI S&I,4494.0,1887.48,1213.38,10412.0,30
CPT,50385,RPLC STENT URETER TRANSURETH LT S&I,2996.0,1258.32,808.92,10412.0,30
CPT,50385,RPLC STENT URETER TRANSURETH RT S&I,2996.0,1258.32,808.92,10412.0,30
CPT,50387,RPLC CATH NEPHROURETER FL GD BI S&I,6033.0,2533.86,1628.91,5912.34,30
CPT,50387,RPLC CATH NEPHROURETER FL GD LT S&I,4022.0,1689.24,1085.94,5367.0,30
CPT,50387,RPLC CATH NEPHROURETER FL GD RT S&I,4022.0,1689.24,1085.94,5367.0,30
CPT,50389,REM TUBE NEPHRO W FLUORO BI S&I,2273.0,954.66,613.71,3186.0,30
CPT,50389,REM TUBE NEPHRO W FLUORO LT S&I,1515.0,636.3,409.05,3186.0,30
CPT,50389,REM TUBE NEPHRO W FLUORO RT S&I,1515.0,636.3,409.05,3186.0,30
CPT,50389,"REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING URETERAL STENT)",,,712.4,3186.0,8
CPT,50390,ASP&/INJ CYST/PELVIS RENAL BI,3258.0,1368.36,879.66,3192.84,60
CPT,50390,ASP&/INJ CYST/PELVIS RENAL LT,2172.0,912.24,586.44,3186.0,60
CPT,50390,ASP&/INJ CYST/PELVIS RENAL RT,2172.0,912.24,586.44,3186.0,60
CPT,50396,STUDY MANOMETRIC RENAL TB/CATH BI,1601.0,672.42,432.27,3186.0,30
CPT,50396,STUDY MANOMETRIC RENAL TB/CATH LT,1067.0,448.14,288.09,3186.0,30
CPT,50396,STUDY MANOMETRIC RENAL TB/CATH RT,1067.0,448.14,288.09,3186.0,30
CPT,50430,INJ NEPH&/URETERGRM ACC NEW BI S&I,3569.0,1498.98,963.63,3497.62,30
CPT,50430,INJ NEPH&/URETERGRM ACC NEW LT S&I,2379.0,999.18,642.33,3186.0,30
CPT,50430,INJ NEPH&/URETERGRM ACC NEW RT S&I,2379.0,999.18,642.33,3186.0,30
CPT,50431,INJ NEPH&/URETERGRM ACC EXST BI S&I,2687.0,1128.54,725.49,3186.0,30
CPT,50431,INJ NEPH&/URETERGRM ACC EXST LT S&I,1791.0,752.22,483.57,3186.0,30
CPT,50431,INJ NEPH&/URETERGRM ACC EXST RT S&I,1791.0,752.22,483.57,3186.0,30
CPT,50432,PLC CATH NEPHROSTOMY PERC BI S&I,7172.0,3012.24,1936.44,10412.0,60
CPT,50432,PLC CATH NEPHROSTOMY PERC LT S&I,4781.0,2008.02,1290.87,10412.0,60
CPT,50432,PLC CATH NEPHROSTOMY PERC RT S&I,4781.0,2008.02,1290.87,10412.0,60
CPT,50433,PLC CATH NEPHROURET PERC NEW BI S&I,7397.0,3106.74,1997.19,10412.0,30
CPT,50433,PLC CATH NEPHROURET PERC NEW LT S&I,4931.0,2071.02,1331.37,10412.0,30
CPT,50433,PLC CATH NEPHROURET PERC NEW RT S&I,4931.0,2071.02,1331.37,10412.0,30
CPT,50434,CNV CATH NEPH PERC PRE EXIST BI S&I,5139.0,2158.38,1387.53,5036.22,30
CPT,50434,CNV CATH NEPH PERC PRE EXIST LT S&I,3426.0,1438.92,925.02,3357.48,30
CPT,50434,CNV CATH NEPH PERC PRE EXIST RT S&I,3426.0,1438.92,925.02,3357.48,30
CPT,50435,EXCHG CATH NEPH PERC BI S&I,4494.0,1887.48,1213.38,4404.12,30
CPT,50435,EXCHG CATH NEPH PERC LT S&I,2996.0,1258.32,808.92,3186.0,30
CPT,50435,EXCHG CATH NEPH PERC RT S&I,2996.0,1258.32,808.92,3186.0,30
CPT,50436,DIL TRACT EXIST PERC BI S&I,7397.0,3106.74,1997.19,10412.0,30
CPT,50436,DIL TRACT EXIST PERC LT S&I,4931.0,2071.02,1331.37,10412.0,30
CPT,50436,DIL TRACT EXIST PERC RT S&I,4931.0,2071.02,1331.37,10412.0,30
CPT,50437,DIL TRACT EXIST PERC NEW ACC BI S&I,7397.0,3106.74,1997.19,14009.0,30
CPT,50437,DIL TRACT EXIST PERC NEW ACC LT S&I,4931.0,2071.02,1331.37,14009.0,30
CPT,50437,DIL TRACT EXIST PERC NEW ACC RT S&I,4931.0,2071.02,1331.37,14009.0,30
CPT,50543,"Laparoscopy, surgical; partial nephrectomy",,,10860.07,25370.0,8
CPT,50544,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",,,10860.07,25370.0,8
CPT,50545,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)",,,3101.0,3101.0,1
CPT,50546,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy",,,3101.0,3101.0,1
CPT,50592,ABL RF TUMOR/S KIDNEY PERC BI,13061.0,5485.62,3526.47,25370.0,30
CPT,50592,ABL RF TUMOR/S KIDNEY PERC LT,8707.0,3656.94,2350.89,25370.0,30
CPT,50592,ABL RF TUMOR/S KIDNEY PERC RT,8707.0,3656.94,2350.89,25370.0,30
CPT,50593,ABL CRYO TUMOR/S KIDNEY PERC BI,22232.0,9337.44,6002.64,25370.0,30
CPT,50593,ABL CRYO TUMOR/S KIDNEY PERC LT,14821.0,6224.82,4001.67,25370.0,30
CPT,50593,ABL CRYO TUMOR/S KIDNEY PERC RT,14821.0,6224.82,4001.67,25370.0,30
CPT,50684,INJ CATH URETERAL BI,782.0,328.44,211.14,766.36,29
CPT,50684,INJ CATH URETERAL LT,521.0,218.82,140.67,510.58,29
CPT,50684,INJ CATH URETERAL RT,521.0,218.82,140.67,510.58,29
CPT,50688,CHG TB/STNT URETER CONDUIT ILEAL,3238.0,1359.96,874.26,5367.0,37
CPT,50690,INJ VISUAL ILEAL CONDUIT,1165.0,489.3,314.55,1141.7,58
CPT,50693,PLC STNT URTR NEPH PREEXIST BI S&I,7397.0,3106.74,1997.19,14009.0,30
CPT,50693,PLC STNT URTR NEPH PREEXIST LT S&I,4931.0,2071.02,1331.37,14009.0,30
CPT,50693,PLC STNT URTR NEPH PREEXIST RT S&I,4931.0,2071.02,1331.37,14009.0,30
CPT,50694,PLC STNT URTR WO NEPH CATH BI S&I,8003.0,3361.26,2160.81,14009.0,30
CPT,50694,PLC STNT URTR WO NEPH CATH LT S&I,5335.0,2240.7,1440.45,14009.0,30
CPT,50694,PLC STNT URTR WO NEPH CATH RT S&I,5335.0,2240.7,1440.45,14009.0,30
CPT,50695,PLC STNT URTR W NEPH CATH BI S&I,10205.0,4286.1,2755.35,14009.0,30
CPT,50695,PLC STNT URTR W NEPH CATH LT S&I,6803.0,2857.26,1836.81,14009.0,30
CPT,50695,PLC STNT URTR W NEPH CATH RT S&I,6803.0,2857.26,1836.81,14009.0,30
CPT,50705,EMB/OCCL URETERAL BI S&I,3582.0,1504.44,967.14,3510.36,29
CPT,50705,EMB/OCCL URETERAL LT S&I,2388.0,1002.96,644.76,2340.24,29
CPT,50705,EMB/OCCL URETERAL RT S&I,2388.0,1002.96,644.76,2340.24,29
CPT,50706,DIL BLN STRICTURE URETERAL BI S&I,6362.0,2672.04,1717.74,6234.76,29
CPT,50706,DIL BLN STRICTURE URETERAL LT S&I,4241.0,1781.22,1145.07,4156.18,29
CPT,50706,DIL BLN STRICTURE URETERAL RT S&I,4241.0,1781.22,1145.07,4156.18,29
CPT,50947,"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITH CYSTOSCOPY AND URETERAL STENT PLACEMENT",,,10860.07,25370.0,8
CPT,50948,"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITHOUT CYSTOSCOPY AND URETERAL STENT PLACEMENT",,,10860.07,25370.0,8
CPT,50949,"UNLISTED LAPAROSCOPY PROCEDURE, URETER",,,6176.47,17965.0,8
CPT,51040,"CYSTOSTOMY, CYSTOTOMY WITH DRAINAGE",,,2135.66,10412.0,8
CPT,51080,DRN ABSCESS PERI/PREVESICAL SPACE,4350.0,1827.0,1174.5,5367.0,37
CPT,51101,ASP BLADDER TROCAR/CATH,1527.0,641.34,412.29,5367.0,37
CPT,51102,ASP BLADDER W INS CATH SUPRAPUBIC,2996.0,1258.32,808.92,10412.0,74
CPT,51102,ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER,,,2135.66,10412.0,8
CPT,51500,"EXCISION OF URACHAL CYST OR SINUS, WITH OR WITHOUT UMBILICAL HERNIA REPAIR",,,6176.47,14009.0,8
CPT,51520,CYSTOTOMY; FOR SIMPLE EXCISION OF VESICAL NECK (SEPARATE PROCEDURE),,,3601.33,10412.0,8
CPT,51600,INJ CYSTOGRAM,517.0,217.14,139.59,506.66,58
CPT,51610,INJ URETHROCYSTOGRAM RETROGRADE,295.0,123.9,79.65,289.1,58
CPT,51700,ED PROCEDURE IRRG BLADDER,374.0,157.08,100.98,370.13,36
CPT,51700,PROCEDURE IRRG BLADDER,374.0,157.08,100.98,370.13,36
CPT,51701,ED INS CATH BLADDER NONINDWL,262.0,110.04,70.74,256.76,36
CPT,51701,INS CATH BLADDER NONINDWL,262.0,110.04,70.74,256.76,36
CPT,51702,ED INS CATH BLADDER INDWL SMPL,204.0,85.68,55.08,199.92,36
CPT,51702,INS CATH BLADDER INDWL SMPL,204.0,85.68,55.08,199.92,72
CPT,51703,INS CATH BLADDER INDWL CMP,404.0,169.68,109.08,395.92,36
CPT,51705,CHG TUBE CYSTO SIMPLE,374.0,157.08,100.98,370.13,36
CPT,51705,Change of cystostomy tube; simple,,,255.26,370.13,7
CPT,51720,BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME),,,712.4,1032.98,7
CPT,51720,INSTILL BLADDER ANTICARCINOGENIC,1067.0,448.14,288.09,1045.66,37
CPT,51798,MEAS URINE&/CAPACITY BLADDER US,107.0,44.94,28.89,104.86,36
CPT,51860,"CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE; SIMPLE",,,9671.5,14023.67,8
CPT,52000,Cystourethroscopy (separate procedure),,,712.4,3186.0,8
CPT,52204,"Cystourethroscopy, with biopsy(s)",,,2135.66,10412.0,8
CPT,52214,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands",,,3601.33,10412.0,8
CPT,52224,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy",,,3601.33,10412.0,8
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)",,,3601.33,10412.0,8
CPT,52235,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)",,,3601.33,10412.0,8
CPT,52240,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)",,,5477.93,10412.0,8
CPT,52276,Cystourethroscopy with direct vision internal urethrotomy,,,2135.66,10412.0,8
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",,,2135.66,5367.0,8
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",,,5477.93,10412.0,8
CPT,52287,"CYSTOURETHROSCOPY, WITH INJECTION(S) FOR CHEMODENERVATION OF THE BLADDER",,,2135.66,5367.0,8
CPT,52310,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",,,2135.66,5367.0,8
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),,,3601.33,10412.0,8
CPT,52318,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM),,,3601.33,10412.0,8
CPT,52320,CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH REMOVAL OF URETERAL CALCULUS,,,3601.33,10412.0,8
CPT,52325,"CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH FRAGMENTATION OF URETERAL CALCULUS (EG, ULTRASONIC OR ELECTRO-HYDRAULIC TECHNIQUE)",,,5477.93,10412.0,8
CPT,52332,"Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,3601.33,10412.0,8
CPT,52341,"CYSTOURETHROSCOPY; WITH TREATMENT OF URETERAL STRICTURE (EG, BALLOON DILATION, LASER, ELECTROCAUTERY, AND INCISION)",,,3601.33,10412.0,8
CPT,52351,"CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; DIAGNOSTIC",,,3601.33,10412.0,8
CPT,52352,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)",,,3601.33,10412.0,8
CPT,52353,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)",,,5477.93,17965.0,8
CPT,52354,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion",,,5477.93,10412.0,8
CPT,52356,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,5477.93,17965.0,8
CPT,52597,"TRANSURETHRAL ROBOTIC-ASSISTED WATERJET RESECTION OF PROSTATE, INCLUDING INTRAOPERATIVE PLANNING, ULTRASOUND GUIDANCE, CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE, INCLUDING VASECTOMY, MEATOTOMY, CYST",,,9671.5,14023.67,8
CPT,52601,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,5477.93,17965.0,8
CPT,52649,"LASER ENUCLEATION OF THE PROSTATE WITH MORCELLATION, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, INTERNAL URET",,,5477.93,17965.0,8
CPT,53450,"Urethromeatoplasty, with mucosal advancement",,,3601.33,14009.0,8
CPT,53600,"DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE; INITIAL",,,255.26,370.13,7
CPT,53899,"UNLISTED PROCEDURE, URINARY SYSTEM",,,255.26,370.13,7
CPT,54150,CIRCUMCISION W BLOCK REGIONAL,665.0,279.3,179.55,3096.71,37
CPT,54430,"CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT (PRIAPISM OPERATION), UNILATERAL OR BILATERAL",,,3101.0,3101.0,1
CPT,54437,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),,,3601.33,10412.0,8
CPT,54520,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach",,,3601.33,14009.0,8
CPT,54640,"Orchiopexy, inguinal or scrotal approach",,,3657.95,14009.0,8
CPT,54861,EPIDIDYMECTOMY; BILATERAL,,,3601.33,10412.0,8
CPT,55040,Excision of hydrocele; unilateral,,,3657.95,14009.0,8
CPT,55700,"Biopsy, prostate; needle or punch, single or multiple, any approach",,,,,0
CPT,55706,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance",,,3601.33,5367.0,8
CPT,55710,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE BIOPSY, FIRST TARGETED LESION",,,3601.33,10412.0,8
CPT,55720,"Prostatotomy, external drainage of prostatic abscess, any approach; simple",,,3601.33,10412.0,8
CPT,55866,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;",,,10860.07,26759.0,8
CPT,55867,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,10860.07,25370.0,8
CPT,55868,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH LYMPH NODE BIOPSY(IES) (LIMITED PELVIC LYMPHADENECTOMY)",,,10860.07,25370.0,8
CPT,55869,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGAST",,,10860.07,25370.0,8
CPT,55874,"TRANSPERINEAL PLACEMENT OF BIODEGRADABLE MATERIAL, PERI-PROSTATIC, SINGLE OR MULTIPLE INJECTION(S), INCLUDING IMAGE GUIDANCE, WHEN PERFORMED",,,5477.93,25370.0,8
CPT,55875,"TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY",,,5477.93,17965.0,8
CPT,55876,"PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PROSTATE (VIA NEEDLE, ANY APPROACH), SINGLE OR MULTIPLE",,,1414.11,5367.0,8
CPT,56740,EXCISION OF BARTHOLIN'S GLAND OR CYST,,,3307.24,10412.0,8
CPT,57155,INS TANDEM UTERI&/OVOID VAG BRACHY,3907.0,1640.94,1054.89,7410.66,37
CPT,57250,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy",,,5110.8,14009.0,8
CPT,57260,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;",,,5110.8,14009.0,8
CPT,57288,"Sling operation for stress incontinence (e.g., fascia or synthetic)",,,5110.8,17965.0,8
CPT,57425,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)",,,10860.07,25370.0,8
CPT,58120,"DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)",,,3307.24,10412.0,8
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",,,14009.0,14009.0,1
CPT,58150,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);",,,14009.0,14009.0,1
CPT,58260,"Vaginal hysterectomy, for uterus 250 g or less;",,,5110.8,14009.0,8
CPT,58262,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)",,,5110.8,14009.0,8
CPT,58301,ED REM IUD,496.0,208.32,133.92,486.08,36
CPT,58550,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;",,,6176.47,25370.0,8
CPT,58552,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,10860.07,25370.0,8
CPT,58558,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",,,3307.24,10412.0,8
CPT,58563,"Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)",,,5110.8,14009.0,8
CPT,58570,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;",,,10860.07,31000.0,10
CPT,58571,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,10860.07,31000.0,10
CPT,58661,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",,,6176.47,25370.0,8
CPT,58662,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",,,6176.47,25370.0,8
CPT,59000,AMNIOCENTESIS DIAGNOSTIC,1410.0,592.2,380.7,3186.0,37
CPT,59001,AMNIOCENTESIS THER US GD,1045.0,438.9,282.15,1024.1,36
CPT,59020,TEST STRESS CONTRACTION FETAL,686.0,288.12,185.22,672.28,37
CPT,59025,TEST NONSTRESS FETAL,766.0,321.72,206.55,750.68,37
CPT,59150,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHOUT SALPINGECTOMY AND/OR OOPHORECTOMY,,,6176.47,25370.0,8
CPT,59151,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITH SALPINGECTOMY AND/OR OOPHORECTOMY,,,6176.47,25370.0,8
CPT,59200,INS DILATOR CERVICAL,617.0,259.14,166.59,604.66,37
CPT,59412,VERSION CEPHALIC EXTERNAL,920.0,386.4,248.4,4795.5,37
CPT,59414,DELIVERY OF PLACENTA,2705.0,1136.1,730.35,4795.5,37
CPT,59414,ED DELIVERY PLACENTA,2705.0,1136.1,730.35,4795.5,36
CPT,59812,"Treatment of incomplete abortion, any trimester, completed surgically",,,3307.24,10412.0,8
CPT,59820,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER",,,3307.24,10412.0,8
CPT,59821,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER",,,3307.24,10412.0,8
CPT,60100,BX THYROID NDL CORE PERC,979.0,411.18,264.33,3186.0,74
CPT,60100,"Biopsy thyroid, percutaneous core needle",,,723.47,3186.0,8
CPT,60210,"PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY",,,6176.47,25370.0,8
CPT,60220,"Total thyroid lobectomy, unilateral; with or without isthmusectomy",,,6176.47,25370.0,8
CPT,60240,"Thyroidectomy, total or complete",,,6176.47,25370.0,8
CPT,60300,ASP&/INJ CYST THYROID,979.0,411.18,264.33,3186.0,37
CPT,60500,Parathyroidectomy or exploration of parathyroid(s);,,,6048.05,17965.0,8
CPT,61070,PUNCT SHUNT TUBE/RESV ASP/INJ,1127.0,473.34,304.29,3186.0,37
CPT,61623,OCC EV ART BLN TEMP CNS W ANG,11118.0,4669.56,3001.86,26759.0,37
CPT,61630,PTA INTRACRANIAL PERC,14072.0,5910.24,3101.0,13790.56,30
CPT,61635,PLC STNT/S INTRAVASC INTRACRN,27059.0,11364.78,3101.0,26517.82,30
CPT,61645,THROMBECTOMY&/INF TRNSL ART PERC BI,6549.0,2750.58,1768.23,6418.02,30
CPT,61645,THROMBECTOMY&/INF TRNSL ART PERC LT,4366.0,1833.72,1178.82,4278.68,30
CPT,61645,THROMBECTOMY&/INF TRNSL ART PERC RT,4366.0,1833.72,1178.82,4278.68,30
CPT,61650,ADM PRLNG AGNT RX INTRACRN EV INIT,2941.0,1235.22,794.07,3101.0,30
CPT,62267,ASP INTERDISCAL DX PERC,1560.0,655.2,421.2,3186.0,111
CPT,62270,PUNCT LUMBAR DIAGNOSTIC,1728.0,725.76,466.56,3186.0,74
CPT,62272,PUNCT SPINE THER DRN CSF,1080.0,453.6,291.6,3186.0,37
CPT,62273,ED INJ EPID PATCH BLOOD/CLOT,1571.0,659.82,424.17,1539.58,36
CPT,62273,INJ EPID PATCH BLOOD/CLOT,1571.0,659.82,424.17,3186.0,111
CPT,62284,INJ MYELOGRAM&/CT LUMBAR,1474.0,619.08,397.98,1444.52,29
CPT,62290,INJ DISCOGRAM LUMBAR,2164.0,908.88,584.28,2120.72,58
CPT,62291,INJ DISCOGRAM CERVICAL/THORACIC,1676.0,703.92,452.52,1642.48,58
CPT,62302,INJ LUMB MYELOGRPHY CERVICAL S&I,2054.0,862.68,554.58,3186.0,74
CPT,62303,INJ LUMB MYELOGRPHY THORACIC S&I,2859.0,1200.78,771.93,3186.0,74
CPT,62304,INJ LUMB MYELOGRPHY LUMBOSACRAL S&I,2885.0,1211.7,778.95,3186.0,74
CPT,62305,INJ LUMB MYELOGRPHY 2+ S&I,3393.0,1425.06,800.9,3325.14,37
CPT,62321,INJ/S EPID/SUB C/T W IMG,3930.0,1650.6,721.17,3851.4,74
CPT,62322,INJ/S EPID/SUB L/S WO IMG,1352.0,567.84,365.04,3186.0,37
CPT,62323,INJ/S EPID/SUB L/S W IMG,3000.0,1260.0,721.17,3186.0,37
CPT,62328,PUNCT LUMBAR DIAGNOSTIC W FL/CT GD,2612.5,1097.25,662.04,3186.0,111
CPT,62329,PUNCT SPINE THER DRN CSF W FL/CT GD,1884.0,791.28,508.68,3186.0,74
CPT,62350,IMP/REV/REPOS CATH IT/EPIDURAL,8495.0,3567.9,2293.65,17965.0,37
CPT,62362,IMP/RPLC DEV INF PUMP PROGRAMMABLE,7574.0,3181.08,2044.98,32969.0,37
CPT,63030,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar",,,7413.38,25370.0,8
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",,,7413.38,25370.0,8
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",,,7413.38,25370.0,8
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",,,7413.38,25370.0,8
CPT,63056,"Transpedicular approach with decompression of spinal cord, cauda equina and/or nerve root(s) (e.g., herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforami",,,7413.38,25370.0,8
CPT,63081,"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, SINGLE SEGMENT",,,25370.0,25370.0,1
CPT,63082,"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN AD",,,3101.0,3101.0,1
CPT,63267,"LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; LUMBAR",,,7413.38,10749.4,8
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",,,31526.06,45712.79,8
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR BI,1130.0,474.6,305.1,1107.4,29
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR LT,753.0,316.26,203.31,737.94,29
CPT,64400,ED INJ/S ANES NRV TRIGEMINAL BR RT,753.0,316.26,203.31,737.94,29
CPT,64400,INJ/S ANES NRV TRIGEMINAL BR BI,1130.0,474.6,305.1,1107.4,29
CPT,64400,INJ/S ANES NRV TRIGEMINAL BR EA,753.0,316.26,203.31,737.94,36
CPT,64400,INJ/S ANES NRV TRIGEMINAL BR LT,753.0,316.26,203.31,737.94,29
CPT,64400,INJ/S ANES NRV TRIGEMINAL BR RT,753.0,316.26,203.31,737.94,29
CPT,64405,INJ/S ANES NRV OCCIPITAL GREAT BI,1992.0,836.64,537.84,1952.16,29
CPT,64405,INJ/S ANES NRV OCCIPITAL GREAT LT,1328.0,557.76,358.56,1301.44,29
CPT,64405,INJ/S ANES NRV OCCIPITAL GREAT RT,1328.0,557.76,358.56,1301.44,29
CPT,64415,INJ/S ANES NRV PLEX BRACH SGL W IMG,1352.0,567.84,365.04,3186.0,37
CPT,64420,ED INJ/S ANES NRV INTRCST LVL SGLBI,2208.0,927.36,596.16,2163.84,29
CPT,64420,ED INJ/S ANES NRV INTRCST LVL SGLLT,1472.0,618.24,397.44,1442.56,29
CPT,64420,ED INJ/S ANES NRV INTRCST LVL SGLRT,1472.0,618.24,397.44,1442.56,29
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL BI,2208.0,927.36,596.16,3186.0,90
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL LT,1472.0,618.24,397.44,3186.0,90
CPT,64420,INJ/S ANES NRV INTRCST LVL SGL RT,1472.0,618.24,397.44,3186.0,90
CPT,64421,ED INJ/S ANES NRV INTRCST LVL ADDBI,2724.0,1144.08,735.48,2669.52,29
CPT,64421,ED INJ/S ANES NRV INTRCST LVL ADDLT,1816.0,762.72,490.32,1779.68,29
CPT,64421,ED INJ/S ANES NRV INTRCST LVL ADDRT,1816.0,762.72,490.32,1779.68,29
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD BI,2724.0,1144.08,735.48,3186.0,90
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD LT,1816.0,762.72,490.32,3186.0,90
CPT,64421,INJ/S ANES NRV INTRCST LVL ADD RT,1816.0,762.72,490.32,3186.0,90
CPT,64425,INJ/S ANES NRV ILIOING ILIOHYGAS BI,1620.0,680.4,437.4,3186.0,30
CPT,64425,INJ/S ANES NRV ILIOING ILIOHYGAS LT,1080.0,453.6,291.6,3186.0,30
CPT,64425,INJ/S ANES NRV ILIOING ILIOHYGAS RT,1080.0,453.6,291.6,3186.0,30
CPT,64430,INJ/S ANES NRV PUDENDAL BI,2028.0,851.76,547.56,3186.0,30
CPT,64430,INJ/S ANES NRV PUDENDAL LT,1352.0,567.84,365.04,3186.0,30
CPT,64430,INJ/S ANES NRV PUDENDAL RT,1352.0,567.84,365.04,3186.0,30
CPT,64447,INJ/S ANES NRV FEMORAL W IMG BI,1779.0,747.18,480.33,3186.0,30
CPT,64447,INJ/S ANES NRV FEMORAL W IMG LT,1186.0,498.12,320.22,3186.0,30
CPT,64447,INJ/S ANES NRV FEMORAL W IMG RT,1186.0,498.12,320.22,3186.0,30
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER BI,2100.0,882.0,567.0,3186.0,30
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER LT,1400.0,588.0,378.0,3186.0,30
CPT,64450,INJ/S ANES NRV/BR PERPH OTHER RT,1400.0,588.0,378.0,3186.0,30
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGBI,2100.0,882.0,567.0,3186.0,30
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGLT,1400.0,588.0,378.0,3186.0,30
CPT,64454,INJ/S ANES NRV GENICULAR INCL IMGRT,1400.0,588.0,378.0,3186.0,30
CPT,64461,PVB THORACIC INJ SINGLE W IMG GD BI,2924.0,1228.08,789.48,3186.0,30
CPT,64461,PVB THORACIC INJ SINGLE W IMG GD LT,1949.0,818.58,526.23,3186.0,30
CPT,64461,PVB THORACIC INJ SINGLE W IMG GD RT,1949.0,818.58,526.23,3186.0,30
CPT,64479,INJ/S EPID TRFR C/T FL/CT GD 1LV BI,4466.0,1875.72,1205.82,4376.68,60
CPT,64479,INJ/S EPID TRFR C/T FL/CT GD 1LV LT,2977.0,1250.34,803.79,3186.0,60
CPT,64479,INJ/S EPID TRFR C/T FL/CT GD 1LV RT,2977.0,1250.34,803.79,3186.0,60
CPT,64480,INJ/S EPID TRFR C/T FL/CT GD ADD BI,1469.0,616.98,396.63,1439.62,58
CPT,64480,INJ/S EPID TRFR C/T FL/CT GD ADD LT,979.0,411.18,264.33,959.42,58
CPT,64480,INJ/S EPID TRFR C/T FL/CT GD ADD RT,979.0,411.18,264.33,959.42,58
CPT,64483,INJ/S EPID TRFR L/S FL/CT GD 1LV BI,2103.0,883.26,567.81,3186.0,60
CPT,64483,INJ/S EPID TRFR L/S FL/CT GD 1LV LT,1402.0,588.84,378.54,3186.0,60
CPT,64483,INJ/S EPID TRFR L/S FL/CT GD 1LV RT,1402.0,588.84,378.54,3186.0,60
CPT,64484,INJ/S EPID TRFR L/S FL/CT GD ADD BI,920.0,386.4,248.4,901.6,58
CPT,64484,INJ/S EPID TRFR L/S FL/CT GD ADD LT,613.0,257.46,165.51,600.74,58
CPT,64484,INJ/S EPID TRFR L/S FL/CT GD ADD RT,613.0,257.46,165.51,600.74,58
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL BI,3948.0,1658.16,1065.96,3869.04,60
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL LT,2632.0,1105.44,710.64,3186.0,60
CPT,64490,INJ/S JT FCT C/T IMG 1 LVL RT,2632.0,1105.44,710.64,3186.0,60
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL BI,2213.0,929.46,597.51,2168.74,58
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL LT,1475.0,619.5,398.25,1445.5,58
CPT,64491,INJ/S JT FCT C/T IMG 2 LVL RT,1475.0,619.5,398.25,1445.5,58
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL BI,1776.0,745.92,479.52,1740.48,58
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL LT,1184.0,497.28,319.68,1160.32,58
CPT,64492,INJ/S JT FCT C/T IMG 3+ LVL RT,1184.0,497.28,319.68,1160.32,58
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL BI,4442.0,1865.64,1199.34,4353.16,60
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL LT,2961.0,1243.62,799.47,3186.0,60
CPT,64493,INJ/S JT FCT L/S IMG 1 LVL RT,2961.0,1243.62,799.47,3186.0,60
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL BI,2532.0,1063.44,683.64,2481.36,29
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL LT,1688.0,708.96,455.76,1654.24,29
CPT,64494,INJ/S JT FCT L/S IMG 2 LVL RT,1688.0,708.96,455.76,1654.24,29
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL BI,1665.0,699.3,449.55,1631.7,29
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL LT,1110.0,466.2,299.7,1087.8,29
CPT,64495,INJ/S JT FCT L/S IMG 3+ LVL RT,1110.0,466.2,299.7,1087.8,29
CPT,64505,INJ ANES GANGLION SPHENO BI,906.0,380.52,244.62,887.88,29
CPT,64505,INJ ANES GANGLION SPHENO LT,604.0,253.68,163.08,591.92,29
CPT,64505,INJ ANES GANGLION SPHENO RT,604.0,253.68,163.08,591.92,29
CPT,64510,INJ ANES GANGLION STELLA BI,2583.0,1084.86,697.41,3186.0,30
CPT,64510,INJ ANES GANGLION STELLA LT,1722.0,723.24,464.94,3186.0,30
CPT,64510,INJ ANES GANGLION STELLA RT,1722.0,723.24,464.94,3186.0,30
CPT,64517,INJ ANES PLEXUS HYPOGASTRIC,2239.0,940.38,604.53,3186.0,74
CPT,64530,INJ ANES PLEXUS CELIAC,1352.0,567.84,365.04,3186.0,37
CPT,64561,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed",,,6511.03,25370.0,8
CPT,64568,"OPEN IMPLANTATION OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR",,,36596.0,65250.72,8
CPT,64581,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement),,,6511.03,26759.0,8
CPT,64582,"OPEN IMPLANTATION OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY",,,31526.06,102097.0,8
CPT,64585,Revision or removal of peripheral neurostimulator electrode array,,,3571.83,14009.0,8
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",,,19820.31,32969.0,8
CPT,64611,CHEMODENERV GLANDS PAR&SUBMAND BI,466.0,195.72,125.82,456.68,36
CPT,64620,DST NRV INTERCOSTAL,2030.0,852.6,548.1,3186.0,37
CPT,64625,ABL RF JOINT SI INCL IMG GD BI,6300.0,2646.0,1701.0,10412.0,30
CPT,64625,ABL RF JOINT SI INCL IMG GD LT,4200.0,1764.0,1134.0,10412.0,30
CPT,64625,ABL RF JOINT SI INCL IMG GD RT,4200.0,1764.0,1134.0,10412.0,30
CPT,64633,DST NRV CERV/THOR FL/CT GD SGL BI,4442.0,1865.64,1199.34,10412.0,30
CPT,64633,DST NRV CERV/THOR FL/CT GD SGL LT,2961.0,1243.62,799.47,10412.0,30
CPT,64633,DST NRV CERV/THOR FL/CT GD SGL RT,2961.0,1243.62,799.47,10412.0,30
CPT,64635,DST NRV LUMB/SAC FL/CT GD SGL BI,6237.0,2619.54,1683.99,10412.0,30
CPT,64635,DST NRV LUMB/SAC FL/CT GD SGL LT,4158.0,1746.36,1122.66,10412.0,30
CPT,64635,DST NRV LUMB/SAC FL/CT GD SGL RT,4158.0,1746.36,1122.66,10412.0,30
CPT,64636,DST NRV LUMB/SAC FL/CT GD ADDL BI,2279.0,957.18,615.33,2233.42,29
CPT,64636,DST NRV LUMB/SAC FL/CT GD ADDL LT,1519.0,637.98,410.13,1488.62,29
CPT,64636,DST NRV LUMB/SAC FL/CT GD ADDL RT,1519.0,637.98,410.13,1488.62,29
CPT,64640,DST NRV PERIPH/BRANCH BI,2079.0,873.18,561.33,3186.0,30
CPT,64640,DST NRV PERIPH/BRANCH LT,1386.0,582.12,374.22,3186.0,30
CPT,64640,DST NRV PERIPH/BRANCH RT,1386.0,582.12,374.22,3186.0,30
CPT,64680,DST NRV PLEXUS CELIAC,2069.0,868.98,558.63,3186.0,37
CPT,64718,NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW,,,1995.02,10412.0,8
CPT,64999,INJ ANES SPG TRANSCTH NOSE,604.0,253.68,163.08,591.92,36
CPT,64999,INJ/S ANES&/STRD BLOCK HARDWARE,2961.0,1243.62,313.6,2901.78,36
CPT,64999,RUPTURE CYST SYNOVIAL INJ,623.0,261.66,168.21,610.54,36
CPT,69110,"EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR",,,2967.63,5367.0,8
CPT,69205,REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA,,,1687.37,5367.0,8
CPT,69210,REM CERUMEN IMPACTED W INST BI,494.0,207.48,60.27,484.12,37
CPT,69210,REM CERUMEN IMPACTED W INST UNI,329.0,138.18,60.27,322.42,37
CPT,69436,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia",,,1585.19,5367.0,8
CPT,69710,IMPLANTATION OR REPLACEMENT OF ELECTROMAGNETIC BONE CONDUCTION HEARING DEVICE IN TEMPORAL BONE,,,17965.0,17965.0,1
CPT,69729,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, SKULL; WITH MAGNETIC TRANSCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR, OUTSIDE OF THE MASTOID AND RESULTING IN REMOVAL OF GREATER THAN OR EQUAL TO 100 SQ M",,,13116.76,25370.0,8
CPT,70030,XR EYE FOREIGN BODY LT,254.0,106.68,68.58,248.92,30
CPT,70030,XR EYE FOREIGN BODY RT,254.0,106.68,68.58,248.92,30
CPT,70100,XR MANDIBLE PARTIAL 1-3 VW,179.0,75.18,48.33,175.42,37
CPT,70110,XR MANDIBLE CMP 4+ VW,254.0,106.68,68.58,248.92,37
CPT,70130,XR MASTOIDS CMP 3+ VW PER SIDE LT,238.0,99.96,64.26,233.24,30
CPT,70130,XR MASTOIDS CMP 3+ VW PER SIDE RT,238.0,99.96,64.26,233.24,30
CPT,70140,XR BONES FACIAL 0-2 VW,179.0,75.18,48.33,175.42,37
CPT,70150,XR BONES FACIAL CMP 3+ VW,216.0,90.72,58.32,211.68,37
CPT,70160,XR BONES NASAL CMP 3+ VW,254.0,106.68,68.58,248.92,37
CPT,70190,XR FORAMINA OPTIC LT,134.0,56.28,36.18,131.32,30
CPT,70190,XR FORAMINA OPTIC RT,134.0,56.28,36.18,131.32,30
CPT,70200,XR ORBITS CMP 4+ VW,254.0,106.68,68.58,248.92,37
CPT,70210,XR SINUSES PARANASAL 0-2 VW,179.0,75.18,48.33,175.42,37
CPT,70220,XR SINUSES PARANASAL CMP 3+ VW,216.0,90.72,58.32,211.68,37
CPT,70240,XR TURCICA SELLA,134.0,56.28,36.18,131.32,37
CPT,70250,XR SKULL 0-3 VW,188.0,78.96,50.76,184.24,37
CPT,70260,XR SKULL CMP 4+ VW,265.0,111.3,71.55,259.7,37
CPT,70328,XR TMJ MOUTH OPEN&CLOSE LT,134.0,56.28,36.18,131.32,30
CPT,70328,XR TMJ MOUTH OPEN&CLOSE RT,134.0,56.28,36.18,131.32,30
CPT,70330,XR TMJ MOUTH OPEN&CLOSE BI,301.0,126.42,81.27,294.98,37
CPT,70332,ARTHRO TMJ LT S&I,366.0,153.72,98.82,358.68,30
CPT,70332,ARTHRO TMJ RT S&I,366.0,153.72,98.82,358.68,30
CPT,70336,MRI JOINT TEMPOROMANDIBULAR BI,2691.0,1130.22,243.77,2637.18,37
CPT,70336,MRI JOINT TEMPOROMANDIBULAR LT,1794.0,753.48,484.38,1758.12,30
CPT,70336,MRI JOINT TEMPOROMANDIBULAR RT,1794.0,753.48,484.38,1758.12,30
CPT,70355,ORTHOPANTOGRAM,172.0,72.24,46.44,168.56,37
CPT,70360,XR TISSUE SOFT NECK,254.0,106.68,68.58,248.92,37
CPT,70371,EVAL SPEECH COMPLEX CINE/VIDEO,366.0,153.72,98.82,358.68,37
CPT,70450,CT HEAD WO CNT,1546.0,649.32,106.81,1515.08,37
CPT,70460,CT HEAD W CNT,1933.0,811.86,179.2,1894.34,37
CPT,70470,CT HEAD W&WO CNT,2319.0,973.98,179.2,2272.62,37
CPT,70471,CTA HEAD&NECK W&WO CNT&PP,4877.0,2048.34,356.43,4779.46,37
CPT,70472,CT PERFUSION CEREBRAL W CNT ADD-ON,1289.0,541.38,348.03,1263.22,30
CPT,70473,CT PERFUSION CEREBRAL W CNT,1991.0,836.22,179.2,1951.18,37
CPT,70480,CT ORB/PF/SEL/IAC WO CNT,1933.0,811.86,106.81,1894.34,37
CPT,70481,CT ORB/PF/SEL/IAC W CNT,2417.0,1015.14,179.2,2368.66,37
CPT,70482,CT ORB/PF/SEL/IAC W&WO CNT,2900.0,1218.0,179.2,2842.0,37
CPT,70486,CT MAXFACIAL WO CNT,1933.0,811.86,106.81,1894.34,37
CPT,70487,CT MAXFACIAL W CNT,2417.0,1015.14,179.2,2368.66,37
CPT,70488,CT MAXFACIAL W&WO CNT,2900.0,1218.0,179.2,2842.0,37
CPT,70490,CT NECK ST WO CNT,1550.0,651.0,106.81,1519.0,37
CPT,70491,CT NECK ST W CNT,1938.0,813.96,179.2,1899.24,37
CPT,70492,CT NECK ST W&WO CNT,2325.0,976.5,179.2,2278.5,37
CPT,70496,CTA HEAD W CNT&PP,2435.0,1022.7,179.2,2386.3,37
CPT,70498,CTA NECK W CNT&PP,2442.0,1025.64,179.2,2393.16,37
CPT,70540,MRI ORBIT FACE&/NECK WO CNT,1627.0,683.34,243.77,1594.46,37
CPT,70542,MRI ORBIT FACE&/NECK W CNT,2034.0,854.28,356.43,1993.32,37
CPT,70543,MRI ORBIT FACE&/NECK W&WO CNT,2441.0,1025.22,356.43,2392.18,37
CPT,70544,MRA HEAD WO CNT,1364.0,572.88,243.77,1336.72,37
CPT,70545,MRA HEAD W CNT,1705.0,716.1,356.43,1670.9,37
CPT,70546,MRA HEAD W&WO CNT,2046.0,859.32,356.43,2005.08,37
CPT,70547,MRA NECK WO CNT,1481.0,622.02,243.77,1451.38,37
CPT,70548,MRA NECK W CNT,1852.0,777.84,356.43,1814.96,37
CPT,70549,MRA NECK W&WO CNT,2222.0,933.24,356.43,2177.56,37
CPT,70551,MRI BRAIN WO CNT,2383.0,1000.86,243.77,2335.34,37
CPT,70552,MRI BRAIN W CNT,2979.0,1251.18,356.43,2919.42,37
CPT,70553,MRI BRAIN W&WO CNT,3575.0,1501.5,356.43,3503.5,37
CPT,71045,XR CHEST 1 VW,254.0,106.68,68.58,248.92,37
CPT,71046,XR CHEST 2 VW,322.0,135.24,86.94,315.56,37
CPT,71047,XR CHEST 3 VW,397.0,166.74,88.91,389.06,37
CPT,71048,XR CHEST 4+ VW,426.0,178.92,106.81,417.48,37
CPT,71100,XR RIBS 2 VW LT,183.0,76.86,49.41,179.34,30
CPT,71100,XR RIBS 2 VW RT,183.0,76.86,49.41,179.34,30
CPT,71101,XR RIBS W CXR 3+ VW,264.0,110.88,71.28,258.72,37
CPT,71110,XR RIBS 3+ VW BI,276.0,115.92,74.52,270.48,37
CPT,71111,XR RIBS W CXR 4+ VW BI,339.0,142.38,91.53,332.22,37
CPT,71120,XR STERNUM 2+ VW,188.0,78.96,50.76,184.24,37
CPT,71130,XR JT/S STERNOCLAVICULAR 3+ VW,215.0,90.3,58.05,210.7,37
CPT,71250,CT CHEST DX WO CNT,1158.0,486.36,106.81,1134.84,37
CPT,71260,CT CHEST DX W CNT,1448.0,608.16,179.2,1419.04,37
CPT,71270,CT CHEST DX W&WO CNT,1737.0,729.54,179.2,1702.26,37
CPT,71275,CTA CHEST W CNT&PP,1824.0,766.08,179.2,1787.52,37
CPT,71550,MRI CHEST WO CNT,2007.0,842.94,243.77,1966.86,37
CPT,71551,MRI CHEST W CNT,2509.0,1053.78,677.43,2458.82,37
CPT,71552,MRI CHEST W&WO CNT,3011.0,1264.62,356.43,2950.78,37
CPT,71555,MRA CHEST W CNT,2635.0,1106.7,711.45,2582.3,30
CPT,71555,MRA CHEST W/WO CNT,3162.0,1328.04,853.74,3098.76,30
CPT,71555,MRA CHEST WO CNT,2108.0,885.36,569.16,2065.84,30
CPT,72020,XR SPINE 1 VW,161.0,67.62,43.47,157.78,74
CPT,72040,XR SPINE CERVICAL 2-3 VW,254.0,106.68,68.58,248.92,37
CPT,72050,XR SPINE CERVICAL 4-5 VW,349.0,146.58,94.23,342.02,37
CPT,72052,XR SPINE CERVICAL 6+ VW,402.0,168.84,106.81,393.96,37
CPT,72070,XR SPINE THORACIC 2 VW,254.0,106.68,68.58,248.92,37
CPT,72072,XR SPINE THORACIC 3 VW,270.0,113.4,72.9,264.6,37
CPT,72074,XR SPINE THORACIC 4+ VW,297.0,124.74,80.19,291.06,37
CPT,72080,XR SPINE THORACOLUMBAR => 2 VW,214.0,89.88,57.78,209.72,37
CPT,72081,XR SPINE ENTIRE THOR&LUMB 1 VW,155.0,65.1,41.85,151.9,37
CPT,72082,XR SPINE ENTIRE THOR&LUMB 2-3 VW,303.0,127.26,81.81,296.94,37
CPT,72083,XR SPINE ENTIRE THOR&LUMB 4-5 VW,341.0,143.22,92.07,334.18,37
CPT,72084,XR SPINE ENTIRE THOR&LUMB 6+ VW,342.0,143.64,92.34,335.16,37
CPT,72100,XR SPINE LS 2-3 VW,254.0,106.68,68.58,248.92,37
CPT,72110,XR SPINE LS 4+ VW,357.0,149.94,96.39,349.86,37
CPT,72114,XR SPINE LS CMP W BEND 6+ VW,410.0,172.2,106.81,401.8,37
CPT,72120,XR SPINE LS BEND 2-3 VW,166.0,69.72,44.82,162.68,37
CPT,72125,CT SPINE CERVICAL WO CNT,1933.0,811.86,106.81,1894.34,37
CPT,72126,CT SPINE CERVICAL W CNT,2417.0,1015.14,356.43,2368.66,37
CPT,72127,CT SPINE CERVICAL W&WO CNT,2900.0,1218.0,179.2,2842.0,37
CPT,72128,CT SPINE THORACIC WO CNT,1927.0,809.34,106.81,1888.46,37
CPT,72129,CT SPINE THORACIC W CNT,2409.0,1011.78,179.2,2360.82,37
CPT,72130,CT SPINE THORACIC W&WO CNT,2891.0,1214.22,179.2,2833.18,37
CPT,72131,CT SPINE LUMBAR WO CNT,1912.0,803.04,106.81,1873.76,37
CPT,72132,CT SPINE LUMBAR W CNT,2390.0,1003.8,356.43,2342.2,37
CPT,72133,CT SPINE LUMBAR W&WO CNT,2868.0,1204.56,179.2,2810.64,37
CPT,72141,MRI SPINE CERVICAL WO CNT,1901.0,798.42,243.77,1862.98,37
CPT,72142,MRI SPINE CERVICAL W CNT,2377.0,998.34,356.43,2329.46,37
CPT,72146,MRI SPINE THORACIC WO CNT,1896.0,796.32,243.77,1858.08,37
CPT,72147,MRI SPINE THORACIC W CNT,2370.0,995.4,356.43,2322.6,37
CPT,72148,MRI SPINE LUMBAR WO CNT,1906.0,800.52,243.77,1867.88,37
CPT,72149,MRI SPINE LUMBAR W CNT,2383.0,1000.86,356.43,2335.34,37
CPT,72156,MRI SPINE CERVICAL W&WO CNT,2852.0,1197.84,356.43,2794.96,37
CPT,72157,MRI SPINE THORACIC W&WO CNT,2844.0,1194.48,356.43,2787.12,37
CPT,72158,MRI SPINE LUMBAR W&WO CNT,2859.0,1200.78,356.43,2801.82,37
CPT,72159,MRA SPINE W CNT,2496.0,1048.32,673.92,2446.08,30
CPT,72159,MRA SPINE W/WO CNT,2995.0,1257.9,808.65,2935.1,30
CPT,72159,MRA SPINE WO CNT,1997.0,838.74,539.19,1957.06,30
CPT,72170,XR PELVIS 1-2 VW,254.0,106.68,68.58,248.92,37
CPT,72190,XR PELVIS CMP 3+ VW,304.0,127.68,82.08,297.92,37
CPT,72191,CTA PELVIS W CNT&PP,1808.0,759.36,179.2,1771.84,37
CPT,72192,CT PELVIS WO CNT,1147.0,481.74,106.81,1124.06,37
CPT,72193,CT PELVIS W CNT,1434.0,602.28,179.2,1405.32,37
CPT,72194,CT PELVIS W&WO CNT,1721.0,722.82,179.2,1686.58,37
CPT,72195,MRI PELVIS WO CNT,1893.0,795.06,243.77,1855.14,37
CPT,72195,MRI PELVIS WO CNT RDC,1893.0,795.06,511.11,1855.14,30
CPT,72196,MRI PELVIS W CNT,2367.0,994.14,356.43,2319.66,37
CPT,72197,MRI PELVIS W&WO CNT,2840.0,1192.8,356.43,2783.2,37
CPT,72198,MRA PELVIS W CNT,2486.0,1044.12,671.22,2436.28,30
CPT,72198,MRA PELVIS W/WO CNT,2982.0,1252.44,805.14,2922.36,30
CPT,72198,MRA PELVIS WO CNT,1988.0,834.96,536.76,1948.24,30
CPT,72200,XR JTS SACROILIAC 1-2 VW,161.0,67.62,43.47,157.78,37
CPT,72202,XR JTS SACROILIAC 3+ VW,215.0,90.3,58.05,210.7,37
CPT,72220,XR SACRUM&COCCYX 2+ VW,254.0,106.68,68.58,248.92,37
CPT,72240,MYELOGRAPHY CERVICAL S&I,1651.0,693.42,445.77,1617.98,37
CPT,72255,MYELOGRAPHY THORACIC S&I,2059.0,864.78,555.93,2017.82,37
CPT,72265,MYELOGRAPHY LUMBOSACRAL S&I,1961.0,823.62,529.47,1921.78,37
CPT,72270,MYELOGRAPHY 2+ REGIONS S&I,1993.0,837.06,538.11,1953.14,37
CPT,72285,DISCOGRAM CERVICAL/THORACIC S&I,5582.0,2344.44,1507.14,5470.36,74
CPT,72295,DISCOGRAM LUMBAR S&I,3200.0,1344.0,864.0,3136.0,74
CPT,73000,XR CLAVICLE CMP LT,254.0,106.68,68.58,248.92,30
CPT,73000,XR CLAVICLE CMP RT,254.0,106.68,68.58,248.92,30
CPT,73010,XR SCAPULA CMP LT,203.0,85.26,54.81,198.94,30
CPT,73010,XR SCAPULA CMP RT,203.0,85.26,54.81,198.94,30
CPT,73020,XR SHOULDER 1 VW LT,185.0,77.7,49.95,181.3,30
CPT,73020,XR SHOULDER 1 VW RT,185.0,77.7,49.95,181.3,30
CPT,73030,XR SHOULDER CMP 2+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73030,XR SHOULDER CMP 2+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73040,XR ARTHRO SHOULDER LT S&I,1329.0,558.18,358.83,1302.42,30
CPT,73040,XR ARTHRO SHOULDER RT S&I,1329.0,558.18,358.83,1302.42,30
CPT,73050,XR JTS ACROMIOCLAVICULAR BI,179.0,75.18,48.33,175.42,37
CPT,73060,XR HUMERUS 2 VW LT RDC,254.0,106.68,68.58,248.92,30
CPT,73060,XR HUMERUS 2 VW RT RDC,254.0,106.68,68.58,248.92,30
CPT,73060,XR HUMERUS 2+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73060,XR HUMERUS 2+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73070,XR ELBOW 2 VW LT,229.0,96.18,61.83,224.42,30
CPT,73070,XR ELBOW 2 VW LT RDC,229.0,96.18,61.83,224.42,30
CPT,73070,XR ELBOW 2 VW RT,229.0,96.18,61.83,224.42,30
CPT,73070,XR ELBOW 2 VW RT RDC,229.0,96.18,61.83,224.42,30
CPT,73080,XR ELBOW CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73080,XR ELBOW CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73085,XR ARTHRO ELBOW LT S&I,549.0,230.58,148.23,538.02,30
CPT,73085,XR ARTHRO ELBOW RT S&I,549.0,230.58,148.23,538.02,30
CPT,73090,XR FOREARM 2 VW LT,229.0,96.18,61.83,224.42,30
CPT,73090,XR FOREARM 2 VW LT RDC,229.0,96.18,61.83,224.42,30
CPT,73090,XR FOREARM 2 VW RT,229.0,96.18,61.83,224.42,30
CPT,73090,XR FOREARM 2 VW RT RDC,229.0,96.18,61.83,224.42,30
CPT,73092,XR EXT UPPER INFANT 2+ VW LT,247.0,103.74,66.69,242.06,30
CPT,73092,XR EXT UPPER INFANT 2+ VW RT,247.0,103.74,66.69,242.06,30
CPT,73100,XR WRIST 2 VW LT,222.0,93.24,59.94,217.56,30
CPT,73100,XR WRIST 2 VW LT RDC,222.0,93.24,59.94,217.56,30
CPT,73100,XR WRIST 2 VW RT,222.0,93.24,59.94,217.56,30
CPT,73100,XR WRIST 2 VW RT RDC,222.0,93.24,59.94,217.56,30
CPT,73110,XR WRIST CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73110,XR WRIST CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73115,XR ARTHRO WRIST LT S&I,761.0,319.62,205.47,745.78,30
CPT,73115,XR ARTHRO WRIST RT S&I,761.0,319.62,205.47,745.78,30
CPT,73120,XR HAND 2 VW LT,222.0,93.24,59.94,217.56,30
CPT,73120,XR HAND 2 VW LT RDC,222.0,93.24,59.94,217.56,30
CPT,73120,XR HAND 2 VW RT,222.0,93.24,59.94,217.56,30
CPT,73120,XR HAND 2 VW RT RDC,222.0,93.24,59.94,217.56,30
CPT,73130,XR HAND 3+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73130,XR HAND 3+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73140,XR FINGER/S 2+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73140,XR FINGER/S 2+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73200,CT EXT UPPER WO CNT LT,1099.0,461.58,296.73,1077.02,30
CPT,73200,CT EXT UPPER WO CNT RT,1099.0,461.58,296.73,1077.02,30
CPT,73201,CT EXT UPPER W CNT LT,1374.0,577.08,370.98,1346.52,30
CPT,73201,CT EXT UPPER W CNT RT,1374.0,577.08,370.98,1346.52,30
CPT,73202,CT EXT UPPER W&WO CNT LT,1649.0,692.58,445.23,1616.02,30
CPT,73202,CT EXT UPPER W&WO CNT RT,1649.0,692.58,445.23,1616.02,30
CPT,73206,CTA EXT UPPER W CNT&PP LT,1732.0,727.44,467.64,1697.36,30
CPT,73206,CTA EXT UPPER W CNT&PP RT,1732.0,727.44,467.64,1697.36,30
CPT,73218,MRI EXT UPPER NONJT WO CNT LT,1470.0,617.4,396.9,1440.6,30
CPT,73218,MRI EXT UPPER NONJT WO CNT RT,1470.0,617.4,396.9,1440.6,30
CPT,73219,MRI EXT UPPER NONJT W CNT LT,1838.0,771.96,496.26,1801.24,30
CPT,73219,MRI EXT UPPER NONJT W CNT RT,1838.0,771.96,496.26,1801.24,30
CPT,73220,MRI EXT UPPER NONJT W&WO CNT LT,2205.0,926.1,595.35,2160.9,30
CPT,73220,MRI EXT UPPER NONJT W&WO CNT RT,2205.0,926.1,595.35,2160.9,30
CPT,73221,MRI EXT UPPER JT WO CNT LT,1906.0,800.52,514.62,1867.88,30
CPT,73221,MRI EXT UPPER JT WO CNT RT,1906.0,800.52,514.62,1867.88,30
CPT,73222,MRI EXT UPPER JT W CNT LT,2383.0,1000.86,643.41,2335.34,30
CPT,73222,MRI EXT UPPER JT W CNT RT,2383.0,1000.86,643.41,2335.34,30
CPT,73223,MRI EXT UPPER JT W&WO CNT LT,2859.0,1200.78,771.93,2801.82,30
CPT,73223,MRI EXT UPPER JT W&WO CNT RT,2859.0,1200.78,771.93,2801.82,30
CPT,73225,MRA EXT UPPER W CNT LT,2503.0,1051.26,675.81,2452.94,30
CPT,73225,MRA EXT UPPER W CNT RT,2503.0,1051.26,675.81,2452.94,30
CPT,73225,MRA EXT UPPER W/WO CNT LT,3002.0,1260.84,810.54,2941.96,30
CPT,73225,MRA EXT UPPER W/WO CNT RT,3002.0,1260.84,810.54,2941.96,30
CPT,73225,MRA EXT UPPER WO CNT LT,2002.0,840.84,540.54,1961.96,30
CPT,73225,MRA EXT UPPER WO CNT RT,2002.0,840.84,540.54,1961.96,30
CPT,73501,XR HIP W PELVIS 1 VW LT,201.0,84.42,54.27,196.98,30
CPT,73501,XR HIP W PELVIS 1 VW RT,201.0,84.42,54.27,196.98,30
CPT,73502,XR HIP W PELVIS 2-3 VW LT,358.0,150.36,96.66,350.84,30
CPT,73502,XR HIP W PELVIS 2-3 VW RT,358.0,150.36,96.66,350.84,30
CPT,73503,XR HIP W PELVIS 4+ VW LT,535.0,224.7,144.45,524.3,30
CPT,73503,XR HIP W PELVIS 4+ VW RT,535.0,224.7,144.45,524.3,30
CPT,73521,XR HIPS W PELVIS 2 VW BI,269.0,112.98,72.63,263.62,37
CPT,73522,XR HIPS W PELVIS 3-4 VW BI,359.0,150.78,96.93,351.82,37
CPT,73523,XR HIPS W PELVIS 5+ VW BI,431.0,181.02,106.81,422.38,37
CPT,73525,XR ARTHRO HIP LT S&I,742.0,311.64,200.34,727.16,60
CPT,73525,XR ARTHRO HIP RT S&I,742.0,311.64,200.34,727.16,60
CPT,73551,XR FEMUR 1 VW LT,194.0,81.48,52.38,190.12,30
CPT,73551,XR FEMUR 1 VW RT,194.0,81.48,52.38,190.12,30
CPT,73552,XR FEMUR 2+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73552,XR FEMUR 2+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73560,XR KNEE 1-2 VW LT,179.0,75.18,48.33,175.42,30
CPT,73560,XR KNEE 1-2 VW RT,179.0,75.18,48.33,175.42,30
CPT,73562,XR KNEE 3 VW LT,254.0,106.68,68.58,248.92,30
CPT,73562,XR KNEE 3 VW RT,254.0,106.68,68.58,248.92,30
CPT,73564,XR KNEE CMP 4+ VW LT,281.0,118.02,75.87,275.38,30
CPT,73564,XR KNEE CMP 4+ VW RT,281.0,118.02,75.87,275.38,30
CPT,73565,XR KNEES STANDING AP BI,241.0,101.22,65.07,236.18,37
CPT,73580,XR ARTHRO KNEE LT S&I,549.0,230.58,148.23,538.02,30
CPT,73580,XR ARTHRO KNEE RT S&I,549.0,230.58,148.23,538.02,30
CPT,73590,XR TIBIA&FIBULA 2 VW LT,254.0,106.68,68.58,248.92,30
CPT,73590,XR TIBIA&FIBULA 2 VW LT RDC,254.0,106.68,68.58,248.92,30
CPT,73590,XR TIBIA&FIBULA 2 VW RT,254.0,106.68,68.58,248.92,30
CPT,73590,XR TIBIA&FIBULA 2 VW RT RDC,254.0,106.68,68.58,248.92,30
CPT,73592,XR EXT LOWER INFANT 2+ VW LT,139.0,58.38,37.53,136.22,30
CPT,73592,XR EXT LOWER INFANT 2+ VW RT,139.0,58.38,37.53,136.22,30
CPT,73600,XR ANKLE 2 VW LT,237.0,99.54,63.99,232.26,30
CPT,73600,XR ANKLE 2 VW LT RDC,237.0,99.54,63.99,232.26,30
CPT,73600,XR ANKLE 2 VW RT,237.0,99.54,63.99,232.26,30
CPT,73600,XR ANKLE 2 VW RT RDC,237.0,99.54,63.99,232.26,30
CPT,73610,XR ANKLE CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73610,XR ANKLE CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73615,XR ARTHRO ANKLE LT S&I,671.0,281.82,181.17,657.58,30
CPT,73615,XR ARTHRO ANKLE RT S&I,671.0,281.82,181.17,657.58,30
CPT,73620,XR FOOT 2 VW LT,219.0,91.98,59.13,214.62,30
CPT,73620,XR FOOT 2 VW LT RDC,219.0,91.98,59.13,214.62,30
CPT,73620,XR FOOT 2 VW RT,219.0,91.98,59.13,214.62,30
CPT,73620,XR FOOT 2 VW RT RDC,219.0,91.98,59.13,214.62,30
CPT,73630,XR FOOT CMP 3+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73630,XR FOOT CMP 3+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73650,XR CALCANEUS 2+ VW LT,233.0,97.86,62.91,228.34,30
CPT,73650,XR CALCANEUS 2+ VW RT,233.0,97.86,62.91,228.34,30
CPT,73660,XR TOE/S 2+ VW LT,254.0,106.68,68.58,248.92,30
CPT,73660,XR TOE/S 2+ VW RT,254.0,106.68,68.58,248.92,30
CPT,73700,CT EXT LOWER WO CNT LT,1933.0,811.86,521.91,1894.34,30
CPT,73700,CT EXT LOWER WO CNT RT,1933.0,811.86,521.91,1894.34,30
CPT,73701,CT EXT LOWER W CNT LT,2417.0,1015.14,652.59,2368.66,30
CPT,73701,CT EXT LOWER W CNT RT,2417.0,1015.14,652.59,2368.66,30
CPT,73702,CT EXT LOWER W&WO CNT LT,2900.0,1218.0,783.0,2842.0,30
CPT,73702,CT EXT LOWER W&WO CNT RT,2900.0,1218.0,783.0,2842.0,30
CPT,73706,CTA EXT LOWER W CNT&PP LT,3045.0,1278.9,822.15,2984.1,30
CPT,73706,CTA EXT LOWER W CNT&PP RT,3045.0,1278.9,822.15,2984.1,30
CPT,73718,MRI EXT LOWER NONJT WO CNT LT,1906.0,800.52,514.62,1867.88,30
CPT,73718,MRI EXT LOWER NONJT WO CNT RT,1906.0,800.52,514.62,1867.88,30
CPT,73719,MRI EXT LOWER NONJT W CNT LT,2383.0,1000.86,643.41,2335.34,30
CPT,73719,MRI EXT LOWER NONJT W CNT RT,2383.0,1000.86,643.41,2335.34,30
CPT,73720,MRI EXT LOWER NONJT W&WO CNT LT,2859.0,1200.78,771.93,2801.82,30
CPT,73720,MRI EXT LOWER NONJT W&WO CNT RT,2859.0,1200.78,771.93,2801.82,30
CPT,73721,MRI EXT LOWER JT WO CNT LT,1906.0,800.52,514.62,1867.88,30
CPT,73721,MRI EXT LOWER JT WO CNT RT,1906.0,800.52,514.62,1867.88,30
CPT,73722,MRI EXT LOWER JT W CNT LT,2383.0,1000.86,643.41,2335.34,30
CPT,73722,MRI EXT LOWER JT W CNT RT,2383.0,1000.86,643.41,2335.34,30
CPT,73723,MRI EXT LOWER JT W&WO CNT LT,2859.0,1200.78,771.93,2801.82,30
CPT,73723,MRI EXT LOWER JT W&WO CNT RT,2859.0,1200.78,771.93,2801.82,30
CPT,73725,MRA EXT LOWER W CNT LT,2503.0,1051.26,675.81,2452.94,30
CPT,73725,MRA EXT LOWER W CNT RT,2503.0,1051.26,675.81,2452.94,30
CPT,73725,MRA EXT LOWER W/WO CNT LT,3002.0,1260.84,810.54,2941.96,30
CPT,73725,MRA EXT LOWER W/WO CNT RT,3002.0,1260.84,810.54,2941.96,30
CPT,73725,MRA EXT LOWER WO CNT LT,2002.0,840.84,540.54,1961.96,30
CPT,73725,MRA EXT LOWER WO CNT RT,2002.0,840.84,540.54,1961.96,30
CPT,74018,XR ABDOMEN 1 VW,231.0,97.02,62.37,226.38,37
CPT,74019,XR ABDOMEN 2 VW,276.0,115.92,74.52,270.48,37
CPT,74021,XR ABDOMEN 3+ VW,322.0,135.24,86.94,315.56,37
CPT,74022,XR ABDOMEN CMP 2+VW W CHEST 1 VW,420.0,176.4,106.81,411.6,37
CPT,74150,CT ABDOMEN WO CNT,1167.0,490.14,106.81,1143.66,37
CPT,74160,CT ABDOMEN W CNT,1459.0,612.78,179.2,1429.82,37
CPT,74170,CT ABDOMEN W&WO CNT,1751.0,735.42,179.2,1715.98,37
CPT,74174,CTA ABDOMEN&PELVIS W CNT&PP,3988.0,1674.96,356.43,3908.24,37
CPT,74175,CTA ABDOMEN W CNT&PP,1839.0,772.38,179.2,1802.22,37
CPT,74176,CT ABDOMEN&PELVIS WO CNT,2532.0,1063.44,243.77,2481.36,37
CPT,74177,CT ABDOMEN&PELVIS W CNT,3165.0,1329.3,356.43,3101.7,37
CPT,74177,CT ABDOMEN&PELVIS W CNT RDC,3165.0,1329.3,854.55,3101.7,30
CPT,74178,CT ABDOMEN&PELVIS W&WO CNT,3798.0,1595.16,356.43,3722.04,37
CPT,74181,MRCP WO CNT,1871.0,785.82,243.77,1833.58,37
CPT,74181,MRI ABDOMEN WO CNT,1871.0,785.82,243.77,1833.58,37
CPT,74182,MRCP W CNT,2339.0,982.38,356.43,2292.22,37
CPT,74182,MRI ABDOMEN W CNT,2339.0,982.38,356.43,2292.22,37
CPT,74183,MRCP W&WO CNT,2807.0,1178.94,356.43,2750.86,37
CPT,74183,MRI ABDOMEN W&WO CNT,2807.0,1178.94,356.43,2750.86,37
CPT,74185,MRA ABDOMEN W CNT,2456.0,1031.52,663.12,2406.88,30
CPT,74185,MRA ABDOMEN W/WO CNT,2948.0,1238.16,795.96,2889.04,30
CPT,74185,MRA ABDOMEN WO CNT,1965.0,825.3,530.55,1925.7,30
CPT,74190,PERITONEOGRAM S&I,838.0,351.96,226.26,821.24,37
CPT,74220,XR ESOPHAGUS STUDY CNT SINGLE,461.0,193.62,124.47,451.78,37
CPT,74221,XR ESOPHAGUS STUDY CNT DOUBLE,485.0,203.7,130.95,475.3,37
CPT,74230,FNCT SWALLOW W CINE/VIDEO STUDY CNT,584.0,245.28,157.68,572.32,37
CPT,74240,XR UGI STUDY CNT SINGLE,478.0,200.76,129.06,468.44,37
CPT,74246,XR UGI STUDY CNT DOUBLE,645.0,270.9,174.15,632.1,37
CPT,74248,XR INTESTINE SM STUDY FOLLOW THRU,216.0,90.72,58.32,211.68,30
CPT,74250,XR INTESTINE SM STUDY CNT SINGLE,432.0,181.44,116.64,423.36,37
CPT,74251,XR INTESTINE SM STUDY CNT DOUBLE,983.0,412.86,179.2,963.34,37
CPT,74261,CT COLONOGRAPHY DX WO CNT,1025.0,430.5,106.81,1004.5,37
CPT,74262,CT COLONOGRAPHY DX W CNT,1282.0,538.44,179.2,1256.36,37
CPT,74263,CT SCREEN COLONOGRAPHY,1715.0,720.3,243.77,1680.7,37
CPT,74270,XR COLON STUDY CNT SINGLE,584.0,245.28,157.68,572.32,37
CPT,74280,XR COLON STUDY CNT DOUBLE,607.0,254.94,163.89,594.86,37
CPT,74283,ENEMA THERAPEUTIC,446.0,187.32,120.42,437.08,37
CPT,74300,CHOLANGIO&/PANCREATOGRAM OR S&I,843.0,354.06,227.61,826.14,30
CPT,74301,CHOLANGIO&/PANCREATOGRAM OR ADD S&I,344.0,144.48,92.88,337.12,30
CPT,74328,CATH ENDO DUCT BILIARY S&I,1112.0,467.04,300.24,1089.76,60
CPT,74329,CATH ENDO DUCT PANCREAS S&I,984.0,413.28,265.68,964.32,30
CPT,74330,CATH ENDO DUCT BILIARY&PANCREAS S&I,1743.0,732.06,470.61,1708.14,60
CPT,74340,INTRO TUBE GI LONG W FLUORO S&I,677.0,284.34,182.79,663.46,60
CPT,74355,PLC TUBE ENTEROCLYSIS PERC S&I,564.0,236.88,152.28,552.72,30
CPT,74360,DIL STRICT&/OBSTRUCT INTRALUM S&I,777.0,326.34,209.79,761.46,60
CPT,74363,DIL STRICT DUCT BILI TRANSHEP S&I,962.0,404.04,259.74,942.76,30
CPT,74400,UROGRAPHY IV W/WO KUB,915.0,384.3,179.2,896.7,37
CPT,74410,UROGRAPHY INF&/BOLUS,1107.0,464.94,179.2,1084.86,37
CPT,74415,UROGRAPHY INF&/BOLUS W NEPHRO,1292.0,542.64,179.2,1266.16,37
CPT,74420,UROGRAPHY RETROGRADE W/WO KUB,680.0,285.6,183.6,666.4,74
CPT,74425,UROGRAPHY ANTEGRADE S&I,686.0,288.12,185.22,672.28,37
CPT,74430,CYSTOGRAM 3+ VW S&I,710.0,298.2,191.7,695.8,74
CPT,74450,URETHROCYSTOGRAM RETROGRADE S&I,491.0,206.22,132.57,481.18,74
CPT,74455,URETHROCYSTOGRAM VOIDING S&I,515.0,216.3,139.05,504.7,37
CPT,74485,DIL URETER(S)/URETHRA S&I,2071.0,869.82,559.17,3096.71,37
CPT,74740,HYSTEROSALPINGOGRAM S&I,750.0,315.0,202.5,735.0,74
CPT,75557,MRI CARD MOR&FUNC WO CNT,1307.0,548.94,243.77,1280.86,37
CPT,75561,MRI CARD MOR&FUNC W&WO CNT,1961.0,823.62,356.43,1921.78,37
CPT,75565,MRI CARDIAC VELOCITY FLW MAP ADD-ON,889.0,373.38,240.03,871.22,30
CPT,75571,CT EVAL QN CALCIUM HRT WO CNT,174.0,73.08,46.98,170.52,37
CPT,75572,CT EVAL STRUC&MORPH HRT W CNT,1237.0,519.54,333.99,1212.26,37
CPT,75573,CT EVAL STRUC&MORPH CONG HRT W CNT,1187.0,498.54,320.49,1163.26,37
CPT,75574,CTA ART&GRAFTS HEART W CNT,1247.0,523.74,336.69,1222.06,37
CPT,75600,AORTO THORACIC WO SERIAL S&I,7092.0,2978.64,1914.84,6950.16,37
CPT,75605,AORTO THORACIC SERIAL S&I,7097.0,2980.74,1916.19,8243.26,74
CPT,75625,AORTO ABD SERIAL S&I,6178.0,2594.76,1668.06,6054.44,74
CPT,75630,AORTO ABD ILIOFEM BI SERIAL S&I,7198.0,3023.16,1943.46,7054.04,74
CPT,75635,CTA AORTA ABD RUNOFF W CNT,2042.0,857.64,179.2,2001.16,37
CPT,75705,ANGIO SPINAL SEL S&I,7097.0,2980.74,1916.19,8243.26,37
CPT,75710,ANGIO EXTREMITY LT S&I,6382.0,2680.44,1723.14,6254.36,60
CPT,75710,ANGIO EXTREMITY RT S&I,6382.0,2680.44,1723.14,6254.36,60
CPT,75716,ANGIO EXTREMITY BI S&I,6723.0,2823.66,1815.21,6588.54,74
CPT,75726,ANGIO VISCERAL SEL S&I,9235.0,3878.7,2493.45,9050.3,74
CPT,75731,ANGIO ADRENAL SEL LT S&I,4040.0,1696.8,1090.8,3959.2,30
CPT,75731,ANGIO ADRENAL SEL RT S&I,4040.0,1696.8,1090.8,3959.2,30
CPT,75733,ANGIO ADRENAL SEL BI S&I,5700.0,2394.0,1539.0,5586.0,37
CPT,75736,ANGIO PELVIC S&I,7097.0,2980.74,1916.19,8243.26,74
CPT,75741,ANGIO PULMONARY SEL LT S&I,5213.0,2189.46,1407.51,5108.74,60
CPT,75741,ANGIO PULMONARY SEL RT S&I,5213.0,2189.46,1407.51,5108.74,60
CPT,75743,ANGIO PULMONARY SEL BI S&I,10489.0,4405.38,2832.03,10279.22,74
CPT,75746,ANGIO PULMONARY NONSEL S&I,5272.0,2214.24,1423.44,5166.56,37
CPT,75756,ANGIO MAMMARY INTERNAL S&I,4040.0,1696.8,1090.8,4677.51,74
CPT,75774,ANGIO SEL VESSEL ADDL S&I,3737.0,1569.54,1008.99,3662.26,60
CPT,75801,LYMPHANGIOGRAPHY EXT LT S&I,1680.0,705.6,453.6,1646.4,30
CPT,75801,LYMPHANGIOGRAPHY EXT RT S&I,1680.0,705.6,453.6,1646.4,30
CPT,75803,LYMPHANGIOGRAPHY EXT BIL S&I,3553.0,1492.26,959.31,3481.94,37
CPT,75805,LYMPHANGIOGRAPHY PLVC/ABD UNI S&I,3062.0,1286.04,826.74,4677.51,37
CPT,75807,LYMPHANGIOGRAPHY PLVC/ABD BI S&I,4040.0,1696.8,1090.8,4677.51,37
CPT,75809,SHUNTOGRAM NONVASCULAR S&I,442.0,185.64,106.81,433.16,37
CPT,75810,SPLENOPORTOGRAPHY S&I,4040.0,1696.8,1090.8,4677.51,37
CPT,75820,VENOGRAM EXTREMITY LT S&I,2925.0,1228.5,789.75,2866.5,60
CPT,75820,VENOGRAM EXTREMITY RT S&I,2925.0,1228.5,789.75,2866.5,60
CPT,75822,VENOGRAM EXTREMITY BI S&I,3721.0,1562.82,1004.67,3646.58,74
CPT,75825,VENOGRAM IVC SERIAL S&I,4040.0,1696.8,1090.8,4677.51,74
CPT,75827,VENOGRAM SVC SERIAL S&I,2362.0,992.04,637.74,2331.96,74
CPT,75831,VENOGRAM RENAL SEL LT S&I,6971.0,2927.82,1882.17,6831.58,60
CPT,75831,VENOGRAM RENAL SEL RT S&I,6971.0,2927.82,1882.17,6831.58,60
CPT,75833,VENOGRAM RENAL SEL BI S&I,8596.0,3610.32,2320.92,8424.08,37
CPT,75840,VENOGRAM ADRENAL SEL LT S&I,4040.0,1696.8,1090.8,3959.2,30
CPT,75840,VENOGRAM ADRENAL SEL RT S&I,4040.0,1696.8,1090.8,3959.2,30
CPT,75860,VENOGRAM SINUS VEN/JUG S&I,4040.0,1696.8,1090.8,4677.51,37
CPT,75870,VENOGRAM SINUS SAGITTAL SUP S&I,4040.0,1696.8,1090.8,4677.51,37
CPT,75872,VENOGRAM EPIDURAL S&I,5814.0,2441.88,640.89,5697.72,37
CPT,75880,VENOGRAM ORBITAL S&I,5457.0,2291.94,640.89,5347.86,37
CPT,75885,PORTOGRAM W EVAL HEMO S&I,4131.0,1735.02,1115.37,4677.51,37
CPT,75887,PORTOGRAM WO EVAL HEMO S&I,4085.0,1715.7,1102.95,4677.51,37
CPT,75889,VENOGRAM HEPATIC W EVAL HEMO S&I,6981.0,2932.02,1884.87,6841.38,37
CPT,75891,VENOGRAM HEPATIC WO EVAL HEMO S&I,4040.0,1696.8,1090.8,4677.51,37
CPT,75893,SAMPLE VENOUS CATH W/WO ANG S&I,7097.0,2980.74,1916.19,8243.26,74
CPT,75894,THERAPY TRANSCATH EMB S&I,1776.0,745.92,479.52,1740.48,90
CPT,75898,ANGIO SUBSQ THRPY EMB/INF NONTHROMB,2981.0,1252.02,804.87,4677.51,37
CPT,75901,REM OBSTRUCT CVD PERICATHETER S&I,910.0,382.2,245.7,891.8,30
CPT,75902,REM OBSTRUCT CVD INTRALUMINAL S&I,344.0,144.48,92.88,337.12,30
CPT,75970,BX TRANSCATHETER S&I,3304.0,1387.68,892.08,3237.92,60
CPT,75984,CHG CATH DRN/TUBE PERC S&I,631.0,265.02,170.37,618.38,60
CPT,75989,CT GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,30
CPT,75989,GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,60
CPT,75989,US GD W PLC CATH DRN PERC S&I,1199.0,503.58,323.73,1175.02,30
CPT,76000,FLUORO 0-1HR TIME PHYS/QHCP,1055.0,443.1,243.77,1033.9,111
CPT,76010,XR FB NOSE TO RECTUM CHILD 1 VW,179.0,75.18,48.33,175.42,37
CPT,76014,MR ASSESS IMP&/FB CLIN INIT 15MIN,45.0,18.9,12.15,44.1,37
CPT,76015,MR ASSESS IMP&/FB CLIN EA ADD 30MIN,183.0,76.86,49.41,179.34,30
CPT,76016,MR DETERMIN SAFETY PHYS/QHCP,134.0,56.28,36.18,131.32,37
CPT,76017,MR CUST EXAM MED PHYSICS SAFETY PLN,469.0,196.98,126.63,459.62,37
CPT,76018,MR PREP ELECT IMP SAFETY PHYS/QHCP,203.0,85.26,54.81,198.94,37
CPT,76019,MR POS IMP SAFETY&/IMMOB PHYS/QHCP,315.0,132.3,60.27,308.7,37
CPT,76080,XR ABSCESS/SINUS/FISTULA S&I,1112.0,467.04,300.24,1089.76,74
CPT,76098,XR SPECIMEN SURGICAL,540.0,226.8,145.8,809.46,37
CPT,76100,TOMOGRAPHY SGL EXCEPT URO,184.0,77.28,49.68,180.32,37
CPT,76376,CT REND 3D W I&R W PP SAME WRKST,144.0,60.48,38.88,141.12,30
CPT,76377,CT REND 3D W I&R W PP DIFF WRKST,354.0,148.68,95.58,346.92,90
CPT,76380,CT LTD/FOLLOWUP,585.0,245.7,88.91,573.3,74
CPT,76498,MRI BODY WHOLE,2975.0,1249.5,88.91,2915.5,37
CPT,76506,US HEAD NEONATAL,347.0,145.74,93.69,340.06,37
CPT,76536,US TISSUE SOFT HEAD&NECK,545.0,228.9,106.81,534.1,37
CPT,76604,US CHEST,408.0,171.36,106.81,399.84,74
CPT,76641,US BREAST CMP BI,612.0,257.04,165.24,599.76,30
CPT,76641,US BREAST CMP LT,408.0,171.36,110.16,399.84,30
CPT,76641,US BREAST CMP RT,408.0,171.36,110.16,399.84,30
CPT,76642,US BREAST LTD BI,501.0,210.42,135.27,490.98,30
CPT,76642,US BREAST LTD LT,334.0,140.28,90.18,327.32,30
CPT,76642,US BREAST LTD RT,334.0,140.28,90.18,327.32,30
CPT,76700,US ABDOMEN CMP,1213.0,509.46,106.81,1188.74,37
CPT,76705,ED US ABDOMEN LTD,905.0,380.1,106.81,886.9,37
CPT,76705,US ABDOMEN LTD,905.0,380.1,106.81,886.9,74
CPT,76770,US RETROPERITONEAL CMP,670.0,281.4,106.81,656.6,37
CPT,76775,US RETROPERITONEAL LTD,403.0,169.26,106.81,394.94,37
CPT,76776,US KIDNEY TRANSPLANTED W DOPPLER,905.0,380.1,106.81,886.9,37
CPT,76800,US SPINAL CANAL&CONTENTS,510.0,214.2,106.81,499.8,37
CPT,76801,US UTERUS PREG 0-13WK GEST SGL,905.0,380.1,106.81,886.9,37
CPT,76802,US UTERUS PREG 0-13WK GEST ADDL,280.0,117.6,75.6,274.4,30
CPT,76805,US UTERUS PREG 14+WK GEST SGL,1041.0,437.22,106.81,1020.18,37
CPT,76810,US UTERUS PREG 14+WK GEST ADDL,408.0,171.36,110.16,399.84,30
CPT,76811,US UTERUS PREG DETAIL GEST SGL,852.0,357.84,230.04,834.96,37
CPT,76812,US UTERUS PREG DETAIL GEST ADDL,954.0,400.68,257.58,934.92,30
CPT,76815,US UTERUS PREG LTD 1+ FETUS,520.0,218.4,106.81,509.6,74
CPT,76816,US UTERUS PREG RE-EVAL FETUS,418.0,175.56,106.81,409.64,37
CPT,76816,US UTERUS PREG RE-EVAL FETUS ADDL,418.0,175.56,112.86,409.64,30
CPT,76817,US UTERUS PREG TRANSVAGINAL,599.0,251.58,106.81,587.02,37
CPT,76818,US PROFILE BIO FETAL W NST,729.0,306.18,106.81,714.42,37
CPT,76818,US PROFILE BIO FETAL W NST ADDL,729.0,306.18,196.83,714.42,30
CPT,76819,US PROFILE BIO FETAL WO NST,523.0,219.66,106.81,512.54,37
CPT,76819,US PROFILE BIO FETAL WO NST ADDL,523.0,219.66,141.21,512.54,30
CPT,76830,US TRANSVAGINAL,905.0,380.1,106.81,886.9,37
CPT,76830,US TRANSVAGINAL RDC,905.0,380.1,244.35,886.9,30
CPT,76856,US PELVIS NON OB CMP,905.0,380.1,106.81,886.9,37
CPT,76857,US PELVIS NON OB LTD,724.0,304.08,106.81,709.52,37
CPT,76870,US SCROTUM&CONTENTS,905.0,380.1,106.81,886.9,37
CPT,76872,US TRANSRECTAL,418.0,175.56,106.81,409.64,74
CPT,76873,US TRANSRECTAL STDY VOL PROSTATE,544.0,228.48,106.81,533.12,74
CPT,76881,US JOINT CMP REALTIME,909.0,381.78,106.81,890.82,37
CPT,76882,US JT/EVAL FOCAL EXT NONVASC LTD,586.0,246.12,106.81,574.28,37
CPT,76885,US HIPS INFANT DYNAMIC,347.0,145.74,88.91,340.06,37
CPT,76886,US HIPS INFANT STATIC,172.0,72.24,46.44,168.56,37
CPT,76936,US GD RPR PSEUDOAN ART/FISTULA AV,1055.0,443.1,220.6,1033.9,37
CPT,76937,US GD VA EVAL SITE W REC PERM,349.0,146.58,94.23,342.02,120
CPT,76940,US GD ABLATION TISSUE,670.0,281.4,180.9,656.6,60
CPT,76942,US GD PLCMT NEEDLE ADDL S&I,1641.0,689.22,443.07,1608.18,60
CPT,76942,US GD PLCMT NEEDLE S&I,1641.0,689.22,443.07,1608.18,90
CPT,76946,US GD AMNIOCENTESIS S&I,439.0,184.38,118.53,430.22,60
CPT,76965,US GD APP RADIOELEMENT INTERSTITIAL,944.0,396.48,254.88,925.12,30
CPT,76998,US GD INTRAOPERATIVE,815.0,342.3,220.05,798.7,30
CPT,77001,FLUORO GD PLC/REPL/REM CVAD,481.0,202.02,129.87,471.38,60
CPT,77002,FLUORO GD PLCMT NEEDLE,559.0,234.78,150.93,547.82,60
CPT,77003,FLUORO GD&LOC NEEDLE SPINE,794.0,333.48,214.38,778.12,60
CPT,77011,CT GD LOC STEREOTACTIC,1895.0,795.9,511.65,1857.1,30
CPT,77012,CT GD PLCMT NEEDLE S&I,2584.0,1085.28,697.68,2532.32,60
CPT,77013,CT GD ABLATION TISSUE,1897.0,796.74,512.19,1859.06,30
CPT,77021,MRI GD PLC NDL S&I,2984.0,1253.28,805.68,2924.32,30
CPT,77046,MRI BREAST WO CNT LT,1141.0,479.22,308.07,1118.18,30
CPT,77046,MRI BREAST WO CNT RT,1141.0,479.22,308.07,1118.18,30
CPT,77047,MRI BREAST WO CNT BI,1591.0,668.22,243.77,1559.18,37
CPT,77048,MRI BREAST W&WO CNT LT,1712.0,719.04,462.24,1677.76,30
CPT,77048,MRI BREAST W&WO CNT RT,1712.0,719.04,462.24,1677.76,30
CPT,77049,MRI BREAST W&WO CNT BI,2387.0,1002.54,644.49,2339.26,30
CPT,77053,DUCTO/GALACTOGRAM MAMMARY SGL LTS&I,419.0,175.98,113.13,410.62,30
CPT,77053,DUCTO/GALACTOGRAM MAMMARY SGL RTS&I,419.0,175.98,113.13,410.62,30
CPT,77054,DUCTO/GALACTOGRAM MAMMARY MULTI S&I,551.0,231.42,148.77,539.98,37
CPT,77071,APPLY MANUAL STRESS JOINT UNI/BI,237.0,99.54,63.99,232.26,37
CPT,77072,STUDIES AGE BONE,161.0,67.62,43.47,157.78,37
CPT,77073,STUDIES LENGTH BONE,216.0,90.72,58.32,211.68,37
CPT,77074,XR SURVEY OSSEOUS LTD,216.0,90.72,58.32,211.68,37
CPT,77075,XR SURVEY OSSEOUS CMP,420.0,176.4,106.81,411.6,37
CPT,77076,XR SURVEY OSSEOUS INFANT,244.0,102.48,65.88,239.12,37
CPT,77077,SURVEY JOINT SGL VW 2+ JTS,189.0,79.38,51.03,185.22,37
CPT,77084,MRI BONE MARROW,1525.0,640.5,243.77,1494.5,37
CPT,77280,RAD THER FIELD SIMULAT LVL 01 SMPL,1106.0,464.52,137.32,1083.88,37
CPT,77285,RAD THER FIELD SIMULAT LVL 02 INTRM,1859.0,780.78,382.54,1821.82,37
CPT,77290,RAD THER FIELD SIMULAT LVL 03 CMPLX,1923.0,807.66,382.54,1884.54,37
CPT,77293,SIMULAT MGMT MOTION RESPIRATORY,1435.0,602.7,387.45,1406.3,30
CPT,77295,PLAN RADTHRPY 3D W HISTGMS DOSE-VOL,6622.0,2781.24,1414.11,6489.56,37
CPT,77300,CALC DOSIMETRY RAD BASIC,657.0,275.94,137.32,643.86,37
CPT,77301,PLAN IMRT HISTOGRAMS DOSE-VOLUME,7241.0,3041.22,1414.11,7096.18,37
CPT,77306,PLAN ISODOSE TELETHRPY LVL 01 SMPL,661.0,277.62,178.47,647.78,37
CPT,77307,PLAN ISODOSE TELETHRPY LVL 02 CMPLX,1590.0,667.8,382.54,1558.2,37
CPT,77316,PLAN ISODOSE BRACHY LVL 01 SMPL,1589.0,667.38,382.54,1557.22,37
CPT,77317,PLAN ISODOSE BRACHY LVL 02 INTRM,2086.0,876.12,382.54,2044.28,37
CPT,77318,PLAN ISODOSE BRACHY LVL 03 CMPLX,2212.0,929.04,382.54,2167.76,37
CPT,77321,PLAN PORT TELETHRPY SPEC,1086.0,456.12,293.22,1064.28,37
CPT,77331,CALC DOSIMETRY SPEC,591.0,248.22,137.32,579.18,37
CPT,77331,CALC DOSIMETRY SPEC DIODE,591.0,248.22,137.32,579.18,37
CPT,77331,CALC DOSIMETRY SPEC TLD,591.0,248.22,137.32,579.18,37
CPT,77332,DEVICE TX DESIGN&CONST LVL 01 SMPL,554.0,232.68,137.32,542.92,37
CPT,77333,DEVICE TX DESIGN&CONST LVL 02 INTRM,759.0,318.78,137.32,743.82,37
CPT,77334,DEVICE TX DESIGN&CONST LVL 03 CMPLX,1304.0,547.68,352.08,1277.92,37
CPT,77336,CONSULT PHYSICS MEDICAL CONTINUING,666.0,279.72,137.32,652.68,37
CPT,77338,DEVICE MLC DESIGN&CONST PER IMRT,1477.0,620.34,382.54,1447.46,37
CPT,77370,CONSULT PHYSICS RAD MEDICAL SPECIAL,913.0,383.46,137.32,894.74,37
CPT,77372,SRS CRANIAL COURSE 1 SESSN,15044.0,6318.48,4061.88,14743.12,36
CPT,77373,SRS/SBRT LINEAR COURSE MAX 5 SESSNS,7291.0,3062.22,1826.78,7145.18,37
CPT,77387,GD LOC VOL TARGET DELIVERY TX RAD,234.0,98.28,63.18,229.32,60
CPT,77402,TX RAD LVL 1 E-SGL/MULTI 2D IMG GD,785.0,329.7,104.24,769.3,37
CPT,77407,TX RAD LVL 2 ISOCNTR SGL IMG GD,2525.0,1060.5,394.05,2474.5,37
CPT,77412,TX RAD LVL 3 ISOCNTRS MULTI IMG GD,2860.0,1201.2,564.51,2802.8,37
CPT,77417,RAD THER IMG/S PORT,329.0,138.18,88.83,322.42,30
CPT,77470,PROCEDURE TX SPECIAL THRPY RAD,1938.0,813.96,523.26,1899.24,37
CPT,77761,APPL BRACHY INTRACAV LVL 01 SMPL,1420.0,596.4,383.4,1391.6,37
CPT,77762,APPL BRACHY INTRACAV LVL 02 INTRM,1875.0,787.5,506.25,1837.5,37
CPT,77763,APPL BRACHY INTRACAV LVL 03 CMPLX,2679.0,1125.18,711.56,2625.42,37
CPT,77770,BRACHY HDR RDNCL ICAV/ISTL 1 CH,3950.0,1659.0,711.56,3871.0,37
CPT,77771,BRACHY HDR RDNCL ICAV/ISTL 2-12 CH,5441.0,2285.22,711.56,5332.18,37
CPT,77772,BRACHY HDR RDNCL ICAV/ISTL 13+CH,5659.0,2376.78,711.56,5545.82,37
CPT,77778,APPL SOURCE RAD INTERSTITIAL CMPLX,3968.0,1666.56,711.56,3888.64,37
CPT,77790,SPVN/HANDLING/LOAD RADIOELEMENT,475.0,199.5,128.25,465.5,60
CPT,78012,NM THYROID UPTAKE MEAS QN SGL/MULT,853.0,358.26,230.31,835.94,37
CPT,78013,NM THYROID W/WO FLOW VASCULAR,834.0,350.28,225.18,817.32,37
CPT,78014,NM THYROID UPTAKE MEAS W/WO FLW STM,2462.0,1034.04,408.43,2412.76,37
CPT,78015,NM METS CA THYROID LTD,962.0,404.04,259.74,942.76,37
CPT,78018,NM METS CA THYROID WHOLE BODY,3045.0,1278.9,554.73,2984.1,37
CPT,78070,NM PLANAR PARATHYROID,1282.0,538.44,346.14,1256.36,37
CPT,78071,NM PLANAR PARATHYROID W SPECT,1336.0,561.12,360.72,1309.28,37
CPT,78072,NM PLANAR PARATHYROID W SPECT/CT,2578.0,1082.76,554.73,2526.44,37
CPT,78102,NM MARROW BONE LTD,819.0,343.98,221.13,802.62,37
CPT,78103,NM MARROW BONE MULTIPLE,1048.0,440.16,282.96,1027.04,37
CPT,78104,NM MARROW BONE BODY WHOLE,1195.0,501.9,322.65,1171.1,37
CPT,78185,NM SPLEEN W/WO FLOW VASCULAR,851.0,357.42,229.77,833.98,37
CPT,78195,NM LYMPH SYSTEM,2928.0,1229.76,554.73,2869.44,37
CPT,78215,NM LIVER&SPLEEN STATIC,1328.0,557.76,358.56,1301.44,37
CPT,78216,NM LIVER&SPLEEN W FLOW VASCULAR,621.0,260.82,167.67,608.58,37
CPT,78226,NM HEPATOBILIARY W/WO GB,2437.0,1023.54,408.43,2388.26,37
CPT,78227,NM HEPATOBILIARY W PHARM W/WO GB,3446.0,1447.32,554.73,3377.08,37
CPT,78262,NM REFLUX GASTROESOPHAGEAL,1045.0,438.9,282.15,1024.1,37
CPT,78264,NM EMPTYING GASTRIC,2874.0,1207.08,408.43,2816.52,37
CPT,78267,NM TEST BREATH UREA C14 ACQ,598.0,251.16,11.06,586.04,37
CPT,78268,NM TEST BREATH UREA C14 ANALYSIS,4975.0,2089.5,94.41,4875.5,37
CPT,78278,NM LOSS BLOOD GI ACUTE,1583.0,664.86,408.43,1551.34,37
CPT,78290,NM INTESTINE,1335.0,560.7,360.45,1308.3,37
CPT,78300,NM BONE&/JOINT LTD,2031.0,853.02,408.43,1990.38,37
CPT,78305,NM BONE&/JOINT MULTIPLE,2427.0,1019.34,408.43,2378.46,37
CPT,78306,NM BONE&/JOINT BODY WHOLE,3328.0,1397.76,408.43,3261.44,37
CPT,78315,NM BONE&/JOINT PHASE 3,3615.0,1518.3,408.43,3542.7,37
CPT,78428,NM DETECTION SHUNT CARDIAC,1515.0,636.3,408.43,1484.7,37
CPT,78451,NM PERF MYOC SPECT WM/EF SGL,1789.0,751.38,483.03,1917.9,37
CPT,78452,NM PERF MYOC SPEC WM/EF MULT,2158.0,906.36,582.66,2114.84,37
CPT,78453,NM PERF MYOC PLANAR WM/EF SGL,1789.0,751.38,483.03,1917.9,37
CPT,78454,NM PERF MYOC PLANAR WM/EF MULT,1984.0,833.28,535.68,1944.32,37
CPT,78466,NM MYOCARDIAL INFARCT PLANAR,1077.0,452.34,290.79,1055.46,37
CPT,78472,NM MUGA REST/STRESS PLANAR SGL,1744.0,732.48,408.43,1709.12,37
CPT,78481,NM POOL BLOOD CARDIAC 1ST PASS SGL,1735.0,728.7,468.45,1700.3,37
CPT,78579,NM VENT PULMONARY,1386.0,582.12,374.22,1358.28,37
CPT,78580,NM PERF PULMONARY,1415.0,594.3,382.05,1386.7,37
CPT,78582,NM VENT&PERF PULMONARY,2500.0,1050.0,554.73,2450.0,37
CPT,78597,NM PERF PULM DIFF QN W/WO IMG,1165.0,489.3,314.55,1141.7,37
CPT,78598,NM PERF&VENT PULM DIFF QN W/WO IMG,1830.0,768.6,494.1,1793.4,37
CPT,78600,NM BRAIN 1-3 VW STATIC,781.0,328.02,210.87,765.38,37
CPT,78601,NM BRAIN 1-3 VW STATIC W FLOW,917.0,385.14,247.59,898.66,37
CPT,78605,NM BRAIN 4+ VW STATIC,832.0,349.44,224.64,815.36,37
CPT,78606,NM BRAIN 4+ VW STATIC W FLOW,1390.0,583.8,375.3,1362.2,37
CPT,78630,NM FLOW CSF CISTERNOGRAM,1424.0,598.08,384.48,1395.52,37
CPT,78645,NM FLOW CSF EVAL SHUNT,1183.0,496.86,319.41,1159.34,37
CPT,78650,NM DETECTION&LOC LEAK CSF,1984.0,833.28,535.68,1944.32,37
CPT,78707,NM KIDNEY FUNCTION&FLOW,1994.0,837.48,538.38,1954.12,37
CPT,78708,NM KIDNEY FUNCTION&FLOW PHARM SGL,1882.0,790.44,508.14,1844.36,37
CPT,78709,NM KIDNEY FUNCTION&FLOW PHARM MULTI,2067.0,868.14,554.73,2025.66,37
CPT,78740,NM REFLEX URETERAL,613.0,257.46,165.51,600.74,37
CPT,78761,NM TESTICULAR W FLOW VASCULAR,613.0,257.46,165.51,600.74,37
CPT,78800,NM LOC RRX TMR PLNR 1 AREA 1D IMG,924.0,388.08,249.48,905.52,37
CPT,78801,NM LOC RRX TMR PLNR 2+AREA 1+D IMG,1298.0,545.16,350.46,1272.04,37
CPT,78802,NM LOC RRX TMR PLNR WHL BODY 1D IMG,1959.0,822.78,528.93,1919.82,37
CPT,78803,NM LOC RRX TMR SPECT 1AREA 1ACQ 1D,4396.0,1846.32,554.73,4308.08,37
CPT,78804,NM LOC RRX TMR PLNR WHL BODY 2D IMG,4836.0,2031.12,554.73,4739.28,37
CPT,78808,INJ RRX LOC STDY PROBE NON-IMG IV,613.0,257.46,165.51,600.74,37
CPT,78815,PET/CT SKULL-THIGH ONC FDG INIT,5138.0,2157.96,1387.26,5035.24,30
CPT,78815,PET/CT SKULL-THIGH ONC FDG SUB 1-3,5138.0,2157.96,1387.26,5035.24,30
CPT,78815,PET/CT SKULL-THIGH ONC FDG SUB 4+,5138.0,2157.96,1387.26,5035.24,30
CPT,78830,NM LOC RRX TMR SPECT CT 1AREA 1ACQ,3284.0,1379.28,886.68,3218.32,37
CPT,78831,NM LOC RRX TMR SPECT 2+AREA 2ACQ,3508.0,1473.36,947.16,3437.84,37
CPT,78832,NM LOC RRX TMR SPECT CT 2+AREA 2ACQ,3633.0,1525.86,980.91,3560.34,37
CPT,79005,THERAPY RRX PO HYPTHYROID ADDL,3317.0,1393.14,238.39,3250.66,37
CPT,79005,THERAPY RRX PO HYPTHYROID INIT,3317.0,1393.14,238.39,3250.66,37
CPT,79005,THERAPY RRX PO THYROID CA ABL,3317.0,1393.14,238.39,3250.66,37
CPT,79005,THERAPY RRX PO THYROID CA METS,3317.0,1393.14,238.39,3250.66,37
CPT,79005,THERAPY RRX PO THYROID SUPPRESSION,3317.0,1393.14,238.39,3250.66,37
CPT,79403,THERAPY RRX INF IV RMA,1350.0,567.0,238.39,1323.0,37
CPT,79440,THERAPY RRX INTRAARTICULAR,436.0,183.12,117.72,427.28,37
CPT,79445,THERAPY RRX INTRAARTERIAL PARTICUL,630.0,264.6,170.1,617.4,37
CPT,80047,LAB PANEL METAB BASIC W CA IONIZED,60.0,25.2,13.73,58.8,37
CPT,80048,LAB PANEL METAB BASIC W CA TOTAL,26.0,10.92,7.02,25.48,37
CPT,80051,LAB PANEL ELECTROLYTE,22.0,9.24,5.94,21.56,37
CPT,80051,POC PANEL ELECTROLYTE TELCOR,22.0,9.24,5.94,21.56,37
CPT,80053,LAB PANEL METAB COMP,32.0,13.44,8.64,31.36,37
CPT,80061,LAB PANEL LIPID,54.0,22.68,13.39,52.92,37
CPT,80061,LAB PANEL LIPID NS,69.0,28.98,13.39,67.62,37
CPT,80069,LAB PANEL FUNCTION RENAL,27.0,11.34,7.29,26.46,37
CPT,80074,LAB PANEL HEPATITIS ACUTE,143.0,60.06,38.61,140.14,37
CPT,80076,LAB PANEL FUNCTION HEPATIC,25.0,10.5,6.75,24.5,37
CPT,80145,LAB ADALIMUMAB,300.0,126.0,38.57,294.0,37
CPT,80150,LAB AMIKACIN PEAK,59.0,24.78,15.08,57.82,37
CPT,80150,LAB AMIKACIN RANDOM,62.0,26.04,15.08,60.76,37
CPT,80150,LAB AMIKACIN TROUGH,62.0,26.04,15.08,60.76,37
CPT,80151,LAB AMIODARONE,90.0,37.8,18.64,88.2,37
CPT,80155,LAB CAFFEINE,116.0,48.72,31.32,113.68,37
CPT,80156,LAB CARBAMAZEPINE TOTAL,52.0,21.84,14.04,50.96,37
CPT,80157,LAB CARBAMAZEPINE FREE,90.0,37.8,13.25,88.2,37
CPT,80158,LAB CYCLOSPORINE,55.0,23.1,14.85,53.9,37
CPT,80158,LAB CYCLOSPORINE A,58.0,24.36,15.66,56.84,37
CPT,80159,LAB CLOZAPINE/NORCLOZAPINE,68.0,28.56,18.36,66.64,37
CPT,80161,LAB CARBAMAZEPINE -10 11-EPOXIDE,58.0,24.36,15.66,56.84,37
CPT,80161,LAB CARBAMAZEPINE -10 11-EPOXIDE NS,90.0,37.8,18.64,88.2,37
CPT,80162,LAB DIGOXIN TOTAL,53.0,22.26,13.28,51.94,37
CPT,80163,LAB DIGOXIN FREE,40.0,16.8,10.8,39.2,37
CPT,80164,LAB ACID VALPROIC TOTAL,53.0,22.26,13.54,51.94,37
CPT,80164,LAB ACID VALPROIC TOTAL NS,66.0,27.72,13.54,64.68,37
CPT,80165,LAB ACID VALPROIC FREE,66.0,27.72,13.54,64.68,37
CPT,80167,LAB FELBAMATE,74.0,31.08,18.64,72.52,37
CPT,80168,LAB ETHOSUXIMIDE,107.0,44.94,16.34,104.86,37
CPT,80169,LAB EVEROLIMUS,60.0,25.2,13.73,58.8,37
CPT,80170,LAB GENTAMICIN PEAK,82.0,34.44,16.38,80.36,37
CPT,80170,LAB GENTAMICIN RANDOM,82.0,34.44,16.38,80.36,37
CPT,80170,LAB GENTAMICIN TROUGH,82.0,34.44,16.38,80.36,37
CPT,80171,LAB GABAPENTIN SRM/PLASMA/BLD WHL,77.0,32.34,20.79,75.46,37
CPT,80173,LAB HALOPERIDOL,99.0,41.58,15.78,97.02,37
CPT,80175,LAB LAMOTRIGINE,61.0,25.62,13.25,59.78,37
CPT,80176,LAB LIDOCAINE,62.0,26.04,14.69,60.76,37
CPT,80177,LAB LEVETIRACETAM NS,63.0,26.46,13.25,61.74,37
CPT,80178,LAB LITHIUM,52.0,21.84,6.61,50.96,37
CPT,80180,LAB ACID MYCOPHENOLIC,55.0,23.1,14.85,53.9,37
CPT,80180,LAB ACID MYCOPHENOLIC NS,55.0,23.1,14.85,53.9,37
CPT,80181,LAB FLECAINIDE,68.0,28.56,18.36,66.64,37
CPT,80183,LAB OXCARBAZEPINE,69.0,28.98,13.25,67.62,37
CPT,80184,LAB PHENOBARBITAL,54.0,22.68,14.58,52.92,37
CPT,80184,LAB PHENOBARBITAL NS,59.0,24.78,15.3,57.82,37
CPT,80185,LAB PHENYTOIN TOTAL,54.0,22.68,13.25,52.92,37
CPT,80186,LAB PHENYTOIN FREE,63.0,26.46,13.76,61.74,37
CPT,80187,LAB POSACONAZOLE,118.0,49.56,27.11,115.64,37
CPT,80188,LAB PRIMIDONE NS,59.0,24.78,15.93,57.82,37
CPT,80189,LAB ITRACONAZOLE,131.0,55.02,27.11,128.38,37
CPT,80192,LAB PROCAINAMIDE W NAPA,51.0,21.42,13.77,49.98,37
CPT,80195,LAB SIROLIMUS,57.0,23.94,13.73,55.86,37
CPT,80197,LAB TACROLIMUS FK-506,57.0,23.94,13.73,55.86,37
CPT,80197,LAB TACROLIMUS FK-506 NS,64.0,26.88,13.73,62.72,37
CPT,80198,LAB THEOPHYLLINE,43.0,18.06,11.61,42.14,37
CPT,80200,LAB TOBRAMYCIN PEAK,49.0,20.58,13.23,48.02,37
CPT,80200,LAB TOBRAMYCIN RANDOM,49.0,20.58,13.23,48.02,37
CPT,80200,LAB TOBRAMYCIN TROUGH,49.0,20.58,13.23,48.02,37
CPT,80201,LAB TOPIRAMATE,36.0,15.12,9.72,35.28,37
CPT,80202,LAB VANCOMYCIN PEAK,41.0,17.22,11.07,40.18,37
CPT,80202,LAB VANCOMYCIN RANDOM,41.0,17.22,11.07,40.18,37
CPT,80202,LAB VANCOMYCIN TROUGH,41.0,17.22,11.07,40.18,37
CPT,80203,LAB ZONISAMIDE,79.0,33.18,13.25,77.42,37
CPT,80204,LAB METHOTREXATE NS,116.0,48.72,31.32,113.68,37
CPT,80230,LAB INFLIXIMAB,266.0,111.72,38.57,260.68,37
CPT,80235,LAB LACOSAMIDE,82.0,34.44,22.14,80.36,37
CPT,80280,LAB VEDOLIZUMAB,317.0,133.14,38.57,310.66,37
CPT,80285,LAB VORICONAZOLE,127.0,53.34,27.11,124.46,37
CPT,80299,LAB ANTI-CD19 CAR T-CELL,500.0,210.0,18.64,490.0,37
CPT,80299,LAB ARIPIPRAZOLE,62.0,26.04,16.74,60.76,37
CPT,80299,LAB BACLOFEN,132.0,55.44,18.64,129.36,37
CPT,80299,LAB BUSULFAN,56.0,23.52,15.12,54.88,37
CPT,80299,LAB CHLORDIAZEPOXIDE,169.0,70.98,18.64,165.62,37
CPT,80299,LAB CLOMIPRAMINE,62.0,26.04,16.74,60.76,37
CPT,80299,LAB CLONAZEPAM,67.0,28.14,18.09,65.66,37
CPT,80299,LAB DEXAMETHASONE,60.0,25.2,16.2,58.8,37
CPT,80299,LAB FLUCONAZOLE,111.0,46.62,18.64,108.78,37
CPT,80299,LAB MEXILETINE,141.0,59.22,18.64,138.18,37
CPT,80299,LAB NORTRIPTYLINE,68.0,28.56,18.36,66.64,37
CPT,80299,LAB RISANKIZUMAB,396.0,166.32,18.64,388.08,37
CPT,80299,LAB THIOPURINE,160.0,67.2,18.64,156.8,37
CPT,80299,LAB USTEKINUMAB,226.0,94.92,18.64,221.48,37
CPT,80305,LAB DRG SCR DIRECT OPT OBS ONLY DAY,38.0,15.96,10.26,37.24,37
CPT,80306,LAB DRG SC DIRECT OPT INST ASST DAY,52.0,21.84,14.04,50.96,37
CPT,80307,LAB DRG SC INST ALYZ CORD BLOOD DAY,248.0,104.16,62.14,243.04,37
CPT,80307,LAB DRG SC INST ALYZ CORD TIS DAY,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ CORD TIS DAYNS,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ MECON DAY,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ MECON DAY NS,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ SERUM DAY,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ SERUM DAY NS,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ URINE DAY,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ URINE DAY NS,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ URINE ETOH DAY,187.0,78.54,50.49,183.26,37
CPT,80307,LAB DRG SC INST ALYZ URINE PMGT DAY,449.0,188.58,62.14,440.02,37
CPT,80320,LAB DRG DF ETOH EXCEPT BR DAY,132.0,55.44,35.64,129.36,30
CPT,80320,LAB DRG DF ETOH EXCEPT BR DAY NS,61.0,25.62,16.47,59.78,30
CPT,80321,LAB DRG DF ETOH BIOMRK 1-2,130.0,54.6,35.1,127.4,30
CPT,80321,LAB DRG DF ETOH BIOMRK TIS CORD 1-2,110.0,46.2,29.7,107.8,30
CPT,80321,LAB DRG DF ETOH BIOMRK URINE 1-2,158.0,66.36,42.66,154.84,30
CPT,80323,LAB DRG DF ALKALOIDS NICOTINE DAY,182.0,76.44,49.14,178.36,30
CPT,80323,LAB DRG DF MITRAGYNINE URINE QN,67.0,28.14,18.09,65.66,30
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2 NON UR,56.0,23.52,15.12,54.88,30
CPT,80324,LAB DRG DF AMPH/METH DAY 1-2 NS,73.0,30.66,19.71,71.54,30
CPT,80324,LAB DRG DF AMPH/METH MCNIUM DAY 1-2,83.0,34.86,22.41,81.34,30
CPT,80324,LAB DRG DF CNFRM AMPH DAY 1-2,73.0,30.66,19.71,71.54,30
CPT,80329,LAB DRG DF ANLG ACETAMINPHN DAY 1-2,178.0,74.76,48.06,174.44,30
CPT,80329,LAB DRG DF ANLG SALICYLATE DAY 1-2,178.0,74.76,48.06,174.44,30
CPT,80333,LAB DRG DF ANTD SEROTONERG DAY 3-5,97.0,40.74,26.19,95.06,30
CPT,80335,LAB DRG DF ANTD CYCL AMIT DAY 1-2,62.0,26.04,16.74,60.76,30
CPT,80335,LAB DRG DF ANTD CYCL DESI DAY 1-2NS,62.0,26.04,16.74,60.76,30
CPT,80335,LAB DRG DF ANTD CYCL DOXE DAY 1-2,74.0,31.08,19.98,72.52,30
CPT,80335,LAB DRG DF ANTD CYCL IMIPRM DAY 1-2,62.0,26.04,16.74,60.76,30
CPT,80335,LAB DRG DF ANTD CYCL NORT DAY 1-2,68.0,28.56,18.36,66.64,30
CPT,80337,LAB DRG DF ANTD CYCL DAY 6+,87.0,36.54,23.49,85.26,30
CPT,80338,LAB DRG DF TRAZODONE DAY,70.0,29.4,18.9,68.6,30
CPT,80338,LAB DRG DF VENLAFAXINE DAY,350.0,147.0,94.5,343.0,30
CPT,80339,LAB DRG DF ANTIEPILEPTICS DAY 1-3,176.0,73.92,47.52,172.48,30
CPT,80345,LAB DRG DF BARB PHENOBARB DAY,164.0,68.88,44.28,160.72,30
CPT,80345,LAB DRG DF BARB PHENOBARB DAY NS,158.0,66.36,42.66,154.84,30
CPT,80345,LAB DRG DF BARB PHENOBARB NON URINE,56.0,23.52,15.12,54.88,30
CPT,80345,LAB DRG DF BARB URINE DAY,67.0,28.14,18.09,65.66,30
CPT,80346,LAB DRG DF BENZ CLONAZEPM DAY 1-12,67.0,28.14,18.09,65.66,30
CPT,80346,LAB DRG DF BENZ DAY 1-12,84.0,35.28,22.68,82.32,30
CPT,80346,LAB DRG DF BENZ DAY 1-12 NON URINE,56.0,23.52,15.12,54.88,30
CPT,80348,LAB DRG DF BUPRENORPHINE DAY NON UR,56.0,23.52,15.12,54.88,30
CPT,80348,LAB DRG DF BUPRENORPHINE DAY NS,109.0,45.78,29.43,106.82,30
CPT,80348,LAB DRG DF BUPRENORPHINE MECON DAY,129.0,54.18,34.83,126.42,30
CPT,80349,LAB DRG DF CANNABINOIDS DAY,84.0,35.28,22.68,82.32,30
CPT,80349,LAB DRG DF CANNABINOIDS DAY NON UR,56.0,23.52,15.12,54.88,30
CPT,80352,LAB DRG DF CANNABINOIDS SYN DAY 7+,175.0,73.5,47.25,171.5,30
CPT,80353,LAB DRG DF COCAINE DAY,67.0,28.14,18.09,65.66,30
CPT,80353,LAB DRG DF COCAINE DAY NON URINE,56.0,23.52,15.12,54.88,30
CPT,80353,LAB DRG DF COCAINE MECONIUM,149.0,62.58,40.23,146.02,30
CPT,80354,LAB DRG DF FENTANYL DAY,67.0,28.14,18.09,65.66,30
CPT,80354,LAB DRG DF FENTANYL DAY NON URINE,56.0,23.52,15.12,54.88,30
CPT,80355,LAB DRG DF GABAPENTN NON BLD DAY,56.0,23.52,15.12,54.88,30
CPT,80356,LAB DRG DF HEROIN METABOLITE DAY,56.0,23.52,15.12,54.88,30
CPT,80357,LAB DRG DF KETAMN&NORKETMN DAY,145.0,60.9,39.15,142.1,30
CPT,80358,LAB DRG DF METHADONE DAY NON URINE,56.0,23.52,15.12,54.88,30
CPT,80358,LAB DRG DF METHADONE DAY NS,67.0,28.14,18.09,65.66,30
CPT,80358,LAB DRG DF METHADONE MECONIUM DAY,165.0,69.3,44.55,161.7,30
CPT,80359,LAB DRG DF METHYLENEDIOXYAMP NON UR,56.0,23.52,15.12,54.88,30
CPT,80359,LAB DRG DF METHYLENEDIOXYAMPH NS,70.0,29.4,18.9,68.6,30
CPT,80360,LAB DRG DF METHYLPHENIDATE DAY,67.0,28.14,18.09,65.66,30
CPT,80361,LAB DRG DF OPIATE DAY 1+,104.0,43.68,28.08,101.92,30
CPT,80361,LAB DRG DF OPIATE DAY 1+ NON URINE,56.0,23.52,15.12,54.88,30
CPT,80361,LAB DRG DF OPIATE MECONIUM DAY 1+,70.0,29.4,18.9,68.6,30
CPT,80362,LAB DRG DF OPIOID DAY 1-2 TISSUE,56.0,23.52,15.12,54.88,30
CPT,80364,LAB DRG DF ANLG OPIOID&OPIAT UR 5+,97.0,40.74,26.19,95.06,30
CPT,80365,LAB DRG DF OXYCODONE DAY,104.0,43.68,28.08,101.92,30
CPT,80365,LAB DRG DF OXYCODONE DAY NON URINE,56.0,23.52,15.12,54.88,30
CPT,80366,LAB DRG DF PREGABALIN,95.0,39.9,25.65,93.1,30
CPT,80367,LAB DRG DF CONF PROPOXYPHENE DAY NS,56.0,23.52,15.12,54.88,30
CPT,80368,LAB DRG DF HYPNOTICS SED DAY,56.0,23.52,15.12,54.88,30
CPT,80369,LAB DRG DF MSCL RELAX DAY 1-2,154.0,64.68,41.58,150.92,30
CPT,80371,LAB DRG DF STIMULANTS SYN DAY,160.0,67.2,43.2,156.8,30
CPT,80372,LAB DRG DF TAPENTADOL DAY,56.0,23.52,15.12,54.88,30
CPT,80373,LAB DRG DF TRAMADOL,67.0,28.14,18.09,65.66,30
CPT,80373,LAB DRG DF TRAMADOL NON URINE,56.0,23.52,15.12,54.88,30
CPT,80375,LAB DRG DF FUROSEMIDE DAY 1-3,181.0,76.02,48.87,177.38,30
CPT,80375,LAB DRG DF GOLD DAY 1-3,170.0,71.4,45.9,166.6,30
CPT,80375,LAB DRG DF MITOTANE DAY 1-3,187.0,78.54,50.49,183.26,30
CPT,80375,LAB DRG DF SULFONAMIDES DAY 1-3,147.0,61.74,39.69,144.06,30
CPT,80375,LAB DRG DF THIOPURINE DAY 1-3,160.0,67.2,43.2,156.8,30
CPT,80375,LAB DRG DF TPMT ACTIVITY DAY 1-3,181.0,76.02,48.87,177.38,30
CPT,80377,LAB DRG DF SULFONYLUREAS DAY 7+,178.0,74.76,48.06,174.44,30
CPT,80503,LAB CONSULT PATH LTD,107.0,44.94,28.89,104.86,37
CPT,80504,LAB CONSULT PATH MOD,348.0,146.16,93.96,341.04,37
CPT,80505,LAB CONSULT PATH COMP,348.0,146.16,93.96,341.04,37
CPT,80506,LAB CONSULT PATH PROLONG ADDL 30MIN,100.0,42.0,27.0,98.0,30
CPT,81001,LAB UA AUTO W MICRO,10.0,4.2,2.7,9.8,37
CPT,81002,LAB UA NONAUTO WO MICRO,11.0,4.62,2.97,10.78,37
CPT,81002,LAB UA REDUCING SUBSTANCE,11.0,4.62,2.97,10.78,37
CPT,81002,POC UA NONAUTO WO MICRO DIPSTICK,11.0,4.62,2.97,10.78,37
CPT,81003,LAB UA AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CPT,81003,LAB UA GRAVITY SPCFC AUTO WO MICRO,53.0,22.26,2.25,51.94,37
CPT,81003,LAB UA KETONES AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CPT,81003,LAB UA PH AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CPT,81003,POC UA AUTO WO MICRO,7.0,2.94,1.89,6.86,37
CPT,81005,LAB UA QL/SEMI QN,7.0,2.94,1.89,6.86,37
CPT,81015,LAB UA MICROSCOPIC ONLY,10.0,4.2,2.7,9.8,37
CPT,81025,LAB PREGNANCY URINE,58.0,24.36,8.61,56.84,37
CPT,81025,POC PREGNANCY URINE,26.0,10.92,7.02,25.48,37
CPT,81050,LAB MEASUREMENT VOL COLL TIMED EA,11.0,4.62,2.97,10.78,37
CPT,81162,LAB GENE BRCA1&2 SEQ&DUP/DEL FULL,5475.0,2299.5,1478.25,5365.5,37
CPT,81170,LAB GENE ABL1 VAR KD,900.0,378.0,243.0,882.0,37
CPT,81178,LAB GENE ATXN1 DET ALLELES ABNORMAL,625.0,262.5,137.0,612.5,37
CPT,81180,LAB GENE ATXN3 DET ALLELES ABNORMAL,640.0,268.8,137.0,627.2,37
CPT,81184,LAB GENE CACNA1A DET ALLELES ABNORM,650.0,273.0,137.0,637.0,37
CPT,81194,LAB ANLY TRANSLOCATION NTRK,1555.0,653.1,419.85,1523.9,37
CPT,81206,LAB GENE BCR/ABL1 BREAKPOINT MAJOR,492.0,206.64,132.84,482.16,37
CPT,81206,LAB GENE BCR/ABL1 REFLEX P210,492.0,206.64,132.84,482.16,37
CPT,81206,LAB GENE BCR/ABL1 REFLEX P210 NS,492.0,206.64,132.84,482.16,37
CPT,81207,LAB GENE BCR/ABL1 BREAKPOINT MIN,435.0,182.7,117.45,426.3,37
CPT,81207,LAB GENE BCR/ABL1 BREAKPOINT MIN NS,435.0,182.7,117.45,426.3,37
CPT,81208,LAB GENE BCR/ABL1 BREAKPOINT OTHER,644.0,270.48,173.88,631.12,37
CPT,81210,LAB GENE BRAF VAR V600E NS,527.0,221.34,142.29,516.46,37
CPT,81218,LAB GENE CEBPA SEQ FULL,726.0,304.92,196.02,711.48,37
CPT,81219,LAB GENE ANLYS MUT CALRETICULIN,365.0,153.3,98.55,357.7,37
CPT,81220,LAB GENE CFTR VAR COMMON,1670.0,701.4,450.9,1636.6,37
CPT,81222,LAB GENE CFTR VAR DUP/DEL,1306.0,548.52,352.62,1279.88,37
CPT,81223,LAB GENE CFTR SEQ FULL,1497.0,628.74,404.19,1467.06,37
CPT,81224,LAB GENE CFTR INTRON 8 POLY-T,507.0,212.94,136.89,496.86,37
CPT,81225,LAB GENE CYP2C19 VAR COMMON,875.0,367.5,236.25,857.5,37
CPT,81225,LAB GENE CYP2C19 VAR COMMON NS,875.0,367.5,236.25,857.5,37
CPT,81226,LAB GENE CYP2D6 VAR COMMON,1353.0,568.26,365.31,1325.94,37
CPT,81227,LAB GENE CYP2C9 VAR COMMON,525.0,220.5,141.75,514.5,37
CPT,81229,LAB GENE MA CYTO COPY NO&SNP BLD,3480.0,1461.6,939.6,3410.4,37
CPT,81229,LAB GENE MA CYTO COPY NO&SNP BLD NS,3480.0,1461.6,939.6,3410.4,37
CPT,81229,LAB GENE MA CYTO COPY NO&SNP POC,3480.0,1461.6,939.6,3410.4,37
CPT,81230,LAB GENE CYP3A4 VAR COMMON,525.0,220.5,141.75,514.5,37
CPT,81231,LAB GENE CYP3A5 VAR COMMON,525.0,220.5,141.75,514.5,37
CPT,81232,LAB GENE DPYD VAR COMMON,525.0,220.5,141.75,514.5,37
CPT,81232,LAB GENE DPYD VAR COMMON NS,525.0,220.5,141.75,514.5,37
CPT,81235,LAB GENE EGFR VAR COMMON,974.0,409.08,262.98,954.52,37
CPT,81235,LAB GENE EGFR VAR COMMON NS,974.0,409.08,262.98,954.52,37
CPT,81240,LAB GENE F2 VAR 20210G>A,198.0,83.16,53.46,194.04,37
CPT,81240,LAB GENE F2 VAR 20210G>A NS,198.0,83.16,53.46,194.04,37
CPT,81241,LAB GENE F5 VAR LEIDEN,221.0,92.82,59.67,216.58,37
CPT,81241,LAB GENE F5 VAR LEIDEN NS,221.0,92.82,59.67,216.58,37
CPT,81243,LAB GENE FMR1 DET ALLELES ABNORMAL,172.0,72.24,46.44,168.56,37
CPT,81245,LAB GENE FLT3 VAR ITD,497.0,208.74,134.19,487.06,37
CPT,81246,LAB GENE FLT3 VAR TKD,249.0,104.58,67.23,244.02,37
CPT,81249,LAB GENE G6PD ANLYS SEQ FULL,1800.0,756.0,486.0,1764.0,37
CPT,81256,LAB GENE HFE VAR COMMON,197.0,82.74,53.19,193.06,37
CPT,81256,LAB GENE HFE VAR COMMON NS,197.0,82.74,53.19,193.06,37
CPT,81257,LAB GENE HBA1/HBA2 DEL/VAR COMMON,307.0,128.94,82.89,300.86,37
CPT,81259,LAB GENE HBA1/HBA2 SEQ FULL,1800.0,756.0,486.0,1764.0,37
CPT,81261,LAB GENE IGH REARRANGEMENT AMP,594.0,249.48,160.38,582.12,37
CPT,81263,LAB GENE IGH MUT VARIABLE REGION,884.0,371.28,238.68,866.32,37
CPT,81264,LAB GENE IGK REARRANGEMENT CLONAL,519.0,217.98,140.13,508.62,37
CPT,81265,LAB GENE MARKERS STR SPEC PT&CMP,700.0,294.0,189.0,686.0,37
CPT,81265,LAB GENE MARKERS STR SPEC PT&CMP NS,1427.0,599.34,233.07,1398.46,37
CPT,81267,LAB GENE CHIMERISM WO CELL SLCT NS,1139.0,478.38,207.46,1116.22,37
CPT,81268,LAB GENE CHIMERISM W CELL SLCT EA,783.0,328.86,211.41,767.34,37
CPT,81269,LAB GENE HBA1/HBA2 VAR DUP/DEL,608.0,255.36,164.16,595.84,37
CPT,81270,LAB GENE JAK2 VAR V617F NS,275.0,115.5,74.25,269.5,37
CPT,81271,LAB GENE HTT DET ALLELES ABNORMAL,411.0,172.62,110.97,402.78,37
CPT,81272,LAB GENE ANLYS MUT C-KIT,989.0,415.38,267.03,969.22,37
CPT,81273,LAB GENE KIT VAR D816,375.0,157.5,101.25,367.5,37
CPT,81275,LAB GENE KRAS VAR CODONS 12&13 NS,580.0,243.6,156.6,568.4,37
CPT,81278,LAB IGH/BCL2 TRAN MBR&MCR REG ANLYS,622.0,261.24,167.94,609.56,37
CPT,81279,LAB GENE JAK2 EXON TGT SEQ 12,556.0,233.52,150.12,544.88,37
CPT,81283,LAB GENE IFNL3,221.0,92.82,59.67,216.58,37
CPT,81284,LAB GENE FXN DET ALLELES ABNORMAL,465.0,195.3,125.55,455.7,37
CPT,81287,LAB GENE MGMT ANLYS METHYLATION,374.0,157.08,100.98,366.52,37
CPT,81288,LAB GENE MLH1 METHYLATION,577.0,242.34,155.79,565.46,37
CPT,81291,LAB GENE MTHFR VAR COMMON,197.0,82.74,53.19,193.06,37
CPT,81291,LAB GENE MTHFR VAR COMMON NS,197.0,82.74,53.19,193.06,37
CPT,81301,LAB GENE INSTABILITY MICROSATELLITE,1046.0,439.32,282.42,1025.08,37
CPT,81305,LAB GENE MYD88 VAR L265P,527.0,221.34,142.29,516.46,37
CPT,81306,LAB GENE NUDT15 VAR COMMON NS,875.0,367.5,236.25,857.5,37
CPT,81309,LAB GENE PIK3CA ANLYS SEQ TARGETED,825.0,346.5,222.75,808.5,37
CPT,81310,LAB GENE NPM1 VAR EXON 12,740.0,310.8,199.8,725.2,37
CPT,81311,LAB GENE NRAS VAR EXON 2&3 NS,888.0,372.96,239.76,870.24,37
CPT,81314,LAB GENE PDGFRA,989.0,415.38,267.03,969.22,37
CPT,81315,LAB GENE PML/RARALPHA BREAKPOINTS,622.0,261.24,167.94,609.56,37
CPT,81327,LAB GENE SEPT9 ANLYS METHYLATION,576.0,241.92,155.52,564.48,37
CPT,81328,LAB GENE SLCO1B1 VAR COMMON,525.0,220.5,141.75,514.5,37
CPT,81329,LAB GENE SMN1 ANALYSIS DOSAGE/DEL,525.0,220.5,137.0,514.5,37
CPT,81331,LAB GENE SNRPN/UBE3A METHYLATION,198.0,83.16,51.07,194.04,37
CPT,81332,LAB GENE SERPINA1 VAR COMMON,346.0,145.32,43.65,339.08,37
CPT,81335,LAB GENE TPMT,525.0,220.5,141.75,514.5,37
CPT,81335,LAB GENE TPMT NS,525.0,220.5,141.75,514.5,37
CPT,81339,LAB GENE MPL MUTATION EXON 10 ANLYS,556.0,233.52,150.12,544.88,37
CPT,81340,LAB GENE TRB REARRANGEMENT AMP,627.0,263.34,169.29,614.46,37
CPT,81342,LAB GENE TRG REARRANGEMENT CLONAL,605.0,254.1,163.35,592.9,37
CPT,81350,LAB GENE UGT1A1 VAR COMMON,702.0,294.84,189.54,687.96,37
CPT,81350,LAB GENE UGT1A1 VAR COMMON NS,702.0,294.84,189.54,687.96,37
CPT,81352,LAB GENE TP53 SEQ TARGETED,989.0,415.38,267.03,969.22,37
CPT,81355,LAB GENE VKORC1 VAR COMMON,265.0,111.3,71.55,259.7,37
CPT,81364,LAB GENE HBB SEQ FULL,974.0,409.08,262.98,954.52,37
CPT,81370,LAB GENE TYPING HLA 1&2 LR,1207.0,506.94,325.89,1182.86,37
CPT,81371,LAB GENE TYPING HLA 1&2 LR VERIF NS,1214.0,509.88,327.78,1189.72,37
CPT,81372,LAB GENE TYPING HLA 1 LR CMP,1211.0,508.62,326.97,1186.78,37
CPT,81373,LAB GENE TYPING HLA 1 LR LOCUS NS,383.0,160.86,103.41,375.34,37
CPT,81374,LAB GENE TYPING HLA 1 LR AG 1 EA,223.0,93.66,60.21,218.54,37
CPT,81374,LAB GENE TYPING HLA 1 LR AG 1 EA NS,223.0,93.66,60.21,218.54,37
CPT,81376,LAB GENE TYPING HLA 2 LR LOCUS NS,367.0,154.14,99.09,359.66,37
CPT,81377,LAB GENE TYPING HLA 2 LR AG 1 EA,285.0,119.7,76.95,279.3,37
CPT,81378,LAB GENE TYPING HLA 1&2 HR NS,1037.0,435.54,279.99,1016.26,37
CPT,81379,LAB GENE TYPING HLA 1 HR CMP,1007.0,422.94,271.89,986.86,37
CPT,81380,LAB GENE TYPING HLA 1 HR LOCUS EA,532.0,223.44,143.64,521.36,37
CPT,81381,LAB GENE TYPING HLA 1 HR ALLE 1/GRP,510.0,214.2,137.7,499.8,37
CPT,81382,LAB GENE TYPING HLA 2 HR LOCUS EA,372.0,156.24,100.44,364.56,37
CPT,81382,LAB GENE TYPING HLA 2 HR LOCUS NS,372.0,156.24,100.44,364.56,37
CPT,81383,LAB GENE TYPING HLA 2 HR ALLE 1/GRP,328.0,137.76,88.56,321.44,37
CPT,81400,LAB PROC PATHOLOGY MOLEC LEVEL 1,192.0,80.64,51.84,188.16,37
CPT,81401,LAB MOPATH LVL2 ADMARK APOE GENO,671.0,281.82,137.0,657.58,37
CPT,81401,LAB MOPATH LVL2 CARDIO IQ APOE GENO,411.0,172.62,110.97,402.78,37
CPT,81401,LAB MOPATH LVL2 CBFB/MYH11 DET QN,411.0,172.62,110.97,402.78,37
CPT,81401,LAB MOPATH LVL2 EML4-ALK,411.0,172.62,110.97,402.78,37
CPT,81402,LAB PROC PATHOLOGY MOLEC LEVEL 3,451.0,189.42,121.77,441.98,37
CPT,81403,LAB PROC PATHOLOGY MOLEC HEA RBC,556.0,233.52,150.12,544.88,37
CPT,81403,LAB PROC PATHOLOGY MOLEC LEVEL 4,556.0,233.52,150.12,544.88,37
CPT,81403,LAB PROC PATHOLOGY MOLEC LEVEL 4 NS,617.0,259.14,166.59,604.66,37
CPT,81404,LAB PROC PATHOLOGY MOLEC LEVEL 5,825.0,346.5,222.75,808.5,37
CPT,81405,LAB PROC PATHOLOGY MOLEC LEVEL 6,905.0,380.1,244.35,886.9,37
CPT,81406,LAB PROC PATHOLOGY MOLEC LEVEL 7,849.0,356.58,229.23,832.02,37
CPT,81406,LAB PROC PATHOLOGY MOLEC LVL7 NOTCH,3185.0,1337.7,282.88,3121.3,37
CPT,81407,LAB PROC PATHOLOGY MOLEC LEVEL 8,2539.0,1066.38,685.53,2488.22,37
CPT,81408,LAB PROC PATHOLOGY MOLEC LEVEL 9,6000.0,2520.0,1620.0,5880.0,37
CPT,81418,LAB GSAP METAB RX >=6,2752.0,1155.84,743.04,2696.96,37
CPT,81420,LAB FETAL CHROMOSOMAL ANEUPLOIDY,2278.0,956.76,615.06,2232.44,37
CPT,81443,LAB TEST GENETIC COND SEVERE INHRTD,7346.0,3085.32,1983.42,7199.08,37
CPT,81445,LAB GENOMIC ANLY SEQ SO 5-50,1794.0,753.48,484.38,1758.12,37
CPT,81445,LAB GENOMIC ANLY SEQ SO 5-50 NS,1794.0,753.48,484.38,1758.12,37
CPT,81450,LAB GENOMIC ANLY SEQ HL 5-50,2279.0,957.18,615.33,2233.42,37
CPT,81450,LAB GENOMIC ANLY SEQ HL 5-50 NS,2395.0,1005.9,646.65,2347.1,37
CPT,81455,LAB GENOMIC ANLY SEQ SO/HL 51+,8759.0,3678.78,2364.93,8583.82,37
CPT,81455,LAB GENOMIC ANLY SEQ SO/HL 51+ NS,8759.0,3678.78,2364.93,8583.82,37
CPT,81456,LAB GENOMIC ANLY SEQ SO/HL RNA 51+,8759.0,3678.78,2364.93,8583.82,37
CPT,81470,LAB ANLY GEN SEQ PANEL XLID 60+,3480.0,1461.6,914.0,3410.4,37
CPT,81479,LAB ANLY MUTATION KRAS,190.0,79.8,51.3,186.2,30
CPT,81479,LAB ANLY MUTATION NRAS,659.0,276.78,177.93,645.82,30
CPT,81479,LAB CSF3R MUTATION EXONS 14&17,300.0,126.0,81.0,294.0,30
CPT,81479,LAB GENE PHARMOCOGENOMICS PANEL,51.0,21.42,13.77,49.98,30
CPT,81479,LAB GENE SEQ MUTATION FAM TARGETED,401.0,168.42,108.27,392.98,30
CPT,81479,LAB GENE TRNSLOC T9-22 BCR-ABL1,275.0,115.5,74.25,269.5,30
CPT,81479,LAB IBD SGI DIAGNOSTIC,292.0,122.64,78.84,286.16,30
CPT,81479,LAB NGS MI PROFILE,3550.0,1491.0,958.5,3479.0,30
CPT,81500,LAB ONC BIOCHEMICAL PROT 2 SERUM,782.0,328.44,211.14,766.36,37
CPT,81508,LAB FETAL CONGENITAL ABNORMALITIES,260.0,109.2,54.3,254.8,37
CPT,81511,LAB ABNORM FETAL CONGENITAL ANLYL 4,490.0,205.8,132.3,480.2,37
CPT,81513,LAB DIS INFCT BAC VAG RNA VG FLU QN,428.0,179.76,115.56,419.44,74
CPT,81515,LAB DIS INFCT BV&VAGINITIS DNA AMP,789.0,331.38,213.03,773.22,37
CPT,81517,LAB LIVER DIS ANYL 3BIOMARK ALG SRM,529.0,222.18,142.83,518.42,37
CPT,81539,LAB ONC BIOCHEMICAL PROT 4 SRM/PLSM,2280.0,957.6,615.6,2234.4,37
CPT,81596,LAB HCV INFCT DIS CHRNC 6 ASSAYS,217.0,91.14,58.59,212.66,37
CPT,81596,LAB HCV INFCT DIS CHRNC 6 ASSAYS NS,217.0,91.14,58.59,212.66,37
CPT,82010,LAB KETONES ACETONE QN,25.0,10.5,6.75,24.5,37
CPT,82010,LAB KETONES BETA-HYDROXYBUTYRATE QN,60.0,25.2,8.17,58.8,37
CPT,82016,LAB ACYLCARNITINES QL EA,50.0,21.0,13.5,49.0,37
CPT,82017,LAB ACYLCARNITINES QN EA,115.0,48.3,16.87,112.7,37
CPT,82024,LAB HORMONE ADRENOCORTICOTROPIC,116.0,48.72,31.32,113.68,37
CPT,82040,LAB ALBUMIN SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CPT,82040,LAB ALBUMIN SRM/PLASMA/BLD WHL NS,63.0,26.46,4.95,61.74,37
CPT,82042,LAB ALBUMIN OTHER SOURCE QN EA,58.0,24.36,7.78,56.84,37
CPT,82042,LAB ALBUMIN OTHER SOURCE QN EA NS,24.0,10.08,6.48,23.52,37
CPT,82043,LAB MICROALBUMIN URINE QN,56.0,23.52,5.78,54.88,37
CPT,82075,LAB ALCOHOL BREATH,90.0,37.8,24.3,88.2,37
CPT,82085,LAB ALDOLASE,53.0,22.26,9.71,51.94,37
CPT,82088,LAB ALDOSTERONE NS,123.0,51.66,33.21,120.54,37
CPT,82088,LAB ALDOSTERONE URINE,123.0,51.66,33.21,120.54,37
CPT,82103,LAB ALPHA-1-ANTITRYPSIN TOTAL,41.0,17.22,11.07,40.18,37
CPT,82103,LAB ALPHA-1-ANTITRYPSIN TOTAL NS,59.0,24.78,13.44,57.82,37
CPT,82104,LAB ALPHA-1-ANTITRYPSIN PHENOTYPE,63.0,26.46,14.46,61.74,37
CPT,82105,LAB AFP SERUM,51.0,21.42,13.77,49.98,37
CPT,82105,LAB AFP SERUM MATERNAL,51.0,21.42,13.77,49.98,37
CPT,82107,LAB AFP-L3 ISOFORM FRAC&AFP TOTAL,194.0,81.48,52.38,190.12,37
CPT,82108,LAB ALUMINUM,77.0,32.34,20.79,75.46,37
CPT,82131,LAB ACIDS AMINO SGL QN SPEC EA,91.0,38.22,22.98,89.18,37
CPT,82135,LAB ACID AMINOLEVULINIC DELTA URINE,75.0,31.5,16.45,73.5,37
CPT,82139,LAB ACIDS AMINO 6+ QN SPEC EA,141.0,59.22,16.87,138.18,37
CPT,82139,LAB ACIDS AMINO 6+ QN URINE SPEC EA,141.0,59.22,16.87,138.18,37
CPT,82140,LAB AMMONIA,44.0,18.48,11.88,43.12,37
CPT,82140,LAB AMMONIA STONE RISK,115.0,48.3,14.57,112.7,37
CPT,82150,LAB AMYLASE,20.0,8.4,5.4,19.6,37
CPT,82150,LAB AMYLASE FLUID BODY,52.0,21.84,6.48,50.96,37
CPT,82150,LAB AMYLASE FLUID CYST PANCREATIC,341.0,143.22,6.48,334.18,37
CPT,82150,LAB AMYLASE TOTAL,54.0,22.68,6.48,52.92,37
CPT,82150,LAB AMYLASE URINE,53.0,22.26,6.48,51.94,37
CPT,82157,LAB ANDROSTENEDIONE,88.0,36.96,23.76,86.24,37
CPT,82164,LAB ANGIOTENSIN I CONVERTING ENZYME,61.0,25.62,14.6,59.78,37
CPT,82166,LAB HORMONE ANTIMULLERIAN,116.0,48.72,31.32,113.68,37
CPT,82166,LAB HORMONE ANTIMULLERIAN NS,116.0,48.72,31.32,113.68,37
CPT,82172,LAB APOLIPOPROTEIN A1 EA,77.0,32.34,20.79,75.46,37
CPT,82172,LAB APOLIPOPROTEIN A1 EA NS,77.0,32.34,20.79,75.46,37
CPT,82172,LAB APOLIPOPROTEIN B EA,64.0,26.88,17.28,62.72,37
CPT,82172,LAB APOLIPOPROTEIN EA,64.0,26.88,17.28,62.72,37
CPT,82175,LAB ARSENIC BLOOD NS,63.0,26.46,17.01,61.74,37
CPT,82175,LAB ARSENIC NON BLOOD,95.0,39.9,18.97,93.1,37
CPT,82180,LAB ACID ASCORBIC BLOOD,59.0,24.78,9.89,57.82,37
CPT,82232,LAB MICROGLOBULIN BETA-2,58.0,24.36,15.66,56.84,37
CPT,82233,LAB BETA AMYLOID 1-40,387.0,162.54,104.49,379.26,37
CPT,82234,LAB BETA AMYLOID 1-42,387.0,162.54,104.49,379.26,37
CPT,82239,LAB ACIDS BILE TOTAL,63.0,26.46,17.01,61.74,37
CPT,82247,LAB BILIRUBIN TOTAL,16.0,6.72,4.32,15.68,37
CPT,82247,LAB BILIRUBIN TOTAL FLUID BODY,57.0,23.94,5.02,55.86,37
CPT,82247,LAB BILIRUBIN TOTAL FLUID BODY NS,136.0,57.12,5.02,133.28,37
CPT,82247,LAB BILIRUBIN TOTAL NS,58.0,24.36,5.02,56.84,37
CPT,82248,LAB BILIRUBIN DIRECT,16.0,6.72,4.32,15.68,37
CPT,82248,LAB BILIRUBIN DIRECT FLUID BODY,16.0,6.72,4.32,15.68,37
CPT,82261,LAB BIOTINIDASE SPEC EA,112.0,47.04,16.87,109.76,37
CPT,82270,LAB BLOOD OCCULT FECES SINGLE QL,14.0,5.88,3.78,13.72,37
CPT,82271,LAB BLOOD OCCULT OTHER SOURCE QL,16.0,6.72,4.32,15.68,37
CPT,82271,POC BLOOD OCCULT OTHER SOURCE QL,16.0,6.72,4.32,15.68,37
CPT,82272,POC BLOOD OCCULT FECES 1-3 TESTS QL,13.0,5.46,3.51,12.74,37
CPT,82274,LAB BLOOD OCCULT FECES 1-3 IMM NS,62.0,26.04,15.92,60.76,37
CPT,82274,LAB BLOOD OCCULT FECES 1-3 IMM QL,62.0,26.04,15.92,60.76,37
CPT,82300,LAB CADMIUM,71.0,29.82,19.17,69.58,37
CPT,82306,LAB VITAMIN D 25 HYDROXY W FRAC,89.0,37.38,24.03,87.22,37
CPT,82306,LAB VITAMIN D 25 HYDROXY W FRAC NS,89.0,37.38,24.03,87.22,37
CPT,82308,LAB CALCITONIN,81.0,34.02,21.87,79.38,37
CPT,82310,LAB CALCIUM TOTAL,16.0,6.72,4.32,15.68,37
CPT,82310,LAB CALCIUM TOTAL NS,65.0,27.3,5.16,63.7,37
CPT,82310,LAB CALCIUM TOTAL URINE,56.0,23.52,5.16,54.88,37
CPT,82330,LAB CALCIUM IONIZED,54.0,22.68,13.68,52.92,37
CPT,82330,POC CALCIUM IONIZED,42.0,17.64,11.34,41.16,37
CPT,82330,POC CALCIUM IONIZED TELCOR,42.0,17.64,11.34,41.16,37
CPT,82340,LAB CALCIUM STONE RISK,77.0,32.34,6.03,75.46,37
CPT,82340,LAB CALCIUM URINE QN TIMED,56.0,23.52,6.03,54.88,37
CPT,82365,LAB CALCULUS SPECTROSCOPY INFRARED,74.0,31.08,12.9,72.52,37
CPT,82374,LAB CARBON DIOXIDE HCO3,15.0,6.3,4.05,14.7,37
CPT,82375,LAB CARBOXYHEMOGLOBIN QN,56.0,23.52,12.32,54.88,37
CPT,82375,LAB CARBOXYHEMOGLOBIN QN NS,75.0,31.5,12.32,73.5,37
CPT,82375,POC CARBOXYHEMOGLOBIN QN,37.0,15.54,9.99,36.26,37
CPT,82378,LAB AG CARCINOEMBRYONIC,57.0,23.94,15.39,55.86,37
CPT,82378,LAB AG CARCINOEMBRYONIC ARUP NS,68.0,28.56,18.36,66.64,37
CPT,82378,LAB AG CARCINOEMBRYONIC MAYO NS,329.0,138.18,18.96,322.42,37
CPT,82379,LAB CARNITINE TOTAL&FREE QN,78.0,32.76,16.87,76.44,37
CPT,82380,LAB CAROTENE,67.0,28.14,9.22,65.66,37
CPT,82384,LAB CATECHOLAMINES FRACTIONATED,76.0,31.92,20.52,74.48,37
CPT,82390,LAB CERULOPLASMIN,53.0,22.26,10.74,51.94,37
CPT,82397,LAB CHEMILUMINESCENT,70.0,29.4,14.12,68.6,37
CPT,82435,LAB CHLORIDE BLOOD,14.0,5.88,3.78,13.72,37
CPT,82435,POC CHLORIDE BLOOD,14.0,5.88,3.78,13.72,37
CPT,82435,POC CHLORIDE BLOOD TELCOR,14.0,5.88,3.78,13.72,37
CPT,82436,LAB CHLORIDE URINE,18.0,7.56,4.86,17.64,37
CPT,82438,LAB CHLORIDE FLUID BODY,51.0,21.42,5.0,49.98,37
CPT,82438,LAB CHLORIDE STOOL NS,58.0,24.36,5.0,56.84,37
CPT,82465,LAB CHOLESTEROL SRM/BLD WHL TTL,55.0,23.1,4.35,53.9,37
CPT,82465,LAB CHOLESTEROL SRM/BLD WHL TTL NS,56.0,23.52,4.35,54.88,37
CPT,82480,LAB CHOLINESTERASE SERUM NS,61.0,25.62,7.87,59.78,37
CPT,82482,LAB CHOLINESTERASE RBC,59.0,24.78,9.81,57.82,37
CPT,82495,LAB CHROMIUM,61.0,25.62,16.47,59.78,37
CPT,82507,LAB CITRATE,84.0,35.28,22.68,82.32,37
CPT,82507,LAB CITRATE STONE RISK,174.0,73.08,27.8,170.52,37
CPT,82523,LAB CROSS LINKS DEOXYPYRIDINOLINE,113.0,47.46,18.68,110.74,37
CPT,82523,LAB CROSS LINKS N-TELOPEPTIDE,68.0,28.56,18.36,66.64,37
CPT,82525,LAB COPPER SERUM,63.0,26.46,12.41,61.74,37
CPT,82525,LAB COPPER TISSUE NS,211.0,88.62,12.41,206.78,37
CPT,82525,LAB COPPER URINE,65.0,27.3,12.41,63.7,37
CPT,82528,LAB CORTICOSTERONE,83.0,34.86,22.41,81.34,37
CPT,82530,LAB CORTISOL FREE,55.0,23.1,14.85,53.9,37
CPT,82533,LAB CORTISOL TOTAL,58.0,24.36,15.66,56.84,37
CPT,82533,LAB CORTISOL TOTAL NS,323.0,135.66,16.3,316.54,37
CPT,82540,LAB CREATINE URINE,60.0,25.2,4.64,58.8,37
CPT,82542,LAB CHROMAT MS APOE ISOFORM,550.0,231.0,24.09,539.0,37
CPT,82542,LAB CHROMAT MS BETA AMYLOID RATIO,1409.0,591.78,24.09,1380.82,37
CPT,82542,LAB CHROMAT MS BILE ACIDS FRAC/TTL,259.0,108.78,24.09,253.82,37
CPT,82542,LAB CHROMAT MS GLUTARIC ACID,400.0,168.0,24.09,392.0,37
CPT,82542,LAB CHROMAT MS IODINE QL/QN,73.0,30.66,19.71,71.54,37
CPT,82542,LAB CHROMAT MS LEUKOTRIENE,325.0,136.5,24.09,318.5,37
CPT,82542,LAB CHROMAT MS METHOXYTYRAMINE,392.0,164.64,24.09,384.16,37
CPT,82542,LAB CHROMAT MS NON-DRUG QL/QN,75.0,31.5,20.25,73.5,37
CPT,82542,LAB CHROMAT MS NON-DRUG QL/QN NS,73.0,30.66,19.71,71.54,37
CPT,82542,LAB CHROMAT MS OMEGA FATTY ACIDS,100.0,42.0,24.09,98.0,37
CPT,82542,LAB CHROMAT MS ORGANIC ACIDS,153.0,64.26,24.09,149.94,37
CPT,82542,LAB CHROMAT MS PROT AMYLOID QN,909.0,381.78,24.09,890.82,37
CPT,82542,LAB CHROMAT/MS METHYLTETRAHYDOFOLAT,266.0,111.72,24.09,260.68,37
CPT,82542,LAB CHROMAT/MS NEOPTERIN,275.0,115.5,24.09,269.5,37
CPT,82550,LAB CREATINE KINASE TOTAL,20.0,8.4,5.4,19.6,37
CPT,82550,LAB CREATINE KINASE TOTAL NS,55.0,23.1,6.51,53.9,37
CPT,82552,LAB CREATINE KINASE ISOENZYMES,59.0,24.78,13.39,57.82,37
CPT,82553,LAB CREATINE KINASE MB ONLY QN,35.0,14.7,9.45,34.3,37
CPT,82565,LAB CREATININE BLOOD,16.0,6.72,4.32,15.68,37
CPT,82565,POC CREATININE BLOOD,16.0,6.72,4.32,15.68,37
CPT,82565,POC CREATININE BLOOD TELCOR,16.0,6.72,4.32,15.68,37
CPT,82570,LAB CREATININE FLUID BODY,56.0,23.52,5.18,54.88,37
CPT,82570,LAB CREATININE OTHER SOURCE,80.0,33.6,5.18,78.4,37
CPT,82570,LAB CREATININE STONE RISK,73.0,30.66,5.18,71.54,37
CPT,82570,LAB CREATININE URINE,16.0,6.72,4.32,15.68,37
CPT,82570,LAB CREATININE URINE NS,52.0,21.84,5.18,50.96,37
CPT,82575,LAB CREATININE CLEARANCE,29.0,12.18,7.83,28.42,37
CPT,82585,LAB CRYOFIBRINOGEN MAYO NS,153.0,64.26,14.14,149.94,37
CPT,82585,LAB CRYOFIBRINOGEN NS,69.0,28.98,14.14,67.62,37
CPT,82595,LAB CRYOGLOBULIN QL/SEMI QN,63.0,26.46,6.47,61.74,37
CPT,82595,LAB CRYOGLOBULIN QL/SEMI QN NS,63.0,26.46,6.47,61.74,37
CPT,82600,LAB CYANIDE,78.0,32.76,19.4,76.44,37
CPT,82607,LAB CYANOCOBALAMIN,54.0,22.68,14.58,52.92,37
CPT,82608,LAB VITAMIN B-12 CAPACITY BNDG NS,66.0,27.72,14.32,64.68,37
CPT,82610,LAB CYSTATIN C,56.0,23.52,15.12,54.88,37
CPT,82626,LAB DEHYDROEPIANDROSTERONE,76.0,31.92,20.52,74.48,37
CPT,82627,LAB DEHYDROEPIANDROSTERONE-SULFATE,67.0,28.14,18.09,65.66,37
CPT,82633,LAB DESOXYCORTICOSTERONE,93.0,39.06,25.11,91.14,37
CPT,82634,LAB DEOXYCORTISOL 11-,88.0,36.96,23.76,86.24,37
CPT,82642,LAB DIHYDROTESTOSTERONE,88.0,36.96,23.76,86.24,37
CPT,82652,LAB VITAMIN D 1 25 DIHYDROXY FRAC,116.0,48.72,31.32,113.68,37
CPT,82653,LAB IMM ELASTASE PANCREATIC QN,100.0,42.0,22.97,98.0,37
CPT,82656,LAB ELASTASE PANCREATIC FECAL,104.0,43.68,11.53,101.92,37
CPT,82657,LAB ACTIVITY ENZYME ALPHA GALACTOS,375.0,157.5,22.17,367.5,37
CPT,82657,LAB ACTIVITY ENZYME CHITOTRIOSIDASE,362.0,152.04,22.17,354.76,37
CPT,82657,LAB ACTIVITY ENZYME L-ASPARAGNSE,325.0,136.5,22.17,318.5,37
CPT,82657,LAB ACTIVITY ENZYME NONRADIOACTIVE,121.0,50.82,22.17,118.58,37
CPT,82664,LAB ELECTRO,185.0,77.7,49.95,181.3,37
CPT,82668,LAB ERYTHROPOIETIN,57.0,23.94,15.39,55.86,37
CPT,82670,LAB ESTRADIOL TOTAL,84.0,35.28,22.68,82.32,37
CPT,82670,LAB ESTRADIOL TOTAL NS,84.0,35.28,22.68,82.32,37
CPT,82671,LAB ESTROGENS FRACTIONATED,98.0,41.16,26.46,96.04,37
CPT,82672,LAB ESTROGEN TOTAL NS,66.0,27.72,17.82,64.68,37
CPT,82677,LAB ESTRIOL SERUM,73.0,30.66,19.71,71.54,37
CPT,82677,LAB ESTRIOL SERUM NS,73.0,30.66,19.71,71.54,37
CPT,82679,LAB ESTRONE,75.0,31.5,20.25,73.5,37
CPT,82681,LAB ESTRADIOL FREE MEASURE DIRECT,84.0,35.28,22.68,82.32,37
CPT,82693,LAB ETHYLENE GLYCOL,81.0,34.02,14.9,79.38,37
CPT,82693,LAB ETHYLENE GLYCOL NS,94.0,39.48,14.9,92.12,37
CPT,82705,LAB FAT/LIPIDS FECES QL NS,68.0,28.56,5.1,66.64,37
CPT,82710,LAB FAT/LIPIDS FECES QN,51.0,21.42,13.77,49.98,37
CPT,82725,LAB ACIDS FATTY NONESTERIFIED,69.0,28.98,18.63,67.62,37
CPT,82726,LAB ACIDS FATTY VERY LONG CHAIN,205.0,86.1,19.75,200.9,37
CPT,82728,LAB FERRITIN,60.0,25.2,13.63,58.8,37
CPT,82731,LAB FIBRONECTIN FETAL SEMI QL,194.0,81.48,52.38,190.12,37
CPT,82746,LAB ACID FOLIC SERUM,45.0,18.9,12.15,44.1,37
CPT,82747,LAB ACID FOLIC RBC,55.0,23.1,14.85,53.9,37
CPT,82775,LAB TRANSFERASE GALACTOSE-1 QN,173.0,72.66,21.07,169.54,37
CPT,82776,LAB SCR TRANSFERASE GALACTOSE-1,36.0,15.12,9.72,35.28,37
CPT,82784,LAB IG IGA IGD IGG IGM CSF EA,63.0,26.46,9.3,61.74,37
CPT,82784,LAB IG IGA IGD IGG IGM SERUM EA,52.0,21.84,9.3,50.96,37
CPT,82784,LAB IG IGA SERUM NS,56.0,23.52,9.3,54.88,37
CPT,82784,LAB IG IGD SERUM EA,63.0,26.46,9.3,61.74,37
CPT,82784,LAB IG IGG SERUM EA,56.0,23.52,9.3,54.88,37
CPT,82785,LAB IG IGE,58.0,24.36,15.66,56.84,37
CPT,82785,LAB IG IGE NS,58.0,24.36,15.66,56.84,37
CPT,82787,LAB IG SUBCLASSES EA,59.0,24.78,8.02,57.82,37
CPT,82800,LAB GASES BLD PH ONLY,33.0,13.86,8.91,32.34,37
CPT,82800,POC GASES BLD PH ONLY,33.0,13.86,8.91,32.34,74
CPT,82800,POC GASES BLD PH ONLY TELCOR,33.0,13.86,8.91,32.34,37
CPT,82803,LAB GASES BLD ANY COMBO ARTERIAL,79.0,33.18,21.33,77.42,37
CPT,82803,LAB GASES BLD ANY COMBO VENOUS,79.0,33.18,21.33,77.42,37
CPT,82803,POC GASES BLD ANY COMBO,79.0,33.18,21.33,77.42,37
CPT,82803,POC GASES BLD ANY COMBO TELCOR,79.0,33.18,21.33,77.42,37
CPT,82805,LAB GASES BLD ANY COMBO W SAT O2,237.0,99.54,63.99,232.26,37
CPT,82805,POC GASES BLD ANY COMBO W SAT O2,237.0,99.54,63.99,232.26,37
CPT,82810,LAB GASES BLD SAT O2 ONLY,98.0,41.16,9.77,96.04,37
CPT,82941,LAB GASTRIN,58.0,24.36,15.66,56.84,37
CPT,82943,LAB GLUCAGON,67.0,28.14,14.29,65.66,37
CPT,82945,LAB GLUCOSE CSF,55.0,23.1,3.93,53.9,37
CPT,82945,LAB GLUCOSE FLUID BODY,56.0,23.52,3.93,54.88,37
CPT,82945,LAB GLUCOSE FLUID BODY NS,131.0,55.02,3.93,128.38,37
CPT,82945,LAB GLUCOSE URINE RANDOM,55.0,23.1,3.93,53.9,37
CPT,82945,LAB GLUCOSE URINE TIMED,56.0,23.52,3.93,54.88,37
CPT,82948,LAB GLUCOSE BLOOD REAGENT STRIP,16.0,6.72,4.32,15.68,37
CPT,82950,LAB GLUCOSE POST DOSE,15.0,6.3,4.05,14.7,37
CPT,82951,LAB GLUCOSE TOLERANCE SPEC 1ST 3,39.0,16.38,10.53,38.22,37
CPT,82952,LAB GLUCOSE TOLERANCE SPEC EA ADDL,12.0,5.04,3.24,11.76,37
CPT,82955,LAB DEHYDROGENASE G6PD QN NS,56.0,23.52,9.7,54.88,37
CPT,82977,LAB TRANSFERASE GAMMA-GLUTAMYL,22.0,9.24,5.94,21.56,37
CPT,82977,LAB TRANSFERASE GAMMA-GLUTAMYL NS,62.0,26.04,7.2,60.76,37
CPT,82985,LAB PROT GLYCATED,53.0,22.26,14.31,51.94,37
CPT,83001,LAB GONADOTROPIN FSH SERUM,56.0,23.52,15.12,54.88,37
CPT,83001,LAB GONADOTROPIN FSH SERUM NS,58.0,24.36,15.66,56.84,37
CPT,83002,LAB GONADOTROPIN LH,58.0,24.36,15.66,56.84,37
CPT,83002,LAB GONADOTROPIN LH NS,57.0,23.94,15.39,55.86,37
CPT,83003,LAB HORMONE HUMAN GROWTH,51.0,21.42,13.77,49.98,37
CPT,83006,LAB GROWTH STIMULATION GENE 2,227.0,95.34,61.29,222.46,37
CPT,83010,LAB HAPTOGLOBIN QN,53.0,22.26,12.58,51.94,37
CPT,83010,LAB HAPTOGLOBIN QN NS,59.0,24.78,12.58,57.82,37
CPT,83013,LAB H PYLORI UREASE NONRADIOACT,203.0,85.26,54.81,198.94,37
CPT,83018,LAB HEAVY METAL QN COBALT,288.0,120.96,21.96,282.24,37
CPT,83018,LAB HEAVY METAL QN EA,106.0,44.52,21.96,103.88,37
CPT,83020,LAB HEMOGLOBIN FRCTN&QN ELECTRO NS,71.0,29.82,12.87,69.58,37
CPT,83021,LAB HEMOGLOBIN FRCTN&QN CHROMAT NS,55.0,23.1,14.85,53.9,37
CPT,83033,LAB HEMOGLOBIN FETAL QL,123.0,51.66,8.0,120.54,37
CPT,83036,HEMOGLOBIN A1C DSM,30.0,12.6,8.1,29.4,37
CPT,83036,LAB HEMOGLOBIN A1C,30.0,12.6,8.1,29.4,37
CPT,83050,LAB HEMOGLOBIN METHEMOGLOBIN QN,59.0,24.78,8.2,57.82,37
CPT,83050,POC HEMOGLOBIN METHEMOGLOBIN QN,25.0,10.5,6.75,24.5,37
CPT,83051,LAB HEMOGLOBIN PLASMA,59.0,24.78,7.31,57.82,37
CPT,83060,LAB HEMOGLOBIN SULFHEMOGLOBIN QN,172.0,72.24,8.8,168.56,37
CPT,83068,LAB SCR HEMOGLOBIN UNSTABLE,126.0,52.92,9.47,123.48,37
CPT,83070,LAB HEMOSIDERIN QL,67.0,28.14,4.75,65.66,37
CPT,83088,LAB HISTAMINE,89.0,37.38,24.03,87.22,37
CPT,83090,LAB HOMOCYSTEINE SERUM,58.0,24.36,15.66,56.84,37
CPT,83150,LAB ACID HOMOVANILLIC,68.0,28.56,18.36,66.64,37
CPT,83497,LAB ACID HYDROXYINDOLACETIC 5-,61.0,25.62,12.9,59.78,37
CPT,83498,LAB HYDROXYPROGESTERONE 17-D NS,82.0,34.44,22.14,80.36,37
CPT,83500,LAB HYDROXYPROLINE FREE,112.0,47.04,22.65,109.76,37
CPT,83516,LAB IMM MS 21-HYDROXYLASE QL,114.0,47.88,11.53,111.72,37
CPT,83516,LAB IMM MS ALPHA 2 MACROGLOBULIN,59.0,24.78,11.53,57.82,37
CPT,83516,LAB IMM MS ANTI TH/TO AB,135.0,56.7,11.53,132.3,37
CPT,83516,LAB IMM MS GP210 IGG,148.0,62.16,11.53,145.04,37
CPT,83516,LAB IMM MS HISTONE QL,62.0,26.04,11.53,60.76,37
CPT,83516,LAB IMM MS MYOSITIS,67.0,28.14,11.53,65.66,37
CPT,83516,LAB IMM MS NEUROMYLTS OPT IGG QL,35.0,14.7,9.45,34.3,37
CPT,83516,LAB IMM MS PHOSPHAT/PROTHROMBIN NS,59.0,24.78,11.53,57.82,37
CPT,83516,LAB IMM MS POLYMERASE III AB,107.0,44.94,11.53,104.86,37
CPT,83516,LAB IMM MS QL/SEMI QN NS,57.0,23.94,11.53,55.86,37
CPT,83516,LAB IMM MS RIBO P PROTEIN QL,35.0,14.7,9.45,34.3,37
CPT,83516,LAB IMM MS SP100 IGG,104.0,43.68,11.53,101.92,37
CPT,83518,LAB IMM SGL STEP QL/SEMI QN NS,524.0,220.08,9.64,513.52,37
CPT,83519,LAB IMM RIA PTH REL PROT QN,72.0,30.24,18.4,70.56,37
CPT,83519,LAB IMM RIA QN,94.0,39.48,18.4,92.12,37
CPT,83519,LAB IMM RIA RECEPTOR TSH QN,101.0,42.42,18.4,98.98,37
CPT,83519,LAB IMM RIA TRYPSIN QN,82.0,34.44,18.4,80.36,37
CPT,83520,LAB IMM AB ADALIMUMAB ANTIDRUG,286.0,120.12,17.27,280.28,37
CPT,83520,LAB IMM AB ADAMTS 13,300.0,126.0,17.27,294.0,37
CPT,83520,LAB IMM AB BP180 QN,73.0,30.66,17.27,71.54,37
CPT,83520,LAB IMM AB BP230 QN,90.0,37.8,17.27,88.2,37
CPT,83520,LAB IMM AB GBM QN,60.0,25.2,16.2,58.8,37
CPT,83520,LAB IMM AB GBM QN NS,52.0,21.84,14.04,50.96,37
CPT,83520,LAB IMM AB HMGCR IGG,315.0,132.3,17.27,308.7,37
CPT,83520,LAB IMM AB LDL OXIDIZED,100.0,42.0,17.27,98.0,37
CPT,83520,LAB IMM AB NEURONAL QN,52.0,21.84,14.04,50.96,37
CPT,83520,LAB IMM AG ANTI-SOLUBLE LIVER QN,71.0,29.82,17.27,69.58,37
CPT,83520,LAB IMM ALZHEIMER EVALUATION,351.0,147.42,17.27,343.98,37
CPT,83520,LAB IMM ANALYTE CYTOKINES QN,135.0,56.7,17.27,132.3,37
CPT,83520,LAB IMM ANALYTE OTHER QN,80.0,33.6,17.27,78.4,37
CPT,83520,LAB IMM ANALYTE PIGF,72.0,30.24,17.27,70.56,37
CPT,83520,LAB IMM ANALYTE SFIT-1,72.0,30.24,17.27,70.56,37
CPT,83520,LAB IMM CYSTIC FIBROSIS QN,52.0,21.84,14.04,50.96,37
CPT,83520,LAB IMM GANGLIOSIDE GM TRIPLE QN,70.0,29.4,17.27,68.6,37
CPT,83520,LAB IMM GLYCPROT MYELIN ASSC IGM,69.0,28.98,17.27,67.62,37
CPT,83520,LAB IMM GROWTH DIFFER FACTOR 15,295.0,123.9,17.27,289.1,37
CPT,83520,LAB IMM IGFBP 3 QN,64.0,26.88,17.27,62.72,37
CPT,83520,LAB IMM INHIBIN B QN,104.0,43.68,17.27,101.92,37
CPT,83520,LAB IMM NEOPTERIN,202.0,84.84,17.27,197.96,37
CPT,83520,LAB IMM NEUTRPHL GEL-ASSC LIPOCALIN,52.0,21.84,14.04,50.96,37
CPT,83520,LAB IMM PHOS TAU/TTL TAU/BETA42,650.0,273.0,17.27,637.0,37
CPT,83520,LAB IMM POLY PANCREATIC QN,91.0,38.22,17.27,89.18,37
CPT,83520,LAB IMM RECEPTOR TSH QN,52.0,21.84,14.04,50.96,37
CPT,83520,LAB IMM TRYPTASE QN,77.0,32.34,17.27,75.46,37
CPT,83520,LAB IMM VWF BINDING ASSAY,145.0,60.9,17.27,142.1,37
CPT,83521,LAB IG FREE LIGHT CHAIN SERUM EA,61.0,25.62,16.47,59.78,37
CPT,83521,LAB IG FREE LIGHT CHAIN URINE EA,69.0,28.98,17.27,67.62,37
CPT,83525,LAB INSULIN TOTAL,57.0,23.94,11.43,55.86,37
CPT,83527,LAB INSULIN FREE,79.0,33.18,12.95,77.42,37
CPT,83529,LAB IMM INTERLEUKIN 6 QN,109.0,45.78,17.27,106.82,37
CPT,83540,LAB IRON,20.0,8.4,5.4,19.6,37
CPT,83540,LAB IRON TISSUE LIVER,208.0,87.36,6.47,203.84,37
CPT,83550,LAB CAPACITY IRON BINDING,27.0,11.34,7.29,26.46,37
CPT,83605,LAB LACTATE/LACTIC ACID,35.0,14.7,9.45,34.3,37
CPT,83615,LAB LDH,19.0,7.98,5.13,18.62,37
CPT,83615,LAB LDH CSF,56.0,23.52,6.04,54.88,37
CPT,83615,LAB LDH FLUID BODY,57.0,23.94,6.04,55.86,37
CPT,83615,LAB LDH NS,55.0,23.1,6.04,53.9,37
CPT,83625,LAB LDH ISOENZYMES,59.0,24.78,12.79,57.82,37
CPT,83630,LAB LACTOFERRIN FECAL QL,73.0,30.66,19.7,71.54,37
CPT,83630,LAB LACTOFERRIN FECAL QL NS,98.0,41.16,19.7,96.04,37
CPT,83631,LAB LACTOFERRIN FECAL QN,204.0,85.68,19.63,199.92,37
CPT,83655,LAB LEAD BLOOD,59.0,24.78,12.11,57.82,37
CPT,83655,LAB LEAD BLOOD NS,37.0,15.54,9.99,36.26,37
CPT,83655,LAB LEAD NON BLOOD,79.0,33.18,12.11,77.42,37
CPT,83690,LAB LIPASE,21.0,8.82,5.67,20.58,37
CPT,83690,LAB LIPASE FLUID BODY,52.0,21.84,6.89,50.96,37
CPT,83690,LAB LIPASE FLUID BODY NS,58.0,24.36,6.89,56.84,37
CPT,83695,LAB LIPOPROTEIN A,57.0,23.94,14.32,55.86,37
CPT,83695,LAB LIPOPROTEIN A NS,58.0,24.36,14.32,56.84,37
CPT,83698,LAB LIPOPROTEIN PHOSPHOLIPASE A2,139.0,58.38,37.53,136.22,37
CPT,83700,LAB LIPOPROTEIN ELECTRO,64.0,26.88,11.26,62.72,37
CPT,83701,LAB LIPOPROTEIN FRCTN HR,102.0,42.84,27.54,99.96,37
CPT,83701,LAB LIPOPROTEIN FRCTN HR NS,102.0,42.84,27.54,99.96,37
CPT,83704,LAB LIPOPROTEIN PART NO/S&SBCLS QN,103.0,43.26,27.81,100.94,37
CPT,83718,LAB LIPOPROTEIN CHOLESTEROL HDL,60.0,25.2,8.19,58.8,37
CPT,83721,LAB LIPOPROTEIN CHOLESTEROL LDL,32.0,13.44,8.64,31.36,37
CPT,83722,LAB LIPOPROTEIN CHOLESTEROL LDL SD,103.0,43.26,27.81,100.94,37
CPT,83735,LAB MAGNESIUM,21.0,8.82,5.67,20.58,37
CPT,83735,LAB MAGNESIUM NS,88.0,36.96,6.7,86.24,37
CPT,83735,LAB MAGNESIUM STOOL,21.0,8.82,5.67,20.58,37
CPT,83735,LAB MAGNESIUM URINE,52.0,21.84,6.7,50.96,37
CPT,83735,LAB MAGNESIUM URINE NS,21.0,8.82,5.67,20.58,37
CPT,83785,LAB MANGANESE,80.0,33.6,21.6,78.4,37
CPT,83789,LAB MS&MS TNDM NON-DRUG QL/QN,73.0,30.66,19.71,71.54,37
CPT,83825,LAB MERCURY BLOOD QN,49.0,20.58,13.23,48.02,37
CPT,83825,LAB MERCURY NON BLOOD QN,88.0,36.96,16.26,86.24,37
CPT,83835,LAB METANEPHRINES,66.0,27.72,16.94,64.68,37
CPT,83873,LAB PROT MYELIN BASIC CSF,63.0,26.46,17.01,61.74,37
CPT,83874,LAB MYOGLOBIN,59.0,24.78,12.92,57.82,37
CPT,83874,LAB MYOGLOBIN URINE,59.0,24.78,12.92,57.82,37
CPT,83880,LAB PEPTIDE NATRIURETIC PB,118.0,49.56,31.86,115.64,37
CPT,83880,LAB PEPTIDE NATRIURETIC PB NS,121.0,50.82,32.67,118.58,37
CPT,83883,LAB ALPHA2-MACROGLOBULIN QN,72.0,30.24,13.6,70.56,37
CPT,83883,LAB KAPPA/LAMBDA LIGHT,69.0,28.98,13.6,67.62,37
CPT,83883,LAB KAPPA/LAMBDA LIGHT NS,55.0,23.1,13.6,53.9,37
CPT,83883,LAB NEPHELOMETRY ANALYTE EA,41.0,17.22,11.07,40.18,37
CPT,83883,LAB NEPHELOMETRY RETINL BIND PROT,365.0,153.3,13.6,357.7,37
CPT,83884,LAB NEUROFILAMENT LC PLASMA,350.0,147.0,94.5,343.0,37
CPT,83915,LAB NUCLEOTIDASE 5-,99.0,41.58,11.15,97.02,37
CPT,83916,LAB BANDS OLIGOCLONAL CSF,83.0,34.86,22.41,81.34,37
CPT,83918,LAB ACIDS ORGANIC TOTAL URINE EA QN,101.0,42.42,23.6,98.98,37
CPT,83919,LAB ACIDS ORGANIC EA QL,50.0,21.0,13.5,49.0,37
CPT,83919,LAB ACIDS ORGANIC URINE EA QL,50.0,21.0,13.5,49.0,37
CPT,83921,LAB ACID ORGANIC SINGLE METHY QN NS,64.0,26.88,17.28,62.72,37
CPT,83921,LAB ACID ORGANIC SINGLE QN,195.0,81.9,21.21,191.1,37
CPT,83930,LAB OSMOLALITY BLOOD,56.0,23.52,6.61,54.88,37
CPT,83935,LAB OSMOLALITY URINE,56.0,23.52,6.82,54.88,37
CPT,83937,LAB OSTEOCALCIN,90.0,37.8,24.3,88.2,37
CPT,83945,LAB OXALATE,109.0,45.78,14.45,106.82,37
CPT,83945,LAB OXALATE STONE RISK,108.0,45.36,14.45,105.84,37
CPT,83945,LAB OXALATE URINE,67.0,28.14,14.45,65.66,37
CPT,83970,LAB PARATHORMONE,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE C-TERMINAL,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE INTRAOP BASELINE 1,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE INTRAOP BASELINE 2,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE INTRAOP EA ADDL,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE INTRAOP POST 10 MN,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE INTRAOP POST 5 MN,124.0,52.08,33.48,121.52,37
CPT,83970,LAB PARATHORMONE NS,124.0,52.08,33.48,121.52,37
CPT,83986,LAB PH FLUID BODY NOS,51.0,21.42,3.58,49.98,37
CPT,83986,LAB PH FLUID BODY NOS NS,104.0,43.68,3.58,101.92,37
CPT,83986,LAB PH STONE RISK,66.0,27.72,3.58,64.68,37
CPT,83986,LAB PH STOOL NS,72.0,30.24,3.58,70.56,37
CPT,83992,LAB DRG DF CNFRM PHENCYCLDN/PCP DAY,67.0,28.14,18.09,65.66,30
CPT,83992,LAB DRG DF PHENCYCLDN NON URINE,56.0,23.52,15.12,54.88,30
CPT,83992,LAB DRG DF PHENCYCLIDINE,94.0,39.48,25.38,92.12,30
CPT,83993,LAB CALPROTECTIN FECAL,250.0,105.0,19.63,245.0,37
CPT,84030,LAB PHENYLALANINE BLOOD,17.0,7.14,4.59,16.66,37
CPT,84060,LAB ACID PHOSPHATASE TOTAL NS,63.0,26.46,7.64,61.74,37
CPT,84066,LAB ACID PHOSPHATASE PROSTATIC,60.0,25.2,9.66,58.8,37
CPT,84075,LAB ALKALINE PHOSPHATASE,16.0,6.72,4.32,15.68,37
CPT,84075,LAB ALKALINE PHOSPHATASE NS,57.0,23.94,5.18,55.86,37
CPT,84080,LAB ALKALINE PHOSPHATASE ISOENZYMES,57.0,23.94,14.78,55.86,37
CPT,84100,LAB PHOSPHORUS INORGANIC,15.0,6.3,4.05,14.7,37
CPT,84100,LAB PHOSPHORUS INORGANIC NS,15.0,6.3,4.05,14.7,37
CPT,84105,LAB PHOSPHORUS INORGANIC URINE,52.0,21.84,5.78,50.96,37
CPT,84105,LAB PHOSPHORUS INORGANIC URINE NS,18.0,7.56,4.86,17.64,37
CPT,84105,LAB PHOSPHORUS STONE RISK,74.0,31.08,5.78,72.52,37
CPT,84110,LAB PORPHOBILINOGEN URINE QN,62.0,26.04,8.44,60.76,37
CPT,84112,POC PAMG-1 CERVICOVAGINAL QL,295.0,123.9,79.65,289.1,37
CPT,84120,LAB PORPHYRINS URINE QN&FRCTN,62.0,26.04,14.71,60.76,37
CPT,84132,LAB POTASS BLD WHL RBC,82.0,34.44,4.76,80.36,37
CPT,84132,LAB POTASS PLASMA,59.0,24.78,4.76,57.82,37
CPT,84132,LAB POTASS SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CPT,84132,POC POTASS SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CPT,84132,POC POTASS SRM/PLASMA/BLD WHL TLCR,15.0,6.3,4.05,14.7,37
CPT,84133,LAB POTASS URINE,55.0,23.1,4.73,53.9,37
CPT,84133,LAB POTASSIUM STONE RISK,70.0,29.4,4.73,68.6,37
CPT,84134,LAB PREALBUMIN,54.0,22.68,14.58,52.92,37
CPT,84140,LAB PREGNENOLONE,63.0,26.46,17.01,61.74,37
CPT,84143,LAB 17-HYDROXYPREGNENOLONE,69.0,28.98,18.63,67.62,37
CPT,84144,LAB PROGESTERONE,63.0,26.46,17.01,61.74,37
CPT,84145,LAB PROCALCITONIN,141.0,59.22,27.22,138.18,37
CPT,84146,LAB PROLACTIN,59.0,24.78,15.93,57.82,37
CPT,84150,LAB PROSTAGLANDIN EA ARP,335.0,140.7,41.77,328.3,37
CPT,84153,LAB PSA TOTAL,56.0,23.52,15.12,54.88,37
CPT,84153,LAB SCR PSA,56.0,23.52,15.12,54.88,37
CPT,84154,LAB PSA FREE,56.0,23.52,15.12,54.88,37
CPT,84155,LAB PROT TTL SRM/PLASMA/BLD WHL,56.0,23.52,3.67,54.88,37
CPT,84155,LAB PROT TTL SRM/PLASMA/BLD WHL NS,53.0,22.26,3.67,51.94,37
CPT,84156,LAB PROT URINE,56.0,23.52,3.67,54.88,37
CPT,84156,LAB PROT URINE NS,59.0,24.78,3.67,57.82,37
CPT,84156,LAB PROT URINE TIMED,12.0,5.04,3.24,11.76,37
CPT,84157,LAB PROT FLUID BODY,12.0,5.04,3.24,11.76,37
CPT,84157,LAB PROT FLUID CEREBROSPINAL,56.0,23.52,4.0,54.88,37
CPT,84165,LAB PROT FRCTN ELECTRO&QN SERUM,57.0,23.94,10.74,55.86,37
CPT,84165,LAB PROT FRCTN ELECTRO&QN SERUM NS,56.0,23.52,10.74,54.88,37
CPT,84166,LAB PROT FRCTN ELECTRO&QN OTHER,54.0,22.68,14.58,52.92,37
CPT,84166,LAB PROT FRCTN ELECTRO&QN URINE,54.0,22.68,14.58,52.92,37
CPT,84181,LAB HSP 70 WB W INTRP,174.0,73.08,17.03,170.52,37
CPT,84181,LAB PROT WB W INTRP,104.0,43.68,17.03,101.92,37
CPT,84182,LAB PROT WB W INTRP ENCEPHALITIS,155.0,65.1,29.21,151.9,37
CPT,84182,LAB PROT WB W INTRP ID BAND,139.0,58.38,29.21,136.22,37
CPT,84182,LAB PROT WB W INTRP ID CREUTZ-JAKOB,89.0,37.38,24.03,87.22,37
CPT,84182,LAB PROT WB W INTRP ID MYOSITIS,88.0,36.96,23.76,86.24,37
CPT,84202,LAB PROTOPORPHYRIN RBC QN,111.0,46.62,14.35,108.78,37
CPT,84206,LAB PROINSULIN,81.0,34.02,21.87,79.38,37
CPT,84207,LAB PYRIDOXAL PHOSPHATE,85.0,35.7,22.95,83.3,37
CPT,84210,LAB PYRUVATE,44.0,18.48,11.88,43.12,37
CPT,84220,LAB PYRUVATE KINASE NS,187.0,78.54,9.44,183.26,37
CPT,84228,LAB QUININE,136.0,57.12,11.63,133.28,37
CPT,84238,LAB INTERLEUKIN 2 RECEPTOR,144.0,60.48,36.57,141.12,37
CPT,84238,LAB RECEPTOR ACETYLCHOLINE NON-ENDO,110.0,46.2,29.7,107.8,37
CPT,84238,LAB RECEPTOR INTERLEUK 2 SOL N-END,500.0,210.0,36.57,490.0,37
CPT,84244,LAB RENIN NS,66.0,27.72,17.82,64.68,37
CPT,84252,LAB RIBOFLAVIN,74.0,31.08,19.98,72.52,37
CPT,84255,LAB SELENIUM,77.0,32.34,20.79,75.46,37
CPT,84260,LAB SEROTONIN,93.0,39.06,25.11,91.14,37
CPT,84270,LAB HORMONE SEX BINDING GLOBULIN,66.0,27.72,17.82,64.68,37
CPT,84295,LAB SODIUM SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CPT,84295,POC SODIUM SRM/PLASMA/BLD WHL,15.0,6.3,4.05,14.7,37
CPT,84295,POC SODIUM SRM/PLASMA/BLD WHL TLCR,15.0,6.3,4.05,14.7,37
CPT,84300,LAB SODIUM STONE RISK,72.0,30.24,5.06,70.56,37
CPT,84300,LAB SODIUM URINE,16.0,6.72,4.32,15.68,37
CPT,84300,LAB SODIUM URINE TIMED,16.0,6.72,4.32,15.68,37
CPT,84302,LAB SODIUM FLUID BODY,15.0,6.3,4.05,14.7,37
CPT,84302,LAB SODIUM OTHER SOURCE,15.0,6.3,4.05,14.7,37
CPT,84302,LAB SODIUM STOOL NS,58.0,24.36,4.86,56.84,37
CPT,84305,LAB SOMATOMEDIN NS,64.0,26.88,17.28,62.72,37
CPT,84307,LAB SOMATOSTATIN,82.0,34.44,18.28,80.36,37
CPT,84311,LAB SPCTPHOT 1-3-BETA-D-GLUCAN,157.0,65.94,8.1,153.86,37
CPT,84311,LAB SPCTPHOT ANALYTE NS,58.0,24.36,8.1,56.84,37
CPT,84311,LAB SPCTPHOT PORPHYRINS SERUM,70.0,29.4,8.1,68.6,37
CPT,84315,LAB GRAVITY SPECIFIC FLUID BODY,10.0,4.2,2.7,9.8,37
CPT,84376,LAB SUGARS SINGLE QL STOOL NS,64.0,26.88,5.5,62.72,37
CPT,84377,LAB SUGARS MULTIPLE QL EA,229.0,96.18,5.5,224.42,37
CPT,84392,LAB SULFATE STONE RISK,72.0,30.24,5.49,70.56,37
CPT,84392,LAB SULFATE URINE,17.0,7.14,4.59,16.66,37
CPT,84393,LAB TAU181 PHOSPHORYLATED EA,387.0,162.54,104.49,379.26,37
CPT,84393,LAB TAU217 PHOSPHORYLATED EA,387.0,162.54,104.49,379.26,37
CPT,84394,LAB TAU TOTAL,387.0,162.54,104.49,379.26,37
CPT,84402,LAB TESTOSTERONE FREE,77.0,32.34,20.79,75.46,37
CPT,84403,LAB TESTOSTERONE TOTAL,78.0,32.76,21.06,76.44,37
CPT,84403,LAB TESTOSTERONE TOTAL NS,78.0,32.76,21.06,76.44,37
CPT,84425,LAB THIAMINE,64.0,26.88,17.28,62.72,37
CPT,84432,LAB THYROGLOBULIN,58.0,24.36,15.66,56.84,37
CPT,84432,LAB THYROGLOBULIN FNA,82.0,34.44,16.06,80.36,37
CPT,84432,LAB THYROGLOBULIN MYO,215.0,90.3,16.06,210.7,37
CPT,84432,LAB THYROGLOBULIN NS,57.0,23.94,15.39,55.86,37
CPT,84433,LAB THIOPURINE S-METHYLTRANSFERASE,112.0,47.04,22.17,109.76,37
CPT,84436,LAB THYROXINE T4 TOTAL,56.0,23.52,6.87,54.88,37
CPT,84437,LAB THYROXINE T-4 ELUTION,20.0,8.4,5.4,19.6,37
CPT,84439,LAB THYROXINE T4 FREE,28.0,11.76,7.56,27.44,37
CPT,84439,LAB THYROXINE T4 FREE NS,66.0,27.72,9.02,64.68,37
CPT,84442,LAB THYROXINE BINDING GLOBULIN,45.0,18.9,12.15,44.1,37
CPT,84443,LAB THYROID STIMULATING HORMONE,54.0,22.68,14.58,52.92,37
CPT,84443,LAB THYROID STIMULATING HORMONE NS,51.0,21.42,13.77,49.98,37
CPT,84445,LAB THYROID STIMULATING IMMUN GLOB,153.0,64.26,41.31,149.94,37
CPT,84446,LAB TOCOPHEROL ALPHA,62.0,26.04,14.18,60.76,37
CPT,84450,LAB TRANSFERASE AMINO ASPARTATE,16.0,6.72,4.32,15.68,37
CPT,84460,LAB TRANSFERASE AMINO ALANINE,16.0,6.72,4.32,15.68,37
CPT,84460,LAB TRANSFERASE AMINO ALANINE NS,59.0,24.78,5.3,57.82,37
CPT,84466,LAB TRANSFERRIN,39.0,16.38,10.53,38.22,37
CPT,84478,LAB TRIGLYCERIDES,18.0,7.56,4.86,17.64,37
CPT,84478,LAB TRIGLYCERIDES FLUID BODY,18.0,7.56,4.86,17.64,37
CPT,84478,LAB TRIGLYCERIDES NS,57.0,23.94,5.74,55.86,37
CPT,84479,LAB UPTAKE HORMONE T3,56.0,23.52,6.47,54.88,37
CPT,84480,LAB TRIIODOTHYRONINE T3 TOTAL,43.0,18.06,11.61,42.14,37
CPT,84480,LAB TRIIODOTHYRONINE T3 TOTAL NS,43.0,18.06,11.61,42.14,37
CPT,84481,LAB TRIIODOTHYRONINE T3 FREE,54.0,22.68,14.58,52.92,37
CPT,84481,LAB TRIIODOTHYRONINE T3 FREE TR DIA,71.0,29.82,16.94,69.58,37
CPT,84482,LAB TRIIODOTHYRONINE T3 REVERSE,59.0,24.78,15.76,57.82,37
CPT,84484,LAB TROPONIN QN,38.0,15.96,10.26,37.24,37
CPT,84484,POC TROPONIN QN,38.0,15.96,10.26,37.24,37
CPT,84510,LAB TYROSINE,100.0,42.0,10.63,98.0,37
CPT,84520,LAB NITROGEN UREA QN,12.0,5.04,3.24,11.76,37
CPT,84520,POC NITROGEN UREA QN,12.0,5.04,3.24,11.76,37
CPT,84520,POC NITROGEN UREA QN TELCOR,12.0,5.04,3.24,11.76,37
CPT,84540,LAB NITROGEN UREA URINE,52.0,21.84,5.56,50.96,37
CPT,84550,LAB ACID URIC BLOOD,14.0,5.88,3.78,13.72,37
CPT,84560,LAB ACID URIC FLUID BODY,56.0,23.52,5.08,54.88,37
CPT,84560,LAB ACID URIC URINE,56.0,23.52,5.08,54.88,37
CPT,84560,LAB URIC ACID STONE RISK,72.0,30.24,5.08,70.56,37
CPT,84585,LAB ACID VANILLYLMANDELIC URINE,82.0,34.44,15.5,80.36,37
CPT,84586,LAB VASOACTIVE INTS PEPTIDE NS,160.0,67.2,35.33,156.8,37
CPT,84588,LAB VASOPRESSIN,102.0,42.84,27.54,99.96,37
CPT,84590,LAB VITAMIN A,62.0,26.04,11.61,60.76,37
CPT,84591,LAB NIACIN,94.0,39.48,17.06,92.12,37
CPT,84591,LAB VITAMIN E BETA/GAMMA TOCOPHER,52.0,21.84,14.04,50.96,37
CPT,84597,LAB VITAMIN K,85.0,35.7,13.72,83.3,37
CPT,84600,LAB SCR VOLATILE,52.0,21.84,14.04,50.96,37
CPT,84600,LAB VOLATILE,52.0,21.84,14.04,50.96,37
CPT,84630,LAB ZINC,61.0,25.62,11.39,59.78,37
CPT,84630,LAB ZINC NS,35.0,14.7,9.45,34.3,37
CPT,84681,LAB C-PEPTIDE,63.0,26.46,17.01,61.74,37
CPT,84702,LAB HCG QN,46.0,19.32,12.42,45.08,37
CPT,84702,LAB HCG QN NS,67.0,28.14,15.05,65.66,37
CPT,84702,LAB HCG TUMOR MARKER QN,57.0,23.94,15.05,55.86,37
CPT,84703,LAB HCG QL,23.0,9.66,6.21,22.54,37
CPT,84999,LAB CHOLESTEROL FLUID BODY,55.0,23.1,14.85,53.9,30
CPT,84999,LAB GENE B-CELL CLONALITY PCR,51.0,21.42,13.77,49.98,30
CPT,84999,LAB OSMOLALITY STOOL,68.0,28.56,18.36,66.64,30
CPT,84999,LAB POTASS FLUID BODY,56.0,23.52,15.12,54.88,30
CPT,85007,LAB COUNT BLD DIFF MANUAL WBC,54.0,22.68,3.8,52.92,37
CPT,85014,LAB COUNT BLD HEMATOCRIT,8.0,3.36,2.16,7.84,37
CPT,85014,LAB COUNT BLD HEMATOCRIT NS,69.0,28.98,2.37,67.62,37
CPT,85018,LAB COUNT BLD HEMOGLOBIN,8.0,3.36,2.16,7.84,37
CPT,85018,LAB COUNT BLD HEMOGLOBIN NS,60.0,25.2,2.37,58.8,37
CPT,85025,LAB CBC AUTO W AUTO DIFF,24.0,10.08,6.48,23.52,37
CPT,85025,LAB HEMO PLT AUTO W AUTO SCAN,24.0,10.08,6.48,23.52,37
CPT,85027,LAB CBC AUTO WO DIFF,20.0,8.4,5.4,19.6,37
CPT,85041,LAB COUNT BLD RBC AUTO,62.0,26.04,3.02,60.76,37
CPT,85041,LAB COUNT BLD RBC AUTO NS,63.0,26.46,3.02,61.74,37
CPT,85044,LAB COUNT BLD RETIC MANUAL,13.0,5.46,3.51,12.74,37
CPT,85046,LAB COUNT BLD RETIC AUTO W PARAM,17.0,7.14,4.59,16.66,37
CPT,85048,LAB COUNT BLD LEUKO AUTO,8.0,3.36,2.16,7.84,37
CPT,85049,LAB COUNT BLD PLATELET AUTOMATED,14.0,5.88,3.78,13.72,37
CPT,85055,LAB PLATELET RETICULATED,108.0,45.36,29.16,105.84,37
CPT,85097,LAB INTRP MARROW BONE SMEAR,1612.0,677.04,435.24,1579.76,37
CPT,85210,LAB CLOTTING FACTOR 2 PROTHROM,64.0,26.88,12.98,62.72,37
CPT,85220,LAB CLOTTING FACTOR 5 LABILE,75.0,31.5,17.65,73.5,37
CPT,85230,LAB CLOTTING FACTOR 7,76.0,31.92,17.9,74.48,37
CPT,85240,LAB CLOTTING FACTOR 8 1-STG,66.0,27.72,17.82,64.68,37
CPT,85240,LAB CLOTTING FACTOR 8 1-STG NS,114.0,47.88,17.9,111.72,37
CPT,85245,LAB CLOTTING FACTOR 8 VWF RIST,74.0,31.08,19.98,72.52,37
CPT,85245,LAB CLOTTING FACTOR 8 VWF RIST NS,87.0,36.54,22.94,85.26,37
CPT,85246,LAB CLOTTING FACTOR 8 VWF AG,74.0,31.08,19.98,72.52,37
CPT,85247,LAB CLOTTING FACTOR 8 VWF MULTI,69.0,28.98,18.63,67.62,37
CPT,85250,LAB CLOTTING FACTOR 9 PTC/XMAS,79.0,33.18,19.04,77.42,37
CPT,85250,LAB CLOTTING FACTOR 9 PTC/XMAS NS,75.0,31.5,19.04,73.5,37
CPT,85260,LAB CLOTTING FACTOR 10 STUART-PROWR,76.0,31.92,17.9,74.48,37
CPT,85270,LAB CLOTTING FACTOR 11 PTA,76.0,31.92,17.9,74.48,37
CPT,85270,LAB CLOTTING FACTOR 11 PTA NS,89.0,37.38,17.9,87.22,37
CPT,85280,LAB CLOTTING FACTOR 12 HAGEMAN,76.0,31.92,19.35,74.48,37
CPT,85290,LAB CLOTTING FACTOR 13 STB FBR NS,98.0,41.16,16.34,96.04,37
CPT,85291,LAB CLOTTING FACTOR 13 SCR SOL,28.0,11.76,7.56,27.44,37
CPT,85300,LAB CLOTTING ACT ANTITHROM 3,63.0,26.46,11.85,61.74,37
CPT,85300,LAB CLOTTING ACT ANTITHROM 3 NS,56.0,23.52,11.85,54.88,37
CPT,85301,LAB CLOTTING AG ANTITHROMBIN 3 NS,69.0,28.98,10.81,67.62,37
CPT,85302,LAB CLOTTING AG PROTEIN C,65.0,27.3,12.01,63.7,37
CPT,85303,LAB CLOTTING ACT PROTEIN C,42.0,17.64,11.34,41.16,37
CPT,85305,LAB CLOTTING PROTEIN S TOTAL NS,58.0,24.36,11.61,56.84,37
CPT,85306,LAB CLOTTING PROTEIN S FREE,66.0,27.72,15.32,64.68,37
CPT,85306,LAB CLOTTING PROTEIN S FREE NS,60.0,25.2,15.32,58.8,37
CPT,85307,LAB PROT C ACT RESISTANCE,66.0,27.72,15.32,64.68,37
CPT,85335,LAB INHIBITOR FACTOR 8,97.0,40.74,12.87,95.06,37
CPT,85335,LAB INHIBITOR FACTOR 9,39.0,16.38,10.53,38.22,37
CPT,85335,LAB INHIBITOR VWF PROTEASE,225.0,94.5,12.87,220.5,37
CPT,85347,LAB COAGULATION TIME ACTIVATED,55.0,23.1,4.28,53.9,37
CPT,85347,POC COAGULATION TIME ACTIVAT TELCOR,13.0,5.46,3.51,12.74,37
CPT,85347,POC COAGULATION TIME ACTIVATED,13.0,5.46,3.51,12.74,37
CPT,85360,LAB LYSIS EUGLOBULIN,26.0,10.92,7.02,25.48,37
CPT,85362,LAB FDP FSP AGG SEMI QN,21.0,8.82,5.67,20.58,37
CPT,85362,LAB FDP FSP AGG SEMI QN NS,80.0,33.6,6.89,78.4,37
CPT,85379,LAB FDP D-DIMER QN,31.0,13.02,8.37,30.38,37
CPT,85384,LAB FIBRINOGEN ACTIVITY,30.0,12.6,8.1,29.4,37
CPT,85384,POC FIBRINOGEN ACTIVITY,30.0,12.6,8.1,29.4,37
CPT,85385,LAB FIBRINOGEN ANTIGEN,44.0,18.48,11.88,43.12,37
CPT,85390,LAB SCR FIBRINOLYSINS/COAG,65.0,27.3,15.48,63.7,37
CPT,85390,POC SCR FIBRINOLYSINS/COAG,47.0,19.74,12.69,46.06,37
CPT,85397,LAB COAGULATION&FIBRINOLYSIS,164.0,68.88,30.86,160.72,37
CPT,85410,LAB ANTIPLASMIN ALPHA-2,24.0,10.08,6.48,23.52,37
CPT,85420,LAB PLASMINOGEN NON-ANTIGENIC,57.0,23.94,6.53,55.86,37
CPT,85420,LAB PLASMINOGEN NON-ANTIGENIC NS,71.0,29.82,6.53,69.58,37
CPT,85460,LAB HGB FETAL KLEIHAUER-BETKE,59.0,24.78,7.73,57.82,37
CPT,85461,LAB HGB FETAL ROSETTE,29.0,12.18,7.83,28.42,37
CPT,85520,LAB ASSAY HEPARIN,65.0,27.3,13.09,63.7,37
CPT,85525,POC NEUTRALIZATION HEPARIN,36.0,15.12,9.72,35.28,37
CPT,85530,POC TOLERANCE HEPARIN-PROTAMINE,40.0,16.8,10.8,39.2,37
CPT,85549,LAB MURAMIDASE,57.0,23.94,15.39,55.86,37
CPT,85557,LAB FRAGILITY OSMOTIC RBC INCUB,57.0,23.94,13.36,55.86,37
CPT,85557,LAB FRAGILITY OSMOTIC RBC INCUB NS,187.0,78.54,13.36,183.26,37
CPT,85576,LAB AGGREGATION PLT ASPIRIN,75.0,31.5,20.25,73.5,37
CPT,85576,LAB AGGREGATION PLT CLOPIDOGREL,75.0,31.5,20.25,73.5,37
CPT,85576,LAB AGGREGATION PLT EA AGENT,75.0,31.5,20.25,73.5,37
CPT,85576,POC AGGREGATION PLT EA AGENT,75.0,31.5,20.25,73.5,37
CPT,85597,LAB NEUTRAL PHOSPHO PLT NS,54.0,22.68,14.58,52.92,37
CPT,85598,LAB NEUTRAL PHOSPHO HEXAGONAL NS,64.0,26.88,17.28,62.72,37
CPT,85610,LAB PROTHROMBIN TIME,51.0,21.42,4.29,49.98,37
CPT,85610,LAB PROTHROMBIN TIME NS,63.0,26.46,4.29,61.74,37
CPT,85610,POC PROTHROMBIN TIME,13.0,5.46,3.51,12.74,37
CPT,85610,POC PROTHROMBIN TIME TELCOR,13.0,5.46,3.51,12.74,37
CPT,85611,LAB PROTHROMBIN TIME SUB,58.0,24.36,3.94,56.84,37
CPT,85613,LAB VENOM TIME RUSSELL VIPER DLT,60.0,25.2,9.58,58.8,37
CPT,85635,LAB REPTILASE,80.0,33.6,9.85,78.4,37
CPT,85651,LAB RATE SEDIMENTATION RBC NONAUTO,13.0,5.46,3.51,12.74,37
CPT,85652,LAB RATE SEDIMENTATION RBC AUTO,9.0,3.78,2.43,8.82,37
CPT,85660,LAB SICKLING RBC REDUCTION,56.0,23.52,5.51,54.88,37
CPT,85670,LAB THROMBIN TIME PLASMA,56.0,23.52,5.77,54.88,37
CPT,85670,LAB THROMBIN TIME PLASMA NS,18.0,7.56,4.86,17.64,37
CPT,85730,LAB PTT PLASMA/BLD WHL,19.0,7.98,5.13,18.62,37
CPT,85730,LAB PTT PLASMA/BLD WHL NS,54.0,22.68,6.01,52.92,37
CPT,85732,LAB PTT SUBSTITUTION FRAC PLASMA,103.0,43.26,6.47,100.94,37
CPT,85810,LAB VISCOSITY,57.0,23.94,11.67,55.86,37
CPT,85999,LAB EOSINOPHILS URINE/OTHER,57.0,23.94,15.39,55.86,30
CPT,86000,LAB AGGLUTININS FEBRILE AG EA,21.0,8.82,5.67,20.58,37
CPT,86001,LAB ALLG IGG QN/SEMI QN EA,109.0,45.78,7.82,106.82,37
CPT,86003,LAB ALLG IGE QN/SEMI QN CRUDE EA,56.0,23.52,5.22,54.88,37
CPT,86003,LAB ALLG IGE QN/SEMI QN CRUDE EA NS,55.0,23.1,5.22,53.9,37
CPT,86005,LAB SCR ALLG IGE QL MULTI,56.0,23.52,7.97,54.88,37
CPT,86005,LAB SCR ALLG IGE QL MULTI NS,59.0,24.78,7.97,57.82,37
CPT,86008,LAB ALLG IGE QN/SEMI QN EA,64.0,26.88,17.28,62.72,37
CPT,86008,LAB ALLG IGE QN/SEMI QN EA NS,80.0,33.6,17.93,78.4,37
CPT,86015,LAB SCR AB MUSCLE SMOOTH FL,60.0,25.2,12.05,58.8,37
CPT,86015,LAB SCR AB MUSCLE SMOOTH FL NS,56.0,23.52,12.05,54.88,37
CPT,86021,LAB AB ID ANTI-NEUTROPHIL,46.0,19.32,12.42,45.08,37
CPT,86021,LAB AB ID LEUKOCYTE,55.0,23.1,14.85,53.9,37
CPT,86021,LAB AB ID LEUKOCYTE NS,54.0,22.68,14.58,52.92,37
CPT,86022,LAB AB ID PLATELET BLOOD PRODUCT,238.0,99.96,18.37,233.24,37
CPT,86022,LAB AB ID PLATELET IGG FLOW CYTO,236.0,99.12,18.37,231.28,37
CPT,86022,LAB AB ID PLATELET PATIENT SERUM,56.0,23.52,15.12,54.88,37
CPT,86022,LAB AB ID PLATELET PATIENT SERUM NS,145.0,60.9,18.37,142.1,37
CPT,86023,LAB AB ID IG PLATELET ASSOCIATED,236.0,99.12,12.46,231.28,37
CPT,86036,LAB SCR AB ANCA FL EA AB,54.0,22.68,12.05,52.92,37
CPT,86037,LAB SCR ANCA TITER AB EA,62.0,26.04,12.05,60.76,37
CPT,86038,LAB SCR ANA,53.0,22.26,12.09,51.94,37
CPT,86039,LAB ANA TITER,59.0,24.78,11.16,57.82,37
CPT,86039,LAB ANA TITER NS,115.0,48.3,11.16,112.7,37
CPT,86041,LAB IMM ACHR BINDING QN,70.0,29.4,18.4,68.6,37
CPT,86042,LAB IMM ACHR BLOCKING QN,99.0,41.58,18.4,97.02,37
CPT,86043,LAB IMM ACHR MODULATING QN,78.0,32.76,12.05,76.44,37
CPT,86051,LAB AQUAPORIN AB,268.0,112.56,11.53,262.64,37
CPT,86052,LAB SCR AQUAPORIN 4 AB IGG CSF,350.0,147.0,12.05,343.0,37
CPT,86052,LAB SCR AQUAPORIN 4 AB IGG SERUM,225.0,94.5,12.05,220.5,37
CPT,86053,LAB AQUAPORIN 4 AB FLOW CYTOMETRY,118.0,49.56,31.86,115.64,37
CPT,86060,LAB ANTISTREPTOLYSIN O TITER,57.0,23.94,7.3,55.86,37
CPT,86140,LAB PROT C-REACTIVE,16.0,6.72,4.32,15.68,37
CPT,86141,LAB PROT C-REACTIVE SENS HIGH,57.0,23.94,12.95,55.86,37
CPT,86146,LAB AB BETA 2 GLYCOPROTEIN I,77.0,32.34,20.79,75.46,37
CPT,86147,LAB AB CARDIOLIPIN IG EA,80.0,33.6,21.6,78.4,37
CPT,86148,LAB AB ANTIPHOSPHATIDYLSERINE,57.0,23.94,15.39,55.86,37
CPT,86156,LAB SCR AGGLUTININ COLD,25.0,10.5,6.75,24.5,37
CPT,86156,LAB SCR AGGLUTININ COLD NS,25.0,10.5,6.75,24.5,37
CPT,86157,LAB AGGLUTININ COLD TITER,58.0,24.36,8.06,56.84,37
CPT,86160,LAB COMPLEMENT AG C1Q COMP EA,76.0,31.92,12.0,74.48,37
CPT,86160,LAB COMPLEMENT AG C2 COMP EA,36.0,15.12,9.72,35.28,37
CPT,86160,LAB COMPLEMENT AG C3 COMP EA,36.0,15.12,9.72,35.28,37
CPT,86160,LAB COMPLEMENT AG C4 COMP EA,53.0,22.26,12.0,51.94,37
CPT,86160,LAB COMPLEMENT AG C5 COMP EA,77.0,32.34,12.0,75.46,37
CPT,86160,LAB COMPLEMENT AG C6 COMP EA,36.0,15.12,9.72,35.28,37
CPT,86160,LAB COMPLEMENT AG COMP EA NS,222.0,93.24,12.0,217.56,37
CPT,86160,LAB COMPLEMENT AG SC5B-9 COMP EA,292.0,122.64,12.0,286.16,37
CPT,86161,LAB COMPLEMENT ACT FUNC,66.0,27.72,12.0,64.68,37
CPT,86161,LAB COMPLEMENT ACT FUNC C1 ESTER,66.0,27.72,12.0,64.68,37
CPT,86161,LAB COMPLEMENT ACT FUNC C3NEF,300.0,126.0,12.0,294.0,37
CPT,86161,LAB COMPLEMENT ACT FUNC NS,185.0,77.7,12.0,181.3,37
CPT,86162,LAB COMPLEMENT TOTAL HEMOLYTIC,61.0,25.62,16.47,59.78,37
CPT,86200,LAB AB PEPTIDE CYCLIC CITRUL,60.0,25.2,12.95,58.8,37
CPT,86215,LAB AB DEOXYRIBONUCLEASE,40.0,16.8,10.8,39.2,37
CPT,86225,LAB AB DNA STRANDED NATVE/DOUBLE,42.0,17.64,11.34,41.16,37
CPT,86225,LAB AB DNA STRANDED NATVE/DOUBLE NS,62.0,26.04,13.74,60.76,37
CPT,86231,LAB SCR AB ENDOMYSIAL FL,61.0,25.62,12.09,59.78,37
CPT,86235,LAB AB ENA CENTROMERE B,60.0,25.2,16.2,58.8,37
CPT,86235,LAB AB ENA CHROMATIN,124.0,52.08,17.93,121.52,37
CPT,86235,LAB AB ENA JO1,123.0,51.66,17.93,120.54,37
CPT,86235,LAB AB ENA MYOSITIS,77.0,32.34,17.93,75.46,37
CPT,86235,LAB AB ENA NS,65.0,27.3,17.55,63.7,37
CPT,86235,LAB AB ENA PM/SC1-100,115.0,48.3,17.93,112.7,37
CPT,86235,LAB AB ENA RNP,55.0,23.1,14.85,53.9,37
CPT,86235,LAB AB ENA SCLERODERMA,123.0,51.66,17.93,120.54,37
CPT,86235,LAB AB ENA SCLERODERMA PANEL,161.0,67.62,17.93,157.78,37
CPT,86235,LAB AB ENA SM/RNP,124.0,52.08,17.93,121.52,37
CPT,86235,LAB AB ENA SMITH,55.0,23.1,14.85,53.9,37
CPT,86235,LAB AB ENA SS-A/RO,55.0,23.1,14.85,53.9,37
CPT,86235,LAB AB ENA SS-B/LA,55.0,23.1,14.85,53.9,37
CPT,86255,LAB SCR AB ANTIMYOCARDIAL FL,76.0,31.92,12.05,74.48,37
CPT,86255,LAB SCR AB CIDP/NP EVALUATION FL,376.0,157.92,12.05,368.48,37
CPT,86255,LAB SCR AB COPEPTIN FL,300.0,126.0,12.05,294.0,37
CPT,86255,LAB SCR AB ENCEPHALITIS FL,98.0,41.16,12.05,96.04,37
CPT,86255,LAB SCR AB FL,128.0,53.76,12.05,125.44,37
CPT,86255,LAB SCR AB FL NS,55.0,23.1,12.05,53.9,37
CPT,86255,LAB SCR AB LG1 FL,565.0,237.3,12.05,553.7,37
CPT,86255,LAB SCR AB LRP4 AUTO FL,850.0,357.0,12.05,833.0,37
CPT,86255,LAB SCR AB MUSCLE STRIATED FL,56.0,23.52,12.05,54.88,37
CPT,86255,LAB SCR AB NEUROMYOTONIA FL,37.0,15.54,9.99,36.26,37
CPT,86255,LAB SCR AB NMDA RECEPTOR FL,167.0,70.14,12.05,163.66,37
CPT,86255,LAB SCR AB PARANEOPLASTIC CSF FL,200.0,84.0,12.05,196.0,37
CPT,86255,LAB SCR AB PARANEOPLASTIC FL,93.0,39.06,12.05,91.14,37
CPT,86255,LAB SCR AB PARIETAL FL,55.0,23.1,12.05,53.9,37
CPT,86255,LAB SCR AB PHOSPHOLIPAS A2 RECPT FL,190.0,79.8,12.05,186.2,37
CPT,86255,LAB SCR AB PURKINJE FL,64.0,26.88,12.05,62.72,37
CPT,86255,LAB SCR AB RETICULUM FL,54.0,22.68,12.05,52.92,37
CPT,86255,LAB SCR AB THSD7A W REFLEX FL,453.0,190.26,12.05,443.94,37
CPT,86256,LAB AB FL TITER,37.0,15.54,9.99,36.26,37
CPT,86256,LAB AB FL TITER ANTIMYOCARDIAL,37.0,15.54,9.99,36.26,37
CPT,86256,LAB AB FL TITER HU,55.0,23.1,12.05,53.9,37
CPT,86256,LAB AB FL TITER MITOCHONDRIA,60.0,25.2,12.05,58.8,37
CPT,86256,LAB AB FL TITER MOG,837.0,351.54,12.05,820.26,37
CPT,86256,LAB AB FL TITER MUSCLE SMOOTH,65.0,27.3,12.05,63.7,37
CPT,86256,LAB AB FL TITER MUSCLE STRIATED,65.0,27.3,12.05,63.7,37
CPT,86256,LAB AB FL TITER NS,78.0,32.76,12.05,76.44,37
CPT,86256,LAB AB FL TITER PARIETAL,55.0,23.1,12.05,53.9,37
CPT,86256,LAB AB FL TITER PHOSPHOLPS A2 RECPT,285.0,119.7,12.05,279.3,37
CPT,86256,LAB AB FL TITER PURKINJE,190.0,79.8,12.05,186.2,37
CPT,86258,LAB IMM MS GLIADIN IGA QL,37.0,15.54,9.99,36.26,37
CPT,86258,LAB IMM MS GLIADIN IGG QL,37.0,15.54,9.99,36.26,37
CPT,86258,LAB IMM MS GLIADIN QL,59.0,24.78,12.05,57.82,37
CPT,86300,LAB IMM AG TUMOR CA 15-3,63.0,26.46,17.01,61.74,37
CPT,86300,LAB IMM AG TUMOR CA 27-29,63.0,26.46,17.01,61.74,37
CPT,86301,LAB IMM AG TUMOR CA 19-9,63.0,26.46,17.01,61.74,37
CPT,86304,LAB IMM AG TUMOR CA 125,63.0,26.46,17.01,61.74,37
CPT,86305,LAB PROT 4 HUMAN EPIDIDYMIS,97.0,40.74,20.81,95.06,37
CPT,86308,LAB SCR AB HETEROPHILE,16.0,6.72,4.32,15.68,37
CPT,86316,LAB IMM AG TUMOR OTHER QN NS,75.0,31.5,20.25,73.5,37
CPT,86317,LAB IMM AB QN CREUTZFELDT-JAKOB,83.0,34.86,14.99,81.34,37
CPT,86317,LAB IMM AB QN HAEMOPHILUS INFLU B,63.0,26.46,14.99,61.74,37
CPT,86317,LAB IMM AB QN NS,142.0,59.64,14.99,139.16,37
CPT,86317,LAB IMM AB QN PNEUMOCOCCAL,51.0,21.42,13.77,49.98,37
CPT,86320,LAB IMMUNOELECTROPHORESIS SERUM,90.0,37.8,24.3,88.2,37
CPT,86328,LAB IMM AB QL/SEMI QN SGL COVID-19,136.0,57.12,36.72,133.28,37
CPT,86329,LAB IMDF,55.0,23.1,14.05,53.9,37
CPT,86331,LAB IMDF GEL AB/AG QL,56.0,23.52,11.98,54.88,37
CPT,86332,LAB IMMUNE COMPLEX C1Q BINDING,74.0,31.08,19.98,72.52,37
CPT,86334,LAB IMMUNOFIXATION EP CRYOGLOBULIN,68.0,28.56,18.36,66.64,37
CPT,86334,LAB IMMUNOFIXATION EP SERUM,68.0,28.56,18.36,66.64,37
CPT,86335,LAB IMMUNOFIXATION EP TRANSFRN BETA,89.0,37.38,24.03,87.22,37
CPT,86335,LAB IMMUNOFIXATION EP URINE/CSF,89.0,37.38,24.03,87.22,37
CPT,86336,LAB INHIBIN A,57.0,23.94,15.39,55.86,37
CPT,86336,LAB INHIBIN A NS,77.0,32.34,15.59,75.46,37
CPT,86337,LAB AB INSULIN,66.0,27.72,17.82,64.68,37
CPT,86340,LAB AB INTRINSIC FACTOR,59.0,24.78,15.08,57.82,37
CPT,86341,LAB AB ISLET CELL NS,71.0,29.82,19.17,69.58,37
CPT,86341,LAB AB ISLET ENCEPHALITIS,144.0,60.48,23.57,141.12,37
CPT,86341,LAB AB ZINC TRANSPORTER,240.0,100.8,23.57,235.2,37
CPT,86343,LAB LEUKOCYTE HISTAMINE RELEASE,64.0,26.88,12.46,62.72,37
CPT,86352,LAB FNCT CELL W STIM&DET BIOMARK,408.0,171.36,110.16,399.84,37
CPT,86353,LAB TRANSFORM LYMPHOCYTE MITOGEN,205.0,86.1,49.03,200.9,37
CPT,86355,LAB B CELLS CD19 COUNT TOTAL,114.0,47.88,30.78,111.72,37
CPT,86355,LAB B CELLS CD19 COUNT TOTAL NS,114.0,47.88,30.78,111.72,37
CPT,86356,LAB AG CELL MONONUC QN EA AG,93.0,39.06,25.11,91.14,37
CPT,86357,LAB COUNT TOTAL CELLS CD56 NK,114.0,47.88,30.78,111.72,37
CPT,86357,LAB COUNT TOTAL CELLS CD56 NK NS,114.0,47.88,30.78,111.72,37
CPT,86359,LAB COUNT TOTAL CELLS T,114.0,47.88,30.78,111.72,37
CPT,86359,LAB COUNT TOTAL CELLS T NS,114.0,47.88,30.78,111.72,37
CPT,86360,LAB COUNT CELLS T CD4&CD8 RATIO,141.0,59.22,38.07,138.18,37
CPT,86360,LAB COUNT CELLS T CD4&CD8 RATIO NS,141.0,59.22,38.07,138.18,37
CPT,86361,LAB COUNT CELLS T CD4 ABSOLUTE,111.0,46.62,26.78,108.78,37
CPT,86362,LAB SCR AB MOG FL,86.0,36.12,12.05,84.28,37
CPT,86362,LAB SCR AB MOG TITER,837.0,351.54,12.05,820.26,37
CPT,86363,LAB AB CYTOM FLOW MOG,211.0,88.62,37.73,206.78,37
CPT,86364,LAB IMM MS TRANSGLUTAMINASE NS,35.0,14.7,9.45,34.3,37
CPT,86364,LAB IMM MS TRANSGLUTAMINASE QL,59.0,24.78,11.53,57.82,37
CPT,86366,LAB IMM MUSK QN,56.0,23.52,15.12,54.88,37
CPT,86376,LAB AB MICROSOMAL EA,44.0,18.48,11.88,43.12,37
CPT,86376,LAB AB MICROSOMAL LIVER-KIDNEY EA,63.0,26.46,14.55,61.74,37
CPT,86381,LAB SCR AB MITOCHONDRIAL,77.0,32.34,20.79,75.46,37
CPT,86382,LAB NEUTRALIZATION VIRAL,69.0,28.98,16.91,67.62,37
CPT,86382,LAB NEUTRALIZATION VIRAL RABIES,127.0,53.34,16.91,124.46,37
CPT,86403,LAB SCR AB AGG PARTICLE EA,74.0,31.08,11.54,72.52,37
CPT,86403,LAB SCR AB CRYPTO AGG PARTICLE,59.0,24.78,11.54,57.82,37
CPT,86403,LAB SCR AB H INFLUENZA AGG PARTICLE,53.0,22.26,11.54,51.94,37
CPT,86403,LAB SCR AB MICRO AGG PARTICLE,62.0,26.04,11.54,60.76,37
CPT,86403,LAB SCR AB NEISS AGG PARTICLE,74.0,31.08,11.54,72.52,37
CPT,86403,LAB SCR AB NEISS GRP A AGG PARTICLE,53.0,22.26,11.54,51.94,37
CPT,86403,LAB SCR AB NEISS GRP C AGG PARTICLE,53.0,22.26,11.54,51.94,37
CPT,86403,LAB SCR AB STREP PNEUMO AGGPARTICLE,53.0,22.26,11.54,51.94,37
CPT,86406,LAB AGG PARTICLE TITER,59.0,24.78,10.64,57.82,37
CPT,86406,LAB AGG PARTICLE TITER STREPTOZYME,81.0,34.02,10.64,79.38,37
CPT,86430,LAB FACTOR RHEUMATOID QL,70.0,29.4,6.14,68.6,37
CPT,86431,LAB FACTOR RHEUMATOID QN,18.0,7.56,4.86,17.64,37
CPT,86431,LAB FACTOR RHEUMATOID QN NS,55.0,23.1,5.67,53.9,37
CPT,86480,LAB TB MEAS IMMUNITY GAMMA INTERFRN,186.0,78.12,50.22,182.28,37
CPT,86481,LAB TB MEAS IMMUNITY T-CELL SUSP,300.0,126.0,81.0,294.0,37
CPT,86481,LAB TB MEAS IMMUNITY T-CELL SUSP NS,300.0,126.0,81.0,294.0,37
CPT,86581,LAB AB STREP PNEU SEROT IA,372.0,156.24,92.03,364.56,37
CPT,86592,LAB SYPHILIS VDRL/RPR QL,52.0,21.84,4.27,50.96,37
CPT,86592,LAB SYPHILIS VDRL/RPR QL CSF,62.0,26.04,4.27,60.76,37
CPT,86592,LAB SYPHILIS VDRL/RPR QL DNR TESTNG,134.0,56.28,4.27,131.32,37
CPT,86593,LAB SYPHILIS VDRL/RPR QN,52.0,21.84,4.4,50.96,37
CPT,86596,LAB AB CHANNEL CA VOLTAGE-GATED,444.0,186.48,12.05,435.12,37
CPT,86603,LAB AB ADENOVIRUS,61.0,25.62,12.87,59.78,37
CPT,86606,LAB AB ASPERGILLUS,55.0,23.1,14.85,53.9,37
CPT,86609,LAB AB BACTERIUM NONSPECIFIED NS,153.0,64.26,12.88,149.94,37
CPT,86609,LAB AB LISTERIA,153.0,64.26,12.88,149.94,37
CPT,86609,LAB AB M FAENI,153.0,64.26,12.88,149.94,37
CPT,86609,LAB AB S VIRIDIS,153.0,64.26,12.88,149.94,37
CPT,86609,LAB AB T CANDIDUS,153.0,64.26,12.88,149.94,37
CPT,86609,LAB AB T VULGARIS,153.0,64.26,12.88,149.94,37
CPT,86611,LAB AB BARTONELLA,62.0,26.04,10.18,60.76,37
CPT,86612,LAB DET AB BLASTOMYCES NS,78.0,32.76,12.9,76.44,37
CPT,86615,LAB AB BORDETELLA,70.0,29.4,13.19,68.6,37
CPT,86617,LAB AB LYME DISEASE CONFIRMATORY,61.0,25.62,15.49,59.78,37
CPT,86618,LAB AB LYME DISEASE IGG IGM,66.0,27.72,17.03,64.68,37
CPT,86622,LAB AB BRUCELLA,67.0,28.14,8.93,65.66,37
CPT,86628,LAB AB CANDIDA,71.0,29.82,12.01,69.58,37
CPT,86631,LAB AB CHLAMYDIA,81.0,34.02,11.82,79.38,37
CPT,86631,LAB AB CHLAMYDIA PNEU IGG IGA,61.0,25.62,11.82,59.78,37
CPT,86631,LAB AB CHLAMYDIA PSITTACI IGG IGA,61.0,25.62,11.82,59.78,37
CPT,86631,LAB AB CHLAMYDIA TRAC IGG IGA,61.0,25.62,11.82,59.78,37
CPT,86632,LAB AB CHLAMYDIA PNEUM IGM,61.0,25.62,12.68,59.78,37
CPT,86632,LAB AB CHLAMYDIA PSITTACI IGM,61.0,25.62,12.68,59.78,37
CPT,86632,LAB AB CHLAMYDIA TRAC IGM,61.0,25.62,12.68,59.78,37
CPT,86635,LAB AB COCCIDIOIDES,55.0,23.1,11.47,53.9,37
CPT,86635,LAB AB COCCIDIOIDES IGG,63.0,26.46,11.47,61.74,37
CPT,86635,LAB AB COCCIDIOIDES IGM,63.0,26.46,11.47,61.74,37
CPT,86635,LAB AB COCCIDIOIDES NS,66.0,27.72,11.47,64.68,37
CPT,86638,LAB AB COXIELLA BRUNETII,57.0,23.94,12.12,55.86,37
CPT,86641,LAB AB CRYPTOCOCCUS IFA,44.0,18.48,11.88,43.12,37
CPT,86644,LAB AB CYTOMEGALOVIRUS,60.0,25.2,14.39,58.8,37
CPT,86644,LAB AB CYTOMEGALOVIRUS NS,56.0,23.52,14.39,54.88,37
CPT,86645,LAB AB CYTOMEGALOVIRUS IGM,61.0,25.62,16.47,59.78,37
CPT,86645,LAB AB CYTOMEGALOVIRUS IGM NS,51.0,21.42,13.77,49.98,37
CPT,86648,LAB AB DIPTHERIA,63.0,26.46,15.21,61.74,37
CPT,86651,LAB AB ENCEPHALITIS CALIFORNIA,65.0,27.3,13.19,63.7,37
CPT,86652,LAB AB ENCEPHALITIS EQUINE EASTERN,65.0,27.3,13.19,63.7,37
CPT,86653,LAB AB ENCEPHALITIS SAINT LOUIS NS,65.0,27.3,13.19,63.7,37
CPT,86654,LAB AB ENCEPHALITIS EQUINE WEST NS,65.0,27.3,13.19,63.7,37
CPT,86658,LAB AB COXSACKIE,53.0,22.26,13.03,51.94,37
CPT,86658,LAB AB ENTEROVIRUS,40.0,16.8,10.8,39.2,37
CPT,86663,LAB AB EBV EARLY AG,55.0,23.1,13.12,53.9,37
CPT,86664,LAB AB EBV EBNA,46.0,19.32,12.42,45.08,37
CPT,86664,LAB AB EBV EBNA NS,54.0,22.68,14.58,52.92,37
CPT,86665,LAB AB EBV VCA,55.0,23.1,14.85,53.9,37
CPT,86665,LAB AB EBV VCA IGG,55.0,23.1,14.85,53.9,37
CPT,86665,LAB AB EBV VCA IGM,62.0,26.04,16.74,60.76,37
CPT,86665,LAB AB EBV VCA IGM NS,55.0,23.1,14.85,53.9,37
CPT,86666,LAB AB EHRLICHIA,80.0,33.6,10.18,78.4,37
CPT,86668,LAB AB FRANCISELLA TULARENSIS,100.0,42.0,14.16,98.0,37
CPT,86671,LAB AB FUNGUS NOT SPECIFIED,55.0,23.1,12.25,53.9,37
CPT,86674,LAB AB GIARDIA LAMBLIA,67.0,28.14,14.72,65.66,37
CPT,86677,LAB AB HELICOBACTER PYLORI,78.0,32.76,16.85,76.44,37
CPT,86682,LAB AB CYSTICERCUS CSF,65.0,27.3,13.01,63.7,37
CPT,86682,LAB AB CYSTICERCUS SERUM,65.0,27.3,13.01,63.7,37
CPT,86682,LAB AB ECHINOCOCCUS,71.0,29.82,13.01,69.58,37
CPT,86682,LAB AB HELMINTH NONSPECIFIED,65.0,27.3,13.01,63.7,37
CPT,86682,LAB AB SCHISTOSOMA SERUM,65.0,27.3,13.01,63.7,37
CPT,86682,LAB AB STRONGYLOIDES,69.0,28.98,13.01,67.62,37
CPT,86684,LAB AB HAEMOPHILUS INFLUENZA IGG,62.0,26.04,15.84,60.76,37
CPT,86687,LAB AB HTLV-I,28.0,11.76,7.56,27.44,37
CPT,86689,LAB AB HTLV/HIV CONFIRM DONOR NS,503.0,211.26,19.35,492.94,37
CPT,86689,LAB AB HTLV/HIV CONFIRM SRM/PLASMA,472.0,198.24,19.35,462.56,37
CPT,86692,LAB AB HEPATITIS DELTA AGENT,85.0,35.7,17.16,83.3,37
CPT,86694,LAB AB HERPES SIMPLEX NONSPECIFIC,44.0,18.48,11.88,43.12,37
CPT,86695,LAB AB HERPES SIMPLEX TYPE 1,40.0,16.8,10.8,39.2,37
CPT,86695,LAB AB HERPES SIMPLEX TYPE 1 NS,53.0,22.26,13.19,51.94,37
CPT,86696,LAB AB HERPES SIMPLEX TYPE 2,59.0,24.78,15.93,57.82,37
CPT,86696,LAB AB HERPES SIMPLEX TYPE 2 NS,59.0,24.78,15.93,57.82,37
CPT,86698,LAB AB HISTOPLASMA COMP FIXATION,63.0,26.46,13.79,61.74,37
CPT,86698,LAB AB HISTOPLASMA IMMUNODIFFUSION,68.0,28.56,13.79,66.64,37
CPT,86701,LAB AB HIV-1,76.0,31.92,8.89,74.48,37
CPT,86702,LAB AB HIV-2,87.0,36.54,13.52,85.26,37
CPT,86703,LAB AB HIV-1&HIV-2 RESULT SGL,42.0,17.64,11.34,41.16,37
CPT,86703,LAB AB HIV-1&HIV-2 RESULT SGL NS,70.0,29.4,13.71,68.6,37
CPT,86704,LAB AB HEPATITIS B CORE TOTAL,55.0,23.1,12.05,53.9,37
CPT,86704,LAB AB HEPATITIS B CORE TOTAL NS,55.0,23.1,12.05,53.9,37
CPT,86705,LAB AB HEPATITIS B CORE IGM,55.0,23.1,11.77,53.9,37
CPT,86706,LAB AB HEPATITIS B SURFACE,55.0,23.1,10.74,53.9,37
CPT,86707,LAB AB HEPATITIS BE,59.0,24.78,11.57,57.82,37
CPT,86708,LAB AB HEPATITIS A,55.0,23.1,12.39,53.9,37
CPT,86709,LAB AB HEPATITIS A IGM,55.0,23.1,11.26,53.9,37
CPT,86710,LAB AB INFLUENZA A,68.0,28.56,13.55,66.64,37
CPT,86710,LAB AB INFLUENZA B,68.0,28.56,13.55,66.64,37
CPT,86711,LAB AB JOHN CUNNINGHAM VIRUS,51.0,21.42,13.77,49.98,37
CPT,86713,LAB AB LEGIONELLA,72.0,30.24,15.3,70.56,37
CPT,86717,LAB AB LEISHMANIA,37.0,15.54,9.99,36.26,37
CPT,86720,LAB AB LEPTOSPIRA IGM DOT BLOT,102.0,42.84,16.2,99.96,37
CPT,86720,LAB AB LEPTOSPIRA TITER,154.0,64.68,16.2,150.92,37
CPT,86727,LAB AB CHORIOMENINGITIS LYMPHOCYTIC,62.0,26.04,12.87,60.76,37
CPT,86735,LAB AB MUMPS,61.0,25.62,13.05,59.78,37
CPT,86735,LAB AB MUMPS IGG,56.0,23.52,13.05,54.88,37
CPT,86735,LAB AB MUMPS IGM,62.0,26.04,13.05,60.76,37
CPT,86738,LAB AB MYCOPLASMA IGG NS,55.0,23.1,13.24,53.9,37
CPT,86738,LAB AB MYCOPLASMA IGM,55.0,23.1,13.24,53.9,37
CPT,86747,LAB AB PARVOVIRUS B19 IGG,62.0,26.04,15.03,60.76,37
CPT,86747,LAB AB PARVOVIRUS B19 IGM,62.0,26.04,15.03,60.76,37
CPT,86753,LAB AB AMOEBIC,65.0,27.3,12.39,63.7,37
CPT,86753,LAB AB CHAGAS IGG,72.0,30.24,12.39,70.56,37
CPT,86753,LAB AB CHAGAS RIPA,38.0,15.96,10.26,37.24,37
CPT,86753,LAB AB PROTOZOA BABESIA,58.0,24.36,12.39,56.84,37
CPT,86753,LAB SCR AB CHAGAS,62.0,26.04,12.39,60.76,37
CPT,86756,LAB AB RSV,72.0,30.24,15.89,70.56,37
CPT,86757,LAB AB RICKETTSIA,71.0,29.82,19.17,69.58,37
CPT,86762,LAB AB RUBELLA IGG,56.0,23.52,14.39,54.88,37
CPT,86762,LAB AB RUBELLA IGM NS,56.0,23.52,14.39,54.88,37
CPT,86765,LAB AB RUBEOLA IGG,60.0,25.2,12.88,58.8,37
CPT,86765,LAB AB RUBEOLA IGM,56.0,23.52,12.88,54.88,37
CPT,86768,LAB AB SALMONELLA,73.0,30.66,13.19,71.54,37
CPT,86769,LAB AB SARS-COV-2 COVID-19,127.0,53.34,34.29,124.46,37
CPT,86769,LAB AB SARS-COV-2 COVID-19 NS,127.0,53.34,34.29,124.46,37
CPT,86774,LAB AB TETANUS,63.0,26.46,14.8,61.74,37
CPT,86777,LAB AB TOXOPLASMA IGA,166.0,69.72,14.39,162.68,37
CPT,86777,LAB AB TOXOPLASMA IGG,60.0,25.2,14.39,58.8,37
CPT,86777,LAB AB TOXOPLASMA IGG NS,63.0,26.46,14.39,61.74,37
CPT,86778,LAB AB TOXOPLASMA IGM,60.0,25.2,14.41,58.8,37
CPT,86778,LAB AB TOXOPLASMA IGM NS,63.0,26.46,14.41,61.74,37
CPT,86780,LAB AB TREPONEMA PALLIDUM CONF,74.0,31.08,13.24,72.52,37
CPT,86780,LAB SCR AB SYPHILIS,53.0,22.26,13.24,51.94,37
CPT,86780,LAB SCR AB SYPHILIS NS,40.0,16.8,10.8,39.2,37
CPT,86787,LAB AB VARICELLA-ZOSTER IGG,39.0,16.38,10.53,38.22,37
CPT,86787,LAB AB VARICELLA-ZOSTER IGG NS,53.0,22.26,12.88,51.94,37
CPT,86787,LAB AB VARICELLA-ZOSTER IGM,39.0,16.38,10.53,38.22,37
CPT,86787,LAB AB VARICELLA-ZOSTER IGM NS,39.0,16.38,10.53,38.22,37
CPT,86788,LAB AB WEST NILE VIRUS IGM NS,72.0,30.24,16.85,70.56,37
CPT,86789,LAB AB WEST NILE VIRUS NS,72.0,30.24,14.39,70.56,37
CPT,86790,LAB AB PARAINFLUENZA,66.0,27.72,12.88,64.68,37
CPT,86790,LAB AB VIRUS DENGUE,70.0,29.4,12.88,68.6,37
CPT,86790,LAB AB VIRUS HEPATITIS E IGG,71.0,29.82,12.88,69.58,37
CPT,86790,LAB AB VIRUS NONSPECIFIED,65.0,27.3,12.88,63.7,37
CPT,86790,LAB HANTAVIRUS,102.0,42.84,12.88,99.96,37
CPT,86800,LAB AB THYROGLOBULIN,57.0,23.94,15.39,55.86,37
CPT,86800,LAB AB THYROGLOBULIN MYO,214.0,89.88,15.91,209.72,37
CPT,86800,LAB AB THYROGLOBULIN NS,96.0,40.32,15.91,94.08,37
CPT,86803,LAB AB HEPATITIS C,43.0,18.06,11.61,42.14,37
CPT,86803,LAB AB HEPATITIS C NS,255.0,107.1,14.27,249.9,37
CPT,86804,LAB AB HEPATITIS C CONFIRMATORY,239.0,100.38,15.49,234.22,37
CPT,86808,LAB SCR SERUM PRA CYTOTOXIC QUICK,90.0,37.8,24.3,88.2,37
CPT,86812,LAB BLOOD TYPE HLA B-27 AG SINGLE,78.0,32.76,21.06,76.44,37
CPT,86825,LAB HLA X-MATCH NON-CYTOTOXIC NS,329.0,138.18,88.83,322.42,37
CPT,86828,LAB HLA CLASS I&II AB QL NS,330.0,138.6,64.19,323.4,37
CPT,86830,LAB HLA CLASS I PHENOTYPE QL NS,287.0,120.54,77.49,281.26,37
CPT,86831,LAB HLA CLASS II PHENOTYPE QL NS,246.0,103.32,66.42,241.08,37
CPT,86832,LAB HLA CLASS I AB HIGH DEF QL NS,972.0,408.24,262.44,952.56,37
CPT,86833,LAB HLA CLASS II AB HIGH DEF QL NS,978.0,410.76,264.06,958.44,37
CPT,86850,LAB SCR AB RBC SERUM EA,107.0,44.94,9.77,104.86,37
CPT,86850,LAB SCR AB RBC SERUM EA NS,158.0,66.36,9.77,154.84,37
CPT,86860,LAB ELUTION AB RBC EA,348.0,146.16,93.96,341.04,37
CPT,86860,LAB ELUTION AB RBC EA NS,348.0,146.16,93.96,341.04,37
CPT,86870,LAB PANEL AB RBC EA TECH SERUM,727.0,305.34,196.29,712.46,37
CPT,86870,LAB PANEL AB RBC EA TECH SERUM NS,727.0,305.34,196.29,712.46,37
CPT,86880,LAB COOMBS DIR ANTISERUM EA,121.0,50.82,5.39,118.58,37
CPT,86880,LAB COOMBS DIR ANTISERUM EA NS,121.0,50.82,5.39,118.58,37
CPT,86885,LAB COOMBS INDIRECT REAGENT EA,348.0,146.16,5.72,341.04,37
CPT,86886,LAB COOMBS INDIRECT TITER AB EA,348.0,146.16,5.18,341.04,37
CPT,86886,LAB COOMBS INDIRECT TITER AB EA NS,348.0,146.16,5.18,341.04,37
CPT,86900,LAB BLOOD TYPE ABO,272.0,114.24,2.99,266.56,37
CPT,86900,LAB BLOOD TYPE ABO DISCREPANCY,272.0,114.24,2.99,266.56,37
CPT,86900,LAB BLOOD TYPE ABO NS,272.0,114.24,2.99,266.56,37
CPT,86901,LAB BLOOD TYPE RHD,77.0,32.34,2.99,75.46,37
CPT,86901,LAB BLOOD TYPE RHD NS,77.0,32.34,2.99,75.46,37
CPT,86902,LAB BLOOD TYPE DONOR SERUM RGT,727.0,305.34,6.35,712.46,37
CPT,86902,LAB BLOOD TYPE DONOR SERUM RGT NS,727.0,305.34,6.35,712.46,37
CPT,86904,LAB SCR AG BLD TYPE SERUM PT U NS,153.0,64.26,16.34,149.94,37
CPT,86905,LAB BLOOD TYPE AG RBC EA,727.0,305.34,3.83,712.46,37
CPT,86905,LAB BLOOD TYPE AG RBC PT EA,727.0,305.34,3.83,712.46,37
CPT,86905,LAB BLOOD TYPE IMMUNOPHENOTYPE,727.0,305.34,3.83,712.46,37
CPT,86906,LAB BLOOD TYPE PHENOTYPING RH COMP,122.0,51.24,7.75,119.56,37
CPT,86920,LAB CROSSMATCH SPIN IMMEDIATE,348.0,146.16,93.96,341.04,37
CPT,86921,LAB CROSSMATCH INCUBATION,348.0,146.16,93.96,341.04,37
CPT,86922,LAB CROSSMATCH ANTIGLOBULIN,348.0,146.16,93.96,341.04,37
CPT,86923,LAB CROSSMATCH ELECTRONIC,348.0,146.16,93.96,341.04,37
CPT,86927,LAB THAWING PLASMA FRESH FROZEN,348.0,146.16,93.96,341.04,37
CPT,86940,LAB SCR HEMOLYSINS&AGGLUTININS AUTO,490.0,205.8,8.77,480.2,37
CPT,86941,LAB HEMOLYSINS&AGGLUTININS INCUBATE,137.0,57.54,12.11,134.26,37
CPT,86965,LAB POOLING PLATELETS/BLOOD PROD,348.0,146.16,93.96,341.04,37
CPT,86970,LAB PRETREAT RBC AB CHEMICAL NS,150.0,63.0,40.5,147.0,37
CPT,86971,LAB PRETREAT RBC INCUB ENZYME,348.0,146.16,93.96,341.04,37
CPT,86972,LAB PRETREAT RBC SEP DENS GRD,455.0,191.1,122.85,445.9,37
CPT,86975,LAB PRETREAT SERUM INCUB W DRUGS,911.0,382.62,245.97,892.78,37
CPT,86976,LAB PRETREAT SERUM RBC AB DILUTION,170.0,71.4,29.55,166.6,37
CPT,86977,LAB PRETREAT SERUM INCUB INHIB,348.0,146.16,93.96,341.04,37
CPT,86978,LAB PRETREAT SERUM ABSORP NS,277.0,116.34,60.27,271.46,37
CPT,86985,LAB SPLITTING BLOOD/BLOOD PROD EA,348.0,146.16,93.96,341.04,37
CPT,86999,HLA MATCH,250.0,105.0,29.55,245.0,37
CPT,86999,LAB HLA SEARCH,230.0,96.6,29.55,225.4,37
CPT,86999,LAB SEPARATION RED CELL,268.0,112.56,29.55,262.64,37
CPT,87015,LAB CONCENTRATION AFB IA,58.0,24.36,6.68,56.84,37
CPT,87015,LAB CONCENTRATION ANY TYPE IA,21.0,8.82,5.67,20.58,37
CPT,87015,LAB CONCENTRATION ANY TYPE IA NS,128.0,53.76,6.68,125.44,37
CPT,87040,LAB CULT BACT AEROBIC BLOOD,31.0,13.02,8.37,30.38,37
CPT,87045,LAB CULT BACT AEROBIC STOOL,29.0,12.18,7.83,28.42,37
CPT,87046,LAB CULT BACT AEROBIC STOOL CAMPY,29.0,12.18,7.83,28.42,37
CPT,87046,LAB CULT BACT AEROBIC STOOL E COLI,29.0,12.18,7.83,28.42,37
CPT,87046,LAB CULT BACT AEROBIC STOOL PATH,79.0,33.18,9.44,77.42,37
CPT,87046,LAB CULT BACT AEROBIC STOOL PATH NS,63.0,26.46,9.44,61.74,37
CPT,87046,LAB CULT BACT AEROBIC STOOL VIBRO,29.0,12.18,7.83,28.42,37
CPT,87046,LAB CULT BACT AEROBIC STOOL YERSNIA,29.0,12.18,7.83,28.42,37
CPT,87070,LAB CULT BACT AEROBIC CATHETER TIP,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT AEROBIC CSF,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT AEROBIC EAR,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT AEROBIC EYE,61.0,25.62,8.62,59.78,37
CPT,87070,LAB CULT BACT AEROBIC GENITAL,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT AEROBIC OTHER,75.0,31.5,8.62,73.5,37
CPT,87070,LAB CULT BACT AEROBIC OTHER NS,68.0,28.56,8.62,66.64,37
CPT,87070,LAB CULT BACT AEROBIC RESP LOWER,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT AEROBIC RESP UPPER,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT AEROBIC TISSUE,112.0,47.04,8.62,109.76,37
CPT,87070,LAB CULT BACT AEROBIC WOUND,26.0,10.92,7.02,25.48,37
CPT,87070,LAB CULT BACT FLUID BODY STERILE,26.0,10.92,7.02,25.48,37
CPT,87071,LAB CULT BACT AEROBIC OTHER QN,61.0,25.62,9.89,59.78,37
CPT,87073,LAB CULT BACT ANAEROBIC OTHER QN,392.0,164.64,9.66,384.16,37
CPT,87075,LAB CULT BACT ANAEROBIC OTHER,29.0,12.18,7.83,28.42,37
CPT,87076,LAB CULT BACT ANAEROBIC ID DF,25.0,10.5,6.75,24.5,37
CPT,87077,LAB CULT BACT AEROBIC ID DF,25.0,10.5,6.75,24.5,37
CPT,87077,LAB CULT BACT AEROBIC ID DF NOCARD,25.0,10.5,6.75,24.5,37
CPT,87077,LAB CULT BACT AEROBIC ID DF NS,96.0,40.32,8.08,94.08,37
CPT,87077,POC CULT BACT H PYLORI FAST,25.0,10.5,6.75,24.5,37
CPT,87081,LAB SCR CULT ACANTHAMOEBA,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT BORDETELLA,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT GONORRHEA,58.0,24.36,6.63,56.84,37
CPT,87081,LAB SCR CULT H PYLORI SGL,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT LEGIONELLA,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT ORGANISMS SGL,59.0,24.78,6.63,57.82,37
CPT,87081,LAB SCR CULT STAPH MRSA,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT STREP GROUP A,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT STREP GROUP B,20.0,8.4,5.4,19.6,37
CPT,87081,LAB SCR CULT VRE,58.0,24.36,6.63,56.84,37
CPT,87086,LAB CULT BACT COLONY COUNT URINE,25.0,10.5,6.75,24.5,37
CPT,87088,LAB CULT BACT ID ISOLATE URINE,25.0,10.5,6.75,24.5,37
CPT,87101,LAB CULT FUNGI ID DERMATOPHYTE,59.0,24.78,7.71,57.82,37
CPT,87102,LAB CULT FUNGI ID ISOLATES,78.0,32.76,8.41,76.44,37
CPT,87102,LAB CULT FUNGI YEAST ID ISOLATES,60.0,25.2,8.41,58.8,37
CPT,87103,LAB CULT FUNGI ID ISOLATES BLOOD,69.0,28.98,18.63,67.62,37
CPT,87106,LAB CULT FUNGI ID DF YEAST,62.0,26.04,10.32,60.76,37
CPT,87106,LAB CULT FUNGI ID DF YEAST NS,136.0,57.12,10.32,133.28,37
CPT,87107,LAB CULT FUNGI ID DF MOLD,62.0,26.04,10.32,60.76,37
CPT,87107,LAB CULT FUNGI ID DF MOLD NS,138.0,57.96,10.32,135.24,37
CPT,87109,LAB CULT MYCOPLASMA/UREAPLASMA,63.0,26.46,15.39,61.74,37
CPT,87110,LAB CULT CHLAMYDIA,71.0,29.82,19.17,69.58,37
CPT,87116,LAB CULT AFB ID ISOLATES,63.0,26.46,10.8,61.74,37
CPT,87116,LAB CULT AFB ID ISOLATES BLOOD,33.0,13.86,8.91,32.34,37
CPT,87116,LAB CULT AFB ID ISOLATES NS,65.0,27.3,10.8,63.7,37
CPT,87118,LAB CULT MYCOBACTERIAL ID DF,64.0,26.88,14.61,62.72,37
CPT,87140,LAB CULT TYPING IF ANTISERUM EA,57.0,23.94,5.57,55.86,37
CPT,87140,LAB CULT TYPING IF ANTISERUM EA NS,56.0,23.52,5.57,54.88,37
CPT,87143,LAB CULT TYPING GLC/HPLC,38.0,15.96,10.26,37.24,37
CPT,87147,LAB CULT TYPING SEROLOGICAL,16.0,6.72,4.32,15.68,37
CPT,87149,LAB CULT TYPING ID NUC ACID PRB DIR,73.0,30.66,19.71,71.54,37
CPT,87150,LAB CULT TYPING ID NUC ACID PRB AMP,137.0,57.54,35.09,134.26,37
CPT,87153,LAB CULT TYPING ID SEQ NUC ACID,347.0,145.74,93.69,340.06,37
CPT,87153,LAB CULT TYPING ID SEQ NUC ACID NS,347.0,145.74,93.69,340.06,37
CPT,87168,LAB EXAM MACROSCOPIC ARTHROPOD,13.0,5.46,3.51,12.74,37
CPT,87169,LAB EXAM MACROSCOPIC PARASITE,58.0,24.36,4.31,56.84,37
CPT,87172,LAB EXAM PINWORM,13.0,5.46,3.51,12.74,37
CPT,87176,LAB HOMOGENIZATION TISSUE,57.0,23.94,5.88,55.86,37
CPT,87177,LAB SMEARS DIRECT OVA&PARASITES,27.0,11.34,7.29,26.46,37
CPT,87181,LAB SUSCPT ETEST AGENT EA,255.0,107.1,4.75,249.9,37
CPT,87181,LAB SUSCPT ETEST AGENT EA NS,66.0,27.72,4.75,64.68,37
CPT,87182,LAB SUSCPT CARBAPENEMASE DET ENZ,56.0,23.52,15.12,54.88,30
CPT,87184,LAB SUSCPT DISK KIRBY BAUER,23.0,9.66,6.21,22.54,37
CPT,87185,LAB SUSCPT DETECTION ENZYME EA,56.0,23.52,4.75,54.88,37
CPT,87186,LAB SUSCPT MIC PLATE EA,26.0,10.92,7.02,25.48,37
CPT,87186,LAB SUSCPT MIC PLATE EA LSI NS,200.0,84.0,8.65,196.0,37
CPT,87186,LAB SUSCPT MIC PLATE EA NS,152.0,63.84,8.65,148.96,37
CPT,87186,LAB SUSCPT MICRODILUTION PLATE EA,60.0,25.2,8.65,58.8,37
CPT,87188,LAB SUSCPT DILUTION MACROBROTH,58.0,24.36,6.64,56.84,37
CPT,87188,LAB SUSCPT DILUTION MACROBROTH NS,115.0,48.3,6.64,112.7,37
CPT,87190,LAB SUSCPT AFB PROPORTION EA NS,63.0,26.46,7.31,61.74,37
CPT,87205,LAB SMEAR GRAM/GIEMSA,13.0,5.46,3.51,12.74,37
CPT,87205,LAB SMEAR GRAM/GIEMSA URINE EOSNPHL,13.0,5.46,3.51,12.74,37
CPT,87206,LAB SMEAR STAIN ACID FAST AFB,58.0,24.36,5.39,56.84,37
CPT,87206,LAB SMEAR STAIN FL AFB,57.0,23.94,5.39,55.86,37
CPT,87206,LAB SMEAR STAIN FL AFB NS,68.0,28.56,5.39,66.64,37
CPT,87206,LAB SMEAR STAIN FL FUNGI,58.0,24.36,5.39,56.84,37
CPT,87207,LAB SMEAR INCL BODIES/PARAS MYO NS,287.0,120.54,5.99,281.26,37
CPT,87207,LAB SMEAR INCL BODIES/PARASITE,18.0,7.56,4.86,17.64,37
CPT,87207,LAB SMEAR INCL BODIES/PARASITE NS,64.0,26.88,5.99,62.72,37
CPT,87209,LAB SMEAR STAIN CMPLX OVA&PARASITES,71.0,29.82,17.98,69.58,37
CPT,87210,LAB SMEAR IA INDIA INK,18.0,7.56,4.86,17.64,37
CPT,87210,LAB SMEAR IA WET MOUNT,53.0,22.26,5.82,51.94,37
CPT,87220,LAB TISSUE KOH SKIN/HAIR/NAIL FUNGI,64.0,26.88,4.27,62.72,37
CPT,87230,LAB TOXIN CULT TISSUE C DIFF NS,79.0,33.18,19.74,77.42,37
CPT,87252,LAB ISO VIRUS INOC TISSUE,79.0,33.18,21.33,77.42,37
CPT,87252,LAB ISO VIRUS INOC TISSUE NS,100.0,42.0,26.07,98.0,37
CPT,87253,LAB ISO VIRUS INOC TISSUE ADDL,65.0,27.3,17.55,63.7,37
CPT,87254,LAB ISO VIRUS SHELL VIAL ID W IF,64.0,26.88,17.28,62.72,37
CPT,87254,LAB ISO VIRUS SHELL VIAL ID W IF NS,106.0,44.52,19.56,103.88,37
CPT,87255,LAB ISO VIRUS ID ACT ENZYMATIC,102.0,42.84,27.54,99.96,37
CPT,87255,LAB ISO VIRUS ID ACT ENZYMATIC NS,102.0,42.84,27.54,99.96,37
CPT,87260,LAB DET AG IA IF ADENOVIRUS,44.0,18.48,11.88,43.12,37
CPT,87265,LAB DET AG IA IF BORDETELLA,36.0,15.12,9.72,35.28,37
CPT,87269,LAB DET AG IA IF GIARDIA,61.0,25.62,13.61,59.78,37
CPT,87272,LAB DET AG IA IF CRYPTOSPORIDIUM,61.0,25.62,11.98,59.78,37
CPT,87273,LAB DET AG IA IF HSV TYPE 2,60.0,25.2,11.98,58.8,37
CPT,87274,LAB DET AG IA IF HSV TYPE 1,60.0,25.2,11.98,58.8,37
CPT,87275,LAB DET AG IA IF INFLUENZA B VIRUS,60.0,25.2,12.25,58.8,37
CPT,87276,LAB DET AG IA IF INFLUENZA A VIRUS,60.0,25.2,16.07,58.8,37
CPT,87279,LAB DET AG IA IF PARAINFLUENZA,50.0,21.0,13.5,49.0,37
CPT,87280,LAB DET AG IA IF RSV,60.0,25.2,13.42,58.8,37
CPT,87281,LAB DET AG IA IF PNEUMOCYSTIS,36.0,15.12,9.72,35.28,37
CPT,87281,LAB DET AG IA IF PNEUMOCYSTIS NS,76.0,31.92,11.98,74.48,37
CPT,87290,LAB DET AG IA IF VARICELLA-ZOSTER,60.0,25.2,13.42,58.8,37
CPT,87300,LAB DET AG IA IF PLYVLT ORG MULT,60.0,25.2,11.98,58.8,37
CPT,87305,LAB DET AG IA IMM ENZ ASPRGLS NS,152.0,63.84,11.98,148.96,37
CPT,87324,LAB DET AG IA IMM ENZ TOXIN C DIFF,60.0,25.2,11.98,58.8,37
CPT,87328,LAB DET AG IA IMM ENZ CRYPTOSPOR NS,74.0,31.08,13.82,72.52,37
CPT,87329,LAB DET AG IA IMM ENZ GIARDIA,36.0,15.12,9.72,35.28,37
CPT,87329,LAB DET AG IA IMM ENZ GIARDIA NS,66.0,27.72,11.98,64.68,37
CPT,87337,LAB DET AG IA IMM ENZ ENTAM HIST NS,73.0,30.66,11.98,71.54,37
CPT,87338,LAB DET AG IA IMM H PYLORI STOOL,75.0,31.5,14.38,73.5,37
CPT,87340,LAB DET AG IA HBSAG QL/SEMI QN,31.0,13.02,8.37,30.38,37
CPT,87340,LAB DET AG IA HBSAG QL/SEMI QN NS,231.0,97.02,10.33,226.38,37
CPT,87341,LAB DET AG IA IMM ENZ HEP B SURF,58.0,24.36,10.33,56.84,37
CPT,87350,LAB DET AG IA IMM ENZ HEP BE,59.0,24.78,11.53,57.82,37
CPT,87380,LAB DET AG IA IMM ENZ HEP DELTA AGT,175.0,73.5,18.36,171.5,37
CPT,87385,LAB DET AG IA IMM ENZ HISTOPLASMA,152.0,63.84,13.25,148.96,37
CPT,87389,LAB DET AG IA IMM HIV1 W HIV 1&2,87.0,36.54,23.49,85.26,37
CPT,87400,LAB DET AG IA IMM ENZ INFLUENZA A/B,43.0,18.06,11.61,42.14,37
CPT,87420,LAB DET AG IA IMM ENZ RSV,42.0,17.64,11.34,41.16,37
CPT,87425,LAB DET AG IA IMM ENZ ROTAVIRUS,36.0,15.12,9.72,35.28,37
CPT,87427,LAB DET AG IA IMM ENZ TOX SHIGA,64.0,26.88,11.98,62.72,37
CPT,87430,LAB DET AG IA IMM ENZ STREP GROUP A,51.0,21.42,13.77,49.98,37
CPT,87430,POC AG EIA STREP GROUP A QL,51.0,21.42,13.77,49.98,37
CPT,87449,LAB DET AG IA IMM ENZ CAMPY,78.0,32.76,11.98,76.44,37
CPT,87449,LAB DET AG IA IMM ENZ FUNGITELL,97.0,40.74,11.98,95.06,37
CPT,87449,LAB DET AG IA IMM ENZ FUNGITELL NS,157.0,65.94,11.98,153.86,37
CPT,87449,LAB DET AG IA IMM ENZ LEGN URINE NS,66.0,27.72,11.98,64.68,37
CPT,87449,LAB DET AG IA IMM ENZ QL,36.0,15.12,9.72,35.28,37
CPT,87449,LAB DET AG IA IMM ENZ SEMI QN,147.0,61.74,11.98,144.06,37
CPT,87449,LAB DET AG IA IMM ENZ STREP PNEU QL,65.0,27.3,11.98,63.7,37
CPT,87468,LAB DET IA ANPLSM PHGCYTPHL PRB QNI,189.0,79.38,35.09,185.22,37
CPT,87471,LAB DET IA BARTONELLA PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87480,LAB DET IA CANDIDA PRB DIR,90.0,37.8,20.05,88.2,37
CPT,87481,LAB DET IA CANDIDA PRB AMP,237.0,99.54,35.09,232.26,37
CPT,87483,LAB DET IA CNS PRB AMP 12-25 TGT,1251.0,525.42,337.77,1225.98,37
CPT,87486,LAB DET IA CHLAMYD PNEU PRB AMP NS,328.0,137.76,35.09,321.44,37
CPT,87491,LAB DET IA CHLAMYD TRAC PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87491,LAB DET IA CHLAMYD TRAC PRB AMP NS,115.0,48.3,31.05,112.7,37
CPT,87493,LAB DET IA TOXIN C DIFF PRB AMP,112.0,47.04,30.24,109.76,37
CPT,87494,LAB DET IA CT&NG PRB AMP MULTIPLEX,211.0,88.62,56.97,206.78,37
CPT,87496,LAB DET IA CMV PRB AMP NS,106.0,44.52,28.62,103.88,37
CPT,87497,LAB DET IA CMV QN,129.0,54.18,34.83,126.42,37
CPT,87497,LAB DET IA CMV QN NS,129.0,54.18,34.83,126.42,37
CPT,87498,LAB DET IA ENTEROVRS PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87498,LAB DET IA ENTEROVRS PRB AMP NS,139.0,58.38,35.09,136.22,37
CPT,87502,LAB DET IA FLU REV T&PRB AMP 1-2,288.0,120.96,77.76,282.24,37
CPT,87502,LAB DET IA FLU REV T&PRB AMP 1-2 NS,288.0,120.96,77.76,282.24,37
CPT,87502,POC DET IA FLU REV T&PRB AMP 1-2,288.0,120.96,77.76,282.24,37
CPT,87503,LAB DET IA FLU REV T&PRB AMP 3+ NS,88.0,36.96,23.76,86.24,37
CPT,87505,LAB DET IA GI MULT PRB AMP 3-5 TGT,385.0,161.7,103.95,377.3,37
CPT,87506,LAB DET IA GI MULT PRB AMP 6-11 TGT,789.0,331.38,213.03,773.22,37
CPT,87507,LAB DET IA GI MULT PRB 12-25TGT NS,1251.0,525.42,337.77,1225.98,37
CPT,87507,LAB DET IA GI MULT PRB AMP 12-25TGT,1251.0,525.42,337.77,1225.98,37
CPT,87510,LAB DET IA GARDNERELLA VAG PRB DIR,90.0,37.8,20.05,88.2,37
CPT,87516,LAB DET IA HEP B PRB AMP,135.0,56.7,35.09,132.3,37
CPT,87517,LAB DET IA HEP B QN,129.0,54.18,34.83,126.42,37
CPT,87521,LAB DET IA HEP C PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87522,LAB DET IA HEP C QN,129.0,54.18,34.83,126.42,37
CPT,87522,LAB DET IA HEP C QN NS,147.0,61.74,39.69,144.06,37
CPT,87523,LAB DET IA HEP D PCR QN,690.0,289.8,42.84,676.2,37
CPT,87529,LAB DET IA HSV PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87529,LAB DET IA HSV PRB AMP NS,106.0,44.52,28.62,103.88,37
CPT,87530,LAB DET IA HSV QN,129.0,54.18,34.83,126.42,37
CPT,87532,LAB DET IA HERPES 6 PRB AMP,120.0,50.4,32.4,117.6,37
CPT,87533,LAB DET IA HERPES 6 PCR QN,126.0,52.92,34.02,123.48,37
CPT,87535,LAB DET IA HIV-1 PRB AMP NS,108.0,45.36,29.16,105.84,37
CPT,87536,LAB DET IA HIV-1 QN,256.0,107.52,69.12,250.88,37
CPT,87536,LAB DET IA HIV-1 QN NS,256.0,107.52,69.12,250.88,37
CPT,87538,LAB DET IA HIV-2 REV T&PRB AMP,122.0,51.24,32.94,119.56,37
CPT,87541,LAB DET IA LEGIONELL PNEUM PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87551,LAB DET IA MYCOBCT PRB AMP,450.0,189.0,48.24,441.0,37
CPT,87556,LAB DET IA MYCOBCT TB PRB AMP,126.0,52.92,34.02,123.48,37
CPT,87556,LAB DET IA MYCOBCT TB PRB AMP NS,126.0,52.92,34.02,123.48,37
CPT,87563,LAB DET IA MYCOPLAS GEN PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87581,LAB DET IA MYCOPLAS PNEU PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87581,LAB DET IA MYCOPLAS PNEU PRB AMP NS,106.0,44.52,28.62,103.88,37
CPT,87591,LAB DET IA GC PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87591,LAB DET IA GC PRB AMP NS,106.0,44.52,28.62,103.88,37
CPT,87593,LAB DET IA ORTHOPOXVIRUS PRB AMP,154.0,64.68,41.58,150.92,37
CPT,87594,LAB DET IA PNEUM JIROVECII RFLX PRB,421.0,176.82,35.09,412.58,37
CPT,87624,LAB DET IA HPV TYPE RISK HIGH POOL,106.0,44.52,28.62,103.88,37
CPT,87625,LAB DET IA HPV TYPES 16&18,122.0,51.24,32.94,119.56,37
CPT,87627,LAB DET IA PATH JT&GENE RXRST 26+,2040.0,856.8,550.8,1999.2,37
CPT,87631,LAB DET IA RESP MLTPLX 3-5 TGT,428.0,179.76,115.56,419.44,37
CPT,87632,LAB DET IA RESP MLTPLX 6-11 TGT,655.0,275.1,176.85,641.9,37
CPT,87633,LAB DET IA RESP MLTPLX 12-25 TGT,1251.0,525.42,337.77,1225.98,37
CPT,87633,LAB DET IA RESP MLTPLX 12-25 TGT NS,1251.0,525.42,337.77,1225.98,37
CPT,87634,LAB DET IA RSV PRB AMP,211.0,88.62,56.97,206.78,37
CPT,87635,LAB DET IA COV19 PRB AMP,154.0,64.68,41.58,150.92,37
CPT,87635,LAB DET IA COV19 PRB AMP NS,154.0,64.68,41.58,150.92,37
CPT,87636,LAB DET IA COV19&FLU A&B PRB AMP,96.0,40.32,25.92,206.81,37
CPT,87641,LAB DET IA MRSA PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87641,LAB DET IA MRSA PRB AMP NS,106.0,44.52,28.62,103.88,37
CPT,87651,LAB DET IA STREP GROUP A PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87653,LAB DET IA STREP GROUP B PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87660,LAB DET IA TRICHOMONAS VAG PRB DIR,61.0,25.62,16.47,59.78,37
CPT,87661,LAB DET IA TRICHOMON VAG PRB AMP NS,111.0,46.62,29.97,108.78,37
CPT,87661,LAB DET IA TRICHOMONAS VAG PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87662,LAB DET IA VIRUS ZIKA PRB AMP,200.0,84.0,51.31,196.0,37
CPT,87798,LAB DET IA ASPERGILLUS PCR PRB AMP,115.0,48.3,31.05,112.7,37
CPT,87798,LAB DET IA B PERTUSSIS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA BK VIRUS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA C BURNETII PCR PRB AMP,744.0,312.48,35.09,729.12,37
CPT,87798,LAB DET IA DENGUE TYPES 1-4 PRB AMP,290.0,121.8,35.09,284.2,37
CPT,87798,LAB DET IA EBV PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA HHV-8 PCR PRB AMP,124.0,52.08,33.48,121.52,37
CPT,87798,LAB DET IA IGM PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA JC VIRUS PCR PRB AMP,123.0,51.66,33.21,120.54,37
CPT,87798,LAB DET IA LEGIONELL PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA LEPTOSPIRA PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA MUCORALES PCR PRB AMP,275.0,115.5,35.09,269.5,37
CPT,87798,LAB DET IA NORCARDIA PCR PRB AMP,362.0,152.04,35.09,354.76,37
CPT,87798,LAB DET IA PARVOVIRUS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA PLASMODIUM PCR PRB AMP,518.0,217.56,35.09,507.64,37
CPT,87798,LAB DET IA PNEUMOCYSTIS PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA PRB AMP NS,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA RUBELLA PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA RUBEOLA PCR PRB AMP,416.0,174.72,35.09,407.68,37
CPT,87798,LAB DET IA RUBEOLA PCR PRB AMP URIN,517.0,217.14,35.09,506.66,37
CPT,87798,LAB DET IA SYPHILIS PCR PRB AMP,371.0,155.82,35.09,363.58,37
CPT,87798,LAB DET IA TOXOPLASMA RFLX PCR PRB,421.0,176.82,35.09,412.58,37
CPT,87798,LAB DET IA VARICELLA-ZOSTER PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB DET IA VZV PCR PRB AMP,106.0,44.52,28.62,103.88,37
CPT,87798,LAB RNA NOROVIRUS AMP PROBE,109.0,45.78,29.43,106.82,37
CPT,87799,LAB DET IA ADENOVIRUS PCR QN,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA BK VIRUS PCR QN,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA BK VIRUS PCR QN NS,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA BK VIRUS PCR QN URINE,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA EBV PCR QN,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA EBV PCR QN NS,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA HEP E PCR QN,251.0,105.42,42.84,245.98,37
CPT,87799,LAB DET IA HHV NON 6 PCR QN,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA JC VIRUS PCR QN,129.0,54.18,34.83,126.42,37
CPT,87799,LAB DET IA PARVOVIRUS PCR QN,141.0,59.22,38.07,138.18,37
CPT,87799,LAB DET IA PNEUMOCYSTIS PCR QN,275.0,115.5,42.84,269.5,37
CPT,87799,LAB DET IA TOXOPLASMA PCR QN,130.0,54.6,35.1,127.4,37
CPT,87799,LAB DET IA VZV PCR QN,129.0,54.18,34.83,126.42,37
CPT,87801,LAB DET IA BACTERIAL MULT PRB AMP,1309.0,549.78,70.2,1282.82,37
CPT,87801,LAB DET IA ENTEROBACTR MULT PRB AMP,411.0,172.62,70.2,402.78,37
CPT,87801,LAB DET IA FUNGAL MULT PRB AMP,1372.0,576.24,70.2,1344.56,37
CPT,87801,LAB DET IA LEGIONELL MULT PRB AMP,211.0,88.62,56.97,206.78,37
CPT,87801,LAB DET IA ORGANISMS FNGL MULT PRB,638.0,267.96,70.2,625.24,37
CPT,87801,LAB DET IA ORGANISMS MULT PRB AMP,211.0,88.62,56.97,206.78,37
CPT,87801,LAB DET IA PERTUSSIS MULT PRB AMP,211.0,88.62,56.97,206.78,37
CPT,87804,LAB DET AG IA INFLUENZA IMM OPT,50.0,21.0,13.5,49.0,37
CPT,87807,LAB DET AG IA RSV IMM OPT,40.0,16.8,10.8,39.2,37
CPT,87880,LAB DET AG IA STREP GROUP A IMM OPT,50.0,21.0,13.5,49.0,37
CPT,87880,POC DET AG IA STREP GROUP A IMM OPT,50.0,21.0,13.5,49.0,37
CPT,87899,LAB DET AG IA IMM OPTICAL,65.0,27.3,16.07,63.7,37
CPT,87899,LAB DET AG IA IMM OPTICAL NS,75.0,31.5,16.07,73.5,37
CPT,87900,LAB SUSCPT PHENOTYPE IA DRUG,392.0,164.64,105.84,384.16,37
CPT,87901,LAB GENOTYPE IA HIV-1 REV T,773.0,324.66,208.71,757.54,37
CPT,87901,LAB GENOTYPE IA HIV-1 REV T NS,773.0,324.66,208.71,757.54,37
CPT,87902,LAB GENOTYPE IA HEPATITIS C NS,773.0,324.66,208.71,757.54,37
CPT,87903,LAB PHENOTYPE IA HIV 1 DRUGS 1-10,1466.0,615.72,395.82,1436.68,37
CPT,87904,LAB PHENOTYPE IA HIV 1 DRUGS ADDL,91.0,38.22,24.57,89.18,37
CPT,87906,LAB GENOTYPE IA HIV-1 TROPISM CORCP,387.0,162.54,104.49,379.26,37
CPT,87910,LAB GENOTYPE IA CYTOMEGALOVIRUS,773.0,324.66,208.71,757.54,37
CPT,87999,LAB PANEL INFCT FLUID SYNOVIAL PCR,856.0,359.52,231.12,838.88,30
CPT,88104,LAB CYTOPATH FLUIDS SMEARS,77.0,32.34,20.79,75.46,37
CPT,88108,LAB CYTOPATH CONCENTRATION,77.0,32.34,20.79,75.46,37
CPT,88112,LAB CYTOP SLD LIQ NONGYN,107.0,44.94,28.89,104.86,37
CPT,88120,LAB CYTOPATH URIN MANUAL PRB 3-5 EA,1181.0,496.02,174.06,1157.38,37
CPT,88142,LAB SCR MANUAL CYTOPATH CERV/VAG,61.0,25.62,16.47,59.78,37
CPT,88160,LAB CYTOPATH SMEARS OTH SC&IN,71.0,29.82,19.17,69.58,37
CPT,88161,LAB CYTOPATH OTH SRCE SMEARS SC&IN,68.0,28.56,18.36,66.64,37
CPT,88172,LAB CYTOPATH EVAL FNA IMMED 1ST,348.0,146.16,93.96,341.04,37
CPT,88173,LAB CYTOPATH EVAL FNA INTRP&RPT,107.0,44.94,28.89,104.86,37
CPT,88173,LAB CYTOPATH EVAL FNA INTRP&RPT NS,107.0,44.94,28.89,104.86,37
CPT,88175,LAB CYTOPATH CERV/VAG AUTO&MANUAL,162.0,68.04,26.61,158.76,37
CPT,88177,LAB CYTOPATH EVAL FNA IMMED ADDL,90.0,37.8,24.3,88.2,30
CPT,88184,LAB CYTOM FLOW TECH MARKER 1ST,727.0,305.34,196.29,712.46,37
CPT,88184,LAB CYTOM FLOW TECH MARKER 1ST NS,727.0,305.34,196.29,712.46,37
CPT,88185,LAB CYTOM FLOW TECH MARKER ADDL,119.0,49.98,32.13,116.62,30
CPT,88185,LAB CYTOM FLOW TECH MARKER ADDL NS,126.0,52.92,34.02,123.48,30
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYT MYO,1148.0,482.16,116.49,1125.04,37
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYTE,350.0,147.0,94.5,343.0,37
CPT,88230,LAB CULT TISS NON-NEO LYMPHOCYTE NS,350.0,147.0,94.5,343.0,37
CPT,88233,LAB CULT TISS NON-NEO SKIN/BX NS,423.0,177.66,114.21,414.54,37
CPT,88235,LAB CULT TISS NON-NEO AF/CELL CV,451.0,189.42,121.77,441.98,37
CPT,88237,LAB CULT TISS NON-NEO MARROW BLD NS,432.0,181.44,116.64,423.36,37
CPT,88239,LAB CULT TISS NEO TMR SOLID NS,443.0,186.06,119.61,434.14,37
CPT,88249,LAB CHROM BRK STRS CLASTGN 100 CELL,520.0,218.4,140.4,509.6,37
CPT,88261,LAB CHROM W BND 5 CLL 1 K CVS DIR,794.0,333.48,214.38,778.12,37
CPT,88261,LAB CHROM W BND 5 CLL 1 KRTY,794.0,333.48,214.38,778.12,37
CPT,88262,LAB CHROM W BND 15-20 CLL 2 KRTY,377.0,158.34,101.79,369.46,37
CPT,88262,LAB CHROM W BND 15-20 CLL 2 KRTY NS,532.0,223.44,125.49,521.36,37
CPT,88263,LAB CHROM W BND 45 CLL 2 KRTY,451.0,189.42,121.77,441.98,37
CPT,88264,LAB CHROM 20-25 CELLS,434.0,182.28,117.18,425.32,37
CPT,88269,LAB CHROM W BND AF 6-12 COL 1 K,521.0,218.82,140.67,510.58,37
CPT,88271,LAB MCG PROBE DNA PROBE EA,65.0,27.3,17.55,63.7,37
CPT,88271,LAB MCG PROBE DNA PROBE EA NS,272.0,114.24,21.42,266.56,37
CPT,88273,LAB MCG IN SITU CHROM 10-30 CELL,335.0,140.7,34.81,328.3,37
CPT,88274,LAB MCG IN SITU INT 25-99 CELL,128.0,53.76,34.56,125.44,37
CPT,88274,LAB MCG IN SITU INT 25-99 CELL NS,128.0,53.76,34.56,125.44,37
CPT,88275,LAB MCG IN SITU INT 100-300 CELL,154.0,64.68,41.58,150.92,37
CPT,88275,LAB MCG IN SITU INT 100-300 CELL NS,154.0,64.68,41.58,150.92,37
CPT,88280,LAB CHROM KARYOTYPES ADDL EA,101.0,42.42,27.27,98.98,37
CPT,88285,LAB CHROM STUDY CELLS COUNTED ADDL,81.0,34.02,21.87,79.38,37
CPT,88289,LAB CHROM STUDY RES HIGH ADDL,104.0,43.68,28.08,101.92,37
CPT,88300,LAB PATH GROSS ONLY LVL 1,60.0,25.2,16.2,58.8,37
CPT,88300,LAB PATH GROSS ONLY LVL 1 NS,60.0,25.2,16.2,58.8,37
CPT,88302,LAB PATH GROSS&MICRO LVL 2,77.0,32.34,20.79,75.46,37
CPT,88304,LAB PATH GROSS&MICRO LVL 3,107.0,44.94,28.89,104.86,37
CPT,88305,LAB PATH GROSS&MICRO LVL 4 NS,107.0,44.94,28.89,104.86,37
CPT,88307,LAB PATH GROSS&MICRO LVL 5,727.0,305.34,196.29,712.46,37
CPT,88307,LAB PATH GROSS&MICRO LVL 5 NS,727.0,305.34,196.29,712.46,37
CPT,88309,LAB PATH GROSS&MICRO LVL 6,1612.0,677.04,435.24,1579.76,37
CPT,88311,LAB DECALCIFICATION,38.0,15.96,10.26,37.24,30
CPT,88312,LAB STAIN SPECIAL 1,107.0,44.94,28.89,104.86,37
CPT,88312,LAB STAIN SPECIAL 1 NS,107.0,44.94,28.89,104.86,37
CPT,88313,LAB STAIN SPECIAL 2 NS,272.0,114.24,73.44,266.56,37
CPT,88313,LAB STAIN SPECIAL 2 PROT AMYLOID,272.0,114.24,73.44,266.56,37
CPT,88314,LAB STAIN HISTOCHEM W BLOCK FROZEN,750.0,315.0,202.5,735.0,30
CPT,88319,LAB STAIN CONSTITUENTS ENZYME NS,1612.0,677.04,435.24,1579.76,37
CPT,88321,LAB CONSULT SLIDES REFERRED NS,77.0,32.34,20.79,75.46,37
CPT,88323,LAB CONSULT SLIDES PREP REQ,107.0,44.94,28.89,104.86,37
CPT,88331,LAB CONSULT PATH SURG BLOCK 1ST,348.0,146.16,93.96,341.04,37
CPT,88332,LAB CONSULT PATH SURG BLOCK EA ADDL,59.0,24.78,15.93,57.82,30
CPT,88333,LAB CONSULT PATH SURG CYTO INITIAL,1612.0,677.04,435.24,1579.76,37
CPT,88334,LAB CONSULT PATH SURG CYTO EA ADDL,65.0,27.3,17.55,63.7,30
CPT,88341,LAB IMHST/IMCYT AB PER SPEC NS ADDL,137.0,57.54,36.99,134.26,30
CPT,88342,LAB IMHST/IMCYT AB 1ST PER SPEC NS,348.0,146.16,93.96,341.04,37
CPT,88344,LAB IMHST/IMCYT MLTPLX PER SPEC NS,1023.0,429.66,276.21,1002.54,37
CPT,88346,LAB IF AB STAIN INITIAL PER SPEC NS,348.0,146.16,93.96,341.04,37
CPT,88348,LAB MICROSCOPY ELECTRON DIAG NS,1612.0,677.04,435.24,1579.76,37
CPT,88350,LAB IF AB STAIN PER SPEC ADDL NS,189.0,79.38,51.03,185.22,30
CPT,88360,LAB MORPHO HER2 MANUAL PER SPEC NS,374.0,157.08,100.98,366.52,37
CPT,88360,LAB MORPHO TMR IHC MNL PER SPEC NS,348.0,146.16,93.96,341.04,37
CPT,88361,LAB MORPHO HER2 COMP PER SPEC,727.0,305.34,196.29,712.46,37
CPT,88364,LAB ISH PRB STAIN PER SPEC ADDL,136.0,57.12,36.72,133.28,30
CPT,88364,LAB ISH PRB STAIN PER SPEC ADDL NS,124.0,52.08,33.48,121.52,30
CPT,88365,LAB ISH 1ST PRB STAIN PER SPEC,348.0,146.16,93.96,341.04,37
CPT,88365,LAB ISH 1ST PRB STAIN PER SPEC NS,348.0,146.16,93.96,341.04,37
CPT,88366,LAB ISH MLTPLX PER SPEC,517.0,217.14,139.59,506.66,37
CPT,88366,LAB ISH MLTPLX PER SPEC NS,348.0,146.16,93.96,341.04,37
CPT,88367,LAB MORPHO ISH COMP 1ST SPEC,727.0,305.34,196.29,712.46,37
CPT,88367,LAB MORPHO ISH COMP 1ST SPEC NS,727.0,305.34,196.29,712.46,37
CPT,88368,LAB MORPHO ISH MANUAL 1ST SPEC,727.0,305.34,196.29,712.46,37
CPT,88368,LAB MORPHO ISH MANUAL 1ST SPEC NS,727.0,305.34,196.29,712.46,37
CPT,88369,LAB MORPHO ISH MANUAL ADDL SPEC,196.0,82.32,52.92,192.08,30
CPT,88369,LAB MORPHO ISH MANUAL ADDL SPEC NS,101.0,42.42,27.27,98.98,30
CPT,88373,LAB MORPHO ISH COMP ADDL SPEC,303.0,127.26,81.81,296.94,30
CPT,88373,LAB MORPHO ISH COMP ADDL SPEC NS,86.0,36.12,23.22,84.28,30
CPT,88374,LAB MORPHO ISH COMP MULT PER SPEC,348.0,146.16,93.96,341.04,37
CPT,88374,LAB MORPHO ISH COMP MULT SPEC NS,553.0,232.26,149.31,541.94,37
CPT,88377,LAB MORPHO ISH MAN MULT PER SPEC NS,348.0,146.16,93.96,341.04,37
CPT,88380,LAB MICRODISSECTION LASER,909.0,381.78,245.43,890.82,30
CPT,88380,LAB MICRODISSECTION LASER PROT AMYL,202.0,84.84,54.54,197.96,30
CPT,88381,LAB MICRODISSECTION MANUAL,230.0,96.6,62.1,225.4,30
CPT,88720,POC BILIRUBIN TOTAL TRANSQ,16.0,6.72,4.32,15.68,37
CPT,89050,LAB COUNT CELL CSF,15.0,6.3,4.05,14.7,37
CPT,89050,LAB COUNT CELL FLUID BODY,15.0,6.3,4.05,14.7,37
CPT,89051,LAB COUNT CELL W DIFF CSF,17.0,7.14,4.59,16.66,37
CPT,89051,LAB COUNT CELL W DIFF FLUID BODY,17.0,7.14,4.59,16.66,37
CPT,89055,LAB ASSESSMENT LEUKOCYTE FECAL,13.0,5.46,3.51,12.74,37
CPT,89060,LAB ID CRYSTAL MICROSCOPY LIGHT,22.0,9.24,5.94,21.56,37
CPT,89125,LAB STAIN FAT/FECES/URINE/SPUTUM,18.0,7.56,4.86,17.64,37
CPT,89220,POC COLLECT SPEC SPUTUM AEROSOL,348.0,146.16,93.96,341.04,37
CPT,89230,LAB COLLECTION SWEAT IONTOPHORESIS,107.0,44.94,28.89,104.86,37
CPT,89310,LAB SEMEN MOTILITY&CT WO HUHNER,26.0,10.92,7.02,25.48,37
CPT,89310,LAB SEMEN MOTILITY&CT WO HUHNER NS,271.0,113.82,8.61,265.58,37
CPT,89321,LAB SEMEN SPERM PRESENCE MOTILITY,37.0,15.54,9.99,36.26,37
CPT,89322,LAB SEMEN VOL COUNT MOT&DIF W MORPH,418.0,175.56,15.5,409.64,37
CPT,89398,LAB MORPHO SEMEN SPERM STRICT CRIT,275.0,115.5,53.24,269.5,37
CPT,90471,ED IMMUNIZATION 1ST VACCINE,131.0,55.02,35.37,128.38,37
CPT,90471,IMMUNIZATION 1ST VACCINE,131.0,55.02,35.37,128.38,111
CPT,90472,ED IMMUNIZATION ADDL VACCINE,59.0,24.78,15.93,57.82,30
CPT,90472,IMMUNIZATION ADDL VACCINE,59.0,24.78,15.93,57.82,60
CPT,90472,IMMUNIZATION VACCINE ADDL,59.0,24.78,15.93,57.82,30
CPT,90935,DIALYSIS OP UNSCH/ER NON ESRD PT,2680.0,1125.6,701.18,2626.4,37
CPT,90935,HEMODIALYSIS IP BEDSIDE,2680.0,1125.6,701.18,2626.4,36
CPT,90935,HEMODIALYSIS IP DIALYSIS UNIT,2680.0,1125.6,701.18,2626.4,36
CPT,91010,MOTILITY ESOPHAGEAL,2603.0,1093.26,381.24,2550.94,36
CPT,91035,TEST ESOPHAGUS PH CAP,1691.0,710.22,456.57,1657.18,36
CPT,91038,TEST ESOPHAGEAL FNCT IMPD >1HR,1337.0,561.54,360.99,1310.26,36
CPT,91110,IMG GI ESOPH-ILEUM INTRALUM W I&R,3617.0,1519.14,926.63,5367.0,37
CPT,91111,IMG GI ESOPHAGUS INTRALUM W I&R,2285.0,959.7,616.95,5367.0,37
CPT,92507,ST TX SPEECH/LANG/VOICE/COM IND,192.0,80.64,51.84,188.16,30
CPT,92508,ST TX SPEECH/LANG/VOICE/COM GROUP,94.0,39.48,25.38,92.12,30
CPT,92511,NASOPHARYNGOSCOPY W ENDOSCOPE,395.0,165.9,106.65,387.1,36
CPT,92522,ST EVAL PROD SOUND SP,281.0,118.02,75.87,275.38,30
CPT,92523,ST EVAL PROD SOUND SP W LANG&EXPRSN,738.0,309.96,199.26,723.24,30
CPT,92524,ST ANALYSIS VOICE&RESON BEH&QUAL,275.0,115.5,74.25,269.5,30
CPT,92526,ST TX DYSFNCT SWALLOW FNCT FEED,244.0,102.48,65.88,239.12,30
CPT,92597,ST EVAL DEVICE VOICE PROSTHETIC,375.0,157.5,101.25,367.5,30
CPT,92610,ST EVAL FNCT SWALLOW ORAL&PHARYNGEL,296.0,124.32,79.92,290.08,30
CPT,92611,ST EVAL FNCT SWALLOW FLUOROSCOPIC,749.0,314.58,202.23,734.02,30
CPT,92612,ST EVAL SWALLOW ENDOSCOPIC FLEX,295.0,123.9,79.65,289.1,30
CPT,92920,PTCA ART COR MAJ SGL&/BR,15180.0,6375.6,4098.6,25370.0,37
CPT,92924,ATHER W ANGIO COR ART MAJ SGL&/BR,18500.0,7770.0,4995.0,26759.0,37
CPT,92928,PLC STNT/S W ANGIO SGL&/BR 1 LSN,15766.0,6621.72,4256.82,25370.0,37
CPT,92930,PLC STNT/S W ANGIO SGL&/BR 2+ LSN,17198.0,7223.16,4643.46,27156.6,37
CPT,92933,ATHER W STENT ANGIO ART MAJ SGL&/BR,21819.0,9163.98,5891.13,27156.6,37
CPT,92937,REVASC GRFT BYPASS ART COR SGL&/BR,12128.0,5093.76,3274.56,25370.0,37
CPT,92941,REVASC OCC MI ACUTE ART COR SGL&/BR,23897.0,10036.74,6452.19,25370.0,30
CPT,92943,REVASC OCC CHRONIC ART/BR/GRFT COR,25698.0,10793.16,6938.46,25370.0,37
CPT,92950,CPR,1485.0,623.7,220.6,1455.3,74
CPT,92950,ED CPR,1485.0,623.7,220.6,1455.3,36
CPT,92953,ED PACING TRANSCUTANEOUS TEMP,1013.0,425.46,273.51,992.74,36
CPT,92960,CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,185
CPT,92960,ED CARDIOVERSION ELECTIVE EXTERNAL,2537.0,1065.54,675.26,2486.26,36
CPT,92972,LITHOTRIPSY CORONARY PERC TRANSL,15305.0,6428.1,4132.35,14998.9,29
CPT,92973,THROMBECT ASP MECH COR PERC,6480.0,2721.6,1749.6,6350.4,29
CPT,92978,IMG ENDOLMNL IVUS/OCT COR VSL INIT,7899.0,3317.58,2132.73,7741.02,29
CPT,92979,IMG ENDOLMNL IVUS/OCT COR VSL ADDL,2596.0,1090.32,700.92,2544.08,29
CPT,92986,VALVULOPLASTY BLN AORTA PERC,11463.0,4814.46,3095.01,25370.0,37
CPT,92987,VALVULOPLASTY BLN MITRAL PERC,11788.0,4950.96,3182.76,25370.0,37
CPT,92990,VALVULOPLASTY BLN PULMONARY PERC,11118.0,4669.56,3001.86,25370.0,37
CPT,92997,PTA BLN ART PULMONARY VSL SGL,11118.0,4669.56,3001.86,17101.63,37
CPT,92998,PTA BLN ART PULMONARY VSL ADDL,5389.0,2263.38,1455.03,5281.22,30
CPT,93005,ED EKG TRACING ROUTINE 12+ LEADS,474.0,199.08,60.27,464.52,37
CPT,93005,EKG TRACING ROUTINE 12+ LEADS,474.0,199.08,60.27,464.52,37
CPT,93017,TEST CV STRESS TREAD/BIKE&/RX TRACE,1396.0,586.32,220.6,1368.08,37
CPT,93041,ED EKG TRACING RHYTHM 1-3 LEADS,108.0,45.36,29.16,105.84,37
CPT,93260,EVAL DEV PROG DEV SUBQ IN PERSON,135.0,56.7,36.45,132.3,37
CPT,93261,EVAL DEV INTRGTN DEV SUBQ IN PERSON,135.0,56.7,36.45,132.3,37
CPT,93282,EVAL DEV PROG ICD TV SGL IN PERSON,238.0,99.96,38.13,233.24,37
CPT,93283,EVAL DEV PROG ICD TV DUAL IN PERSON,278.0,116.76,38.13,272.44,37
CPT,93284,EVAL DEV PROG ICD TV MULT IN PERSON,300.0,126.0,38.13,294.0,37
CPT,93286,EVAL DEV PERIPRO PM/PM LDLS,164.0,68.88,44.28,160.72,30
CPT,93287,EVAL DEV PERIPRO PROG ICD IN PERSON,209.0,87.78,56.43,204.82,30
CPT,93303,ECHO CONG ANM CMP WO CNT,1823.0,765.66,492.21,1786.54,37
CPT,93304,ECHO CONG ANM LTD WO CNT,838.0,351.96,226.26,821.24,37
CPT,93306,ECHO 2D DOPP&CLR FLW CMP WO CNT,2676.0,1123.92,558.25,2622.48,37
CPT,93307,ECHO 2D CMP WO CNT,822.0,345.24,221.94,805.56,74
CPT,93308,ECHO 2D LTD WO CNT,893.0,375.06,241.11,875.14,74
CPT,93312,ECHO 2D TEE CMP WO CNT W I&R,1630.0,684.6,440.1,1597.4,74
CPT,93315,ECHO TEE CONG ANM WO CNT W I&R,967.0,406.14,261.09,947.66,37
CPT,93318,ECHO 2D TEE MONITORING WO CNT,1112.0,467.04,300.24,1089.76,37
CPT,93320,ECHO DOPP CMP,684.0,287.28,184.68,670.32,30
CPT,93321,ECHO DOPP LTD,608.0,255.36,164.16,595.84,30
CPT,93325,ECHO DOPP MAP VELOCITY COLOR FLOW,852.0,357.84,230.04,834.96,30
CPT,93350,ECHO 2D REST&STRESS WO CNT W I&R,2200.0,924.0,558.25,2156.0,37
CPT,93356,ASSESS STRAIN MYOCARDIAL W IMG,377.0,158.34,101.79,369.46,30
CPT,93451,RHC O2 SAT&CARDIAC OUTPUT,12342.0,5183.64,3312.15,17965.0,37
CPT,93452,LHC W INJ/S VENTRCLGRPHY LT S&I,11291.0,4742.22,3048.57,17965.0,37
CPT,93453,RHC&LHC W INJ/S VENTRCLGRPHY LT S&I,13524.0,5680.08,3312.15,17965.0,37
CPT,93454,PLC CATH&INJ/S CAG S&I,19602.0,8232.84,3312.15,19209.96,37
CPT,93455,PLC CATH&INJ/S CAG&GRF S&I,21511.0,9034.62,3312.15,21080.78,37
CPT,93456,PLC CATH&INJ/S CAG W RHC S&I,24040.0,10096.8,3312.15,23559.2,37
CPT,93457,PLC CATH&INJ/S CAG&GRF W RHC S&I,25919.0,10885.98,3312.15,25400.62,37
CPT,93458,PLC CATH&INJ/S CAG&LV W LHC S&I,21978.0,9230.76,3312.15,21538.44,37
CPT,93459,PLC CATH CAG&GRF&LV W LHC S&I,23157.0,9725.94,3312.15,22693.86,37
CPT,93460,PLC CATH CAG&LV W RHC&LHC S&I,25604.0,10753.68,3312.15,25091.92,37
CPT,93461,PLC CATH CAG&GRF&LV W RHC&LHC S&I,28194.0,11841.48,3312.15,27630.12,37
CPT,93462,LHC PUNCT TRANSSEPTAL/TRANSAPICAL,9654.0,4054.68,2606.58,9460.92,29
CPT,93463,ADMIN DRUG&MEAS HEMODYNAMIC,4481.0,1882.02,1209.87,4391.38,29
CPT,93464,STUDY EXERCISE&MEAS HEMODYNAMIC,1210.0,508.2,326.7,1185.8,29
CPT,93503,INS&PLC CATH DIRECTED FLOW,2463.0,1034.46,665.01,3186.0,37
CPT,93505,BX ENDOMYOCARDIAL,6032.0,2533.44,1628.64,14009.0,37
CPT,93566,INJ ANGIO RV/RA HRT CATH S&I,698.0,293.16,188.46,684.04,29
CPT,93567,INJ AORTO SUPRVLV HRT CATH S&I,1647.0,691.74,444.69,1614.06,29
CPT,93568,INJ ANGIO PULM NONSEL HRT CATH S&I,893.0,375.06,241.11,875.14,29
CPT,93569,INJ ANGIO PULM SEL HRT CATH UNI S&I,87.0,36.54,23.49,85.26,29
CPT,93571,VEL&/FLW DOPP INTRAV VSL INIT,4667.0,1960.14,1260.09,4573.66,29
CPT,93571,VEL&/FLW DOPP INTRAV VSL INIT RDC,4667.0,1960.14,1260.09,4573.66,29
CPT,93572,VEL&/FLW DOPP INTRAV VSL ADDL,2155.0,905.1,581.85,2111.9,29
CPT,93572,VEL&/FLW DOPP INTRAV VSL ADDL RDC,2155.0,905.1,581.85,2111.9,29
CPT,93573,INJ ANGIO PULM SEL HRT CATH BI S&I,1071.0,449.82,289.17,1049.58,29
CPT,93580,CLOSE TRANSCATH PFO/ASD CONG W IMP,36422.0,15297.24,9833.94,35693.56,37
CPT,93583,THERAPY RDC SEPTAL TRANSCATH PERC,8277.0,3476.34,2234.79,8111.46,30
CPT,93600,RECORDING BUNDLE OF HIS,6881.0,2890.02,1857.87,11554.47,37
CPT,93602,RECORDING INTRA-ATRIAL,6881.0,2890.02,1857.87,11554.47,37
CPT,93603,RECORDING VENTRICULAR RT,2636.0,1107.12,711.72,2583.28,37
CPT,93609,MAP TACHYCARDIA INTRAVENT&/ATRIAL,5305.0,2228.1,1432.35,5198.9,30
CPT,93610,PACING INTRA-ATRIAL,6881.0,2890.02,1857.87,11554.47,37
CPT,93612,PACING INTRAVENTRICULAR,6007.0,2522.94,1621.89,11554.47,37
CPT,93613,MAP 3D EP INTRACARDIAC,12656.0,5315.52,3417.12,12402.88,30
CPT,93615,RECORDING ESOPH EGM ATR W/WO VENT,2636.0,1107.12,711.72,2583.28,37
CPT,93618,INDUCTION ARRTHYMIA BY PACING,1809.0,759.78,488.43,1803.67,37
CPT,93619,EVAL EP COMP WO ARRHYTHMIA,16063.0,6746.46,4337.01,15741.74,37
CPT,93620,EVAL EP COMP W ARRHYTHMIA,51816.0,21762.72,7968.6,50779.68,37
CPT,93621,EVAL EP COMP PACING&REC ATRIAL LT,14442.0,6065.64,3899.34,14153.16,30
CPT,93622,EVAL EP COMP PACING&REC VENT LT,21229.0,8916.18,5731.83,20804.42,30
CPT,93623,STIMULATION&PACING INF IV DRUG,7297.0,3064.74,1970.19,7151.06,30
CPT,93624,STUDY EP FLWUP PACING&REC,6881.0,2890.02,1857.87,11554.47,37
CPT,93640,EVAL EP LEADS ICD INITIAL,3342.0,1403.64,902.34,3275.16,30
CPT,93641,EVAL EP LEADS W TEST ICD INITIAL,4162.0,1748.04,1123.74,4078.76,30
CPT,93642,EVAL EP ICD TV CHAMBER SGL/DUAL,5624.0,2362.08,1243.91,5511.52,37
CPT,93644,EVAL EP DEFIBRILLATOR SUBQ,127.0,53.34,34.29,124.46,30
CPT,93650,ABL CATH IC NODE A/V W/WO PM TEMP,16948.0,7118.16,4575.96,16609.04,37
CPT,93653,EVAL EP&ABL ARRHYTHMIA SV,44753.0,18796.26,12083.31,43857.94,37
CPT,93654,EVAL EP&ABL ARRHYTHMIA VT,36176.0,15193.92,9767.52,38720.79,37
CPT,93655,ABL ARRHYTHMIA ADDL,11718.0,4921.56,3163.86,11483.64,30
CPT,93656,EVAL EP&ABL FIB ATRIAL VEIN PULM,73071.0,30689.82,19729.17,71609.58,37
CPT,93657,ABL FIB ATRIAL ADDL,11555.0,4853.1,3119.85,11323.9,30
CPT,93660,EVAL FNCT CARDIO W TILT TABLE/EKG,1627.0,683.34,381.24,1594.46,111
CPT,93662,ECHO ICRD INTRV THER/DX,10209.0,4287.78,2756.43,10004.82,30
CPT,93724,ANLYS ELECT SYSTEM PM ANTITACHYCARD,598.0,251.16,161.46,586.04,37
CPT,93798,CR II W EKG 36+ SESSIONS,336.0,141.12,90.72,329.28,30
CPT,93798,CR II W EKG INITIAL SESSION,336.0,141.12,90.72,329.28,37
CPT,93798,CR II W EKG PER SESSION,336.0,141.12,90.72,329.28,37
CPT,93799,CARDIOVERSION ICD INTERNAL,1192.0,500.64,131.46,1168.16,37
CPT,93799,VEL&/FLW DOPP IVAS VSL WO DRUG INT,2945.0,1236.9,131.46,2886.1,36
CPT,93799,VEL&/FLW DOPP IVAS VSL WO DRUG MULT,6626.0,2782.92,131.46,6493.48,36
CPT,93799,VELOCITY/FLW DOPP STAND ALONE,3681.0,1546.02,131.46,3607.38,37
CPT,93880,US DUPLEX EXTRACRANIAL CMP BI,1691.0,710.22,243.77,1657.18,37
CPT,93882,US DUPLEX EXTRACRANIAL UNI/LTD,533.0,223.86,106.81,522.34,37
CPT,93886,US TCD INTRACRANIAL CMP,841.0,353.22,227.07,824.18,37
CPT,93888,US TCD INTRACRANIAL LTD,366.0,153.72,98.82,358.68,37
CPT,93922,ART PHYS 1-2 LEVEL LTD BI,798.0,335.16,135.93,782.04,111
CPT,93922,ART PHYS 1-2 LEVEL LTD UNI,532.0,223.44,143.64,521.36,60
CPT,93923,ART PHYS 3+ LEVEL CMP BI,1023.0,429.66,220.6,1002.54,74
CPT,93923,ART PHYS 3+ LEVEL CMP UNI,682.0,286.44,184.14,668.36,60
CPT,93925,US DUPLEX ART EXT LWR BI,1157.0,485.94,243.77,1133.86,37
CPT,93926,US DUPLEX ART EXT LWR UNI/LTD LT,826.0,346.92,223.02,809.48,30
CPT,93926,US DUPLEX ART EXT LWR UNI/LTD RT,826.0,346.92,223.02,809.48,30
CPT,93930,US DUPLEX ART EXT UPR CMP BI,1929.0,810.18,243.77,1890.42,37
CPT,93931,US DUPLEX ART EXT UPR UNI/LTD LT,753.0,316.26,203.31,737.94,30
CPT,93931,US DUPLEX ART EXT UPR UNI/LTD RT,753.0,316.26,203.31,737.94,30
CPT,93970,US DUPLEX VEIN EXT CMP BI,2466.0,1035.72,243.77,2416.68,37
CPT,93971,US DUPLEX VEIN EXT LTD/UNI,1481.0,622.02,106.81,1451.38,37
CPT,93975,US DUPLEX ABD/PEL/SCR&/RETRO CMP,2013.0,845.46,243.77,1972.74,37
CPT,93976,US DUPLEX ABD/PEL/SCR&/RETRO LTD,1205.0,506.1,106.81,1180.9,37
CPT,93978,US DUPLEX AO/IVC/ILIAC/GRFT CMP,1058.0,444.36,243.77,1036.84,37
CPT,93979,US DUPLEX AO/IVC/ILIAC/GRFT LTD,734.0,308.28,106.81,719.32,37
CPT,93980,US DUPLEX PENILE CMP,1086.0,456.12,106.81,1064.28,37
CPT,93985,US DUPLEX ART&VEN B4 HEMO CMP BI,877.0,368.34,236.79,859.46,37
CPT,93986,US DUPLEX ART&VEN B4 HEMO CMP UNI,654.0,274.68,106.81,640.92,37
CPT,93990,US DUPLEX HEMODIALYSIS,600.0,252.0,106.81,588.0,37
CPT,94002,VENT INITIAL DAY,2531.0,1063.02,631.17,2480.38,37
CPT,94003,VENT SUBSQ DAY,1823.0,765.66,492.21,1786.54,37
CPT,94010,SPIROMETRY W VITAL CAP W/WO VENT,432.0,181.44,116.64,423.36,37
CPT,94060,BRONCHDLTN PRE&POST SPIROMETRY W VC,778.0,326.76,210.06,762.44,37
CPT,94070,EVAL BRONCHSPSM SPIRO W AGENTS,576.0,241.92,155.52,564.48,37
CPT,94150,CAPACITY VITAL TOTAL,256.0,107.52,69.12,250.88,37
CPT,94453,HAST W REPORT&TITRATE OXYGEN SUPP,267.0,112.14,72.09,261.66,37
CPT,94610,ADMIN SURFACTANT INTRAPULMONARY,292.0,122.64,78.84,324.39,37
CPT,94617,TEST EXERCISE BRONCHOSPASMS W REC,1051.0,441.42,135.93,1029.98,37
CPT,94618,TEST STRESS PULMONARY,1051.0,441.42,135.93,1029.98,74
CPT,94621,TEST EXERCISE CARDIOPULMONARY,1495.0,627.9,381.24,1465.1,37
CPT,94625,REHAB PULM OP WO CONT OX 36+ SESSN,195.0,81.9,52.65,191.1,30
CPT,94625,REHAB PULM OP WO CONT OX SESSN,195.0,81.9,52.65,191.1,37
CPT,94626,REHAB PULM OP W CONT OX 36+ SESSN,251.0,105.42,67.77,245.98,30
CPT,94626,REHAB PULM OP W CONT OX SESSN,251.0,105.42,60.27,245.98,37
CPT,94642,INHALATION AEROSOL PENTAMIDINE,555.0,233.1,149.85,543.9,37
CPT,94660,BIPAP INITIAL DAY,1031.0,433.02,223.72,1010.38,37
CPT,94660,BIPAP SUBSQ DAY,1031.0,433.02,223.72,1010.38,37
CPT,94660,CPAP INITIAL DAY,1031.0,433.02,223.72,1010.38,37
CPT,94660,CPAP SUBSQ DAY,1031.0,433.02,223.72,1010.38,37
CPT,94664,DEMO&/EVAL PT AEROSOL/NEB/MDI/IPPB,276.0,115.92,74.52,324.39,37
CPT,94667,CLEARANCE AIRWAY INITIAL,204.0,85.68,55.08,199.92,37
CPT,94667,PHYSIOTHERAPY CHEST COMP INITIAL,204.0,85.68,55.08,199.92,37
CPT,94667,PHYSIOTHERAPY CHEST INITIAL,204.0,85.68,55.08,199.92,37
CPT,94668,CLEARANCE AIRWAY SUBSQ,262.0,110.04,70.74,256.76,37
CPT,94668,PHYSIOTHERAPY CHEST SUBSQ,262.0,110.04,70.74,256.76,37
CPT,94669,OSCILLATION CHEST WALL MECH SESSN,348.0,146.16,93.96,341.04,37
CPT,94726,PLETHYSMOGRAPHY VOLUMES LUNG,572.0,240.24,154.44,560.56,37
CPT,94727,DILUT GAS/WASHOUT VOLUMES LUNG,374.0,157.08,100.98,366.52,37
CPT,94729,CAPACITY DIFFUSING,512.0,215.04,138.24,501.76,30
CPT,95700,EEG CONT SETUP ED TECH MIN CHAN 8,748.0,314.16,201.96,733.04,37
CPT,95705,EEG CONT WO VID 2-12HR UNMNTR,1446.0,607.32,220.6,1417.08,37
CPT,95706,EEG CONT WO VID 2-12HR W INT MNTR,1663.0,698.46,220.6,1629.74,37
CPT,95707,EEG CONT WO VID 2-12HR W CONT MNTR,1808.0,759.36,220.6,1771.84,37
CPT,95708,EEG CONT WO VID 12-26HR UNMNTR,2169.0,910.98,381.24,2125.62,37
CPT,95709,EEG CONT WO VID 12-26HR W INT MNTR,2386.0,1002.12,381.24,2338.28,37
CPT,95710,EEG CONT WO VID 12-26HR W CONT MNTR,2531.0,1063.02,381.24,2480.38,37
CPT,95711,EEG CONT W VID 2-12HR UNMNTR,1808.0,759.36,220.6,1771.84,37
CPT,95712,EEG CONT W VID 2-12HR W INT MNTR,2079.0,873.18,381.24,2037.42,37
CPT,95713,EEG CONT W VID 2-12HR W CONT MNTR,2260.0,949.2,381.24,2214.8,37
CPT,95714,EEG CONT W VID 12-26HR UNMNTR,2712.0,1139.04,381.24,2657.76,37
CPT,95715,EEG CONT W VID 12-26HR W INT MNTR,2983.0,1252.86,381.24,2923.34,37
CPT,95716,EEG CONT W VID 12-26HR W CONT MNTR,3164.0,1328.88,854.28,3100.72,37
CPT,95812,EEG EXTENDED 41-60MIN,1482.0,622.44,220.6,1452.36,37
CPT,95813,EEG EXTENDED 61-119MIN,1675.0,703.5,220.6,1641.5,37
CPT,95816,EEG AWAKE&DROWSY,896.0,376.32,220.6,878.08,37
CPT,95816,EEG AWAKE&DROWSY RDC,896.0,376.32,241.92,878.08,30
CPT,95819,EEG AWAKE&ASLEEP,1442.0,605.64,220.6,1413.16,37
CPT,95819,EEG AWAKE&ASLEEP RDC,1442.0,605.64,389.34,1413.16,30
CPT,95822,EEG COMA/SLEEP ONLY,1137.0,477.54,220.6,1114.26,37
CPT,95824,EEG EVAL DEATH CEREBRAL,628.0,263.76,169.56,615.44,37
CPT,95955,EEG DURING SURGERY NONINTRACRANIAL,1108.0,465.36,299.16,1085.84,30
CPT,95992,PT REPOSITIONING CANALITH PER DAY,90.0,37.8,24.3,88.2,30
CPT,95992,PTA REPOSITIONING CANALITH PER DAY,90.0,37.8,24.3,88.2,30
CPT,96360,ED INF IV HYDRATION 31-60MIN,675.0,283.5,182.25,661.5,36
CPT,96360,INF IV HYDRATION 31-60MIN,675.0,283.5,182.25,661.5,111
CPT,96361,ED INF IV HYDRATION ADDL HR,237.0,99.54,47.84,232.26,36
CPT,96361,INF IV HYDRATION ADDL HR,237.0,99.54,47.84,232.26,111
CPT,96365,ED INF IV THRPY 1ST HR,640.0,268.8,172.8,627.2,36
CPT,96365,INF IV THRPY 1ST HR,640.0,268.8,172.8,627.2,111
CPT,96366,ED INF IV THRPY ADDL HR,234.0,98.28,47.84,229.32,36
CPT,96366,INF IV THRPY ADDL HR,234.0,98.28,47.84,229.32,111
CPT,96367,ED INF IV THRPY SEQ DRUG NEW 1ST HR,472.0,198.24,73.56,462.56,36
CPT,96367,INF IV THRPY SEQ DRUG NEW 1ST HR,472.0,198.24,73.56,462.56,111
CPT,96368,ED INF IV THRPY CONCURRENT,426.0,178.92,115.02,417.48,29
CPT,96368,INF IV THRPY CONCURRENT,426.0,178.92,115.02,417.48,90
CPT,96372,ED INJ SUBQ/IM,228.0,95.76,61.56,223.44,36
CPT,96372,INJ SUBQ/IM,228.0,95.76,61.56,223.44,222
CPT,96373,INJ INTRA-ARTERIAL,326.0,136.92,88.02,319.48,37
CPT,96374,ED INJ IVP DRUG INITIAL,378.0,158.76,102.06,370.44,36
CPT,96374,INJ IVP DRUG INITIAL,378.0,158.76,102.06,370.44,111
CPT,96375,ED INJ IVP SEQ DRUG ADDL NEW,236.0,99.12,47.84,231.28,36
CPT,96375,INJ IVP SEQ DRUG ADDL NEW,236.0,99.12,47.84,231.28,111
CPT,96376,ED INJ IVP SEQ DRUG ADDL SAME,192.0,80.64,51.84,188.16,29
CPT,96376,INJ IVP SEQ DRUG ADDL SAME,192.0,80.64,51.84,188.16,90
CPT,96401,CHEMO SUBQ/IM NONHORMONAL,560.0,235.2,73.56,548.8,74
CPT,96401,ED CHEMO SUBQ/IM NONHORMONAL,560.0,235.2,73.56,548.8,37
CPT,96402,CHEMO SUBQ/IM HORMONAL,205.0,86.1,55.35,200.9,74
CPT,96405,CHEMO INTRALESIONAL LSN 1-7,270.0,113.4,72.9,264.6,74
CPT,96406,CHEMO INTRALESIONAL LSN 8+,648.0,272.16,174.96,635.04,37
CPT,96409,CHEMO IVP DRUG INITIAL,507.0,212.94,136.89,496.86,74
CPT,96411,CHEMO IVP DRUG ADDL,277.0,116.34,73.56,271.46,74
CPT,96413,CHEMO INF IV 1ST HR,851.0,357.42,229.77,833.98,74
CPT,96415,CHEMO INF IV ADDL HR,183.0,76.86,49.41,179.34,74
CPT,96417,CHEMO INF IV SEQ 1ST HR,310.0,130.2,73.56,303.8,74
CPT,96420,CHEMO PUSH INTRAARTERIAL,507.0,212.94,136.89,496.86,37
CPT,96422,CHEMO INF INTRAARTERIAL 1ST HR,727.0,305.34,196.29,712.46,37
CPT,96450,CHEMO CNS REQ PUNCTURE SPINAL,1086.0,456.12,293.22,1064.28,74
CPT,96521,REFILL&MAINT PUMP PORTABLE,441.0,185.22,119.07,432.18,37
CPT,96522,REFILL&MAINT PUMP IMPLANTABLE,343.0,144.06,92.61,336.14,37
CPT,96523,IRRG VAD IMP DELIVERY DRUG,239.0,100.38,60.27,234.22,37
CPT,97012,PT MODALITY APPL TRACTION MECHANIC,71.0,29.82,19.17,69.58,30
CPT,97032,OT MODALITY APPL E-STIM MAN 15MN,95.0,39.9,25.65,93.1,30
CPT,97032,PT MODALITY APPL E-STIM MAN 15MN,95.0,39.9,25.65,93.1,30
CPT,97033,OT MODALITY APPL IONTOPHORES 15MN,119.0,49.98,32.13,116.62,30
CPT,97033,PT MODALITY APPL IONTOPHORES 15MN,119.0,49.98,32.13,116.62,30
CPT,97035,OT MODALITY APPL ULTRASOUND 15MN,99.0,41.58,26.73,97.02,30
CPT,97035,PT MODALITY APPL ULTRASOUND 15MN,99.0,41.58,26.73,97.02,30
CPT,97110,OT THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CPT,97110,OTA THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CPT,97110,PT THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CPT,97110,PTA THER EXERCISE 15MN,122.0,51.24,32.94,119.56,30
CPT,97112,OT THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CPT,97112,OTA THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CPT,97112,PT THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CPT,97112,PTA THER NEUROMUS REEDUCATE 15MN,169.0,70.98,45.63,165.62,30
CPT,97116,PT THER TRAIN GAIT 15MN,86.0,36.12,23.22,84.28,30
CPT,97116,PTA THER TRAIN GAIT 15MN,86.0,36.12,23.22,84.28,30
CPT,97124,PT THER MASSAGE 15MN,87.0,36.54,23.49,85.26,30
CPT,97129,ST SKILLS DEVLPMT COGNITIVE 15MN,195.0,81.9,52.65,191.1,30
CPT,97130,ST SKILLS DEVLPMT COGNITIVE AD 15MN,178.0,74.76,48.06,174.44,30
CPT,97140,OT THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CPT,97140,OTA THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CPT,97140,PT THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CPT,97140,PTA THERAPY MANUAL 15MN,104.0,43.68,28.08,101.92,30
CPT,97150,PT THER GROUP,62.0,26.04,16.74,60.76,30
CPT,97150,PTA THER GROUP,62.0,26.04,16.74,60.76,30
CPT,97161,PT EVAL THERAPY LOW,246.0,103.32,66.42,241.08,30
CPT,97162,PT EVAL THERAPY MOD,392.0,164.64,105.84,384.16,30
CPT,97163,PT EVAL THERAPY HIGH,392.0,164.64,105.84,384.16,30
CPT,97164,PT RE-EVAL THERAPY,170.0,71.4,45.9,166.6,30
CPT,97165,OT EVAL THERAPY LOW,246.0,103.32,66.42,241.08,30
CPT,97166,OT EVAL THERAPY MOD,392.0,164.64,105.84,384.16,30
CPT,97167,OT EVAL THERAPY HIGH,392.0,164.64,105.84,384.16,30
CPT,97168,OT RE-EVAL THERAPY,170.0,71.4,45.9,166.6,30
CPT,97530,OT THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CPT,97530,OTA THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CPT,97530,PT THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CPT,97530,PTA THER ACTIVITIES 15MN,164.0,68.88,44.28,160.72,30
CPT,97533,OT TECHNIQUES SENSORY 15MN,153.0,64.26,41.31,149.94,30
CPT,97533,OTA TECHNIQUES SENSORY 15MN,153.0,64.26,41.31,149.94,30
CPT,97535,OT MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CPT,97535,OTA MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CPT,97535,PT MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CPT,97535,PTA MANAGEMENT SELF-CARE/HOME 15MN,196.0,82.32,52.92,192.08,30
CPT,97542,OT MANAGEMENT WHEELCHAIR 15MN,78.0,32.76,21.06,76.44,30
CPT,97542,PT MANAGEMENT WHEELCHAIR 15MN,78.0,32.76,21.06,76.44,30
CPT,97542,PTA MANAGEMENT WHEELCHAIR 15MN,78.0,32.76,21.06,76.44,30
CPT,97597,DEBRIDE SLCT WND OPEN 1ST 20CM,309.0,129.78,83.43,302.82,37
CPT,97598,DEBRIDE SLCT WND OPEN ADDL 20CM,228.0,95.76,61.56,223.44,30
CPT,97602,DEBRIDE NONSELECT WO ANES SESSN,308.0,129.36,83.16,301.84,37
CPT,97605,WOUND NEG PRESS W DME 0-50 SC,308.0,129.36,83.16,301.84,37
CPT,97606,WOUND NEG PRESS W DME 51+ SC,623.0,261.66,168.21,610.54,37
CPT,97607,WOUND NEG PRESS NONDME 0-50 SC,623.0,261.66,168.21,610.54,37
CPT,97608,WOUND NEG PRESS NONDME 51+ SC,623.0,261.66,168.21,610.54,37
CPT,97750,PT MEAS/TEST PERFORMANCE 15MIN,105.0,44.1,28.35,102.9,30
CPT,97760,OT TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CPT,97760,OTA TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CPT,97760,PT TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CPT,97760,PTA TRAIN ORTHO UE/LE INIT 15MN,184.0,77.28,49.68,180.32,30
CPT,97761,OT TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CPT,97761,OTA TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CPT,97761,PT TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CPT,97761,PTA TRAIN PROSTH UE&/LE INIT 15MN,102.0,42.84,27.54,99.96,30
CPT,97763,OT TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CPT,97763,OTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CPT,97763,PT TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CPT,97763,PTA TRAIN ORTHO/PROS EXT SUBSQ 15MN,200.0,84.0,54.0,196.0,30
CPT,97802,MNT INITIAL ASSESS INDIVIDUAL 15MIN,67.0,28.14,18.09,65.66,30
CPT,97803,MNT RE-ASSESS INDIVIDUAL 15MIN,56.0,23.52,15.12,54.88,30
CPT,97804,MNT GROUP 30MIN,50.0,21.0,13.5,49.0,30
CPT,99151,ED SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CPT,99151,SED MOD SAME 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,150
CPT,99152,ED SED MOD ENDO SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CPT,99152,ED SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CPT,99152,SED MOD ENDO SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,60
CPT,99152,SED MOD SAME 5+Y INIT 15MN,405.0,170.1,109.35,396.9,210
CPT,99153,ED SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,30
CPT,99153,SED MOD SAME ADDL 15MN,205.0,86.1,55.35,200.9,210
CPT,99155,ED SED MOD DIFF 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CPT,99155,SED MOD DIFF 0-4Y INIT 15MN,405.0,170.1,109.35,396.9,30
CPT,99156,ED SED MOD DIFF 5+Y INIT 15MN,405.0,170.1,109.35,396.9,30
CPT,99156,SED MOD DIFF 5+Y INIT 15MN,405.0,170.1,109.35,396.9,60
CPT,99157,ED SED MOD DIFF ADDL 15MN,205.0,86.1,55.35,200.9,30
CPT,99157,SED MOD DIFF ADDL 15MN,205.0,86.1,55.35,200.9,60
CPT,99195,PHLEBOTOMY THERAPEUTIC,326.0,136.92,88.02,319.48,37
CPT,99202,VISIT NEW LEVEL 1,133.0,55.86,35.91,130.34,120
CPT,99202,VISIT NEW LEVEL 2,178.0,74.76,48.06,174.44,120
CPT,99202,VISIT OB TRIAGE NEW LEVEL 1,246.0,103.32,66.42,241.08,30
CPT,99202,VISIT OB TRIAGE NEW LEVEL 2,472.0,198.24,127.44,462.56,30
CPT,99203,VISIT NEW LEVEL 3,235.0,98.7,63.45,230.3,120
CPT,99203,VISIT OB TRIAGE NEW LEVEL 3,707.0,296.94,190.89,692.86,30
CPT,99204,VISIT NEW LEVEL 4,321.0,134.82,86.67,314.58,120
CPT,99204,VISIT OB TRIAGE NEW LEVEL 4,850.0,357.0,229.5,833.0,30
CPT,99205,VISIT NEW LEVEL 5,435.0,182.7,117.45,426.3,120
CPT,99205,VISIT OB TRIAGE NEW LEVEL 5,1137.0,477.54,306.99,1114.26,30
CPT,99211,VISIT ESTABLISHED LEVEL 1,84.0,35.28,22.68,82.32,120
CPT,99211,VISIT OB TRIAGE ESTABLISHED LEVEL 1,93.0,39.06,25.11,91.14,30
CPT,99212,VISIT ESTABLISHED LEVEL 2,104.0,43.68,28.08,101.92,120
CPT,99212,VISIT OB TRIAGE ESTABLISHED LEVEL 2,236.0,99.12,63.72,231.28,30
CPT,99213,VISIT ESTABLISHED LEVEL 3,130.0,54.6,35.1,127.4,120
CPT,99213,VISIT OB TRIAGE ESTABLISHED LEVEL 3,472.0,198.24,127.44,462.56,30
CPT,99214,VISIT ESTABLISHED LEVEL 4,163.0,68.46,44.01,159.74,120
CPT,99214,VISIT OB TRIAGE ESTABLISHED LEVEL 4,728.0,305.76,196.56,713.44,30
CPT,99215,VISIT ESTABLISHED LEVEL 5,203.0,85.26,54.81,198.94,120
CPT,99215,VISIT OB TRIAGE ESTABLISHED LEVEL 5,1024.0,430.08,276.48,1003.52,30
CPT,99281,ED VISIT LEVEL 1,670.0,281.4,86.15,656.6,36
CPT,99282,ED VISIT LEVEL 2,1185.0,497.7,156.87,1161.3,36
CPT,99283,ED VISIT LEVEL 3,1705.0,716.1,278.89,1670.9,36
CPT,99284,ED VISIT LEVEL 4,2490.0,1045.8,426.3,2440.2,36
CPT,99285,ED VISIT LEVEL 5,3511.0,1474.62,608.43,3440.78,36
CPT,99291,ED VISIT CRITICAL CARE 1ST 30-74MIN,7775.0,3265.5,843.92,7619.5,36
CPT,99292,ED VISIT CRITICAL CARE ADDL 30MIN,3885.0,1631.7,1048.95,3807.3,29
CPT,99366,OT CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CPT,99366,OTA CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CPT,99366,PT CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CPT,99366,PTA CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CPT,99366,ST CONF TEAM HCP W PT&/FM 30+MN,130.0,54.6,35.1,127.4,30
CPT,99367,OT CONF TEAM PHY WO PT&/FM 30+MN,117.0,49.14,31.59,114.66,30
CPT,99367,PT CONF TEAM PHY WO PT&/FM 30+MN,117.0,49.14,31.59,114.66,30
CPT,99367,ST CONF TEAM PHY WO PT&/FM 30+MN,117.0,49.14,31.59,114.66,30
CPT,99368,OT CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CPT,99368,OTA CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CPT,99368,PT CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CPT,99368,PTA CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CPT,99368,ST CONF TEAM HCP WO PT&/FM 30+MN,114.0,47.88,30.78,111.72,30
CPT,99406,VISIT SMK&TOB INTRM 3-10MIN,58.0,24.36,15.66,56.84,37
CPT,G0104,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,,,950.1,3186.0,8
CPT,G0105,Colorectal cancer screening; colonoscopy on individual at high risk,,,950.1,3186.0,8
CPT,G0121,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,950.1,3186.0,16
CPT,G0260,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",,,721.17,3186.0,8
CPT,G0463,Hospital outpatient clinic visit for assessment and management of a patient,,,136.02,197.23,7
HCPCS,90375,RABIES IG/150IU 1500U/5ML IM,963.2,404.54,260.06,943.94,37
HCPCS,A0425,MILEAGE GROUND MILE 0.10,2.7,1.13,0.729,400.0,31
HCPCS,A0425,MILEAGE GROUND MILE 1.00,27.0,11.34,7.29,400.0,31
HCPCS,A0426,TRNSPRT NONEMR AMB ALS LEVEL 1,2153.0,904.26,400.0,2109.94,31
HCPCS,A0427,TRNSPRT EMERG AMB ALS LEVEL 1,2492.0,1046.64,400.0,2442.16,31
HCPCS,A0428,TRNSPRT NONEMR AMB BLS,1525.0,640.5,400.0,1494.5,31
HCPCS,A0429,TRNSPRT EMERG AMB BLS,1814.0,761.88,400.0,1777.72,31
HCPCS,A0433,TRNSPRT AMB ALS LEVEL 2,3322.0,1395.24,400.0,3255.56,31
HCPCS,A0434,TRNSPRT SPECIALTY CARE,2716.0,1140.72,400.0,2661.68,31
HCPCS,A0888,MILEAGE NONCOVERED MILE 0.10,2.7,1.13,0.729,400.0,31
HCPCS,A0998,RESPONSE/TREATMENT AMB WO TRNSPRT,222.0,93.24,59.94,400.0,31
HCPCS,A2007,RESTRATA MESH FIX INT 10X12.5/SC,111.9,47.0,30.21,184.35,37
HCPCS,A2007,RESTRATA SOLID FIX INT 2.5X2.5/SC,485.8,204.04,127.14,476.08,37
HCPCS,A2032,MYRIAD MATRIX FIX INT 5X5 THCK/SC,38.0,15.96,10.26,184.35,37
HCPCS,A4648,IMP MARKER TISSUE LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,A4648,IMP MARKER TISSUE LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,A4648,IMP MARKER TISSUE LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,A4648,IMP MARKER TISSUE LVL 04,1894.0,795.48,511.38,1856.12,30
HCPCS,A4648,IMP MARKER TISSUE LVL 05,2580.0,1083.6,696.6,2528.4,30
HCPCS,A4648,IMP MARKER TISSUE LVL 06,3355.0,1409.1,905.85,3287.9,30
HCPCS,A4648,IMP MARKER TISSUE LVL 07,3853.0,1618.26,1040.31,3775.94,30
HCPCS,A4648,IMP MARKER TISSUE LVL 08,6105.0,2564.1,1648.35,5982.9,30
HCPCS,A9500,RRX TC-99 SESTAMIBI DX/DOSE,277.9,116.72,75.03,968.75,30
HCPCS,A9502,RRX TETROFOSMIN DX/DOSE,275.0,115.5,74.25,269.5,30
HCPCS,A9503,RRX TC99 MEDRONATE/0-30MCI DOSE,354.3,148.81,95.66,347.21,30
HCPCS,A9509,RRX I-123 IOD NA DX/1MCI,1542.5,647.85,374.14,1511.65,30
HCPCS,A9510,RRX DISOFENIN DX/0-15MCI DOSE,253.0,106.26,68.31,247.94,30
HCPCS,A9512,RRX PERTECHNETATE DX/MCI,13.0,5.46,3.51,23.69,30
HCPCS,A9516,RRX I-123 IOD NA DX/100UCI <1MCI,381.0,160.02,102.87,373.38,30
HCPCS,A9517,RRX I-131 IOD NA THPY/MCI CAP,160.0,67.2,24.07,156.8,37
HCPCS,A9520,RRX TC-99 TILMANOCEPT/0.5MCI INJ,2399.5,1007.79,647.87,2351.51,29
HCPCS,A9521,RRX EXAMETAZIME DX/0-25MCI DOSE,1813.0,761.46,489.51,3445.55,30
HCPCS,A9528,RRX I-131 IOD NA DX/MCI CAP,85.0,35.7,22.95,209.69,30
HCPCS,A9537,RRX MEBROFENIN DX/0-15MCI DOSE,413.0,173.46,111.51,404.74,30
HCPCS,A9538,RRX PYROPHOSPHATE DX/0-25MCI DOSE,463.2,194.54,97.67,453.94,30
HCPCS,A9540,RRX MAA DX/0-10MCI DOSE,513.0,215.46,65.34,502.74,30
HCPCS,A9541,RRX SULFUR COLLOID DX/0-20MCI DOSE,608.0,255.36,164.16,1615.51,30
HCPCS,A9543,RRX YTTR90 ZEV THR/0-40MCI DOSE,59939.5,25174.59,16183.67,122172.8,37
HCPCS,A9547,RRX INDIUM 111 OXYQ DX/0.5MCI,1749.0,734.58,472.23,1787.64,37
HCPCS,A9548,RRX INDIUM 111 PENTETATE DX/0.5MCI,1865.0,783.3,503.55,1827.7,37
HCPCS,A9552,RRX F18 FDG DX/0-45MCI DOSE,1131.0,475.02,305.37,1108.38,30
HCPCS,A9557,RRX BICISATE DX/0-25MCI DOSE,3395.0,1425.9,775.52,3327.1,37
HCPCS,A9560,RRX RBC LABELED DX/0-30MCI DOSE,614.0,257.88,165.78,601.72,30
HCPCS,A9562,RRX MERTIATIDE DX/0-15MCI DOSE,619.0,259.98,167.13,1705.53,30
HCPCS,A9567,RRX DTPA AEROSOL DOSE 0-75MCI,581.0,244.02,45.24,569.38,30
HCPCS,A9569,RRX EXAMETAZIME WBC LABELED DX/DOSE,6434.0,2702.28,934.13,6305.32,37
HCPCS,A9570,RRX INDIUM-111 WBC LABELED DX/DOSE,4609.0,1935.78,1103.19,4516.82,37
HCPCS,A9572,RRX INDIUM-111 PENTET DX/0-6MCI,12397.0,5206.74,2000.94,12149.06,37
HCPCS,A9582,RRX I-123 IOBENG DX/0-15MCI DOSE,6208.0,2607.36,1676.16,6083.84,37
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1052,HEMOSTATIC AGENT GI TOP LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 01,70.0,29.4,18.9,68.6,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 02,102.0,42.84,27.54,99.96,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 03,166.0,69.72,44.82,162.68,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 04,221.0,92.82,59.67,216.58,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 05,313.0,131.46,84.51,306.74,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 06,447.0,187.74,120.69,438.06,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 07,594.0,249.48,160.38,582.12,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 08,850.0,357.0,229.5,833.0,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 09,1132.0,475.44,305.64,1109.36,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 10,1413.0,593.46,381.51,1384.74,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 11,1619.0,679.98,437.13,1586.62,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 12,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 13,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 14,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 15,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 16,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 17,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 18,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 19,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 20,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1713,IMP ANCHOR/SCREW/WASHER/NUT LVL 21,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1713,IMP BLADE LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1713,IMP BLADE LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP BLADE LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1713,IMP BLADE LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP BOLT LVL 01,709.0,297.78,191.43,694.82,30
HCPCS,C1713,IMP BOLT LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1713,IMP BOLT LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,C1713,IMP BOLT LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1713,IMP BOLT LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1713,IMP BOLT LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1713,IMP BOLT LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP BOLT LVL 08,12506.0,5252.52,3376.62,12255.88,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 02,850.0,357.0,229.5,833.0,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 06,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 07,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 10,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 11,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1713,IMP CEMENT ACCESSORY LVL 12,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1713,IMP CEMENT LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1713,IMP CEMENT LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1713,IMP CEMENT LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP CEMENT LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1713,IMP CEMENT LVL 05,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1713,IMP CEMENT LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP CEMENT LVL 07,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1713,IMP CEMENT LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1713,IMP CEMENT LVL 09,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1713,IMP CEMENT LVL 10,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 02,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 03,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 08,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1713,IMP FIX LW/UP/PELVIC LVL 09,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1713,IMP PIN/WIRE LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1713,IMP PIN/WIRE LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1713,IMP PIN/WIRE LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,C1713,IMP PIN/WIRE LVL 04,1132.0,475.44,305.64,1109.36,30
HCPCS,C1713,IMP PIN/WIRE LVL 05,1413.0,593.46,381.51,1384.74,30
HCPCS,C1713,IMP PIN/WIRE LVL 06,1619.0,679.98,437.13,1586.62,30
HCPCS,C1713,IMP PIN/WIRE LVL 07,1888.0,792.96,509.76,1850.24,30
HCPCS,C1713,IMP PIN/WIRE LVL 08,2426.0,1018.92,655.02,2377.48,30
HCPCS,C1713,IMP PIN/WIRE LVL 09,2827.0,1187.34,763.29,2770.46,30
HCPCS,C1713,IMP PIN/WIRE LVL 10,3340.0,1402.8,901.8,3273.2,30
HCPCS,C1713,IMP PIN/WIRE LVL 11,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1713,IMP PIN/WIRE LVL 12,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP PIN/WIRE LVL 13,8107.0,3404.94,2188.89,7944.86,30
HCPCS,C1713,IMP PIN/WIRE LVL 14,10422.0,4377.24,2813.94,10213.56,30
HCPCS,C1713,IMP PLATE CUST LVL 01,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1713,IMP PLATE CUST LVL 02,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1713,IMP PLATE CUST LVL 03,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1713,IMP PLATE CUST LVL 04,131404.0,55189.68,35479.08,128775.92,30
HCPCS,C1713,IMP PLATE LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1713,IMP PLATE LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1713,IMP PLATE LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,C1713,IMP PLATE LVL 04,1132.0,475.44,305.64,1109.36,30
HCPCS,C1713,IMP PLATE LVL 05,1619.0,679.98,437.13,1586.62,30
HCPCS,C1713,IMP PLATE LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP PLATE LVL 07,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1713,IMP PLATE LVL 08,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1713,IMP PLATE LVL 09,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP PLATE LVL 10,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1713,IMP PLATE LVL 11,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP PLATE LVL 12,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1713,IMP PLATE LVL 13,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1713,IMP PLATE LVL 14,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1713,IMP PLATE LVL 15,18400.0,7728.0,4968.0,18032.0,30
HCPCS,C1713,IMP PLATE LVL 16,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1713,IMP PLATE LVL 17,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1713,IMP PLATE LVL 18,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1713,IMP PLATE LVL 19,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1713,IMP PLATE LVL 20,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1713,IMP PLATE LVL 21,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1713,IMP PLATE LVL 22,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1713,IMP PLATE LVL 23,37234.0,15638.28,10053.18,36489.32,30
HCPCS,C1713,IMP PLATE LVL 24,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1713,IMP PLATE LVL 25,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1713,IMP RING LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP RING LVL 02,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1713,IMP RING LVL 03,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1713,IMP RING LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1713,IMP RING LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1713,IMP ROD/NAIL LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1713,IMP ROD/NAIL LVL 02,850.0,357.0,229.5,833.0,30
HCPCS,C1713,IMP ROD/NAIL LVL 03,1413.0,593.46,381.51,1384.74,30
HCPCS,C1713,IMP ROD/NAIL LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1713,IMP ROD/NAIL LVL 05,3909.0,1641.78,1055.43,3830.82,30
HCPCS,C1713,IMP ROD/NAIL LVL 06,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1713,IMP ROD/NAIL LVL 07,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1713,IMP ROD/NAIL LVL 08,7876.0,3307.92,2126.52,7718.48,30
HCPCS,C1713,IMP ROD/NAIL LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1713,IMP ROD/NAIL LVL 10,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1713,IMP ROD/NAIL LVL 11,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1713,IMP ROD/NAIL LVL 12,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1713,IMP ROD/NAIL LVL 13,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1713,IMP ROD/NAIL LVL 14,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1713,IMP STAPLE BONE LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1713,IMP STAPLE BONE LVL 02,447.0,187.74,120.69,438.06,30
HCPCS,C1713,IMP STAPLE BONE LVL 03,709.0,297.78,191.43,694.82,30
HCPCS,C1713,IMP STAPLE BONE LVL 04,991.0,416.22,267.57,971.18,30
HCPCS,C1713,IMP STAPLE BONE LVL 05,1490.0,625.8,402.3,1460.2,30
HCPCS,C1713,IMP STAPLE BONE LVL 06,2157.0,905.94,582.39,2113.86,30
HCPCS,C1713,IMP STAPLE BONE LVL 07,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1713,IMP STAPLE BONE LVL 08,3909.0,1641.78,1055.43,3830.82,30
HCPCS,C1713,IMP STAPLE BONE LVL 09,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1713,IMP STAPLE BONE LVL 10,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1713,IMP STAPLE BONE LVL 11,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1713,IMP STAPLE BONE LVL 12,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1713,IMP STAPLE BONE LVL 13,8339.0,3502.38,2251.53,8172.22,30
HCPCS,C1713,IMP STAPLE BONE LVL 14,9728.0,4085.76,2626.56,9533.44,30
HCPCS,C1713,IMP STAPLE BONE LVL 15,10654.0,4474.68,2876.58,10440.92,30
HCPCS,C1713,IMP STAPLE BONE LVL 16,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1714,CATH ATHERECT TRANSL DIRECT LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 02,588.0,246.96,158.76,576.24,30
HCPCS,C1715,NEEDLE BRACHYTHERAPY LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 01,43800.0,18396.0,11826.0,42924.0,30
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 02,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 03,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 04,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1721,IMP ICD CHAMBER DUAL LVL 05,131404.0,55189.68,35479.08,128775.92,30
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 01,43800.0,18396.0,11826.0,42924.0,30
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 02,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 03,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1722,IMP ICD CHAMBER SGL LVL 04,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1724,CATH ATHERECT TRANSL ROTAT LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 01,850.0,357.0,229.5,833.0,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 03,1888.0,792.96,509.76,1850.24,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 05,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 06,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 07,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 08,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 10,12969.0,5446.98,3501.63,12709.62,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 11,15772.0,6624.24,4258.44,15456.56,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 12,19276.0,8095.92,5204.52,18890.48,30
HCPCS,C1725,CATH ANGIO TRANSL NONLASER LVL 13,22780.0,9567.6,6150.6,22324.4,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 04,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1726,CATH BALLOON DILAT NONVASC LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1728,IMP CATH BRACHY SEED ADM LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 02,1888.0,792.96,509.76,1850.24,30
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1729,CATH DRAINAGE IMP <30DAYS LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 02,1888.0,792.96,509.76,1850.24,30
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1729,IMP CATH DRAINAGE 30+ DAYS LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 04,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1730,CATH EP NON 3D 1-19 LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1731,CATH EP NON 3D 20+ LVL 01,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1731,CATH EP NON 3D 20+ LVL 02,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1731,CATH EP NON 3D 20+ LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1731,CATH EP NON 3D 20+ LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1731,CATH EP NON 3D 20+ LVL 05,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 01,2157.0,905.94,582.39,2113.86,30
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 02,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 04,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 05,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1732,CATH ABL EP 3D/VECTOR LVL 06,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 01,1619.0,679.98,437.13,1586.62,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 02,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 06,21028.0,8831.76,5677.56,20607.44,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 07,25408.0,10671.36,6860.16,24899.84,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 08,29788.0,12510.96,8042.76,29192.24,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 09,34168.0,14350.56,9225.36,33484.64,30
HCPCS,C1733,CATH ABL EP NON 3D/VECTOR LVL 10,38548.0,16190.16,10407.96,37777.04,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 06,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 10,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1743,IMP SCAF EV NON COR DE W DEL LVL 11,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1747,ENDOSCOPE SINGLE USE UT LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1748,ENDOSCOPE SINGLE USE UGI LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 04,1619.0,679.98,437.13,1586.62,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 06,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 07,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1750,IMP CATH HEM/PER LONG TERM LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 04,1132.0,475.44,305.64,1109.36,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 05,1619.0,679.98,437.13,1586.62,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 07,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1751,CATH INF NON HEMODIALYSIS LVL 10,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 04,1619.0,679.98,437.13,1586.62,30
HCPCS,C1752,CATH HEM/PER SHORT TERM LVL 05,2157.0,905.94,582.39,2113.86,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 01,850.0,357.0,229.5,833.0,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 02,2426.0,1018.92,655.02,2377.48,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 05,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 07,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1753,CATH INTRAVASCULAR US LVL 09,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1755,CATH INTRASPINAL LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1755,CATH INTRASPINAL LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1755,CATH INTRASPINAL LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1755,CATH INTRASPINAL LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1755,CATH INTRASPINAL LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1755,CATH INTRASPINAL LVL 06,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1755,CATH INTRASPINAL LVL 07,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1757,CATH THROMBECTOMY/EMBO DVT PPP,27531.0,11563.02,7433.37,26980.38,30
HCPCS,C1757,CATH THROMBECTOMY/EMBO VTE PPP,37856.0,15899.52,10221.12,37098.88,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 04,2157.0,905.94,582.39,2113.86,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 05,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 07,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 09,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 10,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 11,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 12,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 13,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 14,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 15,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 16,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 17,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1757,CATH THROMBECTOMY/EMBOLECTMY LVL 18,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1758,CATH URETERAL LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1758,CATH URETERAL LVL 02,850.0,357.0,229.5,833.0,30
HCPCS,C1758,CATH URETERAL LVL 03,1888.0,792.96,509.76,1850.24,30
HCPCS,C1758,CATH URETERAL LVL 04,2827.0,1187.34,763.29,2770.46,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 02,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 03,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1759,CATH INTRACARDIAC ECHO LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 04,1619.0,679.98,437.13,1586.62,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 05,2157.0,905.94,582.39,2113.86,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 07,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1760,IMP DEV CLOSURE VASCULAR LVL 11,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 02,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 04,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 06,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 08,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1761,CATH LITHO TRANSL INTRAVASC LVL 10,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 07,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 12,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 13,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 14,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 15,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1762,IMP TISSUE CONNECT HUMAN LVL 16,54754.0,22996.68,14783.58,53658.92,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 01,850.0,357.0,229.5,833.0,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 02,2157.0,905.94,582.39,2113.86,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 03,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 08,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 09,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 10,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 11,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 12,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 13,56944.0,23916.48,15374.88,55805.12,30
HCPCS,C1763,IMP TISSUE CONNECT NONHUMAN LVL 14,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 02,11575.0,4861.5,3125.25,11343.5,30
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 03,14892.0,6254.64,4020.84,14594.16,30
HCPCS,C1764,IMP CARDIAC EVENT REC LVL 04,24970.0,10487.4,6741.9,24470.6,30
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 01,850.0,357.0,229.5,833.0,30
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1765,ADHSN BARRIER IMP <30DAYS LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 01,850.0,357.0,229.5,833.0,30
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1765,IMP ADHSN BARRIER 30+ DAYS LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1766,INTRO EP STEER NONPEEL LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 01,28470.0,11957.4,7686.9,27900.6,30
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 02,43800.0,18396.0,11826.0,42924.0,30
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 03,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 04,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 05,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1767,IMP GENERATOR NEUROSTIM LVL 07,153304.0,64387.68,41392.08,150237.92,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 04,2157.0,905.94,582.39,2113.86,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 06,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 07,3909.0,1641.78,1055.43,3830.82,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 08,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 09,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 10,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 11,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 12,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 13,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 14,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1768,IMP GRAFT VASCULAR LVL 15,54754.0,22996.68,14783.58,53658.92,30
HCPCS,C1769,WIRE GUIDE LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1769,WIRE GUIDE LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1769,WIRE GUIDE LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1769,WIRE GUIDE LVL 04,850.0,357.0,229.5,833.0,30
HCPCS,C1769,WIRE GUIDE LVL 05,1413.0,593.46,381.51,1384.74,30
HCPCS,C1769,WIRE GUIDE LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1769,WIRE GUIDE LVL 07,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1769,WIRE GUIDE LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1769,WIRE GUIDE LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1769,WIRE GUIDE LVL 10,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1769,WIRE GUIDE LVL 11,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1770,COIL IMAGING MAGNETIC RESON LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1770,COIL IMAGING MAGNETIC RESON LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 06,14020.0,5888.4,3785.4,13739.6,30
HCPCS,C1771,IMP DEV URINARY W SLING LVL 07,17962.0,7544.04,4849.74,17602.76,30
HCPCS,C1772,IMP PUMP INF PRG LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1772,IMP PUMP INF PRG LVL 02,8112.0,3407.04,2190.24,7949.76,30
HCPCS,C1772,IMP PUMP INF PRG LVL 03,10431.0,4381.02,2816.37,10222.38,30
HCPCS,C1772,IMP PUMP INF PRG LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1772,IMP PUMP INF PRG LVL 05,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1772,IMP PUMP INF PRG LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1772,IMP PUMP INF PRG LVL 07,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1772,IMP PUMP INF PRG LVL 08,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1772,IMP PUMP INF PRG LVL 09,46870.0,19685.4,12654.9,45932.6,30
HCPCS,C1772,IMP PUMP INF PRG LVL 10,51250.0,21525.0,13837.5,50225.0,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 01,1132.0,475.44,305.64,1109.36,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 02,2157.0,905.94,582.39,2113.86,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 03,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 04,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 06,8107.0,3404.94,2188.89,7944.86,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 07,10422.0,4377.24,2813.94,10213.56,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 08,12737.0,5349.54,3438.99,12482.26,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 09,14239.0,5980.38,3844.53,13954.22,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 10,16429.0,6900.18,4435.83,16100.42,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 11,18619.0,7819.98,5027.13,18246.62,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 12,20809.0,8739.78,5618.43,20392.82,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 13,22999.0,9659.58,6209.73,22539.02,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 14,25189.0,10579.38,6801.03,24685.22,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 15,27379.0,11499.18,7392.33,26831.42,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 16,29569.0,12418.98,7983.63,28977.62,30
HCPCS,C1773,DEVICE INSERT RETRV LVL 17,31759.0,13338.78,8574.93,31123.82,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 12,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 13,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1776,IMP DEV JT ANKLE TOTAL LVL 14,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 08,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 09,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 10,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 11,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 12,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 13,56944.0,23916.48,15374.88,55805.12,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 14,61324.0,25756.08,16557.48,60097.52,30
HCPCS,C1776,IMP DEV JT ELBOW TOTAL LVL 15,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1776,IMP DEV JT FINGER LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP DEV JT FINGER LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT FINGER LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT FINGER LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT FINGER LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 12,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 13,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 14,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 15,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 16,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1776,IMP DEV JT HIP TOTAL LVL 17,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 01,1132.0,475.44,305.64,1109.36,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 03,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 08,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 09,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 10,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 11,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 12,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 13,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 14,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 15,56944.0,23916.48,15374.88,55805.12,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 16,61324.0,25756.08,16557.48,60097.52,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 17,70084.0,29435.28,18922.68,68682.32,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 18,78844.0,33114.48,21287.88,77267.12,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 19,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 20,96364.0,40472.88,26018.28,94436.72,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 21,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 22,122644.0,51510.48,33113.88,120191.12,30
HCPCS,C1776,IMP DEV JT KNEE TOTAL LVL 23,135784.0,57029.28,36661.68,133068.32,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 12,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 13,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 14,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 15,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1776,IMP DEV JT SHDR TOTAL LVL 16,55630.0,23364.6,15020.1,54517.4,30
HCPCS,C1776,IMP DEV JT TOE LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP DEV JT TOE LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT TOE LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT TOE LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT TOE LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT TOE LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP DEV JT WRIST TOTAL LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 08,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP RV/AD/RP ANKLE INSR/TRAY LVL 09,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 04,5856.0,2459.52,1581.12,5738.88,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 05,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 06,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 07,8339.0,3502.38,2251.53,8172.22,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 09,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 10,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 11,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 12,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP ELBOW HEAD LVL 13,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 01,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 02,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 03,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP ELBOW STEM LVL 04,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP HIP BR/AX/YK/BH LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 04,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP HIP CUP LVL 08,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP HIP DIS/POS AUG LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 01,1132.0,475.44,305.64,1109.36,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 02,1619.0,679.98,437.13,1586.62,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 05,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 06,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 07,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 09,12506.0,5252.52,3376.62,12255.88,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 10,14896.0,6256.32,4021.92,14598.08,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 11,17962.0,7544.04,4849.74,17602.76,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 12,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 13,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1776,IMP RV/AD/RP HIP FEMORAL HD LVL 14,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 05,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 06,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 07,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP HIP INSR/EX/RNG LVL 09,12506.0,5252.52,3376.62,12255.88,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 03,4392.0,1844.64,1185.84,4304.16,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 04,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 05,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 07,7876.0,3307.92,2126.52,7718.48,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 08,8802.0,3696.84,2376.54,8625.96,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP LINER LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 02,3591.0,1508.22,969.57,3519.18,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 03,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 04,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 05,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 08,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP HIP SHELL LVL 11,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 02,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 04,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP STEM LVL 05,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 01,9260.0,3889.2,2500.2,9074.8,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 02,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 03,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 04,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 05,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS MODULAR LVL 06,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 01,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS SOLN LVL 02,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 02,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 04,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP HIP SYS TRIFLNG LVL 05,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP HIP TR/CNT/SL LVL 03,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP KN BR/AX/YK/BH LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 01,1126.0,472.92,304.02,1103.48,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 02,1619.0,679.98,437.13,1586.62,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 05,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 06,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 07,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 09,12506.0,5252.52,3376.62,12255.88,30
HCPCS,C1776,IMP RV/AD/RP KN DIS/POS AUG LVL 10,13582.0,5704.44,3667.14,13310.36,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 04,9260.0,3889.2,2500.2,9074.8,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP KN EX/CONNECT LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 01,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 04,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 05,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 06,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 07,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1776,IMP RV/AD/RP KN FEMORAL LVL 08,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 03,2152.0,903.84,581.04,2108.96,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 04,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN INSR/SLV/LN LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 02,2152.0,903.84,581.04,2108.96,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 03,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 04,3909.0,1641.78,1055.43,3830.82,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 06,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 07,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP KN PATELLA LVL 10,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 06,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 07,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 08,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1776,IMP RV/AD/RP KN ROTATING HNG LVL 09,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 02,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 03,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 04,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 05,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 08,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP KN STEM LVL 09,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 01,1126.0,472.92,304.02,1103.48,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 02,1619.0,679.98,437.13,1586.62,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 05,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 06,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 07,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 09,12506.0,5252.52,3376.62,12255.88,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 10,13582.0,5704.44,3667.14,13310.36,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 11,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 12,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP KN TIB/FM TRIAL LVL 13,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 01,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 02,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 04,8802.0,3696.84,2376.54,8625.96,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 05,10654.0,4474.68,2876.58,10440.92,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 06,12506.0,5252.52,3376.62,12255.88,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 07,13582.0,5704.44,3667.14,13310.36,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 08,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 09,17086.0,7176.12,4613.22,16744.28,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 10,21466.0,9015.72,5795.82,21036.68,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 11,25846.0,10855.32,6978.42,25329.08,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 12,30226.0,12694.92,8161.02,29621.48,30
HCPCS,C1776,IMP RV/AD/RP KN TIBIAL LVL 13,34606.0,14534.52,9343.62,33913.88,30
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP SHDR CUP LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 01,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR GLEN CMP LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 04,5856.0,2459.52,1581.12,5738.88,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 05,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 06,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 07,8339.0,3502.38,2251.53,8172.22,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR HEAD LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 02,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR INSERT LVL 05,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1776,IMP RV/AD/RP SHDR LN/SL LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP SHDR PROX BODY LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 01,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 02,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR SHELL LVL 03,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 01,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1776,IMP RV/AD/RP SHDR STEM LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 01,588.0,246.96,158.76,576.24,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 04,2157.0,905.94,582.39,2113.86,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 05,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 06,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 07,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 08,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1776,IMP RV/AD/RP SHL SG/BG/EX/PG LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 07,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1777,IMP LD ICD COIL SGL LVL 09,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 01,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1778,IMP LD NEUROSTIM LVL 08,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 02,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 04,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 06,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1779,IMP LD PCMKR VDD LVL 08,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1780,LENS INTRAOCULAR NEW TECH LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1781,IMP MESH LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1781,IMP MESH LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1781,IMP MESH LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1781,IMP MESH LVL 04,2157.0,905.94,582.39,2113.86,30
HCPCS,C1781,IMP MESH LVL 05,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1781,IMP MESH LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1781,IMP MESH LVL 07,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1781,IMP MESH LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1781,IMP MESH LVL 09,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1781,IMP MESH LVL 10,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1781,IMP MESH LVL 11,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1781,IMP MESH LVL 12,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1781,IMP MESH LVL 13,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1781,IMP MESH LVL 14,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1781,IMP MESH LVL 15,37234.0,15638.28,10053.18,36489.32,30
HCPCS,C1781,IMP MESH LVL 16,41614.0,17477.88,11235.78,40781.72,30
HCPCS,C1781,IMP MESH LVL 17,45994.0,19317.48,12418.38,45074.12,30
HCPCS,C1781,IMP MESH LVL 18,50374.0,21157.08,13600.98,49366.52,30
HCPCS,C1781,IMP MESH LVL 19,54754.0,22996.68,14783.58,53658.92,30
HCPCS,C1781,IMP MESH LVL 20,59134.0,24836.28,15966.18,57951.32,30
HCPCS,C1781,IMP MESH LVL 21,63514.0,26675.88,17148.78,62243.72,30
HCPCS,C1781,IMP MESH LVL 22,67894.0,28515.48,18331.38,66536.12,30
HCPCS,C1781,IMP MESH LVL 23,72362.0,30392.04,19537.74,70914.76,30
HCPCS,C1782,MORCELLATOR LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1782,MORCELLATOR LVL 02,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1782,MORCELLATOR LVL 03,9260.0,3889.2,2500.2,9074.8,30
HCPCS,C1782,MORCELLATOR LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 01,17520.0,7358.4,4730.4,17169.6,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 02,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 03,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 04,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 05,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 06,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1785,IMP PCMKR DUAL RR LVL 07,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1786,IMP PCMKR SGL RR LVL 01,11575.0,4861.5,3125.25,11343.5,30
HCPCS,C1786,IMP PCMKR SGL RR LVL 02,17520.0,7358.4,4730.4,17169.6,30
HCPCS,C1786,IMP PCMKR SGL RR LVL 03,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1786,IMP PCMKR SGL RR LVL 04,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1786,IMP PCMKR SGL RR LVL 05,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1786,IMP PCMKR SGL RR LVL 06,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1787,PROGRAMMER PT NEUROSTIM LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 02,447.0,187.74,120.69,438.06,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 05,1888.0,792.96,509.76,1850.24,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 07,3340.0,1402.8,901.8,3273.2,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 08,4153.0,1744.26,1121.31,4069.94,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 09,4641.0,1949.22,1253.07,4548.18,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 10,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1788,IMP CATH PORT INDWELLING LVL 11,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1789,IMP PROSTH BREAST LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1789,IMP PROSTH BREAST LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1789,IMP PROSTH BREAST LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1789,IMP PROSTH BREAST LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1789,IMP PROSTH BREAST LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 01,844.0,354.48,227.88,827.12,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 04,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 05,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 06,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 07,56944.0,23916.48,15374.88,55805.12,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 08,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1813,IMP PROSTH PENILE INFLT LVL 09,74464.0,31274.88,20105.28,72974.72,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 01,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 02,14020.0,5888.4,3785.4,13739.6,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 03,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 04,25408.0,10671.36,6860.16,24899.84,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 05,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 06,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 07,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 08,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 09,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 10,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 11,56944.0,23916.48,15374.88,55805.12,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 12,61324.0,25756.08,16557.48,60097.52,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 13,67894.0,28515.48,18331.38,66536.12,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 14,74464.0,31274.88,20105.28,72974.72,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 15,76654.0,32194.68,20696.58,75120.92,30
HCPCS,C1815,IMP PROSTH SPHINCTR URIN LVL 16,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1816,IMP NEUROSTIM RECVR&/TRANS LVL 01,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 01,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 02,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 03,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 04,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 05,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 06,37234.0,15638.28,10053.18,36489.32,30
HCPCS,C1817,IMP SEPTAL DEFECT INTRACARD LVL 07,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1819,IMP DEV TISS LOCAL/EXCISION LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 02,6945.0,2916.9,1875.15,6806.1,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 03,14892.0,6254.64,4020.84,14594.16,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 04,28470.0,11957.4,7686.9,27900.6,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 05,43800.0,18396.0,11826.0,42924.0,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 06,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1820,IMP NRSTM BAT RECHG SYS LVL 07,87604.0,36793.68,23653.08,85851.92,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1821,IMP DEV INTERSPINOUS LVL 08,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1830,NEEDLE BIOPSY MRW BONE PWR LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1830,NEEDLE BIOPSY MRW BONE PWR LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1830,NEEDLE BIOPSY MRW BONE PWR LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 04,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 06,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 08,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 09,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 10,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 11,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 12,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 13,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 14,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1874,IMP STENT COAT W DEL LVL 15,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 02,1619.0,679.98,437.13,1586.62,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 03,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 05,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 07,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1876,IMP STENT NONCOAT W DEL LVL 12,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 01,447.0,187.74,120.69,438.06,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 02,850.0,357.0,229.5,833.0,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 08,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 11,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 12,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 13,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1877,IMP STENT NONCOAT WO DEL LVL 14,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 01,588.0,246.96,158.76,576.24,30
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 02,1614.0,677.88,435.78,1581.72,30
HCPCS,C1878,IMP MATERIAL CORD VOCAL LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1880,IMP FILTER VENA CAVA LVL 01,1407.0,590.94,379.89,1378.86,30
HCPCS,C1880,IMP FILTER VENA CAVA LVL 02,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1880,IMP FILTER VENA CAVA LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1880,IMP FILTER VENA CAVA LVL 04,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1880,IMP FILTER VENA CAVA LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1880,IMP FILTER VENA CAVA LVL 06,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 05,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 06,8107.0,3404.94,2188.89,7944.86,30
HCPCS,C1881,IMP ACCESS SYSTEM DIALYS LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 01,61320.0,25754.4,16556.4,60093.6,30
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 02,70080.0,29433.6,18921.6,68678.4,30
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 03,78840.0,33112.8,21286.8,77263.2,30
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 04,96364.0,40472.88,26018.28,94436.72,30
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 05,109504.0,45991.68,29566.08,107313.92,30
HCPCS,C1882,IMP ICD CHAMBER NON SGL/DUAL LVL 06,122644.0,51510.48,33113.88,120191.12,30
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 01,1126.0,472.92,304.02,1103.48,30
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 02,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1883,IMP ADPT/EXT LD PACING/NEURO LVL 03,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 01,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 02,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 03,8339.0,3502.38,2251.53,8172.22,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 04,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 06,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 08,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1884,EMBOLIZATION SYS PROTECT LVL 09,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1885,CATH ANGIO TRANSL LASER LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1886,CATH ABL TISSUE INSERT LVL 02,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1887,CATH GUIDE LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1887,CATH GUIDE LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1887,CATH GUIDE LVL 03,447.0,187.74,120.69,438.06,30
HCPCS,C1887,CATH GUIDE LVL 04,594.0,249.48,160.38,582.12,30
HCPCS,C1887,CATH GUIDE LVL 05,850.0,357.0,229.5,833.0,30
HCPCS,C1887,CATH GUIDE LVL 06,1413.0,593.46,381.51,1384.74,30
HCPCS,C1887,CATH GUIDE LVL 07,2827.0,1187.34,763.29,2770.46,30
HCPCS,C1887,CATH GUIDE LVL 08,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1887,CATH GUIDE LVL 09,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1887,CATH GUIDE LVL 10,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1887,CATH GUIDE LVL 11,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1887,CATH GUIDE LVL 12,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1887,CATH GUIDE LVL 13,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1887,CATH GUIDE LVL 14,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1888,CATH ABL NONCARDIAC LVL 01,1619.0,679.98,437.13,1586.62,30
HCPCS,C1888,CATH ABL NONCARDIAC LVL 02,3083.0,1294.86,832.41,3021.34,30
HCPCS,C1888,CATH ABL NONCARDIAC LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,DURAL SLNT ADHERUS AUTOSPRAY,4621.8,1941.16,1247.89,4529.36,30
HCPCS,C1889,IMP BAND LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1889,IMP BAND LVL 02,850.0,357.0,229.5,833.0,30
HCPCS,C1889,IMP BAND LVL 03,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP BAND LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP BAND LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP BAND LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP BAND LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP BAND LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP CABLE LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1889,IMP CABLE LVL 02,844.0,354.48,227.88,827.12,30
HCPCS,C1889,IMP CABLE LVL 03,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP CABLE LVL 04,2157.0,905.94,582.39,2113.86,30
HCPCS,C1889,IMP CABLE LVL 05,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1889,IMP CABLE LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP CABLE LVL 07,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1889,IMP CABLE LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP CABLE LVL 09,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1889,IMP CLIP ANEURYSM LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP CLIP ANEURYSM LVL 02,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1889,IMP CLIP ANEURYSM LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP CLIP ANEURYSM LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP CLIP/S 1-4 REPAIR MITRAL KIT,109800.0,46116.0,29646.0,107604.0,30
HCPCS,C1889,IMP COVER BURR HOLE LVL 01,588.0,246.96,158.76,576.24,30
HCPCS,C1889,IMP COVER BURR HOLE LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1889,IMP COVER BURR HOLE LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1889,IMP COVER BURR HOLE LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 02,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 03,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1889,IMP DEV CLOSURE ATRIAL APNDG LVL 06,78844.0,33114.48,21287.88,77267.12,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 06,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 10,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 11,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 12,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 13,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP DEV VALVE SHUNT LVL 14,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 01,1132.0,475.44,305.64,1109.36,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 03,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 05,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 07,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP EMBOLIZATION AGENT LVL 09,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 01,1619.0,679.98,437.13,1586.62,30
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 02,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP EMBOLIZATION SPHERE LVL 04,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 02,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 05,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 06,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP FASTENERS W DEV DELIVERY LVL 07,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1889,IMP FIX SPINE LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP FIX SPINE LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1889,IMP FIX SPINE LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP FIX SPINE LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP FIX SPINE LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP FIX SPINE LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP FIX SPINE LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP FIX SPINE LVL 08,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP FIX SPINE LVL 09,27160.0,11407.2,7333.2,26616.8,30
HCPCS,C1889,IMP FIX SPINE LVL 10,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1889,IMP FIX SPINE LVL 11,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1889,IMP FIX SPINE LVL 12,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1889,IMP FIX SPINE LVL 13,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1889,IMP FIX SPINE LVL 14,78844.0,33114.48,21287.88,77267.12,30
HCPCS,C1889,IMP FIX SPINE LVL 15,91984.0,38633.28,24835.68,90144.32,30
HCPCS,C1889,IMP HOOK LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1889,IMP HOOK LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP HOOK LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1889,IMP HOOK LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP HOOK LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP NEURO LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP NEURO LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP NEURO LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP NEURO LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP NEURO LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP NEURO LVL 06,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP NEURO LVL 07,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1889,IMP NEURO LVL 08,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1889,IMP POUCH ECM LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1889,IMP POUCH ECM LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP POUCH ECM LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP POUCH ECM LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP PROS TEMP W ANCHR&STRTS LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP PROS TEMP W ANCHR&STRTS LVL 02,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP PROS TEMP W ANCHR&STRTS LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP RING FALLOPE LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1889,IMP RING FALLOPE LVL 02,588.0,246.96,158.76,576.24,30
HCPCS,C1889,IMP RING FALLOPE LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,C1889,IMP SLEEVE FIXATION LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1889,IMP SLEEVE FIXATION LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1889,IMP SLEEVE FIXATION LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP SLEEVE FIXATION LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 05,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1889,IMP SPACER ORTHOPEDIC LVL 14,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 02,850.0,357.0,229.5,833.0,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 05,1619.0,679.98,437.13,1586.62,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 06,1888.0,792.96,509.76,1850.24,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 07,2426.0,1018.92,655.02,2377.48,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 08,2827.0,1187.34,763.29,2770.46,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 09,3340.0,1402.8,901.8,3273.2,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 10,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 11,4153.0,1744.26,1121.31,4069.94,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 12,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP SPINAL BAR/RG/CLR LVL 13,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1889,IMP SPINE FUSION LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,C1889,IMP SPINE FUSION LVL 02,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1889,IMP SPINE FUSION LVL 03,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C1889,IMP SPINE FUSION LVL 04,8339.0,3502.38,2251.53,8172.22,30
HCPCS,C1889,IMP SPINE FUSION LVL 05,9728.0,4085.76,2626.56,9533.44,30
HCPCS,C1889,IMP SPINE FUSION LVL 06,11117.0,4669.14,3001.59,10894.66,30
HCPCS,C1889,IMP SPINE FUSION LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP SPINE FUSION LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP SPINE FUSION LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP SPINE FUSION LVL 10,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1889,IMP SPINE FUSION LVL 11,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1889,IMP SPINE FUSION LVL 12,35044.0,14718.48,9461.88,34343.12,30
HCPCS,C1889,IMP SPINE FUSION LVL 13,39424.0,16558.08,10644.48,38635.52,30
HCPCS,C1889,IMP SPINE FUSION LVL 14,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C1889,IMP SPINE FUSION LVL 15,48184.0,20237.28,13009.68,47220.32,30
HCPCS,C1889,IMP SPINE FUSION LVL 16,52564.0,22076.88,14192.28,51512.72,30
HCPCS,C1889,IMP SPINE FUSION LVL 17,56944.0,23916.48,15374.88,55805.12,30
HCPCS,C1889,IMP SPINE FUSION LVL 18,61324.0,25756.08,16557.48,60097.52,30
HCPCS,C1889,IMP SPINE FUSION LVL 19,65704.0,27595.68,17740.08,64389.92,30
HCPCS,C1889,IMP SPINE FUSION LVL 20,70084.0,29435.28,18922.68,68682.32,30
HCPCS,C1889,IMP SPINE FUSION LVL 21,74464.0,31274.88,20105.28,72974.72,30
HCPCS,C1889,IMP SPINE FUSION LVL 22,78844.0,33114.48,21287.88,77267.12,30
HCPCS,C1889,IMP SPINE FUSION LVL 23,83224.0,34954.08,22470.48,81559.52,30
HCPCS,C1889,IMP SPINE FUSION LVL 24,111694.0,46911.48,30157.38,109460.12,30
HCPCS,C1889,IMP SPINE KYPHX LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP SPINE KYPHX LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1889,IMP SPINE KYPHX LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP SPINE KYPHX LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1889,IMP SPINE KYPHX LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP SPINE KYPHX LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP SPINE KYPHX LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP SPINE KYPHX LVL 08,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 05,6024.0,2530.08,1626.48,5903.52,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1889,IMP SPINE STABILIZER LVL 10,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 04,1619.0,679.98,437.13,1586.62,30
HCPCS,C1889,IMP STAPLE REINFORCEMENT LVL 05,2157.0,905.94,582.39,2113.86,30
HCPCS,C1889,IMP STIMULATOR BONE LVL 01,13890.0,5833.8,3750.3,13612.2,30
HCPCS,C1889,IMP STIMULATOR BONE LVL 02,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1889,IMP STIMULATOR BONE LVL 03,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1889,IMP STIMULATOR BONE LVL 04,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C1889,IMP STIMULATOR BONE LVL 05,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1889,SEALANT SYS DURASEAL 5ML,2180.2,915.68,588.65,2136.6,30
HCPCS,C1889,SPINE SLNT DURASEAL SYS 5ML 5U,4246.5,1783.53,1146.56,4161.57,30
HCPCS,C1891,IMP PUMP INF NONPRG PERM LVL 01,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 03,1413.0,593.46,381.51,1384.74,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 04,2023.0,849.66,546.21,1982.54,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 06,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1892,INTRO EP FIX CRV PEEL LVL 07,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 03,1888.0,792.96,509.76,1850.24,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1893,INTRO EP FIX CRV NONPEEL LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1894,INTRO NON GD/EP/LASER DVT PPP,7509.0,3153.78,2027.43,7358.82,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 01,96.0,40.32,25.92,94.08,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 04,1619.0,679.98,437.13,1586.62,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 06,3596.0,1510.32,970.92,3524.08,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 07,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 08,7876.0,3307.92,2126.52,7718.48,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 09,10191.0,4280.22,2751.57,9987.18,30
HCPCS,C1894,INTRO NON GD/EP/LASER LVL 10,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1894,INTRO NON GD/EP/LASER VTE PPP,10324.0,4336.08,2787.48,10117.52,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 07,15334.0,6440.28,4140.18,15027.32,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 09,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 10,24094.0,10119.48,6505.38,23612.12,30
HCPCS,C1895,IMP LD ICD COIL DUAL LVL 11,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 04,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C1896,IMP LD ICD NON SGL/DUAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 05,1883.0,790.86,508.41,1845.34,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 07,3909.0,1641.78,1055.43,3830.82,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 08,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C1897,IMP LD NEUROSTIM TEST KIT LVL 09,7644.0,3210.48,2063.88,7491.12,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 05,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 06,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 07,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1898,IMP LD PCMKR NON VDD LVL 08,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 08,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1899,IMP LD PCMKR/ICD COMBO LVL 09,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 03,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 08,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C1900,IMP LD VENOUS COR LV LVL 09,30664.0,12878.88,8279.28,30050.72,30
HCPCS,C2596,PROBE/WATERJET ABL ROBOTIC LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C2596,PROBE/WATERJET ABL ROBOTIC LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2596,PROBE/WATERJET ABL ROBOTIC LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C2596,PROBE/WATERJET ABL ROBOTIC LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C2596,PROBE/WATERJET ABL ROBOTIC LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C2596,PROBE/WATERJET ABL ROBOTIC LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C2613,PLUG BIOPSY LUNG W DELIVERY LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 02,3596.0,1510.32,970.92,3524.08,30
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 03,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C2615,IMP SEALANT PULMONARY LIQUID LVL 04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C2616,BRACHY N-STRND YTTR 90 SIRSP/SRCE,75774.0,31825.08,17771.01,74258.52,37
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 04,1132.0,475.44,305.64,1109.36,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 05,1619.0,679.98,437.13,1586.62,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 07,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,C2617,IMP STENT NONCOR TEMP WO DEL LVL 09,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 01,588.0,246.96,158.76,576.24,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 02,2690.0,1129.8,726.3,2636.2,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 06,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 07,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C2618,PROBE/NEEDLE CRYOABLATION LVL 08,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 01,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 02,24090.0,10117.8,6504.3,23608.2,30
HCPCS,C2619,IMP PCMKR DUAL NON RR LVL 03,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 01,15330.0,6438.6,4139.1,15023.4,30
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 02,19714.0,8279.88,5322.78,19319.72,30
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 03,22776.0,9565.92,6149.52,22320.48,30
HCPCS,C2620,IMP PCMKR SGL NON RR LVL 04,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 02,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 03,21900.0,9198.0,5913.0,21462.0,30
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 04,35040.0,14716.8,9460.8,34339.2,30
HCPCS,C2621,IMP PCMKR NONSGL OR DUAL LVL 05,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 03,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 04,28474.0,11959.08,7687.98,27904.52,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 05,32854.0,13798.68,8870.58,32196.92,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 06,37234.0,15638.28,10053.18,36489.32,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 07,41614.0,17477.88,11235.78,40781.72,30
HCPCS,C2622,IMP PROSTH PENILE NONINF LVL 08,45994.0,19317.48,12418.38,45074.12,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 03,594.0,249.48,160.38,582.12,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 05,1888.0,792.96,509.76,1850.24,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 07,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 08,4397.0,1846.74,1187.19,4309.06,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 09,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 10,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 11,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 12,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C2623,CATH TLA NONLASER DRUG COAT LVL 13,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 01,850.0,357.0,229.5,833.0,30
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 04,3909.0,1641.78,1055.43,3830.82,30
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 05,5373.0,2256.66,1450.71,5265.54,30
HCPCS,C2625,IMP STENT NONCOR TEMP W DEL LVL 06,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 04,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C2626,IMP PUMP INF NONPRG TMP LVL 05,43804.0,18397.68,11827.08,42927.92,30
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 01,251.0,105.42,67.77,245.98,30
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,C2627,CATH SUPRAPUBIC/CYSTOSCOPIC LVL 04,2157.0,905.94,582.39,2113.86,30
HCPCS,C2628,CATH OCCLUSION LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,C2628,CATH OCCLUSION LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,C2628,CATH OCCLUSION LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2628,CATH OCCLUSION LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C2628,CATH OCCLUSION LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2628,CATH OCCLUSION LVL 06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C2629,INTRO EP LASER LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,C2629,INTRO EP LASER LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,C2629,INTRO EP LASER LVL 03,1888.0,792.96,509.76,1850.24,30
HCPCS,C2629,INTRO EP LASER LVL 04,3083.0,1294.86,832.41,3021.34,30
HCPCS,C2629,INTRO EP LASER LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,C2629,INTRO EP LASER LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2629,INTRO EP LASER LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 01,1413.0,593.46,381.51,1384.74,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 04,4880.0,2049.6,1317.6,4782.4,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 05,5861.0,2461.62,1582.47,5743.78,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 06,6487.0,2724.54,1751.49,6357.26,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 07,7413.0,3113.46,2001.51,7264.74,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 09,11575.0,4861.5,3125.25,11343.5,30
HCPCS,C2630,CATH ABL COOL-TIP LVL 10,13432.0,5641.44,3626.64,13163.36,30
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 01,2421.0,1016.82,653.67,2372.58,30
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C2631,IMP DEV URINARY WO SLNG LVL 05,11580.0,4863.6,3126.6,11348.4,30
HCPCS,C2640,BRACHY STRND P-103/SRCE,278.5,116.97,56.16,342.02,74
HCPCS,C8921,ECHO CONG ANM CMP W CNT,2279.0,957.18,615.33,2233.42,37
HCPCS,C8922,ECHO CONG ANM LTD W CNT,1048.0,440.16,282.96,1161.31,37
HCPCS,C8923,ECHO 2D CMP W CNT,1028.0,431.76,277.56,1161.31,74
HCPCS,C8924,ECHO 2D LTD W CNT,1117.0,469.14,301.59,1094.66,74
HCPCS,C8925,ECHO 2D TEE CMP W CNT W I&R,2038.0,855.96,550.26,1997.24,74
HCPCS,C8926,ECHO TEE CONG ANM W CNT W I&R,1209.0,507.78,326.43,1184.82,37
HCPCS,C8927,ECHO 2D TEE MONITORING W CNT,1390.0,583.8,375.3,1362.2,37
HCPCS,C8928,ECHO 2D REST&STRESS W CNT W I&R,2750.0,1155.0,742.5,2695.0,37
HCPCS,C8929,ECHO 2D DOPP&CLR FLW CMP W CNT,3345.0,1404.9,800.9,3278.1,37
HCPCS,C8937,MRI CAD BREAST,79.0,33.18,21.33,77.42,30
HCPCS,C8957,INF IV PROLONG 8+ HR W PUMP,498.0,209.16,134.46,488.04,37
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 03,6100.0,2562.0,1647.0,5978.0,30
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 04,6718.0,2821.56,1813.86,6583.64,30
HCPCS,C9353,IMP NEURAWRAP NRV PROTEC/CM LVL 05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C9355,NEUROMATRIX 2.5CM LENGTH/0.5CM,430.5,180.81,116.23,421.89,30
HCPCS,C9363,INTGR MESH BM FIX INT 5X5/SC,387.7,162.83,104.68,379.95,37
HCPCS,C9600,PLC STENT/S DE SGL COR ART/BR SGL,19708.0,8277.36,5321.16,26759.0,37
HCPCS,C9601,PLC STENT/S DE COR ART/BR ADDL,14783.0,6208.86,3991.41,14487.34,29
HCPCS,C9602,ATHERECT&STENT/PTCA DE ART COR SGL,27274.0,11455.08,7363.98,27156.6,37
HCPCS,C9603,ATHERECT&STENT/PTCA DE ART COR ADD,20457.0,8591.94,5523.39,20047.86,29
HCPCS,C9604,REVASC DE GRFT BYPASS COR VSL SGL,15160.0,6367.2,4093.2,26759.0,37
HCPCS,C9605,REVASC DE GRFT BYPASS COR VSL ADDL,11371.0,4775.82,3070.17,11143.58,29
HCPCS,C9606,REVASC DE OCC MI ACUTE COR VSL SGL,29872.0,12546.24,3101.0,29274.56,30
HCPCS,C9607,REVASC DE OCC CHRONIC COR VSL SGL,32123.0,13491.66,8673.21,31480.54,37
HCPCS,C9608,REVASC DE OCC CHRONIC COR VSL ADDL,24093.0,10119.06,6505.11,23611.14,29
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL01,313.0,131.46,84.51,306.74,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL02,1413.0,593.46,381.51,1384.74,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL03,3853.0,1618.26,1040.31,3775.94,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL04,6105.0,2564.1,1648.35,5982.9,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL05,9265.0,3891.3,2501.55,9079.7,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL06,13895.0,5835.9,3751.65,13617.1,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL07,17524.0,7360.08,4731.48,17173.52,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL08,21904.0,9199.68,5914.08,21465.92,30
HCPCS,C9610,CATH COR TRANSL NONLASER DRUG LVL09,26284.0,11039.28,7096.68,25758.32,30
HCPCS,C9764,REVASC LITH INTRAV INCL ANGIOPLSTY,16067.0,6748.14,4338.09,25370.0,74
HCPCS,C9765,REVASC LITH INTRAV STNT ANGIOPLSTY,23343.0,9804.06,6302.61,27156.6,74
HCPCS,C9766,REVASC LITH INTRAV ATHR ANGIOPLSTY,33257.0,13967.94,8979.39,32591.86,74
HCPCS,C9767,REVASC LITH INTRAV STNT ATHR ANGIO,28438.0,11943.96,7678.26,27869.24,74
HCPCS,C9772,REVASC LITH INTRAV TIB/PER INCL ANG,21999.0,9239.58,5939.73,26759.0,74
HCPCS,C9773,REVASC LITH INTRAV TIB/PER STNT ANG,22524.0,9460.08,6081.48,27156.6,37
HCPCS,C9774,REVASC LITH INTRAV TIB/PER ATHR ANG,22699.0,9533.58,6128.73,27156.6,37
HCPCS,G0008,ADMIN FEE INFLUENZA,131.0,55.02,35.37,128.38,37
HCPCS,G0009,ADMIN FEE PNEUMOCOCCAL,131.0,55.02,35.37,128.38,37
HCPCS,G0010,ADMIN FEE HEPATITIS B,131.0,55.02,35.37,128.38,37
HCPCS,G0108,DSMT IND 30MIN,140.0,58.8,37.8,137.2,30
HCPCS,G0108,DSMT IND GESTATIONAL 30MIN,140.0,58.8,37.8,137.2,30
HCPCS,G0108,DSMT IND GESTATIONAL INSULIN 30MIN,140.0,58.8,37.8,137.2,30
HCPCS,G0108,DSMT IND TYPE 1 30MIN,140.0,58.8,37.8,137.2,30
HCPCS,G0108,DSMT IND TYPE 2 30MIN,140.0,58.8,37.8,137.2,30
HCPCS,G0108,DSMT IND TYPE 2 INSULIN 30MIN,140.0,58.8,37.8,137.2,30
HCPCS,G0109,DSMT GROUP 30MIN,41.0,17.22,11.07,40.18,30
HCPCS,G0109,DSMT GROUP GESTATIONAL 30MIN,41.0,17.22,11.07,40.18,30
HCPCS,G0109,DSMT GROUP TYPE 2 30MIN,41.0,17.22,11.07,40.18,30
HCPCS,G0237,IMPRV RESP STRENGTH MUSC/S 15MIN,122.0,51.24,29.55,119.56,37
HCPCS,G0239,IMPRV RESP FNCT/STRENGTH MUSC/S GRP,267.0,112.14,38.16,261.66,37
HCPCS,G0257,DIALYSIS OP UNSCH/ER ESRD PT,2395.0,1005.9,646.65,2347.1,37
HCPCS,G0269,PLC DEV/S OCCLUSIVE,936.0,393.12,252.72,917.28,58
HCPCS,G0277,HBOT CHAMBER FULL BODY 30MIN,717.0,301.14,140.59,702.66,37
HCPCS,G0278,ANGIO ILIAC/FEMORAL DURING HRT CATH,3363.0,1412.46,908.01,3295.74,29
HCPCS,G0378,OBSRV MEDICAL/SURGICAL PER HOUR,107.0,44.94,28.89,104.86,290
HCPCS,G0378,OBSRV NURSERY PER HOUR,107.0,44.94,28.89,104.86,29
HCPCS,G0378,OBSRV OB PER HOUR,107.0,44.94,28.89,104.86,29
HCPCS,G0379,ADMISSION DIRECT OBSERVATION HOSP,668.0,280.56,180.36,882.22,36
HCPCS,G0390,ED TRAUMA ACT LVL2 EVAL/GREEN W CC,5060.0,2125.2,1361.78,4958.8,37
HCPCS,G0390,ED TRAUMA ACT LVL2 FULL/RED W CC,12670.0,5321.4,1361.78,12416.6,37
HCPCS,G0390,ED TRAUMA ACT LVL2 LTD/YELLOW W CC,8425.0,3538.5,1361.78,8256.5,37
HCPCS,G0416,LAB PATH GROSS&MICRO BX PROS NDL,546.0,229.32,147.42,535.08,37
HCPCS,J1644,HEPARIN/1000U 15U/30ML SNIJ,62.5,26.25,16.88,61.25,30
HCPCS,J2185,MEROPENEM/100MG 500MG PWIJ,14.8,6.22,4.0,14.5,30
HCPCS,J2426,PALIPERD PALM/1MG 234MG/1.5ML IJER,37.3,15.67,10.07,36.55,37
HCPCS,J2700,OXACILLIN/<=250MG 1GM PWIJ,28.1,11.8,7.59,27.54,30
HCPCS,J2794,RISPERIDONE/0.5MG 37.5MG SPIJ,30.1,12.64,8.13,29.5,37
HCPCS,J3246,TIROFBN HCL/0.25MG 12.5MG/250MLSNIV,18.3,7.69,4.94,17.93,30
HCPCS,J3260,TOBRMYCN SULF/<=80MG 20MG/2ML MDV,72.8,30.58,19.66,71.34,30
HCPCS,J3490,BETAXOLOL HCL 0.5%/5ML 5ML SNOP,204.3,85.81,55.16,200.21,30
HCPCS,J3490,DIAZEPAM/2ML 10MG/2ML GLKT,438.6,184.21,118.42,429.83,30
HCPCS,J3490,LIDOCAINE 2%/1ML 200MG/20ML MDV,0.5,0.21,0.135,0.49,30
HCPCS,J3490,LIDOCAINE 2%/1ML 500MG/50ML MDV,0.5,0.21,0.135,0.49,30
HCPCS,J3490,MULTIVITAMIN/ TBCW,5.7,2.39,1.54,5.59,30
HCPCS,J3490,MUPIROCIN 2%/1GM 1GM ON,13.3,5.59,3.59,13.03,30
HCPCS,J3490,SOD CL 0.45%/1000ML 1000ML SNIV,29.1,12.22,7.86,28.52,30
HCPCS,J3590,TUBERCULIN PPD/1ML 5U/0.1ML SNIJ,37.1,15.58,10.02,36.36,30
HCPCS,J7510,PREDNISOLN/5MG 15MG TBDS,54.7,22.97,14.77,53.61,30
HCPCS,J8499,FOSINOPRIL/10MG 10MG TB,4.7,1.97,1.27,4.61,30
HCPCS,J8499,NAPROXEN/500MG 500MG TB,4.9,2.06,1.32,4.8,30
HCPCS,J8499,TAMSULOSIN/0.4MG 0.4MG CP,6.2,2.6,1.67,6.08,30
HCPCS,J8499,TRAMADOL/100MG 100MG TBER,17.8,7.48,4.81,17.44,30
HCPCS,J9999,LIFILEUCEL TIL/DOSE 7.5B-72B SNIJ,3141500.0,1319430.0,848205.0,3078670.0,29
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 05,19272.0,8094.24,5203.44,18886.56,30
HCPCS,L8603,IMP AGENT COLLAGN BULK 2.5ML LVL 06,20152.0,8463.84,5441.04,19748.96,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 02,447.0,187.74,120.69,438.06,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 03,709.0,297.78,191.43,694.82,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 04,1272.0,534.24,343.44,1246.56,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 05,2690.0,1129.8,726.3,2636.2,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 06,3078.0,1292.76,831.06,3016.44,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 07,3591.0,1508.22,969.57,3519.18,30
HCPCS,L8606,IMP AGENT SYNTHETIC BULK 1ML LVL 08,6105.0,2564.1,1648.35,5982.9,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 01,50370.0,21155.4,13599.9,49362.6,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 02,63510.0,26674.2,17147.7,62239.8,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 03,76650.0,32193.0,20695.5,75117.0,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 04,96364.0,40472.88,26018.28,94436.72,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 05,109504.0,45991.68,29566.08,107313.92,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 06,131404.0,55189.68,35479.08,128775.92,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 07,153304.0,64387.68,41392.08,150237.92,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 08,175204.0,73585.68,47305.08,171699.92,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 09,197104.0,82783.68,53218.08,193161.92,30
HCPCS,L8614,IMP DEV COCHLEAR INT&EXT CMP LVL 10,219004.0,91981.68,59131.08,214623.92,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 08,11580.0,4863.6,3126.6,11348.4,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 11,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 12,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 13,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 14,35044.0,14718.48,9461.88,34343.12,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 15,39424.0,16558.08,10644.48,38635.52,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 16,43804.0,18397.68,11827.08,42927.92,30
HCPCS,L8690,IMP DEV OSSEO AUD INT&EXT LVL 17,48184.0,20237.28,13009.68,47220.32,30
HCPCS,L8699,DEVICE HEART ARTIFICIAL 70CC,744600.0,312732.0,201042.0,729708.0,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 04,3083.0,1294.86,832.41,3021.34,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 09,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 10,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 11,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 12,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 13,35482.0,14902.44,9580.14,34772.36,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 14,39862.0,16742.04,10762.74,39064.76,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 15,44242.0,18581.64,11945.34,43357.16,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 16,48622.0,20421.24,13127.94,47649.56,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 17,53002.0,22260.84,14310.54,51941.96,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 18,61324.0,25756.08,16557.48,60097.52,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 19,70084.0,29435.28,18922.68,68682.32,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 20,78844.0,33114.48,21287.88,77267.12,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 21,87604.0,36793.68,23653.08,85851.92,30
HCPCS,L8699,IMP BONE HUMAN/SYNTHETIC LVL 22,96364.0,40472.88,26018.28,94436.72,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 04,3083.0,1294.86,832.41,3021.34,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 08,11580.0,4863.6,3126.6,11348.4,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP COIL EMBOLIZATION LVL 10,15334.0,6440.28,4140.18,15027.32,30
HCPCS,L8699,IMP CONNECTOR NERVE LVL 01,3853.0,1618.26,1040.31,3775.94,30
HCPCS,L8699,IMP CONNECTOR NERVE LVL 02,6105.0,2564.1,1648.35,5982.9,30
HCPCS,L8699,IMP CONNECTOR NERVE LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP CONNECTOR SPINAL LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP EXPANDER TISSUE LVL 01,2426.0,1018.92,655.02,2377.48,30
HCPCS,L8699,IMP EXPANDER TISSUE LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP EXPANDER TISSUE LVL 03,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP EXPANDER TISSUE LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 04,3083.0,1294.86,832.41,3021.34,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP LIG/TNDN HUMAN/SYNTHETIC LVL 09,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 01,2690.0,1129.8,726.3,2636.2,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 02,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 03,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 04,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 05,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 06,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 07,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 08,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 09,35044.0,14718.48,9461.88,34343.12,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 10,39424.0,16558.08,10644.48,38635.52,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 11,52564.0,22076.88,14192.28,51512.72,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 12,65704.0,27595.68,17740.08,64389.92,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 13,78844.0,33114.48,21287.88,77267.12,30
HCPCS,L8699,IMP ORTHOPEDIC CAGE LVL 14,91984.0,38633.28,24835.68,90144.32,30
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 01,159.0,66.78,42.93,155.82,30
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 02,313.0,131.46,84.51,306.74,30
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 04,1413.0,593.46,381.51,1384.74,30
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 05,1888.0,792.96,509.76,1850.24,30
HCPCS,L8699,IMP ORTHOTIC CAP END LVL 06,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 08,35044.0,14718.48,9461.88,34343.12,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 09,39424.0,16558.08,10644.48,38635.52,30
HCPCS,L8699,IMP PROSTH ANKLE LVL 10,43804.0,18397.68,11827.08,42927.92,30
HCPCS,L8699,IMP PROSTH ENT LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP PROSTH ENT LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,L8699,IMP PROSTH ENT LVL 03,1619.0,679.98,437.13,1586.62,30
HCPCS,L8699,IMP PROSTH ENT LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP PROSTH ENT LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP PROSTH ENT LVL 06,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP PROSTH ENT LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP PROSTH ENT LVL 08,11580.0,4863.6,3126.6,11348.4,30
HCPCS,L8699,IMP PROSTH ENT LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP PROSTH ENT LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP PROSTH ENT LVL 11,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP PROSTH ENT LVL 12,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP PROSTH ENT LVL 13,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 02,1413.0,593.46,381.51,1384.74,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 04,3853.0,1618.26,1040.31,3775.94,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 05,6105.0,2564.1,1648.35,5982.9,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 07,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 08,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP PROSTH MAXILLOFACIAL LVL 09,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 04,3596.0,1510.32,970.92,3524.08,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 05,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 06,6105.0,2564.1,1648.35,5982.9,30
HCPCS,L8699,IMP PROSTH OPHTHALMIC LVL 07,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 01,1614.0,677.88,435.78,1581.72,30
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 02,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 03,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP PROSTH ORTHOPEDIC LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 02,1619.0,679.98,437.13,1586.62,30
HCPCS,L8699,IMP PROSTH PLASTIC SURG LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 01,5368.0,2254.56,1449.36,5260.64,30
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 02,11580.0,4863.6,3126.6,11348.4,30
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 03,15334.0,6440.28,4140.18,15027.32,30
HCPCS,L8699,IMP PROSTH SPHINCTR ANAL LVL 04,19714.0,8279.88,5322.78,19319.72,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 01,6105.0,2564.1,1648.35,5982.9,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP PROSTH TESTICULAR LVL 08,35044.0,14718.48,9461.88,34343.12,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 01,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 02,39424.0,16558.08,10644.48,38635.52,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 03,52564.0,22076.88,14192.28,51512.72,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 04,65704.0,27595.68,17740.08,64389.92,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 05,78844.0,33114.48,21287.88,77267.12,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 06,87604.0,36793.68,23653.08,85851.92,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 07,100744.0,42312.48,27200.88,98729.12,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 08,109504.0,45991.68,29566.08,107313.92,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 09,118264.0,49670.88,31931.28,115898.72,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 10,127024.0,53350.08,34296.48,124483.52,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 11,135784.0,57029.28,36661.68,133068.32,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 12,144544.0,60708.48,39026.88,141653.12,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 13,153304.0,64387.68,41392.08,150237.92,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 14,162064.0,68066.88,43757.28,158822.72,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 15,170824.0,71746.08,46122.48,167407.52,30
HCPCS,L8699,IMP PUMP VALVE BLOOD LVL 16,179584.0,75425.28,48487.68,175992.32,30
HCPCS,L8699,IMP RING CARDIAC LVL 01,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP RING CARDIAC LVL 02,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP RING CARDIAC LVL 03,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP SHUNT LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,L8699,IMP SHUNT LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP SHUNT LVL 03,1132.0,475.44,305.64,1109.36,30
HCPCS,L8699,IMP SHUNT LVL 04,1619.0,679.98,437.13,1586.62,30
HCPCS,L8699,IMP SHUNT LVL 05,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP SHUNT LVL 06,3909.0,1641.78,1055.43,3830.82,30
HCPCS,L8699,IMP SHUNT LVL 07,6487.0,2724.54,1751.49,6357.26,30
HCPCS,L8699,IMP SHUNT LVL 08,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP SHUNT LVL 09,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP SHUNT LVL 10,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP SHUNT LVL 11,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP SHUNT LVL 12,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP SHUNT LVL 13,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP STENT NOS LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP STENT NOS LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,L8699,IMP STENT NOS LVL 03,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP STENT NOS LVL 04,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP STENT NOS LVL 05,6950.0,2919.0,1876.5,6811.0,30
HCPCS,L8699,IMP STENT NOS LVL 06,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP STENT NOS LVL 07,11580.0,4863.6,3126.6,11348.4,30
HCPCS,L8699,IMP STENT NOS LVL 08,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP STENT NOS LVL 09,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP STENT NOS LVL 10,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP STENT NOS LVL 11,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP STENT NOS LVL 12,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP STENT NOS LVL 13,35044.0,14718.48,9461.88,34343.12,30
HCPCS,L8699,IMP STENT NOS LVL 14,39424.0,16558.08,10644.48,38635.52,30
HCPCS,L8699,IMP STENT NOS LVL 15,43804.0,18397.68,11827.08,42927.92,30
HCPCS,L8699,IMP STENT NOS LVL 16,50374.0,21157.08,13600.98,49366.52,30
HCPCS,L8699,IMP STENT NOS LVL 17,56944.0,23916.48,15374.88,55805.12,30
HCPCS,L8699,IMP STENT NOS LVL 22,81034.0,34034.28,21879.18,79413.32,30
HCPCS,L8699,IMP TUBE EAR LVL 01,166.0,69.72,44.82,162.68,30
HCPCS,L8699,IMP TUBE EAR LVL 02,447.0,187.74,120.69,438.06,30
HCPCS,L8699,IMP TUBE EAR LVL 03,709.0,297.78,191.43,694.82,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 01,313.0,131.46,84.51,306.74,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 02,594.0,249.48,160.38,582.12,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 03,850.0,357.0,229.5,833.0,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 04,1132.0,475.44,305.64,1109.36,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 05,1413.0,593.46,381.51,1384.74,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 06,1619.0,679.98,437.13,1586.62,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 07,2157.0,905.94,582.39,2113.86,30
HCPCS,L8699,IMP TUBE TRACH 30+ DAYS LVL 08,2695.0,1131.9,727.65,2641.1,30
HCPCS,L8699,IMP VALVE LVL 01,4885.0,2051.7,1318.95,4787.3,30
HCPCS,L8699,IMP VALVE LVL 02,9265.0,3891.3,2501.55,9079.7,30
HCPCS,L8699,IMP VALVE LVL 03,13895.0,5835.9,3751.65,13617.1,30
HCPCS,L8699,IMP VALVE LVL 04,17524.0,7360.08,4731.48,17173.52,30
HCPCS,L8699,IMP VALVE LVL 05,21904.0,9199.68,5914.08,21465.92,30
HCPCS,L8699,IMP VALVE LVL 06,26284.0,11039.28,7096.68,25758.32,30
HCPCS,L8699,IMP VALVE LVL 07,30664.0,12878.88,8279.28,30050.72,30
HCPCS,L8699,IMP VALVE LVL 08,35044.0,14718.48,9461.88,34343.12,30
HCPCS,L8699,IMP VALVE LVL 09,39424.0,16558.08,10644.48,38635.52,30
HCPCS,L8699,IMP VALVE LVL 10,43804.0,18397.68,11827.08,42927.92,30
HCPCS,L8699,IMP VALVE LVL 11,52564.0,22076.88,14192.28,51512.72,30
HCPCS,L8699,IMP VALVE LVL 12,61324.0,25756.08,16557.48,60097.52,30
HCPCS,L8699,IMP VALVE LVL 13,70084.0,29435.28,18922.68,68682.32,30
HCPCS,L8699,IMP VALVE LVL 14,83224.0,34954.08,22470.48,81559.52,30
HCPCS,L8699,IMP VALVE LVL 15,96364.0,40472.88,26018.28,94436.72,30
HCPCS,L8699,IMP VALVE LVL 16,109504.0,45991.68,29566.08,107313.92,30
HCPCS,L8699,IMP VALVE LVL 17,122644.0,51510.48,33113.88,120191.12,30
HCPCS,L8699,IMP VALVE LVL 18,140164.0,58868.88,37844.28,137360.72,30
HCPCS,L8699,IMP VALVE LVL 19,157684.0,66227.28,42574.68,154530.32,30
HCPCS,P9010,BLOOD WHOLE LR EA UNIT,650.0,273.0,175.5,637.0,37
HCPCS,P9011,BLOOD UNIT SPLIT DEGLYCEROLIZED,404.0,169.68,109.08,395.92,37
HCPCS,P9011,BLOOD UNIT SPLIT PLASMA FROZEN,54.0,22.68,14.58,225.97,37
HCPCS,P9011,BLOOD UNIT SPLIT PLATELET ALIQUOTS,379.0,159.18,102.33,371.42,37
HCPCS,P9011,BLOOD UNIT SPLIT PLATELET PTHGN RDC,379.0,159.18,102.33,371.42,37
HCPCS,P9011,BLOOD UNIT SPLIT RBC LR,135.0,56.7,36.45,225.97,37
HCPCS,P9012,CRYOPRECIPITATE EA UNIT,89.0,37.38,24.03,104.33,37
HCPCS,P9016,RBC LR AUTO EA UNIT,714.0,299.88,184.91,699.72,37
HCPCS,P9016,RBC LR EA UNIT,294.0,123.48,79.38,288.12,37
HCPCS,P9017,FFP FRZ WITHIN 8 HRS COLL EA UNIT,93.0,39.06,25.11,124.67,37
HCPCS,P9017,FFP FRZ WITHIN 8 HRS COLL PHER EA,93.0,39.06,25.11,124.67,37
HCPCS,P9022,RBC WASHED EA UNIT,441.0,185.22,119.07,534.44,37
HCPCS,P9022,RBC WASHED IRRD LR EA UNIT,497.0,208.74,134.19,534.44,37
HCPCS,P9035,PLATELETS PHER LR EA UNIT,731.0,307.02,197.37,741.81,37
HCPCS,P9035,PLATELETS PHER LR LOW YIELD EA,1875.0,787.5,506.25,1837.5,37
HCPCS,P9037,PLATELETS PHER LR IRRD EA UNIT,787.0,330.54,212.49,986.88,37
HCPCS,P9037,PLATELETS PHER LR IRRD LOW YIELD EA,2042.0,857.64,551.34,2001.16,37
HCPCS,P9037,PLATELETS PHER LR IRRD WASHED EA,934.0,392.28,252.18,986.88,37
HCPCS,P9040,RBC LR IRRD EA UNIT,350.0,147.0,94.5,384.84,37
HCPCS,P9044,PLASMA CRYOPRECIPITATE RDC EA UNIT,442.0,185.64,119.34,433.16,37
HCPCS,P9050,GRANULOCYTES PHER IRRD EA UNIT,5385.0,2261.7,1453.95,5277.3,30
HCPCS,P9054,RBC DGLC LR EA UNIT,891.0,374.22,240.57,873.18,37
HCPCS,P9056,BLOOD WHOLE LR IRRD EA UNIT,706.0,296.52,84.55,691.88,37
HCPCS,P9057,RBC LR IRRD DGLC EA UNIT,700.0,294.0,189.0,686.0,37
HCPCS,P9059,FFP FRZ 8-24 HRS AFTER COLL EA UNIT,93.0,39.06,25.11,106.97,37
HCPCS,P9073,PLATELETS PATHOGEN PHER LOW YIELDEA,1875.0,787.5,506.25,1837.5,37
HCPCS,P9073,PLATELETS PATHOGEN RDC EA UNIT,1875.0,787.5,506.25,1837.5,37
HCPCS,P9073,PLATELETS PATHOGEN RDC LOW YIELD EA,1875.0,787.5,506.25,1837.5,37
HCPCS,P9073,PLATELETS PATHOGEN RDC VOL RDC EA,1752.0,735.84,473.04,1716.96,37
HCPCS,P9073,PLATELETS PATHOGEN RDC WASHED EA,1752.0,735.84,473.04,1716.96,37
HCPCS,P9100,TEST PATHOGENS PLATELETS,240.0,100.8,60.27,235.2,37
HCPCS,P9612,CATH COLLECT SPEC URINE,37.0,15.54,9.34,36.26,37
HCPCS,P9612,ED CATH COLLECT SPEC URINE,37.0,15.54,9.34,36.26,37
HCPCS,Q0114,POC FERN,66.0,27.72,9.74,64.68,37
HCPCS,Q4081,EPO ALFA ESRD/100U 4KU SNIJ,4.9,2.06,1.32,4.8,30
HCPCS,Q4104,INTGR BM FIX INT 10X25/SC,118.6,49.81,32.02,184.35,37
HCPCS,Q4104,INTGR BM FIX INT 20X25/SC,93.9,39.44,25.35,184.35,37
HCPCS,Q4133,STRAVIX/STRAVPL PRIM FIX INT 3X6/SC,465.3,195.43,125.63,455.99,37
HCPCS,Q4151,AMNIOBAND FIX INT 4X4/SC,506.1,212.56,127.14,495.98,37
HCPCS,Q4166,CYTAL MTRX 2LYR FIX INT 5X5/SC,520.4,218.57,127.14,509.99,37
HCPCS,Q4166,CYTAL MTRX 3LYR FIX INT 5X5/SC,109.9,46.16,29.67,184.35,37
HCPCS,Q4166,CYTAL MTRX 3LYR FIX INT 7X10/SC,87.9,36.92,23.73,184.35,37
HCPCS,Q4432,DURAGEN CL 2.5X2.5/SH,950.8,399.34,127.14,931.78,37
HCPCS,Q4432,DURAGEN CL 2.5X2.5/SH 5/PKG,854.4,358.85,127.14,837.31,37
HCPCS,Q4432,DURAGEN CL 7.5X7.5/SH,1823.8,766.0,127.14,1787.32,37
HCPCS,Q4432,DURAGEN CL 7.5X7.5/SH 5/PKG,2028.5,851.97,127.14,1987.93,37
HCPCS,Q4432,DURAGEN PL 2.5X2.5/SH,841.0,353.22,127.14,824.18,37
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 2KU SNIJ,3.4,1.43,0.918,3.33,30
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 3KU SNIJ,3.4,1.43,0.918,3.33,30
HCPCS,Q5105,EPO ALFA EPBX ESRD/100U 4KU SNIJ,3.4,1.43,0.918,3.33,30
HCPCS,Q9966,IOHEXOL 240MG/1ML 4.8GM/20ML SNIJ,6.1,2.56,1.65,5.98,30
HCPCS,S3620,LAB SCR METABOLIC NEWBORN,157.0,65.94,42.39,153.86,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,V2630,LENS INTRAOCULAR CHAM ANT LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,V2631,LENS INTRAOCULAR IRIS LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,V2632,LENS INTRAOCULAR CHAM POST LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,V2787,LENS INTRAOCULAR ASTIGMATISM LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 01,594.0,249.48,160.38,582.12,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 02,1132.0,475.44,305.64,1109.36,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 03,2157.0,905.94,582.39,2113.86,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 04,2695.0,1131.9,727.65,2641.1,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 05,3853.0,1618.26,1040.31,3775.94,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 06,4885.0,2051.7,1318.95,4787.3,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 07,6105.0,2564.1,1648.35,5982.9,30
HCPCS,V2788,LENS INTRAOCULAR PRESBYOPIA LVL 08,6950.0,2919.0,1876.5,6811.0,30
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 01,2695.0,1131.9,727.65,2641.1,30
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 02,3853.0,1618.26,1040.31,3775.94,30
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 03,6105.0,2564.1,1648.35,5982.9,30
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 04,9265.0,3891.3,2501.55,9079.7,30
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 05,13895.0,5835.9,3751.65,13617.1,30
HCPCS,V2790,IMP MEMBRANE AMNIO OCULAR LVL 06,17524.0,7360.08,4731.48,17173.52,30
MS-DRG,001,MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,364864.99,233470.78,654358.06,10
MS-DRG,002,MS-DRG 42.00: HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,164855.05,94406.71,264597.53,10
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",,287055.67,176829.91,495608.42,11
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",,197923.0,115397.82,323430.19,11
MS-DRG,005,MS-DRG 42.00: LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,139353.95,85898.14,240750.17,10
MS-DRG,006,MS-DRG 42.00: LIVER TRANSPLANT WITHOUT MCC,,65126.09,38631.44,108273.95,10
MS-DRG,007,MS-DRG 42.00: LUNG TRANSPLANT,,165151.26,107889.8,302387.17,10
MS-DRG,008,MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,70848.36,46692.66,130867.41,10
MS-DRG,010,MS-DRG 42.00: PANCREAS TRANSPLANT,,,55420.9,95650.69,10
MS-DRG,011,"MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,69421.16,45438.83,127353.24,11
MS-DRG,012,"MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,53923.92,35124.05,98443.6,11
MS-DRG,013,"MS-DRG 42.00: TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,36164.71,24008.66,67290.03,11
MS-DRG,014,MS-DRG 42.00: ALLOGENEIC BONE MARROW TRANSPLANT,,154312.62,100122.7,280617.97,10
MS-DRG,016,MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,83168.05,49401.09,138458.49,10
MS-DRG,017,MS-DRG 42.00: AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,83168.05,45257.19,112974.3,10
MS-DRG,018,MS-DRG 42.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,496059.66,359761.55,1008318.38,10
MS-DRG,019,MS-DRG 42.00: SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,107632.41,59439.27,154745.12,10
MS-DRG,020,MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,113798.99,65556.0,183736.48,11
MS-DRG,021,MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,82683.34,44103.35,123610.23,11
MS-DRG,022,MS-DRG 42.00: INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,52819.86,26471.33,71803.59,11
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,,76328.26,47739.88,133802.51,11
MS-DRG,024,MS-DRG 42.00: CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,51015.66,32590.57,91342.87,11
MS-DRG,025,MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,59457.68,37879.14,106165.45,11
MS-DRG,026,MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,39759.63,25903.16,72599.82,11
MS-DRG,027,MS-DRG 42.00: CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,32758.28,21018.62,58909.71,11
MS-DRG,028,MS-DRG 42.00: SPINAL PROCEDURES WITH MCC,,81134.97,50055.93,140293.8,11
MS-DRG,029,MS-DRG 42.00: SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,46155.1,28422.47,79660.86,11
MS-DRG,030,MS-DRG 42.00: SPINAL PROCEDURES WITHOUT CC/MCC,,31223.36,18288.5,51257.92,11
MS-DRG,031,MS-DRG 42.00: VENTRICULAR SHUNT PROCEDURES WITH MCC,,55431.9,37327.63,104619.68,11
MS-DRG,032,MS-DRG 42.00: VENTRICULAR SHUNT PROCEDURES WITH CC,,29001.78,17753.63,49758.85,11
MS-DRG,033,MS-DRG 42.00: VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,21852.31,13853.85,38828.71,11
MS-DRG,034,MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH MCC,,52523.65,32247.31,90380.85,11
MS-DRG,035,MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH CC,,30967.54,19915.56,55818.18,11
MS-DRG,036,MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,24343.18,16185.74,45364.38,11
MS-DRG,037,MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH MCC,,45454.97,27426.91,76870.54,11
MS-DRG,038,MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITH CC,,21542.64,13518.09,37887.71,11
MS-DRG,039,MS-DRG 42.00: EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,15362.59,9793.23,27447.92,11
MS-DRG,040,"MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,51850.44,32168.16,90159.02,11
MS-DRG,041,"MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,30038.52,18317.66,51339.64,11
MS-DRG,042,"MS-DRG 42.00: PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,23427.62,14393.69,40341.79,11
MS-DRG,052,MS-DRG 42.00: SPINAL DISORDERS AND INJURIES WITH CC/MCC,,26187.77,15090.17,41581.68,11
MS-DRG,053,MS-DRG 42.00: SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,13248.72,8157.85,22864.32,11
MS-DRG,054,MS-DRG 42.00: NERVOUS SYSTEM NEOPLASMS WITH MCC,,19846.16,12720.8,35653.11,11
MS-DRG,055,MS-DRG 42.00: NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,14447.03,8494.42,23807.66,11
MS-DRG,056,MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,32233.17,19354.04,54244.39,11
MS-DRG,057,MS-DRG 42.00: DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,18351.64,10793.81,30252.26,11
MS-DRG,058,MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,23266.05,14242.08,39916.82,11
MS-DRG,059,MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,15981.95,10338.1,28975.01,11
MS-DRG,060,MS-DRG 42.00: MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,12077.34,7662.97,21477.33,11
MS-DRG,061,"MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,37740.01,22969.76,64378.29,11
MS-DRG,062,"MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,25204.89,14639.48,41030.62,11
MS-DRG,063,"MS-DRG 42.00: ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,20021.19,11695.22,32778.73,11
MS-DRG,064,MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,26968.69,16753.91,46956.85,11
MS-DRG,065,MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,13679.58,8416.94,23590.51,11
MS-DRG,066,MS-DRG 42.00: INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,9263.33,5701.83,15980.74,11
MS-DRG,067,MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,19078.7,12235.94,34294.14,11
MS-DRG,068,MS-DRG 42.00: NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,11727.27,7201.43,20183.74,11
MS-DRG,069,MS-DRG 42.00: TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,10757.86,6654.91,18651.98,11
MS-DRG,070,MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,,24100.83,13869.67,38873.08,11
MS-DRG,071,MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,,14298.93,8547.73,23957.1,11
MS-DRG,072,MS-DRG 42.00: NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,10542.43,6300.0,17657.27,11
MS-DRG,073,MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,20371.26,13365.63,37460.4,11
MS-DRG,074,MS-DRG 42.00: CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,13814.22,8587.73,24069.18,11
MS-DRG,075,MS-DRG 42.00: VIRAL MENINGITIS WITH CC/MCC,,25770.38,15974.95,44773.62,11
MS-DRG,076,MS-DRG 42.00: VIRAL MENINGITIS WITHOUT CC/MCC,,12427.41,6874.86,17484.48,11
MS-DRG,077,MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH MCC,,20344.33,14770.33,23632.53,8
MS-DRG,078,MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITH CC,,13693.04,9532.0,15251.2,8
MS-DRG,079,MS-DRG 42.00: HYPERTENSIVE ENCEPHALOPATHY WITHOUT CC/MCC,,9976.93,6368.35,10189.36,8
MS-DRG,080,MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITH MCC,,29742.31,15079.35,42263.5,11
MS-DRG,081,MS-DRG 42.00: NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,12252.38,7461.36,20912.26,11
MS-DRG,082,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,30671.33,19041.64,53368.76,11
MS-DRG,083,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,18257.39,11628.58,32591.93,11
MS-DRG,084,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,12387.02,7962.88,22317.93,11
MS-DRG,085,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,30604.01,18927.49,53048.86,11
MS-DRG,086,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,17732.29,10852.97,30418.04,11
MS-DRG,087,MS-DRG 42.00: TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,11929.24,7620.47,21358.24,11
MS-DRG,088,MS-DRG 42.00: CONCUSSION WITH MCC,,20654.01,11262.03,31564.53,11
MS-DRG,089,MS-DRG 42.00: CONCUSSION WITH CC,,15483.77,9152.59,25652.31,11
MS-DRG,090,MS-DRG 42.00: CONCUSSION WITHOUT CC/MCC,,12588.98,6858.19,19221.72,11
MS-DRG,091,MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,24087.36,14631.13,41007.27,11
MS-DRG,092,MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,13814.22,8522.76,23887.05,11
MS-DRG,093,MS-DRG 42.00: OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,10421.25,6634.08,18593.6,11
MS-DRG,094,MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,48780.61,29320.59,82177.99,11
MS-DRG,095,MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,32098.53,21487.65,60224.32,11
MS-DRG,096,MS-DRG 42.00: BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,29351.85,21487.65,60224.32,11
MS-DRG,097,MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,48969.11,30090.37,84335.53,11
MS-DRG,098,MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,29015.24,19119.11,53585.92,11
MS-DRG,099,MS-DRG 42.00: NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,17772.68,11350.34,31812.04,11
MS-DRG,100,MS-DRG 42.00: SEIZURES WITH MCC,,26699.41,16135.73,45224.28,11
MS-DRG,101,MS-DRG 42.00: SEIZURES WITHOUT MCC,,12252.38,7519.68,21075.71,11
MS-DRG,102,MS-DRG 42.00: HEADACHES WITH MCC,,16251.23,9338.37,26173.01,11
MS-DRG,103,MS-DRG 42.00: HEADACHES WITHOUT MCC,,11336.81,6967.32,19527.6,11
MS-DRG,113,MS-DRG 42.00: ORBITAL PROCEDURES WITH CC/MCC,,33754.62,19587.32,54898.18,11
MS-DRG,114,MS-DRG 42.00: ORBITAL PROCEDURES WITHOUT CC/MCC,,16587.83,11272.02,31592.55,11
MS-DRG,115,MS-DRG 42.00: EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,21057.93,12787.46,35839.92,11
MS-DRG,116,MS-DRG 42.00: INTRAOCULAR PROCEDURES WITH CC/MCC,,24652.86,15063.52,42219.14,11
MS-DRG,117,MS-DRG 42.00: INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,16130.05,9038.44,25332.42,11
MS-DRG,121,MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,17247.58,9691.6,27163.06,11
MS-DRG,122,MS-DRG 42.00: ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,10030.79,6546.61,18348.43,11
MS-DRG,123,MS-DRG 42.00: NEUROLOGICAL EYE DISORDERS,,10825.18,6653.24,18647.31,11
MS-DRG,124,MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,17799.61,11022.92,30894.38,11
MS-DRG,125,MS-DRG 42.00: OTHER DISORDERS OF THE EYE WITHOUT MCC,,10744.39,6396.63,17928.13,11
MS-DRG,135,MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITH CC/MCC,,35706.92,18078.55,49389.92,11
MS-DRG,136,MS-DRG 42.00: SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,8458.59,23707.26,11
MS-DRG,137,MS-DRG 42.00: MOUTH PROCEDURES WITH CC/MCC,,20263.55,12440.04,34866.22,11
MS-DRG,138,MS-DRG 42.00: MOUTH PROCEDURES WITHOUT CC/MCC,,11659.95,7383.04,20692.77,11
MS-DRG,139,MS-DRG 42.00: SALIVARY GLAND PROCEDURES,,15995.41,10294.78,28220.81,11
MS-DRG,140,MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH MCC,,50867.56,35534.77,99594.76,11
MS-DRG,141,MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITH CC,,27897.72,18171.02,50928.68,11
MS-DRG,142,MS-DRG 42.00: MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,20802.11,13299.82,37275.94,11
MS-DRG,143,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,44781.76,31213.41,87483.11,11
MS-DRG,144,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,23306.44,14437.02,40463.21,11
MS-DRG,145,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,16439.73,10016.52,28073.71,11
MS-DRG,146,"MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,28422.82,17640.34,49441.29,11
MS-DRG,147,"MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,16641.69,10593.02,29689.53,11
MS-DRG,148,"MS-DRG 42.00: EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,6640.73,18612.28,11
MS-DRG,149,MS-DRG 42.00: DYSEQUILIBRIUM,,10030.79,6261.67,17549.86,11
MS-DRG,150,MS-DRG 42.00: EPISTAXIS WITH MCC,,17705.36,11092.9,31090.53,11
MS-DRG,151,MS-DRG 42.00: EPISTAXIS WITHOUT MCC,,10380.86,6115.07,17138.9,11
MS-DRG,152,MS-DRG 42.00: OTITIS MEDIA AND URI WITH MCC,,15995.41,9849.07,27604.37,11
MS-DRG,153,MS-DRG 42.00: OTITIS MEDIA AND URI WITHOUT MCC,,9896.15,6150.04,17236.97,11
MS-DRG,154,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,20707.86,13025.73,36507.72,11
MS-DRG,155,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,12750.55,7635.49,21400.28,11
MS-DRG,156,"MS-DRG 42.00: OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,8832.48,5757.65,16137.18,11
MS-DRG,157,MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH MCC,,22983.3,14302.89,40087.28,11
MS-DRG,158,MS-DRG 42.00: DENTAL AND ORAL DISEASES WITH CC,,12642.84,7579.66,21243.83,11
MS-DRG,159,MS-DRG 42.00: DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,9088.3,5902.6,16543.47,11
MS-DRG,163,MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH MCC,,63470.0,37338.47,104650.03,11
MS-DRG,164,MS-DRG 42.00: MAJOR CHEST PROCEDURES WITH CC,,34333.58,21027.78,58935.4,11
MS-DRG,165,MS-DRG 42.00: MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,25258.74,15947.45,44696.57,11
MS-DRG,166,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,54637.52,31139.27,87275.29,11
MS-DRG,167,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,24504.75,15024.35,42109.39,11
MS-DRG,168,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,18257.39,11383.66,31905.44,11
MS-DRG,173,MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,41402.26,24796.77,69498.94,11
MS-DRG,175,MS-DRG 42.00: PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,18890.2,11443.64,32073.56,11
MS-DRG,176,MS-DRG 42.00: PULMONARY EMBOLISM WITHOUT MCC,,10986.75,6706.56,18796.75,11
MS-DRG,177,MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,22835.2,13019.06,36489.04,11
MS-DRG,178,MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,13289.12,8131.18,22789.6,11
MS-DRG,179,MS-DRG 42.00: RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,10273.15,6290.0,17629.25,11
MS-DRG,180,MS-DRG 42.00: RESPIRATORY NEOPLASMS WITH MCC,,23400.69,14712.77,41236.1,11
MS-DRG,181,MS-DRG 42.00: RESPIRATORY NEOPLASMS WITH CC,,14824.03,8922.64,25007.85,11
MS-DRG,182,MS-DRG 42.00: RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,10757.86,6280.0,17372.4,11
MS-DRG,183,MS-DRG 42.00: MAJOR CHEST TRAUMA WITH MCC,,21206.04,12745.81,35723.17,11
MS-DRG,184,MS-DRG 42.00: MAJOR CHEST TRAUMA WITH CC,,14164.29,8865.16,24846.74,11
MS-DRG,185,MS-DRG 42.00: MAJOR CHEST TRAUMA WITHOUT CC/MCC,,10178.9,6552.43,18364.78,11
MS-DRG,186,MS-DRG 42.00: PLEURAL EFFUSION WITH MCC,,20896.36,12984.08,36390.97,11
MS-DRG,187,MS-DRG 42.00: PLEURAL EFFUSION WITH CC,,13410.29,8240.32,23095.49,11
MS-DRG,188,MS-DRG 42.00: PLEURAL EFFUSION WITHOUT CC/MCC,,10057.72,5975.07,16746.62,11
MS-DRG,189,MS-DRG 42.00: PULMONARY EDEMA AND RESPIRATORY FAILURE,,16587.83,10292.27,28846.59,11
MS-DRG,190,MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,14837.49,9228.38,25864.79,11
MS-DRG,191,MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,11431.06,7023.15,19684.05,11
MS-DRG,192,MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,8643.98,5348.59,14990.7,11
MS-DRG,193,MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,17866.93,10950.43,30691.24,11
MS-DRG,194,MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITH CC,,11067.53,6714.05,18817.76,11
MS-DRG,195,MS-DRG 42.00: SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,8428.56,5236.12,14675.48,11
MS-DRG,196,MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH MCC,,25514.56,15722.53,44066.12,11
MS-DRG,197,MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITH CC,,13437.22,7907.07,22161.49,11
MS-DRG,198,MS-DRG 42.00: INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,10475.11,5966.76,16723.27,11
MS-DRG,199,MS-DRG 42.00: PNEUMOTHORAX WITH MCC,,23885.4,14696.95,41191.74,11
MS-DRG,200,MS-DRG 42.00: PNEUMOTHORAX WITH CC,,14500.89,9158.41,25668.65,11
MS-DRG,201,MS-DRG 42.00: PNEUMOTHORAX WITHOUT CC/MCC,,9505.69,5957.6,16697.58,11
MS-DRG,202,MS-DRG 42.00: BRONCHITIS AND ASTHMA WITH CC/MCC,,12898.66,8091.18,22677.52,11
MS-DRG,203,MS-DRG 42.00: BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,9357.58,5581.86,15644.5,11
MS-DRG,204,MS-DRG 42.00: RESPIRATORY SIGNS AND SYMPTOMS,,11081.0,6726.56,18852.79,11
MS-DRG,205,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,24370.11,15254.3,42753.85,11
MS-DRG,206,MS-DRG 42.00: OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,12306.23,7840.43,21974.69,11
MS-DRG,207,MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,93010.35,53608.32,150250.24,11
MS-DRG,208,MS-DRG 42.00: RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,36339.74,22899.78,64182.14,11
MS-DRG,212,MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,145022.36,90593.54,253910.23,11
MS-DRG,215,MS-DRG 42.00: OTHER HEART ASSIST SYSTEM IMPLANT,,137536.29,82953.06,232495.95,11
MS-DRG,216,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,130669.57,81501.78,228428.38,11
MS-DRG,217,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,85699.31,54779.68,153533.26,11
MS-DRG,218,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,76705.26,54779.68,153533.26,11
MS-DRG,219,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,103822.06,63968.92,179288.3,11
MS-DRG,220,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,70619.46,44428.26,124520.88,11
MS-DRG,221,MS-DRG 42.00: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,62594.83,41990.55,117688.67,11
MS-DRG,228,MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,67845.85,41217.43,115521.79,11
MS-DRG,229,MS-DRG 42.00: OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,42816.0,26238.91,73540.82,11
MS-DRG,231,MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITH MCC,,109261.57,70230.6,196838.17,11
MS-DRG,232,MS-DRG 42.00: CORONARY BYPASS WITH PTCA WITHOUT MCC,,80098.23,50508.3,141561.71,11
MS-DRG,233,MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,105020.37,63693.15,178515.42,11
MS-DRG,234,MS-DRG 42.00: CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,69986.65,45510.46,127554.04,11
MS-DRG,235,MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,79182.66,48892.07,137031.81,11
MS-DRG,236,MS-DRG 42.00: CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,54408.63,34897.44,97808.48,11
MS-DRG,239,MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,64722.17,41003.33,114921.7,11
MS-DRG,240,MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,37820.8,23747.89,66559.18,11
MS-DRG,241,MS-DRG 42.00: AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,18769.02,11533.61,32325.74,11
MS-DRG,242,MS-DRG 42.00: PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,46518.64,26599.64,74551.88,11
MS-DRG,243,MS-DRG 42.00: PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,30671.33,17752.81,49756.51,11
MS-DRG,244,MS-DRG 42.00: PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,24639.39,15058.52,42205.12,11
MS-DRG,245,MS-DRG 42.00: AICD GENERATOR PROCEDURES,,61006.06,38009.95,106532.04,11
MS-DRG,250,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,31654.22,18182.68,50961.38,11
MS-DRG,251,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,21367.61,12450.87,34896.57,11
MS-DRG,252,MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH MCC,,45158.76,29061.48,81451.8,11
MS-DRG,253,MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITH CC,,34347.05,21624.26,60607.26,11
MS-DRG,254,MS-DRG 42.00: OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,23360.3,14843.58,41602.69,11
MS-DRG,255,MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,36986.02,22472.4,62984.29,11
MS-DRG,256,MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,22081.21,14145.44,39645.96,11
MS-DRG,257,MS-DRG 42.00: UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,13342.97,9099.27,25502.87,11
MS-DRG,258,MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,36474.38,26177.24,73368.04,11
MS-DRG,259,MS-DRG 42.00: CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,25137.57,16846.37,47216.04,11
MS-DRG,260,MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,44633.66,27099.51,75952.88,11
MS-DRG,261,MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,25339.53,15750.0,44143.18,11
MS-DRG,262,MS-DRG 42.00: CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,22148.53,13578.91,38058.17,11
MS-DRG,263,MS-DRG 42.00: VEIN LIGATION AND STRIPPING,,38036.22,25471.61,71390.29,11
MS-DRG,264,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,43973.91,27830.98,78003.01,11
MS-DRG,265,MS-DRG 42.00: AICD LEAD PROCEDURES,,47582.3,30143.68,84484.97,11
MS-DRG,266,MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,84097.08,51056.5,143098.14,11
MS-DRG,267,MS-DRG 42.00: ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,65705.05,39662.85,111164.68,11
MS-DRG,268,MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,92296.75,67283.31,160598.96,11
MS-DRG,269,MS-DRG 42.00: AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,55997.4,35184.03,98611.72,11
MS-DRG,270,MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,68088.2,43957.55,123201.6,11
MS-DRG,271,MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,46532.1,29628.01,83039.6,11
MS-DRG,272,MS-DRG 42.00: OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,32852.53,21269.37,59612.55,11
MS-DRG,273,MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,52469.79,34370.08,96330.43,11
MS-DRG,274,MS-DRG 42.00: PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,43637.31,27423.58,76861.2,11
MS-DRG,275,MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,94733.76,59404.3,166494.84,11
MS-DRG,276,MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,83612.37,50041.78,140254.11,11
MS-DRG,277,MS-DRG 42.00: CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,64385.56,38477.34,107841.98,11
MS-DRG,278,MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,60050.11,46372.74,129970.77,11
MS-DRG,279,MS-DRG 42.00: ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,43098.74,30045.38,84209.44,11
MS-DRG,280,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,21367.61,13363.97,37455.74,11
MS-DRG,281,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,12292.77,7657.14,21460.99,11
MS-DRG,282,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,9667.26,6024.23,16884.38,11
MS-DRG,283,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,26537.84,16502.3,46251.68,11
MS-DRG,284,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,9963.47,5766.81,16162.87,11
MS-DRG,285,"MS-DRG 42.00: ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,6583.97,4989.52,13984.32,11
MS-DRG,286,"MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,29028.71,18435.12,51668.88,11
MS-DRG,287,"MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,14568.21,8915.13,24986.83,11
MS-DRG,288,MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,34912.54,22545.71,63189.77,11
MS-DRG,289,MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,19900.01,14220.39,39856.11,11
MS-DRG,290,MS-DRG 42.00: ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,14608.6,7745.45,21708.49,11
MS-DRG,291,MS-DRG 42.00: HEART FAILURE AND SHOCK WITH MCC,,17287.97,10695.51,29976.73,11
MS-DRG,292,MS-DRG 42.00: HEART FAILURE AND SHOCK WITH CC,,11538.78,7073.12,19824.15,11
MS-DRG,293,MS-DRG 42.00: HEART FAILURE AND SHOCK WITHOUT CC/MCC,,7566.85,4715.42,13216.1,11
MS-DRG,294,MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITH CC/MCC,,14729.78,11729.92,18767.87,8
MS-DRG,295,MS-DRG 42.00: DEEP VEIN THROMBOPHLEBITIS WITHOUT CC/MCC,,10730.93,7544.21,12070.74,8
MS-DRG,296,"MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH MCC",,21583.03,13012.4,36470.36,11
MS-DRG,297,"MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITH CC",,9815.37,5281.94,14558.73,11
MS-DRG,298,"MS-DRG 42.00: CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,5924.23,3791.51,10626.58,11
MS-DRG,299,MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITH MCC,,21219.5,13602.24,38123.54,11
MS-DRG,300,MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITH CC,,14366.25,8893.48,24926.12,11
MS-DRG,301,MS-DRG 42.00: PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,9559.55,5995.91,16804.99,11
MS-DRG,302,MS-DRG 42.00: ATHEROSCLEROSIS WITH MCC,,15093.31,9969.02,27940.61,11
MS-DRG,303,MS-DRG 42.00: ATHEROSCLEROSIS WITHOUT MCC,,8859.41,5608.53,15719.22,11
MS-DRG,304,MS-DRG 42.00: HYPERTENSION WITH MCC,,15470.31,9914.04,27786.5,11
MS-DRG,305,MS-DRG 42.00: HYPERTENSION WITHOUT MCC,,10151.97,6290.84,17631.58,11
MS-DRG,306,MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,20694.4,13128.2,36794.93,11
MS-DRG,307,MS-DRG 42.00: CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,12696.69,7607.99,21323.22,11
MS-DRG,308,MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,16183.91,10030.69,28113.4,11
MS-DRG,309,MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,10030.79,6129.22,17178.6,11
MS-DRG,310,MS-DRG 42.00: CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,7445.67,4716.26,13218.43,11
MS-DRG,311,MS-DRG 42.00: ANGINA PECTORIS,,9397.98,5847.62,16389.37,11
MS-DRG,312,MS-DRG 42.00: SYNCOPE AND COLLAPSE,,11633.03,7261.4,20351.86,11
MS-DRG,313,MS-DRG 42.00: CHEST PAIN,,9748.04,5998.41,16812.0,11
MS-DRG,314,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,28193.93,17372.08,48689.42,11
MS-DRG,315,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,13019.83,8025.37,22493.06,11
MS-DRG,316,MS-DRG 42.00: OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,9330.66,5682.66,15927.03,11
MS-DRG,317,MS-DRG 42.00: CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,55706.1,156129.77,11
MS-DRG,319,MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,58730.62,37181.0,104208.71,11
MS-DRG,320,MS-DRG 42.00: OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,29971.2,20038.87,56163.75,11
MS-DRG,321,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,38709.43,22667.35,63530.68,11
MS-DRG,322,MS-DRG 42.00: PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,24545.14,17246.62,41166.05,11
MS-DRG,323,MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,55741.58,36052.14,101044.79,11
MS-DRG,324,MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,39975.06,26251.38,73575.85,11
MS-DRG,325,MS-DRG 42.00: CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,35599.21,26746.25,74962.84,11
MS-DRG,326,"MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,68384.42,41550.69,116455.79,11
MS-DRG,327,"MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,33619.98,20362.96,57072.07,11
MS-DRG,328,"MS-DRG 42.00: STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,21502.25,13348.98,37413.71,11
MS-DRG,329,MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,60817.56,38294.04,107328.27,11
MS-DRG,330,MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,31936.96,19971.39,55974.62,11
MS-DRG,331,MS-DRG 42.00: MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,22512.06,14020.47,39295.71,11
MS-DRG,332,MS-DRG 42.00: RECTAL RESECTION WITH MCC,,49198.0,30164.52,84543.35,11
MS-DRG,333,MS-DRG 42.00: RECTAL RESECTION WITH CC,,28005.43,19513.17,54690.37,11
MS-DRG,334,MS-DRG 42.00: RECTAL RESECTION WITHOUT CC/MCC,,21609.96,13645.56,38244.96,11
MS-DRG,335,MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITH MCC,,48134.33,29749.64,83380.51,11
MS-DRG,336,MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITH CC,,28342.03,17567.86,49238.14,11
MS-DRG,337,MS-DRG 42.00: PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,20142.37,12788.3,35842.25,11
MS-DRG,344,MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,36891.77,21517.64,60308.38,11
MS-DRG,345,MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,20748.25,12535.85,35134.75,11
MS-DRG,346,MS-DRG 42.00: MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,17341.82,9882.4,27697.77,11
MS-DRG,347,MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH MCC,,34320.12,19124.94,53602.26,11
MS-DRG,348,MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITH CC,,17516.86,10903.8,30560.48,11
MS-DRG,349,MS-DRG 42.00: ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,13141.01,7253.08,20328.51,11
MS-DRG,350,MS-DRG 42.00: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,32313.96,20760.35,58185.86,11
MS-DRG,351,MS-DRG 42.00: INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,19603.8,12700.8,35597.07,11
MS-DRG,352,MS-DRG 42.00: INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,14931.74,9729.1,27268.13,11
MS-DRG,353,MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,39369.17,24176.93,67761.7,11
MS-DRG,354,MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,23131.41,14016.29,39284.04,11
MS-DRG,355,MS-DRG 42.00: HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,18351.64,11205.37,31405.75,11
MS-DRG,356,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,57613.1,36597.01,102571.88,11
MS-DRG,357,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,29580.74,19374.04,54300.43,11
MS-DRG,358,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,17247.58,11646.08,32640.97,11
MS-DRG,368,MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH MCC,,22242.78,13262.32,37170.86,11
MS-DRG,369,MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITH CC,,13302.58,8332.78,23354.67,11
MS-DRG,370,MS-DRG 42.00: MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,10017.33,5838.45,16363.68,11
MS-DRG,371,MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,23535.33,14771.93,41401.89,11
MS-DRG,372,MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,14029.64,8506.09,23840.35,11
MS-DRG,373,MS-DRG 42.00: MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,9653.8,6060.07,16984.79,11
MS-DRG,374,MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH MCC,,28261.25,17817.8,49938.64,11
MS-DRG,375,MS-DRG 42.00: DIGESTIVE MALIGNANCY WITH CC,,16130.05,10077.35,28244.16,11
MS-DRG,376,MS-DRG 42.00: DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,11996.56,7700.47,21582.4,11
MS-DRG,377,MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH MCC,,24100.83,15229.31,42683.8,11
MS-DRG,378,MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITH CC,,13248.72,8170.34,22899.35,11
MS-DRG,379,MS-DRG 42.00: GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,8522.81,5251.94,14719.84,11
MS-DRG,380,MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC,,26241.63,16347.34,45817.37,11
MS-DRG,381,MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC,,14447.03,9026.78,25299.72,11
MS-DRG,382,MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,10192.36,6669.9,18694.01,11
MS-DRG,383,MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITH MCC,,18822.88,11502.8,32239.35,11
MS-DRG,384,MS-DRG 42.00: UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,11794.6,7121.45,19959.58,11
MS-DRG,385,MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH MCC,,21098.32,13182.33,36946.71,11
MS-DRG,386,MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITH CC,,13087.15,8133.69,22796.6,11
MS-DRG,387,MS-DRG 42.00: INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,9209.48,5675.99,15908.35,11
MS-DRG,388,MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH MCC,,19576.87,12303.41,34483.28,11
MS-DRG,389,MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITH CC,,10717.46,6579.91,18441.83,11
MS-DRG,390,MS-DRG 42.00: GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,7526.46,4532.15,12702.4,11
MS-DRG,391,"MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,17180.25,10566.37,29614.81,11
MS-DRG,392,"MS-DRG 42.00: ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,10582.82,6494.96,18203.66,11
MS-DRG,393,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,21811.92,13323.96,37343.65,11
MS-DRG,394,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,12615.91,7795.45,21848.6,11
MS-DRG,395,MS-DRG 42.00: OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,8724.77,5406.9,15154.15,11
MS-DRG,397,MS-DRG 42.00: APPENDIX PROCEDURES WITH MCC,,30253.94,19952.23,55920.92,11
MS-DRG,398,MS-DRG 42.00: APPENDIX PROCEDURES WITH CC,,20371.26,12610.0,35342.56,11
MS-DRG,399,MS-DRG 42.00: APPENDIX PROCEDURES WITHOUT CC/MCC,,14985.6,9536.62,26728.74,11
MS-DRG,402,MS-DRG 42.00: SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,33495.31,93878.68,11
MS-DRG,405,"MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,74120.14,45575.44,127736.18,11
MS-DRG,406,"MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,38871.0,24161.93,67719.67,11
MS-DRG,407,"MS-DRG 42.00: PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,28961.39,18491.77,51827.66,11
MS-DRG,408,MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,50113.56,29705.48,83256.76,11
MS-DRG,409,MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,26349.34,18139.38,50839.96,11
MS-DRG,410,MS-DRG 42.00: BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,21071.39,13227.35,37072.79,11
MS-DRG,411,MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,40931.01,27520.22,77132.05,11
MS-DRG,412,MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC,,27816.93,17516.2,49093.38,11
MS-DRG,413,MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,20330.87,13833.84,38772.68,11
MS-DRG,414,MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,47461.13,29680.48,83186.71,11
MS-DRG,415,MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,26605.16,17217.95,48257.44,11
MS-DRG,416,MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,18028.5,11357.83,31833.06,11
MS-DRG,417,MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,31209.9,19881.41,55722.44,11
MS-DRG,418,MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,22013.88,14092.94,39498.86,11
MS-DRG,419,MS-DRG 42.00: LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,17678.43,11378.65,31891.43,11
MS-DRG,420,MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,43098.74,28384.99,79555.79,11
MS-DRG,421,MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,23023.7,14475.33,40570.62,11
MS-DRG,422,MS-DRG 42.00: HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,18997.92,11659.43,32678.33,11
MS-DRG,423,MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,52658.29,34599.19,96972.55,11
MS-DRG,424,MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,28705.57,18227.69,51087.46,11
MS-DRG,425,MS-DRG 42.00: OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,21569.57,12499.19,35032.0,11
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,,,91819.06,257345.02,11
MS-DRG,427,MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,60139.09,168554.31,11
MS-DRG,428,MS-DRG 42.00: MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,46837.61,131273.7,11
MS-DRG,429,MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,75060.15,210374.16,11
MS-DRG,430,MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,48046.47,134661.79,11
MS-DRG,432,MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,25797.31,16397.33,45957.47,11
MS-DRG,433,MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,13881.54,8799.34,24662.27,11
MS-DRG,434,MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,9020.98,5935.93,16636.88,11
MS-DRG,435,MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,23696.9,15301.79,42886.94,11
MS-DRG,436,MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,14824.03,9423.35,26411.19,11
MS-DRG,437,MS-DRG 42.00: MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,11188.71,7108.95,19924.56,11
MS-DRG,438,MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,22471.67,13581.4,38065.17,11
MS-DRG,439,MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,11511.85,7008.14,19642.02,11
MS-DRG,440,MS-DRG 42.00: DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,8293.92,5176.97,14509.69,11
MS-DRG,441,"MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,24612.47,14951.88,41906.25,11
MS-DRG,442,"MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,12817.87,8042.04,22539.76,11
MS-DRG,443,"MS-DRG 42.00: DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,9626.87,5829.29,16338.0,11
MS-DRG,444,MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITH MCC,,21986.96,13920.49,39015.51,11
MS-DRG,445,MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITH CC,,14635.53,9117.59,25554.24,11
MS-DRG,446,MS-DRG 42.00: DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,10798.25,6892.34,19317.46,11
MS-DRG,447,MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,55665.3,156015.36,11
MS-DRG,448,MS-DRG 42.00: MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,35330.66,99022.68,11
MS-DRG,450,MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,52137.0,124446.16,11
MS-DRG,451,MS-DRG 42.00: SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,26912.87,75429.84,11
MS-DRG,456,"MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,113489.32,70009.82,196219.39,11
MS-DRG,457,"MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,81794.71,49679.37,139238.39,11
MS-DRG,458,"MS-DRG 42.00: SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,61006.06,34762.47,97430.21,11
MS-DRG,461,MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,91812.04,46012.83,125170.01,11
MS-DRG,462,MS-DRG 42.00: BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,38318.97,22160.82,62111.0,11
MS-DRG,463,MS-DRG 42.00: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,76260.94,47483.28,133083.33,11
MS-DRG,464,MS-DRG 42.00: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,40405.91,25948.97,72728.24,11
MS-DRG,465,MS-DRG 42.00: WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,25191.42,15193.47,42583.39,11
MS-DRG,466,MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,69838.54,43366.87,121546.09,11
MS-DRG,467,MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,46936.03,29380.56,82346.11,11
MS-DRG,468,MS-DRG 42.00: REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,35949.28,22893.94,64165.8,11
MS-DRG,469,MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,44835.62,25269.98,70825.22,11
MS-DRG,470,MS-DRG 42.00: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,25339.53,16069.91,45039.82,11
MS-DRG,471,MS-DRG 42.00: CERVICAL SPINAL FUSION WITH MCC,,66230.15,40228.54,112750.15,11
MS-DRG,472,MS-DRG 42.00: CERVICAL SPINAL FUSION WITH CC,,39786.56,24544.34,68791.43,11
MS-DRG,473,MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC,,33135.27,20338.78,57004.36,11
MS-DRG,474,MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,57936.24,35764.71,100239.21,11
MS-DRG,475,MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,28880.6,18959.15,53137.6,11
MS-DRG,476,MS-DRG 42.00: AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,15847.3,9832.39,27557.67,11
MS-DRG,477,MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,45360.72,28780.72,80664.91,11
MS-DRG,478,MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,32098.53,20487.93,57422.32,11
MS-DRG,479,MS-DRG 42.00: BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,25097.17,15486.74,43405.32,11
MS-DRG,480,MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,39705.78,24262.75,68002.21,11
MS-DRG,481,MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,27938.11,17449.55,48906.57,11
MS-DRG,482,MS-DRG 42.00: HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,21381.07,13588.08,38083.85,11
MS-DRG,483,MS-DRG 42.00: MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,33444.95,23093.06,64723.86,11
MS-DRG,485,MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,44350.91,26885.38,75352.79,11
MS-DRG,486,MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,27036.01,17421.23,48827.18,11
MS-DRG,487,MS-DRG 42.00: KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,20802.11,13048.21,36570.77,11
MS-DRG,488,MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,28368.96,14736.93,35576.06,11
MS-DRG,489,MS-DRG 42.00: KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,16668.62,9304.2,26077.28,11
MS-DRG,492,"MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,46612.89,30588.57,85731.86,11
MS-DRG,493,"MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,32340.89,21128.58,59217.93,11
MS-DRG,494,"MS-DRG 42.00: LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,25164.5,16716.42,46851.78,11
MS-DRG,495,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,48215.12,30206.17,84660.1,11
MS-DRG,496,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,26766.73,15028.52,42121.07,11
MS-DRG,497,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,19213.34,10066.5,26892.19,11
MS-DRG,498,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,35154.89,25133.36,70442.28,11
MS-DRG,499,MS-DRG 42.00: LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,17368.75,16785.56,47045.58,11
MS-DRG,500,MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH MCC,,43664.24,26366.36,73898.08,11
MS-DRG,501,MS-DRG 42.00: SOFT TISSUE PROCEDURES WITH CC,,23373.76,14563.65,40818.14,11
MS-DRG,502,MS-DRG 42.00: SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,18620.92,11212.86,31426.76,11
MS-DRG,503,MS-DRG 42.00: FOOT PROCEDURES WITH MCC,,36110.85,23253.03,65172.18,11
MS-DRG,504,MS-DRG 42.00: FOOT PROCEDURES WITH CC,,23252.59,15572.56,43645.82,11
MS-DRG,505,MS-DRG 42.00: FOOT PROCEDURES WITHOUT CC/MCC,,22969.84,14936.06,41861.88,11
MS-DRG,506,MS-DRG 42.00: MAJOR THUMB OR JOINT PROCEDURES,,19698.05,11240.36,28010.66,11
MS-DRG,507,MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,28705.57,15049.35,42179.44,11
MS-DRG,508,MS-DRG 42.00: MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,19307.59,12616.65,35361.24,11
MS-DRG,509,MS-DRG 42.00: ARTHROSCOPY,,,16780.11,26848.18,8
MS-DRG,510,"MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,36635.95,25164.19,70528.68,11
MS-DRG,511,"MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,26847.51,17323.76,48553.99,11
MS-DRG,512,"MS-DRG 42.00: SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,21731.14,13791.35,38653.59,11
MS-DRG,513,"MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,21825.39,13115.69,36759.9,11
MS-DRG,514,"MS-DRG 42.00: HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,14029.64,8516.91,23870.71,11
MS-DRG,515,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,42573.64,26550.47,74414.12,11
MS-DRG,516,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,27480.33,17312.91,48523.64,11
MS-DRG,517,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,20115.44,12802.45,35881.94,11
MS-DRG,518,MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,49171.07,31135.94,87265.96,11
MS-DRG,519,MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,26510.91,16663.93,46704.67,11
MS-DRG,520,MS-DRG 42.00: BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,19280.66,12445.88,34882.57,11
MS-DRG,521,MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,40311.66,23912.01,67019.17,11
MS-DRG,522,MS-DRG 42.00: HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,28436.28,17642.82,49448.29,11
MS-DRG,533,MS-DRG 42.00: FRACTURES OF FEMUR WITH MCC,,21960.03,13060.72,36605.79,11
MS-DRG,534,MS-DRG 42.00: FRACTURES OF FEMUR WITHOUT MCC,,10905.96,6715.73,18822.44,11
MS-DRG,535,MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITH MCC,,17463.0,10680.52,29934.7,11
MS-DRG,536,MS-DRG 42.00: FRACTURES OF HIP AND PELVIS WITHOUT MCC,,10596.29,6728.22,18857.46,11
MS-DRG,537,"MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,13019.83,7950.42,22282.9,11
MS-DRG,538,"MS-DRG 42.00: SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,9546.08,6000.91,16819.01,11
MS-DRG,539,MS-DRG 42.00: OSTEOMYELITIS WITH MCC,,26712.87,16409.83,45992.5,11
MS-DRG,540,MS-DRG 42.00: OSTEOMYELITIS WITH CC,,17476.47,10799.66,30268.6,11
MS-DRG,541,MS-DRG 42.00: OSTEOMYELITIS WITHOUT CC/MCC,,11552.24,6559.95,18014.53,11
MS-DRG,542,MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,24558.61,14716.95,41247.78,11
MS-DRG,543,MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,14689.39,8564.4,24003.8,11
MS-DRG,544,MS-DRG 42.00: PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,10340.47,6286.66,17619.91,11
MS-DRG,545,MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH MCC,,33566.13,20675.36,57947.69,11
MS-DRG,546,MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITH CC,,16143.52,9609.12,26931.89,11
MS-DRG,547,MS-DRG 42.00: CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,11081.0,6966.49,19525.27,11
MS-DRG,548,MS-DRG 42.00: SEPTIC ARTHRITIS WITH MCC,,26255.09,16086.58,45086.51,11
MS-DRG,549,MS-DRG 42.00: SEPTIC ARTHRITIS WITH CC,,16237.76,11809.47,28188.12,11
MS-DRG,550,MS-DRG 42.00: SEPTIC ARTHRITIS WITHOUT CC/MCC,,12710.16,7282.24,20410.24,11
MS-DRG,551,MS-DRG 42.00: MEDICAL BACK PROBLEMS WITH MCC,,22915.98,13963.81,39136.93,11
MS-DRG,552,MS-DRG 42.00: MEDICAL BACK PROBLEMS WITHOUT MCC,,13006.37,8008.72,22446.35,11
MS-DRG,553,MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITH MCC,,18203.53,10799.66,30268.6,11
MS-DRG,554,MS-DRG 42.00: BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,11067.53,6915.67,19382.83,11
MS-DRG,555,MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,18836.35,11012.08,30864.03,11
MS-DRG,556,MS-DRG 42.00: SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,11094.46,6919.85,19394.51,11
MS-DRG,557,"MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,20963.68,12387.56,34719.11,11
MS-DRG,558,"MS-DRG 42.00: TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,11821.52,7441.36,20856.22,11
MS-DRG,559,"MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,24922.14,15536.72,43545.42,11
MS-DRG,560,"MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,15241.42,9381.7,26294.44,11
MS-DRG,561,"MS-DRG 42.00: AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,10502.04,6697.39,18771.06,11
MS-DRG,562,"MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,20478.97,11870.2,33269.08,11
MS-DRG,563,"MS-DRG 42.00: FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,12063.88,7460.52,20909.92,11
MS-DRG,564,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,21031.0,12859.94,36043.06,11
MS-DRG,565,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,13450.69,8117.85,22752.24,11
MS-DRG,566,MS-DRG 42.00: OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,10111.58,6242.52,17496.15,11
MS-DRG,570,MS-DRG 42.00: SKIN DEBRIDEMENT WITH MCC,,39342.25,24502.7,68674.68,11
MS-DRG,571,MS-DRG 42.00: SKIN DEBRIDEMENT WITH CC,,22781.34,14075.45,39449.82,11
MS-DRG,572,MS-DRG 42.00: SKIN DEBRIDEMENT WITHOUT CC/MCC,,15349.13,9549.98,26766.1,11
MS-DRG,573,MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,83720.08,54580.58,152975.19,11
MS-DRG,574,MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,45858.89,28920.68,81057.19,11
MS-DRG,575,MS-DRG 42.00: SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,27547.65,14971.03,38144.56,11
MS-DRG,576,MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,76516.76,40832.52,114443.02,11
MS-DRG,577,MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,35666.53,22083.33,61893.85,11
MS-DRG,578,MS-DRG 42.00: SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,21690.75,13383.12,37509.44,11
MS-DRG,579,"MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,44997.19,26980.37,75618.98,11
MS-DRG,580,"MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,23521.87,14396.19,40348.8,11
MS-DRG,581,"MS-DRG 42.00: OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,18136.21,12022.66,33696.39,11
MS-DRG,582,MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,23441.08,16050.76,44986.11,11
MS-DRG,583,MS-DRG 42.00: MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,20492.44,14366.19,40264.74,11
MS-DRG,584,"MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,26376.27,17834.46,49985.35,11
MS-DRG,585,"MS-DRG 42.00: BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,22673.63,16071.58,45044.49,11
MS-DRG,592,MS-DRG 42.00: SKIN ULCERS WITH MCC,,28140.07,16123.26,45189.25,11
MS-DRG,593,MS-DRG 42.00: SKIN ULCERS WITH CC,,16291.62,9883.22,27700.1,11
MS-DRG,594,MS-DRG 42.00: SKIN ULCERS WITHOUT CC/MCC,,10596.29,7221.42,20239.78,11
MS-DRG,595,MS-DRG 42.00: MAJOR SKIN DISORDERS WITH MCC,,29284.53,17667.83,49518.35,11
MS-DRG,596,MS-DRG 42.00: MAJOR SKIN DISORDERS WITHOUT MCC,,13585.33,9018.45,25276.38,11
MS-DRG,597,MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH MCC,,21556.1,13888.84,38926.79,11
MS-DRG,598,MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITH CC,,16143.52,9425.0,26415.85,11
MS-DRG,599,MS-DRG 42.00: MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,9061.37,6409.97,17120.22,11
MS-DRG,600,MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,13814.22,8677.7,24321.36,11
MS-DRG,601,MS-DRG 42.00: NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,8536.27,5040.34,14126.75,11
MS-DRG,602,MS-DRG 42.00: CELLULITIS WITH MCC,,20034.65,11841.02,33187.36,11
MS-DRG,603,MS-DRG 42.00: CELLULITIS WITHOUT MCC,,11915.77,7255.58,20335.51,11
MS-DRG,604,"MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,20277.01,12264.26,34373.54,11
MS-DRG,605,"MS-DRG 42.00: TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,12238.91,7631.31,21388.6,11
MS-DRG,606,MS-DRG 42.00: MINOR SKIN DISORDERS WITH MCC,,21354.14,12606.67,35333.22,11
MS-DRG,607,MS-DRG 42.00: MINOR SKIN DISORDERS WITHOUT MCC,,12036.95,7551.35,21164.44,11
MS-DRG,614,MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,30321.26,18260.17,51178.53,11
MS-DRG,615,MS-DRG 42.00: ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,19805.76,11657.75,32673.65,11
MS-DRG,616,"MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,53291.1,29053.99,81430.79,11
MS-DRG,617,"MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,26726.34,15581.71,43671.5,11
MS-DRG,618,"MS-DRG 42.00: AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,15645.34,11816.05,33117.31,11
MS-DRG,619,MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH MCC,,35047.18,24055.31,67420.79,11
MS-DRG,620,MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITH CC,,21838.85,13332.31,37367.0,11
MS-DRG,621,MS-DRG 42.00: O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,20425.11,12566.68,35221.14,11
MS-DRG,622,"MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,51513.84,29652.15,83107.32,11
MS-DRG,623,"MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,25056.78,14945.22,41887.57,11
MS-DRG,624,"MS-DRG 42.00: SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,15012.53,10429.74,29231.87,11
MS-DRG,625,"MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,25160.86,70519.34,11
MS-DRG,626,"MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,20088.51,12491.69,35010.99,11
MS-DRG,627,"MS-DRG 42.00: THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,16641.69,11066.24,31015.81,11
MS-DRG,628,"MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,54058.56,31048.47,87020.78,11
MS-DRG,629,"MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,30469.37,18151.87,50874.98,11
MS-DRG,630,"MS-DRG 42.00: OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,18795.95,12159.29,34079.32,11
MS-DRG,637,MS-DRG 42.00: DIABETES WITH MCC,,19509.55,11969.34,33546.94,11
MS-DRG,638,MS-DRG 42.00: DIABETES WITH CC,,12104.27,7466.36,20926.27,11
MS-DRG,639,MS-DRG 42.00: DIABETES WITHOUT CC/MCC,,8388.17,5175.3,14505.02,11
MS-DRG,640,"MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,17705.36,11127.06,31186.26,11
MS-DRG,641,"MS-DRG 42.00: MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,10515.5,6483.27,18170.97,11
MS-DRG,642,MS-DRG 42.00: INBORN AND OTHER DISORDERS OF METABOLISM,,17543.79,11847.7,33206.04,11
MS-DRG,643,MS-DRG 42.00: ENDOCRINE DISORDERS WITH MCC,,22148.53,13713.88,38436.43,11
MS-DRG,644,MS-DRG 42.00: ENDOCRINE DISORDERS WITH CC,,14298.93,8539.42,23933.75,11
MS-DRG,645,MS-DRG 42.00: ENDOCRINE DISORDERS WITHOUT CC/MCC,,10246.22,6400.8,17939.81,11
MS-DRG,650,MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,60561.75,39167.98,109777.69,10
MS-DRG,651,MS-DRG 42.00: KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,46559.03,30873.5,86530.43,10
MS-DRG,652,MS-DRG 42.00: KIDNEY TRANSPLANT,,40446.31,26905.39,75408.82,10
MS-DRG,653,MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH MCC,,72894.91,43291.88,121335.94,11
MS-DRG,654,MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITH CC,,36864.84,23321.33,65363.65,11
MS-DRG,655,MS-DRG 42.00: MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,28382.43,17633.68,49422.61,11
MS-DRG,656,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,42250.5,26524.64,74341.73,11
MS-DRG,657,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,24827.89,15245.97,42730.5,11
MS-DRG,658,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,19926.94,12928.25,36234.53,11
MS-DRG,659,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,34858.68,21168.57,59330.01,11
MS-DRG,660,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,18122.75,11011.26,30861.69,11
MS-DRG,661,MS-DRG 42.00: KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,14110.43,8626.04,24176.59,11
MS-DRG,662,MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH MCC,,40352.06,25505.76,71486.02,11
MS-DRG,663,MS-DRG 42.00: MINOR BLADDER PROCEDURES WITH CC,,19644.19,12664.99,35496.67,11
MS-DRG,664,MS-DRG 42.00: MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,14298.93,8721.87,24445.12,11
MS-DRG,665,MS-DRG 42.00: PROSTATECTOMY WITH MCC,,41590.76,26003.13,72880.02,11
MS-DRG,666,MS-DRG 42.00: PROSTATECTOMY WITH CC,,23117.94,14573.65,40846.15,11
MS-DRG,667,MS-DRG 42.00: PROSTATECTOMY WITHOUT CC/MCC,,14137.36,9215.91,25829.77,11
MS-DRG,668,MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH MCC,,37941.97,24326.9,68182.0,11
MS-DRG,669,MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITH CC,,20667.47,12929.91,36239.2,11
MS-DRG,670,MS-DRG 42.00: TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,12965.98,8142.02,22819.96,11
MS-DRG,671,MS-DRG 42.00: URETHRAL PROCEDURES WITH CC/MCC,,23050.62,14954.38,41913.25,11
MS-DRG,672,MS-DRG 42.00: URETHRAL PROCEDURES WITHOUT CC/MCC,,12629.37,8993.45,25206.33,11
MS-DRG,673,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,49790.43,35004.09,98107.36,11
MS-DRG,674,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,32071.6,19483.18,54606.31,11
MS-DRG,675,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,21367.61,13674.71,38326.69,11
MS-DRG,682,MS-DRG 42.00: RENAL FAILURE WITH MCC,,20209.69,12338.42,34581.35,11
MS-DRG,683,MS-DRG 42.00: RENAL FAILURE WITH CC,,12131.2,7296.41,20449.93,11
MS-DRG,684,MS-DRG 42.00: RENAL FAILURE WITHOUT CC/MCC,,8199.67,5001.18,14017.0,11
MS-DRG,686,MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,24760.57,15026.86,42116.39,11
MS-DRG,687,MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,14070.04,8729.34,24466.13,11
MS-DRG,688,MS-DRG 42.00: KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,10515.5,6584.09,18453.51,11
MS-DRG,689,MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,15806.91,9666.6,27093.01,11
MS-DRG,690,MS-DRG 42.00: KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,10865.57,6744.06,18901.83,11
MS-DRG,693,MS-DRG 42.00: URINARY STONES WITH MCC,,19065.24,11201.19,31394.08,11
MS-DRG,694,MS-DRG 42.00: URINARY STONES WITHOUT MCC,,10542.43,6512.45,18252.69,11
MS-DRG,695,MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,16103.12,9529.15,26707.73,11
MS-DRG,696,MS-DRG 42.00: KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,9317.19,5740.15,16088.15,11
MS-DRG,697,MS-DRG 42.00: URETHRAL STRICTURE,,14985.6,8979.29,25166.63,11
MS-DRG,698,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,22269.7,13783.02,38630.24,11
MS-DRG,699,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,13746.9,9929.27,23700.25,11
MS-DRG,700,MS-DRG 42.00: OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,9532.62,5747.65,16109.17,11
MS-DRG,707,MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,26416.66,16664.77,46707.0,11
MS-DRG,708,MS-DRG 42.00: MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,19644.19,12781.62,35823.57,11
MS-DRG,709,MS-DRG 42.00: PENIS PROCEDURES WITH CC/MCC,,29230.67,19387.37,54337.79,11
MS-DRG,710,MS-DRG 42.00: PENIS PROCEDURES WITHOUT CC/MCC,,17463.0,11673.59,32718.02,11
MS-DRG,711,MS-DRG 42.00: TESTES PROCEDURES WITH CC/MCC,,28584.39,17360.41,48656.73,11
MS-DRG,712,MS-DRG 42.00: TESTES PROCEDURES WITHOUT CC/MCC,,15995.41,9161.76,25677.99,11
MS-DRG,713,MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,19536.48,12525.02,35104.39,11
MS-DRG,714,MS-DRG 42.00: TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,12912.12,8809.34,24690.29,11
MS-DRG,715,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,29728.84,18639.24,52240.96,11
MS-DRG,716,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,19146.02,12255.08,34347.85,11
MS-DRG,717,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,24423.97,15750.0,44143.18,11
MS-DRG,718,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,15833.84,11189.55,31361.38,11
MS-DRG,722,"MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,25245.28,15076.85,42256.5,11
MS-DRG,723,"MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,14999.06,9519.99,26682.04,11
MS-DRG,724,"MS-DRG 42.00: MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,10905.96,5462.73,14283.19,11
MS-DRG,725,MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITH MCC,,16709.01,9749.08,27324.17,11
MS-DRG,726,MS-DRG 42.00: BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,9842.29,6015.07,16858.7,11
MS-DRG,727,MS-DRG 42.00: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,21825.39,12354.25,34625.71,11
MS-DRG,728,MS-DRG 42.00: INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,10771.32,6758.21,18941.52,11
MS-DRG,729,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,13518.01,8820.17,24720.65,11
MS-DRG,730,MS-DRG 42.00: OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,8374.7,5598.52,15691.2,11
MS-DRG,734,"MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,29271.06,17745.31,49735.5,11
MS-DRG,735,"MS-DRG 42.00: PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,11209.54,31417.42,11
MS-DRG,736,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,52335.15,29779.62,83464.57,11
MS-DRG,737,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,26578.23,17167.13,48115.01,11
MS-DRG,738,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,18378.56,12234.27,34289.47,11
MS-DRG,739,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,48686.37,29848.77,82339.1,11
MS-DRG,740,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,24060.44,15076.02,42254.16,11
MS-DRG,741,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,17489.93,11881.03,33299.43,11
MS-DRG,742,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,23993.11,15285.95,42842.58,11
MS-DRG,743,MS-DRG 42.00: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,15645.34,10336.42,28970.35,11
MS-DRG,744,"MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,25339.53,17071.31,47846.49,11
MS-DRG,745,"MS-DRG 42.00: D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,13948.86,9476.67,26560.62,11
MS-DRG,746,"MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,22565.91,14472.0,40561.29,11
MS-DRG,747,"MS-DRG 42.00: VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,11942.7,7162.28,19602.33,11
MS-DRG,748,MS-DRG 42.00: FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,18917.13,11557.79,32393.46,11
MS-DRG,749,MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,33889.26,21391.01,59953.46,11
MS-DRG,750,MS-DRG 42.00: OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,18311.24,12295.08,34459.93,11
MS-DRG,754,"MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,24949.07,15343.44,43003.69,11
MS-DRG,755,"MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,14608.6,9062.6,25400.13,11
MS-DRG,756,"MS-DRG 42.00: MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,8002.04,22427.67,11
MS-DRG,757,"MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,20088.51,11929.35,33434.86,11
MS-DRG,758,"MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,13369.9,8156.18,22859.65,11
MS-DRG,759,"MS-DRG 42.00: INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,8697.84,5528.53,15495.06,11
MS-DRG,760,MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,13396.83,8393.61,23525.12,11
MS-DRG,761,MS-DRG 42.00: MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,8159.27,4752.91,13300.16,11
MS-DRG,768,MS-DRG 42.00: VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,16399.33,8927.65,25021.86,11
MS-DRG,769,MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,20788.65,14077.95,39456.83,11
MS-DRG,770,"MS-DRG 42.00: ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,10757.86,8353.63,23413.04,11
MS-DRG,776,MS-DRG 42.00: POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,9653.8,5454.39,15287.25,11
MS-DRG,779,MS-DRG 42.00: ABORTION WITHOUT D&C,,13316.04,7008.97,16650.88,11
MS-DRG,783,MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC,,23858.47,20453.75,57326.58,11
MS-DRG,784,MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC,,13787.29,8831.83,24753.33,11
MS-DRG,785,MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,11659.95,7979.55,22364.63,11
MS-DRG,786,MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,23562.26,13742.21,38515.82,11
MS-DRG,787,MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,14150.82,9304.2,26077.28,11
MS-DRG,788,MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,11511.85,7987.9,22387.98,11
MS-DRG,789,"MS-DRG 42.00: NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,24491.29,4924.3,32535.12,11
MS-DRG,790,"MS-DRG 42.00: EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,80784.9,18626.7,107298.01,11
MS-DRG,791,MS-DRG 42.00: PREMATURITY WITH MAJOR PROBLEMS,,55176.09,18626.7,73277.13,11
MS-DRG,792,MS-DRG 42.00: PREMATURITY WITHOUT MAJOR PROBLEMS,,33296.84,10705.0,44215.41,11
MS-DRG,793,MS-DRG 42.00: FULL TERM NEONATE WITH MAJOR PROBLEMS,,56670.61,7279.4,75273.79,11
MS-DRG,794,MS-DRG 42.00: NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,20061.58,4282.0,26644.42,11
MS-DRG,795,MS-DRG 42.00: NORMAL NEWBORN,,2719.76,1664.57,3606.99,11
MS-DRG,796,MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,19092.16,9722.42,27249.45,11
MS-DRG,797,MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,13410.29,8334.47,23359.34,11
MS-DRG,798,MS-DRG 42.00: VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,11242.56,7973.72,22348.28,11
MS-DRG,799,MS-DRG 42.00: SPLENIC PROCEDURES WITH MCC,,66714.86,37730.85,105749.82,11
MS-DRG,800,MS-DRG 42.00: SPLENIC PROCEDURES WITH CC,,37941.97,23405.49,65599.49,11
MS-DRG,801,MS-DRG 42.00: SPLENIC PROCEDURES WITHOUT CC/MCC,,24100.83,15903.31,44572.82,11
MS-DRG,802,MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,46195.5,33192.05,93028.74,11
MS-DRG,803,MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,25016.39,15486.74,43405.32,11
MS-DRG,804,MS-DRG 42.00: OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,16291.62,11297.01,31662.6,11
MS-DRG,805,MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,13571.86,8990.95,25199.32,11
MS-DRG,806,MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,10057.72,6281.67,17605.9,11
MS-DRG,807,MS-DRG 42.00: VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,8805.55,5616.84,15742.57,11
MS-DRG,808,MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,29486.49,18394.31,51554.46,11
MS-DRG,809,MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,16210.84,10546.37,29558.76,11
MS-DRG,810,MS-DRG 42.00: MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,13531.47,8719.37,24438.11,11
MS-DRG,811,MS-DRG 42.00: RED BLOOD CELL DISORDERS WITH MCC,,18903.67,11699.4,32790.4,11
MS-DRG,812,MS-DRG 42.00: RED BLOOD CELL DISORDERS WITHOUT MCC,,12131.2,7649.64,21439.97,11
MS-DRG,813,MS-DRG 42.00: COAGULATION DISORDERS,,21004.07,12707.48,35615.75,11
MS-DRG,814,MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,28651.71,17717.83,49658.44,11
MS-DRG,815,MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,13383.36,8447.76,23676.9,11
MS-DRG,816,MS-DRG 42.00: RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,9559.55,5265.28,14757.2,11
MS-DRG,817,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,37928.51,19008.3,39414.8,11
MS-DRG,818,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,19267.2,9657.44,24615.57,11
MS-DRG,819,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,12211.98,7163.94,20078.67,11
MS-DRG,820,MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,81417.71,48860.4,136943.08,11
MS-DRG,821,MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,30051.98,18650.06,52271.31,11
MS-DRG,822,MS-DRG 42.00: LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,16682.08,10030.69,28113.4,11
MS-DRG,823,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,60615.6,38196.56,107055.08,11
MS-DRG,824,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,30065.45,18875.0,52901.76,11
MS-DRG,825,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,17382.22,11242.03,31508.49,11
MS-DRG,826,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,62312.08,38971.36,109226.63,11
MS-DRG,827,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,31196.43,19254.91,53966.52,11
MS-DRG,828,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,22081.21,14194.58,39783.73,11
MS-DRG,829,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,42465.93,26326.37,73786.0,11
MS-DRG,830,MS-DRG 42.00: MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,21286.82,12538.36,35141.75,11
MS-DRG,831,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,14473.96,10018.18,28078.38,11
MS-DRG,832,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,9936.54,6011.75,16849.36,11
MS-DRG,833,MS-DRG 42.00: OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,6893.64,4356.34,12209.72,11
MS-DRG,834,MS-DRG 42.00: ACUTE LEUKEMIA WITH MCC,,75385.77,45737.07,128189.16,11
MS-DRG,835,MS-DRG 42.00: ACUTE LEUKEMIA WITH CC,,30105.84,17377.07,48703.43,11
MS-DRG,836,MS-DRG 42.00: ACUTE LEUKEMIA WITHOUT CC/MCC,,19011.38,10159.81,28475.33,11
MS-DRG,837,MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,65220.34,40025.24,112180.4,11
MS-DRG,838,MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,26955.23,17390.41,48740.79,11
MS-DRG,839,MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,17543.79,12029.31,33715.07,11
MS-DRG,840,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,42075.47,26950.37,75534.91,11
MS-DRG,841,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,21192.57,13591.42,38093.19,11
MS-DRG,842,MS-DRG 42.00: LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,14352.78,8417.78,23592.84,11
MS-DRG,843,MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,25056.78,16618.95,46578.58,11
MS-DRG,844,MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,15578.02,10142.33,28426.29,11
MS-DRG,845,MS-DRG 42.00: OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,11646.49,7094.79,19884.86,11
MS-DRG,846,MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,32906.38,21598.45,60534.88,11
MS-DRG,847,MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,16332.01,10898.77,30546.47,11
MS-DRG,848,MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,11256.03,7076.46,19833.49,11
MS-DRG,849,MS-DRG 42.00: RADIOTHERAPY,,36232.03,22573.2,63266.82,11
MS-DRG,850,MS-DRG 42.00: ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,72143.44,202199.33,11
MS-DRG,853,MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,67307.28,41144.12,115316.31,11
MS-DRG,854,MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,27439.94,16646.41,46655.64,11
MS-DRG,855,MS-DRG 42.00: INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,22915.98,12473.39,34959.62,11
MS-DRG,856,MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,59619.25,37895.82,106212.15,11
MS-DRG,857,MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,28759.42,20949.3,50004.03,11
MS-DRG,858,MS-DRG 42.00: POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,17274.5,11604.44,32524.22,11
MS-DRG,862,MS-DRG 42.00: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,24800.96,15193.47,42583.39,11
MS-DRG,863,MS-DRG 42.00: POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,13544.93,8313.64,23300.97,11
MS-DRG,864,MS-DRG 42.00: FEVER AND INFLAMMATORY CONDITIONS,,11888.84,7395.54,20727.79,11
MS-DRG,865,MS-DRG 42.00: VIRAL ILLNESS WITH MCC,,22081.21,12482.54,34985.31,11
MS-DRG,866,MS-DRG 42.00: VIRAL ILLNESS WITHOUT MCC,,12360.09,7244.75,20305.16,11
MS-DRG,867,MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,28167.0,17438.7,48876.22,11
MS-DRG,868,MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,14622.07,8590.24,24076.19,11
MS-DRG,869,MS-DRG 42.00: OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,9303.73,6079.22,17038.49,11
MS-DRG,870,MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,93777.8,57583.12,161390.53,11
MS-DRG,871,MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,26699.41,16183.21,45357.38,11
MS-DRG,872,MS-DRG 42.00: SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,13868.07,8525.25,23894.06,11
MS-DRG,876,MS-DRG 42.00: O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,50248.21,32198.98,90245.41,11
MS-DRG,880,MS-DRG 42.00: ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,12858.26,7999.55,22420.67,11
MS-DRG,881,MS-DRG 42.00: DEPRESSIVE NEUROSES,,12211.98,7838.76,21970.01,11
MS-DRG,882,MS-DRG 42.00: NEUROSES EXCEPT DEPRESSIVE,,12642.84,8945.95,25073.23,11
MS-DRG,883,MS-DRG 42.00: DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,25245.28,16381.51,45913.11,11
MS-DRG,884,MS-DRG 42.00: ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,23656.51,13403.95,37567.82,11
MS-DRG,885,MS-DRG 42.00: PSYCHOSES,,18392.03,11636.91,32615.28,11
MS-DRG,886,MS-DRG 42.00: BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,22646.7,17289.6,48458.25,11
MS-DRG,887,MS-DRG 42.00: OTHER MENTAL DISORDER DIAGNOSES,,17449.54,8921.8,25005.51,11
MS-DRG,894,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,7741.89,5139.48,14404.61,11
MS-DRG,895,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,21663.82,11793.55,33054.26,11
MS-DRG,896,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,23939.26,14538.67,40748.08,11
MS-DRG,897,"MS-DRG 42.00: ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,11525.31,7354.73,20613.38,11
MS-DRG,901,MS-DRG 42.00: WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,58272.84,34962.42,97990.61,11
MS-DRG,902,MS-DRG 42.00: WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,25379.92,15949.96,44703.57,11
MS-DRG,903,MS-DRG 42.00: WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,16722.47,9744.1,27310.16,11
MS-DRG,904,MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITH CC/MCC,,43839.27,30601.09,85766.88,11
MS-DRG,905,MS-DRG 42.00: SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,21327.21,12358.39,33432.53,11
MS-DRG,906,MS-DRG 42.00: HAND PROCEDURES FOR INJURIES,,25339.53,16364.85,41152.04,11
MS-DRG,907,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,50086.64,31985.71,89647.65,11
MS-DRG,908,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,26982.16,16622.28,46587.92,11
MS-DRG,909,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,18257.39,10936.27,30651.54,11
MS-DRG,913,MS-DRG 42.00: TRAUMATIC INJURY WITH MCC,,20128.9,13618.07,38167.91,11
MS-DRG,914,MS-DRG 42.00: TRAUMATIC INJURY WITHOUT MCC,,12225.45,7377.21,20676.42,11
MS-DRG,915,MS-DRG 42.00: ALLERGIC REACTIONS WITH MCC,,23885.4,14009.63,39265.36,11
MS-DRG,916,MS-DRG 42.00: ALLERGIC REACTIONS WITHOUT MCC,,8872.87,5551.03,15558.1,11
MS-DRG,917,MS-DRG 42.00: POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,21488.78,13066.54,36622.14,11
MS-DRG,918,MS-DRG 42.00: POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,11592.63,7140.6,20013.28,11
MS-DRG,919,MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC,,24572.07,15252.64,42749.18,11
MS-DRG,920,MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC,,13921.93,8350.3,23403.71,11
MS-DRG,921,MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,9397.98,5735.16,16074.14,11
MS-DRG,922,"MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,23494.94,14574.48,40848.49,11
MS-DRG,923,"MS-DRG 42.00: OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,13612.26,8478.59,23763.29,11
MS-DRG,927,MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,354901.52,177873.8,430345.17,11
MS-DRG,928,MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,93171.92,59756.71,167482.55,11
MS-DRG,929,MS-DRG 42.00: FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,43300.71,26832.91,75205.68,11
MS-DRG,933,MS-DRG 42.00: EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,32443.08,89119.95,11
MS-DRG,934,MS-DRG 42.00: FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,28180.47,18416.81,51617.51,11
MS-DRG,935,MS-DRG 42.00: NON-EXTENSIVE BURNS,,27480.33,17162.13,48101.0,11
MS-DRG,939,MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,43287.24,30229.52,84725.48,11
MS-DRG,940,MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,29176.81,19469.02,54566.61,11
MS-DRG,941,MS-DRG 42.00: O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,24989.46,16893.03,47346.79,11
MS-DRG,945,MS-DRG 42.00: REHABILITATION WITH CC/MCC,,,12901.59,36159.81,11
MS-DRG,946,MS-DRG 42.00: REHABILITATION WITHOUT CC/MCC,,,9554.14,26777.78,11
MS-DRG,947,MS-DRG 42.00: SIGNS AND SYMPTOMS WITH MCC,,16857.12,10575.54,29640.49,11
MS-DRG,948,MS-DRG 42.00: SIGNS AND SYMPTOMS WITHOUT MCC,,10784.78,6669.06,18691.67,11
MS-DRG,949,MS-DRG 42.00: AFTERCARE WITH CC/MCC,,14447.03,9911.54,27779.49,11
MS-DRG,950,MS-DRG 42.00: AFTERCARE WITHOUT CC/MCC,,8603.59,5229.44,14656.8,11
MS-DRG,951,MS-DRG 42.00: OTHER FACTORS INFLUENCING HEALTH STATUS,,7943.85,4632.11,12982.6,11
MS-DRG,955,MS-DRG 42.00: CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,81996.67,56077.67,157171.18,11
MS-DRG,956,"MS-DRG 42.00: LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,52213.97,31350.04,87866.05,11
MS-DRG,957,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,97386.19,63482.38,177924.67,11
MS-DRG,958,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,54462.49,35106.55,98394.57,11
MS-DRG,959,MS-DRG 42.00: OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,34091.23,24527.68,68744.74,11
MS-DRG,963,MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,36810.99,22775.65,63834.23,11
MS-DRG,964,MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,20209.69,12768.28,35786.21,11
MS-DRG,965,MS-DRG 42.00: OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,12871.73,7835.43,21960.67,11
MS-DRG,969,MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,92539.1,50997.34,142932.36,11
MS-DRG,970,MS-DRG 42.00: HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,37430.34,21972.53,61583.29,11
MS-DRG,974,MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH MCC,,39274.92,24043.63,67388.1,11
MS-DRG,975,MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITH CC,,18351.64,10788.82,30238.25,11
MS-DRG,976,MS-DRG 42.00: HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,11377.21,7520.5,20886.58,11
MS-DRG,977,MS-DRG 42.00: HIV WITH OR WITHOUT OTHER RELATED CONDITION,,19065.24,10811.32,29598.46,11
MS-DRG,981,MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,63658.5,39088.0,109553.53,11
MS-DRG,982,MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,33471.88,24050.37,57405.97,11
MS-DRG,983,MS-DRG 42.00: EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,22013.88,14279.56,40021.9,11
MS-DRG,987,MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,45468.43,28562.46,80053.14,11
MS-DRG,988,MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,22848.66,13693.04,38378.06,11
MS-DRG,989,MS-DRG 42.00: NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,14541.28,9990.69,28001.32,11
MS-DRG,998,MS-DRG 42.00: PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,,,,,0
MS-DRG,999,MS-DRG 42.00: UNGROUPABLE,,,,,0
NDC,00143957510,LIDOCAINE 2%/1ML 500MG/50ML MDV,0.5,0.21,0.135,0.49,30
NDC,00338004304,SOD CL 0.45%/1000ML 1000ML SNIV,29.1,12.22,7.86,28.52,30
NDC,00407141220,IOHEXOL 240MG/1ML 4.8GM/20ML SNIJ,6.1,2.56,1.65,5.98,30
NDC,00409427701,LIDOCAINE 2%/1ML 200MG/20ML MDV,0.5,0.21,0.135,0.49,30
NDC,08290306513,HEPARIN/1000U 15U/30ML SNIJ,62.5,26.25,16.88,61.25,30
NDC,13533031805,RABIES IG/150IU 1500U/5ML IM,963.2,404.54,260.06,943.94,37
NDC,25208000202,TIROFBN HCL/0.25MG 12.5MG/250MLSNIV,18.3,7.69,4.94,17.93,30
NDC,50458030711,RISPERIDONE/0.5MG 37.5MG SPIJ,30.1,12.64,8.13,29.5,37
NDC,50458056401,PALIPERD PALM/1MG 234MG/1.5ML IJER,37.3,15.67,10.07,36.55,37
NDC,55150020720,MEROPENEM/100MG 500MG PWIJ,14.8,6.22,4.0,14.5,30
NDC,61314024501,BETAXOLOL HCL 0.5%/5ML 5ML SNOP,204.3,85.81,55.16,200.21,30
NDC,63323030502,TOBRMYCN SULF/<=80MG 20MG/2ML MDV,72.8,30.58,19.66,71.34,30
NDC,63323081320,OXACILLIN/<=250MG 1GM PWIJ,28.1,11.8,7.59,27.54,30
NDC,63739040310,NAPROXEN/500MG 500MG TB,4.9,2.06,1.32,4.8,30
NDC,63739056710,TAMSULOSIN/0.4MG 0.4MG CP,6.2,2.6,1.67,6.08,30
NDC,66993084535,PREDNISOLN/5MG 15MG TBDS,54.7,22.97,14.77,53.61,30
NDC,68180069706,TRAMADOL/100MG 100MG TBER,17.8,7.48,4.81,17.44,30
NDC,68682065220,DIAZEPAM/2ML 10MG/2ML GLKT,438.6,184.21,118.42,429.83,30
NDC,69097085605,FOSINOPRIL/10MG 10MG TB,4.7,1.97,1.27,4.61,30
NDC,80681004900,MULTIVITAMIN/ TBCW,5.7,2.39,1.54,5.59,30
NDC,81033002050,MUPIROCIN 2%/1GM 1GM ON,13.3,5.59,3.59,13.03,30
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, EYELIDS, NOSE, EARS AND/OR LIPS; DEFECT 10.1 SQ CM TO 30.0 SQ CM",,,2107.97,5367.0,8
RC,360,"ADJACENT TISSUE TRANSFER OR REARRANGEMENT, FOREHEAD, CHEEKS, CHIN, MOUTH, NECK, AXILLAE, GENITALIA, HANDS AND/OR FEET; DEFECT 10 SQ CM OR LESS",,,2107.97,5367.0,8
RC,360,"AMPUTATION, FINGER OR THUMB, PRIMARY OR SECONDARY, ANY JOINT OR PHALANX, SINGLE, INCLUDING NEURECTOMIES; WITH DIRECT CLOSURE",,,3342.87,5367.0,8
RC,360,"AMPUTATION, FOOT; TRANSMETATARSAL",,,3342.87,10412.0,8
RC,360,"AMPUTATION, LEG, THROUGH TIBIA AND FIBULA; SECONDARY CLOSURE OR SCAR REVISION",,,3342.87,10412.0,8
RC,360,"AMPUTATION, THIGH, THROUGH FEMUR, ANY LEVEL;",,,3342.87,26759.0,8
RC,360,"AMPUTATION, TOE; METATARSOPHALANGEAL JOINT",,,3342.87,10412.0,8
RC,360,ANTERIOR INSTRUMENTATION; 4 TO 7 VERTEBRAL SEGMENTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE),,,25370.0,25370.0,1
RC,360,"ANTERIOR TIBIAL TUBERCLEPLASTY (EG, MAQUET TYPE PROCEDURE)",,,7413.38,17965.0,8
RC,360,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM BASILIC VEIN TRANSPOSITION",,,5685.01,25370.0,8
RC,360,"ARTERIOVENOUS ANASTOMOSIS, OPEN; BY UPPER ARM CEPHALIC VEIN TRANSPOSITION",,,5685.01,25370.0,8
RC,360,"ARTHRODESIS, ANKLE, OPEN",,,13116.76,25370.0,8
RC,360,"ARTHRODESIS, GREAT TOE; METATARSOPHALANGEAL JOINT",,,7413.38,25370.0,8
RC,360,"ARTHRODESIS, INTERPHALANGEAL JOINT, WITH OR WITHOUT INTERNAL FIXATION;",,,3342.87,14009.0,8
RC,360,"ARTHRODESIS, MIDTARSAL OR TARSOMETATARSAL, SINGLE JOINT",,,7413.38,25370.0,8
RC,360,"ARTHRODESIS, POSTERIOR OR POSTEROLATERAL TECHNIQUE, SINGLE INTERSPACE; THORACIC (WITH LATERAL TRANSVERSE TECHNIQUE, WHEN PERFORMED)",,,17913.59,26759.0,8
RC,360,"ARTHRODESIS, WITH TENDON LENGTHENING AND ADVANCEMENT, MIDTARSAL, TARSAL NAVICULAR-CUNEIFORM (EG, MILLER TYPE PROCEDURE)",,,13116.76,25370.0,8
RC,360,"ARTHRODESIS, WRIST; LIMITED, WITHOUT BONE GRAFT (EG, INTERCARPAL OR RADIOCARPAL)",,,7413.38,17965.0,8
RC,360,ARTHRODESIS; SUBTALAR,,,13116.76,25370.0,8
RC,360,"ARTHROPLASTY, METACARPOPHALANGEAL JOINT; WITH PROSTHETIC IMPLANT, EACH JOINT",,,7413.38,17965.0,8
RC,360,"ARTHROSCOPY, KNEE, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)",,,3342.87,14009.0,8
RC,360,"ARTHROSCOPY, WRIST, DIAGNOSTIC, WITH OR WITHOUT SYNOVIAL BIOPSY (SEPARATE PROCEDURE)",,,3342.87,14009.0,8
RC,360,"ARTHROTOMY WITH MENISCUS REPAIR, KNEE",,,7413.38,14009.0,8
RC,360,"ARTHROTOMY, KNEE, WITH EXPLORATION, DRAINAGE, OR REMOVAL OF FOREIGN BODY (EG, INFECTION)",,,3342.87,14009.0,8
RC,360,ASPIRATION OF BLADDER; WITH INSERTION OF SUPRAPUBIC CATHETER,,,2135.66,10412.0,8
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),,,14009.0,14009.0,1
RC,360,"Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (e.g., electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (i.e., submucosal)",,,1585.19,5367.0,8
RC,360,"Adenoidectomy, primary; age 12 or over",,,3387.27,10412.0,8
RC,360,"Adenoidectomy, primary; younger than age 12",,,3387.27,10412.0,8
RC,360,"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less",,,2107.97,5367.0,8
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",,,2107.97,5367.0,8
RC,360,"Amputation, toe; interphalangeal joint",,,3342.87,10412.0,8
RC,360,Anterior instrumentation; 2 to 3 vertebral segments (list separately in addition to code for primary procedure),,,25370.0,25370.0,1
RC,360,Appendectomy;,,,6614.04,14009.0,8
RC,360,"Arteriovenous anastomosis, open; direct, any site (e.g., Cimino type) (separate procedure)",,,3225.87,14009.0,8
RC,360,"Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar",,,26759.0,40196.51,8
RC,360,"Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2",,,13116.76,25370.0,8
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 ",,,17965.0,17965.0,1
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), ",,,27721.73,40196.51,8
RC,360,"Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;",,,26759.0,40196.51,8
RC,360,"Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)",,,17913.59,25974.71,8
RC,360,"Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft",,,13116.76,26759.0,8
RC,360,"Arthroplasty, ankle; revision, total ankle",,,17913.59,25974.71,8
RC,360,"Arthroplasty, ankle; with implant (total ankle)",,,25370.0,40196.51,8
RC,360,"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (e.g., total shoulder))",,,17913.59,26759.0,8
RC,360,"Arthroplasty, intercarpal or carpometacarpal joints; interposition (e.g., tendon)",,,3342.87,17965.0,8
RC,360,"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed",,,3342.87,14009.0,8
RC,360,"Arthroplasty, knee, condyle and plateau; medial and lateral compartments with or without patella resurfacing (total knee arthroplasty)",,,13116.76,26759.0,8
RC,360,Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction,,,7413.38,25370.0,8
RC,360,"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)",,,3342.87,14009.0,8
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",,,3342.87,14009.0,8
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)",,,3342.87,14009.0,8
RC,360,"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)",,,3342.87,14009.0,8
RC,360,"Arthroscopy, shoulder, surgical; biceps tenodesis",,,7413.38,25370.0,8
RC,360,"Arthroscopy, shoulder, surgical; capsulorrhaphy",,,7413.38,25370.0,8
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",,,3342.87,25370.0,8
RC,360,"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)",,,3342.87,25370.0,8
RC,360,"Arthroscopy, shoulder, surgical; with rotator cuff repair",,,7413.38,25370.0,8
RC,360,"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each",,,1642.82,5367.0,8
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",,,14009.0,14009.0,1
RC,360,"Avulsion of nail plate, partial or complete, simple; single",,,204.98,297.22,7
RC,360,"BIOPSY, MUSCLE; DEEP",,,2967.63,5367.0,8
RC,360,"BIOPSY, MUSCLE; SUPERFICIAL",,,1687.37,5367.0,8
RC,360,"BIOPSY, PROSTATE, TRANSPERINEAL, ULTRASOUND-GUIDED (IE, SEXTANT) WITH MRI-FUSION-GUIDANCE BIOPSY, FIRST TARGETED LESION",,,3601.33,10412.0,8
RC,360,"BIOPSY, VESTIBULE OF MOUTH",,,551.01,798.96,7
RC,360,BLADDER INSTILLATION OF ANTICARCINOGENIC AGENT (INCLUDING RETENTION TIME),,,712.4,1032.98,7
RC,360,"BONE GRAFT, ANY DONOR AREA; MINOR OR SMALL (EG, DOWEL OR BUTTON)",,,7413.38,14009.0,8
RC,360,"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance",,,3601.33,5367.0,8
RC,360,"Biopsy of breast; open, incisional",,,4000.24,10412.0,8
RC,360,"Biopsy or excision of lymph node(s); open, deep axillary node(s)",,,4000.24,10412.0,8
RC,360,"Biopsy or excision of lymph node(s); open, deep cervical node(s)",,,4000.24,10412.0,8
RC,360,"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)",,,4000.24,14009.0,8
RC,360,"Biopsy or excision of lymph node(s); open, superficial",,,4000.24,10412.0,8
RC,360,"Biopsy thyroid, percutaneous core needle",,,723.47,3186.0,8
RC,360,"Biopsy, bone, open; superficial (e.g., sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)",,,2967.63,10412.0,8
RC,360,"Biopsy, prostate; needle or punch, single or multiple, any approach",,,,,0
RC,360,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)",,,1818.45,5367.0,8
RC,360,"CAPSULORRHAPHY OR RECONSTRUCTION, WRIST, OPEN (EG, CAPSULODESIS, LIGAMENT REPAIR, TENDON TRANSFER OR GRAFT) (INCLUDES SYNOVECTOMY, CAPSULOTOMY AND OPEN REDUCTION) FOR CARPAL INSTABILITY",,,7413.38,17965.0,8
RC,360,CHOLECYSTECTOMY;,,,17965.0,17965.0,1
RC,360,"CLOSURE OF LACERATION, VESTIBULE OF MOUTH; OVER 2.5 CM OR COMPLEX",,,551.01,798.96,7
RC,360,"CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD; INITIAL",,,135.93,197.1,7
RC,360,"CONTROL NASAL HEMORRHAGE, POSTERIOR, WITH POSTERIOR NASAL PACKS AND/OR CAUTERY, ANY METHOD; SUBSEQUENT",,,241.98,350.87,7
RC,360,"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); SIMPLE",,,551.01,798.96,7
RC,360,"CONTROL OROPHARYNGEAL HEMORRHAGE, PRIMARY OR SECONDARY (EG, POST-TONSILLECTOMY); WITH SECONDARY SURGICAL INTERVENTION",,,3387.27,10412.0,8
RC,360,"CORONARY ARTERY BYPASS, USING VENOUS GRAFT(S) AND ARTERIAL GRAFT(S); 2 VENOUS GRAFTS (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)",,,3101.0,3101.0,1
RC,360,"CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT (PRIAPISM OPERATION), UNILATERAL OR BILATERAL",,,3101.0,3101.0,1
RC,360,"CYSTORRHAPHY, SUTURE OF BLADDER WOUND, INJURY OR RUPTURE; SIMPLE",,,9671.5,14023.67,8
RC,360,"CYSTOSTOMY, CYSTOTOMY WITH DRAINAGE",,,2135.66,10412.0,8
RC,360,CYSTOTOMY; FOR SIMPLE EXCISION OF VESICAL NECK (SEPARATE PROCEDURE),,,3601.33,10412.0,8
RC,360,"CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH FRAGMENTATION OF URETERAL CALCULUS (EG, ULTRASONIC OR ELECTRO-HYDRAULIC TECHNIQUE)",,,5477.93,10412.0,8
RC,360,CYSTOURETHROSCOPY (INCLUDING URETERAL CATHETERIZATION); WITH REMOVAL OF URETERAL CALCULUS,,,3601.33,10412.0,8
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)",,,3601.33,10412.0,8
RC,360,"CYSTOURETHROSCOPY, WITH INJECTION(S) FOR CHEMODENERVATION OF THE BLADDER",,,2135.66,5367.0,8
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",,,5477.93,10412.0,8
RC,360,"CYSTOURETHROSCOPY, WITH URETEROSCOPY AND/OR PYELOSCOPY; DIAGNOSTIC",,,3601.33,10412.0,8
RC,360,"CYSTOURETHROSCOPY; WITH TREATMENT OF URETERAL STRICTURE (EG, BALLOON DILATION, LASER, ELECTROCAUTERY, AND INCISION)",,,3601.33,10412.0,8
RC,360,Change of cystostomy tube; simple,,,255.26,370.13,7
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",,,1642.82,3186.0,8
RC,360,"Closed treatment of femoral shaft fracture, with manipulation, with or without skin or skeletal traction",,,1642.82,5367.0,8
RC,360,Closed treatment of mandibular fracture with interdental fixation,,,6048.05,17965.0,8
RC,360,Closed treatment of nasal bone fracture with manipulation; with stabilization,,,3387.27,5367.0,8
RC,360,Closed treatment of nasal bone fracture with manipulation; without stabilization,,,1585.19,5367.0,8
RC,360,"Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb; with manipulation, with or without skin or skeletal traction, each",,,252.01,365.41,7
RC,360,Closed treatment of posterior malleolus fracture; with manipulation,,,1642.82,2382.09,7
RC,360,"Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; with manipulation, with or without skin or skeletal traction",,,1642.82,2382.09,7
RC,360,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,5367.0,8
RC,360,"Colonoscopy, flexible; with biopsy, single or multiple",,,1222.56,5367.0,8
RC,360,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1222.56,5367.0,8
RC,360,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,950.1,3186.0,8
RC,360,"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;",,,5110.8,14009.0,8
RC,360,"Coronary artery bypass, using arterial graft(s); single arterial graft",,,3101.0,3101.0,1
RC,360,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method",,,3342.87,14009.0,8
RC,360,"Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method",,,13116.76,19019.3,8
RC,360,"Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)",,,3342.87,10412.0,8
RC,360,Cystourethroscopy (separate procedure),,,712.4,3186.0,8
RC,360,Cystourethroscopy with direct vision internal urethrotomy,,,2135.66,10412.0,8
RC,360,"Cystourethroscopy, with biopsy(s)",,,2135.66,10412.0,8
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",,,2135.66,5367.0,8
RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; large bladder tumor(s)",,,5477.93,10412.0,8
RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)",,,3601.33,10412.0,8
RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands",,,3601.33,10412.0,8
RC,360,"Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of minor (less than 0.5 cm) lesion(s) with or without biopsy",,,3601.33,10412.0,8
RC,360,"Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,3601.33,10412.0,8
RC,360,"Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple",,,2135.66,5367.0,8
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion",,,5477.93,10412.0,8
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)",,,5477.93,17965.0,8
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)",,,5477.93,17965.0,8
RC,360,"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)",,,3601.33,10412.0,8
RC,360,"DESTRUCTION OF LESION(S), ANUS (EG, CONDYLOMA, PAPILLOMA, MOLLUSCUM CONTAGIOSUM, HERPETIC VESICLE), SIMPLE; SURGICAL EXCISION",,,2835.78,10412.0,8
RC,360,"DILATION AND CURETTAGE, DIAGNOSTIC AND/OR THERAPEUTIC (NONOBSTETRICAL)",,,3307.24,10412.0,8
RC,360,"DILATION OF URETHRAL STRICTURE BY PASSAGE OF SOUND OR URETHRAL DILATOR, MALE; INITIAL",,,255.26,370.13,7
RC,360,"DISTAL REVASCULARIZATION AND INTERVAL LIGATION (DRIL), UPPER EXTREMITY HEMODIALYSIS ACCESS (STEAL SYNDROME)",,,5685.01,25370.0,8
RC,360,"DRAINAGE OF TENDON SHEATH, DIGIT AND/OR PALM, EACH",,,3342.87,5367.0,8
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",,,2967.63,4303.06,8
RC,360,"Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if performed); first 20 sq cm or less",,,1687.37,3186.0,8
RC,360,"Debridement, muscle and/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less",,,755.08,1094.87,7
RC,360,"Debridement, subcutaneous tissue (includes epidermis and dermis, if performed); first 20 sq cm or less",,,415.32,602.21,7
RC,360,EPIDIDYMECTOMY; BILATERAL,,,3601.33,10412.0,8
RC,360,"ESOPHAGOSCOPY, RIGID, TRANSORAL; WITH REMOVAL OF FOREIGN BODY(S)",,,1960.47,5367.0,8
RC,360,"EXCISION DISTAL ULNA PARTIAL OR COMPLETE (EG, DARRACH TYPE OR MATCHED RESECTION)",,,3342.87,14009.0,8
RC,360,"EXCISION EXTERNAL EAR; PARTIAL, SIMPLE REPAIR",,,2967.63,5367.0,8
RC,360,EXCISION OF BARTHOLIN'S GLAND OR CYST,,,3307.24,10412.0,8
RC,360,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)",,,2835.78,14009.0,8
RC,360,"EXCISION OF RECTAL TUMOR, TRANSANAL APPROACH; NOT INCLUDING MUSCULARIS PROPRIA (IE, PARTIAL THICKNESS)",,,2835.78,10412.0,8
RC,360,"EXCISION OF RECTAL TUMOR, TRANSANAL ENDOSCOPIC MICROSURGICAL APPROACH (IE, TEMS), INCLUDING MUSCULARIS PROPRIA (IE, FULL THICKNESS)",,,6202.39,14009.0,8
RC,360,EXCISION OF SUBMANDIBULAR (SUBMAXILLARY) GLAND,,,6048.05,17965.0,8
RC,360,"EXCISION OF THROMBOSED HEMORRHOID, EXTERNAL",,,1222.56,5367.0,8
RC,360,"EXCISION OF URACHAL CYST OR SINUS, WITH OR WITHOUT UMBILICAL HERNIA REPAIR",,,6176.47,14009.0,8
RC,360,"EXCISION OR CURETTAGE OF BONE CYST OR BENIGN TUMOR, HUMERUS; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,7413.38,14009.0,8
RC,360,"EXCISION OR DESTRUCTION LINGUAL TONSIL, ANY METHOD (SEPARATE PROCEDURE)",,,6048.05,10412.0,8
RC,360,"EXCISION OR DESTRUCTION, OPEN, INTRA-ABDOMINAL (IE, PERITONEAL, MESENTERIC, RETROPERITONEAL), PRIMARY OR SECONDARY TUMOR(S) OR CYST(S), SUM OF THE MAXIMUM LENGTH OF TUMOR(S) OR CYST(S); 5.1 TO 10 CM",,,10412.0,10412.0,1
RC,360,"EXCISION, OLECRANON BURSA",,,3342.87,10412.0,8
RC,360,EXPLORATION OF SPINAL FUSION,,,7413.38,25370.0,8
RC,360,"Endoscopy, wrist, surgical, with release of transverse carpal ligament",,,1642.82,14009.0,8
RC,360,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,926.63,5367.0,8
RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,926.63,5367.0,8
RC,360,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1960.47,5367.0,8
RC,360,Excision of hydrocele; unilateral,,,3657.95,14009.0,8
RC,360,"Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve",,,6048.05,17965.0,8
RC,360,"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection",,,6048.05,17965.0,8
RC,360,Excision of pilonidal cyst or sinus; complicated,,,2967.63,10412.0,8
RC,360,Excision or curettage of bone cyst or benign tumor of carpal bones;,,,3342.87,14009.0,8
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",,,723.47,3186.0,8
RC,360,"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), trunk, arms or legs; excised diameter over 4.0 cm",,,1687.37,5367.0,8
RC,360,"Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm",,,1687.37,3186.0,8
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm",,,723.47,3186.0,8
RC,360,"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",,,1687.37,5367.0,8
RC,360,"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm",,,1687.37,5367.0,8
RC,360,"Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); less than 5 cm",,,2967.63,10412.0,8
RC,360,"Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater",,,1687.37,10412.0,8
RC,360,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); 5 cm or greater",,,2967.63,10412.0,8
RC,360,"Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); less than 5 cm",,,2967.63,5367.0,8
RC,360,"Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); 5 cm or greater",,,2967.63,10412.0,8
RC,360,"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm",,,1687.37,5367.0,8
RC,360,"FASCIECTOMY, PARTIAL PALMAR WITH RELEASE OF SINGLE DIGIT INCLUDING PROXIMAL INTERPHALANGEAL JOINT, WITH OR WITHOUT Z-PLASTY, OTHER LOCAL TISSUE REARRANGEMENT, OR SKIN GRAFTING (INCLUDES OBTAINING GRAF",,,3342.87,14009.0,8
RC,360,"FRACTURE NASAL INFERIOR TURBINATE(S), THERAPEUTIC",,,3387.27,10412.0,8
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",,,2107.97,5367.0,8
RC,360,"GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)",,,3342.87,14009.0,8
RC,360,"HEMORRHOIDECTOMY, EXTERNAL, 2 OR MORE COLUMNS/GROUPS",,,2835.78,10412.0,8
RC,360,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, 2 OR MORE COLUMNS/GROUPS;",,,2835.78,10412.0,8
RC,360,"HEMORRHOIDECTOMY, INTERNAL AND EXTERNAL, SINGLE COLUMN/GROUP;",,,2835.78,10412.0,8
RC,360,"HEMORRHOIDECTOMY, INTERNAL, BY TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, 2 OR MORE HEMORRHOID COLUMNS/GROUPS, INCLUDING ULTRASOUND GUIDANCE, WITH MUCOPEXY, WHEN PERFORMED",,,2835.78,10412.0,8
RC,360,"Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implant",,,3342.87,10412.0,8
RC,360,"Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation)",,,5110.8,14009.0,8
RC,360,"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C",,,3307.24,10412.0,8
RC,360,IMPLANTATION OR REPLACEMENT OF ELECTROMAGNETIC BONE CONDUCTION HEARING DEVICE IN TEMPORAL BONE,,,17965.0,17965.0,1
RC,360,"IMPLANTATION, OSSEOINTEGRATED IMPLANT, SKULL; WITH MAGNETIC TRANSCUTANEOUS ATTACHMENT TO EXTERNAL SPEECH PROCESSOR, OUTSIDE OF THE MASTOID AND RESULTING IN REMOVAL OF GREATER THAN OR EQUAL TO 100 SQ M",,,13116.76,25370.0,8
RC,360,INCISION AND DRAINAGE ABSCESS; PERITONSILLAR,,,241.98,350.87,7
RC,360,"INCISION AND DRAINAGE ABSCESS; RETROPHARYNGEAL OR PARAPHARYNGEAL, EXTERNAL APPROACH",,,6048.05,17965.0,8
RC,360,"INCISION AND DRAINAGE, DEEP ABSCESS OR HEMATOMA, SOFT TISSUES OF NECK OR THORAX;",,,2967.63,10412.0,8
RC,360,"INCISION AND REMOVAL OF FOREIGN BODY, SUBCUTANEOUS TISSUES; COMPLICATED",,,1687.37,5367.0,8
RC,360,"INCISION, DEEP, WITH OPENING OF BONE CORTEX (EG, FOR OSTEOMYELITIS OR BONE ABSCESS), HUMERUS OR ELBOW",,,3342.87,10412.0,8
RC,360,"Incision and drainage of hematoma, seroma or fluid collection",,,1687.37,5367.0,8
RC,360,Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure),,,1222.56,5367.0,8
RC,360,"Incision and drainage, complex, postoperative wound infection",,,2967.63,10412.0,8
RC,360,"Incision and removal of foreign body, subcutaneous tissues; simple",,,415.32,602.21,7
RC,360,Incision of lingual frenum (frenotomy),,,1585.19,5367.0,8
RC,360,"Incision, extensor tendon sheath, wrist (e.g., de Quervains disease)",,,1642.82,10412.0,8
RC,360,"Insertion of tunneled centrally inserted central venous access device, with subcutaneous port; age 5 years or older",,,3225.87,14009.0,8
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",,,19820.31,32969.0,8
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",,,31526.06,45712.79,8
RC,360,"LAMINECTOMY FOR EXCISION OR EVACUATION OF INTRASPINAL LESION OTHER THAN NEOPLASM, EXTRADURAL; LUMBAR",,,7413.38,10749.4,8
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",,,7413.38,25370.0,8
RC,360,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITH SALPINGECTOMY AND/OR OOPHORECTOMY,,,6176.47,25370.0,8
RC,360,LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; WITHOUT SALPINGECTOMY AND/OR OOPHORECTOMY,,,6176.47,25370.0,8
RC,360,"LAPAROSCOPY, ABDOMEN, PERITONEUM, AND OMENTUM, DIAGNOSTIC, WITH OR WITHOUT COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING (SEPARATE PROCEDURE)",,,6176.47,17965.0,8
RC,360,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH BILATERAL PELVIC LYMPHADENECTOMY, INCLUDING EXTERNAL ILIAC, HYPOGAST",,,10860.07,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL PROSTATECTOMY, RETROPUBIC RADICAL, INCLUDING NERVE SPARING, INCLUDES ROBOTIC ASSISTANCE, WHEN PERFORMED; WITH LYMPH NODE BIOPSY(IES) (LIMITED PELVIC LYMPHADENECTOMY)",,,10860.07,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL, REPAIR OF PARAESOPHAGEAL HERNIA, INCLUDES FUNDOPLASTY, WHEN PERFORMED; WITH IMPLANTATION OF MESH",,,10860.07,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL, WITH VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;",,,6176.47,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL; PROCTOPEXY (FOR PROLAPSE)",,,14009.0,14009.0,1
RC,360,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",,,10860.07,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITH CYSTOSCOPY AND URETERAL STENT PLACEMENT",,,10860.07,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL; URETERONEOCYSTOSTOMY WITHOUT CYSTOSCOPY AND URETERAL STENT PLACEMENT",,,10860.07,25370.0,8
RC,360,"LAPAROSCOPY, SURGICAL; WITH BIOPSY (SINGLE OR MULTIPLE)",,,6176.47,17965.0,8
RC,360,"LAPAROSCOPY, SURGICAL; WITH INSERTION OF TUNNELED INTRAPERITONEAL CATHETER",,,6176.47,17965.0,8
RC,360,"LAPAROSCOPY, SURGICAL; WITH REVISION OF PREVIOUSLY PLACED INTRAPERITONEAL CANNULA OR CATHETER, WITH REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL IF PERFORMED",,,6176.47,17965.0,8
RC,360,"LASER ENUCLEATION OF THE PROSTATE WITH MORCELLATION, INCLUDING CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR DILATION, INTERNAL URET",,,5477.93,17965.0,8
RC,360,"LIGAMENTOUS RECONSTRUCTION (AUGMENTATION), KNEE; INTRA-ARTICULAR (OPEN)",,,13116.76,25370.0,8
RC,360,LIGATION OR BANDING OF ANGIOACCESS ARTERIOVENOUS FISTULA,,,3225.87,14009.0,8
RC,360,"LIGATION OR BIOPSY, TEMPORAL ARTERY",,,1687.37,5367.0,8
RC,360,"LIGATION, DIVISION, AND/OR EXCISION OF VARICOSE VEIN CLUSTER(S), 1 LEG",,,3225.87,14009.0,8
RC,360,LITHOLAPAXY: CRUSHING OR FRAGMENTATION OF CALCULUS BY ANY MEANS IN BLADDER AND REMOVAL OF FRAGMENTS; COMPLICATED OR LARGE (OVER 2.5 CM),,,3601.33,10412.0,8
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),,,3601.33,10412.0,8
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",,,7413.38,25370.0,8
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",,,7413.38,25370.0,8
RC,360,"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc; 1 interspace, lumbar",,,7413.38,25370.0,8
RC,360,"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;",,,10860.07,26759.0,8
RC,360,"Laparoscopy, surgical prostatectomy, simple subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy), includes robot",,,10860.07,25370.0,8
RC,360,"Laparoscopy, surgical, appendectomy",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)",,,10860.07,25370.0,8
RC,360,"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (i.e., sleeve gastrectomy)",,,25370.0,25370.0,1
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device and subcutaneous port components",,,3938.98,26759.0,8
RC,360,"Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y gastroenterostomy (Roux limb 150 cm or less)",,,25370.0,25370.0,1
RC,360,"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh",,,10860.07,25370.0,8
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;",,,10860.07,31000.0,10
RC,360,"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,10860.07,31000.0,10
RC,360,"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)",,,10860.07,25370.0,8
RC,360,"Laparoscopy, surgical; cholecystectomy",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical; cholecystectomy with cholangiography",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical; nephrectomy, including partial ureterectomy",,,3101.0,3101.0,1
RC,360,"Laparoscopy, surgical; partial nephrectomy",,,10860.07,25370.0,8
RC,360,"Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy)",,,3101.0,3101.0,1
RC,360,"Laparoscopy, surgical; repair initial inguinal hernia",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical; repair recurrent inguinal hernia",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy",,,10860.07,25370.0,8
RC,360,"Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method",,,6176.47,25370.0,8
RC,360,"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)",,,6176.47,25370.0,8
RC,360,"Laryngoscopy, direct, operative, with biopsy;",,,3809.1,10412.0,8
RC,360,"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope",,,3809.1,10412.0,8
RC,360,"Laryngoscopy, flexible; diagnostic",,,203.93,295.7,7
RC,360,"Laryngoscopy, indirect; with removal of lesion",,,3809.1,10412.0,8
RC,360,"Ligamentous reconstruction (augmentation), knee; extra-articular",,,7413.38,25370.0,8
RC,360,"MASTOTOMY WITH EXPLORATION OR DRAINAGE OF ABSCESS, DEEP",,,1687.37,10412.0,8
RC,360,"MEDIASTINOSCOPY; WITH LYMPH NODE BIOPSY(IES) (EG, LUNG CANCER STAGING)",,,6176.47,17965.0,8
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",,,14009.0,14009.0,1
RC,360,"Mastectomy, partial (e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy);",,,4000.24,10412.0,8
RC,360,"Mastectomy, simple, complete",,,6783.99,14009.0,8
RC,360,"NASAL/SINUS ENDOSCOPY, SURGICAL; WITH CONTROL OF NASAL HEMORRHAGE",,,1818.45,5367.0,8
RC,360,NEUROPLASTY AND/OR TRANSPOSITION; ULNAR NERVE AT ELBOW,,,1995.02,10412.0,8
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)",,,7210.32,10454.96,8
RC,360,"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)",,,7210.32,14009.0,8
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",,,7210.32,14009.0,8
RC,360,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;",,,3809.1,10412.0,8
RC,360,"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus",,,7210.32,10454.96,8
RC,360,"Nasal/sinus endoscopy, surgical, with sphenoidotomy;",,,7210.32,14009.0,8
RC,360,"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)",,,1818.45,5367.0,8
RC,360,"OPEN IMPLANTATION OF CRANIAL NERVE (EG, VAGUS NERVE) NEUROSTIMULATOR ELECTRODE ARRAY AND PULSE GENERATOR",,,36596.0,65250.72,8
RC,360,"OPEN IMPLANTATION OF HYPOGLOSSAL NERVE NEUROSTIMULATOR ARRAY, PULSE GENERATOR, AND DISTAL RESPIRATORY SENSOR ELECTRODE OR ELECTRODE ARRAY",,,31526.06,102097.0,8
RC,360,"OPEN TREATMENT AND/OR REDUCTION OF VERTEBRAL FRACTURE(S) AND/OR DISLOCATION(S), POSTERIOR APPROACH, 1 FRACTURED VERTEBRA OR DISLOCATED SEGMENT; LUMBAR",,,13116.76,25370.0,8
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",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF CLAVICULAR FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF DISTAL FIBULAR FRACTURE (LATERAL MALLEOLUS), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 2 FRAGMENTS,,,7413.38,25370.0,8
RC,360,OPEN TREATMENT OF DISTAL RADIAL INTRA-ARTICULAR FRACTURE OR EPIPHYSEAL SEPARATION; WITH INTERNAL FIXATION OF 3 OR MORE FRAGMENTS,,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF DISTAL TIBIOFIBULAR JOINT (SYNDESMOSIS) DISRUPTION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF FEMORAL SHAFT FRACTURE WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,7413.38,17965.0,8
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",,,7413.38,17965.0,8
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",,,13116.76,25370.0,8
RC,360,"OPEN TREATMENT OF GREATER HUMERAL TUBEROSITY FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF INTERCONDYLAR SPINE(S) AND/OR TUBEROSITY FRACTURE(S) OF THE KNEE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,17965.0,8
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",,,7413.38,25370.0,8
RC,360,OPEN TREATMENT OF PALATAL OR MAXILLARY FRACTURE (LEFORT I TYPE);,,,6048.05,17965.0,8
RC,360,"OPEN TREATMENT OF PATELLAR FRACTURE, WITH INTERNAL FIXATION AND/OR PARTIAL OR COMPLETE PATELLECTOMY AND SOFT TISSUE REPAIR",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF POSTERIOR MALLEOLUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF PROXIMAL TIBIOFIBULAR JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, OR WITH EXCISION OF PROXIMAL FIBULA",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF RADIAL HEAD OR NECK FRACTURE, INCLUDES INTERNAL FIXATION OR RADIAL HEAD EXCISION, WHEN PERFORMED;",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF TALUS FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF TARSOMETATARSAL JOINT DISLOCATION, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF TIBIAL FRACTURE, PROXIMAL (PLATEAU); UNICONDYLAR, INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,17965.0,8
RC,360,"OPEN TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE), WITH PLATE/SCREWS, WITH OR WITHOUT CERCLAGE",,,13116.76,25370.0,8
RC,360,"OPEN TREATMENT OF TRIMALLEOLAR ANKLE FRACTURE, INCLUDES INTERNAL FIXATION, WHEN PERFORMED, MEDIAL AND/OR LATERAL MALLEOLUS; WITH FIXATION OF POSTERIOR LIP",,,7413.38,25370.0,8
RC,360,"OPEN TREATMENT OF ULNAR FRACTURE, PROXIMAL END (EG, OLECRANON OR CORONOID PROCESS[ES]), INCLUDES INTERNAL FIXATION, WHEN PERFORMED",,,7413.38,25370.0,8
RC,360,"OSTECTOMY, PARTIAL, EXOSTECTOMY OR CONDYLECTOMY, METATARSAL HEAD, EACH METATARSAL HEAD",,,3342.87,10412.0,8
RC,360,"OSTEOTOMY, SHORTENING, ANGULAR OR ROTATIONAL CORRECTION; PROXIMAL PHALANX, FIRST TOE (SEPARATE PROCEDURE)",,,7413.38,10749.4,8
RC,360,"OSTEOTOMY, WITH OR WITHOUT LENGTHENING, SHORTENING OR ANGULAR CORRECTION, METATARSAL; FIRST METATARSAL",,,7413.38,10749.4,8
RC,360,"OSTEOTOMY; CALCANEUS (EG, DWYER OR CHAMBERS TYPE PROCEDURE), WITH OR WITHOUT INTERNAL FIXATION",,,7413.38,25370.0,8
RC,360,Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement),,,6511.03,26759.0,8
RC,360,"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone",,,3342.87,25370.0,8
RC,360,"Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each",,,3342.87,10412.0,8
RC,360,"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach",,,3601.33,14009.0,8
RC,360,"Orchiopexy, inguinal or scrotal approach",,,3657.95,14009.0,8
RC,360,"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each",,,3342.87,10412.0,8
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); PHALANX OF TOE",,,3342.87,10412.0,8
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TALUS OR CALCANEUS",,,3342.87,10412.0,8
RC,360,"PARTIAL EXCISION (CRATERIZATION, SAUCERIZATION, SEQUESTRECTOMY, OR DIAPHYSECTOMY) BONE (EG, OSTEOMYELITIS OR BOSSING); TARSAL OR METATARSAL BONE, EXCEPT TALUS OR CALCANEUS",,,3342.87,10412.0,8
RC,360,"PARTIAL EXCISION OF POSTERIOR VERTEBRAL COMPONENT (EG, SPINOUS PROCESS, LAMINA OR FACET) FOR INTRINSIC BONY LESION, SINGLE VERTEBRAL SEGMENT; THORACIC",,,7413.38,25370.0,8
RC,360,"PARTIAL THYROID LOBECTOMY, UNILATERAL; WITH OR WITHOUT ISTHMUSECTOMY",,,6176.47,25370.0,8
RC,360,PERCUTANEOUS SKELETAL FIXATION OF DISTAL RADIAL FRACTURE OR EPIPHYSEAL SEPARATION,,,3342.87,10412.0,8
RC,360,"PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION THERAPY GUIDANCE (EG, FIDUCIAL MARKERS, DOSIMETER), PROSTATE (VIA NEEDLE, ANY APPROACH), SINGLE OR MULTIPLE",,,1414.11,5367.0,8
RC,360,PLACEMENT OF SETON,,,2835.78,10412.0,8
RC,360,"PLACEMENT, ENTEROSTOMY OR CECOSTOMY, TUBE OPEN (EG, FOR FEEDING OR DECOMPRESSION) (SEPARATE PROCEDURE)",,,1960.47,5367.0,8
RC,360,"PLASTIC REPAIR OF SALIVARY DUCT, SIALODOCHOPLASTY; PRIMARY OR SIMPLE",,,6048.05,10412.0,8
RC,360,PROCTOPLASTY; FOR PROLAPSE OF MUCOUS MEMBRANE,,,2835.78,14009.0,8
RC,360,Parathyroidectomy or exploration of parathyroid(s);,,,6048.05,17965.0,8
RC,360,"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed",,,6511.03,25370.0,8
RC,360,"Percutaneous nephrolithotomy or pyelolithotomy, lithotripsy, stone extraction, antegrade ureteroscopy, antegrade stent placement and nephrostomy tube placement, when performed, including imaging guida",,,9671.5,17965.0,16
RC,360,"Percutaneous skeletal fixation of supracondylar or transcondylar humeral fracture, with or without intercondylar extension",,,7413.38,10749.4,8
RC,360,"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy",,,5110.8,14009.0,8
RC,360,"Prostatotomy, external drainage of prostatic abscess, any approach; simple",,,3601.33,10412.0,8
RC,360,REINSERTION OF SPINAL FIXATION DEVICE,,,13116.76,26759.0,8
RC,360,"REMOVAL (VIA SNARE/CAPTURE) OF INTERNALLY DWELLING URETERAL STENT VIA PERCUTANEOUS APPROACH, INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION",,,2135.66,10412.0,8
RC,360,REMOVAL FOREIGN BODY FROM EXTERNAL AUDITORY CANAL; WITH GENERAL ANESTHESIA,,,1687.37,5367.0,8
RC,360,"REMOVAL OF ANAL SETON, OTHER MARKER",,,1222.56,5367.0,8
RC,360,"REMOVAL OF NEPHROSTOMY TUBE, REQUIRING FLUOROSCOPIC GUIDANCE (EG, WITH CONCURRENT INDWELLING URETERAL STENT)",,,712.4,3186.0,8
RC,360,"REMOVAL OF POSTERIOR NONSEGMENTAL INSTRUMENTATION (EG, HARRINGTON ROD)",,,7413.38,25370.0,8
RC,360,"REMOVAL OF TUNNELED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT OR PUMP, CENTRAL OR PERIPHERAL INSERTION",,,1608.25,5367.0,8
RC,360,REMOVAL OF TUNNELED INTRAPERITONEAL CATHETER,,,3225.87,14009.0,8
RC,360,"REPAIR BLOOD VESSEL, DIRECT; LOWER EXTREMITY",,,723.47,3186.0,8
RC,360,"REPAIR INGUINAL HERNIA, SLIDING, ANY AGE",,,3657.95,14009.0,8
RC,360,"REPAIR INITIAL INGUINAL HERNIA, AGE 6 MONTHS TO YOUNGER THAN 5 YEARS, WITH OR WITHOUT HYDROCELECTOMY; INCARCERATED OR STRANGULATED",,,3657.95,14009.0,8
RC,360,"REPAIR NON-UNION, METACARPAL OR PHALANX (INCLUDES OBTAINING BONE GRAFT WITH OR WITHOUT EXTERNAL OR INTERNAL FIXATION)",,,7413.38,14009.0,8
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",,,6176.47,25370.0,24
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",,,3657.95,14009.0,16
RC,360,"REPAIR OF NONUNION OR MALUNION, RADIUS OR ULNA; WITH AUTOGRAFT (INCLUDES OBTAINING GRAFT)",,,7413.38,25370.0,8
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",,,25370.0,25370.0,1
RC,360,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; ACUTE",,,7413.38,17965.0,8
RC,360,"REPAIR OF RUPTURED MUSCULOTENDINOUS CUFF (EG, ROTATOR CUFF) OPEN; CHRONIC",,,7413.38,17965.0,8
RC,360,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),,,3601.33,10412.0,8
RC,360,"REPAIR RECURRENT INGUINAL HERNIA, ANY AGE; INCARCERATED OR STRANGULATED",,,6614.04,14009.0,8
RC,360,"REPAIR, FLEXOR TENDON, LEG; PRIMARY, WITHOUT GRAFT, EACH TENDON",,,3342.87,10412.0,8
RC,360,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; BOTH COLLATERAL LIGAMENTS",,,7413.38,14009.0,8
RC,360,"REPAIR, PRIMARY, DISRUPTED LIGAMENT, ANKLE; COLLATERAL",,,7413.38,14009.0,8
RC,360,"REPAIR, PRIMARY, OPEN OR PERCUTANEOUS, RUPTURED ACHILLES TENDON;",,,7413.38,17965.0,8
RC,360,"REPAIR, SECONDARY, DISRUPTED LIGAMENT, ANKLE, COLLATERAL (EG, WATSON-JONES PROCEDURE)",,,7413.38,14009.0,8
RC,360,"REPAIR, TENDON, FLEXOR, FOOT; PRIMARY OR SECONDARY, WITHOUT FREE GRAFT, EACH TENDON",,,3342.87,10412.0,8
RC,360,"REPLACEMENT, COMPLETE, OF A TUNNELED CENTRALLY INSERTED CENTRAL VENOUS ACCESS DEVICE, WITH SUBCUTANEOUS PORT, THROUGH SAME VENOUS ACCESS",,,3225.87,14009.0,8
RC,360,"Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate)",,,2967.63,10412.0,8
RC,360,"Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 15 lesions",,,204.98,297.22,7
RC,360,"Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated",,,3657.95,14009.0,8
RC,360,"Repair initial inguinal hernia, age 5 years or older; reducible",,,3657.95,14009.0,8
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",,,3657.95,25370.0,17
RC,360,"Repair recurrent inguinal hernia, any age; reducible",,,3657.95,14009.0,8
RC,360,"Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm",,,755.08,1094.87,7
RC,360,"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon",,,1642.82,5367.0,8
RC,360,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm",,,415.32,602.21,7
RC,360,"Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm",,,415.32,602.21,7
RC,360,"Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm",,,415.32,602.21,7
RC,360,"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft",,,13116.76,26759.0,8
RC,360,"Revision of total knee arthroplasty, with or without allograft; 1 component",,,13116.76,26759.0,8
RC,360,Revision or removal of peripheral neurostimulator electrode array,,,3571.83,14009.0,8
RC,360,"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)",,,5685.01,25370.0,8
RC,360,"SIALOLITHOTOMY; SUBMANDIBULAR (SUBMAXILLARY), SUBLINGUAL OR PAROTID, UNCOMPLICATED, INTRAORAL",,,3387.27,5367.0,8
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)",,,2107.97,5367.0,8
RC,360,"STAB PHLEBECTOMY OF VARICOSE VEINS, 1 EXTREMITY; 10-20 STAB INCISIONS",,,3225.87,14009.0,8
RC,360,SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS,,,2835.78,10412.0,8
RC,360,"SURGICAL TREATMENT OF ANAL FISTULA (FISTULECTOMY/FISTULOTOMY); TRANSSPHINCTERIC, SUPRASPHINCTERIC, EXTRASPHINCTERIC OR MULTIPLE, INCLUDING PLACEMENT OF SETON, WHEN PERFORMED",,,2835.78,10412.0,8
RC,360,"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft",,,3387.27,10412.0,8
RC,360,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,3186.0,8
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",,,204.98,297.22,7
RC,360,"Sling operation for stress incontinence (e.g., fascia or synthetic)",,,5110.8,17965.0,8
RC,360,"Submucous resection inferior turbinate, partial or complete, any method",,,3387.27,10412.0,8
RC,360,"TENOTOMY, FLEXOR, FINGER, OPEN, EACH TENDON",,,1642.82,5367.0,8
RC,360,"TENOTOMY, PERCUTANEOUS, TOE; MULTIPLE TENDONS",,,1642.82,10412.0,8
RC,360,"THORACOSCOPY; WITH DIAGNOSTIC BIOPSY(IES) OF LUNG INFILTRATE(S) (EG, WEDGE, INCISIONAL), UNILATERAL",,,10860.07,17965.0,8
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",,,7413.38,17965.0,8
RC,360,"TRANSPERINEAL PLACEMENT OF BIODEGRADABLE MATERIAL, PERI-PROSTATIC, SINGLE OR MULTIPLE INJECTION(S), INCLUDING IMAGE GUIDANCE, WHEN PERFORMED",,,5477.93,25370.0,8
RC,360,"TRANSPERINEAL PLACEMENT OF NEEDLES OR CATHETERS INTO PROSTATE FOR INTERSTITIAL RADIOELEMENT APPLICATION, WITH OR WITHOUT CYSTOSCOPY",,,5477.93,17965.0,8
RC,360,"TRANSURETHRAL ROBOTIC-ASSISTED WATERJET RESECTION OF PROSTATE, INCLUDING INTRAOPERATIVE PLANNING, ULTRASOUND GUIDANCE, CONTROL OF POSTOPERATIVE BLEEDING, COMPLETE, INCLUDING VASECTOMY, MEATOTOMY, CYST",,,9671.5,14023.67,8
RC,360,"TRANSURETHRAL WATERJET ABLATION OF PROSTATE, INCLUDING CONTROL OF POST-OPERATIVE BLEEDING, INCLUDING ULTRASOUND GUIDANCE, COMPLETE (VASECTOMY, MEATOTOMY, CYSTOURETHROSCOPY, URETHRAL CALIBRATION AND/OR",,,,,0
RC,360,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; FIRST TRIMESTER",,,3307.24,10412.0,8
RC,360,"TREATMENT OF MISSED ABORTION, COMPLETED SURGICALLY; SECOND TRIMESTER",,,3307.24,10412.0,8
RC,360,"TREATMENT OF TIBIAL SHAFT FRACTURE (WITH OR WITHOUT FIBULAR FRACTURE) BY INTRAMEDULLARY IMPLANT, WITH OR WITHOUT INTERLOCKING SCREWS AND/OR CERCLAGE",,,13116.76,25370.0,8
RC,360,"Tendon sheath incision (e.g., for trigger finger)",,,1642.82,5367.0,8
RC,360,Tenodesis of long tendon of biceps,,,7413.38,17965.0,8
RC,360,"Thyroidectomy, total or complete",,,6176.47,25370.0,8
RC,360,Tonsillectomy and adenoidectomy; age 12 or over,,,3387.27,10412.0,8
RC,360,"Tonsillectomy, primary or secondary; age 12 or over",,,3387.27,10412.0,8
RC,360,"Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);",,,14009.0,14009.0,1
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)",,,17913.59,25974.71,8
RC,360,"Total thyroid lobectomy, unilateral; with or without isthmusectomy",,,6176.47,25370.0,8
RC,360,"Transpedicular approach with decompression of spinal cord, cauda equina and/or nerve root(s) (e.g., herniated intervertebral disc), single segment; lumbar (including transfacet, or lateral extraforami",,,7413.38,25370.0,8
RC,360,"Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal ",,,5477.93,17965.0,8
RC,360,"Treatment of incomplete abortion, any trimester, completed surgically",,,3307.24,10412.0,8
RC,360,"Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage",,,7413.38,17965.0,8
RC,360,Treatment of superficial wound dehiscence; simple closure,,,755.08,1094.87,7
RC,360,"Tympanostomy (requiring insertion of ventilating tube), general anesthesia",,,1585.19,5367.0,8
RC,360,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER",,,6176.47,17965.0,8
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",,,6176.47,17965.0,8
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HERNIOTOMY",,,6176.47,17965.0,8
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH",,,6176.47,17965.0,8
RC,360,"UNLISTED LAPAROSCOPY PROCEDURE, URETER",,,6176.47,17965.0,8
RC,360,"UNLISTED PROCEDURE, ANUS",,,950.1,3186.0,8
RC,360,"UNLISTED PROCEDURE, HUMERUS OR ELBOW",,,252.01,365.41,7
RC,360,"UNLISTED PROCEDURE, RECTUM",,,950.1,3186.0,8
RC,360,"UNLISTED PROCEDURE, URINARY SYSTEM",,,255.26,370.13,7
RC,360,"UNLISTED PROCEDURE, VASCULAR SURGERY",,,640.89,3186.0,8
RC,360,"UVULECTOMY, EXCISION OF UVULA",,,3387.27,5367.0,8
RC,360,"Urethromeatoplasty, with mucosal advancement",,,3601.33,14009.0,8
RC,360,"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, EACH ADDITIONAL SEGMENT (LIST SEPARATELY IN AD",,,3101.0,3101.0,1
RC,360,"VERTEBRAL CORPECTOMY (VERTEBRAL BODY RESECTION), PARTIAL OR COMPLETE, ANTERIOR APPROACH WITH DECOMPRESSION OF SPINAL CORD AND/OR NERVE ROOT(S); CERVICAL, SINGLE SEGMENT",,,25370.0,25370.0,1
RC,360,"Vaginal hysterectomy, for uterus 250 g or less;",,,5110.8,14009.0,8
RC,360,"Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)",,,5110.8,14009.0,8
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure)",,,1818.45,5367.0,8
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage",,,1818.45,5367.0,8
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites",,,1818.45,5367.0,8
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings",,,1818.45,5367.0,8
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",,,3809.1,10412.0,16
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body",,,1818.45,5367.0,8
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with therapeutic aspiration of tracheobronchial tree, initial",,,1818.45,5367.0,8
RC,361,"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe",,,3809.1,5523.19,8
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)",,,3809.1,14009.0,8
RC,361,"Colonoscopy, flexible; with biopsy, single or multiple",,,1222.56,5367.0,8
RC,361,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1222.56,5367.0,8
RC,361,"ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP); WITH TRANS-ENDOSCOPIC BALLOON DILATION OF BILIARY/PANCREATIC DUCT(S) OR OF AMPULLA (SPHINCTEROPLASTY), INCLUDING SPHINCTEROTOMY, WHEN PERFORMED, ",,,3938.98,10412.0,8
RC,361,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,6202.39,14009.0,8
RC,361,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple",,,3938.98,10412.0,8
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",,,6202.39,10412.0,8
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",,,6202.39,10412.0,8
RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s),,,3938.98,10412.0,8
RC,361,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s),,,1960.47,5367.0,8
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,926.63,5367.0,8
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire",,,926.63,5367.0,8
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)",,,926.63,5367.0,8
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)",,,1960.47,5367.0,8
RC,361,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,1960.47,5367.0,8
RC,361,Hospital outpatient clinic visit for assessment and management of a patient,,,136.02,197.23,7
RC,361,"INJECTION PROCEDURE FOR SACROILIAC JOINT; PROVISION OF ANESTHETIC, STEROID AND/OR OTHER THERAPEUTIC AGENT, WITH OR WITHOUT ARTHROGRAPHY",,,721.17,3186.0,8
RC,361,"REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT",,,255.26,370.13,7
RC,361,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, ILIAC ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL, WHEN PERFORMED",,,,,0
RC,361,"REVASCULARIZATION, ENDOVASCULAR, OPEN OR PERCUTANEOUS, TIBIAL, PERONEAL ARTERY, UNILATERAL, INITIAL VESSEL; WITH TRANSLUMINAL STENT PLACEMENT(S), INCLUDES ANGIOPLASTY WITHIN THE SAME VESSEL, WHEN PERF",,,,,0
RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal angioplasty",,,,,0
RC,361,"Revascularization, endovascular, open or percutaneous, femoral, popliteal artery(s), unilateral; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed",,,,,0
RC,361,"Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, unilateral, initial vessel; with transluminal angioplasty",,,,,0
RC,361,"SIGMOIDOSCOPY, FLEXIBLE; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)",,,5367.0,8993.47,8
RC,361,"Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less",,,204.98,297.22,7
RC,361,"UNLISTED PROCEDURE, SMALL INTESTINE",,,926.63,5367.0,8
RC,750,"ANOSCOPY; DIAGNOSTIC, INCLUDING COLLECTION OF SPECIMEN(S) BY BRUSHING OR WASHING, WHEN PERFORMED (SEPARATE PROCEDURE)",,,135.93,197.1,7
RC,750,COLORECTAL CANCER SCREENING; FLEXIBLE SIGMOIDOSCOPY,,,950.1,3186.0,8
RC,750,"Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,5367.0,8
RC,750,"Colonoscopy through stoma; with biopsy, single or multiple",,,1222.56,5367.0,8
RC,750,"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1222.56,5367.0,8
RC,750,"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,5367.0,8
RC,750,"Colonoscopy, flexible; with biopsy, single or multiple",,,1222.56,5367.0,8
RC,750,"Colonoscopy, flexible; with control of bleeding, any method",,,1222.56,5367.0,8
RC,750,"Colonoscopy, flexible; with directed submucosal injection(s), any substance",,,1222.56,5367.0,8
RC,750,"Colonoscopy, flexible; with removal of foreign body(s)",,,1222.56,5367.0,8
RC,750,"Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1222.56,5367.0,8
RC,750,Colorectal cancer screening; colonoscopy on individual at high risk,,,950.1,3186.0,8
RC,750,Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk,,,950.1,3186.0,8
RC,750,"DILATION OF ESOPHAGUS, BY UNGUIDED SOUND OR BOUGIE, SINGLE OR MULTIPLE PASSES",,,926.63,5367.0,8
RC,750,"ENDOSCOPIC EVALUATION OF SMALL INTESTINAL POUCH (EG, KOCK POUCH, ILEAL RESERVOIR [S OR J]); WITH BIOPSY, SINGLE OR MULTIPLE",,,950.1,5367.0,8
RC,750,"ESOPHAGOGASTRODUODENOSCOPY, FLEXIBLE, TRANSORAL; WITH INJECTION SCLEROSIS OF ESOPHAGEAL/GASTRIC VARICES",,,1960.47,5367.0,8
RC,750,"Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or multiple",,,3938.98,10412.0,8
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",,,6202.39,10412.0,8
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",,,6202.39,10412.0,8
RC,750,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of calculi/debris from biliary/pancreatic duct(s),,,3938.98,10412.0,8
RC,750,Endoscopic retrograde cholangiopancreatography (ERCP); with removal of foreign body(s) or stent(s) from biliary/pancreatic duct(s),,,1960.47,5367.0,8
RC,750,Endoscopic retrograde cholangiopancreatography (ERCP); with sphincterotomy/papillotomy,,,3938.98,10412.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,926.63,5367.0,8
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)",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple",,,926.63,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (e.g., balloon, bougie)",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance",,,926.63,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic ultrasound examination limited to the esophagus, stomach or duodenum, and adjacent structures",,,1960.47,5367.0,8
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 ",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire",,,926.63,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)",,,926.63,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter)",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the eso",,,1960.47,5367.0,8
RC,750,"Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), (includes endoscopic ultrasound examination limited t",,,1960.47,5367.0,8
RC,750,"Esophagoscopy, rigid, transoral; diagnostic, including collection of specimen(s) by brushing or washing when performed (separate procedure)",,,1960.47,5367.0,8
RC,750,"ILEOSCOPY, THROUGH STOMA; WITH BIOPSY, SINGLE OR MULTIPLE",,,926.63,5367.0,8
RC,750,"REPLACEMENT OF GASTROSTOMY TUBE, PERCUTANEOUS, INCLUDES REMOVAL, WHEN PERFORMED, WITHOUT IMAGING OR ENDOSCOPIC GUIDANCE; NOT REQUIRING REVISION OF GASTROSTOMY TRACT",,,255.26,370.13,7
RC,750,"SIGMOIDOSCOPY, FLEXIBLE; WITH CONTROL OF BLEEDING, ANY METHOD",,,1222.56,5367.0,8
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH BIOPSY, SINGLE OR MULTIPLE",,,1960.47,5367.0,8
RC,750,"SMALL INTESTINAL ENDOSCOPY, ENTEROSCOPY BEYOND SECOND PORTION OF DUODENUM, NOT INCLUDING ILEUM; WITH CONVERSION OF PERCUTANEOUS GASTROSTOMY TUBE TO PERCUTANEOUS JEJUNOSTOMY TUBE",,,1960.47,5367.0,8
RC,750,"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)",,,950.1,3186.0,8
RC,750,"Sigmoidoscopy, flexible; with biopsy, single or multiple",,,950.1,3186.0,8
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