code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
CDM,PMC - 3001 - 110000110,IP PRIVATE,1889.0,944.5,,,0
CDM,PMC - 3001 - 110000112,IP L&D,1754.0,877.0,,,0
CDM,PMC - 3001 - 110000114,BEH MED PRIVATE,2859.0,1429.5,,,0
CDM,PMC - 3001 - 110000117,IP ONCOLOGY,2919.0,1459.5,,,0
CDM,PMC - 3001 - 110000119,IP TRANSPLANT AND SURGICAL ADMISSION,3506.0,1753.0,,,0
CDM,PMC - 3001 - 110000120,IP SEMIPRIVATE,1889.0,944.5,,,0
CDM,PMC - 3001 - 110000124,BEH MED SEMIPRIVATE,2859.0,1429.5,,,0
CDM,PMC - 3001 - 110000130,IP 3-4 BEDS IN ROOM,1738.0,869.0,,,0
CDM,PMC - 3001 - 110000150,IP WARD,1738.0,869.0,,,0
CDM,PMC - 3001 - 110000169,IP L&D,4205.0,2102.5,,,0
CDM,PMC - 3001 - 110000171,NEWBORN CARE LEVEL 1,1260.0,630.0,,,0
CDM,PMC - 3001 - 110000172,NEWBORN CARE LEVEL 2,2839.0,1419.5,,,0
CDM,PMC - 3001 - 110000173,NEWBORN CARE LEVEL 3,3165.0,1582.5,,,0
CDM,PMC - 3001 - 110000174,NEWBORN CARE LEVEL 4,4703.0,2351.5,,,0
CDM,PMC - 3001 - 110000190,IP SNF - SEMI PRIVATE,1500.0,750.0,,,0
CDM,PMC - 3001 - 110000200,IP INTENSIVE,4818.0,2409.0,,,0
CDM,PMC - 3001 - 110000206,IP STEPDOWN,3823.0,1911.5,,,0
CDM,PMC - 3001 - 110000208,IP TRAUMA ICU,6172.0,3086.0,,,0
CDM,PMC - 3001 - 110000209,IP INTENSIVE ICU RC 209,3749.0,1874.5,,,0
CDM,PMC - 3001 - 110000210,IP INTENSIVE CCU,4818.0,2409.0,,,0
CDM,PMC - 3001 - 110000214,IP STEPDOWN,3823.0,1911.5,,,0
CDM,PMC - 3001 - 110001120,BEH MED LOA,1889.0,944.5,,,0
CDM,PMC - 3001 - 110001169,IP HIGH RISK L&D,4205.0,2102.5,,,0
CDM,PMC - 3001 - 110001190,IP SNF - PRIVATE,225.0,112.5,,,0
CDM,PMC - 3001 - 110001210,IP INTENSIVE CVRU,4818.0,2409.0,,,0
CDM,PMC - 3001 - 110002110,HOSPICE PRIVATE,2359.0,1179.5,,,0
CDM,PMC - 3001 - 220000014,INPT LACTATION CONSULT 15 MIN,57.0,28.5,,,0
CDM,PMC - 3001 - 220000015,INPT LACTATION CONSULT 30 MIN,111.0,55.5,,,0
CDM,PMC - 3001 - 220000016,INPT LACTATION CONSULT 45 MIN,168.0,84.0,,,0
CDM,PMC - 3001 - 220000017,INPT LACTATION CONSULT 60 MIN,223.0,111.5,,,0
CDM,PMC - 3001 - 220000018,INPT CONSULT EACH ADDL 15 MIN,53.0,26.5,,,0
CDM,PMC - 3001 - 220000032,SPECIAL NEED FEEDER MINI STERILE,44.0,22.0,,,0
CDM,PMC - 3001 - 220000033,SPECIAL NEEDS FEEDER STERILE,44.0,22.0,,,0
CDM,PMC - 3001 - 220000037,BREASTFEEDING INITIATION KIT,137.0,68.5,,,0
CDM,PMC - 3001 - 220000044,OP SYMPHONY MONTHLY RENTAL,115.0,57.5,,,0
CDM,PMC - 3001 - 220000047,SNS,275.0,137.5,,,0
CDM,PMC - 3001 - 220000049,SOFT SHELLS SORE NIPPLES,81.0,40.5,,,0
CDM,PMC - 3001 - 220000050,STARTER SNS - STERILE,88.0,44.0,,,0
CDM,PMC - 3001 - 220000054,SYMPHONY DOUBLE PUMP KIT,415.0,207.5,,,0
CDM,PMC - 3001 - 260000545,OP BEDSIDE PROCEDURE LEVEL 1,477.0,238.5,,,0
CDM,PMC - 3001 - 260000546,OP BEDSIDE PROCEDURE LEVEL 2,855.0,427.5,,,0
CDM,PMC - 3001 - 260000547,OP BEDSIDE PROCEDURE LEVEL 3,1736.0,868.0,,,0
CDM,PMC - 3001 - 260000548,OP BEDSIDE PROCEDURE LEVEL 4,2339.0,1169.5,,,0
CDM,PMC - 3001 - 260000549,OP BEDSIDE PROCEDURE LEVEL 5,4202.0,2101.0,,,0
CDM,PMC - 3001 - 260000550,OP BEDSIDE PROCEDURE LEVEL 6,8167.0,4083.5,,,0
CDM,PMC - 3001 - 260000551,SCALP COOLING 1ST MEASUREMENT & CAP CALIBRATION,3381.0,1690.5,,,0
CDM,PMC - 3001 - 260000552,SCALP COOLING PLACEMENT MNTR & REMOVAL OF DEVICE,53.0,26.5,,,0
CDM,PMC - 3001 - 311000182,NEURO CSF PRION PRTN QUAL,1721.0,860.5,,,0
CDM,PMC - 3001 - 311000192,NFCT DS 22 TRGT SARS-COV-2,5310.0,2655.0,,,0
CDM,PMC - 3001 - 311000201,ONC NONSM CLL LNG CA CELL FREE DNA ALYS 23 GEN,22596.0,11298.0,,,0
CDM,PMC - 3001 - 311000216,ARC HEA BEAD CHIP,370.0,185.0,,,0
CDM,PMC - 3001 - 311000310,OB PE SFLT-1/PLGF IA SRM/PLS,955.0,477.5,,,0
CDM,PMC - 3001 - 320000395,ILIAC ART ANGIO CARDIAC CATH,5622.0,2811.0,,,0
CDM,PMC - 3001 - 333000055,INSERT UTERINE TANDEMOVOID,12194.0,6097.0,,,0
CDM,PMC - 3001 - 333000102,TRANSPERINEAL PLMT NDL PROSTATE INTERSTIL TX,10584.0,5292.0,,,0
CDM,PMC - 3001 - 333000112,SCALP COOLING 1ST MEASUREMENT & CAP CALIBRATION,3381.0,1690.5,,,0
CDM,PMC - 3001 - 333000113,SCALP COOLING PLACEMENT MNTR & REMOVAL OF DEVICE,53.0,26.5,,,0
CDM,PMC - 3001 - 343000001,RADIOPHARMACY UBC 250,2.0,1.0,,,0
CDM,PMC - 3001 - 343000002,RADIOPHARMACY UBC 255,2.0,1.0,,,0
CDM,PMC - 3001 - 343000005,RADIOPHARMACY UBC 636,2.0,1.0,,,0
CDM,PMC - 3001 - 343000006,CONTRAST UBC 636,2.0,1.0,,,0
CDM,PMC - 3001 - 343000007,ABLAVAR 244MG / ML 10ML,456.0,228.0,,,0
CDM,PMC - 3001 - 343000159,I-123 SOD IODIDE CAP P/MCI,4385.0,2192.5,,,0
CDM,PMC - 3001 - 351000157,CT PERFUSION W CONTRAST CBF,1630.0,815.0,,,0
CDM,PMC - 3001 - 360000001,"OR CATEGORY I 0""-15""",3442.0,1721.0,,,0
CDM,PMC - 3001 - 360000002,"OR CATEGORY I 16""-30""",4784.0,2392.0,,,0
CDM,PMC - 3001 - 360000003,"OR CATEGORY I 31""-45""",5928.0,2964.0,,,0
CDM,PMC - 3001 - 360000004,"OR CATEGORY I 46""-60""",6609.0,3304.5,,,0
CDM,PMC - 3001 - 360000005,"OR CATEGORY I 1'01""-1'15""",7665.0,3832.5,,,0
CDM,PMC - 3001 - 360000006,"OR CATEGORY I 1'16""-1'30""",8720.0,4360.0,,,0
CDM,PMC - 3001 - 360000007,"OR CATEGORY I 1'31""-1'45""",9776.0,4888.0,,,0
CDM,PMC - 3001 - 360000008,"OR CATEGORY I 1'46""-2'00""",10832.0,5416.0,,,0
CDM,PMC - 3001 - 360000009,"OR CATEGORY I 2'01""-2'15""",11887.0,5943.5,,,0
CDM,PMC - 3001 - 360000010,"OR CATEGORY I 2'16""-2'30""",12943.0,6471.5,,,0
CDM,PMC - 3001 - 360000011,"OR CATEGORY I 2'31""-2'45""",13998.0,6999.0,,,0
CDM,PMC - 3001 - 360000012,"OR CATEGORY I 2'46""-3'00""",15054.0,7527.0,,,0
CDM,PMC - 3001 - 360000013,"OR CATEGORY I 3'01""-3'15""",16110.0,8055.0,,,0
CDM,PMC - 3001 - 360000014,"OR CATEGORY I 3'16""-3'30""",17165.0,8582.5,,,0
CDM,PMC - 3001 - 360000015,"OR CATEGORY I 3'31""-3'45""",18221.0,9110.5,,,0
CDM,PMC - 3001 - 360000016,"OR CATEGORY I 3'46""-4'00""",19276.0,9638.0,,,0
CDM,PMC - 3001 - 360000017,"OR CATEGORY I 4'01""-4'15""",20332.0,10166.0,,,0
CDM,PMC - 3001 - 360000018,"OR CATEGORY I 4'16""-4'30""",21388.0,10694.0,,,0
CDM,PMC - 3001 - 360000019,"OR CATEGORY I 4'31""-4'45""",22443.0,11221.5,,,0
CDM,PMC - 3001 - 360000020,"OR CATEGORY I 4'46""-5'00""",23499.0,11749.5,,,0
CDM,PMC - 3001 - 360000021,"OR CATEGORY I 5'01""-5'15""",24554.0,12277.0,,,0
CDM,PMC - 3001 - 360000022,"OR CATEGORY I 5'16""-5'30""",25610.0,12805.0,,,0
CDM,PMC - 3001 - 360000023,"OR CATEGORY I 5'31""-5'45""",26666.0,13333.0,,,0
CDM,PMC - 3001 - 360000024,"OR CATEGORY I 5'46""-6'00""",27721.0,13860.5,,,0
CDM,PMC - 3001 - 360000025,"OR CATEGORY I 6'01""-6'15""",28777.0,14388.5,,,0
CDM,PMC - 3001 - 360000026,"OR CATEGORY I 6'16""-6'30""",29832.0,14916.0,,,0
CDM,PMC - 3001 - 360000027,"OR CATEGORY I 6'31""-6'45""",30888.0,15444.0,,,0
CDM,PMC - 3001 - 360000028,"OR CATEGORY I 6'46""-7'00""",31944.0,15972.0,,,0
CDM,PMC - 3001 - 360000029,"OR CATEGORY I 7'01""-7'15""",32999.0,16499.5,,,0
CDM,PMC - 3001 - 360000030,"OR CATEGORY I 7'16""-7'30""",34055.0,17027.5,,,0
CDM,PMC - 3001 - 360000031,"OR CATEGORY I 7'31""-7'45""",35110.0,17555.0,,,0
CDM,PMC - 3001 - 360000032,"OR CATEGORY I 7'46""-8'00""",36166.0,18083.0,,,0
CDM,PMC - 3001 - 360000033,OR CATEGORY I EA ADDL 15 MIN,1056.0,528.0,,,0
CDM,PMC - 3001 - 360000034,"OR CATEGORY II 0""-15""",5336.0,2668.0,,,0
CDM,PMC - 3001 - 360000035,"OR CATEGORY II 16""-30""",6683.0,3341.5,,,0
CDM,PMC - 3001 - 360000036,"OR CATEGORY II 31""-45""",8424.0,4212.0,,,0
CDM,PMC - 3001 - 360000037,"OR CATEGORY II 46""-60""",9755.0,4877.5,,,0
CDM,PMC - 3001 - 360000038,"OR CATEGORY II 1'01""-1'15""",10723.0,5361.5,,,0
CDM,PMC - 3001 - 360000039,"OR CATEGORY II 1'16""-1'30""",12070.0,6035.0,,,0
CDM,PMC - 3001 - 360000040,"OR CATEGORY II 1'31""-1'45""",13417.0,6708.5,,,0
CDM,PMC - 3001 - 360000041,"OR CATEGORY II 1'46""-2'00""",14764.0,7382.0,,,0
CDM,PMC - 3001 - 360000042,"OR CATEGORY II 2'01""-2'15""",16111.0,8055.5,,,0
CDM,PMC - 3001 - 360000043,"OR CATEGORY II 2'16""-2'30""",17457.0,8728.5,,,0
CDM,PMC - 3001 - 360000044,"OR CATEGORY II 2'31""-2'45""",18804.0,9402.0,,,0
CDM,PMC - 3001 - 360000045,"OR CATEGORY II 2'46""-3'00""",20151.0,10075.5,,,0
CDM,PMC - 3001 - 360000046,"OR CATEGORY II 3'01""-3'15""",21498.0,10749.0,,,0
CDM,PMC - 3001 - 360000047,"OR CATEGORY II 3'16""-3'30""",22845.0,11422.5,,,0
CDM,PMC - 3001 - 360000048,"OR CATEGORY II 3'31""-3'45""",24191.0,12095.5,,,0
CDM,PMC - 3001 - 360000049,"OR CATEGORY II 3'46""-4'00""",25538.0,12769.0,,,0
CDM,PMC - 3001 - 360000050,"OR CATEGORY II 4'01""-4'15""",26885.0,13442.5,,,0
CDM,PMC - 3001 - 360000051,"OR CATEGORY II 4'16""-4'30""",28232.0,14116.0,,,0
CDM,PMC - 3001 - 360000052,"OR CATEGORY II 4'31""-4'45""",29579.0,14789.5,,,0
CDM,PMC - 3001 - 360000053,"OR CATEGORY II 4'46""-5'00""",30925.0,15462.5,,,0
CDM,PMC - 3001 - 360000054,"OR CATEGORY II 5'01""-5'15""",32272.0,16136.0,,,0
CDM,PMC - 3001 - 360000055,"OR CATEGORY II 5'16""-5'30""",33619.0,16809.5,,,0
CDM,PMC - 3001 - 360000056,"OR CATEGORY II 5'31""-5'45""",34966.0,17483.0,,,0
CDM,PMC - 3001 - 360000057,"OR CATEGORY II 5'46""-6'00""",36313.0,18156.5,,,0
CDM,PMC - 3001 - 360000058,"OR CATEGORY II 6'01""-6'15""",37659.0,18829.5,,,0
CDM,PMC - 3001 - 360000059,"OR CATEGORY II 6'16""-6'30""",39006.0,19503.0,,,0
CDM,PMC - 3001 - 360000060,"OR CATEGORY II 6'31""-6'45""",40353.0,20176.5,,,0
CDM,PMC - 3001 - 360000061,"OR CATEGORY II 6'46""-7'00""",41700.0,20850.0,,,0
CDM,PMC - 3001 - 360000062,"OR CATEGORY II 7'01""-7'15""",43047.0,21523.5,,,0
CDM,PMC - 3001 - 360000063,"OR CATEGORY II 7'16""-7'30""",44393.0,22196.5,,,0
CDM,PMC - 3001 - 360000064,"OR CATEGORY II 7'31""-7'45""",45740.0,22870.0,,,0
CDM,PMC - 3001 - 360000065,"OR CATEGORY II 7'46""-8'00""",47087.0,23543.5,,,0
CDM,PMC - 3001 - 360000066,OR CATEGORY II EA ADDL 15 MIN,1347.0,673.5,,,0
CDM,PMC - 3001 - 360000067,"OR CATEGORY III 0""-15""",7738.0,3869.0,,,0
CDM,PMC - 3001 - 360000068,"OR CATEGORY III 16""-30""",9282.0,4641.0,,,0
CDM,PMC - 3001 - 360000069,"OR CATEGORY III 31""-45""",11440.0,5720.0,,,0
CDM,PMC - 3001 - 360000070,"OR CATEGORY III 46""-60""",13156.0,6578.0,,,0
CDM,PMC - 3001 - 360000071,"OR CATEGORY III 1'01""-1'15""",14508.0,7254.0,,,0
CDM,PMC - 3001 - 360000072,"OR CATEGORY III 1'16""-1'30""",15460.0,7730.0,,,0
CDM,PMC - 3001 - 360000073,"OR CATEGORY III 1'31""-1'45""",17004.0,8502.0,,,0
CDM,PMC - 3001 - 360000074,"OR CATEGORY III 1'46""-2'00""",18548.0,9274.0,,,0
CDM,PMC - 3001 - 360000075,"OR CATEGORY III 2'01""-2'15""",20093.0,10046.5,,,0
CDM,PMC - 3001 - 360000076,"OR CATEGORY III 2'16""-2'30""",21637.0,10818.5,,,0
CDM,PMC - 3001 - 360000077,"OR CATEGORY III 2'31""-2'45""",23182.0,11591.0,,,0
CDM,PMC - 3001 - 360000078,"OR CATEGORY III 2'46""-3'00""",24726.0,12363.0,,,0
CDM,PMC - 3001 - 360000079,"OR CATEGORY III 3'01""-3'15""",26270.0,13135.0,,,0
CDM,PMC - 3001 - 360000080,"OR CATEGORY III 3'16""-3'30""",27815.0,13907.5,,,0
CDM,PMC - 3001 - 360000081,"OR CATEGORY III 3'31""-3'45""",29359.0,14679.5,,,0
CDM,PMC - 3001 - 360000082,"OR CATEGORY III 3'46""-4'00""",30904.0,15452.0,,,0
CDM,PMC - 3001 - 360000083,"OR CATEGORY III 4'01""-4'15""",32448.0,16224.0,,,0
CDM,PMC - 3001 - 360000084,"OR CATEGORY III 4'16""-4'30""",33992.0,16996.0,,,0
CDM,PMC - 3001 - 360000085,"OR CATEGORY III 4'31""-4'45""",35537.0,17768.5,,,0
CDM,PMC - 3001 - 360000086,"OR CATEGORY III 4'46""-5'00""",37081.0,18540.5,,,0
CDM,PMC - 3001 - 360000087,"OR CATEGORY III 5'01""-5'15""",38626.0,19313.0,,,0
CDM,PMC - 3001 - 360000088,"OR CATEGORY III 5'16""-5'30""",40170.0,20085.0,,,0
CDM,PMC - 3001 - 360000089,"OR CATEGORY III 5'31""-5'45""",41714.0,20857.0,,,0
CDM,PMC - 3001 - 360000090,"OR CATEGORY III 5'46""-6'00""",43259.0,21629.5,,,0
CDM,PMC - 3001 - 360000091,"OR CATEGORY III 6'01""-6'15""",44803.0,22401.5,,,0
CDM,PMC - 3001 - 360000092,"OR CATEGORY III 6'16""-6'30""",46348.0,23174.0,,,0
CDM,PMC - 3001 - 360000093,"OR CATEGORY III 6'31""-6'45""",47892.0,23946.0,,,0
CDM,PMC - 3001 - 360000094,"OR CATEGORY III 6'46""-7'00""",49436.0,24718.0,,,0
CDM,PMC - 3001 - 360000095,"OR CATEGORY III 7'01""-7'15""",50981.0,25490.5,,,0
CDM,PMC - 3001 - 360000096,"OR CATEGORY III 7'16""-7'30""",52525.0,26262.5,,,0
CDM,PMC - 3001 - 360000097,"OR CATEGORY III 7'31""-7'45""",54070.0,27035.0,,,0
CDM,PMC - 3001 - 360000098,"OR CATEGORY III 7'46""-8'00""",55614.0,27807.0,,,0
CDM,PMC - 3001 - 360000099,"OR CATEGORY III 8'01""-8'15""",57158.0,28579.0,,,0
CDM,PMC - 3001 - 360000100,"OR CATEGORY III 8'16""-8'30""",58703.0,29351.5,,,0
CDM,PMC - 3001 - 360000101,"OR CATEGORY III 8'31""-8'45""",60247.0,30123.5,,,0
CDM,PMC - 3001 - 360000102,"OR CATEGORY III 8'46""-9'00""",61792.0,30896.0,,,0
CDM,PMC - 3001 - 360000103,"OR CATEGORY III 9'01-9'15""",63336.0,31668.0,,,0
CDM,PMC - 3001 - 360000104,"OR CATEGORY III 9'16""-9'30""",64880.0,32440.0,,,0
CDM,PMC - 3001 - 360000105,"OR CATEGORY III 9'31""-9'45""",66425.0,33212.5,,,0
CDM,PMC - 3001 - 360000106,"OR CATEGORY III 9'46""-10'00""",67969.0,33984.5,,,0
CDM,PMC - 3001 - 360000107,OR CATEGORY III EA ADDL 15MIN,1544.0,772.0,,,0
CDM,PMC - 3001 - 360000108,"OR CATEGORY IV 0""-15""",12999.0,6499.5,,,0
CDM,PMC - 3001 - 360000109,"OR CATEGORY IV 16""-30""",15001.0,7500.5,,,0
CDM,PMC - 3001 - 360000110,"OR CATEGORY IV 31""-45""",17003.0,8501.5,,,0
CDM,PMC - 3001 - 360000111,"OR CATEGORY IV 46""-60""",19005.0,9502.5,,,0
CDM,PMC - 3001 - 360000112,"OR CATEGORY IV 1'01""-1'15""",21007.0,10503.5,,,0
CDM,PMC - 3001 - 360000113,"OR CATEGORY IV 1'16""-1'30""",23009.0,11504.5,,,0
CDM,PMC - 3001 - 360000114,"OR CATEGORY IV 1'31""-1'45""",25011.0,12505.5,,,0
CDM,PMC - 3001 - 360000115,"OR CATEGORY IV 1'46""-2'00""",27013.0,13506.5,,,0
CDM,PMC - 3001 - 360000116,"OR CATEGORY IV 2'01""-2'15""",29015.0,14507.5,,,0
CDM,PMC - 3001 - 360000117,"OR CATEGORY IV 2'16""-2'30""",31017.0,15508.5,,,0
CDM,PMC - 3001 - 360000118,"OR CATEGORY IV 2'31""-2'45""",33019.0,16509.5,,,0
CDM,PMC - 3001 - 360000119,"OR CATEGORY IV 2'46""-3'00""",35021.0,17510.5,,,0
CDM,PMC - 3001 - 360000120,"OR CATEGORY IV 3'01""-3'15""",37023.0,18511.5,,,0
CDM,PMC - 3001 - 360000121,"OR CATEGORY IV 3'16""-3'30""",39025.0,19512.5,,,0
CDM,PMC - 3001 - 360000122,"OR CATEGORY IV 3'31""-3'45""",41027.0,20513.5,,,0
CDM,PMC - 3001 - 360000123,"OR CATEGORY IV 3'46""-4'00""",43029.0,21514.5,,,0
CDM,PMC - 3001 - 360000124,"OR CATEGORY IV 4'01""-4'15""",45031.0,22515.5,,,0
CDM,PMC - 3001 - 360000125,"OR CATEGORY IV 4'16""-4'30""",47033.0,23516.5,,,0
CDM,PMC - 3001 - 360000126,"OR CATEGORY IV 4'31""-4'45""",49035.0,24517.5,,,0
CDM,PMC - 3001 - 360000127,"OR CATEGORY IV 4'46""-5'00""",51037.0,25518.5,,,0
CDM,PMC - 3001 - 360000128,"OR CATEGORY IV 5'01""-5'15""",53039.0,26519.5,,,0
CDM,PMC - 3001 - 360000129,"OR CATEGORY IV 5'16""-5'30""",55041.0,27520.5,,,0
CDM,PMC - 3001 - 360000130,"OR CATEGORY IV 5'31""-5'45""",57043.0,28521.5,,,0
CDM,PMC - 3001 - 360000131,"OR CATEGORY IV 5'46""-6'00""",59045.0,29522.5,,,0
CDM,PMC - 3001 - 360000132,"OR CATEGORY IV 6'01""-6'15""",61047.0,30523.5,,,0
CDM,PMC - 3001 - 360000133,"OR CATEGORY IV 6'16""-6'30""",63049.0,31524.5,,,0
CDM,PMC - 3001 - 360000134,"OR CATEGORY IV 6'31""-6'45""",65051.0,32525.5,,,0
CDM,PMC - 3001 - 360000135,"OR CATEGORY IV 6'46""-7'00""",67053.0,33526.5,,,0
CDM,PMC - 3001 - 360000136,"OR CATEGORY IV 7'01""-7'15""",69055.0,34527.5,,,0
CDM,PMC - 3001 - 360000137,"OR CATEGORY IV 7'16""-7'30""",71057.0,35528.5,,,0
CDM,PMC - 3001 - 360000138,"OR CATEGORY IV 7'31""-7'45""",73059.0,36529.5,,,0
CDM,PMC - 3001 - 360000139,"OR CATEGORY IV 7'46""-8'00""",75061.0,37530.5,,,0
CDM,PMC - 3001 - 360000140,"OR CATEGORY IV 8'01""-8'15""",77063.0,38531.5,,,0
CDM,PMC - 3001 - 360000141,"OR CATEGORY IV 8'16""-8'30""",79065.0,39532.5,,,0
CDM,PMC - 3001 - 360000142,"OR CATEGORY IV 8'31""-8'45""",81067.0,40533.5,,,0
CDM,PMC - 3001 - 360000143,"OR CATEGORY IV 8'46""-9'00""",83069.0,41534.5,,,0
CDM,PMC - 3001 - 360000144,OR CATEGORY IV EA ADDL 15 MIN,2002.0,1001.0,,,0
CDM,PMC - 3001 - 360000145,"OR CATEGORY V 0""-15""",14299.0,7149.5,,,0
CDM,PMC - 3001 - 360000146,"OR CATEGORY V 16""-30""",16447.0,8223.5,,,0
CDM,PMC - 3001 - 360000147,"OR CATEGORY V 31""-45""",18594.0,9297.0,,,0
CDM,PMC - 3001 - 360000148,"OR CATEGORY V 46""-60""",20742.0,10371.0,,,0
CDM,PMC - 3001 - 360000149,"OR CATEGORY V 1'01""-1'15""",22889.0,11444.5,,,0
CDM,PMC - 3001 - 360000150,"OR CATEGORY V 1'16""-1'30""",25037.0,12518.5,,,0
CDM,PMC - 3001 - 360000151,"OR CATEGORY V 1'31""-1'45""",27185.0,13592.5,,,0
CDM,PMC - 3001 - 360000152,"OR CATEGORY V 1'46""-2'00""",29332.0,14666.0,,,0
CDM,PMC - 3001 - 360000153,"OR CATEGORY V 2'01""-2'15""",31480.0,15740.0,,,0
CDM,PMC - 3001 - 360000154,"OR CATEGORY V 2'16""-2'30""",33627.0,16813.5,,,0
CDM,PMC - 3001 - 360000155,"OR CATEGORY V 2'31""-2'45""",35775.0,17887.5,,,0
CDM,PMC - 3001 - 360000156,"OR CATEGORY V 2'46""-3'00""",37923.0,18961.5,,,0
CDM,PMC - 3001 - 360000157,"OR CATEGORY V 3'01""-3'15""",40070.0,20035.0,,,0
CDM,PMC - 3001 - 360000158,"OR CATEGORY V 3'16""-3'30""",42218.0,21109.0,,,0
CDM,PMC - 3001 - 360000159,"OR CATEGORY V 3'31""-3'45""",44365.0,22182.5,,,0
CDM,PMC - 3001 - 360000160,"OR CATEGORY V 3'46""-4'00""",46513.0,23256.5,,,0
CDM,PMC - 3001 - 360000161,"OR CATEGORY V 4'01""-4'15""",48661.0,24330.5,,,0
CDM,PMC - 3001 - 360000162,"OR CATEGORY V 4'16""-4'30""",50808.0,25404.0,,,0
CDM,PMC - 3001 - 360000163,"OR CATEGORY V 4'31""-4'45""",52956.0,26478.0,,,0
CDM,PMC - 3001 - 360000164,"OR CATEGORY V 4'46""-5'00""",55103.0,27551.5,,,0
CDM,PMC - 3001 - 360000165,"OR CATEGORY V 5'01""-5'15""",57251.0,28625.5,,,0
CDM,PMC - 3001 - 360000166,"OR CATEGORY V 5'16""-5'30""",59399.0,29699.5,,,0
CDM,PMC - 3001 - 360000167,"OR CATEGORY V 5'31""-5'45""",61546.0,30773.0,,,0
CDM,PMC - 3001 - 360000168,"OR CATEGORY V 5'46""-6'00""",63694.0,31847.0,,,0
CDM,PMC - 3001 - 360000169,"OR CATEGORY V 6'01""-6'15""",65841.0,32920.5,,,0
CDM,PMC - 3001 - 360000170,"OR CATEGORY V 6'16""-6'30""",67989.0,33994.5,,,0
CDM,PMC - 3001 - 360000171,"OR CATEGORY V 6'31""-6'45""",70137.0,35068.5,,,0
CDM,PMC - 3001 - 360000172,"OR CATEGORY V 6'46""-7'00""",72284.0,36142.0,,,0
CDM,PMC - 3001 - 360000173,"OR CATEGORY V 7'01""-7'15""",74432.0,37216.0,,,0
CDM,PMC - 3001 - 360000174,"OR CATEGORY V 7'16""-7'30""",76579.0,38289.5,,,0
CDM,PMC - 3001 - 360000175,"OR CATEGORY V 7'31""-7'45""",78727.0,39363.5,,,0
CDM,PMC - 3001 - 360000176,"OR CATEGORY V 7'46""-8'00""",80875.0,40437.5,,,0
CDM,PMC - 3001 - 360000177,OR CATEGORY V EA ADDL 15 MIN,2148.0,1074.0,,,0
CDM,PMC - 3001 - 360000220,LITHOTRIPSY,17085.0,8542.5,,,0
CDM,PMC - 3001 - 360000232,"OR CATEGORY I 8'01""-8'15""",37222.0,18611.0,,,0
CDM,PMC - 3001 - 360000233,"OR CATEGORY I 8'16""-8'30""",38277.0,19138.5,,,0
CDM,PMC - 3001 - 360000234,"OR CATEGORY I 8'31""-8'45""",39333.0,19666.5,,,0
CDM,PMC - 3001 - 360000235,"OR CATEGORY I 8'46""-9'00""",40388.0,20194.0,,,0
CDM,PMC - 3001 - 360000236,"OR CATEGORY I 9'01-9'15""",41444.0,20722.0,,,0
CDM,PMC - 3001 - 360000237,"OR CATEGORY I 9'16""-9'30""",42500.0,21250.0,,,0
CDM,PMC - 3001 - 360000238,"OR CATEGORY I 9'31""-9'45""",43555.0,21777.5,,,0
CDM,PMC - 3001 - 360000239,"OR CATEGORY I 9'46""-10'00""",44611.0,22305.5,,,0
CDM,PMC - 3001 - 360000240,"OR CATEGORY II 8'01""-8'15""",48434.0,24217.0,,,0
CDM,PMC - 3001 - 360000241,"OR CATEGORY II 8'16""-8'30""",49781.0,24890.5,,,0
CDM,PMC - 3001 - 360000242,"OR CATEGORY II 8'31""-8'45""",51127.0,25563.5,,,0
CDM,PMC - 3001 - 360000243,"OR CATEGORY II 8'46""-9'00""",52474.0,26237.0,,,0
CDM,PMC - 3001 - 360000244,"OR CATEGORY II 9'01-9'15""",53821.0,26910.5,,,0
CDM,PMC - 3001 - 360000245,"OR CATEGORY II 9'16""-9'30""",55168.0,27584.0,,,0
CDM,PMC - 3001 - 360000246,"OR CATEGORY II 9'31""-9'45""",56515.0,28257.5,,,0
CDM,PMC - 3001 - 360000247,"OR CATEGORY II 9'46""-10'00""",57861.0,28930.5,,,0
CDM,PMC - 3001 - 360000248,"OR CATEGORY IV 9'01-9'15""",85071.0,42535.5,,,0
CDM,PMC - 3001 - 360000249,"OR CATEGORY IV 9'16""-9'30""",87073.0,43536.5,,,0
CDM,PMC - 3001 - 360000250,"OR CATEGORY IV 9'31""-9'45""",89075.0,44537.5,,,0
CDM,PMC - 3001 - 360000251,"OR CATEGORY IV 9'46""-10'00""",91077.0,45538.5,,,0
CDM,PMC - 3001 - 360000252,"OR CATEGORY V 8'01""-8'15""",83022.0,41511.0,,,0
CDM,PMC - 3001 - 360000253,"OR CATEGORY V 8'16""-8'30""",85170.0,42585.0,,,0
CDM,PMC - 3001 - 360000254,"OR CATEGORY V 8'31""-8'45""",87317.0,43658.5,,,0
CDM,PMC - 3001 - 360000255,"OR CATEGORY V 8'46""-9'00""",89465.0,44732.5,,,0
CDM,PMC - 3001 - 360000256,"OR CATEGORY V 9'01-9'15""",91613.0,45806.5,,,0
CDM,PMC - 3001 - 360000257,"OR CATEGORY V 9'16""-9'30""",93760.0,46880.0,,,0
CDM,PMC - 3001 - 360000258,"OR CATEGORY V 9'31""-9'45""",95908.0,47954.0,,,0
CDM,PMC - 3001 - 360000259,"OR CATEGORY V 9'46""-10'00""",98055.0,49027.5,,,0
CDM,PMC - 3001 - 360000291,REFRACTIVE LENS EXCHANGE,1400.0,700.0,,,0
CDM,PMC - 3001 - 360000292,OPTIWAVE REFRACTIVE ANALYSIS,200.0,100.0,,,0
CDM,PMC - 3001 - 362000001,PLACE PICC/MIDLINE,1999.0,999.5,,,0
CDM,PMC - 3001 - 362000002,INSERT NON TUNNEL CV CATH,3548.0,1774.0,,,0
CDM,PMC - 3001 - 362000005,INSERT FEMORAL SUBCLAV CATH,942.0,471.0,,,0
CDM,PMC - 3001 - 362000006,INSERT CENTRAL LINE,3527.0,1763.5,,,0
CDM,PMC - 3001 - 362000007,INSERT CHEST TUBE,1925.0,962.5,,,0
CDM,PMC - 3001 - 362000010,CLOSED MANIPULATION,1310.0,655.0,,,0
CDM,PMC - 3001 - 362000018,CHEMODENERVATION LARYNX EMG,5098.0,2549.0,,,0
CDM,PMC - 3001 - 362000019,LARYNGOSCOPY FLEX DX,596.0,298.0,,,0
CDM,PMC - 3001 - 362000020,INSERT VAGINAL CYLINDER,1114.0,557.0,,,0
CDM,PMC - 3001 - 362000021,PLACE TISSUE MARKER PROSTATE,752.0,376.0,,,0
CDM,PMC - 3001 - 362000022,CIRCUMCISION,438.0,219.0,,,0
CDM,PMC - 3001 - 362000023,CHEMODENERVATION LARNYX,128.0,64.0,,,0
CDM,PMC - 3001 - 366000350,CT PERFUSION W CONTRAST CBF,1630.0,815.0,,,0
CDM,PMC - 3001 - 366000400,"SURG PROC LVL I 0""-15""",2948.0,1474.0,,,0
CDM,PMC - 3001 - 366000401,"SURG PROC LVL I 16""-30""",3876.0,1938.0,,,0
CDM,PMC - 3001 - 366000402,"SURG PROC LVL I 30""-1.0'",4919.0,2459.5,,,0
CDM,PMC - 3001 - 366000403,SURG PROC LVL I 1.0'-1.5',5972.0,2986.0,,,0
CDM,PMC - 3001 - 366000404,SURG PROC LVL I 1.5'-2.0',7037.0,3518.5,,,0
CDM,PMC - 3001 - 366000405,"SURG PROC LVL I EA AD30""",1050.0,525.0,,,0
CDM,PMC - 3001 - 366000406,"SURG PROC LVL II 0""-30""",3897.0,1948.5,,,0
CDM,PMC - 3001 - 366000407,"SURG PROC LVL II 30""-1.0'",5195.0,2597.5,,,0
CDM,PMC - 3001 - 366000408,SURG PROC LVL II 1.0'-1.5',6703.0,3351.5,,,0
CDM,PMC - 3001 - 366000409,SURG PROC LVL II 1.5'-2.0',8209.0,4104.5,,,0
CDM,PMC - 3001 - 366000410,SURG PROC LVL II 2.0'-2.5',9710.0,4855.0,,,0
CDM,PMC - 3001 - 366000411,SURG PROC LVL II EA AD30,1508.0,754.0,,,0
CDM,PMC - 3001 - 366000412,"SURG PROC LVL III 0'-30""",9776.0,4888.0,,,0
CDM,PMC - 3001 - 366000413,"SURG PROC LVL III 30""-1.0'",14455.0,7227.5,,,0
CDM,PMC - 3001 - 366000414,SURG PROC LVL III 1.0'-1.5',19121.0,9560.5,,,0
CDM,PMC - 3001 - 366000415,SURG PROC LVL III 1.5'-2.0',23778.0,11889.0,,,0
CDM,PMC - 3001 - 366000416,SURG PROC LVL III 2.0'-2.5',28425.0,14212.5,,,0
CDM,PMC - 3001 - 366000417,SURG PROC LVL III 2.5'-3.0',33062.0,16531.0,,,0
CDM,PMC - 3001 - 366000418,SURG PROC LVL III 3.0'-3.5',37688.0,18844.0,,,0
CDM,PMC - 3001 - 366000419,"SURG PROC LVL III EA AD30""",6946.0,3473.0,,,0
CDM,PMC - 3001 - 366000420,"SURG PROC LVL IV 0'-30""",10400.0,5200.0,,,0
CDM,PMC - 3001 - 366000421,"SURG PROC LVL IV 30""-1.0'",15860.0,7930.0,,,0
CDM,PMC - 3001 - 366000422,SURG PROC LVL IV 1.0'-1.5',21310.0,10655.0,,,0
CDM,PMC - 3001 - 366000423,SURG PROC LVL IV 1.5'-2.0',26749.0,13374.5,,,0
CDM,PMC - 3001 - 366000424,SURG PROC LVL IV 2.0'-2.5',32178.0,16089.0,,,0
CDM,PMC - 3001 - 366000425,SURG PROC LVL IV 2.5'-3.0',37596.0,18798.0,,,0
CDM,PMC - 3001 - 366000426,SURG PROC LVL IV 3.0'-3.5',43004.0,21502.0,,,0
CDM,PMC - 3001 - 366000427,"SURG PROC LVL IV EA AD30""",8063.0,4031.5,,,0
CDM,PMC - 3001 - 366000428,DX PERIPHERAL 0-1.0HR,21507.0,10753.5,,,0
CDM,PMC - 3001 - 366000429,DX PERIPHERAL 1.0-1.5HR,27092.0,13546.0,,,0
CDM,PMC - 3001 - 366000430,DX PERIPHERAL 1.5-2.0HR,32672.0,16336.0,,,0
CDM,PMC - 3001 - 366000431,DX PERIPHERAL 2.0-2.5HR,38237.0,19118.5,,,0
CDM,PMC - 3001 - 366000432,DX PERIPHERAL 2.5-3.0HR,43802.0,21901.0,,,0
CDM,PMC - 3001 - 366000433,DX PERIPHERAL 3.0-3.5HR,49367.0,24683.5,,,0
CDM,PMC - 3001 - 366000434,DX PERIPHERAL 3.5-4.0HR,54931.0,27465.5,,,0
CDM,PMC - 3001 - 366000435,DX PERIPHERAL 4.0-4.5HR,60493.0,30246.5,,,0
CDM,PMC - 3001 - 366000436,DX PERIPHERAL 4.5-5.0HR,66054.0,33027.0,,,0
CDM,PMC - 3001 - 366000437,DX PERIPHERAL EA +30MIN,9019.0,4509.5,,,0
CDM,PMC - 3001 - 366000438,PERIPH INTERVENTN 0-1.0HR,18325.0,9162.5,,,0
CDM,PMC - 3001 - 366000439,PERIPH INTERVENTN 1.0-1.5HR,25061.0,12530.5,,,0
CDM,PMC - 3001 - 366000440,PERIPH INTERVENTN 1.5-2.0HR,31796.0,15898.0,,,0
CDM,PMC - 3001 - 366000441,PERIPH INTERVENTN 2.0-2.5HR,38529.0,19264.5,,,0
CDM,PMC - 3001 - 366000442,PERIPH INTERVENTN 2.5-3.0HR,45261.0,22630.5,,,0
CDM,PMC - 3001 - 366000443,PERIPH INTERVENTN 3.0-3.5HR,51992.0,25996.0,,,0
CDM,PMC - 3001 - 366000444,PERIPH INTERVENTN 3.5-4.0HR,58720.0,29360.0,,,0
CDM,PMC - 3001 - 366000445,PERIPH INTERVENTN 4.0-4.5HR,65449.0,32724.5,,,0
CDM,PMC - 3001 - 366000446,PERIPH INTERVENTN 4.5-5.0HR,72175.0,36087.5,,,0
CDM,PMC - 3001 - 366000447,PERIPH INTERVENTN EA +30MIN,7529.0,3764.5,,,0
CDM,PMC - 3001 - 366000448,DX PERIPH W/ INTERV 0-1.0HR,21429.0,10714.5,,,0
CDM,PMC - 3001 - 366000449,DX PERIPH W/ INTERV 1.0-1.5HR,29220.0,14610.0,,,0
CDM,PMC - 3001 - 366000450,DX PERIPH W/ INTERV 1.5-2.0HR,37003.0,18501.5,,,0
CDM,PMC - 3001 - 366000451,DX PERIPH W/ INTERV 2.0-2.5HR,44784.0,22392.0,,,0
CDM,PMC - 3001 - 366000452,DX PERIPH W/ INTERV 2.5-3.0HR,52561.0,26280.5,,,0
CDM,PMC - 3001 - 366000453,DX PERIPH W/ INTERV 3.0-3.5HR,60332.0,30166.0,,,0
CDM,PMC - 3001 - 366000454,DX PERIPH W/ INTERV 3.5-4.0HR,68099.0,34049.5,,,0
CDM,PMC - 3001 - 366000455,DX PERIPH W/ INTERV 4.0-4.5HR,75862.0,37931.0,,,0
CDM,PMC - 3001 - 366000456,DX PERIPH W/ INTERV 4.5-5.0HR,83619.0,41809.5,,,0
CDM,PMC - 3001 - 366000457,DX PERIPH W/ INTERV EA +30MIN,8900.0,4450.0,,,0
CDM,PMC - 3001 - 366000458,PAIN MANAGEMENT BLOCK 0-15 MN,973.0,486.5,,,0
CDM,PMC - 3001 - 366000459,PAIN MANAGEMENT BLOCK 16-30MN,1161.0,580.5,,,0
CDM,PMC - 3001 - 366000460,PAIN MANAGEMENT BLOCK 31-45MN,1344.0,672.0,,,0
CDM,PMC - 3001 - 366000461,PAIN MANAGEMENT BLOCK 46-60MN,1527.0,763.5,,,0
CDM,PMC - 3001 - 366000462,PAIN MANAGEMENT BLOCK 61-75MN,1710.0,855.0,,,0
CDM,PMC - 3001 - 366000463,PAIN MANAGEMENT BLOCK 76-90MN,1893.0,946.5,,,0
CDM,PMC - 3001 - 366000464,PAIN MANAGEMENT BLOCK91-105MN,2073.0,1036.5,,,0
CDM,PMC - 3001 - 366000465,SURG PROC MRGFUS,86445.0,43222.5,,,0
CDM,PMC - 3001 - 366000479,CSF SHUNT REPROGRAM,423.0,211.5,,,0
CDM,PMC - 3001 - 370000001,"LEVEL I ANES MAC 0""-15""",320.88,160.44,,,0
CDM,PMC - 3001 - 370000022,"LEVEL II ANES REG 0""-15""",411.81,205.91,,,0
CDM,PMC - 3001 - 370000043,"LEVEL III ANES GEN 0""-15""",589.49,294.75,,,0
CDM,PMC - 3001 - 370000080,"LEVEL IV ANES INV 0""-15""",623.99,312.0,,,0
CDM,PMC - 3001 - 370000117,"LEVEL V ANES T&H 0""-15""",644.89,322.45,,,0
CDM,PMC - 3001 - 370000158,ACCOMMODATING LENS ANESTH,992.0,496.0,,,0
CDM,PMC - 3001 - 370000159,ECT ANESTH,401.0,200.5,,,0
CDM,PMC - 3001 - 370000171,EPIDURA NERVE BLOCK LUMB/CAUDA,1545.0,772.5,,,0
CDM,PMC - 3001 - 370000185,NM SEDATION ORAL/RECTAL,737.0,368.5,,,0
CDM,PMC - 3001 - 370000186,EPIDURAL ANESTHESIA,1057.0,528.5,,,0
CDM,PMC - 3001 - 370000189,LEVEL I ANES MAC EA ADD MN,27.18,13.59,,,0
CDM,PMC - 3001 - 370000190,LEVEL II ANES REG EA ADD MN,34.5,17.25,,,0
CDM,PMC - 3001 - 370000191,LEVEL III ANES GEN EA ADDMN,48.08,24.04,,,0
CDM,PMC - 3001 - 370000192,LEVEL IV ANES INV EA ADD MN,51.22,25.61,,,0
CDM,PMC - 3001 - 370000193,LEVEL V ANES T&H EA ADD MN,52.26,26.13,,,0
CDM,PMC - 3001 - 370000194,CATH CENT VEIN MULTI LUMEN,553.0,276.5,,,0
CDM,PMC - 3001 - 370000195,CATH EPIDURAL,192.0,96.0,,,0
CDM,PMC - 3001 - 370000196,CATH SWAN-GANZ,2081.0,1040.5,,,0
CDM,PMC - 3001 - 370000198,PAIN PUMP,2209.0,1104.5,,,0
CDM,PMC - 3001 - 370000204,INJ ANES TAP (TRANSVERSE ABDOMINUS PLANE) NERVE BLOCK,1081.0,540.5,,,0
CDM,PMC - 3001 - 370000208,MOD SED ENDO SERVICE SAME PHYS/QHP 5/>YRS INITIAL 15 MINUTES,161.0,80.5,,,0
CDM,PMC - 3001 - 370000213,TRANSVERSUS ABDOMINIS PLANE BLOCK,1473.0,736.5,,,0
CDM,PMC - 3001 - 370000215,"ASC LEVEL I ANES MAC 0""-15""",288.8,144.4,,,0
CDM,PMC - 3001 - 370000216,ASC LEVEL I ANES MAC EA ADD MN,24.46,12.23,,,0
CDM,PMC - 3001 - 370000217,"ASC LEVEL II ANES REG 0""-15""",370.62,185.31,,,0
CDM,PMC - 3001 - 370000218,ASC LEVEL II ANES REG EA ADD MN,31.04,15.52,,,0
CDM,PMC - 3001 - 370000219,"ASC LEVEL III ANES GEN 0""-15""",530.55,265.28,,,0
CDM,PMC - 3001 - 370000220,ASC LEVEL III ANES GEN EA ADDMN,43.27,21.64,,,0
CDM,PMC - 3001 - 370000221,"ASC LEVEL IV ANES INV 0""-15""",561.59,280.8,,,0
CDM,PMC - 3001 - 370000222,ASC LEVEL IV ANES INV EA ADD MN,46.1,23.05,,,0
CDM,PMC - 3001 - 370000223,"ASC LEVEL V ANES T&H 0""-15""",580.4,290.2,,,0
CDM,PMC - 3001 - 370000224,ASC LEVEL V ANES T&H EA ADD M,47.04,23.52,,,0
CDM,PMC - 3001 - 370000226,TRANSVERSUS ABDOMINIS PLANE BLOCK CONT,2135.0,1067.5,,,0
CDM,PMC - 3001 - 370000233,ANES TRAUMA RIB FRACTURE-UNILATERAL,682.0,341.0,,,0
CDM,PMC - 3001 - 370000234,ANES TRAUMA RIB FRACTURE-BILATERAL,682.0,341.0,,,0
CDM,PMC - 3001 - 410000034,BRONCHOSCOPY,853.0,426.5,,,0
CDM,PMC - 3001 - 410000035,BRONCHOSCOPY W COMBI CATH,394.0,197.0,,,0
CDM,PMC - 3001 - 410000036,BRONCHOSCOPY WBRUSHING,727.0,363.5,,,0
CDM,PMC - 3001 - 410000079,OXYGEN HOOD,386.0,193.0,,,0
CDM,PMC - 3001 - 420000073,DRY NEEDLING INITIAL,85.0,42.5,,,0
CDM,PMC - 3001 - 420000074,DRY NEEDLING SUBSEQUENT,113.0,56.5,,,0
CDM,PMC - 3001 - 427000043,HAND FINGER ELASTIC PREF,90.0,45.0,,,0
CDM,PMC - 3001 - 450000014,PROCEDURE LEVEL 1,356.0,178.0,,,0
CDM,PMC - 3001 - 450000015,PROCEDURE LEVEL 2,528.0,264.0,,,0
CDM,PMC - 3001 - 450000016,PROCEDURE LEVEL 3,742.0,371.0,,,0
CDM,PMC - 3001 - 450000017,PROCEDURE LEVEL 4,1296.0,648.0,,,0
CDM,PMC - 3001 - 450000018,PROCEDURE LEVEL 5,2126.0,1063.0,,,0
CDM,PMC - 3001 - 450000019,PROCEDURE LEVEL 6,2496.0,1248.0,,,0
CDM,PMC - 3001 - 450000074,KIT ARCTICGEL PAD SM/MD/LG,4982.0,2491.0,,,0
CDM,PMC - 3001 - 450000099,FETAL MONITORING DAILY CHG,344.0,172.0,,,0
CDM,PMC - 3001 - 471000006,AUDIOLOGY CONSULT COMPLEX,660.0,330.0,,,0
CDM,PMC - 3001 - 481000001,DX CARDIAC CATH 0-1.0 HR,22238.0,11119.0,,,0
CDM,PMC - 3001 - 481000002,DX CARDIAC CATH 1.0-1.5 HRS,27334.0,13667.0,,,0
CDM,PMC - 3001 - 481000003,DX CARDIAC CATH 1.5-2.0 HRS,32419.0,16209.5,,,0
CDM,PMC - 3001 - 481000004,DX CARDIAC CATH 2.0-2.5 HRS,37504.0,18752.0,,,0
CDM,PMC - 3001 - 481000005,DX CARDIAC CATH 2.5-3.0 HRS,42589.0,21294.5,,,0
CDM,PMC - 3001 - 481000006,DX CARDIAC CATH 3.0-3.5 HRS,47672.0,23836.0,,,0
CDM,PMC - 3001 - 481000007,DX CARDIAC CATH 3.5-4.0 HRS,52751.0,26375.5,,,0
CDM,PMC - 3001 - 481000008,CARD INTERVENTION 0-1.0 HR,18594.0,9297.0,,,0
CDM,PMC - 3001 - 481000009,CARD INTERVENTION 1.0-1.5 HRS,25427.0,12713.5,,,0
CDM,PMC - 3001 - 481000010,CARD INTERVENTION 1.5-2.0 HRS,32230.0,16115.0,,,0
CDM,PMC - 3001 - 481000011,CARD INTERVENTION 2.0-2.5 HRS,39031.0,19515.5,,,0
CDM,PMC - 3001 - 481000012,CARD INTERVENTION 2.5-3.0 HRS,45829.0,22914.5,,,0
CDM,PMC - 3001 - 481000013,CARD INTERVENTION 3.0-3.5 HRS,52624.0,26312.0,,,0
CDM,PMC - 3001 - 481000014,CARD INTERVENTION 3.5-4.0 HRS,59418.0,29709.0,,,0
CDM,PMC - 3001 - 481000015,CARD INTERVENTION 4.0-4.5 HRS,66206.0,33103.0,,,0
CDM,PMC - 3001 - 481000016,CARD INTERVENTION 4.5-5.0 HRS,72993.0,36496.5,,,0
CDM,PMC - 3001 - 481000017,DX CATH W/ INTERV 0-1.0 HR,21620.0,10810.0,,,0
CDM,PMC - 3001 - 481000018,DX CATH W/ INTERV 1.0-1.5 HRS,29412.0,14706.0,,,0
CDM,PMC - 3001 - 481000019,DX CATH W/ INTERV 1.5-2.0 HRS,37205.0,18602.5,,,0
CDM,PMC - 3001 - 481000020,DX CATH W/ INTERV 2.0-2.5 HRS,44996.0,22498.0,,,0
CDM,PMC - 3001 - 481000021,DX CATH W/ INTERV 2.5-3.0 HRS,52776.0,26388.0,,,0
CDM,PMC - 3001 - 481000022,DX CATH W/ INTERV 3.0-3.5 HRS,60554.0,30277.0,,,0
CDM,PMC - 3001 - 481000023,DX CATH W/ INTERV 3.5-4.0 HRS,68332.0,34166.0,,,0
CDM,PMC - 3001 - 481000024,DX CATH W/ INTERV 4.0-4.5 HRS,76108.0,38054.0,,,0
CDM,PMC - 3001 - 481000025,DX CATH W/ INTERV 4.5-5.0 HRS,83881.0,41940.5,,,0
CDM,PMC - 3001 - 481000026,DX PERIPHERAL 0-1.0HR,21717.0,10858.5,,,0
CDM,PMC - 3001 - 481000027,DX PERIPHERAL 1.0-1.5HRS,27377.0,13688.5,,,0
CDM,PMC - 3001 - 481000028,DX PERIPHERAL 1.5-2.0HRS,33009.0,16504.5,,,0
CDM,PMC - 3001 - 481000029,DX PERIPHERAL 2.0-2.5HRS,38635.0,19317.5,,,0
CDM,PMC - 3001 - 481000030,DX PERIPHERAL 2.5-3.0HRS,44245.0,22122.5,,,0
CDM,PMC - 3001 - 481000031,DX PERIPHERAL 3.0-3.5HRS,49852.0,24926.0,,,0
CDM,PMC - 3001 - 481000032,DX PERIPHERAL 3.5-4.0HRS,55458.0,27729.0,,,0
CDM,PMC - 3001 - 481000033,DX PERIPHERAL 4.0-4.5HRS,61062.0,30531.0,,,0
CDM,PMC - 3001 - 481000034,DX PERIPHERAL 4.5-5.0HRS,66664.0,33332.0,,,0
CDM,PMC - 3001 - 481000035,DX PERIPHERAL ADD'L 30MIN,9105.0,4552.5,,,0
CDM,PMC - 3001 - 481000036,PERIPH INTERVENTN 0-1.0HR,18502.0,9251.0,,,0
CDM,PMC - 3001 - 481000037,PERIPH INTERVENTN 1.0-1.5HRS,25238.0,12619.0,,,0
CDM,PMC - 3001 - 481000038,PERIPH INTERVENTN 1.5-2.0HRS,31973.0,15986.5,,,0
CDM,PMC - 3001 - 481000039,PERIPH INTERVENTN 2.0-2.5HRS,38706.0,19353.0,,,0
CDM,PMC - 3001 - 481000040,PERIPH INTERVENTN 2.5-3.0HRS,45437.0,22718.5,,,0
CDM,PMC - 3001 - 481000041,PERIPH INTERVENTN 3.0-3.5HRS,52167.0,26083.5,,,0
CDM,PMC - 3001 - 481000042,PERIPH INTERVENTN 3.5-4.0HRS,58896.0,29448.0,,,0
CDM,PMC - 3001 - 481000043,PERIPH INTERVENTN 4.0-4.5HRS,65625.0,32812.5,,,0
CDM,PMC - 3001 - 481000044,PERIPH INTERVENTN 4.5-5.0HRS,72351.0,36175.5,,,0
CDM,PMC - 3001 - 481000045,DX PERIPH W/ INTERV 0-1.0HR,21630.0,10815.0,,,0
CDM,PMC - 3001 - 481000046,DX PERIPH W/ INTERV 1.0-1.5HR,29421.0,14710.5,,,0
CDM,PMC - 3001 - 481000047,DX PERIPH W/ INTERV 1.5-2.0HR,37206.0,18603.0,,,0
CDM,PMC - 3001 - 481000048,DX PERIPH W/ INTERV 2.0-2.5HR,44987.0,22493.5,,,0
CDM,PMC - 3001 - 481000049,DX PERIPH W/ INTERV 2.5-3.0HR,52763.0,26381.5,,,0
CDM,PMC - 3001 - 481000050,DX PERIPH W/ INTERV 3.0-3.5HR,60535.0,30267.5,,,0
CDM,PMC - 3001 - 481000051,DX PERIPH W/ INTERV 3.5-4.0HR,68304.0,34152.0,,,0
CDM,PMC - 3001 - 481000052,DX PERIPH W/ INTERV 4.0-4.5HR,76065.0,38032.5,,,0
CDM,PMC - 3001 - 481000053,DX PERIPH W/ INTERV 4.5-5.0HR,83822.0,41911.0,,,0
CDM,PMC - 3001 - 481000054,DX PERIPH W/P INTER ADD'L30MIN,8986.0,4493.0,,,0
CDM,PMC - 3001 - 481000082,EP LAB SERVICES 0-1 HR,11523.0,5761.5,,,0
CDM,PMC - 3001 - 481000083,EP LAB SERVICES 1-2 HRS,18467.0,9233.5,,,0
CDM,PMC - 3001 - 481000084,EP LAB SERVICES 2-3 HRS,25411.0,12705.5,,,0
CDM,PMC - 3001 - 481000085,EP LAB SERVICES 3-4 HRS,32352.0,16176.0,,,0
CDM,PMC - 3001 - 481000086,EP LAB SERVICES 4-5 HRS,39293.0,19646.5,,,0
CDM,PMC - 3001 - 481000087,EP LAB SERVICES 5-6 HRS,46232.0,23116.0,,,0
CDM,PMC - 3001 - 481000088,EP LAB SERVICES 6-7 HRS,53167.0,26583.5,,,0
CDM,PMC - 3001 - 481000089,EP LAB SERVICES 7-8+ HRS,60102.0,30051.0,,,0
CDM,PMC - 3001 - 481000090,EP NON-INVASIVE SVCS 0-1HR,822.0,411.0,,,0
CDM,PMC - 3001 - 481000093,PERICARDIOCENTESIS,2884.0,1442.0,,,0
CDM,PMC - 3001 - 481001074,PERIPH INTERVENTN ADD'L30MIN,6317.0,3158.5,,,0
CDM,PMC - 3001 - 481001365,IVUS NONCORON W S&I 1ST VESSEL,965.0,482.5,,,0
CDM,PMC - 3001 - 481001366,IVUS NONCORON W S&I EA ADDL,182.0,91.0,,,0
CDM,PMC - 3001 - 481001572,DX CATH W/ INTERV EA ADDL 30 MIN,8986.0,4493.0,,,0
CDM,PMC - 3001 - 481001573,DX CARDIAC CATH EA ADDL 30 MIN,5115.0,2557.5,,,0
CDM,PMC - 3001 - 481001574,DX PERIPHERAL 5.0-5.5 HRS,72264.0,36132.0,,,0
CDM,PMC - 3001 - 481001575,DX PERIPHERAL 5.5-6.0 HRS,77865.0,38932.5,,,0
CDM,PMC - 3001 - 481001576,DX PERIPHERAL 6.0-6.5 HRS,83460.0,41730.0,,,0
CDM,PMC - 3001 - 481001577,DX PERIPHERAL 6.5-7.0 HRS,89055.0,44527.5,,,0
CDM,PMC - 3001 - 481001578,DX PERIPHERAL 7.0-7.5 HRS,94645.0,47322.5,,,0
CDM,PMC - 3001 - 481001579,DX PERIPHERAL 7.5-8.0 HRS,100235.0,50117.5,,,0
CDM,PMC - 3001 - 481001580,DX PERIPH W/ INTERV 5.0-5.5 HRS,91575.0,45787.5,,,0
CDM,PMC - 3001 - 481001581,DX PERIPH W/ INTERV 5.5-6.0 HRS,99323.0,49661.5,,,0
CDM,PMC - 3001 - 481001582,DX PERIPH W/ INTERV 6.0-6.5 HRS,107067.0,53533.5,,,0
CDM,PMC - 3001 - 481001583,DX PERIPH W/ INTERV 6.5-7.0 HRS,114806.0,57403.0,,,0
CDM,PMC - 3001 - 481001584,DX PERIPH W/ INTERV 7.0-7.5 HRS,122540.0,61270.0,,,0
CDM,PMC - 3001 - 481001585,DX PERIPH W/ INTERV 7.5-8.0 HRS,130269.0,65134.5,,,0
CDM,PMC - 3001 - 481001586,PERIPH INTERVENTN 5.0-5.5 HRS,79077.0,39538.5,,,0
CDM,PMC - 3001 - 481001587,PERIPH INTERVENTN 5.5-6.0 HRS,85801.0,42900.5,,,0
CDM,PMC - 3001 - 481001588,PERIPH INTERVENTN 6.0-6.5 HRS,92524.0,46262.0,,,0
CDM,PMC - 3001 - 481001589,PERIPH INTERVENTN 6.5-7.0 HRS,99245.0,49622.5,,,0
CDM,PMC - 3001 - 481001590,PERIPH INTERVENTN 7.0-7.5 HRS,105965.0,52982.5,,,0
CDM,PMC - 3001 - 481001591,PERIPH INTERVENTN 7.5-8.0 HRS,112683.0,56341.5,,,0
CDM,PMC - 3001 - 481001592,DX CARDIAC CATH 4.0-4.5 HRS,57828.0,28914.0,,,0
CDM,PMC - 3001 - 481001593,DX CARDIAC CATH 4.5-5.0 HRS,62904.0,31452.0,,,0
CDM,PMC - 3001 - 481001594,DX CARDIAC CATH 5.0-5.5 HRS,67979.0,33989.5,,,0
CDM,PMC - 3001 - 481001595,DX CARDIAC CATH 5.5-6.0 HRS,73050.0,36525.0,,,0
CDM,PMC - 3001 - 481001596,DX CARDIAC CATH 6.0-6. 5 HRS,78120.0,39060.0,,,0
CDM,PMC - 3001 - 481001597,DX CARDIAC CATH 6.5-7.0 HRS,83188.0,41594.0,,,0
CDM,PMC - 3001 - 481001598,DX CARDIAC CATH 7.0-7.5 HRS,88252.0,44126.0,,,0
CDM,PMC - 3001 - 481001599,DX CARDIAC CATH 7.5-8.0 HRS,93316.0,46658.0,,,0
CDM,PMC - 3001 - 481001600,DX CATH W/ INTERV 5.0-5.5 HRS,91649.0,45824.5,,,0
CDM,PMC - 3001 - 481001601,DX CATH W/ INTERV 5.5-6.0 HRS,99415.0,49707.5,,,0
CDM,PMC - 3001 - 481001602,DX CATH W/ INTERV 6.0-6.5 HRS,107176.0,53588.0,,,0
CDM,PMC - 3001 - 481001603,DX CATH W/ INTERV 6.5-7.0 HRS,114936.0,57468.0,,,0
CDM,PMC - 3001 - 481001604,DX CATH W/ INTERV 7.0-7.5 HRS,122692.0,61346.0,,,0
CDM,PMC - 3001 - 481001605,DX CATH W/ INTERV 7.5-8.0 HRS,130444.0,65222.0,,,0
CDM,PMC - 3001 - 481001606,CARD INTERVENTION 5.0-5.5 HRS,79778.0,39889.0,,,0
CDM,PMC - 3001 - 481001607,CARD INTERVENTION 5.5-6.0 HRS,86560.0,43280.0,,,0
CDM,PMC - 3001 - 481001608,CARD INTERVENTION 6.0-6.5 HRS,93339.0,46669.5,,,0
CDM,PMC - 3001 - 481001609,CARD INTERVENTION 6.5-7.0 HRS,100116.0,50058.0,,,0
CDM,PMC - 3001 - 481001610,CARD INTERVENTION 7.0-7.5 HRS,106889.0,53444.5,,,0
CDM,PMC - 3001 - 481001611,CARD INTERVENTION 7.5-8.0 HRS,113660.0,56830.0,,,0
CDM,PMC - 3001 - 610000185,QUANTITATIVE MRI ANALYSIS BRAIN W/DX MRI,628.0,314.0,,,0
CDM,PMC - 3001 - 710000001,PACU 0-15 MIN PHASE I,848.0,424.0,,,0
CDM,PMC - 3001 - 710000002,PACU 16-30 MIN PHASE I,1238.0,619.0,,,0
CDM,PMC - 3001 - 710000003,PACU 0-30 MIN PHASE I,1238.0,619.0,,,0
CDM,PMC - 3001 - 710000004,PACU 31-60 MIN PHASE I,2239.0,1119.5,,,0
CDM,PMC - 3001 - 710000005,PACU 61-90 MIN PHASE I,3230.0,1615.0,,,0
CDM,PMC - 3001 - 710000006,PACU 91-120 MIN PHASE I,4219.0,2109.5,,,0
CDM,PMC - 3001 - 710000007,PACU 121-150 MIN PHASE I,5199.0,2599.5,,,0
CDM,PMC - 3001 - 710000008,PACU 151-180 MIN PHASE I,6178.0,3089.0,,,0
CDM,PMC - 3001 - 710000009,PACU 181-210 MIN PHASE I,7155.0,3577.5,,,0
CDM,PMC - 3001 - 710000010,PACU 211-240 MIN PHASE I,8132.0,4066.0,,,0
CDM,PMC - 3001 - 710000011,PACU 241-270 MIN PHASE I,9108.0,4554.0,,,0
CDM,PMC - 3001 - 710000012,PACU 271-300 MIN PHASE I,10080.0,5040.0,,,0
CDM,PMC - 3001 - 710000013,PACU 301-330 MIN PHASE I,11049.0,5524.5,,,0
CDM,PMC - 3001 - 710000014,PACU 331-360 MIN PHASE I,12016.0,6008.0,,,0
CDM,PMC - 3001 - 710000015,PACU 361-390 MIN PHASE I,12982.0,6491.0,,,0
CDM,PMC - 3001 - 710000016,PACU 391-420 MIN PHASE I,13947.0,6973.5,,,0
CDM,PMC - 3001 - 710000017,PACU 421-450 MIN PHASE I,14912.0,7456.0,,,0
CDM,PMC - 3001 - 710000018,PACU 451-480 MIN PHASE I,15875.0,7937.5,,,0
CDM,PMC - 3001 - 710000019,PACU EA ADDL 15 MIN PHASE I,346.0,173.0,,,0
CDM,PMC - 3001 - 720000001,TRIAGE >0-1 HR,660.0,330.0,,,0
CDM,PMC - 3001 - 720000002,TRIAGE >1-2 HRS,1039.0,519.5,,,0
CDM,PMC - 3001 - 720000003,TRIAGE >2-4 HRS,1438.0,719.0,,,0
CDM,PMC - 3001 - 720000004,TRIAGE >4-6 HRS,1933.0,966.5,,,0
CDM,PMC - 3001 - 720000005,TRIAGE >6-8 HRS,2442.0,1221.0,,,0
CDM,PMC - 3001 - 720000006,TRIAGE >8-10 HRS,2952.0,1476.0,,,0
CDM,PMC - 3001 - 720000007,TRIAGE >10 HRS,3475.0,1737.5,,,0
CDM,PMC - 3001 - 720000019,LABOR > 0-1 HR,777.0,388.5,,,0
CDM,PMC - 3001 - 720000020,LABOR > 1-2 HRS,1350.0,675.0,,,0
CDM,PMC - 3001 - 720000021,LABOR > 2-4 HRS,1922.0,961.0,,,0
CDM,PMC - 3001 - 720000022,LABOR > 4-6 HRS,2493.0,1246.5,,,0
CDM,PMC - 3001 - 720000023,LABOR > 6-8 HRS,3064.0,1532.0,,,0
CDM,PMC - 3001 - 720000024,LABOR > 8-10 HRS,3635.0,1817.5,,,0
CDM,PMC - 3001 - 720000025,LABOR >10-12 HRS,4206.0,2103.0,,,0
CDM,PMC - 3001 - 720000026,LABOR >12-14 HRS,4776.0,2388.0,,,0
CDM,PMC - 3001 - 720000027,LABOR >14-16 HRS,5346.0,2673.0,,,0
CDM,PMC - 3001 - 720000028,LABOR >16-18 HRS,5916.0,2958.0,,,0
CDM,PMC - 3001 - 720000029,LABOR >18-20 HRS,6485.0,3242.5,,,0
CDM,PMC - 3001 - 720000030,LABOR >20-22 HRS,7054.0,3527.0,,,0
CDM,PMC - 3001 - 720000031,LABOR >22-24 HRS,7624.0,3812.0,,,0
CDM,PMC - 3001 - 720000032,LABOR >24-26 HRS,8193.0,4096.5,,,0
CDM,PMC - 3001 - 720000033,LABOR >26-28 HRS,8760.0,4380.0,,,0
CDM,PMC - 3001 - 720000034,LABOR >28-30 HRS,9330.0,4665.0,,,0
CDM,PMC - 3001 - 720000035,LABOR >30-32 HRS,9898.0,4949.0,,,0
CDM,PMC - 3001 - 720000036,LABOR >32-34 HRS,10485.0,5242.5,,,0
CDM,PMC - 3001 - 720000037,LABOR >34-36 HRS,11069.0,5534.5,,,0
CDM,PMC - 3001 - 720000038,LABOR EA ADDL 2 HRS,613.0,306.5,,,0
CDM,PMC - 3001 - 720000039,HIGH RISK-LEVEL 1 LABOR AD-ON,1609.0,804.5,,,0
CDM,PMC - 3001 - 720000040,HIGH RISK-LEVEL 2 LABOR AD-ON,2257.0,1128.5,,,0
CDM,PMC - 3001 - 720000041,DELIVERY-ATTEMPTED,998.0,499.0,,,0
CDM,PMC - 3001 - 720000042,DELIVERY LEVEL 1,4377.0,2188.5,,,0
CDM,PMC - 3001 - 720000043,DELIVERY LEVEL 2,5037.0,2518.5,,,0
CDM,PMC - 3001 - 720000044,DELIVERY LEVEL 3,6290.0,3145.0,,,0
CDM,PMC - 3001 - 720000045,C-SECTION 0-60 MIN,5732.0,2866.0,,,0
CDM,PMC - 3001 - 720000046,C-SECTION 61-90 MIN,6272.0,3136.0,,,0
CDM,PMC - 3001 - 720000047,C-SECTION 91-120 MIN,6808.0,3404.0,,,0
CDM,PMC - 3001 - 720000048,C-SECTION 121-140 MIN,7341.0,3670.5,,,0
CDM,PMC - 3001 - 720000049,C-SECT EA ADDL 30 MIN,666.0,333.0,,,0
CDM,PMC - 3001 - 720000050,SURGERY OBGYN 0-20 MIN,2966.0,1483.0,,,0
CDM,PMC - 3001 - 720000051,SURGERY OBGYN 21-40 MIN,3828.0,1914.0,,,0
CDM,PMC - 3001 - 720000052,SURGERY OBGYN 41-60 MIN,4690.0,2345.0,,,0
CDM,PMC - 3001 - 720000053,SURGERY OBGYN 61-80 MIN,5552.0,2776.0,,,0
CDM,PMC - 3001 - 720000054,SURGERY OBGYN 81-100 MIN,6413.0,3206.5,,,0
CDM,PMC - 3001 - 720000055,SURGERY OBGYN 101-120 MIN,7273.0,3636.5,,,0
CDM,PMC - 3001 - 720000056,SURGERY OBGYN 121-140 MIN,8132.0,4066.0,,,0
CDM,PMC - 3001 - 720000057,SURGERY OBGYN 141-160 MIN,8991.0,4495.5,,,0
CDM,PMC - 3001 - 720000058,SURGERY OBGYN 161-180 MIN,9849.0,4924.5,,,0
CDM,PMC - 3001 - 720000059,SURGERY OBGYN 181-200 MIN,10704.0,5352.0,,,0
CDM,PMC - 3001 - 720000075,SKIN STAPLES - PROXIMATE,588.0,294.0,,,0
CDM,PMC - 3001 - 720000076,POSTPARTUM HEM BALLOON,1655.0,827.5,,,0
CDM,PMC - 3001 - 720000096,FETAL MONITORING DAILY CHG,320.0,160.0,,,0
CDM,PMC - 3001 - 740000103,PROBE CORTICAL STIMULATOR BIPOLOAR,2782.0,1391.0,,,0
CDM,PMC - 3001 - 740000123,DBS MICROELECTRODE RECORDING,5866.0,2933.0,,,0
CDM,PMC - 3001 - 750000001,"ENDO LEVEL 1 0"" - 15""",1087.0,543.5,,,0
CDM,PMC - 3001 - 750000002,"ENDO LEVEL 1 16"" - 30""",1891.0,945.5,,,0
CDM,PMC - 3001 - 750000003,"ENDO LEVEL 1 31"" - 45""",2692.0,1346.0,,,0
CDM,PMC - 3001 - 750000004,"ENDO LEVEL 1 46"" - 60""",3491.0,1745.5,,,0
CDM,PMC - 3001 - 750000005,"ENDO LEVEL 1 1' 01"" - 1' 15""",4286.0,2143.0,,,0
CDM,PMC - 3001 - 750000006,"ENDO LEVEL 1 1' 16"" - 1' 30""",5078.0,2539.0,,,0
CDM,PMC - 3001 - 750000007,"ENDO LEVEL 1 1' 31"" - 1' 45""",5867.0,2933.5,,,0
CDM,PMC - 3001 - 750000008,"ENDO LEVEL 1 1' 46"" - 2' 00""",6652.0,3326.0,,,0
CDM,PMC - 3001 - 750000009,"ENDO LEVEL 1 2' 01"" - 2' 15""",7434.0,3717.0,,,0
CDM,PMC - 3001 - 750000010,"ENDO LEVEL 1 2' 16"" - 2' 30""",8211.0,4105.5,,,0
CDM,PMC - 3001 - 750000011,"ENDO LEVEL 1 2' 31"" - 2' 45""",8988.0,4494.0,,,0
CDM,PMC - 3001 - 750000012,"ENDO LEVEL 1 2' 46"" - 3' 00""",9759.0,4879.5,,,0
CDM,PMC - 3001 - 750000013,"ENDO LEVEL 1 3' 01"" - 3' 15""",10528.0,5264.0,,,0
CDM,PMC - 3001 - 750000014,"ENDO LEVEL 1 3' 16"" - 3' 30""",11293.0,5646.5,,,0
CDM,PMC - 3001 - 750000015,"ENDO LEVEL 1 3' 31"" - 3' 45""",12056.0,6028.0,,,0
CDM,PMC - 3001 - 750000016,"ENDO LEVEL 1 3' 46"" - 4' 00""",12814.0,6407.0,,,0
CDM,PMC - 3001 - 750000017,ENDO LEVEL 1 EA ADDL 15 MINS,668.0,334.0,,,0
CDM,PMC - 3001 - 750000018,"ENDO LEVEL 2 0"" - 15""",1345.0,672.5,,,0
CDM,PMC - 3001 - 750000019,"ENDO LEVEL 2 16"" - 30""",2375.0,1187.5,,,0
CDM,PMC - 3001 - 750000020,"ENDO LEVEL 2 31"" - 45""",3406.0,1703.0,,,0
CDM,PMC - 3001 - 750000021,"ENDO LEVEL 2 46"" - 60""",4435.0,2217.5,,,0
CDM,PMC - 3001 - 750000022,"ENDO LEVEL 2 1' 01"" - 1' 15""",5453.0,2726.5,,,0
CDM,PMC - 3001 - 750000023,"ENDO LEVEL 2 1' 16"" - 1' 30""",6468.0,3234.0,,,0
CDM,PMC - 3001 - 750000024,"ENDO LEVEL 2 1' 31"" - 1' 45""",7481.0,3740.5,,,0
CDM,PMC - 3001 - 750000025,"ENDO LEVEL 2 1' 46"" - 2' 00""",8490.0,4245.0,,,0
CDM,PMC - 3001 - 750000026,"ENDO LEVEL 2 2' 01"" - 2' 15""",9493.0,4746.5,,,0
CDM,PMC - 3001 - 750000027,"ENDO LEVEL 2 2' 16"" - 2' 30""",10494.0,5247.0,,,0
CDM,PMC - 3001 - 750000028,"ENDO LEVEL 2 2' 31"" - 2' 45""",11490.0,5745.0,,,0
CDM,PMC - 3001 - 750000029,"ENDO LEVEL 2 2' 46"" - 3' 00""",12482.0,6241.0,,,0
CDM,PMC - 3001 - 750000030,"ENDO LEVEL 2 3' 01"" - 3' 15""",13469.0,6734.5,,,0
CDM,PMC - 3001 - 750000031,"ENDO LEVEL 2 3' 16"" - 3' 30""",14454.0,7227.0,,,0
CDM,PMC - 3001 - 750000032,"ENDO LEVEL 2 3' 31"" - 3' 45""",15434.0,7717.0,,,0
CDM,PMC - 3001 - 750000033,"ENDO LEVEL 2 3' 46"" - 4' 00""",16409.0,8204.5,,,0
CDM,PMC - 3001 - 750000034,ENDO LEVEL 2 EA ADDL 15 MINS,770.0,385.0,,,0
CDM,PMC - 3001 - 750000035,"ENDO LEVEL 3 0"" - 15""",1503.0,751.5,,,0
CDM,PMC - 3001 - 750000036,"ENDO LEVEL 3 16"" - 30""",2648.0,1324.0,,,0
CDM,PMC - 3001 - 750000037,"ENDO LEVEL 3 31"" - 45""",3791.0,1895.5,,,0
CDM,PMC - 3001 - 750000038,"ENDO LEVEL 3 46"" - 60""",4926.0,2463.0,,,0
CDM,PMC - 3001 - 750000039,"ENDO LEVEL 3 1' 01"" - 1' 15""",6060.0,3030.0,,,0
CDM,PMC - 3001 - 750000040,"ENDO LEVEL 3 1' 16"" - 1' 30""",7187.0,3593.5,,,0
CDM,PMC - 3001 - 750000041,"ENDO LEVEL 3 1' 31"" - 1' 45""",8312.0,4156.0,,,0
CDM,PMC - 3001 - 750000042,"ENDO LEVEL 3 1' 46"" - 2' 00""",9431.0,4715.5,,,0
CDM,PMC - 3001 - 750000043,"ENDO LEVEL 3 2' 01"" - 2' 15""",10546.0,5273.0,,,0
CDM,PMC - 3001 - 750000044,"ENDO LEVEL 3 2' 16"" - 2' 30""",11656.0,5828.0,,,0
CDM,PMC - 3001 - 750000045,"ENDO LEVEL 3 2' 31"" - 2' 45""",12762.0,6381.0,,,0
CDM,PMC - 3001 - 750000046,"ENDO LEVEL 3 2' 46"" - 3' 00""",13862.0,6931.0,,,0
CDM,PMC - 3001 - 750000047,"ENDO LEVEL 3 3' 01"" - 3' 15""",14959.0,7479.5,,,0
CDM,PMC - 3001 - 750000048,"ENDO LEVEL 3 3' 16"" - 3' 30""",16051.0,8025.5,,,0
CDM,PMC - 3001 - 750000049,"ENDO LEVEL 3 3' 31"" - 3' 45""",17138.0,8569.0,,,0
CDM,PMC - 3001 - 750000050,"ENDO LEVEL 3 3' 46"" - 4' 00""",18222.0,9111.0,,,0
CDM,PMC - 3001 - 750000051,ENDO LEVEL 3 EA ADDL 15 MINS,976.0,488.0,,,0
CDM,PMC - 3001 - 750000052,"ENDO LEVEL 4 0"" - 15""",1633.0,816.5,,,0
CDM,PMC - 3001 - 750000053,"ENDO LEVEL 4 16"" - 30""",2892.0,1446.0,,,0
CDM,PMC - 3001 - 750000054,"ENDO LEVEL 4 31"" - 45""",4149.0,2074.5,,,0
CDM,PMC - 3001 - 750000055,"ENDO LEVEL 4 46"" - 60""",5403.0,2701.5,,,0
CDM,PMC - 3001 - 750000056,"ENDO LEVEL 4 1' 01"" - 1' 15""",6655.0,3327.5,,,0
CDM,PMC - 3001 - 750000057,"ENDO LEVEL 4 1' 16"" - 1' 30""",7904.0,3952.0,,,0
CDM,PMC - 3001 - 750000058,"ENDO LEVEL 4 1' 31"" - 1' 45""",9151.0,4575.5,,,0
CDM,PMC - 3001 - 750000059,"ENDO LEVEL 4 1' 46"" - 2' 00""",10395.0,5197.5,,,0
CDM,PMC - 3001 - 750000060,"ENDO LEVEL 4 2' 01"" - 2' 15""",11637.0,5818.5,,,0
CDM,PMC - 3001 - 750000061,"ENDO LEVEL 4 2' 16"" - 2' 30""",12876.0,6438.0,,,0
CDM,PMC - 3001 - 750000062,"ENDO LEVEL 4 2' 31"" - 2' 45""",14113.0,7056.5,,,0
CDM,PMC - 3001 - 750000063,"ENDO LEVEL 4 2' 46"" - 3' 00""",15347.0,7673.5,,,0
CDM,PMC - 3001 - 750000064,"ENDO LEVEL 4 3' 01"" - 3' 15""",16579.0,8289.5,,,0
CDM,PMC - 3001 - 750000065,"ENDO LEVEL 4 3' 16"" - 3' 30""",17808.0,8904.0,,,0
CDM,PMC - 3001 - 750000066,"ENDO LEVEL 4 3' 31"" - 3' 45""",19034.0,9517.0,,,0
CDM,PMC - 3001 - 750000067,"ENDO LEVEL 4 3' 46"" - 4' 00""",20258.0,10129.0,,,0
CDM,PMC - 3001 - 750000068,ENDO LEVEL 4 EA ADDL 15 MINS,1074.0,537.0,,,0
CDM,PMC - 3001 - 750000069,"ENDO LEVEL 5 0"" - 15""",1760.0,880.0,,,0
CDM,PMC - 3001 - 750000070,"ENDO LEVEL 5 16"" - 30""",3142.0,1571.0,,,0
CDM,PMC - 3001 - 750000071,"ENDO LEVEL 5 31"" - 45""",4523.0,2261.5,,,0
CDM,PMC - 3001 - 750000072,"ENDO LEVEL 5 46"" - 60""",5902.0,2951.0,,,0
CDM,PMC - 3001 - 750000073,"ENDO LEVEL 5 1' 01"" - 1' 15""",7278.0,3639.0,,,0
CDM,PMC - 3001 - 750000074,"ENDO LEVEL 5 1' 16"" - 1' 30""",8652.0,4326.0,,,0
CDM,PMC - 3001 - 750000075,"ENDO LEVEL 5 1' 31"" - 1' 45""",10021.0,5010.5,,,0
CDM,PMC - 3001 - 750000076,"ENDO LEVEL 5 1' 46"" - 2' 00""",11389.0,5694.5,,,0
CDM,PMC - 3001 - 750000077,"ENDO LEVEL 5 2' 01"" - 2' 15""",12754.0,6377.0,,,0
CDM,PMC - 3001 - 750000078,"ENDO LEVEL 5 2' 16"" - 2' 30""",14115.0,7057.5,,,0
CDM,PMC - 3001 - 750000079,"ENDO LEVEL 5 2' 31"" - 2' 45""",15475.0,7737.5,,,0
CDM,PMC - 3001 - 750000080,"ENDO LEVEL 5 2' 46"" - 3' 00""",16831.0,8415.5,,,0
CDM,PMC - 3001 - 750000081,"ENDO LEVEL 5 3' 01"" - 3' 15""",18184.0,9092.0,,,0
CDM,PMC - 3001 - 750000082,"ENDO LEVEL 5 3' 16"" - 3' 30""",19535.0,9767.5,,,0
CDM,PMC - 3001 - 750000083,"ENDO LEVEL 5 3' 31"" - 3' 45""",20883.0,10441.5,,,0
CDM,PMC - 3001 - 750000084,"ENDO LEVEL 5 3' 46"" - 4' 00""",22228.0,11114.0,,,0
CDM,PMC - 3001 - 750000085,ENDO LEVEL 5 EA ADDL 15 MINS,1175.0,587.5,,,0
CDM,PMC - 3001 - 750000086,PAIN MANAGEMENT BLOCK 0-15 MIN,973.0,486.5,,,0
CDM,PMC - 3001 - 750000087,PAIN MANAGEMENT BLOCK 16-30MIN,1161.0,580.5,,,0
CDM,PMC - 3001 - 750000088,PAIN MANAGEMENT BLOCK 31-45MIN,1344.0,672.0,,,0
CDM,PMC - 3001 - 750000089,PAIN MANAGEMENT BLOCK 46-60MIN,1527.0,763.5,,,0
CDM,PMC - 3001 - 750000090,PAIN MANAGEMENT BLOCK 61-75MIN,1710.0,855.0,,,0
CDM,PMC - 3001 - 750000091,PAIN MANAGEMENT BLOCK 76-90MIN,1893.0,946.5,,,0
CDM,PMC - 3001 - 750000092,PAIN MANAGEMENT BLOCK91-105MIN,2073.0,1036.5,,,0
CDM,PMC - 3001 - 750000102,PAIN MANAGEMENT BLOCK106-120MIN,2174.0,1087.0,,,0
CDM,PMC - 3001 - 750000103,PAIN MANAGEMENT BLOCK EA ADD'L 15 MIN,2346.0,1173.0,,,0
CDM,PMC - 3001 - 761000135,DRSG AQUACEL AG 4X4,103.0,51.5,,,0
CDM,PMC - 3001 - 761000226,THERASKIN EXLARGE 103TSXL 3X6,18198.0,9099.0,,,0
CDM,PMC - 3001 - 761000227,ECMO/ECLS DAILY MANAGEMENT,521.0,260.5,,,0
CDM,PMC - 3001 - 801000010,CONT AMB PERITONEAL DIALYSIS,1047.0,523.5,,,0
CDM,PMC - 3001 - 801000011,CONT CYCLING PERITONEAL DIALY,1047.0,523.5,,,0
CDM,PMC - 3001 - 914000019,PHP ACTIVITY THERAPY,165.0,82.5,,,0
CDM,PMC - 3001 - 964000001,CRNA-ANESTHESIA,218.0,109.0,,,0
CDM,PMC - 3001 - 964000024,CRNA-PICC/MIDLINE,275.0,137.5,,,0
CDM,PMC - 3006 - 710000003,PACU 0-30 MIN PHASE I,866.0,433.0,,,0
CDM,PMC - 3006 - 710000004,PACU 31-60 MIN PHASE I,1567.0,783.5,,,0
CDM,PMC - 3006 - 710000005,PACU 61-90 MIN PHASE I,2261.0,1130.5,,,0
CDM,PMC - 3006 - 710000006,PACU 91-120 MIN PHASE I,2954.0,1477.0,,,0
CDM,PMC - 3006 - 710000007,PACU 121-150 MIN PHASE I,3639.0,1819.5,,,0
CDM,PMC - 3006 - 710000008,PACU 151-180 MIN PHASE I,4324.0,2162.0,,,0
CDM,PMC - 3006 - 710000009,PACU 181-210 MIN PHASE I,5009.0,2504.5,,,0
CDM,PMC - 3006 - 710000010,PACU 211-240 MIN PHASE I,5692.0,2846.0,,,0
CDM,PMC - 3006 - 710000011,PACU 241-270 MIN PHASE I,6376.0,3188.0,,,0
CDM,PMC - 3006 - 710000012,PACU 271-300 MIN PHASE I,7055.0,3527.5,,,0
CDM,PMC - 3006 - 710000013,PACU 301-330 MIN PHASE I,7734.0,3867.0,,,0
CDM,PMC - 3006 - 710000014,PACU 331-360 MIN PHASE I,8412.0,4206.0,,,0
CDM,PMC - 3006 - 710000015,PACU 361-390 MIN PHASE I,9088.0,4544.0,,,0
CDM,PMC - 3006 - 710000016,PACU 391-420 MIN PHASE I,9764.0,4882.0,,,0
CDM,PMC - 3006 - 710000017,PACU 421-450 MIN PHASE I,10438.0,5219.0,,,0
CDM,PMC - 3006 - 710000018,PACU 451-480 MIN PHASE I,11112.0,5556.0,,,0
CDM,PMC - 3011 - 360000001,"OR CATEGORY I 0""-15""",4131.0,2065.5,,,0
CDM,PMC - 3011 - 360000002,"OR CATEGORY I 16""-30""",5398.0,2699.0,,,0
CDM,PMC - 3011 - 360000003,"OR CATEGORY I 31""-45""",6664.0,3332.0,,,0
CDM,PMC - 3011 - 360000004,"OR CATEGORY I 46""-60""",7931.0,3965.5,,,0
CDM,PMC - 3011 - 360000005,"OR CATEGORY I 1'01""-1'15""",9198.0,4599.0,,,0
CDM,PMC - 3011 - 360000006,"OR CATEGORY I 1'16""-1'30""",10464.0,5232.0,,,0
CDM,PMC - 3011 - 360000007,"OR CATEGORY I 1'31""-1'45""",11731.0,5865.5,,,0
CDM,PMC - 3011 - 360000008,"OR CATEGORY I 1'46""-2'00""",12998.0,6499.0,,,0
CDM,PMC - 3011 - 360000009,"OR CATEGORY I 2'01""-2'15""",14265.0,7132.5,,,0
CDM,PMC - 3011 - 360000010,"OR CATEGORY I 2'16""-2'30""",15531.0,7765.5,,,0
CDM,PMC - 3011 - 360000011,"OR CATEGORY I 2'31""-2'45""",16798.0,8399.0,,,0
CDM,PMC - 3011 - 360000012,"OR CATEGORY I 2'46""-3'00""",18065.0,9032.5,,,0
CDM,PMC - 3011 - 360000013,"OR CATEGORY I 3'01""-3'15""",19332.0,9666.0,,,0
CDM,PMC - 3011 - 360000014,"OR CATEGORY I 3'16""-3'30""",20598.0,10299.0,,,0
CDM,PMC - 3011 - 360000015,"OR CATEGORY I 3'31""-3'45""",21865.0,10932.5,,,0
CDM,PMC - 3011 - 360000016,"OR CATEGORY I 3'46""-4'00""",23132.0,11566.0,,,0
CDM,PMC - 3011 - 360000017,"OR CATEGORY I 4'01""-4'15""",24398.0,12199.0,,,0
CDM,PMC - 3011 - 360000018,"OR CATEGORY I 4'16""-4'30""",25665.0,12832.5,,,0
CDM,PMC - 3011 - 360000019,"OR CATEGORY I 4'31""-4'45""",26932.0,13466.0,,,0
CDM,PMC - 3011 - 360000020,"OR CATEGORY I 4'46""-5'00""",28199.0,14099.5,,,0
CDM,PMC - 3011 - 360000021,"OR CATEGORY I 5'01""-5'15""",29465.0,14732.5,,,0
CDM,PMC - 3011 - 360000022,"OR CATEGORY I 5'16""-5'30""",30732.0,15366.0,,,0
CDM,PMC - 3011 - 360000023,"OR CATEGORY I 5'31""-5'45""",31999.0,15999.5,,,0
CDM,PMC - 3011 - 360000024,"OR CATEGORY I 5'46""-6'00""",33265.0,16632.5,,,0
CDM,PMC - 3011 - 360000025,"OR CATEGORY I 6'01""-6'15""",34532.0,17266.0,,,0
CDM,PMC - 3011 - 360000026,"OR CATEGORY I 6'16""-6'30""",35799.0,17899.5,,,0
CDM,PMC - 3011 - 360000027,"OR CATEGORY I 6'31""-6'45""",37066.0,18533.0,,,0
CDM,PMC - 3011 - 360000028,"OR CATEGORY I 6'46""-7'00""",38332.0,19166.0,,,0
CDM,PMC - 3011 - 360000029,"OR CATEGORY I 7'01""-7'15""",39599.0,19799.5,,,0
CDM,PMC - 3011 - 360000030,"OR CATEGORY I 7'16""-7'30""",40866.0,20433.0,,,0
CDM,PMC - 3011 - 360000031,"OR CATEGORY I 7'31""-7'45""",42132.0,21066.0,,,0
CDM,PMC - 3011 - 360000032,"OR CATEGORY I 7'46""-8'00""",43399.0,21699.5,,,0
CDM,PMC - 3011 - 360000033,OR CATEGORY I EA ADDL 15 MIN,1267.0,633.5,,,0
CDM,PMC - 3011 - 360000034,"OR CATEGORY II 0""-15""",6403.0,3201.5,,,0
CDM,PMC - 3011 - 360000035,"OR CATEGORY II 16""-30""",8019.0,4009.5,,,0
CDM,PMC - 3011 - 360000036,"OR CATEGORY II 31""-45""",9636.0,4818.0,,,0
CDM,PMC - 3011 - 360000037,"OR CATEGORY II 46""-60""",11252.0,5626.0,,,0
CDM,PMC - 3011 - 360000038,"OR CATEGORY II 1'01""-1'15""",12868.0,6434.0,,,0
CDM,PMC - 3011 - 360000039,"OR CATEGORY II 1'16""-1'30""",14484.0,7242.0,,,0
CDM,PMC - 3011 - 360000040,"OR CATEGORY II 1'31""-1'45""",16100.0,8050.0,,,0
CDM,PMC - 3011 - 360000041,"OR CATEGORY II 1'46""-2'00""",17716.0,8858.0,,,0
CDM,PMC - 3011 - 360000042,"OR CATEGORY II 2'01""-2'15""",19333.0,9666.5,,,0
CDM,PMC - 3011 - 360000043,"OR CATEGORY II 2'16""-2'30""",20949.0,10474.5,,,0
CDM,PMC - 3011 - 360000044,"OR CATEGORY II 2'31""-2'45""",22565.0,11282.5,,,0
CDM,PMC - 3011 - 360000045,"OR CATEGORY II 2'46""-3'00""",24181.0,12090.5,,,0
CDM,PMC - 3011 - 360000046,"OR CATEGORY II 3'01""-3'15""",25797.0,12898.5,,,0
CDM,PMC - 3011 - 360000047,"OR CATEGORY II 3'16""-3'30""",27413.0,13706.5,,,0
CDM,PMC - 3011 - 360000048,"OR CATEGORY II 3'31""-3'45""",29030.0,14515.0,,,0
CDM,PMC - 3011 - 360000049,"OR CATEGORY II 3'46""-4'00""",30646.0,15323.0,,,0
CDM,PMC - 3011 - 360000050,"OR CATEGORY II 4'01""-4'15""",32262.0,16131.0,,,0
CDM,PMC - 3011 - 360000051,"OR CATEGORY II 4'16""-4'30""",33878.0,16939.0,,,0
CDM,PMC - 3011 - 360000052,"OR CATEGORY II 4'31""-4'45""",35494.0,17747.0,,,0
CDM,PMC - 3011 - 360000053,"OR CATEGORY II 4'46""-5'00""",37110.0,18555.0,,,0
CDM,PMC - 3011 - 360000054,"OR CATEGORY II 5'01""-5'15""",38726.0,19363.0,,,0
CDM,PMC - 3011 - 360000055,"OR CATEGORY II 5'16""-5'30""",40343.0,20171.5,,,0
CDM,PMC - 3011 - 360000056,"OR CATEGORY II 5'31""-5'45""",41959.0,20979.5,,,0
CDM,PMC - 3011 - 360000057,"OR CATEGORY II 5'46""-6'00""",43575.0,21787.5,,,0
CDM,PMC - 3011 - 360000058,"OR CATEGORY II 6'01""-6'15""",45191.0,22595.5,,,0
CDM,PMC - 3011 - 360000059,"OR CATEGORY II 6'16""-6'30""",46807.0,23403.5,,,0
CDM,PMC - 3011 - 360000060,"OR CATEGORY II 6'31""-6'45""",48423.0,24211.5,,,0
CDM,PMC - 3011 - 360000061,"OR CATEGORY II 6'46""-7'00""",50040.0,25020.0,,,0
CDM,PMC - 3011 - 360000062,"OR CATEGORY II 7'01""-7'15""",51656.0,25828.0,,,0
CDM,PMC - 3011 - 360000063,"OR CATEGORY II 7'16""-7'30""",53272.0,26636.0,,,0
CDM,PMC - 3011 - 360000064,"OR CATEGORY II 7'31""-7'45""",54888.0,27444.0,,,0
CDM,PMC - 3011 - 360000065,"OR CATEGORY II 7'46""-8'00""",56504.0,28252.0,,,0
CDM,PMC - 3011 - 360000066,OR CATEGORY II EA ADDL 15 MIN,1616.0,808.0,,,0
CDM,PMC - 3011 - 360000067,"OR CATEGORY III 0""-15""",9285.0,4642.5,,,0
CDM,PMC - 3011 - 360000068,"OR CATEGORY III 16""-30""",11138.0,5569.0,,,0
CDM,PMC - 3011 - 360000069,"OR CATEGORY III 31""-45""",12992.0,6496.0,,,0
CDM,PMC - 3011 - 360000070,"OR CATEGORY III 46""-60""",14845.0,7422.5,,,0
CDM,PMC - 3011 - 360000071,"OR CATEGORY III 1'01""-1'15""",16698.0,8349.0,,,0
CDM,PMC - 3011 - 360000072,"OR CATEGORY III 1'16""-1'30""",18552.0,9276.0,,,0
CDM,PMC - 3011 - 360000073,"OR CATEGORY III 1'31""-1'45""",20405.0,10202.5,,,0
CDM,PMC - 3011 - 360000074,"OR CATEGORY III 1'46""-2'00""",22258.0,11129.0,,,0
CDM,PMC - 3011 - 360000075,"OR CATEGORY III 2'01""-2'15""",24111.0,12055.5,,,0
CDM,PMC - 3011 - 360000076,"OR CATEGORY III 2'16""-2'30""",25965.0,12982.5,,,0
CDM,PMC - 3011 - 360000077,"OR CATEGORY III 2'31""-2'45""",27818.0,13909.0,,,0
CDM,PMC - 3011 - 360000078,"OR CATEGORY III 2'46""-3'00""",29671.0,14835.5,,,0
CDM,PMC - 3011 - 360000079,"OR CATEGORY III 3'01""-3'15""",31524.0,15762.0,,,0
CDM,PMC - 3011 - 360000080,"OR CATEGORY III 3'16""-3'30""",33378.0,16689.0,,,0
CDM,PMC - 3011 - 360000081,"OR CATEGORY III 3'31""-3'45""",35231.0,17615.5,,,0
CDM,PMC - 3011 - 360000082,"OR CATEGORY III 3'46""-4'00""",37084.0,18542.0,,,0
CDM,PMC - 3011 - 360000083,"OR CATEGORY III 4'01""-4'15""",38938.0,19469.0,,,0
CDM,PMC - 3011 - 360000084,"OR CATEGORY III 4'16""-4'30""",40791.0,20395.5,,,0
CDM,PMC - 3011 - 360000085,"OR CATEGORY III 4'31""-4'45""",42644.0,21322.0,,,0
CDM,PMC - 3011 - 360000086,"OR CATEGORY III 4'46""-5'00""",44497.0,22248.5,,,0
CDM,PMC - 3011 - 360000087,"OR CATEGORY III 5'01""-5'15""",46351.0,23175.5,,,0
CDM,PMC - 3011 - 360000088,"OR CATEGORY III 5'16""-5'30""",48204.0,24102.0,,,0
CDM,PMC - 3011 - 360000089,"OR CATEGORY III 5'31""-5'45""",50057.0,25028.5,,,0
CDM,PMC - 3011 - 360000090,"OR CATEGORY III 5'46""-6'00""",51911.0,25955.5,,,0
CDM,PMC - 3011 - 360000091,"OR CATEGORY III 6'01""-6'15""",53764.0,26882.0,,,0
CDM,PMC - 3011 - 360000092,"OR CATEGORY III 6'16""-6'30""",55617.0,27808.5,,,0
CDM,PMC - 3011 - 360000093,"OR CATEGORY III 6'31""-6'45""",57470.0,28735.0,,,0
CDM,PMC - 3011 - 360000094,"OR CATEGORY III 6'46""-7'00""",59324.0,29662.0,,,0
CDM,PMC - 3011 - 360000095,"OR CATEGORY III 7'01""-7'15""",61177.0,30588.5,,,0
CDM,PMC - 3011 - 360000096,"OR CATEGORY III 7'16""-7'30""",63030.0,31515.0,,,0
CDM,PMC - 3011 - 360000097,"OR CATEGORY III 7'31""-7'45""",64884.0,32442.0,,,0
CDM,PMC - 3011 - 360000098,"OR CATEGORY III 7'46""-8'00""",66737.0,33368.5,,,0
CDM,PMC - 3011 - 360000099,"OR CATEGORY III 8'01""-8'15""",68590.0,34295.0,,,0
CDM,PMC - 3011 - 360000100,"OR CATEGORY III 8'16""-8'30""",70443.0,35221.5,,,0
CDM,PMC - 3011 - 360000101,"OR CATEGORY III 8'31""-8'45""",72297.0,36148.5,,,0
CDM,PMC - 3011 - 360000102,"OR CATEGORY III 8'46""-9'00""",74150.0,37075.0,,,0
CDM,PMC - 3011 - 360000103,"OR CATEGORY III 9'01-9'15""",76003.0,38001.5,,,0
CDM,PMC - 3011 - 360000104,"OR CATEGORY III 9'16""-9'30""",77856.0,38928.0,,,0
CDM,PMC - 3011 - 360000105,"OR CATEGORY III 9'31""-9'45""",79710.0,39855.0,,,0
CDM,PMC - 3011 - 360000106,"OR CATEGORY III 9'46""-10'00""",81563.0,40781.5,,,0
CDM,PMC - 3011 - 360000107,OR CATEGORY III EA ADDL 15MIN,1853.0,926.5,,,0
CDM,PMC - 3011 - 360000108,"OR CATEGORY IV 0""-15""",15599.0,7799.5,,,0
CDM,PMC - 3011 - 360000109,"OR CATEGORY IV 16""-30""",18001.0,9000.5,,,0
CDM,PMC - 3011 - 360000110,"OR CATEGORY IV 31""-45""",20404.0,10202.0,,,0
CDM,PMC - 3011 - 360000111,"OR CATEGORY IV 46""-60""",22806.0,11403.0,,,0
CDM,PMC - 3011 - 360000112,"OR CATEGORY IV 1'01""-1'15""",25209.0,12604.5,,,0
CDM,PMC - 3011 - 360000113,"OR CATEGORY IV 1'16""-1'30""",27611.0,13805.5,,,0
CDM,PMC - 3011 - 360000114,"OR CATEGORY IV 1'31""-1'45""",30013.0,15006.5,,,0
CDM,PMC - 3011 - 360000115,"OR CATEGORY IV 1'46""-2'00""",32416.0,16208.0,,,0
CDM,PMC - 3011 - 360000116,"OR CATEGORY IV 2'01""-2'15""",34818.0,17409.0,,,0
CDM,PMC - 3011 - 360000117,"OR CATEGORY IV 2'16""-2'30""",37221.0,18610.5,,,0
CDM,PMC - 3011 - 360000118,"OR CATEGORY IV 2'31""-2'45""",39623.0,19811.5,,,0
CDM,PMC - 3011 - 360000119,"OR CATEGORY IV 2'46""-3'00""",42025.0,21012.5,,,0
CDM,PMC - 3011 - 360000120,"OR CATEGORY IV 3'01""-3'15""",44428.0,22214.0,,,0
CDM,PMC - 3011 - 360000121,"OR CATEGORY IV 3'16""-3'30""",46830.0,23415.0,,,0
CDM,PMC - 3011 - 360000122,"OR CATEGORY IV 3'31""-3'45""",49233.0,24616.5,,,0
CDM,PMC - 3011 - 360000123,"OR CATEGORY IV 3'46""-4'00""",51635.0,25817.5,,,0
CDM,PMC - 3011 - 360000124,"OR CATEGORY IV 4'01""-4'15""",54037.0,27018.5,,,0
CDM,PMC - 3011 - 360000125,"OR CATEGORY IV 4'16""-4'30""",56440.0,28220.0,,,0
CDM,PMC - 3011 - 360000126,"OR CATEGORY IV 4'31""-4'45""",58842.0,29421.0,,,0
CDM,PMC - 3011 - 360000127,"OR CATEGORY IV 4'46""-5'00""",61245.0,30622.5,,,0
CDM,PMC - 3011 - 360000128,"OR CATEGORY IV 5'01""-5'15""",63647.0,31823.5,,,0
CDM,PMC - 3011 - 360000129,"OR CATEGORY IV 5'16""-5'30""",66049.0,33024.5,,,0
CDM,PMC - 3011 - 360000130,"OR CATEGORY IV 5'31""-5'45""",68452.0,34226.0,,,0
CDM,PMC - 3011 - 360000131,"OR CATEGORY IV 5'46""-6'00""",70854.0,35427.0,,,0
CDM,PMC - 3011 - 360000132,"OR CATEGORY IV 6'01""-6'15""",73257.0,36628.5,,,0
CDM,PMC - 3011 - 360000133,"OR CATEGORY IV 6'16""-6'30""",75659.0,37829.5,,,0
CDM,PMC - 3011 - 360000134,"OR CATEGORY IV 6'31""-6'45""",78061.0,39030.5,,,0
CDM,PMC - 3011 - 360000135,"OR CATEGORY IV 6'46""-7'00""",80464.0,40232.0,,,0
CDM,PMC - 3011 - 360000136,"OR CATEGORY IV 7'01""-7'15""",82866.0,41433.0,,,0
CDM,PMC - 3011 - 360000137,"OR CATEGORY IV 7'16""-7'30""",85269.0,42634.5,,,0
CDM,PMC - 3011 - 360000138,"OR CATEGORY IV 7'31""-7'45""",87671.0,43835.5,,,0
CDM,PMC - 3011 - 360000139,"OR CATEGORY IV 7'46""-8'00""",90073.0,45036.5,,,0
CDM,PMC - 3011 - 360000140,"OR CATEGORY IV 8'01""-8'15""",92476.0,46238.0,,,0
CDM,PMC - 3011 - 360000141,"OR CATEGORY IV 8'16""-8'30""",94878.0,47439.0,,,0
CDM,PMC - 3011 - 360000142,"OR CATEGORY IV 8'31""-8'45""",97281.0,48640.5,,,0
CDM,PMC - 3011 - 360000143,"OR CATEGORY IV 8'46""-9'00""",99683.0,49841.5,,,0
CDM,PMC - 3011 - 360000144,OR CATEGORY IV EA ADDL 15 MIN,2402.0,1201.0,,,0
CDM,PMC - 3011 - 360000145,"OR CATEGORY V 0""-15""",17159.0,8579.5,,,0
CDM,PMC - 3011 - 360000146,"OR CATEGORY V 16""-30""",19736.0,9868.0,,,0
CDM,PMC - 3011 - 360000147,"OR CATEGORY V 31""-45""",22313.0,11156.5,,,0
CDM,PMC - 3011 - 360000148,"OR CATEGORY V 46""-60""",24890.0,12445.0,,,0
CDM,PMC - 3011 - 360000149,"OR CATEGORY V 1'01""-1'15""",27467.0,13733.5,,,0
CDM,PMC - 3011 - 360000150,"OR CATEGORY V 1'16""-1'30""",30045.0,15022.5,,,0
CDM,PMC - 3011 - 360000151,"OR CATEGORY V 1'31""-1'45""",32622.0,16311.0,,,0
CDM,PMC - 3011 - 360000152,"OR CATEGORY V 1'46""-2'00""",35199.0,17599.5,,,0
CDM,PMC - 3011 - 360000153,"OR CATEGORY V 2'01""-2'15""",37776.0,18888.0,,,0
CDM,PMC - 3011 - 360000154,"OR CATEGORY V 2'16""-2'30""",40353.0,20176.5,,,0
CDM,PMC - 3011 - 360000155,"OR CATEGORY V 2'31""-2'45""",42930.0,21465.0,,,0
CDM,PMC - 3011 - 360000156,"OR CATEGORY V 2'46""-3'00""",45507.0,22753.5,,,0
CDM,PMC - 3011 - 360000157,"OR CATEGORY V 3'01""-3'15""",48084.0,24042.0,,,0
CDM,PMC - 3011 - 360000158,"OR CATEGORY V 3'16""-3'30""",50662.0,25331.0,,,0
CDM,PMC - 3011 - 360000159,"OR CATEGORY V 3'31""-3'45""",53239.0,26619.5,,,0
CDM,PMC - 3011 - 360000160,"OR CATEGORY V 3'46""-4'00""",55816.0,27908.0,,,0
CDM,PMC - 3011 - 360000161,"OR CATEGORY V 4'01""-4'15""",58393.0,29196.5,,,0
CDM,PMC - 3011 - 360000162,"OR CATEGORY V 4'16""-4'30""",60970.0,30485.0,,,0
CDM,PMC - 3011 - 360000163,"OR CATEGORY V 4'31""-4'45""",63547.0,31773.5,,,0
CDM,PMC - 3011 - 360000164,"OR CATEGORY V 4'46""-5'00""",66124.0,33062.0,,,0
CDM,PMC - 3011 - 360000165,"OR CATEGORY V 5'01""-5'15""",68701.0,34350.5,,,0
CDM,PMC - 3011 - 360000166,"OR CATEGORY V 5'16""-5'30""",71278.0,35639.0,,,0
CDM,PMC - 3011 - 360000167,"OR CATEGORY V 5'31""-5'45""",73856.0,36928.0,,,0
CDM,PMC - 3011 - 360000168,"OR CATEGORY V 5'46""-6'00""",76433.0,38216.5,,,0
CDM,PMC - 3011 - 360000169,"OR CATEGORY V 6'01""-6'15""",79010.0,39505.0,,,0
CDM,PMC - 3011 - 360000170,"OR CATEGORY V 6'16""-6'30""",81587.0,40793.5,,,0
CDM,PMC - 3011 - 360000171,"OR CATEGORY V 6'31""-6'45""",84164.0,42082.0,,,0
CDM,PMC - 3011 - 360000172,"OR CATEGORY V 6'46""-7'00""",86741.0,43370.5,,,0
CDM,PMC - 3011 - 360000173,"OR CATEGORY V 7'01""-7'15""",89318.0,44659.0,,,0
CDM,PMC - 3011 - 360000174,"OR CATEGORY V 7'16""-7'30""",91895.0,45947.5,,,0
CDM,PMC - 3011 - 360000175,"OR CATEGORY V 7'31""-7'45""",94473.0,47236.5,,,0
CDM,PMC - 3011 - 360000176,"OR CATEGORY V 7'46""-8'00""",97050.0,48525.0,,,0
CDM,PMC - 3011 - 360000177,OR CATEGORY V EA ADDL 15 MIN,2577.0,1288.5,,,0
CDM,PMC - 3011 - 360000211,CVOR CATEGORY C 0-1 HOUR,23245.0,11622.5,,,0
CDM,PMC - 3011 - 360000212,CVOR CATEGORY C 1.0-1.5 HRS,34845.0,17422.5,,,0
CDM,PMC - 3011 - 360000213,CVOR CATEGORY C 1.5-2.0 HRS,41044.0,20522.0,,,0
CDM,PMC - 3011 - 360000214,CVOR CATEGORY C 2.0-2.5 HRS,50106.0,25053.0,,,0
CDM,PMC - 3011 - 360000215,CVOR CATEGORY C 2.5-3.0 HRS,59167.0,29583.5,,,0
CDM,PMC - 3011 - 360000216,CVOR CATEGORY C 3.0-3.5 HRS,68234.0,34117.0,,,0
CDM,PMC - 3011 - 360000217,CVOR CATEGORY C 3.5-4.0 HRS,76845.0,38422.5,,,0
CDM,PMC - 3011 - 360000218,CVOR CATEGORY C 4.0-4.5 HRS,105049.0,52524.5,,,0
CDM,PMC - 3011 - 360000219,CVOR CATEGORY C 4.5-5.0 HRS,108585.0,54292.5,,,0
CDM,PMC - 3011 - 360000232,"OR CATEGORY I 8'01""-8'15""",44666.0,22333.0,,,0
CDM,PMC - 3011 - 360000233,"OR CATEGORY I 8'16""-8'30""",45933.0,22966.5,,,0
CDM,PMC - 3011 - 360000234,"OR CATEGORY I 8'31""-8'45""",47199.0,23599.5,,,0
CDM,PMC - 3011 - 360000235,"OR CATEGORY I 8'46""-9'00""",48466.0,24233.0,,,0
CDM,PMC - 3011 - 360000236,"OR CATEGORY I 9'01-9'15""",49733.0,24866.5,,,0
CDM,PMC - 3011 - 360000237,"OR CATEGORY I 9'16""-9'30""",51000.0,25500.0,,,0
CDM,PMC - 3011 - 360000238,"OR CATEGORY I 9'31""-9'45""",52266.0,26133.0,,,0
CDM,PMC - 3011 - 360000239,"OR CATEGORY I 9'46""-10'00""",53533.0,26766.5,,,0
CDM,PMC - 3011 - 360000240,"OR CATEGORY II 8'01""-8'15""",58120.0,29060.0,,,0
CDM,PMC - 3011 - 360000241,"OR CATEGORY II 8'16""-8'30""",59737.0,29868.5,,,0
CDM,PMC - 3011 - 360000242,"OR CATEGORY II 8'31""-8'45""",61353.0,30676.5,,,0
CDM,PMC - 3011 - 360000243,"OR CATEGORY II 8'46""-9'00""",62969.0,31484.5,,,0
CDM,PMC - 3011 - 360000244,"OR CATEGORY II 9'01-9'15""",64585.0,32292.5,,,0
CDM,PMC - 3011 - 360000245,"OR CATEGORY II 9'16""-9'30""",66201.0,33100.5,,,0
CDM,PMC - 3011 - 360000246,"OR CATEGORY II 9'31""-9'45""",67817.0,33908.5,,,0
CDM,PMC - 3011 - 360000247,"OR CATEGORY II 9'46""-10'00""",69434.0,34717.0,,,0
CDM,PMC - 3011 - 360000248,"OR CATEGORY IV 9'01-9'15""",102085.0,51042.5,,,0
CDM,PMC - 3011 - 360000249,"OR CATEGORY IV 9'16""-9'30""",104488.0,52244.0,,,0
CDM,PMC - 3011 - 360000250,"OR CATEGORY IV 9'31""-9'45""",106890.0,53445.0,,,0
CDM,PMC - 3011 - 360000251,"OR CATEGORY IV 9'46""-10'00""",109293.0,54646.5,,,0
CDM,PMC - 3011 - 360000252,"OR CATEGORY V 8'01""-8'15""",99627.0,49813.5,,,0
CDM,PMC - 3011 - 360000253,"OR CATEGORY V 8'16""-8'30""",102204.0,51102.0,,,0
CDM,PMC - 3011 - 360000254,"OR CATEGORY V 8'31""-8'45""",104781.0,52390.5,,,0
CDM,PMC - 3011 - 360000255,"OR CATEGORY V 8'46""-9'00""",107358.0,53679.0,,,0
CDM,PMC - 3011 - 360000256,"OR CATEGORY V 9'01-9'15""",109935.0,54967.5,,,0
CDM,PMC - 3011 - 360000257,"OR CATEGORY V 9'16""-9'30""",112512.0,56256.0,,,0
CDM,PMC - 3011 - 360000258,"OR CATEGORY V 9'31""-9'45""",115090.0,57545.0,,,0
CDM,PMC - 3011 - 360000259,"OR CATEGORY V 9'46""-10'00""",117667.0,58833.5,,,0
CDM,PMC - 3011 - 360000281,CVOR CATEGORY C ADD'L 30MIN,10142.0,5071.0,,,0
CDM,PMC - 3016 - 311000182,NEURO CSF PRION PRTN QUAL,1721.0,860.5,,,0
CDM,PMC - 3016 - 311000192,NFCT DS 22 TRGT SARS-COV-2,1770.0,885.0,,,0
CDM,PMC - 3016 - 311000201,ONC NONSM CLL LNG CA CELL FREE DNA ALYS 23 GEN,22596.0,11298.0,,,0
CDM,PMC - 3016 - 311000216,ARC HEA BEAD CHIP,370.0,185.0,,,0
CDM,PMC - 3016 - 311000310,OB PE SFLT-1/PLGF IA SRM/PLS,955.0,477.5,,,0
CDM,PMC - 3016 - 333000055,INSERT UTERINE TANDEMOVOID,3277.0,1638.5,,,0
CDM,PMC - 3016 - 420000148,PT MASSAGE THERAPY 1 HR,160.0,80.0,,,0
CDM,PMC - 3016 - 420000149,PT MASSAGE THERAPY 30 MIN,80.0,40.0,,,0
CDM,PMC - 3016 - 420000150,PT ACUPUNCTURE NEW PATIENT,250.0,125.0,,,0
CDM,PMC - 3016 - 420000151,PT ACUPUNCTURE FOLLOW-UP,170.0,85.0,,,0
CDM,PMC - 3016 - 420000152,PT ACUPNHIMGRP â€“ ACUPUNCTURE GROUP,100.0,50.0,,,0
CDM,PMC - 3021 - 360000001,"OR CATEGORY I 0""-15""",1790.0,895.0,,,0
CDM,PMC - 3021 - 360000002,"OR CATEGORY I 16""-30""",2339.0,1169.5,,,0
CDM,PMC - 3021 - 360000003,"OR CATEGORY I 31""-45""",2888.0,1444.0,,,0
CDM,PMC - 3021 - 360000004,"OR CATEGORY I 46""-60""",3437.0,1718.5,,,0
CDM,PMC - 3021 - 360000005,"OR CATEGORY I 1'01""-1'15""",3986.0,1993.0,,,0
CDM,PMC - 3021 - 360000006,"OR CATEGORY I 1'16""-1'30""",4535.0,2267.5,,,0
CDM,PMC - 3021 - 360000007,"OR CATEGORY I 1'31""-1'45""",5085.0,2542.5,,,0
CDM,PMC - 3021 - 360000008,"OR CATEGORY I 1'46""-2'00""",5634.0,2817.0,,,0
CDM,PMC - 3021 - 360000009,"OR CATEGORY I 2'01""-2'15""",6183.0,3091.5,,,0
CDM,PMC - 3021 - 360000010,"OR CATEGORY I 2'16""-2'30""",6732.0,3366.0,,,0
CDM,PMC - 3021 - 360000011,"OR CATEGORY I 2'31""-2'45""",7281.0,3640.5,,,0
CDM,PMC - 3021 - 360000012,"OR CATEGORY I 2'46""-3'00""",7830.0,3915.0,,,0
CDM,PMC - 3021 - 360000013,"OR CATEGORY I 3'01""-3'15""",8379.0,4189.5,,,0
CDM,PMC - 3021 - 360000014,"OR CATEGORY I 3'16""-3'30""",8928.0,4464.0,,,0
CDM,PMC - 3021 - 360000015,"OR CATEGORY I 3'31""-3'45""",9478.0,4739.0,,,0
CDM,PMC - 3021 - 360000016,"OR CATEGORY I 3'46""-4'00""",10027.0,5013.5,,,0
CDM,PMC - 3021 - 360000017,"OR CATEGORY I 4'01""-4'15""",10576.0,5288.0,,,0
CDM,PMC - 3021 - 360000018,"OR CATEGORY I 4'16""-4'30""",11125.0,5562.5,,,0
CDM,PMC - 3021 - 360000019,"OR CATEGORY I 4'31""-4'45""",11674.0,5837.0,,,0
CDM,PMC - 3021 - 360000020,"OR CATEGORY I 4'46""-5'00""",12223.0,6111.5,,,0
CDM,PMC - 3021 - 360000021,"OR CATEGORY I 5'01""-5'15""",12772.0,6386.0,,,0
CDM,PMC - 3021 - 360000022,"OR CATEGORY I 5'16""-5'30""",13321.0,6660.5,,,0
CDM,PMC - 3021 - 360000023,"OR CATEGORY I 5'31""-5'45""",13870.0,6935.0,,,0
CDM,PMC - 3021 - 360000024,"OR CATEGORY I 5'46""-6'00""",14420.0,7210.0,,,0
CDM,PMC - 3021 - 360000025,"OR CATEGORY I 6'01""-6'15""",14969.0,7484.5,,,0
CDM,PMC - 3021 - 360000026,"OR CATEGORY I 6'16""-6'30""",15518.0,7759.0,,,0
CDM,PMC - 3021 - 360000027,"OR CATEGORY I 6'31""-6'45""",16067.0,8033.5,,,0
CDM,PMC - 3021 - 360000028,"OR CATEGORY I 6'46""-7'00""",16616.0,8308.0,,,0
CDM,PMC - 3021 - 360000029,"OR CATEGORY I 7'01""-7'15""",17165.0,8582.5,,,0
CDM,PMC - 3021 - 360000030,"OR CATEGORY I 7'16""-7'30""",17714.0,8857.0,,,0
CDM,PMC - 3021 - 360000031,"OR CATEGORY I 7'31""-7'45""",18263.0,9131.5,,,0
CDM,PMC - 3021 - 360000032,"OR CATEGORY I 7'46""-8'00""",18813.0,9406.5,,,0
CDM,PMC - 3021 - 360000033,OR CATEGORY I EA ADDL 15 MIN,549.0,274.5,,,0
CDM,PMC - 3021 - 360000034,"OR CATEGORY II 0""-15""",2775.0,1387.5,,,0
CDM,PMC - 3021 - 360000035,"OR CATEGORY II 16""-30""",3475.0,1737.5,,,0
CDM,PMC - 3021 - 360000036,"OR CATEGORY II 31""-45""",4175.0,2087.5,,,0
CDM,PMC - 3021 - 360000037,"OR CATEGORY II 46""-60""",4874.0,2437.0,,,0
CDM,PMC - 3021 - 360000038,"OR CATEGORY II 1'01""-1'15""",5574.0,2787.0,,,0
CDM,PMC - 3021 - 360000039,"OR CATEGORY II 1'16""-1'30""",6274.0,3137.0,,,0
CDM,PMC - 3021 - 360000040,"OR CATEGORY II 1'31""-1'45""",6974.0,3487.0,,,0
CDM,PMC - 3021 - 360000041,"OR CATEGORY II 1'46""-2'00""",7674.0,3837.0,,,0
CDM,PMC - 3021 - 360000042,"OR CATEGORY II 2'01""-2'15""",8374.0,4187.0,,,0
CDM,PMC - 3021 - 360000043,"OR CATEGORY II 2'16""-2'30""",9074.0,4537.0,,,0
CDM,PMC - 3021 - 360000044,"OR CATEGORY II 2'31""-2'45""",9774.0,4887.0,,,0
CDM,PMC - 3021 - 360000045,"OR CATEGORY II 2'46""-3'00""",10474.0,5237.0,,,0
CDM,PMC - 3021 - 360000046,"OR CATEGORY II 3'01""-3'15""",11174.0,5587.0,,,0
CDM,PMC - 3021 - 360000047,"OR CATEGORY II 3'16""-3'30""",11874.0,5937.0,,,0
CDM,PMC - 3021 - 360000048,"OR CATEGORY II 3'31""-3'45""",12574.0,6287.0,,,0
CDM,PMC - 3021 - 360000049,"OR CATEGORY II 3'46""-4'00""",13274.0,6637.0,,,0
CDM,PMC - 3021 - 360000050,"OR CATEGORY II 4'01""-4'15""",13973.0,6986.5,,,0
CDM,PMC - 3021 - 360000051,"OR CATEGORY II 4'16""-4'30""",14673.0,7336.5,,,0
CDM,PMC - 3021 - 360000052,"OR CATEGORY II 4'31""-4'45""",15373.0,7686.5,,,0
CDM,PMC - 3021 - 360000053,"OR CATEGORY II 4'46""-5'00""",16073.0,8036.5,,,0
CDM,PMC - 3021 - 360000054,"OR CATEGORY II 5'01""-5'15""",16773.0,8386.5,,,0
CDM,PMC - 3021 - 360000055,"OR CATEGORY II 5'16""-5'30""",17473.0,8736.5,,,0
CDM,PMC - 3021 - 360000056,"OR CATEGORY II 5'31""-5'45""",18173.0,9086.5,,,0
CDM,PMC - 3021 - 360000057,"OR CATEGORY II 5'46""-6'00""",18873.0,9436.5,,,0
CDM,PMC - 3021 - 360000058,"OR CATEGORY II 6'01""-6'15""",19573.0,9786.5,,,0
CDM,PMC - 3021 - 360000059,"OR CATEGORY II 6'16""-6'30""",20273.0,10136.5,,,0
CDM,PMC - 3021 - 360000060,"OR CATEGORY II 6'31""-6'45""",20973.0,10486.5,,,0
CDM,PMC - 3021 - 360000061,"OR CATEGORY II 6'46""-7'00""",21673.0,10836.5,,,0
CDM,PMC - 3021 - 360000062,"OR CATEGORY II 7'01""-7'15""",22372.0,11186.0,,,0
CDM,PMC - 3021 - 360000063,"OR CATEGORY II 7'16""-7'30""",23072.0,11536.0,,,0
CDM,PMC - 3021 - 360000064,"OR CATEGORY II 7'31""-7'45""",23772.0,11886.0,,,0
CDM,PMC - 3021 - 360000065,"OR CATEGORY II 7'46""-8'00""",24472.0,12236.0,,,0
CDM,PMC - 3021 - 360000066,OR CATEGORY II EA ADDL 15 MIN,700.0,350.0,,,0
CDM,PMC - 3021 - 360000067,"OR CATEGORY III 0""-15""",4024.0,2012.0,,,0
CDM,PMC - 3021 - 360000068,"OR CATEGORY III 16""-30""",4827.0,2413.5,,,0
CDM,PMC - 3021 - 360000069,"OR CATEGORY III 31""-45""",5630.0,2815.0,,,0
CDM,PMC - 3021 - 360000070,"OR CATEGORY III 46""-60""",6432.0,3216.0,,,0
CDM,PMC - 3021 - 360000071,"OR CATEGORY III 1'01""-1'15""",7235.0,3617.5,,,0
CDM,PMC - 3021 - 360000072,"OR CATEGORY III 1'16""-1'30""",8038.0,4019.0,,,0
CDM,PMC - 3021 - 360000073,"OR CATEGORY III 1'31""-1'45""",8841.0,4420.5,,,0
CDM,PMC - 3021 - 360000074,"OR CATEGORY III 1'46""-2'00""",9644.0,4822.0,,,0
CDM,PMC - 3021 - 360000075,"OR CATEGORY III 2'01""-2'15""",10447.0,5223.5,,,0
CDM,PMC - 3021 - 360000076,"OR CATEGORY III 2'16""-2'30""",11250.0,5625.0,,,0
CDM,PMC - 3021 - 360000077,"OR CATEGORY III 2'31""-2'45""",12053.0,6026.5,,,0
CDM,PMC - 3021 - 360000078,"OR CATEGORY III 2'46""-3'00""",12855.0,6427.5,,,0
CDM,PMC - 3021 - 360000079,"OR CATEGORY III 3'01""-3'15""",13658.0,6829.0,,,0
CDM,PMC - 3021 - 360000080,"OR CATEGORY III 3'16""-3'30""",14461.0,7230.5,,,0
CDM,PMC - 3021 - 360000081,"OR CATEGORY III 3'31""-3'45""",15264.0,7632.0,,,0
CDM,PMC - 3021 - 360000082,"OR CATEGORY III 3'46""-4'00""",16067.0,8033.5,,,0
CDM,PMC - 3021 - 360000083,"OR CATEGORY III 4'01""-4'15""",16870.0,8435.0,,,0
CDM,PMC - 3021 - 360000084,"OR CATEGORY III 4'16""-4'30""",17673.0,8836.5,,,0
CDM,PMC - 3021 - 360000085,"OR CATEGORY III 4'31""-4'45""",18476.0,9238.0,,,0
CDM,PMC - 3021 - 360000086,"OR CATEGORY III 4'46""-5'00""",19278.0,9639.0,,,0
CDM,PMC - 3021 - 360000087,"OR CATEGORY III 5'01""-5'15""",20081.0,10040.5,,,0
CDM,PMC - 3021 - 360000088,"OR CATEGORY III 5'16""-5'30""",20884.0,10442.0,,,0
CDM,PMC - 3021 - 360000089,"OR CATEGORY III 5'31""-5'45""",21687.0,10843.5,,,0
CDM,PMC - 3021 - 360000090,"OR CATEGORY III 5'46""-6'00""",22490.0,11245.0,,,0
CDM,PMC - 3021 - 360000091,"OR CATEGORY III 6'01""-6'15""",23293.0,11646.5,,,0
CDM,PMC - 3021 - 360000092,"OR CATEGORY III 6'16""-6'30""",24096.0,12048.0,,,0
CDM,PMC - 3021 - 360000093,"OR CATEGORY III 6'31""-6'45""",24899.0,12449.5,,,0
CDM,PMC - 3021 - 360000094,"OR CATEGORY III 6'46""-7'00""",25702.0,12851.0,,,0
CDM,PMC - 3021 - 360000095,"OR CATEGORY III 7'01""-7'15""",26504.0,13252.0,,,0
CDM,PMC - 3021 - 360000096,"OR CATEGORY III 7'16""-7'30""",27307.0,13653.5,,,0
CDM,PMC - 3021 - 360000097,"OR CATEGORY III 7'31""-7'45""",28110.0,14055.0,,,0
CDM,PMC - 3021 - 360000098,"OR CATEGORY III 7'46""-8'00""",28913.0,14456.5,,,0
CDM,PMC - 3021 - 360000099,"OR CATEGORY III 8'01""-8'15""",29716.0,14858.0,,,0
CDM,PMC - 3021 - 360000100,"OR CATEGORY III 8'16""-8'30""",30519.0,15259.5,,,0
CDM,PMC - 3021 - 360000101,"OR CATEGORY III 8'31""-8'45""",31322.0,15661.0,,,0
CDM,PMC - 3021 - 360000102,"OR CATEGORY III 8'46""-9'00""",32125.0,16062.5,,,0
CDM,PMC - 3021 - 360000103,"OR CATEGORY III 9'01-9'15""",32927.0,16463.5,,,0
CDM,PMC - 3021 - 360000104,"OR CATEGORY III 9'16""-9'30""",33730.0,16865.0,,,0
CDM,PMC - 3021 - 360000105,"OR CATEGORY III 9'31""-9'45""",34533.0,17266.5,,,0
CDM,PMC - 3021 - 360000106,"OR CATEGORY III 9'46""-10'00""",35336.0,17668.0,,,0
CDM,PMC - 3021 - 360000107,OR CATEGORY III EA ADDL 15MIN,803.0,401.5,,,0
CDM,PMC - 3021 - 360000108,"OR CATEGORY IV 0""-15""",6759.0,3379.5,,,0
CDM,PMC - 3021 - 360000109,"OR CATEGORY IV 16""-30""",7800.0,3900.0,,,0
CDM,PMC - 3021 - 360000110,"OR CATEGORY IV 31""-45""",8841.0,4420.5,,,0
CDM,PMC - 3021 - 360000111,"OR CATEGORY IV 46""-60""",9882.0,4941.0,,,0
CDM,PMC - 3021 - 360000112,"OR CATEGORY IV 1'01""-1'15""",10923.0,5461.5,,,0
CDM,PMC - 3021 - 360000113,"OR CATEGORY IV 1'16""-1'30""",11964.0,5982.0,,,0
CDM,PMC - 3021 - 360000114,"OR CATEGORY IV 1'31""-1'45""",13005.0,6502.5,,,0
CDM,PMC - 3021 - 360000115,"OR CATEGORY IV 1'46""-2'00""",14046.0,7023.0,,,0
CDM,PMC - 3021 - 360000116,"OR CATEGORY IV 2'01""-2'15""",15087.0,7543.5,,,0
CDM,PMC - 3021 - 360000117,"OR CATEGORY IV 2'16""-2'30""",16128.0,8064.0,,,0
CDM,PMC - 3021 - 360000118,"OR CATEGORY IV 2'31""-2'45""",17169.0,8584.5,,,0
CDM,PMC - 3021 - 360000119,"OR CATEGORY IV 2'46""-3'00""",18210.0,9105.0,,,0
CDM,PMC - 3021 - 360000120,"OR CATEGORY IV 3'01""-3'15""",19251.0,9625.5,,,0
CDM,PMC - 3021 - 360000121,"OR CATEGORY IV 3'16""-3'30""",20292.0,10146.0,,,0
CDM,PMC - 3021 - 360000122,"OR CATEGORY IV 3'31""-3'45""",21334.0,10667.0,,,0
CDM,PMC - 3021 - 360000123,"OR CATEGORY IV 3'46""-4'00""",22375.0,11187.5,,,0
CDM,PMC - 3021 - 360000124,"OR CATEGORY IV 4'01""-4'15""",23416.0,11708.0,,,0
CDM,PMC - 3021 - 360000125,"OR CATEGORY IV 4'16""-4'30""",24457.0,12228.5,,,0
CDM,PMC - 3021 - 360000126,"OR CATEGORY IV 4'31""-4'45""",25498.0,12749.0,,,0
CDM,PMC - 3021 - 360000127,"OR CATEGORY IV 4'46""-5'00""",26539.0,13269.5,,,0
CDM,PMC - 3021 - 360000128,"OR CATEGORY IV 5'01""-5'15""",27580.0,13790.0,,,0
CDM,PMC - 3021 - 360000129,"OR CATEGORY IV 5'16""-5'30""",28621.0,14310.5,,,0
CDM,PMC - 3021 - 360000130,"OR CATEGORY IV 5'31""-5'45""",29662.0,14831.0,,,0
CDM,PMC - 3021 - 360000131,"OR CATEGORY IV 5'46""-6'00""",30703.0,15351.5,,,0
CDM,PMC - 3021 - 360000132,"OR CATEGORY IV 6'01""-6'15""",31744.0,15872.0,,,0
CDM,PMC - 3021 - 360000133,"OR CATEGORY IV 6'16""-6'30""",32785.0,16392.5,,,0
CDM,PMC - 3021 - 360000134,"OR CATEGORY IV 6'31""-6'45""",33826.0,16913.0,,,0
CDM,PMC - 3021 - 360000135,"OR CATEGORY IV 6'46""-7'00""",34867.0,17433.5,,,0
CDM,PMC - 3021 - 360000136,"OR CATEGORY IV 7'01""-7'15""",35908.0,17954.0,,,0
CDM,PMC - 3021 - 360000137,"OR CATEGORY IV 7'16""-7'30""",36949.0,18474.5,,,0
CDM,PMC - 3021 - 360000138,"OR CATEGORY IV 7'31""-7'45""",37990.0,18995.0,,,0
CDM,PMC - 3021 - 360000139,"OR CATEGORY IV 7'46""-8'00""",39031.0,19515.5,,,0
CDM,PMC - 3021 - 360000140,"OR CATEGORY IV 8'01""-8'15""",40072.0,20036.0,,,0
CDM,PMC - 3021 - 360000141,"OR CATEGORY IV 8'16""-8'30""",41113.0,20556.5,,,0
CDM,PMC - 3021 - 360000142,"OR CATEGORY IV 8'31""-8'45""",42154.0,21077.0,,,0
CDM,PMC - 3021 - 360000143,"OR CATEGORY IV 8'46""-9'00""",43195.0,21597.5,,,0
CDM,PMC - 3021 - 360000144,OR CATEGORY IV EA ADDL 15 MIN,1041.0,520.5,,,0
CDM,PMC - 3021 - 360000145,"OR CATEGORY V 0""-15""",7435.0,3717.5,,,0
CDM,PMC - 3021 - 360000146,"OR CATEGORY V 16""-30""",8552.0,4276.0,,,0
CDM,PMC - 3021 - 360000147,"OR CATEGORY V 31""-45""",9669.0,4834.5,,,0
CDM,PMC - 3021 - 360000148,"OR CATEGORY V 46""-60""",10786.0,5393.0,,,0
CDM,PMC - 3021 - 360000149,"OR CATEGORY V 1'01""-1'15""",11903.0,5951.5,,,0
CDM,PMC - 3021 - 360000150,"OR CATEGORY V 1'16""-1'30""",13020.0,6510.0,,,0
CDM,PMC - 3021 - 360000151,"OR CATEGORY V 1'31""-1'45""",14137.0,7068.5,,,0
CDM,PMC - 3021 - 360000152,"OR CATEGORY V 1'46""-2'00""",15254.0,7627.0,,,0
CDM,PMC - 3021 - 360000153,"OR CATEGORY V 2'01""-2'15""",16371.0,8185.5,,,0
CDM,PMC - 3021 - 360000154,"OR CATEGORY V 2'16""-2'30""",17488.0,8744.0,,,0
CDM,PMC - 3021 - 360000155,"OR CATEGORY V 2'31""-2'45""",18605.0,9302.5,,,0
CDM,PMC - 3021 - 360000156,"OR CATEGORY V 2'46""-3'00""",19722.0,9861.0,,,0
CDM,PMC - 3021 - 360000157,"OR CATEGORY V 3'01""-3'15""",20838.0,10419.0,,,0
CDM,PMC - 3021 - 360000158,"OR CATEGORY V 3'16""-3'30""",21955.0,10977.5,,,0
CDM,PMC - 3021 - 360000159,"OR CATEGORY V 3'31""-3'45""",23072.0,11536.0,,,0
CDM,PMC - 3021 - 360000160,"OR CATEGORY V 3'46""-4'00""",24189.0,12094.5,,,0
CDM,PMC - 3021 - 360000161,"OR CATEGORY V 4'01""-4'15""",25306.0,12653.0,,,0
CDM,PMC - 3021 - 360000162,"OR CATEGORY V 4'16""-4'30""",26423.0,13211.5,,,0
CDM,PMC - 3021 - 360000163,"OR CATEGORY V 4'31""-4'45""",27540.0,13770.0,,,0
CDM,PMC - 3021 - 360000164,"OR CATEGORY V 4'46""-5'00""",28657.0,14328.5,,,0
CDM,PMC - 3021 - 360000165,"OR CATEGORY V 5'01""-5'15""",29774.0,14887.0,,,0
CDM,PMC - 3021 - 360000166,"OR CATEGORY V 5'16""-5'30""",30891.0,15445.5,,,0
CDM,PMC - 3021 - 360000167,"OR CATEGORY V 5'31""-5'45""",32008.0,16004.0,,,0
CDM,PMC - 3021 - 360000168,"OR CATEGORY V 5'46""-6'00""",33125.0,16562.5,,,0
CDM,PMC - 3021 - 360000169,"OR CATEGORY V 6'01""-6'15""",34242.0,17121.0,,,0
CDM,PMC - 3021 - 360000170,"OR CATEGORY V 6'16""-6'30""",35359.0,17679.5,,,0
CDM,PMC - 3021 - 360000171,"OR CATEGORY V 6'31""-6'45""",36476.0,18238.0,,,0
CDM,PMC - 3021 - 360000172,"OR CATEGORY V 6'46""-7'00""",37593.0,18796.5,,,0
CDM,PMC - 3021 - 360000173,"OR CATEGORY V 7'01""-7'15""",38710.0,19355.0,,,0
CDM,PMC - 3021 - 360000174,"OR CATEGORY V 7'16""-7'30""",39827.0,19913.5,,,0
CDM,PMC - 3021 - 360000175,"OR CATEGORY V 7'31""-7'45""",40944.0,20472.0,,,0
CDM,PMC - 3021 - 360000176,"OR CATEGORY V 7'46""-8'00""",42061.0,21030.5,,,0
CDM,PMC - 3021 - 360000177,OR CATEGORY V EA ADDL 15 MIN,1117.0,558.5,,,0
CDM,PMC - 3021 - 360000232,"OR CATEGORY I 8'01""-8'15""",19362.0,9681.0,,,0
CDM,PMC - 3021 - 360000233,"OR CATEGORY I 8'16""-8'30""",19911.0,9955.5,,,0
CDM,PMC - 3021 - 360000234,"OR CATEGORY I 8'31""-8'45""",20460.0,10230.0,,,0
CDM,PMC - 3021 - 360000235,"OR CATEGORY I 8'46""-9'00""",21009.0,10504.5,,,0
CDM,PMC - 3021 - 360000236,"OR CATEGORY I 9'01-9'15""",21558.0,10779.0,,,0
CDM,PMC - 3021 - 360000237,"OR CATEGORY I 9'16""-9'30""",22107.0,11053.5,,,0
CDM,PMC - 3021 - 360000238,"OR CATEGORY I 9'31""-9'45""",22656.0,11328.0,,,0
CDM,PMC - 3021 - 360000239,"OR CATEGORY I 9'46""-10'00""",23206.0,11603.0,,,0
CDM,PMC - 3021 - 360000240,"OR CATEGORY II 8'01""-8'15""",25172.0,12586.0,,,0
CDM,PMC - 3021 - 360000241,"OR CATEGORY II 8'16""-8'30""",25872.0,12936.0,,,0
CDM,PMC - 3021 - 360000242,"OR CATEGORY II 8'31""-8'45""",26572.0,13286.0,,,0
CDM,PMC - 3021 - 360000243,"OR CATEGORY II 8'46""-9'00""",27272.0,13636.0,,,0
CDM,PMC - 3021 - 360000244,"OR CATEGORY II 9'01-9'15""",27972.0,13986.0,,,0
CDM,PMC - 3021 - 360000245,"OR CATEGORY II 9'16""-9'30""",28672.0,14336.0,,,0
CDM,PMC - 3021 - 360000246,"OR CATEGORY II 9'31""-9'45""",29372.0,14686.0,,,0
CDM,PMC - 3021 - 360000247,"OR CATEGORY II 9'46""-10'00""",30072.0,15036.0,,,0
CDM,PMC - 3021 - 360000248,"OR CATEGORY IV 9'01-9'15""",44236.0,22118.0,,,0
CDM,PMC - 3021 - 360000249,"OR CATEGORY IV 9'16""-9'30""",45277.0,22638.5,,,0
CDM,PMC - 3021 - 360000250,"OR CATEGORY IV 9'31""-9'45""",46318.0,23159.0,,,0
CDM,PMC - 3021 - 360000251,"OR CATEGORY IV 9'46""-10'00""",47360.0,23680.0,,,0
CDM,PMC - 3021 - 360000252,"OR CATEGORY V 8'01""-8'15""",43178.0,21589.0,,,0
CDM,PMC - 3021 - 360000253,"OR CATEGORY V 8'16""-8'30""",44295.0,22147.5,,,0
CDM,PMC - 3021 - 360000254,"OR CATEGORY V 8'31""-8'45""",45412.0,22706.0,,,0
CDM,PMC - 3021 - 360000255,"OR CATEGORY V 8'46""-9'00""",46529.0,23264.5,,,0
CDM,PMC - 3021 - 360000256,"OR CATEGORY V 9'01-9'15""",47646.0,23823.0,,,0
CDM,PMC - 3021 - 360000257,"OR CATEGORY V 9'16""-9'30""",48762.0,24381.0,,,0
CDM,PMC - 3021 - 360000258,"OR CATEGORY V 9'31""-9'45""",49879.0,24939.5,,,0
CDM,PMC - 3021 - 360000259,"OR CATEGORY V 9'46""-10'00""",50996.0,25498.0,,,0
CDM,PMC - 3021 - 710000003,PACU 0-30 MIN PHASE I,866.0,433.0,,,0
CDM,PMC - 3021 - 710000004,PACU 31-60 MIN PHASE I,1567.0,783.5,,,0
CDM,PMC - 3021 - 710000005,PACU 61-90 MIN PHASE I,2261.0,1130.5,,,0
CDM,PMC - 3021 - 710000006,PACU 91-120 MIN PHASE I,2954.0,1477.0,,,0
CDM,PMC - 3021 - 710000007,PACU 121-150 MIN PHASE I,3639.0,1819.5,,,0
CDM,PMC - 3021 - 710000008,PACU 151-180 MIN PHASE I,4324.0,2162.0,,,0
CDM,PMC - 3021 - 710000009,PACU 181-210 MIN PHASE I,5009.0,2504.5,,,0
CDM,PMC - 3021 - 710000010,PACU 211-240 MIN PHASE I,5692.0,2846.0,,,0
CDM,PMC - 3021 - 710000011,PACU 241-270 MIN PHASE I,6376.0,3188.0,,,0
CDM,PMC - 3021 - 710000012,PACU 271-300 MIN PHASE I,7055.0,3527.5,,,0
CDM,PMC - 3021 - 710000013,PACU 301-330 MIN PHASE I,7734.0,3867.0,,,0
CDM,PMC - 3021 - 710000014,PACU 331-360 MIN PHASE I,8412.0,4206.0,,,0
CDM,PMC - 3021 - 710000015,PACU 361-390 MIN PHASE I,9088.0,4544.0,,,0
CDM,PMC - 3021 - 710000016,PACU 391-420 MIN PHASE I,9764.0,4882.0,,,0
CDM,PMC - 3021 - 710000017,PACU 421-450 MIN PHASE I,10438.0,5219.0,,,0
CDM,PMC - 3021 - 710000018,PACU 451-480 MIN PHASE I,11112.0,5556.0,,,0
CDM,PMC - 3021 - 750000001,"ENDO LEVEL 1 0"" - 15""",972.0,486.0,,,0
CDM,PMC - 3021 - 750000002,"ENDO LEVEL 1 16"" - 30""",1692.0,846.0,,,0
CDM,PMC - 3021 - 750000003,"ENDO LEVEL 1 31"" - 45""",2409.0,1204.5,,,0
CDM,PMC - 3021 - 750000004,"ENDO LEVEL 1 46"" - 60""",3125.0,1562.5,,,0
CDM,PMC - 3021 - 750000005,"ENDO LEVEL 1 1' 01"" - 1' 15""",3836.0,1918.0,,,0
CDM,PMC - 3021 - 750000006,"ENDO LEVEL 1 1' 16"" - 1' 30""",4545.0,2272.5,,,0
CDM,PMC - 3021 - 750000007,"ENDO LEVEL 1 1' 31"" - 1' 45""",5251.0,2625.5,,,0
CDM,PMC - 3021 - 750000008,"ENDO LEVEL 1 1' 46"" - 2' 00""",5953.0,2976.5,,,0
CDM,PMC - 3021 - 750000009,"ENDO LEVEL 1 2' 01"" - 2' 15""",6653.0,3326.5,,,0
CDM,PMC - 3021 - 750000010,"ENDO LEVEL 1 2' 16"" - 2' 30""",7349.0,3674.5,,,0
CDM,PMC - 3021 - 750000011,"ENDO LEVEL 1 2' 31"" - 2' 45""",8044.0,4022.0,,,0
CDM,PMC - 3021 - 750000012,"ENDO LEVEL 1 2' 46"" - 3' 00""",8735.0,4367.5,,,0
CDM,PMC - 3021 - 750000013,"ENDO LEVEL 1 3' 01"" - 3' 15""",9422.0,4711.0,,,0
CDM,PMC - 3021 - 750000014,"ENDO LEVEL 1 3' 16"" - 3' 30""",10108.0,5054.0,,,0
CDM,PMC - 3021 - 750000015,"ENDO LEVEL 1 3' 31"" - 3' 45""",10790.0,5395.0,,,0
CDM,PMC - 3021 - 750000016,"ENDO LEVEL 1 3' 46"" - 4' 00""",11468.0,5734.0,,,0
CDM,PMC - 3021 - 750000017,ENDO LEVEL 1 EA ADDL 15 MINS,598.0,299.0,,,0
CDM,PMC - 3021 - 750000018,"ENDO LEVEL 2 0"" - 15""",1203.0,601.5,,,0
CDM,PMC - 3021 - 750000019,"ENDO LEVEL 2 16"" - 30""",2126.0,1063.0,,,0
CDM,PMC - 3021 - 750000020,"ENDO LEVEL 2 31"" - 45""",3048.0,1524.0,,,0
CDM,PMC - 3021 - 750000021,"ENDO LEVEL 2 46"" - 60""",3969.0,1984.5,,,0
CDM,PMC - 3021 - 750000022,"ENDO LEVEL 2 1' 01"" - 1' 15""",4880.0,2440.0,,,0
CDM,PMC - 3021 - 750000023,"ENDO LEVEL 2 1' 16"" - 1' 30""",5789.0,2894.5,,,0
CDM,PMC - 3021 - 750000024,"ENDO LEVEL 2 1' 31"" - 1' 45""",6696.0,3348.0,,,0
CDM,PMC - 3021 - 750000025,"ENDO LEVEL 2 1' 46"" - 2' 00""",7598.0,3799.0,,,0
CDM,PMC - 3021 - 750000026,"ENDO LEVEL 2 2' 01"" - 2' 15""",8497.0,4248.5,,,0
CDM,PMC - 3021 - 750000027,"ENDO LEVEL 2 2' 16"" - 2' 30""",9392.0,4696.0,,,0
CDM,PMC - 3021 - 750000028,"ENDO LEVEL 2 2' 31"" - 2' 45""",10284.0,5142.0,,,0
CDM,PMC - 3021 - 750000029,"ENDO LEVEL 2 2' 46"" - 3' 00""",11172.0,5586.0,,,0
CDM,PMC - 3021 - 750000030,"ENDO LEVEL 2 3' 01"" - 3' 15""",12055.0,6027.5,,,0
CDM,PMC - 3021 - 750000031,"ENDO LEVEL 2 3' 16"" - 3' 30""",12937.0,6468.5,,,0
CDM,PMC - 3021 - 750000032,"ENDO LEVEL 2 3' 31"" - 3' 45""",13813.0,6906.5,,,0
CDM,PMC - 3021 - 750000033,"ENDO LEVEL 2 3' 46"" - 4' 00""",14686.0,7343.0,,,0
CDM,PMC - 3021 - 750000034,ENDO LEVEL 2 EA ADDL 15 MINS,690.0,345.0,,,0
CDM,PMC - 3021 - 750000035,"ENDO LEVEL 3 0"" - 15""",1345.0,672.5,,,0
CDM,PMC - 3021 - 750000036,"ENDO LEVEL 3 16"" - 30""",2370.0,1185.0,,,0
CDM,PMC - 3021 - 750000037,"ENDO LEVEL 3 31"" - 45""",3392.0,1696.0,,,0
CDM,PMC - 3021 - 750000038,"ENDO LEVEL 3 46"" - 60""",4410.0,2205.0,,,0
CDM,PMC - 3021 - 750000039,"ENDO LEVEL 3 1' 01"" - 1' 15""",5424.0,2712.0,,,0
CDM,PMC - 3021 - 750000040,"ENDO LEVEL 3 1' 16"" - 1' 30""",6432.0,3216.0,,,0
CDM,PMC - 3021 - 750000041,"ENDO LEVEL 3 1' 31"" - 1' 45""",7439.0,3719.5,,,0
CDM,PMC - 3021 - 750000042,"ENDO LEVEL 3 1' 46"" - 2' 00""",8441.0,4220.5,,,0
CDM,PMC - 3021 - 750000043,"ENDO LEVEL 3 2' 01"" - 2' 15""",9438.0,4719.0,,,0
CDM,PMC - 3021 - 750000044,"ENDO LEVEL 3 2' 16"" - 2' 30""",10432.0,5216.0,,,0
CDM,PMC - 3021 - 750000045,"ENDO LEVEL 3 2' 31"" - 2' 45""",11422.0,5711.0,,,0
CDM,PMC - 3021 - 750000046,"ENDO LEVEL 3 2' 46"" - 3' 00""",12406.0,6203.0,,,0
CDM,PMC - 3021 - 750000047,"ENDO LEVEL 3 3' 01"" - 3' 15""",13389.0,6694.5,,,0
CDM,PMC - 3021 - 750000048,"ENDO LEVEL 3 3' 16"" - 3' 30""",14366.0,7183.0,,,0
CDM,PMC - 3021 - 750000049,"ENDO LEVEL 3 3' 31"" - 3' 45""",15339.0,7669.5,,,0
CDM,PMC - 3021 - 750000050,"ENDO LEVEL 3 3' 46"" - 4' 00""",16308.0,8154.0,,,0
CDM,PMC - 3021 - 750000051,ENDO LEVEL 3 EA ADDL 15 MINS,874.0,437.0,,,0
CDM,PMC - 3021 - 750000052,"ENDO LEVEL 4 0"" - 15""",1461.0,730.5,,,0
CDM,PMC - 3021 - 750000053,"ENDO LEVEL 4 16"" - 30""",2589.0,1294.5,,,0
CDM,PMC - 3021 - 750000054,"ENDO LEVEL 4 31"" - 45""",3713.0,1856.5,,,0
CDM,PMC - 3021 - 750000055,"ENDO LEVEL 4 46"" - 60""",4836.0,2418.0,,,0
CDM,PMC - 3021 - 750000056,"ENDO LEVEL 4 1' 01"" - 1' 15""",5956.0,2978.0,,,0
CDM,PMC - 3021 - 750000057,"ENDO LEVEL 4 1' 16"" - 1' 30""",7074.0,3537.0,,,0
CDM,PMC - 3021 - 750000058,"ENDO LEVEL 4 1' 31"" - 1' 45""",8190.0,4095.0,,,0
CDM,PMC - 3021 - 750000059,"ENDO LEVEL 4 1' 46"" - 2' 00""",9304.0,4652.0,,,0
CDM,PMC - 3021 - 750000060,"ENDO LEVEL 4 2' 01"" - 2' 15""",10415.0,5207.5,,,0
CDM,PMC - 3021 - 750000061,"ENDO LEVEL 4 2' 16"" - 2' 30""",11524.0,5762.0,,,0
CDM,PMC - 3021 - 750000062,"ENDO LEVEL 4 2' 31"" - 2' 45""",12631.0,6315.5,,,0
CDM,PMC - 3021 - 750000063,"ENDO LEVEL 4 2' 46"" - 3' 00""",13736.0,6868.0,,,0
CDM,PMC - 3021 - 750000064,"ENDO LEVEL 4 3' 01"" - 3' 15""",14838.0,7419.0,,,0
CDM,PMC - 3021 - 750000065,"ENDO LEVEL 4 3' 16"" - 3' 30""",15938.0,7969.0,,,0
CDM,PMC - 3021 - 750000066,"ENDO LEVEL 4 3' 31"" - 3' 45""",17035.0,8517.5,,,0
CDM,PMC - 3021 - 750000067,"ENDO LEVEL 4 3' 46"" - 4' 00""",18131.0,9065.5,,,0
CDM,PMC - 3021 - 750000068,ENDO LEVEL 4 EA ADDL 15 MINS,961.0,480.5,,,0
CDM,PMC - 3021 - 750000069,"ENDO LEVEL 5 0"" - 15""",1575.0,787.5,,,0
CDM,PMC - 3021 - 750000070,"ENDO LEVEL 5 16"" - 30""",2812.0,1406.0,,,0
CDM,PMC - 3021 - 750000071,"ENDO LEVEL 5 31"" - 45""",4048.0,2024.0,,,0
CDM,PMC - 3021 - 750000072,"ENDO LEVEL 5 46"" - 60""",5282.0,2641.0,,,0
CDM,PMC - 3021 - 750000073,"ENDO LEVEL 5 1' 01"" - 1' 15""",6514.0,3257.0,,,0
CDM,PMC - 3021 - 750000074,"ENDO LEVEL 5 1' 16"" - 1' 30""",7744.0,3872.0,,,0
CDM,PMC - 3021 - 750000075,"ENDO LEVEL 5 1' 31"" - 1' 45""",8969.0,4484.5,,,0
CDM,PMC - 3021 - 750000076,"ENDO LEVEL 5 1' 46"" - 2' 00""",10193.0,5096.5,,,0
CDM,PMC - 3021 - 750000077,"ENDO LEVEL 5 2' 01"" - 2' 15""",11414.0,5707.0,,,0
CDM,PMC - 3021 - 750000078,"ENDO LEVEL 5 2' 16"" - 2' 30""",12633.0,6316.5,,,0
CDM,PMC - 3021 - 750000079,"ENDO LEVEL 5 2' 31"" - 2' 45""",13851.0,6925.5,,,0
CDM,PMC - 3021 - 750000080,"ENDO LEVEL 5 2' 46"" - 3' 00""",15064.0,7532.0,,,0
CDM,PMC - 3021 - 750000081,"ENDO LEVEL 5 3' 01"" - 3' 15""",16275.0,8137.5,,,0
CDM,PMC - 3021 - 750000082,"ENDO LEVEL 5 3' 16"" - 3' 30""",17484.0,8742.0,,,0
CDM,PMC - 3021 - 750000083,"ENDO LEVEL 5 3' 31"" - 3' 45""",18691.0,9345.5,,,0
CDM,PMC - 3021 - 750000084,"ENDO LEVEL 5 3' 46"" - 4' 00""",19894.0,9947.0,,,0
CDM,PMC - 3021 - 750000085,ENDO LEVEL 5 EA ADDL 15 MINS,1051.0,525.5,,,0
CDM,PMC - 3043 - 366000400,"SURG PROC LVL I 0""-15""",1603.0,801.5,,,0
CDM,PMC - 3043 - 366000401,"SURG PROC LVL I 16""-30""",2107.0,1053.5,,,0
CDM,PMC - 3043 - 366000402,"SURG PROC LVL I 30""-1.0'",2675.0,1337.5,,,0
CDM,PMC - 3043 - 366000403,SURG PROC LVL I 1.0'-1.5',3246.0,1623.0,,,0
CDM,PMC - 3043 - 366000404,SURG PROC LVL I 1.5'-2.0',3825.0,1912.5,,,0
CDM,PMC - 3043 - 366000405,"SURG PROC LVL I EA AD30""",572.0,286.0,,,0
CDM,PMC - 3043 - 366000406,"SURG PROC LVL II 0""-30""",2119.0,1059.5,,,0
CDM,PMC - 3043 - 366000407,"SURG PROC LVL II 30""-1.0'",2824.0,1412.0,,,0
CDM,PMC - 3043 - 366000408,SURG PROC LVL II 1.0'-1.5',3644.0,1822.0,,,0
CDM,PMC - 3043 - 366000409,SURG PROC LVL II 1.5'-2.0',4463.0,2231.5,,,0
CDM,PMC - 3043 - 366000410,SURG PROC LVL II 2.0'-2.5',5279.0,2639.5,,,0
CDM,PMC - 3043 - 366000411,SURG PROC LVL II EA AD30,820.0,410.0,,,0
CDM,PMC - 3043 - 366000412,"SURG PROC LVL III 0'-30""",6281.0,3140.5,,,0
CDM,PMC - 3043 - 366000413,"SURG PROC LVL III 30""-1.0'",9287.0,4643.5,,,0
CDM,PMC - 3043 - 366000414,SURG PROC LVL III 1.0'-1.5',12286.0,6143.0,,,0
CDM,PMC - 3043 - 366000415,SURG PROC LVL III 1.5'-2.0',15277.0,7638.5,,,0
CDM,PMC - 3043 - 366000416,SURG PROC LVL III 2.0'-2.5',18263.0,9131.5,,,0
CDM,PMC - 3043 - 366000417,SURG PROC LVL III 2.5'-3.0',21243.0,10621.5,,,0
CDM,PMC - 3043 - 366000418,SURG PROC LVL III 3.0'-3.5',24215.0,12107.5,,,0
CDM,PMC - 3043 - 366000419,"SURG PROC LVL III EA AD30""",4463.0,2231.5,,,0
CDM,PMC - 3043 - 366000420,"SURG PROC LVL IV 0'-30""",6682.0,3341.0,,,0
CDM,PMC - 3043 - 366000421,"SURG PROC LVL IV 30""-1.0'",10191.0,5095.5,,,0
CDM,PMC - 3043 - 366000422,SURG PROC LVL IV 1.0'-1.5',13692.0,6846.0,,,0
CDM,PMC - 3043 - 366000423,SURG PROC LVL IV 1.5'-2.0',17186.0,8593.0,,,0
CDM,PMC - 3043 - 366000424,SURG PROC LVL IV 2.0'-2.5',20674.0,10337.0,,,0
CDM,PMC - 3043 - 366000425,SURG PROC LVL IV 2.5'-3.0',24156.0,12078.0,,,0
CDM,PMC - 3043 - 366000426,SURG PROC LVL IV 3.0'-3.5',27631.0,13815.5,,,0
CDM,PMC - 3043 - 366000427,"SURG PROC LVL IV EA AD30""",5181.0,2590.5,,,0
CDM,PMC - 3043 - 610000185,QUANTITATIVE MRI ANALYSIS BRAIN W/DX MRI,621.0,310.5,,,0
CDM,PMC - 3081 - 710000003,PACU 0-30 MIN PHASE I,514.0,257.0,,,0
CDM,PMC - 3081 - 710000004,PACU 31-60 MIN PHASE I,931.0,465.5,,,0
CDM,PMC - 3081 - 710000005,PACU 61-90 MIN PHASE I,1343.0,671.5,,,0
CDM,PMC - 3081 - 710000006,PACU 91-120 MIN PHASE I,1753.0,876.5,,,0
CDM,PMC - 3081 - 710000007,PACU 121-150 MIN PHASE I,2160.0,1080.0,,,0
CDM,PMC - 3081 - 710000008,PACU 151-180 MIN PHASE I,2567.0,1283.5,,,0
CDM,PMC - 4001 - 320000373,DEXA BODY COMPOSITION STUDY,156.92,78.46,,,0
CDM,PMC - 4001 - 320000395,ILIAC ART ANGIO CARDIAC CATH,5173.0,2586.5,,,0
CDM,PMC - 4001 - 343000159,I-123 SOD IODIDE CAP P/MCI,4122.0,2061.0,,,0
CDM,PMC - 4001 - 351000075,CT CALCIUM SCORE SCREEN,200.0,100.0,,,0
CPT,100,ANESTH SALIVARY GLAND,,,,,0
CPT,10004,FNA BX W/O IMG GDN EA ADDL,,,,,0
CPT,10005,FNA BX W/US GDN 1ST LES,1444.0,722.0,251.54,1400.68,54
CPT,10006,FNA BX W/US GDN EA ADDL,622.0,311.0,108.35,603.34,47
CPT,10007,FNA BX W/FLUOR GDN 1ST LES,,,688.14,1376.28,8
CPT,10008,FNA BX W/FLUOR GDN EA ADDL,,,,,0
CPT,10009,FNA BX W/CT GDN 1ST LES,,,688.14,1376.28,8
CPT,1000F,TOBACCO USE ASSESSED,,,,,0
CPT,10010,FNA BX W/CT GDN EA ADDL,,,,,0
CPT,10011,FNA BX W/MR GDN 1ST LES,,,688.14,1376.28,8
CPT,10012,FNA BX W/MR GDN EA ADDL,,,,,0
CPT,10021,FINE NEEDLE ASPIRATION,1233.0,616.5,214.78,1196.01,54
CPT,10021,FNA BX W/O IMG GDN 1ST LES,439.0,219.5,76.47,790.08,54
CPT,1002F,ASSESS ANGINAL SYMPTOM/LEVEL,,,,,0
CPT,10030,IMG GID FLU COLL DRG SFT TIS,,,639.78,1376.28,24
CPT,10035,PLMT SFT TISS LOCLZJ DEV 1ST,,,688.14,1376.28,8
CPT,10036,PLMT SFT TISS LOCLZJ DEV EA,,,,,0
CPT,1003F,LEVEL OF ACTIVITY ASSESS,,,,,0
CPT,10040,ACNE SURGERY,,,194.97,389.94,8
CPT,1004F,CLIN SYMP VOL OVRLD ASSESS,,,,,0
CPT,1005F,ASTHMA SYMPTOMS EVALUATE,,,,,0
CPT,10060,I&D ABSCESS SIMPLE SINGLE,406.0,203.0,70.72,393.82,54
CPT,10060,I&D ABSCESS SIMPLE/SINGLE,,,,,0
CPT,10060,PROF I&D ABSCESS SIMPLE SINGLE,659.0,329.5,114.79,639.23,53
CPT,10061,I&D ABSCESS COMP/MULTIPLE,,,,,0
CPT,10061,I&D ABSCESS COMPLICMX,636.0,318.0,110.79,790.08,54
CPT,1006F,OSTEOARTHRITIS ASSESS,,,,,0
CPT,1007F,ANTI-INFLM/ANLGSC OTC ASSESS,,,,,0
CPT,10080,I&D PILONIDAL CYST SIMPLE,,,688.14,1376.28,8
CPT,10081,I&D PILONIDAL CYST COMP,,,688.14,1376.28,8
CPT,1008F,GI/RENAL RISK ASSESS,,,,,0
CPT,100T,PROSTH RETINA RECEIVE&GEN,,,,,0
CPT,1010F,SEVERITY ANGINA BY ACTVTY,,,,,0
CPT,1011F,ANGINA PRESENT,,,,,0
CPT,10120,INC&RMVL FB SUBQ TISS SMPL,,,,,0
CPT,10120,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,921.0,460.5,160.43,893.37,54
CPT,10121,INC&RMVL FB SUBQ TISS COMP,,,1604.96,3209.92,8
CPT,1012F,ANGINA ABSENT,,,,,0
CPT,10140,I & D HEMATOMA,2571.0,1285.5,447.86,3209.92,54
CPT,10140,I&D HMTMA SEROMA/FLUID COLLJ,,,,,0
CPT,1015F,COPD SYMPTOMS ASSESS,,,,,0
CPT,10160,PNXR ASPIR ABSC HMTMA BULLA,,,,,0
CPT,10160,PUNCT ASPIR ABSCESHEMAT,419.0,209.5,72.98,790.08,54
CPT,10180,I&D COMPLEX PO WOUND INFCTJ,,,2822.69,5645.38,8
CPT,1018F,ASSESS DYSPNEA NOT PRESENT,,,,,0
CPT,1019F,ASSESS DYSPNEA PRESENT,,,,,0
CPT,101T,ESW MUSCSKEL SYS NOS,,,239.7,479.4,8
CPT,101U,HERED COLON CA DO 15 GENES,,,1743.95,3487.9,8
CPT,102,ANESTH REPAIR OF CLEFT LIP,,,,,0
CPT,1022F,PNEUMO IMM STATUS ASSESS,,,,,0
CPT,1026F,CO-MORBID CONDITION ASSESS,,,,,0
CPT,102T,ESW PHY ANES LAT HMRL EPCNDL,,,3179.6,6359.2,8
CPT,102U,HERED BRST CA RLTD DO 17 GEN,,,1303.95,2607.9,8
CPT,103,ANESTH BLEPHAROPLASTY,,,,,0
CPT,1030F,INFLUENZA IMM STATUS ASSESS,,,,,0
CPT,1031F,SMOKING & 2ND HAND ASSESSED,,,,,0
CPT,1032F,SMOKER/EXPOSED 2ND HND SMOKE,,,,,0
CPT,1033F,TOBACCO NONSMOKER NOR 2NDHND,,,,,0
CPT,1034F,CURRENT TOBACCO SMOKER,,,,,0
CPT,1035F,SMOKELESS TOBACCO USER,,,,,0
CPT,1036F,TOBACCO NON-USER,,,,,0
CPT,1038F,PERSISTENT ASTHMA,,,,,0
CPT,1039F,INTERMITTENT ASTHMA,,,,,0
CPT,103U,HERED OVA CA PNL 24 GENES,,,1743.95,3487.9,8
CPT,104,ANESTH ELECTROSHOCK,,,,,0
CPT,1040F,DSM-5 INFO MDD DOCD,,,,,0
CPT,1050F,HISTORY OF MOLE CHANGES,,,,,0
CPT,1052F,TYPE LOCATION ACTIVITYASSESS,,,,,0
CPT,1055F,VISUAL FUNCT STATUS ASSESS,,,,,0
CPT,105U,NEPH CKD MULT ECLIA TUM NEC,,,950.0,1900.0,8
CPT,1060F,DOC PERM/CONT/PAROX ATR FIB,,,,,0
CPT,1061F,DOC LACK PERM&CONT&PAROX FIB,,,,,0
CPT,1065F,ISCHM STROKE SYMP LT3 HRSB/4,,,,,0
CPT,1066F,ISCHM STROKE SX ONSET>=3HR,,,,,0
CPT,106T,TOUCH QUANT SENSORY TEST,,,36.3,72.6,8
CPT,106U,GSTR EMPTG 7 TIMED BRTH SPEC,,,874.49,1748.98,8
CPT,1070F,ALARM SYMP ASSESSED-ABSENT,,,,,0
CPT,1071F,ALARM SYMP ASSESSED-1+ PRSNT,,,,,0
CPT,107T,VIBRATE QUANT SENSORY TEST,,,36.3,72.6,8
CPT,107U,C DIFF TOX AG DETCJ IA STOOL,,,16.0,32.0,8
CPT,108T,COOL QUANT SENSORY TEST,,,57.33,114.66,8
CPT,108U,GI BARRETT ESOPH 9 PRTN BMRK,,,4950.0,9900.0,8
CPT,1090F,PRES/ABSN URINE INCON ASSESS,,,,,0
CPT,1091F,URINE INCON CHARACTERIZED,,,,,0
CPT,109T,HEAT QUANT SENSORY TEST,,,36.3,72.6,8
CPT,109U,ID ASPERGILLUS DNA 4 SPECIES,,,142.63,285.26,8
CPT,10U,NFCT DS STRN TYP WHL GEN SEQ,,,427.26,854.52,8
CPT,11000,DBRDMT ECZ/INFECTED SKIN<10%,,,395.04,790.08,8
CPT,11001,DBRDMT ECZ/INFCT SKN EA ADDL,,,,,0
CPT,11004,DBRDMT SKIN XTRNL GENT&PER,,,,,0
CPT,11005,DBRDMT SKIN ABDOMINAL WALL,,,,,0
CPT,11006,DBRDMT SKIN XTRNL GENT PER,,,,,0
CPT,11008,RMV PRSTC MTRL/MESH ABD WALL,,,,,0
CPT,1100F,PTFALLS ASSESS-DOCD GE2>/YR,,,,,0
CPT,11010,DEBRIDE SKIN AT FX SITE,,,,,0
CPT,11010,PROF DEBRIDE SKIN FX,1032.0,516.0,179.77,1376.28,53
CPT,11011,DEBRIDE SKIN MUSC AT FX SITE,,,688.14,1376.28,8
CPT,11012,DEB SKIN BONE AT FX SITE,,,2822.69,5645.38,8
CPT,1101F,PT FALLS ASSESS-DOCD LE1/YR,,,,,0
CPT,11042,DBRDMT SUBQ TIS 1ST 20SQCM/<,,,,,0
CPT,11042,DEBRID SUBQ TISSUE 20 SQ CM/<,813.5,406.75,141.1,792.49,108
CPT,11042,PROF DEBRID SKIN & SUBQ TISS,268.0,134.0,46.68,790.08,53
CPT,11043,DBRDMT MUSC&/FSCA 1ST 20/<,,,,,0
CPT,11043,DEBRID MUSC FASCIA 20 SQ CM/<,817.0,408.5,142.32,1436.4,54
CPT,11043,PROF DEBRID SKIN TISS &MUSCLE,1819.0,909.5,316.86,1764.43,53
CPT,11044,DBRDMT BONE 1ST 20 SQ CM/<,,,,,0
CPT,11044,DEBRID BONE MUS FASC 20 SQ CM/<,1949.0,974.5,339.51,3209.92,54
CPT,11044,PROF DEBRID SKIN SUBQ TISS&MU,1188.0,594.0,206.94,3209.92,53
CPT,11045,DBRDMT SUBQ TISS EACH ADDL,,,,,0
CPT,11045,DEBRID SUBQ TISSUE EA ADDL 20 SQ CM,1217.0,608.5,212.0,1180.49,94
CPT,11046,DBRDMT MUSC&/FSCA EA ADDL,,,,,0
CPT,11047,DBRDMT BONE EACH ADDL,,,,,0
CPT,11047,DEBRIDE BONE EA ADD 20 SQ CM,2383.0,1191.5,415.11,2311.51,47
CPT,11055,PARING/CUTG B9 HYPRKER LES 1,,,,,0
CPT,11055,PROF PARING SINGLE LESION,347.0,173.5,60.44,389.94,53
CPT,11056,PARNG/CUTG B9 HYPRKR LES 2-4,,,,,0
CPT,11056,PROF PARING 2-4 LESIONS,462.0,231.0,80.48,448.14,53
CPT,11057,PARNG/CUTG B9 HYPRKR LES >4,,,194.97,389.94,8
CPT,110T,NOS QUANT SENSORY TEST,,,129.29,258.58,8
CPT,110U,RX MNTR 1+ORAL ONC RX&SBSTS,,,27.11,54.22,8
CPT,11102,TANGENTIAL BIOPSY SKIN SINGLE LESION,435.0,217.5,75.77,790.08,54
CPT,11102,TANGNTL BX SKIN SINGLE LES,,,,,0
CPT,11103,TANGNTL BX SKIN EA SEP/ADDL,,,,,0
CPT,11104,PUNCH BIOPSY SKIN SINGLE LESION,431.0,215.5,75.08,790.08,54
CPT,11104,PUNCH BX SKIN SINGLE LESION,,,,,0
CPT,11105,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,431.0,215.5,75.08,418.07,47
CPT,11105,PUNCH BX SKIN EA SEP/ADDL,,,,,0
CPT,11106,INCAL BX SKN SINGLE LES,,,,,0
CPT,11106,INCISIONAL BIOPSY SKIN SINGLE LESION,1591.0,795.5,277.15,1543.27,54
CPT,11107,INCAL BX SKN EA SEP/ADDL,,,,,0
CPT,11107,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,435.0,217.5,75.77,421.95,47
CPT,1110F,PT LFT INPT FAC W/IN 60 DAYS,,,,,0
CPT,1111F,DSCHRG MED/CURRENT MED MERGE,,,,,0
CPT,1112,ANESTH BONE ASPIRATE/BX,,,,,0
CPT,1116F,AURIC/PERI PAIN ASSESSED,,,,,0
CPT,1118F,GERD SYMPS ASSESSED 12 MONTH,,,,,0
CPT,1119F,INIT EVAL FOR CONDITION,,,,,0
CPT,111U,ONC COLON CA KRAS&NRAS ALYS,,,682.29,1364.58,8
CPT,1120,ANESTH PELVIS SURGERY,,,,,0
CPT,11200,REMOVAL OF SKIN TAGS <W/15,445.0,222.5,77.51,431.65,54
CPT,11200,RMVL SKIN TAGS UP TO&INC 15,,,,,0
CPT,11201,RMVL SKIN TAGS EA ADDL 10,,,,,0
CPT,1121F,SUBS EVAL FOR CONDITION,,,,,0
CPT,1123F,ACP DISCUSS/DSCN MKR DOCD,,,,,0
CPT,1124F,ACP DISCUSS-NO DSCNMKR DOCD,,,,,0
CPT,1125F,AMNT PAIN NOTED PAIN PRSNT,,,,,0
CPT,1126F,AMNT PAIN NOTED NONE PRSNT,,,,,0
CPT,1127F,NEW EPISODE FOR CONDITION,,,,,0
CPT,1128F,SUBS EPISODE FOR CONDITION,,,,,0
CPT,112U,IADI 16S&18S RRNA GENES,,,356.13,712.26,8
CPT,1130,ANESTH BODY CAST PROCEDURE,,,,,0
CPT,11300,SHAVE SKIN LESION 0.5 CM/<,,,395.04,790.08,8
CPT,11301,SHAVE SKIN LESION 0.6-1.0 CM,,,194.97,389.94,8
CPT,11302,SHAVE SKIN LESION 1.1-2.0 CM,,,194.97,389.94,8
CPT,11303,SHAVE SKIN LESION >2.0 CM,,,395.04,790.08,8
CPT,11305,SHAVE SKIN LESION 0.5 CM/<,,,194.97,389.94,8
CPT,11306,SHAVE SKIN LESION 0.6-1.0 CM,,,194.97,389.94,8
CPT,11307,SHAVE SKIN LESION 1.1-2.0 CM,,,194.97,389.94,8
CPT,11308,SHAVE SKIN LESION >2.0 CM,,,395.04,790.08,8
CPT,1130F,BK PAIN & FXN ASSESSED,,,,,0
CPT,11310,SHAVE SKIN LESION 0.5 CM/<,,,194.97,389.94,8
CPT,11311,SHAVE SKIN LESION 0.6-1.0 CM,,,194.97,389.94,8
CPT,11312,SHAVE SKIN LESION 1.1-2.0 CM,,,395.04,790.08,8
CPT,11313,SHAVE SKIN LESION >2.0 CM,,,395.04,790.08,8
CPT,1134F,EPSD BK PAIN FOR 6 WKS/<,,,,,0
CPT,1135F,EPSD BK PAIN FOR >6 WKS,,,,,0
CPT,1136F,EPSD BK PAIN FOR 12 WKS/<,,,,,0
CPT,1137F,EPSD BK PAIN FOR >12 WKS,,,,,0
CPT,113U,ONC PRST8 PCA3&TMPRSS2-ERG,,,760.0,1520.0,8
CPT,1140,ANESTH AMPUTATION AT PELVIS,,,,,0
CPT,11400,EXC TR-EXT B9+MARG 0.5 < CM,1559.0,779.5,271.57,1512.23,54
CPT,11400,EXC TR-EXT B9+MARG 0.5 CM<,,,,,0
CPT,11401,EXC B9 LES T/A/L 0.6-1.0 CM,810.0,405.0,141.1,790.08,54
CPT,11401,EXC TR-EXT B9+MARG 0.6-1 CM,,,,,0
CPT,11402,EXC TR-EXT B9 MARG1.1-2CM,1800.0,900.0,313.56,1746.0,54
CPT,11402,EXC TR-EXT B9+MARG 1.1-2 CM,,,,,0
CPT,11403,EXC TR-EXT B9+MARG 2.1-3CM,1543.0,771.5,268.79,1496.71,54
CPT,11404,EXC TR-EXT B9+MARG 3.1-4 CM,3373.0,1686.5,587.57,3271.81,54
CPT,11406,EXC TR-EXT B9+MARG > 4.0 CM,3406.0,1703.0,593.32,3303.82,54
CPT,11406,EXC TR-EXT B9+MARG >4.0 CM,,,,,0
CPT,11420,EXC H-F-NK-SP B9+MARG 0.5/<,3472.0,1736.0,604.82,3367.84,54
CPT,11421,EXC BENIGN LES 0.6-1.0CM,1800.0,900.0,313.56,1746.0,54
CPT,11421,EXC H-F-NK-SP B9+MARG 0.6-1,,,,,0
CPT,11422,EXC B9 LES XCP SKTG F/E/E/N/L/M 1.1-2.0CM,2070.0,1035.0,360.59,3209.92,54
CPT,11422,EXC H-F-NK-SP B9+MARG 1.1-2,,,,,0
CPT,11423,EXC H-F-NK-SP B9+MARG 2.1-3,5055.0,2527.5,880.58,4903.35,54
CPT,11424,EXC H-F-NK-SP B9+MARG 3.1-4,,,1604.96,3209.92,8
CPT,11426,EXC H-F-NK-SP B9+MARG >4 CM,,,2822.69,5645.38,8
CPT,11440,EXC FACE-MM B9+MARG 0.5 CM/<,,,688.14,1376.28,8
CPT,11441,EXC FACE-MM B9+MARG 0.6-1 CM,,,688.14,1376.28,8
CPT,11442,EXC FACE-MM B9+MARG 1.1-2 CM,,,688.14,1376.28,8
CPT,11443,EXC FACE-MM B9+MARG 2.1-3 CM,,,1604.96,3209.92,8
CPT,11444,EXC FACE-MM B9+MARG 3.1-4 CM,3506.0,1753.0,610.74,3400.82,54
CPT,11446,EXC FACE-MM B9+MARG >4 CM,,,2822.69,5645.38,8
CPT,11450,EXC SKN HDRDNT AX SMPL/NTRM,,,2822.69,5645.38,8
CPT,11451,EXC SKN HDRDNT AX COMPLEX,,,2822.69,5645.38,8
CPT,11462,EXC SKN HDRDNT ING SMPL/NTRM,,,2822.69,5645.38,8
CPT,11463,EXC SKN HDRDNT ING COMPLEX,,,2822.69,5645.38,8
CPT,11470,EXC SKN H/P/P/U SMPL/NTRM,,,2822.69,5645.38,8
CPT,11471,EXC SKN H/P/P/U COMPLEX,,,2822.69,5645.38,8
CPT,114U,GI BARRETTS ESOPH VIM&CCNA1,,,1938.01,3876.02,8
CPT,1150,ANESTH PELVIC TUMOR SURGERY,,,,,0
CPT,1150F,DOC PT RSK DEATH W/IN 1YR,,,,,0
CPT,1151F,DOC NO PT RSK DEATH W/IN 1YR,,,,,0
CPT,1152F,DOC ADVNCD DIS COMFORT 1ST,,,,,0
CPT,1153F,DOC ADVNCD DIS CMFRT NOT 1ST,,,,,0
CPT,1157F,ADVNC CARE PLAN IN RCRD,,,,,0
CPT,1158F,ADVNC CARE PLAN TLK DOCD,,,,,0
CPT,1159F,MED LIST DOCD IN RCRD,,,,,0
CPT,115U,RESPIR IADNA 18 VIRAL&2 BACT,,,275.35,550.7,8
CPT,1160,ANESTH PELVIS PROCEDURE,,,,,0
CPT,11600,EXC TR-EXT MAL+MARG 0.5 CM/<,,,688.14,1376.28,8
CPT,11601,EXC TR-EXT MAL+MARG 0.6-1 CM,,,,,0
CPT,11601,EXC TR-EXT MLG+MARG 0.6-1 CM,1543.0,771.5,268.79,1496.71,54
CPT,11602,EXC TR-EXT MAL+MARG 1.1-2 CM,,,,,0
CPT,11602,EXC TR-EXT MLG+MARG 1.1-2 CM,808.0,404.0,140.75,790.08,54
CPT,11603,EXC TR-EXT MAL+MARG 2.1-3 CM,,,,,0
CPT,11603,EXC TR-EXT MLG+MARG 2.1-3 CM,1543.0,771.5,268.79,1496.71,54
CPT,11604,EXC TR-EXT MAL+MARG 3.1-4 CM,,,,,0
CPT,11604,EXC TR-EXT MLG+MARG 3.1-4 CM,1543.0,771.5,268.79,1496.71,54
CPT,11606,EXC TR-EXT MAL+MARG >4 CM,,,,,0
CPT,11606,EXC TR-EXT MLG+MARG > 4 CM,3506.0,1753.0,610.74,3400.82,54
CPT,1160F,RVW MEDS BY RX/DR IN RCRD,,,,,0
CPT,11620,EXC H-F-NK-SP MAL+MARG 0.5/<,,,1604.96,3209.92,8
CPT,11621,EXC S/N/H/F/G MAL+MRG 0.6-1,,,688.14,1376.28,8
CPT,11622,EXC H-F-NK-SP MLG+MARG 1.1-2,1559.0,779.5,271.57,1512.23,54
CPT,11622,EXC S/N/H/F/G MAL+MRG 1.1-2,,,,,0
CPT,11623,EXC H-F-NK-SP MLG+MARG 2.1-3,3506.0,1753.0,610.74,3400.82,54
CPT,11623,EXC S/N/H/F/G MAL+MRG 2.1-3,,,,,0
CPT,11624,EXC S/N/H/F/G MAL+MRG 3.1-4,,,1604.96,3209.92,8
CPT,11626,EXC H-F-NK-SP MLG+MAR > 4 CM,8504.0,4252.0,1481.39,8248.88,54
CPT,11626,EXC S/N/H/F/G MAL+MRG >4 CM,,,,,0
CPT,11640,EXC F/E/E/N/L MAL+MRG 0.5CM<,,,688.14,1376.28,8
CPT,11641,EXC F/E/E/N/L MAL+MRG 0.6-1,,,688.14,1376.28,8
CPT,11642,EXC F/E/E/N/L MAL+MRG 1.1-2,,,688.14,1376.28,8
CPT,11643,EXC F/E/E/N/L MAL+MRG 2.1-3,,,1604.96,3209.92,8
CPT,11644,EXC F/E/E/N/L MAL+MRG 3.1-4,,,1604.96,3209.92,8
CPT,11646,EXC F/E/E/N/L MAL+MRG >4 CM,,,2822.69,5645.38,8
CPT,116U,RX MNTR NZM IA 35+ORAL FLU,,,246.92,493.84,8
CPT,1170,ANESTH PELVIS SURGERY,,,,,0
CPT,1170F,FXNL STATUS ASSESSED,,,,,0
CPT,11719,TRIM NAIL(S) ANY NUMBER,,,,,0
CPT,11719,TRIM NONDYSTROPHIC NAILS,177.0,88.5,30.83,171.69,54
CPT,11720,DEBRID OF NAILS 1-5,188.0,94.0,32.74,182.36,54
CPT,11720,DEBRIDE NAIL 1-5,,,,,0
CPT,11721,DEBRIDE NAIL 6 OR MORE,,,57.33,114.66,8
CPT,1173,ANESTH FX REPAIR PELVIS,,,,,0
CPT,11730,AVULSION NAIL PLATE,1188.0,594.0,194.97,1152.36,54
CPT,11730,REMOVAL OF NAIL PLATE,,,,,0
CPT,11732,REMOVE NAIL PLATE ADD-ON,,,,,0
CPT,11740,DRAIN BLOOD FROM UNDER NAIL,,,129.29,258.58,8
CPT,11750,EXC NAILMATRIX PARTCOMP,838.0,419.0,145.97,812.86,54
CPT,11750,PROF EXC NAILMATRIX PARTCOMP,1188.0,594.0,206.94,1152.36,53
CPT,11750,REMOVAL OF NAIL BED,,,,,0
CPT,11755,BIOPSY NAIL UNIT,,,688.14,1376.28,8
CPT,1175F,FUNCTION STAT ASSESSED RVWD,,,,,0
CPT,11760,REPAIR OF NAIL BED,,,718.2,1436.4,8
CPT,11762,RECONSTRUCTION OF NAIL BED,,,2005.02,4010.04,8
CPT,11765,EXCISION OF NAIL FOLD TOE,,,395.04,790.08,8
CPT,11770,REMOVE PILONIDAL CYST SIMPLE,,,2822.69,5645.38,8
CPT,11771,REMOVE PILONIDAL CYST EXTEN,,,2822.69,5645.38,8
CPT,11772,REMOVE PILONIDAL CYST COMPL,,,2822.69,5645.38,8
CPT,117U,PAIN MGMT 11 ENDOGENOUS ANAL,,,840.65,1681.3,8
CPT,1180F,THROMBOEMB RISK ASSESSED,,,,,0
CPT,1181F,NEUROPSYCHIA SYMPTS ASSESSED,,,,,0
CPT,1182F,NEUROPSYCHI SYMPT 1+PRESENT,,,,,0
CPT,1183F,NEUROPSYCHIATRIC SYMP ABSENT,,,,,0
CPT,118U,TRNSPLJ DON-DRV CLL-FR DNA,,,2753.25,5506.5,8
CPT,11900,INJECT SKIN LESIONS </W 7,,,,,0
CPT,11900,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,517.0,258.5,90.06,501.49,54
CPT,11901,INJECT SKIN LESIONS >7,,,194.97,389.94,8
CPT,11920,CORRECT SKIN COLOR 6.0 CM/<,,,718.2,1436.4,8
CPT,11921,CORRECT SKN COLOR 6.1-20.0CM,,,718.2,1436.4,8
CPT,11922,CORRECT SKIN COLOR EA 20.0CM,,,,,0
CPT,11950,TX CONTOUR DEFECTS 1 CC/<,,,194.97,389.94,8
CPT,11951,TX CONTOUR DEFECTS 1.1-5.0CC,,,718.2,1436.4,8
CPT,11952,TX CONTOUR DEFECTS 5.1-10CC,,,718.2,1436.4,8
CPT,11954,TX CONTOUR DEFECTS >10.0 CC,,,718.2,1436.4,8
CPT,11960,INSERT TISSUE EXPANDER(S),,,3443.66,6887.32,8
CPT,11970,RPLCMT TISS XPNDR PERM IMPLT,,,7051.31,14102.62,8
CPT,11971,RMVL TIS XPNDR WO INSJ IMPLT,,,2822.69,5645.38,8
CPT,11976,REMOVE CONTRACEPTIVE CAPSULE,,,688.14,1376.28,8
CPT,11980,IMPLANT HORMONE PELLET(S),,,434.11,868.22,8
CPT,11981,INSERTION DRUG DLVR IMPLANT,,,129.29,258.58,8
CPT,11982,REMOVE DRUG IMPLANT DEVICE,,,434.11,868.22,8
CPT,11983,REMOVE/INSERT DRUG IMPLANT,,,434.11,868.22,8
CPT,119U,CRD CERAMIDES LIQ CHROM PLSM,,,83.76,167.52,8
CPT,11M,ONC PRST8 CA MRNA 12 GEN ALG,,,760.0,1520.0,8
CPT,11U,RX MNTR LC-MS/MS ORAL FLUID,,,114.43,228.86,8
CPT,120,ANESTH EAR SURGERY,,,,,0
CPT,1200,ANESTH HIP JOINT PROCEDURE,,,,,0
CPT,12001,RPR S/N/AX/GEN/TRNK 2.5CM/<,,,194.97,389.94,8
CPT,12002,RPR S/N/AX/GEN/TRNK2.6-7.5CM,,,194.97,389.94,8
CPT,12004,RPR S/N/AX/GEN/TRK7.6-12.5CM,,,194.97,389.94,8
CPT,12005,RPR S/N/A/GEN/TRK12.6-20.0CM,,,395.04,790.08,8
CPT,12006,RPR S/N/A/GEN/TRK20.1-30.0CM,,,395.04,790.08,8
CPT,12007,RPR S/N/AX/GEN/TRNK >30.0 CM,,,194.97,389.94,8
CPT,1200F,SEIZURE TYPE& FREQU DOCD,,,,,0
CPT,12011,RPR F/E/E/N/L/M 2.5 CM/<,,,194.97,389.94,8
CPT,12013,RPR F/E/E/N/L/M 2.6-5.0 CM,,,194.97,389.94,8
CPT,12014,RPR F/E/E/N/L/M 5.1-7.5 CM,,,194.97,389.94,8
CPT,12015,RPR F/E/E/N/L/M 7.6-12.5 CM,,,194.97,389.94,8
CPT,12016,RPR FE/E/EN/L/M 12.6-20.0 CM,,,395.04,790.08,8
CPT,12017,RPR FE/E/EN/L/M 20.1-30.0 CM,,,395.04,790.08,8
CPT,12018,RPR F/E/E/N/L/M >30.0 CM,,,194.97,389.94,8
CPT,1202,ANESTH ARTHROSCOPY OF HIP,,,,,0
CPT,12020,TX SUPFC WND DEHSN SMPL CLSR,,,718.2,1436.4,8
CPT,12021,TX SUPFC WND DEHSN W/PACKING,,,395.04,790.08,8
CPT,12031,INTMD RPR S/A/T/EXT 2.5 CM/<,,,,,0
CPT,12031,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1454.0,727.0,253.28,1410.38,54
CPT,12032,INTMD RPR S/A/T/EXT 2.6-7.5,,,,,0
CPT,12032,INTMD WND REPAIR S/TR/EXT,808.0,404.0,140.75,790.08,54
CPT,12034,INTMD RPR S/TR/EXT 7.6-12.5,,,,,0
CPT,12034,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1454.0,727.0,253.28,1410.38,54
CPT,12035,INTMD RPR S/A/T/EXT 12.6-20,,,395.04,790.08,8
CPT,12036,INTMD RPR S/A/T/EXT 20.1-30,,,718.2,1436.4,8
CPT,12037,INTMD RPR S/TR/EXT >30.0 CM,,,2005.02,4010.04,8
CPT,12041,INTMD RPR N-HF/GENIT 2.5CM/<,,,395.04,790.08,8
CPT,12042,INTMD RPR N-HF/GENIT2.6-7.5,,,395.04,790.08,8
CPT,12044,INTMD RPR N-HF/GENIT7.6-12.5,,,718.2,1436.4,8
CPT,12045,INTMD RPR N-HF/GENIT12.6-20,,,718.2,1436.4,8
CPT,12046,INTMD RPR N-HF/GENIT20.1-30,,,718.2,1436.4,8
CPT,12047,INTMD RPR N-HF/GENIT >30.0CM,,,2005.02,4010.04,8
CPT,12051,INTMD RPR FACE/MM 2.5 CM/<,,,395.04,790.08,8
CPT,12052,INTMD RPR FACE/MM 2.6-5.0 CM,,,395.04,790.08,8
CPT,12053,INTMD RPR FACE/MM 5.1-7.5 CM,,,395.04,790.08,8
CPT,12054,INTMD RPR FACE/MM 7.6-12.5CM,,,395.04,790.08,8
CPT,12055,INTMD RPR FACE/MM 12.6-20 CM,,,395.04,790.08,8
CPT,12056,INTMD RPR FACE/MM 20.1-30.0,,,395.04,790.08,8
CPT,12057,INTMD RPR FACE/MM >30.0 CM,,,395.04,790.08,8
CPT,1205F,EPI ETIOL SYND RVWD AND DOCD,,,,,0
CPT,120U,ONC B CLL LYMPHM MRNA 58 GEN,,,2510.21,5020.42,8
CPT,1210,ANESTH HIP JOINT SURGERY,,,,,0
CPT,1212,ANESTH HIP DISARTICULATION,,,,,0
CPT,1214,ANESTH HIP ARTHROPLASTY,,,,,0
CPT,1215,ANESTH REVISE HIP REPAIR,,,,,0
CPT,121U,SC DIS VCAM-1 WHOLE BLOOD,,,509.2,1018.4,8
CPT,1220,ANESTH PROCEDURE ON FEMUR,,,,,0
CPT,1220F,PT SCREENED FOR DEPRESSION,,,,,0
CPT,122U,SC DIS P-SELECTIN WHL BLOOD,,,526.23,1052.46,8
CPT,1230,ANESTH SURGERY OF FEMUR,,,,,0
CPT,1232,ANESTH AMPUTATION OF FEMUR,,,,,0
CPT,1234,ANESTH RADICAL FEMUR SURG,,,,,0
CPT,123U,MCHNL FRAGILITY RBC PRFLG,,,357.63,715.26,8
CPT,124,ANESTH EAR EXAM,,,,,0
CPT,1250,ANESTH UPPER LEG SURGERY,,,,,0
CPT,126,ANESTH TYMPANOTOMY,,,,,0
CPT,1260,ANESTH UPPER LEG VEINS SURG,,,,,0
CPT,1270,ANESTH THIGH ARTERIES SURG,,,,,0
CPT,1272,ANESTH FEMORAL ARTERY SURG,,,,,0
CPT,1274,ANESTH FEMORAL EMBOLECTOMY,,,,,0
CPT,129U,HERED BRST CA RLTD DO PANEL,,,1303.95,2607.9,8
CPT,12F,CAP BACTERIAL ASSESS,,,,,0
CPT,12M,ONC MRNA 5 GEN RSK URTHL CA,,,760.0,1520.0,8
CPT,130U,HERED COLON CA DO MRNA PNL,,,584.9,1169.8,8
CPT,13100,CMPLX RPR TRUNK 1.1-2.5 CM,,,718.2,1436.4,8
CPT,13101,CMPLX RPR TRUNK 2.6-7.5 CM,,,718.2,1436.4,8
CPT,13102,CMPLX RPR TRUNK ADDL 5CM/<,,,,,0
CPT,13120,CMPLX RPR S/A/L 1.1-2.5 CM,,,395.04,790.08,8
CPT,13121,CMPLX RPR S/A/L 2.6-7.5 CM,,,,,0
CPT,13121,REPAIR OF WOUND OR LESION,1415.0,707.5,246.49,1372.55,54
CPT,13122,CMPLX RPR S/A/L ADDL 5 CM/>,,,,,0
CPT,13122,REPAIR WOUND/LESION ADD-ON,223.0,111.5,38.84,216.31,47
CPT,13131,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,395.04,790.08,8
CPT,13132,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,395.04,790.08,8
CPT,13133,CMPLX RPR F/C/C/M/N/AX/G/H/F,,,,,0
CPT,13151,CMPLX RPR E/N/E/L 1.1-2.5 CM,,,718.2,1436.4,8
CPT,13152,CMPLX RPR E/N/E/L 2.6-7.5 CM,,,718.2,1436.4,8
CPT,13153,CMPLX RPR E/N/E/L ADDL 5CM/<,,,,,0
CPT,13160,SEC CLSR SURG WND/DEHSN XTN,,,3443.66,6887.32,8
CPT,131U,HERED BRST CA RLTD DO PNL 13,,,,,0
CPT,1320,ANESTH KNEE AREA SURGERY,,,,,0
CPT,132U,HERED OVA CA RLTD DO PNL 17,,,,,0
CPT,133U,HERED PRST8 CA RLTD DO 11,,,690.29,1380.58,8
CPT,1340,ANESTH KNEE AREA PROCEDURE,,,,,0
CPT,134U,HERED PAN CA MRNA PNL 18 GEN,,,748.39,1496.78,8
CPT,135U,HERED GYN CA MRNA PNL 12 GEN,,,,,0
CPT,1360,ANESTH KNEE AREA SURGERY,,,,,0
CPT,136U,ATM MRNA SEQ ALYS,,,407.43,814.86,8
CPT,137U,PALB2 MRNA SEQ ALYS,,,282.88,565.76,8
CPT,1380,ANESTH KNEE JOINT PROCEDURE,,,,,0
CPT,1382,ANESTH DX KNEE ARTHROSCOPY,,,,,0
CPT,138U,BRCA1 BRCA2 MRNA SEQ ALYS,,,468.33,936.66,8
CPT,1390,ANESTH KNEE AREA PROCEDURE,,,,,0
CPT,1392,ANESTH KNEE AREA SURGERY,,,,,0
CPT,13M,ONC MRNA 5 GEN RECR URTHL CA,,,760.0,1520.0,8
CPT,140,ANESTH PROCEDURES ON EYE,,,,,0
CPT,1400,ANESTH KNEE JOINT SURGERY,,,,,0
CPT,14000,TIS TRNFR TRUNK 10 SQ CM/<,,,2005.02,4010.04,8
CPT,14001,TIS TRNFR TRUNK 10.1-30SQCM,,,2005.02,4010.04,8
CPT,1400F,PRKNS DIAG RVIEWED,,,,,0
CPT,1402,ANESTH KNEE ARTHROPLASTY,,,,,0
CPT,14020,TIS TRNFR S/A/L 10 SQ CM/<,,,2005.02,4010.04,8
CPT,14021,TIS TRNFR S/A/L 10.1-30 SQCM,,,2005.02,4010.04,8
CPT,1404,ANESTH AMPUTATION AT KNEE,,,,,0
CPT,14040,TIS TRNFR F/C/C/M/N/A/G/H/F,,,2005.02,4010.04,8
CPT,14041,TIS TRNFR F/C/C/M/N/A/G/H/F,,,2005.02,4010.04,8
CPT,14060,TIS TRNFR E/N/E/L 10 SQ CM/<,,,2005.02,4010.04,8
CPT,14061,TIS TRNFR E/N/E/L10.1-30SQCM,,,2005.02,4010.04,8
CPT,140U,NFCT DS FUNGI DNA 15 TRGT,,,156.75,313.5,8
CPT,141U,NFCT DS BACT&FNG GRAM POS,,,156.75,313.5,8
CPT,142,ANESTH LENS SURGERY,,,,,0
CPT,1420,ANESTH KNEE JOINT CASTING,,,,,0
CPT,142U,NFCT DS BACT&FNG GRAM NEG,,,156.75,313.5,8
CPT,1430,ANESTH KNEE VEINS SURGERY,,,,,0
CPT,14301,TIS TRNFR ANY 30.1-60 SQ CM,,,3443.66,6887.32,8
CPT,14302,TIS TRNFR ADDL 30 SQ CM,,,,,0
CPT,1432,ANESTH KNEE VESSEL SURG,,,,,0
CPT,14350,FILLETED FINGER/TOE FLAP,,,2005.02,4010.04,8
CPT,144,ANESTH CORNEAL TRANSPLANT,,,,,0
CPT,1440,ANESTH KNEE ARTERIES SURG,,,,,0
CPT,1442,ANESTH KNEE ARTERY SURG,,,,,0
CPT,1444,ANESTH KNEE ARTERY REPAIR,,,,,0
CPT,145,ANESTH VITREORETINAL SURG,,,,,0
CPT,1450F,SYMPTOMS IMPROVED/CONSIST,,,,,0
CPT,1451F,SYMPT SHOW CLIN IMPORT DROP,,,,,0
CPT,1460F,QUAL CARD DIAG PRIOR 12 MONS,,,,,0
CPT,1461F,NO QUAL CARD DIAG PRIOR12MON,,,,,0
CPT,1462,ANESTH LOWER LEG PROCEDURE,,,,,0
CPT,1464,ANESTH ANKLE/FT ARTHROSCOPY,,,,,0
CPT,147,ANESTH IRIDECTOMY,,,,,0
CPT,1470,ANESTH LOWER LEG SURGERY,,,,,0
CPT,1472,ANESTH ACHILLES TENDON SURG,,,,,0
CPT,1474,ANESTH LOWER LEG SURGERY,,,,,0
CPT,148,ANESTH EYE EXAM,,,,,0
CPT,1480,ANESTH LOWER LEG BONE SURG,,,,,0
CPT,1482,ANESTH RADICAL LEG SURGERY,,,,,0
CPT,1484,ANESTH LOWER LEG REVISION,,,,,0
CPT,1486,ANESTH ANKLE REPLACEMENT,,,,,0
CPT,1490,ANESTH LOWER LEG CASTING,,,,,0
CPT,1490F,DEM SEVERITY CLASSIFIED MILD,,,,,0
CPT,1491F,DEM SEVERITY CLASSIFIED MOD,,,,,0
CPT,1493F,DEM SEVERITY CLASS SEVERE,,,,,0
CPT,1494F,COGNIT ASSESSED AND REVIEWED,,,,,0
CPT,14F,COMP PREOP ASSESS CAT SURG,,,,,0
CPT,1500,ANESTH LEG ARTERIES SURG,,,,,0
CPT,15002,WOUND PREP TRK/ARM/LEG,,,718.2,1436.4,8
CPT,15003,WOUND PREP ADDL 100 CM,,,,,0
CPT,15004,WOUND PREP F/N/HF/G,,,395.04,790.08,8
CPT,15005,WND PREP F/N/HF/G ADDL CM,,,,,0
CPT,1500F,SYMPTOM&SIGN SYMM POLYNEURO,,,,,0
CPT,15011,Harvest of skin for skin cell suspension autograft; first 25 sq cm or less,,,2005.02,4010.04,8
CPT,15012,Harvest of skin for skin cell suspension autograft; each additional 25 sq cm or part thereof (List separately in addition to code for primary procedure),,,,,0
CPT,15013,"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; first 25 sq cm or less of harvested skin",,,6896.39,13792.78,8
CPT,15014,"Preparation of skin cell suspension autograft, requiring enzymatic processing, manual mechanical disaggregation of skin cells, and filtration; each additional 25 sq cm of harvested skin or part thereo",,,,,0
CPT,15015,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; first 480 sq cm or less",,,2005.02,4010.04,8
CPT,15016,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, trunk, arms, legs; each additional 480 sq cm or part thereof (List separately in addi",,,,,0
CPT,15017,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multi",,,2005.02,4010.04,8
CPT,15018,"Application of skin cell suspension autograft to wound and donor sites, including application of primary dressing, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multi",,,,,0
CPT,1501F,NOT INITIAL EVAL FOR COND,,,,,0
CPT,1502,ANESTH LWR LEG EMBOLECTOMY,,,,,0
CPT,1502F,PT QUERIED PAIN FXN W/ INSTR,,,,,0
CPT,1503F,PT QUERIED SYMP RESP INSUFF,,,,,0
CPT,15040,HARVEST CULTURED SKIN GRAFT,,,2005.02,4010.04,8
CPT,1504F,PT HAS RESP INSUFFICIENCY,,,,,0
CPT,15050,PINCH GRAFT UP TO 2 CM DIAM,,,718.2,1436.4,8
CPT,1505F,PT HAS NO RESP INSUFFICIENCY,,,,,0
CPT,15100,SKIN SPLT GRFT TRNK/ARM/LEG,,,2005.02,4010.04,8
CPT,15101,SKIN SPLT GRFT T/A/L ADD-ON,,,,,0
CPT,15110,EPIDRM AUTOGRFT TRNK/ARM/LEG,,,2005.02,4010.04,8
CPT,15111,EPIDRM AUTOGRFT T/A/L ADD-ON,,,,,0
CPT,15115,EPIDRM A-GRFT FACE/NCK/HF/G,,,2005.02,4010.04,8
CPT,15116,EPIDRM A-GRFT F/N/HF/G ADDL,,,,,0
CPT,15120,SKN SPLT A-GRFT FAC/NCK/HF/G,,,3443.66,6887.32,8
CPT,15121,SKN SPLT A-GRFT F/N/HF/G ADD,,,,,0
CPT,15130,DERM AUTOGRAFT TRNK/ARM/LEG,,,2005.02,4010.04,8
CPT,15131,DERM AUTOGRAFT T/A/L ADD-ON,,,,,0
CPT,15135,DERM AUTOGRAFT FACE/NCK/HF/G,,,3443.66,6887.32,8
CPT,15136,DERM AUTOGRAFT F/N/HF/G ADD,,,,,0
CPT,15150,CULT SKIN GRFT T/ARM/LEG,,,2005.02,4010.04,8
CPT,15151,CULT SKIN GRFT T/A/L ADDL,,,,,0
CPT,15152,CULT SKIN GRAFT T/A/L +%,,,,,0
CPT,15155,CULT SKIN GRAFT F/N/HF/G,,,3443.66,6887.32,8
CPT,15156,CULT SKIN GRFT F/N/HFG ADD,,,,,0
CPT,15157,CULT EPIDERM GRFT F/N/HFG +%,,,,,0
CPT,1520,ANESTH LOWER LEG VEIN SURG,,,,,0
CPT,15200,FTH GRF FR TRNK 20 SQ CM/<,,,2005.02,4010.04,8
CPT,15201,FTH GRF FR TRNK EACH ADDL,,,,,0
CPT,1522,ANESTH LOWER LEG VEIN SURG,,,,,0
CPT,15220,FTH GRF FR S/A/L 20 SQ CM/<,,,2005.02,4010.04,8
CPT,15221,FTH GRF FR S/A/L EACH ADDL,,,,,0
CPT,15240,FTH GR FR F/C/C/M/N/AX/G/H/F,,,2005.02,4010.04,8
CPT,15241,FTH GR F/C/C/M/N/AX/G/H/F EA,,,,,0
CPT,15260,FTH GRF FR N/E/E/L 20 SQCM/<,,,2005.02,4010.04,8
CPT,15261,FTH GRF FR N/E/E/L EACH ADDL,,,,,0
CPT,15271,APPL SKIN SUB T/ARM/L 1ST 25/<,4596.0,2298.0,718.2,4458.12,54
CPT,15271,PROF APPL SKINSUB1ST 25 (LEG),4551.0,2275.5,718.2,4414.47,53
CPT,15271,SKIN SUB GRAFT TRNK/ARM/LEG,,,,,0
CPT,15272,PROF APPL SKINSUB ADD 25(LEG),4427.0,2213.5,771.18,4294.19,46
CPT,15272,SKIN SUB GRAFT T/A/L ADD-ON,,,,,0
CPT,15273,SKIN SUB GRFT T/ARM/LG CHILD,,,2005.02,4010.04,8
CPT,15274,SKN SUB GRFT T/A/L CHILD ADD,,,,,0
CPT,15275,APPL SKIN SUB F/S/N/HF/G 1ST 25 SQCM/<,2993.0,1496.5,521.38,2903.21,54
CPT,15275,SKIN SUB GRAFT FACE/NK/HF/G,,,,,0
CPT,15276,SKIN SUB GRAFT F/N/HF/G ADDL,,,,,0
CPT,15277,SKN SUB GRFT F/N/HF/G CHILD,,,2005.02,4010.04,8
CPT,15278,SKN SUB GRFT F/N/HF/G CH ADD,,,,,0
CPT,152U,NFCT DS DNA UNTRGT NGNRJ SEQ,,,2126.2,4252.4,8
CPT,153U,ONC BREAST MRNA 101 GENES,,,3159.42,6318.84,8
CPT,154U,ONC URTHL CA RNA FGFR3 GENE,,,482.14,964.28,8
CPT,15570,SKIN PEDICLE FLAP TRUNK,,,2005.02,4010.04,8
CPT,15572,SKIN PEDICLE FLAP ARMS/LEGS,,,3443.66,6887.32,8
CPT,15574,PEDCLE FH/CH/CH/M/N/AX/G/H/F,,,2005.02,4010.04,8
CPT,15576,PEDICLE E/N/E/L/NTRORAL,,,2005.02,4010.04,8
CPT,155U,ONC BRST CA DNA PIK3CA GENE,,,274.83,549.66,8
CPT,15600,DELAY FLAP TRUNK,,,3443.66,6887.32,8
CPT,15610,DELAY FLAP ARMS/LEGS,,,2005.02,4010.04,8
CPT,15620,DELAY FLAP F/C/C/N/AX/G/H/F,,,2005.02,4010.04,8
CPT,15630,DELAY FLAP EYE/NOS/EAR/LIP,,,2005.02,4010.04,8
CPT,15650,TRANSFER SKIN PEDICLE FLAP,,,2005.02,4010.04,8
CPT,156U,COPY NUMBER SEQUENCE ALYS,,,1740.0,3480.0,8
CPT,15730,MDFC FLAP W/PRSRV VASC PEDCL,,,3443.66,6887.32,8
CPT,15731,FOREHEAD FLAP W/VASC PEDICLE,,,3443.66,6887.32,8
CPT,15733,MUSC MYOQ/FSCQ FLP H&N PEDCL,,,3443.66,6887.32,8
CPT,15734,MUSCLE-SKIN GRAFT TRUNK,,,3443.66,6887.32,8
CPT,15736,MUSCLE-SKIN GRAFT ARM,,,2005.02,4010.04,8
CPT,15738,MUSCLE-SKIN GRAFT LEG,,,3443.66,6887.32,8
CPT,15740,ISLAND PEDICLE FLAP GRAFT,,,2005.02,4010.04,8
CPT,15750,NEUROVASCULAR PEDICLE FLAP,,,3443.66,6887.32,8
CPT,15756,FREE MYO/SKIN FLAP MICROVASC,,,,,0
CPT,15757,FREE SKIN FLAP MICROVASC,,,,,0
CPT,15758,FREE FASCIAL FLAP MICROVASC,,,,,0
CPT,15760,COMPOSITE SKIN GRAFT,,,2005.02,4010.04,8
CPT,15769,GRFG AUTOL SOFT TISS DIR EXC,,,3443.66,6887.32,8
CPT,15770,DERMA-FAT-FASCIA GRAFT,,,3443.66,6887.32,8
CPT,15771,GRFG AUTOL FAT LIPO 50 CC/<,,,3443.66,6887.32,8
CPT,15772,GRFG AUTOL FAT LIPO EA ADDL,,,,,0
CPT,15773,GRFG AUTOL FAT LIPO 25 CC/<,,,2005.02,4010.04,8
CPT,15774,GFRG AUTOL FAT LIPO EA ADDL,,,,,0
CPT,15775,HAIR TRNSPL 1-15 PUNCH GRFTS,,,395.04,790.08,8
CPT,15776,HAIR TRNSPL >15 PUNCH GRAFTS,,,395.04,790.08,8
CPT,15777,ACELLULAR DERM MATRIX IMPLT,,,,,0
CPT,15778,IMPL ABSRB MSH/PRSTH DLY CLS,,,,,0
CPT,15780,DERMABRASION TOTAL FACE,,,2822.69,5645.38,8
CPT,15781,DERMABRASION SEGMENTAL FACE,,,688.14,1376.28,8
CPT,15782,DERMABRASION OTHER THAN FACE,,,2822.69,5645.38,8
CPT,15783,DERMABRASION SUPRFL ANY SITE,,,395.04,790.08,8
CPT,15786,ABRASION LESION SINGLE,,,194.97,389.94,8
CPT,15787,ABRASION LESIONS ADD-ON,,,,,0
CPT,15788,CHEMICAL PEEL FACE EPIDERM,,,395.04,790.08,8
CPT,15789,CHEMICAL PEEL FACE DERMAL,,,718.2,1436.4,8
CPT,15792,CHEMICAL PEEL NONFACIAL,,,718.2,1436.4,8
CPT,15793,CHEMICAL PEEL NONFACIAL,,,395.04,790.08,8
CPT,157U,APC MRNA SEQ ALYS,,,282.88,565.76,8
CPT,15820,REVISION OF LOWER EYELID,,,2005.02,4010.04,8
CPT,15821,REVISION OF LOWER EYELID,,,2005.02,4010.04,8
CPT,15822,REVISION OF UPPER EYELID,,,2005.02,4010.04,8
CPT,15823,REVISION OF UPPER EYELID,,,2005.02,4010.04,8
CPT,15824,REMOVAL OF FOREHEAD WRINKLES,,,2005.02,4010.04,8
CPT,15825,REMOVAL OF NECK WRINKLES,,,3443.66,6887.32,8
CPT,15826,REMOVAL OF BROW WRINKLES,,,3443.66,6887.32,8
CPT,15828,REMOVAL OF FACE WRINKLES,,,3443.66,6887.32,8
CPT,15829,REMOVAL OF SKIN WRINKLES,,,3443.66,6887.32,8
CPT,15830,EXC SKIN ABD,,,6452.66,12905.32,8
CPT,15832,EXCISE EXCESSIVE SKIN THIGH,,,2822.69,5645.38,8
CPT,15833,EXCISE EXCESSIVE SKIN LEG,,,2822.69,5645.38,8
CPT,15834,EXCISE EXCESSIVE SKIN HIP,,,2822.69,5645.38,8
CPT,15835,EXCISE EXCESSIVE SKIN BUTTCK,,,2822.69,5645.38,8
CPT,15836,EXCISE EXCESSIVE SKIN ARM,,,2822.69,5645.38,8
CPT,15837,EXCISE EXCESS SKIN ARM/HAND,,,2822.69,5645.38,8
CPT,15838,EXCISE EXCESS SKIN FAT PAD,,,2822.69,5645.38,8
CPT,15839,EXCISE EXCESS SKIN & TISSUE,,,2822.69,5645.38,8
CPT,15840,NERVE PALSY FASCIAL GRAFT,,,3443.66,6887.32,8
CPT,15841,NERVE PALSY MUSCLE GRAFT,,,3443.66,6887.32,8
CPT,15842,NERVE PALSY MICROSURG GRAFT,,,2005.02,4010.04,8
CPT,15845,SKIN AND MUSCLE REPAIR FACE,,,3443.66,6887.32,8
CPT,15847,EXC SKIN ABD ADD-ON,,,,,0
CPT,15851,REMOVAL SUTR/STAPLE REQ ANES,,,2005.02,4010.04,8
CPT,15852,DRESSING CHANGE NOT FOR BURN,,,718.2,1436.4,8
CPT,15853,REMOVAL SUTR/STAPL XREQ ANES,,,,,0
CPT,15854,REMOVAL SUTR&STAPL XREQ ANES,,,,,0
CPT,15860,TEST FOR BLOOD FLOW IN GRAFT,,,434.11,868.22,8
CPT,15876,SUCTION LIPECTOMY HEAD&NECK,,,3443.66,6887.32,8
CPT,15877,SUCTION LIPECTOMY TRUNK,,,3443.66,6887.32,8
CPT,15878,SUCTION LIPECTOMY UPR EXTREM,,,2005.02,4010.04,8
CPT,15879,SUCTION LIPECTOMY LWR EXTREM,,,3443.66,6887.32,8
CPT,158U,MLH1 MRNA SEQ ALYS,,,282.88,565.76,8
CPT,15920,REMOVAL OF TAIL BONE ULCER,,,2822.69,5645.38,8
CPT,15922,REMOVAL OF TAIL BONE ULCER,,,3443.66,6887.32,8
CPT,15931,REMOVE SACRUM PRESSURE SORE,,,2822.69,5645.38,8
CPT,15933,REMOVE SACRUM PRESSURE SORE,,,2822.69,5645.38,8
CPT,15934,REMOVE SACRUM PRESSURE SORE,,,3443.66,6887.32,8
CPT,15935,REMOVE SACRUM PRESSURE SORE,,,3443.66,6887.32,8
CPT,15936,REMOVE SACRUM PRESSURE SORE,,,2005.02,4010.04,8
CPT,15937,REMOVE SACRUM PRESSURE SORE,,,2005.02,4010.04,8
CPT,15940,REMOVE HIP PRESSURE SORE,,,2822.69,5645.38,8
CPT,15941,REMOVE HIP PRESSURE SORE,,,2822.69,5645.38,8
CPT,15944,REMOVE HIP PRESSURE SORE,,,3443.66,6887.32,8
CPT,15945,REMOVE HIP PRESSURE SORE,,,2005.02,4010.04,8
CPT,15946,REMOVE HIP PRESSURE SORE,,,2005.02,4010.04,8
CPT,15950,REMOVE THIGH PRESSURE SORE,,,1604.96,3209.92,8
CPT,15951,REMOVE THIGH PRESSURE SORE,,,2822.69,5645.38,8
CPT,15952,REMOVE THIGH PRESSURE SORE,,,2005.02,4010.04,8
CPT,15953,REMOVE THIGH PRESSURE SORE,,,3443.66,6887.32,8
CPT,15956,REMOVE THIGH PRESSURE SORE,,,2005.02,4010.04,8
CPT,15958,REMOVE THIGH PRESSURE SORE,,,3443.66,6887.32,8
CPT,15999,UNLISTED PX EXC PRESSURE ULC,,,688.14,1376.28,8
CPT,159U,MSH2 MRNA SEQ ALYS,,,282.88,565.76,8
CPT,15F,MELAN FOLLOW-UP COMPLETE,,,,,0
CPT,15M,ADRNL CORTCL TUM BCHM ASY 25,,,1305.37,2610.74,8
CPT,160,ANESTH NOSE/SINUS SURGERY,,,,,0
CPT,16000,INITIAL TREATMENT OF BURN(S),,,194.97,389.94,8
CPT,16020,BURN TREATMENT SMALL,723.0,361.5,125.94,701.31,54
CPT,16020,DRESS/DEBRID P-THICK BURN S,,,,,0
CPT,16020,PROF BURN TRT SMALL,722.0,361.0,125.77,700.34,53
CPT,16025,DRESS/DEBRID P-THICK BURN M,,,194.97,389.94,8
CPT,16030,DRESS/DEBRID P-THICK BURN L,,,395.04,790.08,8
CPT,16035,INCISION OF BURN SCAB INITI,,,395.04,790.08,8
CPT,16036,ESCHAROTOMY ADDL INCISION,,,,,0
CPT,160U,MSH6 MRNA SEQ ALYS,,,282.88,565.76,8
CPT,1610,ANESTH SURGERY OF SHOULDER,,,,,0
CPT,161U,PMS2 MRNA SEQ ALYS,,,282.88,565.76,8
CPT,162,ANESTH NOSE/SINUS SURGERY,,,,,0
CPT,1620,ANESTH SHOULDER PROCEDURE,,,,,0
CPT,1622,ANES DX SHOULDER ARTHROSCOPY,,,,,0
CPT,162U,HERED COLON CA TRGT MRNA PNL,,,486.54,973.08,8
CPT,1630,ANESTH SURGERY OF SHOULDER,,,,,0
CPT,1634,ANESTH SHOULDER JOINT AMPUT,,,,,0
CPT,1636,ANESTH FOREQUARTER AMPUT,,,,,0
CPT,1638,ANESTH SHOULDER REPLACEMENT,,,,,0
CPT,163U,ONC CLRCT SCR 3 PRTN ALG,,,390.75,781.5,8
CPT,164,ANESTH BIOPSY OF NOSE,,,,,0
CPT,164T,REMOVE LUMB ARTIF DISC ADDL,,,,,0
CPT,164U,GI IBS IA ANTI-CDTB&VINCULIN,,,112.02,224.04,8
CPT,1650,ANESTH SHOULDER ARTERY SURG,,,,,0
CPT,1652,ANESTH SHOULDER VESSEL SURG,,,,,0
CPT,1654,ANESTH SHOULDER VESSEL SURG,,,,,0
CPT,1656,ANESTH ARM-LEG VESSEL SURG,,,,,0
CPT,165T,REVISE LUMB ARTIF DISC ADDL,,,,,0
CPT,165U,PEANUT ALLG ASMT EPI,,,463.76,927.52,8
CPT,166U,LIVER DS 10 BIOCHEM ASY SRM,,,503.4,1006.8,8
CPT,1670,ANESTH SHOULDER VEIN SURG,,,,,0
CPT,1680,ANESTH SHOULDER CASTING,,,,,0
CPT,169U,NUDT15&TPMT GENE COM VRNT,,,466.17,932.34,8
CPT,16M,ONC BLADDER MRNA 219 GEN ALG,,,3489.63,6979.26,8
CPT,16U,ONC HMTLMF NEO RNA BCR/ABL1,,,163.96,327.92,8
CPT,170,ANESTH PROCEDURE ON MOUTH,,,,,0
CPT,17000,DESTRUCT PREMALG LESION,,,194.97,389.94,8
CPT,17003,DESTRUCT PREMALG LES 2-14,,,,,0
CPT,17004,DESTROY PREMAL LESIONS 15/>,,,395.04,790.08,8
CPT,170U,NEURO ASD RNA NEXT GEN SEQ,,,1950.0,3900.0,8
CPT,1710,ANESTH ELBOW AREA SURGERY,,,,,0
CPT,17106,DESTRUCTION OF SKIN LESIONS,,,395.04,790.08,8
CPT,17107,DESTRUCTION OF SKIN LESIONS,,,718.2,1436.4,8
CPT,17108,DESTRUCTION OF SKIN LESIONS,,,2005.02,4010.04,8
CPT,17110,DESTRUCT B9 LESION 1-14,,,194.97,389.94,8
CPT,17111,DESTRUCT LESION 15 OR MORE,,,194.97,389.94,8
CPT,1712,ANESTH UPPR ARM TENDON SURG,,,,,0
CPT,1714,ANESTH UPPR ARM TENDON SURG,,,,,0
CPT,1716,ANESTH BICEPS TENDON REPAIR,,,,,0
CPT,171U,TRGT GEN SEQ ALYS PNL DNA 23,,,1519.06,3038.12,8
CPT,172,ANESTH CLEFT PALATE REPAIR,,,,,0
CPT,17250,CHEM CAUT OF GRANLTJ TISSUE,,,,,0
CPT,17250,PROF CHEM CAUTERIZATION,513.0,256.5,89.36,497.61,53
CPT,17250,PT CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,448.0,224.0,78.04,434.56,53
CPT,17260,DSTRJ MAL LES T/A/L 0.5 CM/<,,,194.97,389.94,8
CPT,17261,DSTRJ MAL LES T/A/L .6-1.0CM,,,194.97,389.94,8
CPT,17262,DSTRJ MAL LES T/A/L 1.1-2.0,,,194.97,389.94,8
CPT,17263,DSTRJ MAL LES T/A/L 2.1-3.0,,,194.97,389.94,8
CPT,17264,DSTRJ MAL LES T/A/L 3.1-4.0,,,395.04,790.08,8
CPT,17266,DSTRJ MAL LES T/A/L >4.0 CM,,,395.04,790.08,8
CPT,17270,DSTR MAL LES S/N/H/F/G .5 /<,,,194.97,389.94,8
CPT,17271,DSTR MAL LES S/N/H/F/G 0.6-1,,,194.97,389.94,8
CPT,17272,DSTR MAL LES S/N/H/F/G 1.1-2,,,194.97,389.94,8
CPT,17273,DSTR MAL LES S/N/H/F/G 2.1-3,,,395.04,790.08,8
CPT,17274,DSTR MAL LES S/N/H/F/G 3.1-4,,,395.04,790.08,8
CPT,17276,DSTR MAL LES S/N/H/F/G >4.0,,,395.04,790.08,8
CPT,17280,DSTR MAL LS F/E/E/N/L/M .5/<,,,194.97,389.94,8
CPT,17281,DSTR MAL LS F/E/E/N/L/M .6-1,,,194.97,389.94,8
CPT,17282,DSTR MAL LS F/E/E/N/L/M1.1-2,,,194.97,389.94,8
CPT,17283,DSTR MAL LS F/E/E/N/L/M2.1-3,,,395.04,790.08,8
CPT,17284,DSTR MAL LS F/E/E/N/L/M3.1-4,,,718.2,1436.4,8
CPT,17286,DSTR MAL LS F/E/E/N/L/M>4.0,,,718.2,1436.4,8
CPT,172U,ONC SLD TUM ALYS BRCA1 BRCA2,,,3030.0,6060.0,8
CPT,1730,ANESTH UPPR ARM PROCEDURE,,,,,0
CPT,17311,MOHS 1 STAGE H/N/HF/G,,,718.2,1436.4,8
CPT,17312,MOHS ADDL STAGE,,,,,0
CPT,17313,MOHS 1 STAGE T/A/L,,,718.2,1436.4,8
CPT,17314,MOHS ADDL STAGE T/A/L,,,,,0
CPT,17315,MOHS SURG ADDL BLOCK,,,,,0
CPT,1732,ANESTH DX ELBOW ARTHROSCOPY,,,,,0
CPT,17340,CRYOTHERAPY OF SKIN,,,57.33,114.66,8
CPT,17360,SKIN PEEL THERAPY,,,194.97,389.94,8
CPT,17380,HAIR REMOVAL BY ELECTROLYSIS,,,718.2,1436.4,8
CPT,173U,PSYC GEN ALYS PANEL 14 GENES,,,466.17,932.34,8
CPT,174,ANESTH PHARYNGEAL SURGERY,,,,,0
CPT,1740,ANESTH UPPER ARM SURGERY,,,,,0
CPT,1742,ANESTH HUMERUS SURGERY,,,,,0
CPT,1744,ANESTH HUMERUS REPAIR,,,,,0
CPT,174T,CAD CXR WITH INTERP,,,,,0
CPT,174U,ONC SOLID TUMOR 30 PRTN TRGT,,,1305.37,2610.74,8
CPT,1756,ANESTH RADICAL HUMERUS SURG,,,,,0
CPT,1758,ANESTH HUMERAL LESION SURG,,,,,0
CPT,175T,CAD CXR REMOTE,,,,,0
CPT,175U,PSYC GEN ALYS PANEL 15 GENES,,,1336.09,2672.18,8
CPT,176,ANESTH PHARYNGEAL SURGERY,,,,,0
CPT,1760,ANESTH ELBOW REPLACEMENT,,,,,0
CPT,176U,CDTB&VINCULIN IGG ANTB IA,,,64.19,128.38,8
CPT,1770,ANESTH UPPR ARM ARTERY SURG,,,,,0
CPT,1772,ANESTH UPPR ARM EMBOLECTOMY,,,,,0
CPT,177U,ONC BRST CA DNA PIK3CA 11,,,274.83,549.66,8
CPT,1780,ANESTH UPPER ARM VEIN SURG,,,,,0
CPT,1782,ANESTH UPPR ARM VEIN REPAIR,,,,,0
CPT,178U,PEANUT ALLG ASMT EPI CLIN RX,,,459.86,919.72,8
CPT,17999,UNLISTD PX SKN MUC MEMB SUBQ,,,194.97,389.94,8
CPT,179U,ONC NONSM CLL LNG CA ALYS 23,,,1943.21,3886.42,8
CPT,17M,ONC DLBCL MRNA 20 GENES ALG,,,2510.21,5020.42,8
CPT,17U,ONC HMTLMF NEO JAK2 MUT DNA,,,91.66,183.32,8
CPT,180U,ABO GNOTYP ABO 7 EXONS,,,274.83,549.66,8
CPT,1810,ANESTH LOWER ARM SURGERY,,,,,0
CPT,181U,CO GNOTYP AQP1 EXON 1,,,185.2,370.4,8
CPT,1820,ANESTH LOWER ARM PROCEDURE,,,,,0
CPT,1829,ANESTH DX WRIST ARTHROSCOPY,,,,,0
CPT,182U,CROM GNOTYP CD55 EXONS 1-10,,,301.35,602.7,8
CPT,1830,ANESTH LOWER ARM SURGERY,,,,,0
CPT,1832,ANESTH WRIST REPLACEMENT,,,,,0
CPT,183U,DI GNOTYP SLC4A1 EXON 19,,,185.2,370.4,8
CPT,1840,ANESTH LWR ARM ARTERY SURG,,,,,0
CPT,1842,ANESTH LWR ARM EMBOLECTOMY,,,,,0
CPT,1844,ANESTH VASCULAR SHUNT SURG,,,,,0
CPT,184T,EXC RECTAL TUMOR ENDOSCOPIC,,,5899.47,11798.94,8
CPT,184U,DO GNOTYP ART4 EXON 2,,,185.2,370.4,8
CPT,1850,ANESTH LOWER ARM VEIN SURG,,,,,0
CPT,1852,ANESTH LWR ARM VEIN REPAIR,,,,,0
CPT,185U,FUT1 GNOTYP FUT1 EXON 4,,,185.2,370.4,8
CPT,1860,ANESTH LOWER ARM CASTING,,,,,0
CPT,186U,FUT2 GNOTYP FUT2 EXON 2,,,185.2,370.4,8
CPT,187U,FY GNOTYP ACKR1 EXONS 1-2,,,274.83,549.66,8
CPT,188U,GE GNOTYP GYPC EXONS 1-4,,,274.83,549.66,8
CPT,189U,GYPA GNOTYP NTRNS 1 5 EXON 2,,,274.83,549.66,8
CPT,18M,TRNSPLJ RNL MEAS CD154+CLL,,,640.73,1281.46,8
CPT,18U,ONC THYR 10 MICRORNA SEQ ALG,,,3002.09,6004.18,8
CPT,190,ANESTH FACE/SKULL BONE SURG,,,,,0
CPT,19000,DRAINAGE OF BREAST LESION,1543.0,771.5,92.05,1496.71,54
CPT,19000,PUNCTURE ASPIR CYST BREAST,,,,,0
CPT,19001,PUNCTURE ASPIR CYST BRST EA,,,24.04,27.92,16
CPT,19020,INCISION OF BREAST LESION,3472.0,1736.0,604.82,3367.84,54
CPT,19020,MASTOTOMY EXPL DRG ABSC DP,,,,,0
CPT,19030,NJX PX ONLY MAM DUCTO/GLCTO,,,138.63,160.98,16
CPT,19081,BX BREAST 1ST LESION STRTCTC,,,573.02,3209.92,24
CPT,19082,BX BREAST ADD LESION STRTCTC,,,448.66,521.03,16
CPT,19083,BX BREAST 1ST LESION US IMAG,,,566.44,3209.92,24
CPT,19084,BX BREAST ADD LESION US IMAG,,,441.89,513.17,16
CPT,19085,BX BREAST 1ST LESION MR IMAG,,,847.6,3209.92,24
CPT,19086,BX BREAST ADD LESION MR IMAG,,,653.12,758.46,16
CPT,190U,GYPB GNOTYP NTRNS 1 5 SEUX 3,,,274.83,549.66,8
CPT,19100,BX BREAST PERCUT W/O IMAGE,,,122.54,3209.92,24
CPT,19101,BIOPSY OF BREAST OPEN,7738.0,3869.0,1347.95,7609.74,54
CPT,19105,CRYOSURG ABLATE FA EACH,,,1478.63,7609.74,24
CPT,19110,NIPPLE EXPLORATION,,,3804.87,7609.74,8
CPT,19112,EXCISE BREAST DUCT FISTULA,,,3804.87,7609.74,8
CPT,19120,REMOVAL OF BREAST LESION,7664.0,3832.0,1335.06,7609.74,54
CPT,19125,EXCISION BREAST LESION,,,3804.87,7609.74,8
CPT,19126,EXCISION ADDL BREAST LESION,,,,,0
CPT,1916,ANESTH DX ARTERIOGRAPHY,,,,,0
CPT,191U,IN GNOTYP CD44 EXONS 2 3 6,,,274.83,549.66,8
CPT,192,ANESTH FACIAL BONE SURGERY,,,,,0
CPT,1920,ANESTH CATHETERIZE HEART,,,,,0
CPT,1922,ANESTH CAT OR MRI SCAN,,,,,0
CPT,1924,ANES THER INTERVEN RAD ARTRL,,,,,0
CPT,1925,ANES THER INTERVEN RAD CARD,,,,,0
CPT,1926,ANES TX INTERV RAD HRT/CRAN,,,,,0
CPT,19281,PERQ DEVICE BREAST 1ST IMAG,,,202.26,3209.92,24
CPT,19282,PERQ DEVICE BREAST EA IMAG,,,136.31,158.3,16
CPT,19283,PERQ DEV BREAST 1ST STRTCTC,,,228.87,1376.28,24
CPT,19284,PERQ DEV BREAST ADD STRTCTC,,,163.5,189.87,16
CPT,19285,PERQ DEV BREAST 1ST US IMAG,,,382.12,1376.28,24
CPT,19286,PERQ DEV BREAST ADD US IMAG,,,316.47,367.52,16
CPT,19287,PERQ DEV BREAST 1ST MR GUIDE,,,688.14,1376.28,24
CPT,19288,PERQ DEV BREAST ADD MR GUIDE,,,556.46,646.21,16
CPT,19294,PREPJ TUM CAV IORT PRTL MAST,,,,,0
CPT,19296,PLACE PO BREAST CATH FOR RAD,,,7942.59,15885.18,8
CPT,19297,PLACE BREAST CATH FOR RAD,,,,,0
CPT,19298,PLACE BREAST RAD TUBE/CATHS,,,13391.8,26783.6,8
CPT,192U,JK GNOTYP SLC14A1 EXON 9,,,274.83,549.66,8
CPT,1930,ANES THER INTERVEN RAD VEIN,,,,,0
CPT,19300,REMOVAL OF BREAST TISSUE,,,3804.87,7609.74,8
CPT,19301,MASTECTOMY PARTIAL,9956.0,4978.0,1734.33,9657.32,54
CPT,19301,PARTIAL MASTECTOMY,,,,,0
CPT,19302,P-MASTECTOMY W/LN REMOVAL,,,6452.66,12905.32,8
CPT,19303,MAST SIMPLE COMPLETE,,,6452.66,12905.32,8
CPT,19305,MAST RADICAL,,,,,0
CPT,19306,MAST RAD URBAN TYPE,,,,,0
CPT,19307,MAST MOD RAD,,,6452.66,12905.32,8
CPT,1931,ANES THER INTERVEN RAD TIPS,,,,,0
CPT,19316,SUSPENSION OF BREAST,,,6452.66,12905.32,8
CPT,19318,BREAST REDUCTION,,,6452.66,12905.32,8
CPT,1932,ANES TX INTERV RAD TH VEIN,,,,,0
CPT,19325,BREAST AUGMENTATION W/IMPLT,,,7942.59,15885.18,8
CPT,19328,RMVL INTACT BREAST IMPLANT,,,3804.87,7609.74,8
CPT,1933,ANES TX INTERV RAD CRAN VEIN,,,,,0
CPT,19330,RMVL RUPTURED BREAST IMPLANT,,,3804.87,7609.74,8
CPT,19340,INSJ BREAST IMPLT SM D MAST,,,7942.59,15885.18,8
CPT,19342,INSJ/RPLCMT BRST IMPLT SEP D,,,7942.59,15885.18,8
CPT,19350,BREAST RECONSTRUCTION,,,3804.87,7609.74,8
CPT,19355,CORRECT INVERTED NIPPLE(S),,,3804.87,7609.74,8
CPT,19357,TISS XPNDR PLMT BRST RCNSTJ,,,13391.8,26783.6,8
CPT,19361,BRST RCNSTJ LATSMS DRSI FLAP,,,,,0
CPT,19364,BRST RCNSTJ FREE FLAP,,,,,0
CPT,19367,BRST RCNSTJ 1 PDCL TRAM FLAP,,,,,0
CPT,19368,BRST RCNSTJ 1PDCL TRAM ANAST,,,,,0
CPT,19369,BRST RCNSTJ 2 PDCL TRAM FLAP,,,,,0
CPT,1937,ANES DRG/ASPIR CRV/THRC,,,,,0
CPT,19370,REVJ PERI-IMPLT CAPSULE BRST,,,3804.87,7609.74,8
CPT,19371,PERI-IMPLT CAPSLC BRST COMPL,,,3804.87,7609.74,8
CPT,1938,ANES DRG/ASPIR LMBR/SAC,,,,,0
CPT,19380,REVJ RECONSTRUCTED BREAST,,,6452.66,12905.32,8
CPT,1939,ANES NULYT AGT CRV/THRC,,,,,0
CPT,19396,DESIGN CUSTOM BREAST IMPLANT,,,3804.87,7609.74,8
CPT,193U,JR GNOTYP ABCG2 EXONS 2-26,,,282.88,565.76,8
CPT,1940,ANES NULYT AGT LMBR/SAC,,,,,0
CPT,1941,ANES NEUROMD/NTRVRT CRV/THRC,,,,,0
CPT,1942,ANES NEUROMD/NTRVRT LMBR/SAC,,,,,0
CPT,19499,UNLISTED PROCEDURE BREAST,,,3804.87,7609.74,8
CPT,194U,KEL GNOTYP KEL EXON 8,,,185.2,370.4,8
CPT,1951,ANESTH BURN LESS 4 PERCENT,,,,,0
CPT,1952,ANESTH BURN 4-9 PERCENT,,,,,0
CPT,1953,ANESTH BURN EACH 9 PERCENT,,,,,0
CPT,1958,ANES XTRNL CEPHALIC VERSION,,,,,0
CPT,195U,KLF1 TARGETED SEQUENCING,,,375.25,750.5,8
CPT,1960,ANES VAGINAL DELIVERY ONLY,,,,,0
CPT,1961,ANES CESAREAN DELIVERY ONLY,,,,,0
CPT,1962,ANES URGENT HYSTERECTOMY,,,,,0
CPT,1963,ANES CESAREAN HYSTERECTOMY,,,,,0
CPT,1965,ANES INCOMPL/MISSED AB PX,,,,,0
CPT,1966,ANES INDUCED ABORTION PX,,,,,0
CPT,1967,NEURAXL LBR ANES VAG DLVR,,,,,0
CPT,1968,ANES/ANALG CS DLVR NEURAXIAL,,,,,0
CPT,1969,ANES C HYST FLWG NEURAXIAL,,,,,0
CPT,196U,LU GNOTYP BCAM EXON 3,,,185.2,370.4,8
CPT,197U,LW GNOTYP ICAM4 EXON 1,,,185.2,370.4,8
CPT,198T,OCULAR BLOOD FLOW MEASURE,,,129.29,258.58,8
CPT,198U,RHD&RHCE GNTYP RHD1-10&RHCE5,,,282.88,565.76,8
CPT,1990,SUPPORT FOR ORGAN DONOR,,,,,0
CPT,1991,ANESTH NERVE BLOCK/INJ,,,,,0
CPT,1992,ANESTH N BLOCK/INJ PRONE,,,,,0
CPT,1996,HOSP MANAGE CONT DRUG ADMIN,,,,,0
CPT,1999,UNLISTED ANES PROCEDURE,,,,,0
CPT,199U,SC GNOTYP ERMAP EXONS 4 12,,,274.83,549.66,8
CPT,19M,CV DS PLASMA ALYS PRTN BMRK,,,712.4,1424.8,8
CPT,19U,ONC RNA TISS PREDICT ALG,,,3675.0,7350.0,8
CPT,1F,HEART FAILURE COMPOSITE,,,,,0
CPT,1U,RBC DNA HEA 35 AG 11 BLD GRP,,,720.0,1440.0,8
CPT,2000F,BLOOD PRESSURE MEASURE,,,,,0
CPT,2001F,WEIGHT RECORD,,,,,0
CPT,2002F,CLIN SIGN VOL OVRLD ASSESS,,,,,0
CPT,2004F,INITIAL EXAM INVOLVED JOINTS,,,,,0
CPT,200T,PERQ SACRAL AUGMT UNILAT INJ,,,7051.31,14102.62,8
CPT,200U,XK GNOTYP XK EXONS 1-3,,,274.83,549.66,8
CPT,20100,EXPLORE WOUND NECK,,,524.1,1048.2,8
CPT,20101,EXPLORE WOUND CHEST,,,2005.02,4010.04,8
CPT,20102,EXPLORE WOUND ABDOMEN,,,2005.02,4010.04,8
CPT,20103,EXPLORE WOUND EXTREMITY,,,1604.96,3209.92,8
CPT,2010F,VITAL SIGNS RECORDED,,,,,0
CPT,2014F,MENTAL STATUS ASSESS,,,,,0
CPT,20150,EXCISE EPIPHYSEAL BAR,,,3179.6,6359.2,8
CPT,2015F,ASTHMA IMPAIRMENT ASSESSED,,,,,0
CPT,2016F,ASTHMA RISK ASSESSED,,,,,0
CPT,2018F,HYDRATION STATUS ASSESS,,,,,0
CPT,2019F,DILATED MACUL EXAM DONE,,,,,0
CPT,201T,PERQ SACRAL AUGMT BILAT INJ,,,7051.31,14102.62,8
CPT,201U,YT GNOTYP ACHE EXON 2,,,185.2,370.4,8
CPT,20200,MUSCLE BIOPSY SUPERFICIAL,,,1604.96,3209.92,8
CPT,20205,DEEP MUSCLE BIOPSY,,,2822.69,5645.38,8
CPT,20206,BIOPSY MUSCLE PERQ NEEDLE,,,205.52,3209.92,24
CPT,2020F,DILATED FUNDUS EVAL DONE,,,,,0
CPT,2021F,DILAT MACULAR EXAM DONE,,,,,0
CPT,20220,BONE BIOPSY TROCAR/NDL SUPFC,,,140.42,3209.92,24
CPT,20225,BONE BIOPSY TROCAR/NDL DEEP,,,518.18,3209.92,24
CPT,2022F,DILAT RTA XM EVC RTNOPTHY,,,,,0
CPT,2023F,DILAT RTA XM W/O RTNOPTHY,,,,,0
CPT,20240,BONE BIOPSY OPEN SUPERFICIAL,,,2822.69,5645.38,8
CPT,20245,BONE BIOPSY OPEN DEEP,,,2822.69,5645.38,8
CPT,2024F,7 FLD RTA PHOTO EVC RTNOPTHY,,,,,0
CPT,20250,BIOPSY VRT BDY OPEN THORACIC,,,3179.6,6359.2,8
CPT,20251,BIOPSY VRT BDY OPEN LMBR/CRV,,,7051.31,14102.62,8
CPT,2025F,7 FLD RTA PHOTO W/O RTNOPTHY,,,,,0
CPT,2026F,EYE IMG VALID EVC RTNOPTHY,,,,,0
CPT,2027F,OPTIC NERVE HEAD EVAL DONE,,,,,0
CPT,2028F,FOOT EXAM PERFORMED,,,,,0
CPT,2029F,COMPLETE PHYS SKIN EXAM DONE,,,,,0
CPT,202T,POST VERT ARTHRPLST 1 LUMBAR,,,12476.14,24952.28,8
CPT,202U,NFCT DS 22 TRGT SARS-COV-2,,,416.78,833.56,8
CPT,2030F,H2O STAT DOCD NORMAL,,,,,0
CPT,2031F,H2O STAT DOCD DEHYDRATED,,,,,0
CPT,2033F,EYE IMG VALID W/O RTNOPTHY,,,,,0
CPT,2035F,TYMP MEMB MOTION EXAMD,,,,,0
CPT,203U,AI IBD MRNA XPRSN PRFL 17,,,760.0,1520.0,8
CPT,2040F,BK PN XM ON INIT VISIT DATE,,,,,0
CPT,2044F,DOC MNTL TST B/4 BK TRXMNT,,,,,0
CPT,20500,INJECTION OF SINUS TRACT,,,1507.77,3015.54,8
CPT,20501,INJECT SINUS TRACT FOR X-RAY,,,103.15,119.79,16
CPT,2050F,WOUND CHAR SIZE ETC DOCD,,,,,0
CPT,20520,REMOVAL OF FOREIGN BODY,,,1604.96,3209.92,8
CPT,20525,REMOVAL OF FOREIGN BODY,,,2822.69,5645.38,8
CPT,20526,THER INJECTION CARP TUNNEL,,,298.28,596.56,8
CPT,20527,INJ DUPUYTREN CORD W/ENZYME,,,298.28,596.56,8
CPT,20550,INJ TENDON SHEATH/LIGAMENT,,,298.28,596.56,8
CPT,20551,INJ TENDON ORIGIN/INSERTION,,,298.28,596.56,8
CPT,20552,INJ TRIGGER POINT 1/2 MUSCL,,,298.28,596.56,8
CPT,20553,INJECT TRIGGER POINTS 3/>,,,298.28,596.56,8
CPT,20555,PLACE NDL MUSC/TIS FOR RT,,,3179.6,6359.2,8
CPT,20560,NDL INSJ W/O NJX 1 OR 2 MUSC,,,,,0
CPT,20560,NEEDLE INSJ W/O INJECTION 1 OR 2 MUSC,43.0,21.5,7.49,56.22,53
CPT,20561,NDL INSJ W/O NJX 3+ MUSC,,,,,0
CPT,20561,NEEDLE INSJ W/O INJECTION 3+ MUSC,79.0,39.5,13.76,76.63,53
CPT,205U,OPH AMD ALYS 3 GENE VARIANTS,,,47.0,94.0,8
CPT,20600,DRAIN/INJ JOINT/BURSA W/O US,,,298.28,596.56,8
CPT,20604,DRAIN/INJ JOINT/BURSA W/US,,,298.28,596.56,8
CPT,20605,DRAIN/INJ JOINT/BURSA W/O US,,,49.37,596.56,24
CPT,20606,DRAIN/INJ JOINT/BURSA W/US,,,685.95,1371.9,8
CPT,2060F,PT INTRVWD ON/BEFORE DX MDD,,,,,0
CPT,20610,DRAIN/INJ JOINT/BURSA W/O US,,,65.64,596.56,24
CPT,20611,DRAIN/INJ JOINT/BURSA W/US,,,298.28,596.56,8
CPT,20612,ASPIRATE/INJ GANGLION CYST,,,298.28,596.56,8
CPT,20615,TREATMENT OF BONE CYST,,,688.14,1376.28,8
CPT,20650,INSERT AND REMOVE BONE PIN,,,3179.6,6359.2,8
CPT,20660,APPLY REM FIXATION DEVICE,,,1562.58,3125.16,8
CPT,20661,APPLICATION HALO CRANIAL,,,1562.58,3125.16,8
CPT,20662,APPLICATION HALO PELVIC,,,1562.58,3125.16,8
CPT,20663,APPLICATION HALO FEMORAL,,,3179.6,6359.2,8
CPT,20664,APPL HALO CRANIAL 6+PINS,,,1562.58,3125.16,8
CPT,20665,RMVL TONGS/HALO ANTHR INDIV,,,434.11,868.22,8
CPT,20670,REMOVAL IMPLANT SUPERFICIAL,,,1604.96,3209.92,8
CPT,20680,REMOVAL OF IMPLANT DEEP,,,2822.69,5645.38,8
CPT,20690,APPL UNIPLN UNI EXT FIXJ SYS,,,7051.31,14102.62,8
CPT,20692,APPL MLTPLN UNI EXT FIXJ SYS,,,12476.14,24952.28,8
CPT,20693,ADJMT/REVJ EXT FIXJ SYS ANES,,,7051.31,14102.62,8
CPT,20694,RMVL EXT FIXJ SYS UNDER ANES,,,1562.58,3125.16,8
CPT,20696,APP MLTPLN UNI XTRNL FIX 1ST,,,26367.8,52735.6,8
CPT,20697,APP MLTPLN UNI XTRNL FIX XCH,,,1562.58,3125.16,8
CPT,206U,NEURO ALZHEIMER CELL AGGREGJ,,,2215.4,4430.8,8
CPT,20700,MNL PREP&INSJ DP RX DLVR DEV,,,,,0
CPT,20701,RMVL DEEP RX DELIVERY DEVICE,,,,,0
CPT,20702,MNL PREP&INSJ IMED RX DEV,,,,,0
CPT,20703,RMVL IMED RX DELIVERY DEVICE,,,,,0
CPT,20704,MNL PREP&INSJ I-ARTIC RX DEV,,,,,0
CPT,20705,RMVL I-ARTIC RX DELIVERY DEV,,,,,0
CPT,207T,CLEAR EYELID GLAND W/HEAT,,,129.29,258.58,8
CPT,207U,NEURO ALZHEIMER QUAN IMAGING,,,511.2,1022.4,8
CPT,20802,REPLANTATION ARM COMPLETE,,,17038.69,34077.38,8
CPT,20805,REPLANT FOREARM COMPLETE,,,17038.69,34077.38,8
CPT,20808,REPLANTATION HAND COMPLETE,,,17038.69,34077.38,8
CPT,20816,REPLANTATION DIGIT COMPLETE,,,1562.58,3125.16,8
CPT,20822,REPLANTATION DIGIT COMPLETE,,,1562.58,3125.16,8
CPT,20824,REPLANTATION THUMB COMPLETE,,,1562.58,3125.16,8
CPT,20827,REPLANTATION THUMB COMPLETE,,,1562.58,3125.16,8
CPT,20838,REPLANTATION FOOT COMPLETE,,,17038.69,34077.38,8
CPT,208T,AUDIOMETRY AIR ONLY,,,36.3,72.6,8
CPT,20900,REMOVAL OF BONE FOR GRAFT,,,7051.31,14102.62,8
CPT,20902,REMOVAL OF BONE FOR GRAFT,,,7051.31,14102.62,8
CPT,20910,REMOVE CARTILAGE FOR GRAFT,,,718.2,1436.4,8
CPT,20912,REMOVE CARTILAGE FOR GRAFT,,,3443.66,6887.32,8
CPT,20920,REMOVAL OF FASCIA FOR GRAFT,,,2005.02,4010.04,8
CPT,20922,REMOVAL OF FASCIA FOR GRAFT,,,2005.02,4010.04,8
CPT,20924,REMOVAL OF TENDON FOR GRAFT,,,7051.31,14102.62,8
CPT,20930,SP BONE ALGRFT MORSEL ADD-ON,,,,,0
CPT,20931,SP BONE ALGRFT STRUCT ADD-ON,,,,,0
CPT,20932,OSTEOART ALGRFT W/SURF & B1,,,,,0
CPT,20933,HEMICRT INTRCLRY ALGRFT PRTL,,,,,0
CPT,20934,INTERCALARY ALGRFT COMPL,,,,,0
CPT,20936,SP BONE AGRFT LOCAL ADD-ON,,,,,0
CPT,20937,SP BONE AGRFT MORSEL ADD-ON,,,,,0
CPT,20938,SP BONE AGRFT STRUCT ADD-ON,,,,,0
CPT,20939,BONE MARROW ASPIR BONE GRFG,,,,,0
CPT,20950,FLUID PRESSURE MUSCLE,,,688.14,1376.28,8
CPT,20955,FIBULA BONE GRAFT MICROVASC,,,7051.31,14102.62,8
CPT,20956,ILIAC BONE GRAFT MICROVASC,,,7051.31,14102.62,8
CPT,20957,MT BONE GRAFT MICROVASC,,,7051.31,14102.62,8
CPT,20962,OTHER BONE GRAFT MICROVASC,,,7051.31,14102.62,8
CPT,20969,BONE/SKIN GRAFT MICROVASC,,,7051.31,14102.62,8
CPT,20970,BONE/SKIN GRAFT ILIAC CREST,,,7051.31,14102.62,8
CPT,20972,BONE/SKIN GRAFT METATARSAL,,,7051.31,14102.62,8
CPT,20973,BONE/SKIN GRAFT GREAT TOE,,,7051.31,14102.62,8
CPT,20974,ELECTRICAL BONE STIMULATION,,,,,0
CPT,20975,ELECTRICAL BONE STIMULATION,,,,,0
CPT,20979,US BONE STIMULATION,,,28.11,56.22,8
CPT,20982,ABLATE BONE TUMOR(S) PERQ,,,17038.69,34077.38,8
CPT,20983,ABLATE BONE TUMOR(S) PERQ,,,7051.31,14102.62,8
CPT,20985,CPTR-ASST DIR MS PX,,,,,0
CPT,20999,UNLISTED PX MUSCSKEL GENERAL,,,239.7,479.4,8
CPT,209T,AUDIOMETRY AIR & BONE,,,36.3,72.6,8
CPT,209U,CYTOG CONST ALYS INTERROG,,,787.15,1574.3,8
CPT,20M,"Oncology (central nervous system), analysis of 30000 DNA methylation loci by methylation array, utilizing DNA extracted from tumor tissue, diagnostic algorithm reported as probability of matching a re",,,2500.0,5000.0,8
CPT,210,ANESTH CRANIAL SURG NOS,,,,,0
CPT,21010,INCISION OF JAW JOINT,,,3221.84,6443.68,8
CPT,21011,EXC FACE LES SC <2 CM,,,1604.96,3209.92,8
CPT,21012,EXC FACE LES SBQ 2 CM/>,,,1604.96,3209.92,8
CPT,21013,EXC FACE TUM DEEP < 2 CM,,,1604.96,3209.92,8
CPT,21014,EXC FACE TUM DEEP 2 CM/>,,,2822.69,5645.38,8
CPT,21015,RESECT FACE/SCALP TUM < 2 CM,,,2822.69,5645.38,8
CPT,21016,RESECT FACE/SCALP TUM 2 CM/>,,,2822.69,5645.38,8
CPT,21025,EXCISION OF BONE LOWER JAW,,,5752.66,11505.32,8
CPT,21026,EXCISION OF FACIAL BONE(S),,,5752.66,11505.32,8
CPT,21029,CONTOUR OF FACE BONE LESION,,,3221.84,6443.68,8
CPT,21030,EXCISE MAX/ZYGOMA B9 TUMOR,,,5752.66,11505.32,8
CPT,21031,REMOVE EXOSTOSIS MANDIBLE,,,3221.84,6443.68,8
CPT,21032,REMOVE EXOSTOSIS MAXILLA,,,3221.84,6443.68,8
CPT,21034,EXCISE MAX/ZYGOMA MAL TUMOR,,,5752.66,11505.32,8
CPT,21040,EXCISE MANDIBLE LESION,,,3221.84,6443.68,8
CPT,21044,REMOVAL OF JAW BONE LESION,,,5752.66,11505.32,8
CPT,21045,EXTENSIVE JAW SURGERY,,,5752.66,11505.32,8
CPT,21046,REMOVE MANDIBLE CYST COMPLEX,,,5752.66,11505.32,8
CPT,21047,EXCISE LWR JAW CYST W/REPAIR,,,5752.66,11505.32,8
CPT,21048,REMOVE MAXILLA CYST COMPLEX,,,5752.66,11505.32,8
CPT,21049,EXCIS UPPR JAW CYST W/REPAIR,,,5752.66,11505.32,8
CPT,21050,REMOVAL OF JAW JOINT,,,5752.66,11505.32,8
CPT,21060,REMOVE JAW JOINT CARTILAGE,,,5752.66,11505.32,8
CPT,21070,REMOVE CORONOID PROCESS,,,5752.66,11505.32,8
CPT,21073,MNPJ OF TMJ W/ANESTH,,,1507.77,3015.54,8
CPT,21076,PREPARE FACE/ORAL PROSTHESIS,,,1507.77,3015.54,8
CPT,21077,PREPARE FACE/ORAL PROSTHESIS,,,5752.66,11505.32,8
CPT,21079,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21080,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21081,PREPARE FACE/ORAL PROSTHESIS,,,5752.66,11505.32,8
CPT,21082,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21083,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21084,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21085,PREPARE FACE/ORAL PROSTHESIS,,,230.16,460.32,8
CPT,21086,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21087,PREPARE FACE/ORAL PROSTHESIS,,,5752.66,11505.32,8
CPT,21088,PREPARE FACE/ORAL PROSTHESIS,,,3221.84,6443.68,8
CPT,21089,UNLISTED MAXLFCL PROSTH PX,,,230.16,460.32,8
CPT,210T,SPEECH AUDIOMETRY THRESHOLD,,,36.3,72.6,8
CPT,210U,SYPHILIS TST ANTB IA QUAN,,,18.63,37.26,8
CPT,211,ANESTH CRAN SURG HEMOTOMA,,,,,0
CPT,21100,MAXILLOFACIAL FIXATION,,,5752.66,11505.32,8
CPT,21110,INTERDENTAL FIXATION,,,1507.77,3015.54,8
CPT,21116,INJECTION JAW JOINT X-RAY,,,,,0
CPT,21120,RECONSTRUCTION OF CHIN,,,5752.66,11505.32,8
CPT,21121,RECONSTRUCTION OF CHIN,,,3221.84,6443.68,8
CPT,21122,RECONSTRUCTION OF CHIN,,,5752.66,11505.32,8
CPT,21123,RECONSTRUCTION OF CHIN,,,3221.84,6443.68,8
CPT,21125,AUGMENTATION LOWER JAW BONE,,,5752.66,11505.32,8
CPT,21127,AUGMENTATION LOWER JAW BONE,,,5752.66,11505.32,8
CPT,21137,REDUCTION OF FOREHEAD,,,3221.84,6443.68,8
CPT,21138,REDUCTION OF FOREHEAD,,,5752.66,11505.32,8
CPT,21139,REDUCTION OF FOREHEAD,,,5752.66,11505.32,8
CPT,21141,LEFORT I-1 PIECE W/O GRAFT,,,5752.66,11505.32,8
CPT,21142,LEFORT I-2 PIECE W/O GRAFT,,,5752.66,11505.32,8
CPT,21143,LEFORT I-3/> PIECE W/O GRAFT,,,5752.66,11505.32,8
CPT,21145,LEFORT I-1 PIECE W/ GRAFT,,,5752.66,11505.32,8
CPT,21146,LEFORT I-2 PIECE W/ GRAFT,,,5752.66,11505.32,8
CPT,21147,LEFORT I-3/> PIECE W/ GRAFT,,,5752.66,11505.32,8
CPT,21150,LEFORT II ANTERIOR INTRUSION,,,5752.66,11505.32,8
CPT,21151,LEFORT II W/BONE GRAFTS,,,5752.66,11505.32,8
CPT,21154,LEFORT III W/O LEFORT I,,,5752.66,11505.32,8
CPT,21155,LEFORT III W/ LEFORT I,,,5752.66,11505.32,8
CPT,21159,LEFORT III W/FHDW/O LEFORT I,,,5752.66,11505.32,8
CPT,21160,LEFORT III W/FHD W/ LEFORT I,,,5752.66,11505.32,8
CPT,21172,RECONSTRUCT ORBIT/FOREHEAD,,,5752.66,11505.32,8
CPT,21175,RECONSTRUCT ORBIT/FOREHEAD,,,5752.66,11505.32,8
CPT,21179,RECONSTRUCT ENTIRE FOREHEAD,,,5752.66,11505.32,8
CPT,21180,RECONSTRUCT ENTIRE FOREHEAD,,,5752.66,11505.32,8
CPT,21181,CONTOUR CRANIAL BONE LESION,,,5752.66,11505.32,8
CPT,21182,RECONSTRUCT CRANIAL BONE,,,5752.66,11505.32,8
CPT,21183,RECONSTRUCT CRANIAL BONE,,,5752.66,11505.32,8
CPT,21184,RECONSTRUCT CRANIAL BONE,,,5752.66,11505.32,8
CPT,21188,RECONSTRUCTION OF MIDFACE,,,5752.66,11505.32,8
CPT,21193,RECONST LWR JAW W/O GRAFT,,,5752.66,11505.32,8
CPT,21194,RECONST LWR JAW W/GRAFT,,,5752.66,11505.32,8
CPT,21195,RECONST LWR JAW W/O FIXATION,,,5752.66,11505.32,8
CPT,21196,RECONST LWR JAW W/FIXATION,,,5752.66,11505.32,8
CPT,21198,RECONSTR LWR JAW SEGMENT,,,5752.66,11505.32,8
CPT,21199,RECONSTR LWR JAW W/ADVANCE,,,5752.66,11505.32,8
CPT,211T,SPEECH AUDIOM THRESH & RECOG,,,36.3,72.6,8
CPT,211U,ONC PAN-TUM DNA&RNA GNRJ SEQ,,,8455.0,16910.0,8
CPT,212,ANESTH SKULL DRAINAGE,,,,,0
CPT,21206,RECONSTRUCT UPPER JAW BONE,,,5752.66,11505.32,8
CPT,21208,AUGMENTATION OF FACIAL BONES,,,5752.66,11505.32,8
CPT,21209,REDUCTION OF FACIAL BONES,,,5752.66,11505.32,8
CPT,21210,FACE BONE GRAFT,,,5752.66,11505.32,8
CPT,21215,LOWER JAW BONE GRAFT,,,5752.66,11505.32,8
CPT,21230,RIB CARTILAGE GRAFT,,,5752.66,11505.32,8
CPT,21235,EAR CARTILAGE GRAFT,,,5752.66,11505.32,8
CPT,21240,RECONSTRUCTION OF JAW JOINT,,,5752.66,11505.32,8
CPT,21242,RECONSTRUCTION OF JAW JOINT,,,5752.66,11505.32,8
CPT,21243,RECONSTRUCTION OF JAW JOINT,,,26367.8,52735.6,8
CPT,21244,RECONSTRUCTION OF LOWER JAW,,,5752.66,11505.32,8
CPT,21245,RECONSTRUCTION OF JAW,,,5752.66,11505.32,8
CPT,21246,RECONSTRUCTION OF JAW,,,5752.66,11505.32,8
CPT,21247,RECONSTRUCT LOWER JAW BONE,,,5752.66,11505.32,8
CPT,21248,RECONSTRUCTION OF JAW,,,5752.66,11505.32,8
CPT,21249,RECONSTRUCTION OF JAW,,,5752.66,11505.32,8
CPT,21255,RECONSTRUCT LOWER JAW BONE,,,5752.66,11505.32,8
CPT,21256,RECONSTRUCTION OF ORBIT,,,5752.66,11505.32,8
CPT,21260,REVISE EYE SOCKETS,,,5752.66,11505.32,8
CPT,21261,REVISE EYE SOCKETS,,,5752.66,11505.32,8
CPT,21263,REVISE EYE SOCKETS,,,5752.66,11505.32,8
CPT,21267,REVISE EYE SOCKETS,,,5752.66,11505.32,8
CPT,21268,REVISE EYE SOCKETS,,,5752.66,11505.32,8
CPT,21270,AUGMENTATION CHEEK BONE,,,5752.66,11505.32,8
CPT,21275,REVISION ORBITOFACIAL BONES,,,5752.66,11505.32,8
CPT,21280,REVISION OF EYELID,,,3221.84,6443.68,8
CPT,21282,REVISION OF EYELID,,,3221.84,6443.68,8
CPT,21295,REVISION OF JAW MUSCLE/BONE,,,1507.77,3015.54,8
CPT,21296,REVISION OF JAW MUSCLE/BONE,,,3221.84,6443.68,8
CPT,21299,UNLISTED CRANFCL&MAXLFCL PX,,,230.16,460.32,8
CPT,212T,COMPRE AUDIOMETRY EVALUATION,,,125.04,250.08,8
CPT,212U,RARE DS GEN DNA ALYS PROBAND,,,5475.2,10950.4,8
CPT,21315,CLSD TX NSL FX MNPJ WO STBLJ,,,1507.77,3015.54,8
CPT,21320,CLSD TX NSL FX W/MNPJ&STABLJ,,,3221.84,6443.68,8
CPT,21325,OPEN TX NOSE FX UNCOMPLICATD,,,3221.84,6443.68,8
CPT,21330,OPEN TX NOSE FX W/SKELE FIXJ,,,5752.66,11505.32,8
CPT,21335,OPEN TX NOSE & SEPTAL FX,,,3221.84,6443.68,8
CPT,21336,OPEN TX SEPTAL FX W/WO STABJ,,,3179.6,6359.2,8
CPT,21337,CLOSED TX SEPTAL&NOSE FX,,,3221.84,6443.68,8
CPT,21338,OPEN NASOETHMOID FX W/O FIXJ,,,5752.66,11505.32,8
CPT,21339,OPEN NASOETHMOID FX W/ FIXJ,,,5752.66,11505.32,8
CPT,21340,PERQ TX NASOETHMOID FX,,,3221.84,6443.68,8
CPT,21343,OPEN TX DPRSD FRONT SINUS FX,,,5752.66,11505.32,8
CPT,21344,OPEN TX COMPL FRONT SINUS FX,,,5752.66,11505.32,8
CPT,21345,CLOSED TX NOSE/JAW FX,,,1507.77,3015.54,8
CPT,21346,OPN TX NASOMAX FX W/FIXJ,,,5752.66,11505.32,8
CPT,21347,OPN TX NASOMAX FX MULTPLE,,,5752.66,11505.32,8
CPT,21348,OPN TX NASOMAX FX W/GRAFT,,,5752.66,11505.32,8
CPT,21355,PERQ TX MALAR FRACTURE,,,3221.84,6443.68,8
CPT,21356,OPN TX DPRSD ZYGOMATIC ARCH,,,5752.66,11505.32,8
CPT,21360,OPN TX DPRSD MALAR FRACTURE,,,5752.66,11505.32,8
CPT,21365,OPN TX COMPLX MALAR FX,,,5752.66,11505.32,8
CPT,21366,OPN TX COMPLX MALAR W/GRFT,,,5752.66,11505.32,8
CPT,21385,OPN TX ORBIT FX TRANSANTRAL,,,5752.66,11505.32,8
CPT,21386,OPN TX ORBIT FX PERIORBITAL,,,5752.66,11505.32,8
CPT,21387,OPN TX ORBIT FX COMBINED,,,5752.66,11505.32,8
CPT,21390,OPN TX ORBIT PERIORBTL IMPLT,,,5752.66,11505.32,8
CPT,21395,OPN TX ORBIT PERIORBT W/GRFT,,,5752.66,11505.32,8
CPT,213T,NJX PARAVERT W/US CER/THOR,,,859.5,1719.0,8
CPT,213U,RARE DS GEN DNA ALYS EA COMP,,,2709.95,5419.9,8
CPT,214,ANESTH SKULL DRAINAGE,,,,,0
CPT,21400,CLOSED TX ORBIT W/O MANIPULJ,,,524.1,1048.2,8
CPT,21401,CLOSED TX ORBIT W/MANIPULJ,,,1507.77,3015.54,8
CPT,21406,OPN TX ORBIT FX W/O IMPLANT,,,5752.66,11505.32,8
CPT,21407,OPN TX ORBIT FX W/IMPLANT,,,5752.66,11505.32,8
CPT,21408,OPN TX ORBIT FX W/BONE GRFT,,,5752.66,11505.32,8
CPT,21421,TREAT MOUTH ROOF FRACTURE,,,3221.84,6443.68,8
CPT,21422,TREAT MOUTH ROOF FRACTURE,,,5752.66,11505.32,8
CPT,21423,TREAT MOUTH ROOF FRACTURE,,,5752.66,11505.32,8
CPT,21431,TREAT CRANIOFACIAL FRACTURE,,,5752.66,11505.32,8
CPT,21432,TREAT CRANIOFACIAL FRACTURE,,,5752.66,11505.32,8
CPT,21433,TREAT CRANIOFACIAL FRACTURE,,,5752.66,11505.32,8
CPT,21435,TREAT CRANIOFACIAL FRACTURE,,,5752.66,11505.32,8
CPT,21436,TREAT CRANIOFACIAL FRACTURE,,,5752.66,11505.32,8
CPT,21440,TREAT DENTAL RIDGE FRACTURE,,,3221.84,6443.68,8
CPT,21445,TREAT DENTAL RIDGE FRACTURE,,,5752.66,11505.32,8
CPT,21450,TREAT LOWER JAW FRACTURE,,,524.1,1048.2,8
CPT,21451,TREAT LOWER JAW FRACTURE,,,1507.77,3015.54,8
CPT,21452,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21453,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21454,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21461,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21462,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21465,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21470,TREAT LOWER JAW FRACTURE,,,5752.66,11505.32,8
CPT,21480,RESET DISLOCATED JAW,,,239.7,479.4,8
CPT,21485,RESET DISLOCATED JAW,,,1507.77,3015.54,8
CPT,21490,REPAIR DISLOCATED JAW,,,3221.84,6443.68,8
CPT,21497,INTERDENTAL WIRING,,,1507.77,3015.54,8
CPT,21499,UNLISTED MUSCSKEL PX HEAD,,,230.16,460.32,8
CPT,214T,NJX PARAVERT W/US CER/THOR,,,,,0
CPT,214U,RARE DS XOM DNA ALYS PROBAND,,,5224.6,10449.2,8
CPT,215,ANESTH SKULL REPAIR/FRACT,,,,,0
CPT,21501,DRAIN NECK/CHEST LESION,,,2822.69,5645.38,8
CPT,21502,DRAIN CHEST LESION,,,3179.6,6359.2,8
CPT,21510,DRAINAGE OF BONE LESION,,,3179.6,6359.2,8
CPT,21550,BIOPSY OF NECK/CHEST,,,1604.96,3209.92,8
CPT,21552,EXC NECK LES SC 3 CM/>,,,2822.69,5645.38,8
CPT,21554,EXC NECK TUM DEEP 5 CM/>,,,2822.69,5645.38,8
CPT,21555,EXC NECK LES SC < 3 CM,3506.0,1753.0,610.74,3400.82,54
CPT,21556,EXC NECK TUM DEEP < 5 CM,,,2822.69,5645.38,8
CPT,21557,RESECT NECK THORAX TUMOR<5CM,,,2822.69,5645.38,8
CPT,21558,RESECT NECK TUMOR 5 CM/>,,,2822.69,5645.38,8
CPT,215T,NJX PARAVERT W/US CER/THOR,,,,,0
CPT,215U,RARE DS XOM DNA ALYS EA COMP,,,2574.65,5149.3,8
CPT,216,ANESTH HEAD VESSEL SURGERY,,,,,0
CPT,21600,PARTIAL REMOVAL OF RIB,,,7051.31,14102.62,8
CPT,21601,EXC CHEST WALL TUMOR W/RIBS,,,2822.69,5645.38,8
CPT,21602,EXC CH WAL TUM W/O LYMPHADEC,,,7051.31,14102.62,8
CPT,21603,EXC CH WAL TUM W/LYMPHADEC,,,7051.31,14102.62,8
CPT,21610,PARTIAL REMOVAL OF RIB,,,3179.6,6359.2,8
CPT,21615,REMOVAL OF RIB,,,7051.31,14102.62,8
CPT,21616,REMOVAL OF RIB AND NERVES,,,7051.31,14102.62,8
CPT,21620,PARTIAL REMOVAL OF STERNUM,,,3179.6,6359.2,8
CPT,21627,STERNAL DEBRIDEMENT,,,3179.6,6359.2,8
CPT,21630,EXTENSIVE STERNUM SURGERY,,,7051.31,14102.62,8
CPT,21685,HYOID MYOTOMY & SUSPENSION,,,5752.66,11505.32,8
CPT,216T,NJX PARAVERT W/US LUMB/SAC,,,859.5,1719.0,8
CPT,216U,NEURO INH ATAXIA DNA 12 COM,,,1537.02,3074.04,8
CPT,21700,REVISION OF NECK MUSCLE,,,7051.31,14102.62,8
CPT,21705,REVISION OF NECK MUSCLE/RIB,,,7051.31,14102.62,8
CPT,21720,REVISION OF NECK MUSCLE,,,3179.6,6359.2,8
CPT,21725,REVISION OF NECK MUSCLE,,,688.14,1376.28,8
CPT,21740,RECONSTRUCTION OF STERNUM,,,7051.31,14102.62,8
CPT,21742,REPAIR STERN/NUSS W/O SCOPE,,,3179.6,6359.2,8
CPT,21743,REPAIR STERNUM/NUSS W/SCOPE,,,3179.6,6359.2,8
CPT,21750,REPAIR OF STERNUM SEPARATION,,,7051.31,14102.62,8
CPT,217T,NJX PARAVERT W/US LUMB/SAC,,,,,0
CPT,217U,NEURO INH ATAXIA DNA 51 GENE,,,2198.35,4396.7,8
CPT,218,ANESTH SPECIAL HEAD SURGERY,,,,,0
CPT,21811,OPTX OF RIB FX W/FIXJ SCOPE,,,7051.31,14102.62,8
CPT,21812,TREATMENT OF RIB FRACTURE,,,7051.31,14102.62,8
CPT,21813,TREATMENT OF RIB FRACTURE,,,1562.58,3125.16,8
CPT,21820,TREAT STERNUM FRACTURE,,,239.7,479.4,8
CPT,21825,TREAT STERNUM FRACTURE,,,7051.31,14102.62,8
CPT,21899,UNLISTED PX NECK/THORAX,,,230.16,460.32,8
CPT,218T,NJX PARAVERT W/US LUMB/SAC,,,,,0
CPT,218U,NEURO MUSC DYS DMD SEQ ALYS,,,2279.0,4558.0,8
CPT,21920,BIOPSY SOFT TISSUE OF BACK,,,1604.96,3209.92,8
CPT,21925,BIOPSY SOFT TISSUE OF BACK,,,1604.96,3209.92,8
CPT,21930,EXC BACK LES SC < 3 CM,,,1604.96,3209.92,8
CPT,21931,EXC BACK LES SC 3 CM/>,,,1604.96,3209.92,8
CPT,21932,EXC BACK TUM DEEP < 5 CM,,,2822.69,5645.38,8
CPT,21933,EXC BACK TUM DEEP 5 CM/>,,,2822.69,5645.38,8
CPT,21935,RESECT BACK TUM < 5 CM,,,2822.69,5645.38,8
CPT,21936,RESECT BACK TUM 5 CM/>,,,2822.69,5645.38,8
CPT,219T,PLMT POST FACET IMPLT CERV,,,12476.14,24952.28,8
CPT,219U,NFCT AGT HIV GNRJ SEQ ALYS,,,725.0,1450.0,8
CPT,21U,ONC PRST8 DETCJ 8 AUTOANTB,,,760.0,1520.0,8
CPT,220,ANESTH INTRCRN NERVE,,,,,0
CPT,22010,I&D P-SPINE C/T/CERV-THOR,,,7051.31,14102.62,8
CPT,22015,I&D ABSCESS P-SPINE L/S/LS,,,7051.31,14102.62,8
CPT,220T,PLMT POST FACET IMPLT THOR,,,12476.14,24952.28,8
CPT,220U,ONC BRST CA AI ASSMT 12 FEAT,,,706.25,1412.5,8
CPT,22100,REMOVE PART OF NECK VERTEBRA,,,7051.31,14102.62,8
CPT,22101,REMOVE PART THORAX VERTEBRA,,,7051.31,14102.62,8
CPT,22102,REMOVE PART LUMBAR VERTEBRA,,,7051.31,14102.62,8
CPT,22103,REMOVE EXTRA SPINE SEGMENT,,,,,0
CPT,22110,REMOVE PART OF NECK VERTEBRA,,,7051.31,14102.62,8
CPT,22112,REMOVE PART THORAX VERTEBRA,,,7051.31,14102.62,8
CPT,22114,REMOVE PART LUMBAR VERTEBRA,,,7051.31,14102.62,8
CPT,22116,REMOVE EXTRA SPINE SEGMENT,,,,,0
CPT,221T,PLMT POST FACET IMPLT LUMB,,,7051.31,14102.62,8
CPT,221U,ABO GNOTYP NEXT GNRJ SEQ ABO,,,274.83,549.66,8
CPT,222,ANESTH HEAD NERVE SURGERY,,,,,0
CPT,22206,INCIS SPINE 3 COLUMN THORAC,,,7051.31,14102.62,8
CPT,22207,INCIS SPINE 3 COLUMN LUMBAR,,,7051.31,14102.62,8
CPT,22208,INCIS SPINE 3 COLUMN ADL SEG,,,,,0
CPT,22210,INCIS 1 VERTEBRAL SEG CERV,,,7051.31,14102.62,8
CPT,22212,INCIS 1 VERTEBRAL SEG THORAC,,,7051.31,14102.62,8
CPT,22214,INCIS 1 VERTEBRAL SEG LUMBAR,,,7051.31,14102.62,8
CPT,22216,INCIS ADDL SPINE SEGMENT,,,,,0
CPT,22220,OSTEOT DSC ANT 1 VRT SGM CRV,,,7051.31,14102.62,8
CPT,22222,OSTEOT DSC ANT 1VRT SGM THRC,,,7051.31,14102.62,8
CPT,22224,OSTEOT DSC ANT 1VRT SGM LMBR,,,7051.31,14102.62,8
CPT,22226,OSTEOT DSC ANT 1VRT SGM EA,,,,,0
CPT,222T,PLMT POST FACET IMPLT ADDL,,,,,0
CPT,222U,RHD&RHCE GNTYP NEXT GNRJ SEQ,,,282.88,565.76,8
CPT,22310,CLOSED TX VERT FX W/O MANJ,,,239.7,479.4,8
CPT,22315,CLOSED TX VERT FX W/MANJ,,,3179.6,6359.2,8
CPT,22318,TREAT ODONTOID FX W/O GRAFT,,,12476.14,24952.28,8
CPT,22319,TREAT ODONTOID FX W/GRAFT,,,12476.14,24952.28,8
CPT,22325,TREAT SPINE FRACTURE,,,12476.14,24952.28,8
CPT,22326,TREAT NECK SPINE FRACTURE,,,12476.14,24952.28,8
CPT,22327,TREAT THORAX SPINE FRACTURE,,,12476.14,24952.28,8
CPT,22328,TREAT EACH ADD SPINE FX,,,,,0
CPT,223U,NFCT DS 22 TRGT SARS-COV-2,,,416.78,833.56,8
CPT,224U,ANTIBODY SARS-COV-2 TITER(S),,,51.43,102.86,8
CPT,22505,MANIPULATION OF SPINE,,,1562.58,3125.16,8
CPT,22510,PERQ CERVICOTHORACIC INJECT,,,3179.6,6359.2,8
CPT,22511,PERQ LUMBOSACRAL INJECTION,,,3179.6,6359.2,8
CPT,22512,VERTEBROPLASTY ADDL INJECT,,,,,0
CPT,22513,PERQ VERTEBRAL AUGMENTATION,,,7051.31,14102.62,8
CPT,22514,PERQ VERTEBRAL AUGMENTATION,,,7051.31,14102.62,8
CPT,22515,PERQ VERTEBRAL AUGMENTATION,,,,,0
CPT,22526,IDET SINGLE LEVEL,,,,,0
CPT,22527,IDET 1 OR MORE LEVELS,,,,,0
CPT,22532,ARTHRD LAT XTRCVTRY TQ THRC,,,12476.14,24952.28,8
CPT,22533,ARTHRD LAT XTRCVTRY TQ LMBR,,,17038.69,34077.38,8
CPT,22534,ARTHRD LAT XTRCVTRY TQ EA AD,,,,,0
CPT,22548,ARTHRD ANT TORAL/XORAL C1-C2,,,12476.14,24952.28,8
CPT,22551,ARTHRD ANT NTRBDY CERVICAL,,,12476.14,24952.28,8
CPT,22552,ARTHRD ANT NTRBD CERVICAL EA,,,,,0
CPT,22554,ARTHRD ANT NTRBD MIN DSC CRV,,,12476.14,24952.28,8
CPT,22556,ARTHRD ANT NTRBD MIN DSC THC,,,17038.69,34077.38,8
CPT,22558,ARTHRD ANT NTRBD MIN DSC LUM,,,26367.8,52735.6,8
CPT,22585,ARTHRD ANT NTRBD MIN DSC EA,,,,,0
CPT,22586,ARTHRD PRE-SAC NTRBDY L5-S1,,,17038.69,34077.38,8
CPT,22590,ARTHRD PST TQ CRANIOCERVICAL,,,12476.14,24952.28,8
CPT,22595,ARTHRD PST TQ ATLAS-AXIS,,,12476.14,24952.28,8
CPT,225U,NFCT DS DNA&RNA 21 SARSCOV2,,,416.78,833.56,8
CPT,22600,ARTHRD PST TQ 1NTRSPC CRV,,,17038.69,34077.38,8
CPT,22610,ARTHRD PST TQ 1NTRSPC THRC,,,17038.69,34077.38,8
CPT,22612,ARTHRD PST TQ 1NTRSPC LUMBAR,,,17038.69,34077.38,8
CPT,22614,ARTHRD PST TQ 1NTRSPC EA ADD,,,,,0
CPT,22630,ARTHRD PST TQ 1NTRSPC LUM,,,26367.8,52735.6,8
CPT,22632,ARTHRD PST TQ 1NTRSPC LM EA,,,,,0
CPT,22633,ARTHRD CMBN 1NTRSPC LUMBAR,,,26367.8,52735.6,8
CPT,22634,ARTHRD CMBN 1NTRSPC EA ADDL,,,,,0
CPT,226U,SVNT SARSCOV2 ELISA PLSM SRM,,,42.28,84.56,8
CPT,227U,RX ASY PRSMV 30+RX/METABLT,,,62.14,124.28,8
CPT,22800,ARTHRD PST DFRM<6 VRT SGM,,,17038.69,34077.38,8
CPT,22802,ARTHRD PST DFRM 7-12 VRT SGM,,,17038.69,34077.38,8
CPT,22804,ARTHRD PST DFRM 13+ VRT SGM,,,17038.69,34077.38,8
CPT,22808,ARTHRD ANT DFRM 2-3 VRT SGM,,,17038.69,34077.38,8
CPT,22810,ARTHRD ANT DFRM 4-7 VRT SGM,,,17038.69,34077.38,8
CPT,22812,ARTHRD ANT DFRM 8+ VRT SGM,,,17038.69,34077.38,8
CPT,22818,KYPHECTOMY 1-2 SEGMENTS,,,17038.69,34077.38,8
CPT,22819,KYPHECTOMY 3 OR MORE,,,17038.69,34077.38,8
CPT,22830,EXPLORATION OF SPINAL FUSION,,,7051.31,14102.62,8
CPT,22836,ANT THRC VRT BODY TETHRG <7,,,17038.69,34077.38,8
CPT,22837,ANT THRC VRT BODY TETHRG 8+,,,17038.69,34077.38,8
CPT,22838,REV RPLC/RMV THRC VRT TETHRG,,,17038.69,34077.38,8
CPT,22840,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22841,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22842,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22843,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22844,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22845,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22846,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22847,INSERT SPINE FIXATION DEVICE,,,,,0
CPT,22848,INSERT PELV FIXATION DEVICE,,,,,0
CPT,22849,REINSERT SPINAL FIXATION,,,12476.14,24952.28,8
CPT,22850,REMOVE SPINE FIXATION DEVICE,,,7051.31,14102.62,8
CPT,22852,REMOVE SPINE FIXATION DEVICE,,,7051.31,14102.62,8
CPT,22853,INSJ BIOMECHANICAL DEVICE,,,,,0
CPT,22854,INSJ BIOMECHANICAL DEVICE,,,,,0
CPT,22855,REMOVAL ANTERIOR INSTRMJ,,,7051.31,14102.62,8
CPT,22856,TOT DISC ARTHRP 1NTRSPC CRV,,,17038.69,34077.38,8
CPT,22857,TOT DISC ARTHRP 1NTRSPC LMBR,,,17038.69,34077.38,8
CPT,22858,TOT DISC ARTHRP 2ND LVL CRV,,,,,0
CPT,22859,INSJ BIOMECHANICAL DEVICE,,,,,0
CPT,22860,TOT DISC ARTHRP 2NTRSPC LMBR,,,,,0
CPT,22861,REV RPLCM ARTHRP 1NTRSPC CRV,,,17038.69,34077.38,8
CPT,22862,REV RPLCM RTHRP 1NTRSPC LMBR,,,17038.69,34077.38,8
CPT,22864,RMVL TOT ARTHRP 1NTRSPC CRV,,,7051.31,14102.62,8
CPT,22865,RMVL TOT ARTHRP 1NTRSPC LMBR,,,7051.31,14102.62,8
CPT,22867,INSJ STABLJ DEV W/DCMPRN,,,17038.69,34077.38,8
CPT,22868,INSJ STABLJ DEV W/DCMPRN,,,,,0
CPT,22869,INSJ STABLJ DEV W/O DCMPRN,,,12476.14,24952.28,8
CPT,22870,INSJ STABLJ DEV W/O DCMPRN,,,,,0
CPT,22899,UNLISTED PROCEDURE SPINE,,,239.7,479.4,8
CPT,228U,ONC PRST8 MA MOLEC PRFL ALG,,,173.03,346.06,8
CPT,22900,EXC ABDL TUM DEEP < 5 CM,,,2822.69,5645.38,8
CPT,22901,EXC ABDL TUM DEEP 5 CM/>,,,2822.69,5645.38,8
CPT,22902,EXC ABD LES SC < 3 CM,,,1604.96,3209.92,8
CPT,22903,EXC ABD LES SC 3 CM/>,,,2822.69,5645.38,8
CPT,22904,RADICAL RESECT ABD TUMOR<5CM,,,2822.69,5645.38,8
CPT,22905,RAD RESECT ABD TUMOR 5 CM/>,,,2822.69,5645.38,8
CPT,22999,UNLISTED PX ABDOMEN MUSCSKEL,,,239.7,479.4,8
CPT,229U,BCAT1&IKZF1 PRMTR MTHYLN ALY,,,384.0,768.0,8
CPT,22U,TGSAP NSM LUNG NEO DNA&RNA23,,,1950.0,3900.0,8
CPT,23000,REMOVAL OF CALCIUM DEPOSITS,,,2822.69,5645.38,8
CPT,23020,RELEASE SHOULDER JOINT,,,3179.6,6359.2,8
CPT,23030,DRAIN SHOULDER LESION,,,2822.69,5645.38,8
CPT,23031,DRAIN SHOULDER BURSA,,,2822.69,5645.38,8
CPT,23035,DRAIN SHOULDER BONE LESION,,,1562.58,3125.16,8
CPT,23040,EXPLORATORY SHOULDER SURGERY,,,3179.6,6359.2,8
CPT,23044,EXPLORATORY SHOULDER SURGERY,,,3179.6,6359.2,8
CPT,23065,BIOPSY SHOULDER TISSUES,,,1604.96,3209.92,8
CPT,23066,BIOPSY SHOULDER TISSUES,,,2822.69,5645.38,8
CPT,23071,EXC SHOULDER LES SC 3 CM/>,,,1604.96,3209.92,8
CPT,23073,EXC SHOULDER TUM DEEP 5 CM/>,,,2822.69,5645.38,8
CPT,23075,EXC SHOULDER LES SC < 3 CM,,,1604.96,3209.92,8
CPT,23076,EXC SHOULDER TUM DEEP < 5 CM,,,2822.69,5645.38,8
CPT,23077,RESECT SHOULDER TUMOR < 5 CM,,,2822.69,5645.38,8
CPT,23078,RESECT SHOULDER TUMOR 5 CM/>,,,2822.69,5645.38,8
CPT,230U,AR FULL SEQUENCE ANALYSIS,,,301.35,602.7,8
CPT,23100,BIOPSY OF SHOULDER JOINT,,,3179.6,6359.2,8
CPT,23101,SHOULDER JOINT SURGERY,,,3179.6,6359.2,8
CPT,23105,REMOVE SHOULDER JOINT LINING,,,7051.31,14102.62,8
CPT,23106,INCISION OF COLLARBONE JOINT,,,3179.6,6359.2,8
CPT,23107,EXPLORE TREAT SHOULDER JOINT,,,7051.31,14102.62,8
CPT,23120,PARTIAL REMOVAL COLLAR BONE,,,3179.6,6359.2,8
CPT,23125,REMOVAL OF COLLAR BONE,,,3179.6,6359.2,8
CPT,23130,REMOVE SHOULDER BONE PART,,,3179.6,6359.2,8
CPT,23140,REMOVAL OF BONE LESION,,,3179.6,6359.2,8
CPT,23145,REMOVAL OF BONE LESION,,,3179.6,6359.2,8
CPT,23146,REMOVAL OF BONE LESION,,,7051.31,14102.62,8
CPT,23150,REMOVAL OF HUMERUS LESION,,,3179.6,6359.2,8
CPT,23155,REMOVAL OF HUMERUS LESION,,,7051.31,14102.62,8
CPT,23156,REMOVAL OF HUMERUS LESION,,,7051.31,14102.62,8
CPT,23170,REMOVE COLLAR BONE LESION,,,3179.6,6359.2,8
CPT,23172,REMOVE SHOULDER BLADE LESION,,,3179.6,6359.2,8
CPT,23174,REMOVE HUMERUS LESION,,,7051.31,14102.62,8
CPT,23180,REMOVE COLLAR BONE LESION,,,7051.31,14102.62,8
CPT,23182,REMOVE SHOULDER BLADE LESION,,,7051.31,14102.62,8
CPT,23184,REMOVE HUMERUS LESION,,,7051.31,14102.62,8
CPT,23190,PARTIAL REMOVAL OF SCAPULA,,,3179.6,6359.2,8
CPT,23195,REMOVAL OF HEAD OF HUMERUS,,,7051.31,14102.62,8
CPT,231U,CACNA1A FULL GENE ANALYSIS,,,846.27,1692.54,8
CPT,23200,RESECT CLAVICLE TUMOR,,,7051.31,14102.62,8
CPT,23210,RESECT SCAPULA TUMOR,,,7051.31,14102.62,8
CPT,23220,RESECT PROX HUMERUS TUMOR,,,7051.31,14102.62,8
CPT,232T,NJX PLATELET PLASMA,,,434.11,868.22,8
CPT,232U,CSTB FULL GENE ANALYSIS,,,274.83,549.66,8
CPT,23330,REMOVE SHOULDER FOREIGN BODY,,,1604.96,3209.92,8
CPT,23333,REMOVE SHOULDER FB DEEP,,,2822.69,5645.38,8
CPT,23334,SHOULDER PROSTHESIS REMOVAL,,,7051.31,14102.62,8
CPT,23335,SHOULDER PROSTHESIS REMOVAL,,,7051.31,14102.62,8
CPT,23350,INJECTION FOR SHOULDER X-RAY,,,124.78,144.9,16
CPT,23395,MUSCLE TRANSFER SHOULDER/ARM,,,7051.31,14102.62,8
CPT,23397,MUSCLE TRANSFERS,,,7051.31,14102.62,8
CPT,233U,FXN GENE ANALYSIS,,,274.83,549.66,8
CPT,23400,FIXATION OF SHOULDER BLADE,,,7051.31,14102.62,8
CPT,23405,INCISION OF TENDON & MUSCLE,,,7051.31,14102.62,8
CPT,23406,INCISE TENDON(S) & MUSCLE(S),,,7051.31,14102.62,8
CPT,23410,REPAIR ROTATOR CUFF ACUTE,,,7051.31,14102.62,8
CPT,23412,REPAIR ROTATOR CUFF CHRONIC,,,7051.31,14102.62,8
CPT,23415,RELEASE OF SHOULDER LIGAMENT,,,7051.31,14102.62,8
CPT,23420,REPAIR OF SHOULDER,,,7051.31,14102.62,8
CPT,23430,REPAIR BICEPS TENDON,,,7051.31,14102.62,8
CPT,23440,REMOVE/TRANSPLANT TENDON,,,7051.31,14102.62,8
CPT,23450,REPAIR SHOULDER CAPSULE,,,7051.31,14102.62,8
CPT,23455,REPAIR SHOULDER CAPSULE,,,7051.31,14102.62,8
CPT,23460,REPAIR SHOULDER CAPSULE,,,7051.31,14102.62,8
CPT,23462,REPAIR SHOULDER CAPSULE,,,7051.31,14102.62,8
CPT,23465,REPAIR SHOULDER CAPSULE,,,7051.31,14102.62,8
CPT,23466,REPAIR SHOULDER CAPSULE,,,7051.31,14102.62,8
CPT,23470,RECONSTRUCT SHOULDER JOINT,,,12476.14,24952.28,8
CPT,23472,RECONSTRUCT SHOULDER JOINT,,,17038.69,34077.38,8
CPT,23473,REVIS RECONST SHOULDER JOINT,,,12476.14,24952.28,8
CPT,23474,REVIS RECONST SHOULDER JOINT,,,12476.14,24952.28,8
CPT,23480,REVISION OF COLLAR BONE,,,7051.31,14102.62,8
CPT,23485,REVISION OF COLLAR BONE,,,12476.14,24952.28,8
CPT,23490,REINFORCE CLAVICLE,,,7051.31,14102.62,8
CPT,23491,REINFORCE SHOULDER BONES,,,12476.14,24952.28,8
CPT,234T,TRLUML PERIP ATHRC RENAL ART,,,11218.2,22436.4,8
CPT,234U,MECP2 FULL GENE ANALYSIS,,,527.87,1055.74,8
CPT,23500,CLTX CLAVICULAR FX W/O MNPJ,,,239.7,479.4,8
CPT,23505,CLTX CLAVICULAR FX W/MNPJ,,,1562.58,3125.16,8
CPT,23515,OPTX CLAVICULAR FX W/INT FIX,,,7051.31,14102.62,8
CPT,23520,CLTX STRNCLAV DISLC W/O MNPJ,,,1562.58,3125.16,8
CPT,23525,CLTX STRNCLAV DISLC W/MNPJ,,,239.7,479.4,8
CPT,23530,OPTX STRNCLAV DISLC AQT/CHRN,,,7051.31,14102.62,8
CPT,23532,OPTX STRCLV DSLC AQ/CHRN GRF,,,7051.31,14102.62,8
CPT,23540,CLTX ACROMCLAV DISLC WO MNPJ,,,239.7,479.4,8
CPT,23545,CLTX ACROMCLAV DISLC W/MNPJ,,,239.7,479.4,8
CPT,23550,OPTX ACROMCLV DISLC AQT/CHRN,,,7051.31,14102.62,8
CPT,23552,OPTX ACRCLV DSLC AQ/CHRN GRF,,,7051.31,14102.62,8
CPT,23570,CLTX SCAPULAR FX W/O MNPJ,,,239.7,479.4,8
CPT,23575,CLTX SCAP FX W/MNPJ +-TRACTJ,,,1562.58,3125.16,8
CPT,23585,OPTX SCAPULAR FX W/INT FIXJ,,,7051.31,14102.62,8
CPT,235T,TRLUML PERIP ATHRC VISCERAL,,,,,0
CPT,235U,PTEN FULL GENE ANALYSIS,,,600.0,1200.0,8
CPT,23600,CLTX PROX HUMRL FX W/O MNPJ,,,239.7,479.4,8
CPT,23605,CLTX PRX HMRL FX MNPJ+-TRACT,,,1562.58,3125.16,8
CPT,23615,OPTX PROX HUMRL FX W/INT FIX,,,12476.14,24952.28,8
CPT,23616,OPTX PRX HMRL FX FIX RPR RPL,,,17038.69,34077.38,8
CPT,23620,CLTX GR HMRL TBRS FX WO MNPJ,,,239.7,479.4,8
CPT,23625,CLTX GR HMRL TBRS FX W/MNPJ,,,1562.58,3125.16,8
CPT,23630,OPTX GR HMRL TBRS FX INT FIX,,,7051.31,14102.62,8
CPT,23650,CLTX SHO DSLC W/MNPJ WO ANES,,,239.7,479.4,8
CPT,23655,CLTX SHO DSLC W/MNPJ W/ANES,,,1562.58,3125.16,8
CPT,23660,OPTX ACUTE SHOULDER DISLC,,,7051.31,14102.62,8
CPT,23665,CLTX SHO DSLC FX GR HMRL TBR,,,1562.58,3125.16,8
CPT,23670,OPTX SHO DISLC FX,,,7051.31,14102.62,8
CPT,23675,CLTX SHO DISLC NECK FX MNPJ,,,1562.58,3125.16,8
CPT,23680,OPTX SHO DISLC NECK FX FIXJ,,,12476.14,24952.28,8
CPT,236T,TRLUML PERIP ATHRC ABD AORTA,,,11218.2,22436.4,8
CPT,236U,SMN1&SMN2 FULL GENE ANALYSIS,,,602.7,1205.4,8
CPT,23700,MNPJ ANES SHO JT FIXJ APRATS,,,1562.58,3125.16,8
CPT,237T,TRLUML PERIP ATHRC BRCHIOCPH,,,11218.2,22436.4,8
CPT,237U,CAR ION CHNLPTHY GEN SEQ PNL,,,584.9,1169.8,8
CPT,23800,ARTHRODESIS GLENOHUMERAL JT,,,7051.31,14102.62,8
CPT,23802,ARTHRD GLENOHUMERAL JT W/GRF,,,12476.14,24952.28,8
CPT,238T,TRLUML PERIP ATHRC ILIAC ART,,,17813.98,35627.96,8
CPT,238U,ONC LNCH SYN GEN DNA SEQ ALY,,,584.9,1169.8,8
CPT,23900,INTERTHORACOSCPLR AMPUTATION,,,12476.14,24952.28,8
CPT,23920,DISARTICULATION SHOULDER,,,12476.14,24952.28,8
CPT,23921,DISARTICULATION SHO SEC CLSR,,,2005.02,4010.04,8
CPT,23929,UNLISTED PROCEDURE SHOULDER,,,239.7,479.4,8
CPT,23930,I&D UPR A/E DP ABSC/HMTMA,,,2822.69,5645.38,8
CPT,23931,I&D UPR A/E BURSA,,,1604.96,3209.92,8
CPT,23935,INC DP OPN B1 CRTX HUM/ELBW,,,3179.6,6359.2,8
CPT,239U,TRGT GEN SEQ ALYS PNL 311+,,,3500.0,7000.0,8
CPT,23U,ONC AML DNA DETCJ/NONDETCJ,,,248.51,497.02,8
CPT,24000,ARTHRT ELBW EXPL DRG/RMVL FB,,,3179.6,6359.2,8
CPT,24006,ARTHRT ELBW CAPSL EXC RLS,,,3179.6,6359.2,8
CPT,24065,BIOPSY ARM/ELBOW SOFT TISSUE,,,1604.96,3209.92,8
CPT,24066,BIOPSY ARM/ELBOW SOFT TISSUE,,,2822.69,5645.38,8
CPT,24071,EXC ARM/ELBOW LES SC 3 CM/>,,,2822.69,5645.38,8
CPT,24073,EX ARM/ELBOW TUM DEEP 5 CM/>,,,2822.69,5645.38,8
CPT,24075,EXC ARM/ELBOW LES SC < 3 CM,,,1604.96,3209.92,8
CPT,24076,EX ARM/ELBOW TUM DEEP < 5 CM,,,2822.69,5645.38,8
CPT,24077,RAD RESCJ TUM TISS A/E <5CM,,,2822.69,5645.38,8
CPT,24079,RAD RESCJ TUM TISS A/E 5 CM+,,,2822.69,5645.38,8
CPT,24100,ARTHRT ELBW SYNOVIAL BX ONLY,,,3179.6,6359.2,8
CPT,24101,ARTHRT ELBW JT EXPL BX RMVL,,,3179.6,6359.2,8
CPT,24102,ARTHRT ELBOW W/SYNOVECTOMY,,,3179.6,6359.2,8
CPT,24105,EXCISION OLECRANON BURSA,,,3179.6,6359.2,8
CPT,24110,EXC/CURTG B1 CST/B9 TUM HUM,,,3179.6,6359.2,8
CPT,24115,EXC/CRTG B1 CST/TUM HUM AGRF,,,7051.31,14102.62,8
CPT,24116,EXC/CRTG B1 CST/TUM HUM ALGR,,,7051.31,14102.62,8
CPT,24120,EXC/CRTG B1 CST/B9 TUM RDS,,,3179.6,6359.2,8
CPT,24125,EXC/CRTG B1 CST/TUM RDS AGRF,,,3179.6,6359.2,8
CPT,24126,EXC/CRTG B1 CST/TUM RDS ALGR,,,7051.31,14102.62,8
CPT,24130,EXCISION RADIAL HEAD,,,3179.6,6359.2,8
CPT,24134,SEQUESTRECTOMY SHFT/DSTL HUM,,,7051.31,14102.62,8
CPT,24136,SEQUESTRECTOMY RADIAL H/N,,,3179.6,6359.2,8
CPT,24138,SEQUESTRECTOMY OLECRN PROCES,,,7051.31,14102.62,8
CPT,24140,PARTIAL EXC BONE HUMERUS,,,3179.6,6359.2,8
CPT,24145,PRTL EXC BONE RADIAL H/N,,,7051.31,14102.62,8
CPT,24147,PRTL EXC BONE OLECRN PROCESS,,,3179.6,6359.2,8
CPT,24149,RADICAL RESECTION OF ELBOW,,,7051.31,14102.62,8
CPT,24150,RAD RESCJ TUM DSTL/SHFT HUM,,,7051.31,14102.62,8
CPT,24152,RAD RESECTION TUM RADIAL H/N,,,7051.31,14102.62,8
CPT,24155,RESECTION OF ELBOW JOINT,,,3179.6,6359.2,8
CPT,24160,RMVL PROSTHHUMRL&ULNAR CMPNT,,,3179.6,6359.2,8
CPT,24164,REMOVAL PROSTH RADIAL HEAD,,,3179.6,6359.2,8
CPT,24200,RMVL FB UPPER ARM/ELBW SUBQ,,,1604.96,3209.92,8
CPT,24201,RMVL FB UPPER ARM/ELBW DEEP,,,2822.69,5645.38,8
CPT,24220,INJECTION PX FOR ELBOW ARTHG,,,137.84,160.08,16
CPT,242U,TRGT GEN SEQ ALYS PNL 55-74,,,5000.0,10000.0,8
CPT,24300,MNPJ ELBOW UNDER ANES,,,1562.58,3125.16,8
CPT,24301,MUSC/TDN TRANSFER UPR A/E 1,,,7051.31,14102.62,8
CPT,24305,TENDON LNGTH UPR A/E EA TDN,,,3179.6,6359.2,8
CPT,24310,TNOT OPN ELBW TO SHO EA TDN,,,3179.6,6359.2,8
CPT,24320,TENOPLASTY ELBOW TO SHO 1,,,7051.31,14102.62,8
CPT,24330,FLEXOR-PLASTY ELBOW,,,7051.31,14102.62,8
CPT,24331,FLEXOR-PLASTY ELBW W/ADVMNT,,,7051.31,14102.62,8
CPT,24332,TENOLYSIS TRICEPS,,,3179.6,6359.2,8
CPT,24340,TENODESIS BICEPS TDN AT ELBW,,,7051.31,14102.62,8
CPT,24341,RPR TDN/MUSC UPR A/E EACH,,,7051.31,14102.62,8
CPT,24342,REPAIR OF RUPTURED TENDON,,,7051.31,14102.62,8
CPT,24343,REPR ELBOW LAT LIGMNT W/TISS,,,3179.6,6359.2,8
CPT,24344,RECONSTRUCT ELBOW LAT LIGMNT,,,7051.31,14102.62,8
CPT,24345,REPR ELBW MED LIGMNT W/TISSU,,,7051.31,14102.62,8
CPT,24346,RECONSTRUCT ELBOW MED LIGMNT,,,12476.14,24952.28,8
CPT,24357,REPAIR ELBOW PERC,,,3179.6,6359.2,8
CPT,24358,REPAIR ELBOW W/DEB OPEN,,,3179.6,6359.2,8
CPT,24359,REPAIR ELBOW DEB/ATTCH OPEN,,,3179.6,6359.2,8
CPT,24360,RECONSTRUCT ELBOW JOINT,,,7051.31,14102.62,8
CPT,24361,RECONSTRUCT ELBOW JOINT,,,17038.69,34077.38,8
CPT,24362,RECONSTRUCT ELBOW JOINT,,,12476.14,24952.28,8
CPT,24363,REPLACE ELBOW JOINT,,,17038.69,34077.38,8
CPT,24365,RECONSTRUCT HEAD OF RADIUS,,,12476.14,24952.28,8
CPT,24366,RECONSTRUCT HEAD OF RADIUS,,,12476.14,24952.28,8
CPT,24370,REVISE RECONST ELBOW JOINT,,,12476.14,24952.28,8
CPT,24371,REVISE RECONST ELBOW JOINT,,,17038.69,34077.38,8
CPT,243U,OB PE BIOCHEM ASSAY PGF ALG,,,64.41,128.82,8
CPT,24400,REVISION OF HUMERUS,,,7051.31,14102.62,8
CPT,24410,REVISION OF HUMERUS,,,12476.14,24952.28,8
CPT,24420,REVISION OF HUMERUS,,,7051.31,14102.62,8
CPT,24430,REPAIR OF HUMERUS,,,12476.14,24952.28,8
CPT,24435,REPAIR HUMERUS WITH GRAFT,,,12476.14,24952.28,8
CPT,24470,REVISION OF ELBOW JOINT,,,3179.6,6359.2,8
CPT,24495,DECOMPRESSION OF FOREARM,,,7051.31,14102.62,8
CPT,24498,REINFORCE HUMERUS,,,12476.14,24952.28,8
CPT,244U,ONC SOLID ORGN DNA 257 GENES,,,3500.0,7000.0,8
CPT,24500,TREAT HUMERUS FRACTURE,,,239.7,479.4,8
CPT,24505,TREAT HUMERUS FRACTURE,,,1562.58,3125.16,8
CPT,24515,TREAT HUMERUS FRACTURE,,,12476.14,24952.28,8
CPT,24516,TREAT HUMERUS FRACTURE,,,12476.14,24952.28,8
CPT,24530,TREAT HUMERUS FRACTURE,,,239.7,479.4,8
CPT,24535,TREAT HUMERUS FRACTURE,,,1562.58,3125.16,8
CPT,24538,TREAT HUMERUS FRACTURE,,,7051.31,14102.62,8
CPT,24545,TREAT HUMERUS FRACTURE,,,12476.14,24952.28,8
CPT,24546,TREAT HUMERUS FRACTURE,,,12476.14,24952.28,8
CPT,24560,TREAT HUMERUS FRACTURE,,,239.7,479.4,8
CPT,24565,TREAT HUMERUS FRACTURE,,,1562.58,3125.16,8
CPT,24566,TREAT HUMERUS FRACTURE,,,1562.58,3125.16,8
CPT,24575,TREAT HUMERUS FRACTURE,,,12476.14,24952.28,8
CPT,24576,TREAT HUMERUS FRACTURE,,,239.7,479.4,8
CPT,24577,TREAT HUMERUS FRACTURE,,,1562.58,3125.16,8
CPT,24579,TREAT HUMERUS FRACTURE,,,12476.14,24952.28,8
CPT,24582,TREAT HUMERUS FRACTURE,,,7051.31,14102.62,8
CPT,24586,TREAT ELBOW FRACTURE,,,12476.14,24952.28,8
CPT,24587,TREAT ELBOW FRACTURE,,,12476.14,24952.28,8
CPT,245U,ONC THYR MUT ALYS 10 GEN&37,,,1266.07,2532.14,8
CPT,24600,TREAT ELBOW DISLOCATION,,,239.7,479.4,8
CPT,24605,TREAT ELBOW DISLOCATION,,,1562.58,3125.16,8
CPT,24615,TREAT ELBOW DISLOCATION,,,7051.31,14102.62,8
CPT,24620,TREAT ELBOW FRACTURE,,,1562.58,3125.16,8
CPT,24635,TREAT ELBOW FRACTURE,,,7051.31,14102.62,8
CPT,24640,TREAT ELBOW DISLOCATION,,,239.7,479.4,8
CPT,24650,TREAT RADIUS FRACTURE,,,239.7,479.4,8
CPT,24655,TREAT RADIUS FRACTURE,,,1562.58,3125.16,8
CPT,24665,TREAT RADIUS FRACTURE,,,7051.31,14102.62,8
CPT,24666,TREAT RADIUS FRACTURE,,,12476.14,24952.28,8
CPT,24670,TREAT ULNAR FRACTURE,,,239.7,479.4,8
CPT,24675,TREAT ULNAR FRACTURE,,,1562.58,3125.16,8
CPT,24685,TREAT ULNAR FRACTURE,,,7051.31,14102.62,8
CPT,246U,RBC DNA GNOTYP 16 BLD GROUPS,,,720.0,1440.0,8
CPT,247U,OB PRTRM BRTH IBP4 SHBG MEAS,,,750.0,1500.0,8
CPT,24800,FUSION OF ELBOW JOINT,,,7051.31,14102.62,8
CPT,24802,FUSION/GRAFT OF ELBOW JOINT,,,12476.14,24952.28,8
CPT,248U,ONC BRN SPHRD CLL 12 RX PNL,,,3033.86,6067.72,8
CPT,24900,AMPUTATION OF UPPER ARM,,,12476.14,24952.28,8
CPT,24920,AMPUTATION OF UPPER ARM,,,12476.14,24952.28,8
CPT,24925,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,24930,AMPUTATION FOLLOW-UP SURGERY,,,7051.31,14102.62,8
CPT,24931,AMPUTATE UPPER ARM & IMPLANT,,,12476.14,24952.28,8
CPT,24935,REVISION OF AMPUTATION,,,7051.31,14102.62,8
CPT,24940,REVISION OF UPPER ARM,,,12476.14,24952.28,8
CPT,24999,UNLISTED PX HUMERUS/ELBOW,,,239.7,479.4,8
CPT,249U,ONC BRST ALYS 32 PHSPRTN ALG,,,2219.13,4438.26,8
CPT,24U,GLYCA NUC MR SPECTRSC QUAN,,,34.19,68.38,8
CPT,25000,INCISION OF TENDON SHEATH,,,1562.58,3125.16,8
CPT,25001,INCISE FLEXOR CARPI RADIALIS,,,3179.6,6359.2,8
CPT,25020,DECOMPRESS FOREARM 1 SPACE,,,1562.58,3125.16,8
CPT,25023,DECOMPRESS FOREARM 1 SPACE,,,3179.6,6359.2,8
CPT,25024,DECOMPRESS FOREARM 2 SPACES,,,3179.6,6359.2,8
CPT,25025,DECOMPRESS FOREARM 2 SPACES,,,1562.58,3125.16,8
CPT,25028,DRAINAGE OF FOREARM LESION,,,3179.6,6359.2,8
CPT,25031,DRAINAGE OF FOREARM BURSA,,,1562.58,3125.16,8
CPT,25035,TREAT FOREARM BONE LESION,,,7051.31,14102.62,8
CPT,25040,EXPLORE/TREAT WRIST JOINT,,,3179.6,6359.2,8
CPT,25065,BIOPSY FOREARM SOFT TISSUES,,,1604.96,3209.92,8
CPT,25066,BIOPSY FOREARM SOFT TISSUES,,,2822.69,5645.38,8
CPT,25071,EXC FOREARM LES SC 3 CM/>,,,1604.96,3209.92,8
CPT,25073,EXC FOREARM TUM DEEP 3 CM/>,,,2822.69,5645.38,8
CPT,25075,EXC FOREARM LES SC < 3 CM,,,1604.96,3209.92,8
CPT,25076,EXC FOREARM TUM DEEP < 3 CM,,,1604.96,3209.92,8
CPT,25077,RESECT FOREARM/WRIST TUM<3CM,,,2822.69,5645.38,8
CPT,25078,RESECT FORARM/WRIST TUM 3CM>,,,2822.69,5645.38,8
CPT,25085,INCISION OF WRIST CAPSULE,,,3179.6,6359.2,8
CPT,250U,ONC SLD ORG NEO DNA 505 GENE,,,2919.6,5839.2,8
CPT,25100,BIOPSY OF WRIST JOINT,,,3179.6,6359.2,8
CPT,25101,EXPLORE/TREAT WRIST JOINT,,,3179.6,6359.2,8
CPT,25105,REMOVE WRIST JOINT LINING,,,3179.6,6359.2,8
CPT,25107,REMOVE WRIST JOINT CARTILAGE,,,3179.6,6359.2,8
CPT,25109,EXCISE TENDON FOREARM/WRIST,,,3179.6,6359.2,8
CPT,25110,REMOVE WRIST TENDON LESION,,,1562.58,3125.16,8
CPT,25111,REMOVE WRIST TENDON LESION,,,1562.58,3125.16,8
CPT,25112,REREMOVE WRIST TENDON LESION,,,1562.58,3125.16,8
CPT,25115,REMOVE WRIST/FOREARM LESION,,,1562.58,3125.16,8
CPT,25116,REMOVE WRIST/FOREARM LESION,,,3179.6,6359.2,8
CPT,25118,EXCISE WRIST TENDON SHEATH,,,1562.58,3125.16,8
CPT,25119,PARTIAL REMOVAL OF ULNA,,,3179.6,6359.2,8
CPT,25120,REMOVAL OF FOREARM LESION,,,3179.6,6359.2,8
CPT,25125,REMOVE/GRAFT FOREARM LESION,,,1562.58,3125.16,8
CPT,25126,REMOVE/GRAFT FOREARM LESION,,,3179.6,6359.2,8
CPT,25130,REMOVAL OF WRIST LESION,,,3179.6,6359.2,8
CPT,25135,REMOVE & GRAFT WRIST LESION,,,7051.31,14102.62,8
CPT,25136,REMOVE & GRAFT WRIST LESION,,,7051.31,14102.62,8
CPT,25145,REMOVE FOREARM BONE LESION,,,3179.6,6359.2,8
CPT,25150,PARTIAL REMOVAL OF ULNA,,,3179.6,6359.2,8
CPT,25151,PARTIAL REMOVAL OF RADIUS,,,3179.6,6359.2,8
CPT,25170,RESECT RADIUS/ULNAR TUMOR,,,7051.31,14102.62,8
CPT,251U,HEPCIDIN-25 ELISA SERUM/PLSM,,,17.27,34.54,8
CPT,25210,REMOVAL OF WRIST BONE,,,3179.6,6359.2,8
CPT,25215,REMOVAL OF WRIST BONES,,,3179.6,6359.2,8
CPT,25230,PARTIAL REMOVAL OF RADIUS,,,3179.6,6359.2,8
CPT,25240,PARTIAL REMOVAL OF ULNA,,,3179.6,6359.2,8
CPT,25246,INJECTION FOR WRIST X-RAY,,,140.97,163.71,16
CPT,25248,REMOVE FOREARM FOREIGN BODY,,,1562.58,3125.16,8
CPT,25250,REMOVAL OF WRIST PROSTHESIS,,,1562.58,3125.16,8
CPT,25251,REMOVAL OF WRIST PROSTHESIS,,,3179.6,6359.2,8
CPT,25259,MANIPULATE WRIST W/ANESTHES,,,1562.58,3125.16,8
CPT,25260,REPAIR FOREARM TENDON/MUSCLE,,,3179.6,6359.2,8
CPT,25263,REPAIR FOREARM TENDON/MUSCLE,,,7051.31,14102.62,8
CPT,25265,REPAIR FOREARM TENDON/MUSCLE,,,3179.6,6359.2,8
CPT,25270,REPAIR FOREARM TENDON/MUSCLE,,,3179.6,6359.2,8
CPT,25272,REPAIR FOREARM TENDON/MUSCLE,,,3179.6,6359.2,8
CPT,25274,REPAIR FOREARM TENDON/MUSCLE,,,3179.6,6359.2,8
CPT,25275,REPAIR FOREARM TENDON SHEATH,,,3179.6,6359.2,8
CPT,25280,REVISE WRIST/FOREARM TENDON,,,3179.6,6359.2,8
CPT,25290,INCISE WRIST/FOREARM TENDON,,,3179.6,6359.2,8
CPT,25295,RELEASE WRIST/FOREARM TENDON,,,3179.6,6359.2,8
CPT,252U,FTL ANEUPLOIDY STR ALYS DNA,,,759.05,1518.1,8
CPT,25300,FUSION OF TENDONS AT WRIST,,,3179.6,6359.2,8
CPT,25301,FUSION OF TENDONS AT WRIST,,,3179.6,6359.2,8
CPT,25310,TRANSPLANT FOREARM TENDON,,,3179.6,6359.2,8
CPT,25312,TRANSPLANT FOREARM TENDON,,,3179.6,6359.2,8
CPT,25315,REVISE PALSY HAND TENDON(S),,,7051.31,14102.62,8
CPT,25316,REVISE PALSY HAND TENDON(S),,,7051.31,14102.62,8
CPT,25320,REPAIR/REVISE WRIST JOINT,,,7051.31,14102.62,8
CPT,25332,REVISE WRIST JOINT,,,3179.6,6359.2,8
CPT,25335,REALIGNMENT OF HAND,,,3179.6,6359.2,8
CPT,25337,RECONSTRUCT ULNA/RADIOULNAR,,,7051.31,14102.62,8
CPT,25350,REVISION OF RADIUS,,,7051.31,14102.62,8
CPT,25355,REVISION OF RADIUS,,,3179.6,6359.2,8
CPT,25360,REVISION OF ULNA,,,7051.31,14102.62,8
CPT,25365,REVISE RADIUS & ULNA,,,12476.14,24952.28,8
CPT,25370,REVISE RADIUS OR ULNA,,,3179.6,6359.2,8
CPT,25375,REVISE RADIUS & ULNA,,,3179.6,6359.2,8
CPT,25390,SHORTEN RADIUS OR ULNA,,,7051.31,14102.62,8
CPT,25391,LENGTHEN RADIUS OR ULNA,,,12476.14,24952.28,8
CPT,25392,SHORTEN RADIUS & ULNA,,,7051.31,14102.62,8
CPT,25393,LENGTHEN RADIUS & ULNA,,,7051.31,14102.62,8
CPT,25394,REPAIR CARPAL BONE SHORTEN,,,3179.6,6359.2,8
CPT,253T,INSERT AQUEOUS DRAIN DEVICE,,,4016.7,8033.4,8
CPT,253U,RPRDTVE MED RNA GEN PRFL 238,,,3159.42,6318.84,8
CPT,25400,REPAIR RADIUS OR ULNA,,,7051.31,14102.62,8
CPT,25405,REPAIR/GRAFT RADIUS OR ULNA,,,7051.31,14102.62,8
CPT,25415,REPAIR RADIUS & ULNA,,,7051.31,14102.62,8
CPT,25420,REPAIR/GRAFT RADIUS & ULNA,,,7051.31,14102.62,8
CPT,25425,REPAIR/GRAFT RADIUS OR ULNA,,,7051.31,14102.62,8
CPT,25426,REPAIR/GRAFT RADIUS & ULNA,,,3179.6,6359.2,8
CPT,25430,VASC GRAFT INTO CARPAL BONE,,,3179.6,6359.2,8
CPT,25431,REPAIR NONUNION CARPAL BONE,,,7051.31,14102.62,8
CPT,25440,REPAIR/GRAFT WRIST BONE,,,7051.31,14102.62,8
CPT,25441,RECONSTRUCT WRIST JOINT,,,12476.14,24952.28,8
CPT,25442,RECONSTRUCT WRIST JOINT,,,17038.69,34077.38,8
CPT,25443,RECONSTRUCT WRIST JOINT,,,7051.31,14102.62,8
CPT,25444,RECONSTRUCT WRIST JOINT,,,12476.14,24952.28,8
CPT,25445,RECONSTRUCT WRIST JOINT,,,7051.31,14102.62,8
CPT,25446,WRIST REPLACEMENT,,,17038.69,34077.38,8
CPT,25447,REPAIR WRIST JOINTS,,,3179.6,6359.2,8
CPT,25448,"Arthroplasty, intercarpal or carpometacarpal joints; suspension, including transfer or transplant of tendon, with interposition, when performed",,,3179.6,6359.2,8
CPT,25449,REMOVE WRIST JOINT IMPLANT,,,7051.31,14102.62,8
CPT,25450,REVISION OF WRIST JOINT,,,3179.6,6359.2,8
CPT,25455,REVISION OF WRIST JOINT,,,3179.6,6359.2,8
CPT,25490,REINFORCE RADIUS,,,7051.31,14102.62,8
CPT,25491,REINFORCE ULNA,,,12476.14,24952.28,8
CPT,25492,REINFORCE RADIUS AND ULNA,,,3179.6,6359.2,8
CPT,254U,REPRDTVE MED ALYS 24 CHRMSM,,,759.05,1518.1,8
CPT,25500,TREAT FRACTURE OF RADIUS,,,239.7,479.4,8
CPT,25505,TREAT FRACTURE OF RADIUS,,,1562.58,3125.16,8
CPT,25515,TREAT FRACTURE OF RADIUS,,,7051.31,14102.62,8
CPT,25520,TREAT FRACTURE OF RADIUS,,,1562.58,3125.16,8
CPT,25525,TREAT FRACTURE OF RADIUS,,,7051.31,14102.62,8
CPT,25526,TREAT FRACTURE OF RADIUS,,,7051.31,14102.62,8
CPT,25530,TREAT FRACTURE OF ULNA,,,239.7,479.4,8
CPT,25535,TREAT FRACTURE OF ULNA,,,239.7,479.4,8
CPT,25545,TREAT FRACTURE OF ULNA,,,7051.31,14102.62,8
CPT,25560,TREAT FRACTURE RADIUS & ULNA,,,239.7,479.4,8
CPT,25565,TREAT FRACTURE RADIUS & ULNA,,,1562.58,3125.16,8
CPT,25574,TREAT FRACTURE RADIUS & ULNA,,,7051.31,14102.62,8
CPT,25575,TREAT FRACTURE RADIUS/ULNA,,,7051.31,14102.62,8
CPT,255U,ANDROLOGY INFERTILITY ASSMT,,,31.6,63.2,8
CPT,25600,TREAT FRACTURE RADIUS/ULNA,,,239.7,479.4,8
CPT,25605,TREAT FRACTURE RADIUS/ULNA,,,1562.58,3125.16,8
CPT,25606,TREAT FX DISTAL RADIAL,,,3179.6,6359.2,8
CPT,25607,TREAT FX RAD EXTRA-ARTICUL,,,7051.31,14102.62,8
CPT,25608,TREAT FX RAD INTRA-ARTICUL,,,7051.31,14102.62,8
CPT,25609,TREAT FX RADIAL 3+ FRAG,,,7051.31,14102.62,8
CPT,25622,TREAT WRIST BONE FRACTURE,,,239.7,479.4,8
CPT,25624,TREAT WRIST BONE FRACTURE,,,1562.58,3125.16,8
CPT,25628,TREAT WRIST BONE FRACTURE,,,7051.31,14102.62,8
CPT,25630,TREAT WRIST BONE FRACTURE,,,239.7,479.4,8
CPT,25635,TREAT WRIST BONE FRACTURE,,,1562.58,3125.16,8
CPT,25645,TREAT WRIST BONE FRACTURE,,,3179.6,6359.2,8
CPT,25650,TREAT WRIST BONE FRACTURE,,,239.7,479.4,8
CPT,25651,PIN ULNAR STYLOID FRACTURE,,,3179.6,6359.2,8
CPT,25652,TREAT FRACTURE ULNAR STYLOID,,,7051.31,14102.62,8
CPT,25660,TREAT WRIST DISLOCATION,,,239.7,479.4,8
CPT,25670,TREAT WRIST DISLOCATION,,,7051.31,14102.62,8
CPT,25671,PIN RADIOULNAR DISLOCATION,,,3179.6,6359.2,8
CPT,25675,TREAT WRIST DISLOCATION,,,239.7,479.4,8
CPT,25676,TREAT WRIST DISLOCATION,,,7051.31,14102.62,8
CPT,25680,TREAT WRIST FRACTURE,,,239.7,479.4,8
CPT,25685,TREAT WRIST FRACTURE,,,7051.31,14102.62,8
CPT,25690,TREAT WRIST DISLOCATION,,,1562.58,3125.16,8
CPT,25695,TREAT WRIST DISLOCATION,,,7051.31,14102.62,8
CPT,256U,TMA/TMAO PRFL MS/MS UR ALG,,,159.95,319.9,8
CPT,257U,VLCAD LEUK NZM ACTV WHL BLD,,,712.47,1424.94,8
CPT,25800,FUSION OF WRIST JOINT,,,7051.31,14102.62,8
CPT,25805,FUSION/GRAFT OF WRIST JOINT,,,7051.31,14102.62,8
CPT,25810,FUSION/GRAFT OF WRIST JOINT,,,12476.14,24952.28,8
CPT,25820,FUSION OF HAND BONES,,,7051.31,14102.62,8
CPT,25825,FUSE HAND BONES WITH GRAFT,,,7051.31,14102.62,8
CPT,25830,FUSION RADIOULNAR JNT/ULNA,,,7051.31,14102.62,8
CPT,258U,AI PSOR MRNA 50-100 GEN ALG,,,3675.0,7350.0,8
CPT,25900,AMPUTATION OF FOREARM,,,7051.31,14102.62,8
CPT,25905,AMPUTATION OF FOREARM,,,7051.31,14102.62,8
CPT,25907,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,25909,AMPUTATION FOLLOW-UP SURGERY,,,7051.31,14102.62,8
CPT,25915,AMPUTATION OF FOREARM,,,7051.31,14102.62,8
CPT,25920,AMPUTATE HAND AT WRIST,,,3179.6,6359.2,8
CPT,25922,AMPUTATE HAND AT WRIST,,,1562.58,3125.16,8
CPT,25924,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,25927,AMPUTATION OF HAND,,,3179.6,6359.2,8
CPT,25929,AMPUTATION FOLLOW-UP SURGERY,,,2005.02,4010.04,8
CPT,25931,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,25999,UNLISTED PX FOREARM/WRIST,,,239.7,479.4,8
CPT,259U,NEPH CKD NUC MRS MEAS GFR,,,52.71,105.42,8
CPT,25U,TENOFOVIR LIQ CHROM UR QUAN,,,114.43,228.86,8
CPT,26010,DRAINAGE OF FINGER ABSCESS,,,194.97,389.94,8
CPT,26011,DRAINAGE OF FINGER ABSCESS,,,1604.96,3209.92,8
CPT,26020,DRAIN HAND TENDON SHEATH,,,3179.6,6359.2,8
CPT,26025,DRAINAGE OF PALM BURSA,,,3179.6,6359.2,8
CPT,26030,DRAINAGE OF PALM BURSAS,,,3179.6,6359.2,8
CPT,26034,TREAT HAND BONE LESION,,,1562.58,3125.16,8
CPT,26035,DECOMPRESS FINGERS/HAND,,,3179.6,6359.2,8
CPT,26037,DECOMPRESS FINGERS/HAND,,,3179.6,6359.2,8
CPT,26040,RELEASE PALM CONTRACTURE,,,1562.58,3125.16,8
CPT,26045,RELEASE PALM CONTRACTURE,,,3179.6,6359.2,8
CPT,26055,INCISE FINGER TENDON SHEATH,,,1562.58,3125.16,8
CPT,26060,INCISION OF FINGER TENDON,,,1562.58,3125.16,8
CPT,26070,EXPLORE/TREAT HAND JOINT,,,1562.58,3125.16,8
CPT,26075,EXPLORE/TREAT FINGER JOINT,,,3179.6,6359.2,8
CPT,26080,EXPLORE/TREAT FINGER JOINT,,,1562.58,3125.16,8
CPT,260U,RARE DS ID OPT GENOME MAPG,,,1263.53,2527.06,8
CPT,26100,BIOPSY HAND JOINT LINING,,,3179.6,6359.2,8
CPT,26105,BIOPSY FINGER JOINT LINING,,,3179.6,6359.2,8
CPT,26110,BIOPSY FINGER JOINT LINING,,,1562.58,3125.16,8
CPT,26111,EXC HAND LES SC 1.5 CM/>,,,1604.96,3209.92,8
CPT,26113,EXC HAND TUM DEEP 1.5 CM/>,,,1604.96,3209.92,8
CPT,26115,EXC HAND LES SC < 1.5 CM,,,1604.96,3209.92,8
CPT,26116,EXC HAND TUM DEEP < 1.5 CM,,,1604.96,3209.92,8
CPT,26117,RAD RESECT HAND TUMOR < 3 CM,,,2822.69,5645.38,8
CPT,26118,RAD RESECT HAND TUMOR 3 CM/>,,,2822.69,5645.38,8
CPT,26121,RELEASE PALM CONTRACTURE,,,3179.6,6359.2,8
CPT,26123,RELEASE PALM CONTRACTURE,,,3179.6,6359.2,8
CPT,26125,RELEASE PALM CONTRACTURE,,,,,0
CPT,26130,REMOVE WRIST JOINT LINING,,,3179.6,6359.2,8
CPT,26135,REVISE FINGER JOINT EACH,,,3179.6,6359.2,8
CPT,26140,REVISE FINGER JOINT EACH,,,1562.58,3125.16,8
CPT,26145,TENDON EXCISION PALM/FINGER,,,1562.58,3125.16,8
CPT,26160,REMOVE TENDON SHEATH LESION,,,1562.58,3125.16,8
CPT,26170,REMOVAL OF PALM TENDON EACH,,,1562.58,3125.16,8
CPT,26180,REMOVAL OF FINGER TENDON,,,1562.58,3125.16,8
CPT,26185,REMOVE FINGER BONE,,,1562.58,3125.16,8
CPT,261U,ONC CLRCT CA IMG ALYS W/AI,,,2513.25,5026.5,8
CPT,26200,REMOVE HAND BONE LESION,,,1562.58,3125.16,8
CPT,26205,REMOVE/GRAFT BONE LESION,,,7051.31,14102.62,8
CPT,26210,REMOVAL OF FINGER LESION,,,1562.58,3125.16,8
CPT,26215,REMOVE/GRAFT FINGER LESION,,,3179.6,6359.2,8
CPT,26230,PARTIAL REMOVAL OF HAND BONE,,,3179.6,6359.2,8
CPT,26235,PARTIAL REMOVAL FINGER BONE,,,1562.58,3125.16,8
CPT,26236,PARTIAL REMOVAL FINGER BONE,,,1562.58,3125.16,8
CPT,26250,EXTENSIVE HAND SURGERY,,,3179.6,6359.2,8
CPT,26260,RESECT PROX FINGER TUMOR,,,3179.6,6359.2,8
CPT,26262,RESECT DISTAL FINGER TUMOR,,,1562.58,3125.16,8
CPT,262U,ONC SLD TUM RT-PCR 7 GEN,,,3200.0,6400.0,8
CPT,26320,REMOVAL OF IMPLANT FROM HAND,,,1604.96,3209.92,8
CPT,26340,MANIPULATE FINGER W/ANESTH,,,1562.58,3125.16,8
CPT,26341,MANIPULAT PALM CORD POST INJ,,,239.7,479.4,8
CPT,26350,REPAIR FINGER/HAND TENDON,,,3179.6,6359.2,8
CPT,26352,REPAIR/GRAFT HAND TENDON,,,7051.31,14102.62,8
CPT,26356,REPAIR FINGER/HAND TENDON,,,3179.6,6359.2,8
CPT,26357,REPAIR FINGER/HAND TENDON,,,3179.6,6359.2,8
CPT,26358,REPAIR/GRAFT HAND TENDON,,,7051.31,14102.62,8
CPT,26370,REPAIR FINGER/HAND TENDON,,,3179.6,6359.2,8
CPT,26372,REPAIR/GRAFT HAND TENDON,,,7051.31,14102.62,8
CPT,26373,REPAIR FINGER/HAND TENDON,,,3179.6,6359.2,8
CPT,26390,REVISE HAND/FINGER TENDON,,,7051.31,14102.62,8
CPT,26392,REPAIR/GRAFT HAND TENDON,,,7051.31,14102.62,8
CPT,263T,IM B1 MRW CEL THER CMPL,,,4232.51,8465.02,8
CPT,263U,NEURO ASD MEAS 16 C METBLT,,,750.0,1500.0,8
CPT,26410,REPAIR HAND TENDON,,,1562.58,3125.16,8
CPT,26412,REPAIR/GRAFT HAND TENDON,,,3179.6,6359.2,8
CPT,26415,EXCISION HAND/FINGER TENDON,,,3179.6,6359.2,8
CPT,26416,GRAFT HAND OR FINGER TENDON,,,3179.6,6359.2,8
CPT,26418,REPAIR FINGER TENDON,,,1562.58,3125.16,8
CPT,26420,REPAIR/GRAFT FINGER TENDON,,,3179.6,6359.2,8
CPT,26426,REPAIR FINGER/HAND TENDON,,,3179.6,6359.2,8
CPT,26428,REPAIR/GRAFT FINGER TENDON,,,3179.6,6359.2,8
CPT,26432,REPAIR FINGER TENDON,,,1562.58,3125.16,8
CPT,26433,REPAIR FINGER TENDON,,,3179.6,6359.2,8
CPT,26434,REPAIR/GRAFT FINGER TENDON,,,3179.6,6359.2,8
CPT,26437,REALIGNMENT OF TENDONS,,,3179.6,6359.2,8
CPT,26440,RELEASE PALM/FINGER TENDON,,,1562.58,3125.16,8
CPT,26442,RELEASE PALM & FINGER TENDON,,,3179.6,6359.2,8
CPT,26445,RELEASE HAND/FINGER TENDON,,,3179.6,6359.2,8
CPT,26449,RELEASE FOREARM/HAND TENDON,,,3179.6,6359.2,8
CPT,26450,INCISION OF PALM TENDON,,,3179.6,6359.2,8
CPT,26455,INCISION OF FINGER TENDON,,,1562.58,3125.16,8
CPT,26460,INCISE HAND/FINGER TENDON,,,1562.58,3125.16,8
CPT,26471,FUSION OF FINGER TENDONS,,,3179.6,6359.2,8
CPT,26474,FUSION OF FINGER TENDONS,,,1562.58,3125.16,8
CPT,26476,TENDON LENGTHENING,,,3179.6,6359.2,8
CPT,26477,TENDON SHORTENING,,,3179.6,6359.2,8
CPT,26478,LENGTHENING OF HAND TENDON,,,3179.6,6359.2,8
CPT,26479,SHORTENING OF HAND TENDON,,,3179.6,6359.2,8
CPT,26480,TRANSPLANT HAND TENDON,,,3179.6,6359.2,8
CPT,26483,TRANSPLANT/GRAFT HAND TENDON,,,3179.6,6359.2,8
CPT,26485,TRANSPLANT PALM TENDON,,,3179.6,6359.2,8
CPT,26489,TRANSPLANT/GRAFT PALM TENDON,,,3179.6,6359.2,8
CPT,26490,REVISE THUMB TENDON,,,3179.6,6359.2,8
CPT,26492,TENDON TRANSFER WITH GRAFT,,,3179.6,6359.2,8
CPT,26494,HAND TENDON/MUSCLE TRANSFER,,,3179.6,6359.2,8
CPT,26496,REVISE THUMB TENDON,,,3179.6,6359.2,8
CPT,26497,FINGER TENDON TRANSFER,,,3179.6,6359.2,8
CPT,26498,FINGER TENDON TRANSFER,,,3179.6,6359.2,8
CPT,26499,REVISION OF FINGER,,,3179.6,6359.2,8
CPT,264T,IM B1 MRW CEL THER XCL HRVST,,,4232.51,8465.02,8
CPT,264U,RARE DS ID OPT GENOME MAPG,,,1263.53,2527.06,8
CPT,26500,HAND TENDON RECONSTRUCTION,,,7051.31,14102.62,8
CPT,26502,HAND TENDON RECONSTRUCTION,,,3179.6,6359.2,8
CPT,26508,RELEASE THUMB CONTRACTURE,,,3179.6,6359.2,8
CPT,26510,THUMB TENDON TRANSFER,,,3179.6,6359.2,8
CPT,26516,FUSION OF KNUCKLE JOINT,,,3179.6,6359.2,8
CPT,26517,FUSION OF KNUCKLE JOINTS,,,3179.6,6359.2,8
CPT,26518,FUSION OF KNUCKLE JOINTS,,,7051.31,14102.62,8
CPT,26520,RELEASE KNUCKLE CONTRACTURE,,,3179.6,6359.2,8
CPT,26525,RELEASE FINGER CONTRACTURE,,,1562.58,3125.16,8
CPT,26530,REVISE KNUCKLE JOINT,,,7051.31,14102.62,8
CPT,26531,REVISE KNUCKLE WITH IMPLANT,,,7051.31,14102.62,8
CPT,26535,REVISE FINGER JOINT,,,3179.6,6359.2,8
CPT,26536,REVISE/IMPLANT FINGER JOINT,,,7051.31,14102.62,8
CPT,26540,REPAIR HAND JOINT,,,3179.6,6359.2,8
CPT,26541,REPAIR HAND JOINT WITH GRAFT,,,3179.6,6359.2,8
CPT,26542,REPAIR HAND JOINT WITH GRAFT,,,3179.6,6359.2,8
CPT,26545,RECONSTRUCT FINGER JOINT,,,3179.6,6359.2,8
CPT,26546,REPAIR NONUNION HAND,,,7051.31,14102.62,8
CPT,26548,RECONSTRUCT FINGER JOINT,,,3179.6,6359.2,8
CPT,26550,CONSTRUCT THUMB REPLACEMENT,,,3179.6,6359.2,8
CPT,26551,GREAT TOE-HAND TRANSFER,,,7051.31,14102.62,8
CPT,26553,SINGLE TRANSFER TOE-HAND,,,7051.31,14102.62,8
CPT,26554,DOUBLE TRANSFER TOE-HAND,,,7051.31,14102.62,8
CPT,26555,POSITIONAL CHANGE OF FINGER,,,7051.31,14102.62,8
CPT,26556,TOE JOINT TRANSFER,,,7051.31,14102.62,8
CPT,26560,REPAIR OF WEB FINGER,,,1562.58,3125.16,8
CPT,26561,REPAIR OF WEB FINGER,,,3179.6,6359.2,8
CPT,26562,REPAIR OF WEB FINGER,,,3179.6,6359.2,8
CPT,26565,CORRECT METACARPAL FLAW,,,3179.6,6359.2,8
CPT,26567,CORRECT FINGER DEFORMITY,,,3179.6,6359.2,8
CPT,26568,LENGTHEN METACARPAL/FINGER,,,7051.31,14102.62,8
CPT,26580,REPAIR HAND DEFORMITY,,,3179.6,6359.2,8
CPT,26587,RECONSTRUCT EXTRA FINGER,,,3179.6,6359.2,8
CPT,26590,REPAIR FINGER DEFORMITY,,,1562.58,3125.16,8
CPT,26591,REPAIR MUSCLES OF HAND,,,3179.6,6359.2,8
CPT,26593,RELEASE MUSCLES OF HAND,,,3179.6,6359.2,8
CPT,26596,EXCISION CONSTRICTING TISSUE,,,3179.6,6359.2,8
CPT,265T,IM B1 MRW CEL THER HRVST ONL,,,4232.51,8465.02,8
CPT,265U,RAR DO WHL GN&MTCDRL DNA ALS,,,5475.8,10951.6,8
CPT,26600,TREAT METACARPAL FRACTURE,,,239.7,479.4,8
CPT,26605,TREAT METACARPAL FRACTURE,,,239.7,479.4,8
CPT,26607,TREAT METACARPAL FRACTURE,,,3179.6,6359.2,8
CPT,26608,TREAT METACARPAL FRACTURE,,,3179.6,6359.2,8
CPT,26615,TREAT METACARPAL FRACTURE,,,3179.6,6359.2,8
CPT,26641,TREAT THUMB DISLOCATION,,,239.7,479.4,8
CPT,26645,TREAT THUMB FRACTURE,,,1562.58,3125.16,8
CPT,26650,TREAT THUMB FRACTURE,,,3179.6,6359.2,8
CPT,26665,TREAT THUMB FRACTURE,,,3179.6,6359.2,8
CPT,26670,TREAT HAND DISLOCATION,,,239.7,479.4,8
CPT,26675,TREAT HAND DISLOCATION,,,1562.58,3125.16,8
CPT,26676,PIN HAND DISLOCATION,,,3179.6,6359.2,8
CPT,26685,TREAT HAND DISLOCATION,,,3179.6,6359.2,8
CPT,26686,TREAT HAND DISLOCATION,,,3179.6,6359.2,8
CPT,266T,IMPLT/RPL CRTD SNS DEV TOTAL,,,,,0
CPT,266U,UNXPL CNST HRTBL DO GN XPRSN,,,3200.0,6400.0,8
CPT,26700,TREAT KNUCKLE DISLOCATION,,,239.7,479.4,8
CPT,26705,TREAT KNUCKLE DISLOCATION,,,1562.58,3125.16,8
CPT,26706,PIN KNUCKLE DISLOCATION,,,3179.6,6359.2,8
CPT,26715,TREAT KNUCKLE DISLOCATION,,,3179.6,6359.2,8
CPT,26720,TREAT FINGER FRACTURE EACH,,,239.7,479.4,8
CPT,26725,TREAT FINGER FRACTURE EACH,,,239.7,479.4,8
CPT,26727,TREAT FINGER FRACTURE EACH,,,3179.6,6359.2,8
CPT,26735,TREAT FINGER FRACTURE EACH,,,3179.6,6359.2,8
CPT,26740,TREAT FINGER FRACTURE EACH,,,239.7,479.4,8
CPT,26742,TREAT FINGER FRACTURE EACH,,,1562.58,3125.16,8
CPT,26746,TREAT FINGER FRACTURE EACH,,,3179.6,6359.2,8
CPT,26750,TREAT FINGER FRACTURE EACH,,,239.7,479.4,8
CPT,26755,TREAT FINGER FRACTURE EACH,,,239.7,479.4,8
CPT,26756,PIN FINGER FRACTURE EACH,,,3179.6,6359.2,8
CPT,26765,TREAT FINGER FRACTURE EACH,,,3179.6,6359.2,8
CPT,26770,TREAT FINGER DISLOCATION,,,239.7,479.4,8
CPT,26775,TREAT FINGER DISLOCATION,,,271.79,543.58,8
CPT,26776,PIN FINGER DISLOCATION,,,3179.6,6359.2,8
CPT,26785,TREAT FINGER DISLOCATION,,,3179.6,6359.2,8
CPT,267T,IMPLT/RPL CRTD SNS DEV LEAD,,,,,0
CPT,267U,RARE DO ID OPT GEN MAPG&SEQ,,,6739.33,13478.66,8
CPT,26820,THUMB FUSION WITH GRAFT,,,7051.31,14102.62,8
CPT,26841,FUSION OF THUMB,,,7051.31,14102.62,8
CPT,26842,THUMB FUSION WITH GRAFT,,,7051.31,14102.62,8
CPT,26843,FUSION OF HAND JOINT,,,7051.31,14102.62,8
CPT,26844,FUSION/GRAFT OF HAND JOINT,,,7051.31,14102.62,8
CPT,26850,FUSION OF KNUCKLE,,,7051.31,14102.62,8
CPT,26852,FUSION OF KNUCKLE WITH GRAFT,,,7051.31,14102.62,8
CPT,26860,FUSION OF FINGER JOINT,,,3179.6,6359.2,8
CPT,26861,FUSION OF FINGER JNT ADD-ON,,,,,0
CPT,26862,FUSION/GRAFT OF FINGER JOINT,,,3179.6,6359.2,8
CPT,26863,FUSE/GRAFT ADDED JOINT,,,,,0
CPT,268T,IMPLT/RPL CRTD SNS DEV GEN,,,,,0
CPT,268U,HEM AHUS GEN SEQ ALYS 15 GEN,,,608.17,1216.34,8
CPT,26910,AMPUTATE METACARPAL BONE,,,3179.6,6359.2,8
CPT,26951,AMPUTATION OF FINGER/THUMB,,,3179.6,6359.2,8
CPT,26952,AMPUTATION OF FINGER/THUMB,,,3179.6,6359.2,8
CPT,26989,UNLISTED PX HANDS/FINGERS,,,239.7,479.4,8
CPT,26990,DRAINAGE OF PELVIS LESION,,,3179.6,6359.2,8
CPT,26991,DRAINAGE OF PELVIS BURSA,,,1562.58,3125.16,8
CPT,26992,DRAINAGE OF BONE LESION,,,3179.6,6359.2,8
CPT,269T,REV/REMVL CRTD SNS DEV TOTAL,,,,,0
CPT,269U,HEM AUT DM CGEN TRMBCTPNA 22,,,608.17,1216.34,8
CPT,26U,ONC THYR DNA&MRNA 112 GENES,,,3600.0,7200.0,8
CPT,27000,INCISION OF HIP TENDON,,,1562.58,3125.16,8
CPT,27001,INCISION OF HIP TENDON,,,3179.6,6359.2,8
CPT,27003,INCISION OF HIP TENDON,,,7051.31,14102.62,8
CPT,27005,INCISION OF HIP TENDON,,,3179.6,6359.2,8
CPT,27006,INCISION OF HIP TENDONS,,,3179.6,6359.2,8
CPT,27025,INCISION OF HIP/THIGH FASCIA,,,3179.6,6359.2,8
CPT,27027,BUTTOCK FASCIOTOMY,,,7051.31,14102.62,8
CPT,27030,DRAINAGE OF HIP JOINT,,,7051.31,14102.62,8
CPT,27033,EXPLORATION OF HIP JOINT,,,7051.31,14102.62,8
CPT,27035,DENERVATION OF HIP JOINT,,,3179.6,6359.2,8
CPT,27036,EXCISION OF HIP JOINT/MUSCLE,,,7051.31,14102.62,8
CPT,27040,BIOPSY OF SOFT TISSUES,,,1604.96,3209.92,8
CPT,27041,BIOPSY OF SOFT TISSUES,,,1604.96,3209.92,8
CPT,27043,EXC HIP PELVIS LES SC 3 CM/>,,,2822.69,5645.38,8
CPT,27045,EXC HIP/PELV TUM DEEP 5 CM/>,,,2822.69,5645.38,8
CPT,27047,EXC HIP/PELVIS LES SC < 3 CM,,,2822.69,5645.38,8
CPT,27048,EXC HIP/PELV TUM DEEP < 5 CM,,,2822.69,5645.38,8
CPT,27049,RESECT HIP/PELV TUM < 5 CM,,,2822.69,5645.38,8
CPT,27050,BIOPSY OF SACROILIAC JOINT,,,1562.58,3125.16,8
CPT,27052,BIOPSY OF HIP JOINT,,,1562.58,3125.16,8
CPT,27054,REMOVAL OF HIP JOINT LINING,,,3179.6,6359.2,8
CPT,27057,BUTTOCK FASCIOTOMY W/DBRDMT,,,1562.58,3125.16,8
CPT,27059,RESECT HIP/PELV TUM 5 CM/>,,,2822.69,5645.38,8
CPT,27060,REMOVAL OF ISCHIAL BURSA,,,7051.31,14102.62,8
CPT,27062,REMOVE FEMUR LESION/BURSA,,,3179.6,6359.2,8
CPT,27065,REMOVE HIP BONE LES SUPER,,,7051.31,14102.62,8
CPT,27066,REMOVE HIP BONE LES DEEP,,,3179.6,6359.2,8
CPT,27067,REMOVE/GRAFT HIP BONE LESION,,,7051.31,14102.62,8
CPT,27070,PART REMOVE HIP BONE SUPER,,,3179.6,6359.2,8
CPT,27071,PART REMOVAL HIP BONE DEEP,,,3179.6,6359.2,8
CPT,27075,RESECT HIP TUMOR,,,7051.31,14102.62,8
CPT,27076,RESECT HIP TUM INCL ACETABUL,,,7051.31,14102.62,8
CPT,27077,RESECT HIP TUM W/INNOM BONE,,,7051.31,14102.62,8
CPT,27078,RSECT HIP TUM INCL FEMUR,,,7051.31,14102.62,8
CPT,27080,REMOVAL OF TAIL BONE,,,3179.6,6359.2,8
CPT,27086,REMOVE HIP FOREIGN BODY,,,2822.69,5645.38,8
CPT,27087,REMOVE HIP FOREIGN BODY,,,3179.6,6359.2,8
CPT,27090,REMOVAL OF HIP PROSTHESIS,,,7051.31,14102.62,8
CPT,27091,REMOVAL OF HIP PROSTHESIS,,,12476.14,24952.28,8
CPT,27093,INJECTION FOR HIP X-RAY,,,157.48,182.88,16
CPT,27095,INJECTION FOR HIP X-RAY,,,189.8,220.41,16
CPT,27096,INJECT SACROILIAC JOINT,,,147.64,171.45,16
CPT,27097,REVISION OF HIP TENDON,,,3179.6,6359.2,8
CPT,27098,TRANSFER TENDON TO PELVIS,,,3179.6,6359.2,8
CPT,270T,REV/REMVL CRTD SNS DEV LEAD,,,,,0
CPT,270U,HEM CGEN COAGJ DO 20 GENES,,,608.17,1216.34,8
CPT,27100,TRANSFER OF ABDOMINAL MUSCLE,,,7051.31,14102.62,8
CPT,27105,TRANSFER OF SPINAL MUSCLE,,,3179.6,6359.2,8
CPT,27110,TRANSFER OF ILIOPSOAS MUSCLE,,,7051.31,14102.62,8
CPT,27111,TRANSFER OF ILIOPSOAS MUSCLE,,,3179.6,6359.2,8
CPT,27120,RECONSTRUCTION OF HIP SOCKET,,,12476.14,24952.28,8
CPT,27122,RECONSTRUCTION OF HIP SOCKET,,,7051.31,14102.62,8
CPT,27125,PARTIAL HIP REPLACEMENT,,,12476.14,24952.28,8
CPT,27130,TOTAL HIP ARTHROPLASTY,,,12476.14,24952.28,8
CPT,27132,TOTAL HIP ARTHROPLASTY,,,12476.14,24952.28,8
CPT,27134,REVISE HIP JOINT REPLACEMENT,,,12476.14,24952.28,8
CPT,27137,REVISE HIP JOINT REPLACEMENT,,,12476.14,24952.28,8
CPT,27138,REVISE HIP JOINT REPLACEMENT,,,12476.14,24952.28,8
CPT,27140,TRANSPLANT FEMUR RIDGE,,,7051.31,14102.62,8
CPT,27146,INCISION OF HIP BONE,,,7051.31,14102.62,8
CPT,27147,REVISION OF HIP BONE,,,7051.31,14102.62,8
CPT,27151,INCISION OF HIP BONES,,,7051.31,14102.62,8
CPT,27156,REVISION OF HIP BONES,,,7051.31,14102.62,8
CPT,27158,REVISION OF PELVIS,,,7051.31,14102.62,8
CPT,27161,INCISION OF NECK OF FEMUR,,,7051.31,14102.62,8
CPT,27165,INCISION/FIXATION OF FEMUR,,,7051.31,14102.62,8
CPT,27170,REPAIR/GRAFT FEMUR HEAD/NECK,,,7051.31,14102.62,8
CPT,27175,TREAT SLIPPED EPIPHYSIS,,,3179.6,6359.2,8
CPT,27176,TREAT SLIPPED EPIPHYSIS,,,3179.6,6359.2,8
CPT,27177,TREAT SLIPPED EPIPHYSIS,,,3179.6,6359.2,8
CPT,27178,TREAT SLIPPED EPIPHYSIS,,,3179.6,6359.2,8
CPT,27179,REVISE HEAD/NECK OF FEMUR,,,7051.31,14102.62,8
CPT,27181,TREAT SLIPPED EPIPHYSIS,,,7051.31,14102.62,8
CPT,27185,REVISION OF FEMUR EPIPHYSIS,,,3179.6,6359.2,8
CPT,27187,REINFORCE HIP BONES,,,7051.31,14102.62,8
CPT,27197,CLSD TX PELVIC RING FX,,,239.7,479.4,8
CPT,27198,CLSD TX PELVIC RING FX,,,239.7,479.4,8
CPT,271T,REV/REMVL CRTD SNS DEV GEN,,,,,0
CPT,271U,HEM CGEN NEUTROPENIA 24 GEN,,,608.17,1216.34,8
CPT,27200,TREAT TAIL BONE FRACTURE,,,239.7,479.4,8
CPT,27202,TREAT TAIL BONE FRACTURE,,,3179.6,6359.2,8
CPT,27215,TREAT PELVIC FRACTURE(S),,,,,0
CPT,27216,TREAT PELVIC RING FRACTURE,,,,,0
CPT,27217,TREAT PELVIC RING FRACTURE,,,,,0
CPT,27218,TREAT PELVIC RING FRACTURE,,,,,0
CPT,27220,TREAT HIP SOCKET FRACTURE,,,239.7,479.4,8
CPT,27222,TREAT HIP SOCKET FRACTURE,,,239.7,479.4,8
CPT,27226,TREAT HIP WALL FRACTURE,,,7051.31,14102.62,8
CPT,27227,TREAT HIP FRACTURE(S),,,7051.31,14102.62,8
CPT,27228,TREAT HIP FRACTURE(S),,,7051.31,14102.62,8
CPT,27230,TREAT THIGH FRACTURE,,,239.7,479.4,8
CPT,27232,TREAT THIGH FRACTURE,,,1562.58,3125.16,8
CPT,27235,TREAT THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27236,TREAT THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27238,TREAT THIGH FRACTURE,,,1562.58,3125.16,8
CPT,27240,TREAT THIGH FRACTURE,,,1562.58,3125.16,8
CPT,27244,TREAT THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27245,TREAT THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27246,TREAT THIGH FRACTURE,,,239.7,479.4,8
CPT,27248,TREAT THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27250,TREAT HIP DISLOCATION,,,239.7,479.4,8
CPT,27252,TREAT HIP DISLOCATION,,,1562.58,3125.16,8
CPT,27253,TREAT HIP DISLOCATION,,,3179.6,6359.2,8
CPT,27254,TREAT HIP DISLOCATION,,,7051.31,14102.62,8
CPT,27256,TREAT HIP DISLOCATION,,,239.7,479.4,8
CPT,27257,TREAT HIP DISLOCATION,,,1562.58,3125.16,8
CPT,27258,TREAT HIP DISLOCATION,,,3179.6,6359.2,8
CPT,27259,TREAT HIP DISLOCATION,,,3179.6,6359.2,8
CPT,27265,TREAT HIP DISLOCATION,,,239.7,479.4,8
CPT,27266,TREAT HIP DISLOCATION,,,1562.58,3125.16,8
CPT,27267,CLTX THIGH FX,,,3179.6,6359.2,8
CPT,27268,CLTX THIGH FX W/MNPJ,,,1562.58,3125.16,8
CPT,27269,OPTX THIGH FX,,,7051.31,14102.62,8
CPT,27275,MANIPULATION OF HIP JOINT,,,1562.58,3125.16,8
CPT,27278,ARTHRD SI JT PRQ WO TFXJ DEV,,,17038.69,34077.38,8
CPT,27279,ARTHRD SI JT PERQ/MIN NVAS,,,17038.69,34077.38,8
CPT,27280,ARTHR SI JT OPN B1GRF INSTRM,,,17038.69,34077.38,8
CPT,27282,ARTHRODESIS SYMPHYSIS PUBIS,,,3179.6,6359.2,8
CPT,27284,ARTHRODESIS HIP JOINT,,,12476.14,24952.28,8
CPT,27286,ARTHRD HIP JT SBTRCHC OSTEOT,,,12476.14,24952.28,8
CPT,27290,AMPUTATION OF LEG AT HIP,,,17038.69,34077.38,8
CPT,27295,AMPUTATION OF LEG AT HIP,,,17038.69,34077.38,8
CPT,27299,UNLISTED PX PELVIS/HIP JOINT,,,239.7,479.4,8
CPT,272T,INTERROGATE CRTD SNS DEV,,,,,0
CPT,272U,HEM GENETIC BLD DO 60 GENES,,,608.17,1216.34,8
CPT,27301,DRAIN THIGH/KNEE LESION,,,2822.69,5645.38,8
CPT,27303,DRAINAGE OF BONE LESION,,,3179.6,6359.2,8
CPT,27305,INCISE THIGH TENDON & FASCIA,,,3179.6,6359.2,8
CPT,27306,INCISION OF THIGH TENDON,,,3179.6,6359.2,8
CPT,27307,INCISION OF THIGH TENDONS,,,3179.6,6359.2,8
CPT,27310,EXPLORATION OF KNEE JOINT,,,3179.6,6359.2,8
CPT,27323,BIOPSY THIGH SOFT TISSUES,,,1604.96,3209.92,8
CPT,27324,BIOPSY THIGH SOFT TISSUES,,,2822.69,5645.38,8
CPT,27325,NEURECTOMY HAMSTRING,,,1897.58,3795.16,8
CPT,27326,NEURECTOMY POPLITEAL,,,1897.58,3795.16,8
CPT,27327,EXC THIGH/KNEE LES SC < 3 CM,,,1604.96,3209.92,8
CPT,27328,EXC THIGH/KNEE TUM DEEP <5CM,,,2822.69,5645.38,8
CPT,27329,RESECT THIGH/KNEE TUM < 5 CM,,,2822.69,5645.38,8
CPT,27330,BIOPSY KNEE JOINT LINING,,,3179.6,6359.2,8
CPT,27331,EXPLORE/TREAT KNEE JOINT,,,3179.6,6359.2,8
CPT,27332,REMOVAL OF KNEE CARTILAGE,,,3179.6,6359.2,8
CPT,27333,REMOVAL OF KNEE CARTILAGE,,,3179.6,6359.2,8
CPT,27334,REMOVE KNEE JOINT LINING,,,3179.6,6359.2,8
CPT,27335,REMOVE KNEE JOINT LINING,,,7051.31,14102.62,8
CPT,27337,EXC THIGH/KNEE LES SC 3 CM/>,,,2822.69,5645.38,8
CPT,27339,EXC THIGH/KNEE TUM DEP 5CM/>,,,2822.69,5645.38,8
CPT,27340,REMOVAL OF KNEECAP BURSA,,,3179.6,6359.2,8
CPT,27345,REMOVAL OF KNEE CYST,,,3179.6,6359.2,8
CPT,27347,REMOVE KNEE CYST,,,3179.6,6359.2,8
CPT,27350,REMOVAL OF KNEECAP,,,7051.31,14102.62,8
CPT,27355,REMOVE FEMUR LESION,,,3179.6,6359.2,8
CPT,27356,REMOVE FEMUR LESION/GRAFT,,,12476.14,24952.28,8
CPT,27357,REMOVE FEMUR LESION/GRAFT,,,7051.31,14102.62,8
CPT,27358,REMOVE FEMUR LESION/FIXATION,,,,,0
CPT,27360,PARTIAL REMOVAL LEG BONE(S),,,3179.6,6359.2,8
CPT,27364,RESECT THIGH/KNEE TUM 5 CM/>,,,2822.69,5645.38,8
CPT,27365,RESECT FEMUR/KNEE TUMOR,,,3179.6,6359.2,8
CPT,27369,NJX CNTRST KNE ARTHG/CT/MRI,,,,,0
CPT,27372,REMOVAL OF FOREIGN BODY,,,2822.69,5645.38,8
CPT,27380,REPAIR OF KNEECAP TENDON,,,7051.31,14102.62,8
CPT,27381,REPAIR/GRAFT KNEECAP TENDON,,,7051.31,14102.62,8
CPT,27385,REPAIR OF THIGH MUSCLE,,,7051.31,14102.62,8
CPT,27386,REPAIR/GRAFT OF THIGH MUSCLE,,,7051.31,14102.62,8
CPT,27390,INCISION OF THIGH TENDON,,,3179.6,6359.2,8
CPT,27391,INCISION OF THIGH TENDONS,,,3179.6,6359.2,8
CPT,27392,INCISION OF THIGH TENDONS,,,3179.6,6359.2,8
CPT,27393,LENGTHENING OF THIGH TENDON,,,7051.31,14102.62,8
CPT,27394,LENGTHENING OF THIGH TENDONS,,,7051.31,14102.62,8
CPT,27395,LENGTHENING OF THIGH TENDONS,,,3179.6,6359.2,8
CPT,27396,TRANSPLANT OF THIGH TENDON,,,7051.31,14102.62,8
CPT,27397,TRANSPLANTS OF THIGH TENDONS,,,7051.31,14102.62,8
CPT,273T,INTERROGATE CRTD SNS W/PGRMG,,,,,0
CPT,273U,HEM GEN HYPRFIBRNLYSIS 8 GEN,,,608.17,1216.34,8
CPT,27400,REVISE THIGH MUSCLES/TENDONS,,,7051.31,14102.62,8
CPT,27403,REPAIR OF KNEE CARTILAGE,,,7051.31,14102.62,8
CPT,27405,REPAIR OF KNEE LIGAMENT,,,7051.31,14102.62,8
CPT,27407,REPAIR OF KNEE LIGAMENT,,,7051.31,14102.62,8
CPT,27409,REPAIR OF KNEE LIGAMENTS,,,7051.31,14102.62,8
CPT,27412,AUTOCHONDROCYTE IMPLANT KNEE,,,7051.31,14102.62,8
CPT,27415,OSTEOCHONDRAL KNEE ALLOGRAFT,,,12476.14,24952.28,8
CPT,27416,OSTEOCHONDRAL KNEE AUTOGRAFT,,,7051.31,14102.62,8
CPT,27418,REPAIR DEGENERATED KNEECAP,,,7051.31,14102.62,8
CPT,27420,REVISION OF UNSTABLE KNEECAP,,,7051.31,14102.62,8
CPT,27422,REVISION OF UNSTABLE KNEECAP,,,7051.31,14102.62,8
CPT,27424,REVISION/REMOVAL OF KNEECAP,,,7051.31,14102.62,8
CPT,27425,LAT RETINACULAR RELEASE OPEN,,,3179.6,6359.2,8
CPT,27427,RECONSTRUCTION KNEE,,,7051.31,14102.62,8
CPT,27428,RECONSTRUCTION KNEE,,,12476.14,24952.28,8
CPT,27429,RECONSTRUCTION KNEE,,,12476.14,24952.28,8
CPT,27430,REVISION OF THIGH MUSCLES,,,7051.31,14102.62,8
CPT,27435,INCISION OF KNEE JOINT,,,3179.6,6359.2,8
CPT,27437,REVISE KNEECAP,,,7051.31,14102.62,8
CPT,27438,REVISE KNEECAP WITH IMPLANT,,,12476.14,24952.28,8
CPT,27440,REVISION OF KNEE JOINT,,,12476.14,24952.28,8
CPT,27441,REVISION OF KNEE JOINT,,,12476.14,24952.28,8
CPT,27442,REVISION OF KNEE JOINT,,,12476.14,24952.28,8
CPT,27443,REVISION OF KNEE JOINT,,,12476.14,24952.28,8
CPT,27445,REVISION OF KNEE JOINT,,,,,0
CPT,27446,REVISION OF KNEE JOINT,,,12476.14,24952.28,8
CPT,27447,TOTAL KNEE ARTHROPLASTY,,,12476.14,24952.28,8
CPT,27448,INCISION OF THIGH,,,7051.31,14102.62,8
CPT,27450,INCISION OF THIGH,,,7051.31,14102.62,8
CPT,27454,REALIGNMENT OF THIGH BONE,,,7051.31,14102.62,8
CPT,27455,REALIGNMENT OF KNEE,,,7051.31,14102.62,8
CPT,27457,REALIGNMENT OF KNEE,,,7051.31,14102.62,8
CPT,27465,SHORTENING OF THIGH BONE,,,7051.31,14102.62,8
CPT,27466,LENGTHENING OF THIGH BONE,,,7051.31,14102.62,8
CPT,27468,SHORTEN/LENGTHEN THIGHS,,,,,0
CPT,27470,REPAIR OF THIGH,,,7051.31,14102.62,8
CPT,27472,REPAIR/GRAFT OF THIGH,,,7051.31,14102.62,8
CPT,27475,SURGERY TO STOP LEG GROWTH,,,7051.31,14102.62,8
CPT,27477,SURGERY TO STOP LEG GROWTH,,,7051.31,14102.62,8
CPT,27479,SURGERY TO STOP LEG GROWTH,,,7051.31,14102.62,8
CPT,27485,SURGERY TO STOP LEG GROWTH,,,7051.31,14102.62,8
CPT,27486,REVISE/REPLACE KNEE JOINT,,,12476.14,24952.28,8
CPT,27487,REVISE/REPLACE KNEE JOINT,,,17038.69,34077.38,8
CPT,27488,REMOVAL OF KNEE PROSTHESIS,,,12476.14,24952.28,8
CPT,27495,REINFORCE THIGH,,,7051.31,14102.62,8
CPT,27496,DECOMPRESSION OF THIGH/KNEE,,,3179.6,6359.2,8
CPT,27497,DECOMPRESSION OF THIGH/KNEE,,,3179.6,6359.2,8
CPT,27498,DECOMPRESSION OF THIGH/KNEE,,,1562.58,3125.16,8
CPT,27499,DECOMPRESSION OF THIGH/KNEE,,,7051.31,14102.62,8
CPT,274T,PERQ LAMOT/LAM CRV/THRC,,,7051.31,14102.62,8
CPT,274U,HEM GEN PLTLT DO 62 GENES,,,608.17,1216.34,8
CPT,27500,TREATMENT OF THIGH FRACTURE,,,239.7,479.4,8
CPT,27501,TREATMENT OF THIGH FRACTURE,,,239.7,479.4,8
CPT,27502,TREATMENT OF THIGH FRACTURE,,,1562.58,3125.16,8
CPT,27503,TREATMENT OF THIGH FRACTURE,,,1562.58,3125.16,8
CPT,27506,TREATMENT OF THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27507,TREATMENT OF THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27508,TREATMENT OF THIGH FRACTURE,,,239.7,479.4,8
CPT,27509,TREATMENT OF THIGH FRACTURE,,,7051.31,14102.62,8
CPT,27510,TREATMENT OF THIGH FRACTURE,,,1562.58,3125.16,8
CPT,27511,TREATMENT OF THIGH FRACTURE,,,12476.14,24952.28,8
CPT,27513,TREATMENT OF THIGH FRACTURE,,,12476.14,24952.28,8
CPT,27514,TREATMENT OF THIGH FRACTURE,,,12476.14,24952.28,8
CPT,27516,TREAT THIGH FX GROWTH PLATE,,,239.7,479.4,8
CPT,27517,TREAT THIGH FX GROWTH PLATE,,,1562.58,3125.16,8
CPT,27519,TREAT THIGH FX GROWTH PLATE,,,7051.31,14102.62,8
CPT,27520,TREAT KNEECAP FRACTURE,,,239.7,479.4,8
CPT,27524,TREAT KNEECAP FRACTURE,,,7051.31,14102.62,8
CPT,27530,TREAT KNEE FRACTURE,,,239.7,479.4,8
CPT,27532,TREAT KNEE FRACTURE,,,3179.6,6359.2,8
CPT,27535,TREAT KNEE FRACTURE,,,7051.31,14102.62,8
CPT,27536,TREAT KNEE FRACTURE,,,7051.31,14102.62,8
CPT,27538,TREAT KNEE FRACTURE(S),,,239.7,479.4,8
CPT,27540,TREAT KNEE FRACTURE,,,7051.31,14102.62,8
CPT,27550,TREAT KNEE DISLOCATION,,,239.7,479.4,8
CPT,27552,TREAT KNEE DISLOCATION,,,1562.58,3125.16,8
CPT,27556,TREAT KNEE DISLOCATION,,,7051.31,14102.62,8
CPT,27557,TREAT KNEE DISLOCATION,,,7051.31,14102.62,8
CPT,27558,TREAT KNEE DISLOCATION,,,7051.31,14102.62,8
CPT,27560,TREAT KNEECAP DISLOCATION,,,239.7,479.4,8
CPT,27562,TREAT KNEECAP DISLOCATION,,,239.7,479.4,8
CPT,27566,TREAT KNEECAP DISLOCATION,,,7051.31,14102.62,8
CPT,27570,FIXATION OF KNEE JOINT,,,1562.58,3125.16,8
CPT,27580,FUSION OF KNEE,,,12476.14,24952.28,8
CPT,27590,AMPUTATE LEG AT THIGH,,,3179.6,6359.2,8
CPT,27591,AMPUTATE LEG AT THIGH,,,3179.6,6359.2,8
CPT,27592,AMPUTATE LEG AT THIGH,,,3179.6,6359.2,8
CPT,27594,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,27596,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,27598,AMPUTATE LOWER LEG AT KNEE,,,3179.6,6359.2,8
CPT,27599,UNLISTED PX FEMUR/KNEE,,,239.7,479.4,8
CPT,275T,PERQ LAMOT/LAM LUMBAR,,,,,0
CPT,275U,HEM HEPRN NDUC TRMBCTPNA SRM,,,18.37,36.74,8
CPT,27600,DECOMPRESSION OF LOWER LEG,,,3179.6,6359.2,8
CPT,27601,DECOMPRESSION OF LOWER LEG,,,3179.6,6359.2,8
CPT,27602,DECOMPRESSION OF LOWER LEG,,,3179.6,6359.2,8
CPT,27603,DRAIN LOWER LEG LESION,,,2822.69,5645.38,8
CPT,27604,DRAIN LOWER LEG BURSA,,,3179.6,6359.2,8
CPT,27605,INCISION OF ACHILLES TENDON,,,1562.58,3125.16,8
CPT,27606,INCISION OF ACHILLES TENDON,,,3179.6,6359.2,8
CPT,27607,TREAT LOWER LEG BONE LESION,,,3179.6,6359.2,8
CPT,27610,EXPLORE/TREAT ANKLE JOINT,,,3179.6,6359.2,8
CPT,27612,EXPLORATION OF ANKLE JOINT,,,3179.6,6359.2,8
CPT,27613,BIOPSY LOWER LEG SOFT TISSUE,,,1604.96,3209.92,8
CPT,27614,BIOPSY LOWER LEG SOFT TISSUE,,,2822.69,5645.38,8
CPT,27615,RESECT LEG/ANKLE TUM < 5 CM,,,2822.69,5645.38,8
CPT,27616,RESECT LEG/ANKLE TUM 5 CM/>,,,2822.69,5645.38,8
CPT,27618,EXC LEG/ANKLE TUM < 3 CM,,,1604.96,3209.92,8
CPT,27619,EXC LEG/ANKLE TUM DEEP <5 CM,,,2822.69,5645.38,8
CPT,27620,EXPLORE/TREAT ANKLE JOINT,,,3179.6,6359.2,8
CPT,27625,REMOVE ANKLE JOINT LINING,,,3179.6,6359.2,8
CPT,27626,REMOVE ANKLE JOINT LINING,,,3179.6,6359.2,8
CPT,27630,REMOVAL OF TENDON LESION,,,3179.6,6359.2,8
CPT,27632,EXC LEG/ANKLE LES SC 3 CM/>,,,2822.69,5645.38,8
CPT,27634,EXC LEG/ANKLE TUM DEP 5 CM/>,,,2822.69,5645.38,8
CPT,27635,REMOVE LOWER LEG BONE LESION,,,3179.6,6359.2,8
CPT,27637,REMOVE/GRAFT LEG BONE LESION,,,7051.31,14102.62,8
CPT,27638,REMOVE/GRAFT LEG BONE LESION,,,7051.31,14102.62,8
CPT,27640,PARTIAL REMOVAL OF TIBIA,,,3179.6,6359.2,8
CPT,27641,PARTIAL REMOVAL OF FIBULA,,,3179.6,6359.2,8
CPT,27645,RESECT TIBIA TUMOR,,,3179.6,6359.2,8
CPT,27646,RESECT FIBULA TUMOR,,,3179.6,6359.2,8
CPT,27647,RESECT TALUS/CALCANEUS TUM,,,3179.6,6359.2,8
CPT,27648,INJECTION FOR ANKLE X-RAY,,,132.31,153.66,16
CPT,27650,REPAIR ACHILLES TENDON,,,7051.31,14102.62,8
CPT,27652,REPAIR/GRAFT ACHILLES TENDON,,,7051.31,14102.62,8
CPT,27654,REPAIR OF ACHILLES TENDON,,,7051.31,14102.62,8
CPT,27656,REPAIR LEG FASCIA DEFECT,,,3179.6,6359.2,8
CPT,27658,REPAIR OF LEG TENDON EACH,,,3179.6,6359.2,8
CPT,27659,REPAIR OF LEG TENDON EACH,,,7051.31,14102.62,8
CPT,27664,REPAIR OF LEG TENDON EACH,,,7051.31,14102.62,8
CPT,27665,REPAIR OF LEG TENDON EACH,,,7051.31,14102.62,8
CPT,27675,REPAIR LOWER LEG TENDONS,,,3179.6,6359.2,8
CPT,27676,REPAIR LOWER LEG TENDONS,,,7051.31,14102.62,8
CPT,27680,RELEASE OF LOWER LEG TENDON,,,3179.6,6359.2,8
CPT,27681,RELEASE OF LOWER LEG TENDONS,,,3179.6,6359.2,8
CPT,27685,REVISION OF LOWER LEG TENDON,,,3179.6,6359.2,8
CPT,27686,REVISE LOWER LEG TENDONS,,,3179.6,6359.2,8
CPT,27687,REVISION OF CALF TENDON,,,3179.6,6359.2,8
CPT,27690,REVISE LOWER LEG TENDON,,,7051.31,14102.62,8
CPT,27691,REVISE LOWER LEG TENDON,,,7051.31,14102.62,8
CPT,27692,REVISE ADDITIONAL LEG TENDON,,,,,0
CPT,27695,REPAIR OF ANKLE LIGAMENT,,,7051.31,14102.62,8
CPT,27696,REPAIR OF ANKLE LIGAMENTS,,,7051.31,14102.62,8
CPT,27698,REPAIR OF ANKLE LIGAMENT,,,7051.31,14102.62,8
CPT,276U,HEM INH THROMBOCYTOPENIA 42,,,2448.56,4897.12,8
CPT,27700,REVISION OF ANKLE JOINT,,,7051.31,14102.62,8
CPT,27702,RECONSTRUCT ANKLE JOINT,,,26367.8,52735.6,8
CPT,27703,RECONSTRUCTION ANKLE JOINT,,,17038.69,34077.38,8
CPT,27704,REMOVAL OF ANKLE IMPLANT,,,3179.6,6359.2,8
CPT,27705,INCISION OF TIBIA,,,7051.31,14102.62,8
CPT,27707,INCISION OF FIBULA,,,3179.6,6359.2,8
CPT,27709,INCISION OF TIBIA & FIBULA,,,12476.14,24952.28,8
CPT,27712,REALIGNMENT OF LOWER LEG,,,12476.14,24952.28,8
CPT,27715,REVISION OF LOWER LEG,,,12476.14,24952.28,8
CPT,27720,REPAIR OF TIBIA,,,7051.31,14102.62,8
CPT,27722,REPAIR/GRAFT OF TIBIA,,,7051.31,14102.62,8
CPT,27724,REPAIR/GRAFT OF TIBIA,,,7051.31,14102.62,8
CPT,27725,REPAIR OF LOWER LEG,,,7051.31,14102.62,8
CPT,27726,REPAIR FIBULA NONUNION,,,7051.31,14102.62,8
CPT,27727,REPAIR OF LOWER LEG,,,3179.6,6359.2,8
CPT,27730,REPAIR OF TIBIA EPIPHYSIS,,,3179.6,6359.2,8
CPT,27732,REPAIR OF FIBULA EPIPHYSIS,,,3179.6,6359.2,8
CPT,27734,REPAIR LOWER LEG EPIPHYSES,,,3179.6,6359.2,8
CPT,27740,REPAIR OF LEG EPIPHYSES,,,3179.6,6359.2,8
CPT,27742,REPAIR OF LEG EPIPHYSES,,,3179.6,6359.2,8
CPT,27745,REINFORCE TIBIA,,,7051.31,14102.62,8
CPT,27750,TREATMENT OF TIBIA FRACTURE,,,239.7,479.4,8
CPT,27752,TREATMENT OF TIBIA FRACTURE,,,1562.58,3125.16,8
CPT,27756,TREATMENT OF TIBIA FRACTURE,,,7051.31,14102.62,8
CPT,27758,TREATMENT OF TIBIA FRACTURE,,,12476.14,24952.28,8
CPT,27759,TREATMENT OF TIBIA FRACTURE,,,12476.14,24952.28,8
CPT,27760,CLTX MEDIAL ANKLE FX,,,239.7,479.4,8
CPT,27762,CLTX MED ANKLE FX W/MNPJ,,,1562.58,3125.16,8
CPT,27766,OPTX MEDIAL ANKLE FX,,,7051.31,14102.62,8
CPT,27767,CLTX POST ANKLE FX,,,239.7,479.4,8
CPT,27768,CLTX POST ANKLE FX W/MNPJ,,,1562.58,3125.16,8
CPT,27769,OPTX POST ANKLE FX,,,7051.31,14102.62,8
CPT,27780,TREATMENT OF FIBULA FRACTURE,,,239.7,479.4,8
CPT,27781,TREATMENT OF FIBULA FRACTURE,,,1562.58,3125.16,8
CPT,27784,TREATMENT OF FIBULA FRACTURE,,,7051.31,14102.62,8
CPT,27786,TREATMENT OF ANKLE FRACTURE,,,239.7,479.4,8
CPT,27788,TREATMENT OF ANKLE FRACTURE,,,239.7,479.4,8
CPT,27792,TREATMENT OF ANKLE FRACTURE,,,7051.31,14102.62,8
CPT,277U,HEM GEN PLTLT FUNCJ DO 40,,,608.17,1216.34,8
CPT,27808,TREATMENT OF ANKLE FRACTURE,,,239.7,479.4,8
CPT,27810,TREATMENT OF ANKLE FRACTURE,,,1562.58,3125.16,8
CPT,27814,TREATMENT OF ANKLE FRACTURE,,,7051.31,14102.62,8
CPT,27816,TREATMENT OF ANKLE FRACTURE,,,239.7,479.4,8
CPT,27818,TREATMENT OF ANKLE FRACTURE,,,1562.58,3125.16,8
CPT,27822,TREATMENT OF ANKLE FRACTURE,,,7051.31,14102.62,8
CPT,27823,TREATMENT OF ANKLE FRACTURE,,,7051.31,14102.62,8
CPT,27824,TREAT LOWER LEG FRACTURE,,,239.7,479.4,8
CPT,27825,TREAT LOWER LEG FRACTURE,,,1562.58,3125.16,8
CPT,27826,TREAT LOWER LEG FRACTURE,,,7051.31,14102.62,8
CPT,27827,TREAT LOWER LEG FRACTURE,,,12476.14,24952.28,8
CPT,27828,TREAT LOWER LEG FRACTURE,,,12476.14,24952.28,8
CPT,27829,TREAT LOWER LEG JOINT,,,7051.31,14102.62,8
CPT,27830,TREAT LOWER LEG DISLOCATION,,,239.7,479.4,8
CPT,27831,TREAT LOWER LEG DISLOCATION,,,3179.6,6359.2,8
CPT,27832,TREAT LOWER LEG DISLOCATION,,,7051.31,14102.62,8
CPT,27840,TREAT ANKLE DISLOCATION,,,239.7,479.4,8
CPT,27842,TREAT ANKLE DISLOCATION,,,1562.58,3125.16,8
CPT,27846,TREAT ANKLE DISLOCATION,,,7051.31,14102.62,8
CPT,27848,TREAT ANKLE DISLOCATION,,,7051.31,14102.62,8
CPT,27860,FIXATION OF ANKLE JOINT,,,3179.6,6359.2,8
CPT,27870,FUSION OF ANKLE JOINT OPEN,,,12476.14,24952.28,8
CPT,27871,FUSION OF TIBIOFIBULAR JOINT,,,12476.14,24952.28,8
CPT,27880,AMPUTATION OF LOWER LEG,,,7051.31,14102.62,8
CPT,27881,AMPUTATION OF LOWER LEG,,,3179.6,6359.2,8
CPT,27882,AMPUTATION OF LOWER LEG,,,3179.6,6359.2,8
CPT,27884,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,27886,AMPUTATION FOLLOW-UP SURGERY,,,3179.6,6359.2,8
CPT,27888,AMPUTATION OF FOOT AT ANKLE,,,3179.6,6359.2,8
CPT,27889,AMPUTATION OF FOOT AT ANKLE,,,7051.31,14102.62,8
CPT,27892,DECOMPRESSION OF LEG,,,3179.6,6359.2,8
CPT,27893,DECOMPRESSION OF LEG,,,7051.31,14102.62,8
CPT,27894,DECOMPRESSION OF LEG,,,3179.6,6359.2,8
CPT,27899,UNLISTED PX LEG/ANKLE,,,239.7,479.4,8
CPT,278T,TEMPR,,,125.04,250.08,8
CPT,278U,HEM GEN THROMBOSIS 14 GENES,,,608.17,1216.34,8
CPT,279U,HEM VW FACTOR&CLGN III BNDG,,,11.53,23.06,8
CPT,27U,JAK2 GENE TRGT SEQ ALYS,,,121.91,243.82,8
CPT,28001,DRAINAGE OF BURSA OF FOOT,,,1604.96,3209.92,8
CPT,28002,TREATMENT OF FOOT INFECTION,,,1562.58,3125.16,8
CPT,28003,TREATMENT OF FOOT INFECTION,,,3179.6,6359.2,8
CPT,28005,TREAT FOOT BONE LESION,,,3179.6,6359.2,8
CPT,28008,INCISION OF FOOT FASCIA,,,3179.6,6359.2,8
CPT,28010,INCISION OF TOE TENDON,,,1562.58,3125.16,8
CPT,28011,INCISION OF TOE TENDONS,,,1562.58,3125.16,8
CPT,28020,EXPLORATION OF FOOT JOINT,,,3179.6,6359.2,8
CPT,28022,EXPLORATION OF FOOT JOINT,,,3179.6,6359.2,8
CPT,28024,EXPLORATION OF TOE JOINT,,,1562.58,3125.16,8
CPT,28035,DECOMPRESSION OF TIBIA NERVE,,,1897.58,3795.16,8
CPT,28039,EXC FOOT/TOE TUM SC 1.5 CM/>,,,2822.69,5645.38,8
CPT,28041,EXC FOOT/TOE TUM DEP 1.5CM/>,,,2822.69,5645.38,8
CPT,28043,EXC FOOT/TOE TUM SC < 1.5 CM,,,1604.96,3209.92,8
CPT,28045,EXC FOOT/TOE TUM DEEP <1.5CM,,,2822.69,5645.38,8
CPT,28046,RESECT FOOT/TOE TUMOR < 3 CM,,,2822.69,5645.38,8
CPT,28047,RESECT FOOT/TOE TUMOR 3 CM/>,,,2822.69,5645.38,8
CPT,28050,BIOPSY OF FOOT JOINT LINING,,,3179.6,6359.2,8
CPT,28052,BIOPSY OF FOOT JOINT LINING,,,3179.6,6359.2,8
CPT,28054,BIOPSY OF TOE JOINT LINING,,,3179.6,6359.2,8
CPT,28055,NEURECTOMY FOOT,,,1897.58,3795.16,8
CPT,28060,PARTIAL REMOVAL FOOT FASCIA,,,3179.6,6359.2,8
CPT,28062,REMOVAL OF FOOT FASCIA,,,3179.6,6359.2,8
CPT,28070,REMOVAL OF FOOT JOINT LINING,,,7051.31,14102.62,8
CPT,28072,REMOVAL OF FOOT JOINT LINING,,,3179.6,6359.2,8
CPT,28080,REMOVAL OF FOOT LESION,,,1562.58,3125.16,8
CPT,28086,EXCISE FOOT TENDON SHEATH,,,3179.6,6359.2,8
CPT,28088,EXCISE FOOT TENDON SHEATH,,,3179.6,6359.2,8
CPT,28090,REMOVAL OF FOOT LESION,,,1562.58,3125.16,8
CPT,28092,REMOVAL OF TOE LESIONS,,,1562.58,3125.16,8
CPT,280U,HEM VW FACTOR&CLGN IV BNDG,,,17.27,34.54,8
CPT,28100,REMOVAL OF ANKLE/HEEL LESION,,,3179.6,6359.2,8
CPT,28102,REMOVE/GRAFT FOOT LESION,,,7051.31,14102.62,8
CPT,28103,REMOVE/GRAFT FOOT LESION,,,7051.31,14102.62,8
CPT,28104,REMOVAL OF FOOT LESION,,,3179.6,6359.2,8
CPT,28106,REMOVE/GRAFT FOOT LESION,,,7051.31,14102.62,8
CPT,28107,REMOVE/GRAFT FOOT LESION,,,7051.31,14102.62,8
CPT,28108,REMOVAL OF TOE LESIONS,,,1562.58,3125.16,8
CPT,28110,PART REMOVAL OF METATARSAL,,,3179.6,6359.2,8
CPT,28111,PART REMOVAL OF METATARSAL,,,3179.6,6359.2,8
CPT,28112,PART REMOVAL OF METATARSAL,,,3179.6,6359.2,8
CPT,28113,PART REMOVAL OF METATARSAL,,,3179.6,6359.2,8
CPT,28114,REMOVAL OF METATARSAL HEADS,,,3179.6,6359.2,8
CPT,28116,REVISION OF FOOT,,,3179.6,6359.2,8
CPT,28118,REMOVAL OF HEEL BONE,,,3179.6,6359.2,8
CPT,28119,REMOVAL OF HEEL SPUR,,,3179.6,6359.2,8
CPT,28120,PART REMOVAL OF ANKLE/HEEL,,,3179.6,6359.2,8
CPT,28122,PARTIAL REMOVAL OF FOOT BONE,,,3179.6,6359.2,8
CPT,28124,PARTIAL REMOVAL OF TOE,,,3179.6,6359.2,8
CPT,28126,PARTIAL REMOVAL OF TOE,,,3179.6,6359.2,8
CPT,28130,REMOVAL OF ANKLE BONE,,,7051.31,14102.62,8
CPT,28140,REMOVAL OF METATARSAL,,,3179.6,6359.2,8
CPT,28150,REMOVAL OF TOE,,,3179.6,6359.2,8
CPT,28153,PARTIAL REMOVAL OF TOE,,,3179.6,6359.2,8
CPT,28160,PARTIAL REMOVAL OF TOE,,,3179.6,6359.2,8
CPT,28171,RESECT TARSAL TUMOR,,,3179.6,6359.2,8
CPT,28173,RESECT METATARSAL TUMOR,,,3179.6,6359.2,8
CPT,28175,RESECT PHALANX OF TOE TUMOR,,,1562.58,3125.16,8
CPT,28190,REMOVAL OF FOOT FOREIGN BODY,,,688.14,1376.28,8
CPT,28192,REMOVAL OF FOOT FOREIGN BODY,,,1604.96,3209.92,8
CPT,28193,REMOVAL OF FOOT FOREIGN BODY,,,1604.96,3209.92,8
CPT,281U,HEM VWD PROPEPTIDE AG LVL,,,17.27,34.54,8
CPT,28200,REPAIR OF FOOT TENDON,,,3179.6,6359.2,8
CPT,28202,REPAIR/GRAFT OF FOOT TENDON,,,7051.31,14102.62,8
CPT,28208,REPAIR OF FOOT TENDON,,,3179.6,6359.2,8
CPT,28210,REPAIR/GRAFT OF FOOT TENDON,,,7051.31,14102.62,8
CPT,28220,RELEASE OF FOOT TENDON,,,1562.58,3125.16,8
CPT,28222,RELEASE OF FOOT TENDONS,,,3179.6,6359.2,8
CPT,28225,RELEASE OF FOOT TENDON,,,3179.6,6359.2,8
CPT,28226,RELEASE OF FOOT TENDONS,,,3179.6,6359.2,8
CPT,28230,INCISION OF FOOT TENDON(S),,,1562.58,3125.16,8
CPT,28232,INCISION OF TOE TENDON,,,1562.58,3125.16,8
CPT,28234,INCISION OF FOOT TENDON,,,1562.58,3125.16,8
CPT,28238,REVISION OF FOOT TENDON,,,7051.31,14102.62,8
CPT,28240,RELEASE OF BIG TOE,,,3179.6,6359.2,8
CPT,28250,REVISION OF FOOT FASCIA,,,3179.6,6359.2,8
CPT,28260,RELEASE OF MIDFOOT JOINT,,,3179.6,6359.2,8
CPT,28261,REVISION OF FOOT TENDON,,,1562.58,3125.16,8
CPT,28262,REVISION OF FOOT AND ANKLE,,,7051.31,14102.62,8
CPT,28264,RELEASE OF MIDFOOT JOINT,,,1562.58,3125.16,8
CPT,28270,RELEASE OF FOOT CONTRACTURE,,,3179.6,6359.2,8
CPT,28272,RELEASE OF TOE JOINT EACH,,,1562.58,3125.16,8
CPT,28280,FUSION OF TOES,,,3179.6,6359.2,8
CPT,28285,REPAIR OF HAMMERTOE,,,3179.6,6359.2,8
CPT,28286,REPAIR OF HAMMERTOE,,,3179.6,6359.2,8
CPT,28288,PARTIAL REMOVAL OF FOOT BONE,,,3179.6,6359.2,8
CPT,28289,CORRJ HALUX RIGDUS W/O IMPLT,,,3179.6,6359.2,8
CPT,28291,CORRJ HALUX RIGDUS W/IMPLT,,,7051.31,14102.62,8
CPT,28292,COR HLX VLGS RSC PRX PHLX BS,,,3179.6,6359.2,8
CPT,28295,COR HLX VLGS PRX MTAR OSTEOT,,,3179.6,6359.2,8
CPT,28296,COR HLX VLGS DSTL MTAR OSTEO,,,3179.6,6359.2,8
CPT,28297,COR HLX VLGS JT ARTHRD,,,12476.14,24952.28,8
CPT,28298,COR HLX VLGS PRX PHLX OSTEOT,,,7051.31,14102.62,8
CPT,28299,COR HLX VLGS DOUBLE OSTEOT,,,7051.31,14102.62,8
CPT,282U,RBC DNA GNTYP 12 BLD GRP GEN,,,720.0,1440.0,8
CPT,28300,INCISION OF HEEL BONE,,,7051.31,14102.62,8
CPT,28302,INCISION OF ANKLE BONE,,,7051.31,14102.62,8
CPT,28304,INCISION OF MIDFOOT BONES,,,7051.31,14102.62,8
CPT,28305,INCISE/GRAFT MIDFOOT BONES,,,7051.31,14102.62,8
CPT,28306,INCISION OF METATARSAL,,,7051.31,14102.62,8
CPT,28307,INCISION OF METATARSAL,,,7051.31,14102.62,8
CPT,28308,INCISION OF METATARSAL,,,3179.6,6359.2,8
CPT,28309,INCISION OF METATARSALS,,,7051.31,14102.62,8
CPT,28310,REVISION OF BIG TOE,,,7051.31,14102.62,8
CPT,28312,REVISION OF TOE,,,3179.6,6359.2,8
CPT,28313,REPAIR DEFORMITY OF TOE,,,3179.6,6359.2,8
CPT,28315,REMOVAL OF SESAMOID BONE,,,3179.6,6359.2,8
CPT,28320,REPAIR OF FOOT BONES,,,12476.14,24952.28,8
CPT,28322,REPAIR OF METATARSALS,,,7051.31,14102.62,8
CPT,28340,RESECT ENLARGED TOE TISSUE,,,3179.6,6359.2,8
CPT,28341,RESECT ENLARGED TOE,,,3179.6,6359.2,8
CPT,28344,REPAIR EXTRA TOE(S),,,3179.6,6359.2,8
CPT,28345,REPAIR WEBBED TOE(S),,,1562.58,3125.16,8
CPT,28360,RECONSTRUCT CLEFT FOOT,,,7051.31,14102.62,8
CPT,283U,VW FACTOR TYPE 2B EVAL PLSM,,,18.4,36.8,8
CPT,28400,TREATMENT OF HEEL FRACTURE,,,239.7,479.4,8
CPT,28405,TREATMENT OF HEEL FRACTURE,,,239.7,479.4,8
CPT,28406,TREATMENT OF HEEL FRACTURE,,,7051.31,14102.62,8
CPT,28415,TREAT HEEL FRACTURE,,,7051.31,14102.62,8
CPT,28420,TREAT/GRAFT HEEL FRACTURE,,,12476.14,24952.28,8
CPT,28430,TREATMENT OF ANKLE FRACTURE,,,239.7,479.4,8
CPT,28435,TREATMENT OF ANKLE FRACTURE,,,1562.58,3125.16,8
CPT,28436,TREATMENT OF ANKLE FRACTURE,,,7051.31,14102.62,8
CPT,28445,TREAT ANKLE FRACTURE,,,7051.31,14102.62,8
CPT,28446,OSTEOCHONDRAL TALUS AUTOGRFT,,,7051.31,14102.62,8
CPT,28450,TREAT MIDFOOT FRACTURE EACH,,,239.7,479.4,8
CPT,28455,TREAT MIDFOOT FRACTURE EACH,,,1562.58,3125.16,8
CPT,28456,TREAT MIDFOOT FRACTURE,,,7051.31,14102.62,8
CPT,28465,TREAT MIDFOOT FRACTURE EACH,,,7051.31,14102.62,8
CPT,28470,TREAT METATARSAL FRACTURE,,,239.7,479.4,8
CPT,28475,TREAT METATARSAL FRACTURE,,,239.7,479.4,8
CPT,28476,TREAT METATARSAL FRACTURE,,,3179.6,6359.2,8
CPT,28485,TREAT METATARSAL FRACTURE,,,7051.31,14102.62,8
CPT,28490,TREAT BIG TOE FRACTURE,,,239.7,479.4,8
CPT,28495,TREAT BIG TOE FRACTURE,,,239.7,479.4,8
CPT,28496,TREAT BIG TOE FRACTURE,,,3179.6,6359.2,8
CPT,284U,VW FACTOR TYPE 2N EVAL PLSM,,,17.27,34.54,8
CPT,28505,TREAT BIG TOE FRACTURE,,,3179.6,6359.2,8
CPT,28510,TREATMENT OF TOE FRACTURE,,,239.7,479.4,8
CPT,28515,TREATMENT OF TOE FRACTURE,,,239.7,479.4,8
CPT,28525,TREAT TOE FRACTURE,,,3179.6,6359.2,8
CPT,28530,TREAT SESAMOID BONE FRACTURE,,,239.7,479.4,8
CPT,28531,TREAT SESAMOID BONE FRACTURE,,,7051.31,14102.62,8
CPT,28540,TREAT FOOT DISLOCATION,,,239.7,479.4,8
CPT,28545,TREAT FOOT DISLOCATION,,,3179.6,6359.2,8
CPT,28546,TREAT FOOT DISLOCATION,,,1562.58,3125.16,8
CPT,28555,REPAIR FOOT DISLOCATION,,,7051.31,14102.62,8
CPT,28570,TREAT FOOT DISLOCATION,,,239.7,479.4,8
CPT,28575,TREAT FOOT DISLOCATION,,,3179.6,6359.2,8
CPT,28576,TREAT FOOT DISLOCATION,,,7051.31,14102.62,8
CPT,28585,REPAIR FOOT DISLOCATION,,,7051.31,14102.62,8
CPT,285U,ONC RSPS RADJ CLL FR DNA TOX,,,443.31,886.62,8
CPT,28600,TREAT FOOT DISLOCATION,,,239.7,479.4,8
CPT,28605,TREAT FOOT DISLOCATION,,,239.7,479.4,8
CPT,28606,TREAT FOOT DISLOCATION,,,3179.6,6359.2,8
CPT,28615,REPAIR FOOT DISLOCATION,,,7051.31,14102.62,8
CPT,28630,TREAT TOE DISLOCATION,,,239.7,479.4,8
CPT,28635,TREAT TOE DISLOCATION,,,1562.58,3125.16,8
CPT,28636,TREAT TOE DISLOCATION,,,3179.6,6359.2,8
CPT,28645,REPAIR TOE DISLOCATION,,,3179.6,6359.2,8
CPT,28660,TREAT TOE DISLOCATION,,,239.7,479.4,8
CPT,28665,TREAT TOE DISLOCATION,,,271.79,543.58,8
CPT,28666,TREAT TOE DISLOCATION,,,3179.6,6359.2,8
CPT,28675,REPAIR OF TOE DISLOCATION,,,3179.6,6359.2,8
CPT,286U,CEP72 NUDT15&TPMT GENE ALYS,,,134.13,268.26,8
CPT,28705,FUSION OF FOOT BONES,,,17038.69,34077.38,8
CPT,28715,FUSION OF FOOT BONES,,,12476.14,24952.28,8
CPT,28725,FUSION OF FOOT BONES,,,12476.14,24952.28,8
CPT,28730,FUSION OF FOOT BONES,,,12476.14,24952.28,8
CPT,28735,FUSION OF FOOT BONES,,,12476.14,24952.28,8
CPT,28737,REVISION OF FOOT BONES,,,12476.14,24952.28,8
CPT,28740,FUSION OF FOOT BONES,,,7051.31,14102.62,8
CPT,28750,FUSION OF BIG TOE JOINT,,,7051.31,14102.62,8
CPT,28755,FUSION OF BIG TOE JOINT,,,7051.31,14102.62,8
CPT,28760,FUSION OF BIG TOE JOINT,,,7051.31,14102.62,8
CPT,287U,ONC THYR DNA&MRNA 112 GENES,,,3600.0,7200.0,8
CPT,28800,AMPUTATION OF MIDFOOT,,,3179.6,6359.2,8
CPT,28805,AMPUTATION THRU METATARSAL,,,3179.6,6359.2,8
CPT,28810,AMPUTATION TOE & METATARSAL,,,3179.6,6359.2,8
CPT,28820,AMPUTATION OF TOE,,,3179.6,6359.2,8
CPT,28825,PARTIAL AMPUTATION OF TOE,,,3179.6,6359.2,8
CPT,28890,HI ENRGY ESWT PLANTAR FASCIA,,,1562.58,3125.16,8
CPT,28899,UNLISTED PX FOOT/TOES,,,239.7,479.4,8
CPT,288U,ONC LUNG MRNA QUAN PCR 11&3,,,3873.0,7746.0,8
CPT,289U,NEURO ALZHEIMER MRNA 24 GEN,,,760.0,1520.0,8
CPT,29000,APPLICATION OF BODY CAST,,,271.79,543.58,8
CPT,29010,APPLICATION OF BODY CAST,,,271.79,543.58,8
CPT,29015,APPLICATION OF BODY CAST,,,271.79,543.58,8
CPT,29035,APPLICATION OF BODY CAST,,,271.79,543.58,8
CPT,29040,APPLICATION OF BODY CAST,,,271.79,543.58,8
CPT,29044,APPLICATION OF BODY CAST,,,157.91,315.82,8
CPT,29046,APPLICATION OF BODY CAST,,,271.79,543.58,8
CPT,29049,APPLICATION OF FIGURE EIGHT,,,271.79,543.58,8
CPT,29055,APPLICATION OF SHOULDER CAST,,,271.79,543.58,8
CPT,29058,APPLICATION OF SHOULDER CAST,,,271.79,543.58,8
CPT,29065,APPLICATION OF LONG ARM CAST,,,271.79,543.58,8
CPT,29075,APPLICATION OF FOREARM CAST,,,271.79,543.58,8
CPT,29085,APPLY HAND/WRIST CAST,,,157.91,315.82,8
CPT,29086,APPLY FINGER CAST,,,157.91,315.82,8
CPT,290U,PAIN MGMT MRNA GEN XPRSN 36,,,760.0,1520.0,8
CPT,29105,APPLY LONG ARM SPLINT,,,157.91,315.82,8
CPT,29125,APPLY FOREARM SPLINT,,,129.29,258.58,8
CPT,29126,APPLY FOREARM SPLINT,,,129.29,258.58,8
CPT,29130,APPLICATION OF FINGER SPLINT,,,129.29,258.58,8
CPT,29131,APPLICATION OF FINGER SPLINT,,,57.33,114.66,8
CPT,291U,PSYC MOOD DO MRNA 144 GENES,,,1755.0,3510.0,8
CPT,29200,STRAPPING OF CHEST,,,157.91,315.82,8
CPT,29240,STRAPPING OF SHOULDER,,,129.29,258.58,8
CPT,29260,STRAPPING OF ELBOW OR WRIST,,,57.33,114.66,8
CPT,29280,STRAPPING OF HAND OR FINGER,,,57.33,114.66,8
CPT,292U,PSYC STRS DO MRNA 72 GENES,,,1755.0,3510.0,8
CPT,29305,APPLICATION OF HIP CAST,,,271.79,543.58,8
CPT,29325,APPLICATION OF HIP CASTS,,,271.79,543.58,8
CPT,29345,APPLICATION OF LONG LEG CAST,,,271.79,543.58,8
CPT,29355,APPLICATION OF LONG LEG CAST,,,271.79,543.58,8
CPT,29358,APPLY LONG LEG CAST BRACE,,,271.79,543.58,8
CPT,29365,APPLICATION OF LONG LEG CAST,,,271.79,543.58,8
CPT,293U,PSYC SUICIDAL IDEA MRNA 54,,,760.0,1520.0,8
CPT,29405,APPLY SHORT LEG CAST,,,271.79,543.58,8
CPT,29425,APPLY SHORT LEG CAST,,,271.79,543.58,8
CPT,29435,APPLY SHORT LEG CAST,,,271.79,543.58,8
CPT,29440,ADDITION OF WALKER TO CAST,,,157.91,315.82,8
CPT,29445,APPLY RIGID LEG CAST,,,,,0
CPT,29445,PT RIGID TOTAL CONTACT LEGCAS,424.0,212.0,73.86,543.58,53
CPT,29450,APPLICATION OF LEG CAST,,,157.91,315.82,8
CPT,294U,LNGVTY&MRTLTY RSK MRNA 18GEN,,,760.0,1520.0,8
CPT,29505,APPLICATION LONG LEG SPLINT,,,157.91,315.82,8
CPT,29515,APPLICATION LOWER LEG SPLINT,,,157.91,315.82,8
CPT,29520,STRAPPING OF HIP,,,129.29,258.58,8
CPT,29530,STRAPPING OF KNEE,,,129.29,258.58,8
CPT,29540,STRAPPING OF ANKLE AND/OR FT,,,157.91,315.82,8
CPT,29550,STRAPPING OF TOES,,,57.33,114.66,8
CPT,29580,APPLICATION OF PASTE BOOT,,,,,0
CPT,29580,PT UNNA BOOT,193.0,96.5,33.62,315.82,53
CPT,29581,APPLY MULTLAY COMPRS LWR LEG,,,157.91,315.82,8
CPT,29584,APPL MULTLAY COMPRS ARM/HAND,,,157.91,315.82,8
CPT,295U,ONC BRST DUX CARC 7 PROTEINS,,,5435.0,10870.0,8
CPT,296U,ONC ORL&/OROP CA 20 MLC FEAT,,,1950.0,3900.0,8
CPT,29700,REMOVAL/REVISION OF CAST,,,271.79,543.58,8
CPT,29705,REMOVAL/REVISION OF CAST,,,271.79,543.58,8
CPT,29710,REMOVAL/REVISION OF CAST,,,271.79,543.58,8
CPT,29720,REPAIR OF BODY CAST,,,157.91,315.82,8
CPT,29730,WINDOWING OF CAST,,,157.91,315.82,8
CPT,29740,WEDGING OF CAST,,,271.79,543.58,8
CPT,29750,WEDGING OF CLUBFOOT CAST,,,271.79,543.58,8
CPT,29799,UNLISTED PX CASTING/STRPG,,,157.91,315.82,8
CPT,297U,ONC PAN TUM WHL GEN SEQ DNA,,,2919.6,5839.2,8
CPT,29800,JAW ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29804,JAW ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29805,SHO ARTHRS DX +- SYNOVIAL BX,,,3179.6,6359.2,8
CPT,29806,SHO ARTHRS SRG CAPSULORRAPHY,,,7051.31,14102.62,8
CPT,29807,SHO ARTHRS SRG RPR SLAP LES,,,7051.31,14102.62,8
CPT,29819,SHO ARTHRS SRG RMVL LOOSE/FB,,,3179.6,6359.2,8
CPT,29820,SHO ARTHRS SRG PRTL SYNVCT,,,7051.31,14102.62,8
CPT,29821,SHO ARTHRS SRG COMPL SYNVCT,,,3179.6,6359.2,8
CPT,29822,SHO ARTHRS SRG LMTD DBRDMT,,,3179.6,6359.2,8
CPT,29823,SHO ARTHRS SRG XTNSV DBRDMT,,,3179.6,6359.2,8
CPT,29824,SHO ARTHRS SRG DSTL CLAVICLC,,,3179.6,6359.2,8
CPT,29825,SHO ARTHRS SRG LSS&RESCJ ADS,,,3179.6,6359.2,8
CPT,29826,SHO ARTHRS SRG DECOMPRESSION,,,,,0
CPT,29827,SHO ARTHRS SRG RT8TR CUF RPR,,,7051.31,14102.62,8
CPT,29828,SHO ARTHRS SRG BICP TENODSIS,,,7051.31,14102.62,8
CPT,29830,ELBOW ARTHROSCOPY,,,3179.6,6359.2,8
CPT,29834,ELBOW ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29835,ELBOW ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29836,ELBOW ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29837,ELBOW ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29838,ELBOW ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29840,WRIST ARTHROSCOPY,,,3179.6,6359.2,8
CPT,29843,WRIST ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29844,WRIST ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29845,WRIST ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29846,WRIST ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29847,WRIST ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29848,WRIST ENDOSCOPY/SURGERY,,,1562.58,3125.16,8
CPT,29850,KNEE ARTHROSCOPY/SURGERY,,,1562.58,3125.16,8
CPT,29851,KNEE ARTHROSCOPY/SURGERY,,,1562.58,3125.16,8
CPT,29855,TIBIAL ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29856,TIBIAL ARTHROSCOPY/SURGERY,,,12476.14,24952.28,8
CPT,29860,HIP ARTHROSCOPY DX,,,7051.31,14102.62,8
CPT,29861,HIP ARTHRO W/FB REMOVAL,,,7051.31,14102.62,8
CPT,29862,HIP ARTHR0 W/DEBRIDEMENT,,,7051.31,14102.62,8
CPT,29863,HIP ARTHR0 W/SYNOVECTOMY,,,3179.6,6359.2,8
CPT,29866,AUTGRFT IMPLNT KNEE W/SCOPE,,,7051.31,14102.62,8
CPT,29867,ALLGRFT IMPLNT KNEE W/SCOPE,,,12476.14,24952.28,8
CPT,29868,MENISCAL TRNSPL KNEE W/SCPE,,,7051.31,14102.62,8
CPT,29870,KNEE ARTHROSCOPY DX,,,3179.6,6359.2,8
CPT,29871,KNEE ARTHROSCOPY/DRAINAGE,,,3179.6,6359.2,8
CPT,29873,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29874,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29875,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29876,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29877,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29879,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29880,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29881,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29882,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29883,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29884,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29885,KNEE ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29886,KNEE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29887,KNEE ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29888,KNEE ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29889,KNEE ARTHROSCOPY/SURGERY,,,12476.14,24952.28,8
CPT,29891,ANKLE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29892,ANKLE ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,29893,SCOPE PLANTAR FASCIOTOMY,,,3179.6,6359.2,8
CPT,29894,ANKLE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29895,ANKLE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29897,ANKLE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29898,ANKLE ARTHROSCOPY/SURGERY,,,3179.6,6359.2,8
CPT,29899,ANKLE ARTHROSCOPY/SURGERY,,,7051.31,14102.62,8
CPT,298U,ONC PAN TUM WHL TRNS SEQ RNA,,,2919.6,5839.2,8
CPT,29900,MCP JOINT ARTHROSCOPY DX,,,3179.6,6359.2,8
CPT,29901,MCP JOINT ARTHROSCOPY SURG,,,3179.6,6359.2,8
CPT,29902,MCP JOINT ARTHROSCOPY SURG,,,1562.58,3125.16,8
CPT,29904,SUBTALAR ARTHRO W/FB RMVL,,,3179.6,6359.2,8
CPT,29905,SUBTALAR ARTHRO W/EXC,,,7051.31,14102.62,8
CPT,29906,SUBTALAR ARTHRO W/DEB,,,3179.6,6359.2,8
CPT,29907,SUBTALAR ARTHRO W/FUSION,,,12476.14,24952.28,8
CPT,29914,HIP ARTHRO W/FEMOROPLASTY,,,7051.31,14102.62,8
CPT,29915,HIP ARTHRO ACETABULOPLASTY,,,7051.31,14102.62,8
CPT,29916,HIP ARTHRO W/LABRAL REPAIR,,,7051.31,14102.62,8
CPT,29999,UNLISTED PX ARTHROSCOPY,,,239.7,479.4,8
CPT,299U,ONC PAN TUM WHL GEN OPT MAPG,,,1863.22,3726.44,8
CPT,29U,RX METAB ADVRS TRGT SEQ ALYS,,,742.27,1484.54,8
CPT,2M,LIVER DIS 10 ASSAYS W/ASH,,,503.4,1006.8,8
CPT,2U,ONC CLRCT 3 UR METAB ALG PLP,,,25.0,50.0,8
CPT,300,ANESTH HEAD/NECK/PTRUNK,,,,,0
CPT,30000,DRAINAGE OF NOSE LESION,,,230.16,460.32,8
CPT,30020,DRAINAGE OF NOSE LESION,,,524.1,1048.2,8
CPT,3006F,CXR DOC REV,,,,,0
CPT,3008F,BODY MASS INDEX DOCD,,,,,0
CPT,300U,ONC PAN TUM WHL GEN SEQ&OPT,,,4183.13,8366.26,8
CPT,30100,INTRANASAL BIOPSY,,,1507.77,3015.54,8
CPT,30110,REMOVAL OF NOSE POLYP(S),,,1507.77,3015.54,8
CPT,30115,REMOVAL OF NOSE POLYP(S),,,3221.84,6443.68,8
CPT,30117,REMOVAL OF INTRANASAL LESION,,,3221.84,6443.68,8
CPT,30118,REMOVAL OF INTRANASAL LESION,,,3221.84,6443.68,8
CPT,3011F,LIPID PANEL DOC REV,,,,,0
CPT,30120,REVISION OF NOSE,,,3221.84,6443.68,8
CPT,30124,REMOVAL OF NOSE LESION,,,1507.77,3015.54,8
CPT,30125,REMOVAL OF NOSE LESION,,,5752.66,11505.32,8
CPT,30130,EXCISE INFERIOR TURBINATE,,,3221.84,6443.68,8
CPT,30140,RESECT INFERIOR TURBINATE,,,3221.84,6443.68,8
CPT,3014F,SCREEN MAMMO DOC REV,,,,,0
CPT,30150,PARTIAL REMOVAL OF NOSE,,,5752.66,11505.32,8
CPT,3015F,CERV CANCER SCREEN DOCD,,,,,0
CPT,30160,REMOVAL OF NOSE,,,5752.66,11505.32,8
CPT,3016F,PT SCRND UNHLTHY OH USE,,,,,0
CPT,3017F,COLORECTAL CA SCREEN DOC REV,,,,,0
CPT,3018F,PRE-PRXD RSK ET AL DOCD,,,,,0
CPT,3019F,LVEF ASSESS PLANPOST DSCHRGE,,,,,0
CPT,301U,IADNA BARTONELLA DDPCR,,,262.72,525.44,8
CPT,30200,INJECTION TREATMENT OF NOSE,,,524.1,1048.2,8
CPT,3020F,LVF ASSESS,,,,,0
CPT,30210,NASAL SINUS THERAPY,,,1507.77,3015.54,8
CPT,3021F,LVEF MOD/SEVER DEPRS SYST,,,,,0
CPT,30220,INSERT NASAL SEPTAL BUTTON,,,1507.77,3015.54,8
CPT,3022F,LVEF >=40% SYSTOLIC,,,,,0
CPT,3023F,SPIROM DOC REV,,,,,0
CPT,3025F,SPIROM FEV/FVC <70% W/COPD,,,,,0
CPT,3027F,SPIROM FEV/FVC>=70%/W/OCOPD,,,,,0
CPT,3028F,O2 SATURATION DOC REV,,,,,0
CPT,302U,IADNA BRTNLA DDPCR FLWG LIQ,,,361.37,722.74,8
CPT,30300,REMOVE NASAL FOREIGN BODY,,,129.29,258.58,8
CPT,30310,REMOVE NASAL FOREIGN BODY,,,3221.84,6443.68,8
CPT,30320,REMOVE NASAL FOREIGN BODY,,,1507.77,3015.54,8
CPT,3035F,O2 SATURATION<=88%/PAO<=55,,,,,0
CPT,3037F,O2 SATURATION >88%/PAO>55 HG,,,,,0
CPT,3038F,PULM FX W/IN 12 MON B/4 SURG,,,,,0
CPT,303U,HEM RBC ADS WHL BLD HYPOXIC,,,2201.62,4403.24,8
CPT,30400,RECONSTRUCTION OF NOSE,,,5752.66,11505.32,8
CPT,3040F,FEV <40% PREDICTED VALUE,,,,,0
CPT,30410,RECONSTRUCTION OF NOSE,,,5752.66,11505.32,8
CPT,30420,RECONSTRUCTION OF NOSE,,,5752.66,11505.32,8
CPT,3042F,FEV >=40% PREDICTED VALUE,,,,,0
CPT,30430,REVISION OF NOSE,,,5752.66,11505.32,8
CPT,30435,REVISION OF NOSE,,,5752.66,11505.32,8
CPT,3044F,HG A1C LEVEL LT 7.0%,,,,,0
CPT,30450,REVISION OF NOSE,,,5752.66,11505.32,8
CPT,30460,REVISION OF NOSE,,,5752.66,11505.32,8
CPT,30462,REVISION OF NOSE,,,5752.66,11505.32,8
CPT,30465,REPAIR NASAL STENOSIS,,,5752.66,11505.32,8
CPT,30468,RPR NSL VLV COLLAPSE W/IMPLT,,,5752.66,11505.32,8
CPT,30469,RPR NSL VLV COLLAPSE W/RMDLG,,,5752.66,11505.32,8
CPT,3046F,HEMOGLOBIN A1C LEVEL >9.0%,,,,,0
CPT,3048F,LDL-C <100 MG/DL,,,,,0
CPT,3049F,LDL-C 100-129 MG/DL,,,,,0
CPT,304U,HEM RBC ADS WHL BLD NORMOXIC,,,2075.8,4151.6,8
CPT,3050F,LDL-C >= 130 MG/DL,,,,,0
CPT,3051F,HG A1C>EQUAL 7.0%<8.0%,,,,,0
CPT,30520,REPAIR OF NASAL SEPTUM,,,3221.84,6443.68,8
CPT,3052F,HG A1C>EQUAL 8.0%<EQUAL 9.0%,,,,,0
CPT,30540,RPR CHOANAL ATRESIA NTRANASL,,,5752.66,11505.32,8
CPT,30545,RPR CHOANAL ATRESIA TRSNPLTN,,,5752.66,11505.32,8
CPT,3055F,LVEF LESS THAN/EQUAL TO 35%,,,,,0
CPT,30560,LYSIS INTRANASAL SYNECHIA,,,524.1,1048.2,8
CPT,3056F,LVEF GREATER THAN 35%,,,,,0
CPT,30580,REPAIR UPPER JAW FISTULA,,,5752.66,11505.32,8
CPT,305U,HEM RBC FNCLTY&DFRM SHR STRS,,,662.58,1325.16,8
CPT,30600,REPAIR MOUTH/NOSE FISTULA,,,5752.66,11505.32,8
CPT,3060F,POS MICROALBUMINURIA REV,,,,,0
CPT,3061F,NEG MICROALBUMINURIA REV,,,,,0
CPT,30620,INTRANASAL RECONSTRUCTION,,,5752.66,11505.32,8
CPT,3062F,POS MACROALBUMINURIA REV,,,,,0
CPT,30630,REPAIR NASAL SEPTUM DEFECT,,,3221.84,6443.68,8
CPT,3066F,NEPHROPATHY DOC TX,,,,,0
CPT,306U,ONC MRD NXT-GNRJ ALYS 1ST,,,3878.45,7756.9,8
CPT,3072F,LOW RISK FOR RETINOPATHY,,,,,0
CPT,3073F,PRE-SURG EYE MEASURES DOCD,,,,,0
CPT,3074F,SYST BP LT 130 MM HG,,,,,0
CPT,3075F,SYST BP GE 130 - 139MM HG,,,,,0
CPT,3077F,SYST BP >= 140 MM HG,,,,,0
CPT,3078F,DIAST BP <80 MM HG,,,,,0
CPT,3079F,DIAST BP 80-89 MM HG,,,,,0
CPT,307U,ONC MRD NXT-GNRJ ALYS SBSQ,,,794.49,1588.98,8
CPT,30801,ABLATE INF TURBINATE SUPERF,,,1507.77,3015.54,8
CPT,30802,ABLATE INF TURBINATE SUBMUC,,,1507.77,3015.54,8
CPT,3080F,DIAST BP >= 90 MM HG,,,,,0
CPT,3082F,KT/V <1.2,,,,,0
CPT,3083F,KT/V =/> 1.2 & <1.7,,,,,0
CPT,3084F,KT/V >= 1.7,,,,,0
CPT,3085F,SUICIDE RISK ASSESSED,,,,,0
CPT,3088F,MDD MILD,,,,,0
CPT,3089F,MDD MODERATE,,,,,0
CPT,308T,INSJ OCULAR TELESCOPE PROSTH,,,15996.0,31992.0,8
CPT,308U,CRD CAD ALYS 3 PRTN 3 PARAM,,,390.75,781.5,8
CPT,30901,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,383.0,191.5,66.71,371.51,54
CPT,30901,CONTROL OF NOSEBLEED,,,,,0
CPT,30903,CONTROL OF NOSEBLEED,,,129.29,258.58,8
CPT,30905,CONTROL OF NOSEBLEED,,,129.29,258.58,8
CPT,30906,REPEAT CONTROL OF NOSEBLEED,,,230.16,460.32,8
CPT,3090F,MDD SEVERE W/O PSYCH,,,,,0
CPT,30915,LIGATION NASAL SINUS ARTERY,,,3068.32,6136.64,8
CPT,3091F,MDD SEVERE W/PSYCH,,,,,0
CPT,30920,LIGATION UPPER JAW ARTERY,,,3068.32,6136.64,8
CPT,3092F,MDD IN REMISSION,,,,,0
CPT,30930,THER FX NASAL INF TURBINATE,,,3221.84,6443.68,8
CPT,3093F,DOC NEW DIAG 1ST/ADDL MDD,,,,,0
CPT,3095F,CENTRAL DEXA RESULTS DOCD,,,,,0
CPT,3096F,CENTRAL DEXA ORDERED,,,,,0
CPT,30999,UNLISTED PROCEDURE NOSE,,,230.16,460.32,8
CPT,309U,CRD CV DS ALY 4 PRTN PLM ALG,,,390.75,781.5,8
CPT,30U,RX METAB WARF TRGT SEQ ALYS,,,134.13,268.26,8
CPT,31000,IRRIGATION MAXILLARY SINUS,,,230.16,460.32,8
CPT,31002,IRRIGATION SPHENOID SINUS,,,1507.77,3015.54,8
CPT,3100F,IMAGE TEST REF CAROT DIAM,,,,,0
CPT,31020,EXPLORATION MAXILLARY SINUS,,,3221.84,6443.68,8
CPT,31030,EXPLORATION MAXILLARY SINUS,,,5752.66,11505.32,8
CPT,31032,EXPLORE SINUS REMOVE POLYPS,,,5752.66,11505.32,8
CPT,31040,EXPLORATION BEHIND UPPER JAW,,,5752.66,11505.32,8
CPT,31050,EXPLORATION SPHENOID SINUS,,,5752.66,11505.32,8
CPT,31051,SPHENOID SINUS SURGERY,,,5752.66,11505.32,8
CPT,31070,EXPLORATION OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31075,EXPLORATION OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31080,REMOVAL OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31081,REMOVAL OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31084,REMOVAL OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31085,REMOVAL OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31086,REMOVAL OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31087,REMOVAL OF FRONTAL SINUS,,,5752.66,11505.32,8
CPT,31090,EXPLORATION OF SINUSES,,,5752.66,11505.32,8
CPT,310U,PED VSCLTS KD ALYS 3 BMRKS,,,390.75,781.5,8
CPT,3110F,PRES/ABSN HMRHG/LESION DOCD,,,,,0
CPT,3111F,CT/MRI BRAIN DONE W/IN 24HRS,,,,,0
CPT,3112F,CT/MRI BRAIN DONE 24 HRS,,,,,0
CPT,3115F,QUANT RESULTS ACTIVITY &SYMP,,,,,0
CPT,3117F,HF ASSESSMENT TOOL COMPLETED,,,,,0
CPT,3118F,NY HEART ASSOC CLASS DOCD,,,,,0
CPT,3119F,NO EVAL ACTIVITY CLIN SYMP,,,,,0
CPT,311U,NFCT DS BCT QUAN ANTMCRB SC,,,8.08,16.16,8
CPT,31200,REMOVAL OF ETHMOID SINUS,,,5752.66,11505.32,8
CPT,31201,REMOVAL OF ETHMOID SINUS,,,1507.77,3015.54,8
CPT,31205,REMOVAL OF ETHMOID SINUS,,,3221.84,6443.68,8
CPT,3120F,12-LEAD ECG PERFORMED,,,,,0
CPT,31225,REMOVAL OF UPPER JAW,,,,,0
CPT,31230,REMOVAL OF UPPER JAW,,,,,0
CPT,31231,NASAL ENDOSCOPY DX,,,193.97,387.94,8
CPT,31233,NSL/SINS NDSC DX MAX SINUSC,,,380.07,760.14,8
CPT,31235,NSL/SINS NDSC DX SPHN SINUSC,,,1729.64,3459.28,8
CPT,31237,NASAL/SINUS ENDOSCOPY SURG,5124.0,2562.0,892.6,4970.28,54
CPT,31237,NSL/SINS NDSC SURG BX POLYPC,,,,,0
CPT,31238,NSL/SINS NDSC SRG NSL HEMRRG,,,1729.64,3459.28,8
CPT,31239,NSL/SINUS ENDOSCOPY SURG DCR,,,3623.06,7246.12,8
CPT,31240,NSL/SNS NDSC CNCH BULL RESCJ,,,1729.64,3459.28,8
CPT,31241,NSL/SNS NDSC LIG SPHNPTN ART,,,1729.64,3459.28,8
CPT,31242,NSL/SINUS NDSC RF ABLTJ PNN,,,5752.66,11505.32,8
CPT,31243,NSL/SINUS NDSC CRYOABLTJ PNN,,,5752.66,11505.32,8
CPT,31253,NSL/SINS NDSC TOTAL,,,6858.17,13716.34,8
CPT,31254,NSL/SINS NDSC W/PRTL ETHMDCT,,,6858.17,13716.34,8
CPT,31255,NSL/SINS NDSC W/TOT ETHMDCT,,,6858.17,13716.34,8
CPT,31256,EXPLORATION MAXILLARY SINUS,,,3623.06,7246.12,8
CPT,31257,NSL/SINS NDSC TOT W/SPHENDT,,,6858.17,13716.34,8
CPT,31259,NSL/SINS NDSC SPHN TISS RMVL,,,6858.17,13716.34,8
CPT,31267,ENDOSCOPY MAXILLARY SINUS,,,6858.17,13716.34,8
CPT,3126F,ESOPH BX RPRT W/DYSPL INFO,,,,,0
CPT,31276,NSL/SINS NDSC FRNT TISS RMVL,,,6858.17,13716.34,8
CPT,31287,NASAL/SINUS ENDOSCOPY SURG,,,6858.17,13716.34,8
CPT,31288,NASAL/SINUS ENDOSCOPY SURG,,,6858.17,13716.34,8
CPT,31290,NASAL/SINUS ENDOSCOPY SURG,,,,,0
CPT,31291,NASAL/SINUS ENDOSCOPY SURG,,,,,0
CPT,31292,NSL/SINS NDSC MED/INF DCMPRN,,,6858.17,13716.34,8
CPT,31293,NSL/SINS NDSC MED&INF DCMPRN,,,6858.17,13716.34,8
CPT,31294,NSL/SINS NDSC SURG ON DCMPRN,,,6858.17,13716.34,8
CPT,31295,NSL/SINS NDSC SURG MAX SINS,,,6858.17,13716.34,8
CPT,31296,NSL/SINS NDSC SURG FRNT SINS,,,6858.17,13716.34,8
CPT,31297,NSL/SINS NDSC SURG SPHN SINS,,,6858.17,13716.34,8
CPT,31298,NSL/SINS NDSC SURG FRNT&SPHN,,,6858.17,13716.34,8
CPT,31299,UNLISTED PX ACCESSORY SINUS,,,230.16,460.32,8
CPT,312U,AI DS SLE ALYS 8 IGG AUTOANT,,,840.65,1681.3,8
CPT,31300,REMOVAL OF LARYNX LESION,,,3221.84,6443.68,8
CPT,3130F,UPPER GI ENDOSCOPY PERFORMED,,,,,0
CPT,3132F,DOC REF UPPER GI ENDOSCOPY,,,,,0
CPT,31360,REMOVAL OF LARYNX,,,,,0
CPT,31365,REMOVAL OF LARYNX,,,,,0
CPT,31367,PARTIAL REMOVAL OF LARYNX,,,,,0
CPT,31368,PARTIAL REMOVAL OF LARYNX,,,,,0
CPT,31370,PARTIAL REMOVAL OF LARYNX,,,,,0
CPT,31375,PARTIAL REMOVAL OF LARYNX,,,,,0
CPT,31380,PARTIAL REMOVAL OF LARYNX,,,,,0
CPT,31382,PARTIAL REMOVAL OF LARYNX,,,,,0
CPT,31390,REMOVAL OF LARYNX & PHARYNX,,,,,0
CPT,31395,RECONSTRUCT LARYNX & PHARYNX,,,,,0
CPT,313U,ONC PNCRS DNA&MRNA SEQ 74,,,3600.0,7200.0,8
CPT,31400,REVISION OF LARYNX,,,5752.66,11505.32,8
CPT,3140F,UPPER GI ENDO SHOWS BARRTTS,,,,,0
CPT,3141F,UPPER GI ENDO NOT BARRTTS,,,,,0
CPT,31420,REMOVAL OF EPIGLOTTIS,,,5752.66,11505.32,8
CPT,3142F,BARIUM SWALLOW TEST ORDERED,,,,,0
CPT,314U,ONC CUTAN MLNMA MRNA 35 GENE,,,1950.0,3900.0,8
CPT,31500,CRNA-INTUBATION EMERGENT,1055.0,527.5,183.78,1023.35,53
CPT,31500,INSERT EMERGENCY AIRWAY,,,,,0
CPT,31500,INTUBATION,951.0,475.5,165.66,922.47,53
CPT,31502,CHANGE OF WINDPIPE AIRWAY,,,,,0
CPT,31502,TRACHEOTOMY TUBE CHANGE BY RT TEAM MEMBER,865.0,432.5,150.68,839.05,53
CPT,31502,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,806.0,403.0,140.4,781.82,54
CPT,31505,DIAGNOSTIC LARYNGOSCOPY,,,193.97,387.94,8
CPT,3150F,FORCEPS ESOPH BIOPSY DONE,,,,,0
CPT,31510,LARYNGOSCOPY WITH BIOPSY,,,3623.06,7246.12,8
CPT,31511,REMOVE FOREIGN BODY LARYNX,,,193.97,387.94,8
CPT,31512,REMOVAL OF LARYNX LESION,,,3623.06,7246.12,8
CPT,31513,INJECTION INTO VOCAL CORD,,,380.07,760.14,8
CPT,31515,LARYNGOSCOPY FOR ASPIRATION,,,380.07,760.14,8
CPT,31520,DX LARYNGOSCOPY NEWBORN,,,380.07,760.14,8
CPT,31525,DX LARYNGOSCOPY EXCL NB,3654.0,1827.0,636.52,3544.38,54
CPT,31526,DX LARYNGOSCOPY W/OPER SCOPE,,,1729.64,3459.28,8
CPT,31527,LARYNGOSCOPY FOR TREATMENT,,,3623.06,7246.12,8
CPT,31528,LARYNGOSCOPY AND DILATION,,,3623.06,7246.12,8
CPT,31529,LARYNGOSCOPY AND DILATION,,,3623.06,7246.12,8
CPT,31530,LARYNGOSCOPY W/FB REMOVAL,,,1729.64,3459.28,8
CPT,31531,LARYNGOSCOPY W/FB & OP SCOPE,,,3623.06,7246.12,8
CPT,31535,LARYNGOSCOPY W/BIOPSY,,,3623.06,7246.12,8
CPT,31536,LARYNGOSCOPY W/BX & OP SCOPE,,,3623.06,7246.12,8
CPT,31540,LARYNGOSCOPY W/EXC OF TUMOR,,,3623.06,7246.12,8
CPT,31541,LARYNSCOP W/TUMR EXC + SCOPE,,,3623.06,7246.12,8
CPT,31545,REMOVE VC LESION W/SCOPE,,,3623.06,7246.12,8
CPT,31546,REMOVE VC LESION SCOPE/GRAFT,,,6858.17,13716.34,8
CPT,31551,LARYNGOPLASTY LARYNGEAL STEN,,,5752.66,11505.32,8
CPT,31552,LARYNGOPLASTY LARYNGEAL STEN,,,5752.66,11505.32,8
CPT,31553,LARYNGOPLASTY LARYNGEAL STEN,,,5752.66,11505.32,8
CPT,31554,LARYNGOPLASTY LARYNGEAL STEN,,,5752.66,11505.32,8
CPT,3155F,CYTOGEN TEST MARROW B/4 TX,,,,,0
CPT,31560,LARYNGOSCOP W/ARYTENOIDECTOM,,,6858.17,13716.34,8
CPT,31561,LARYNSCOP REMVE CART + SCOP,,,6858.17,13716.34,8
CPT,31570,LARYNGOSCOPE W/VC INJ,,,3623.06,7246.12,8
CPT,31571,LARYNGOSCOP W/VC INJ + SCOPE,,,3623.06,7246.12,8
CPT,31572,LARGSC W/LASER DSTRJ LES,,,3623.06,7246.12,8
CPT,31573,LARGSC W/THER INJECTION,,,1729.64,3459.28,8
CPT,31574,LARGSC W/NJX AUGMENTATION,,,1729.64,3459.28,8
CPT,31575,DIAGNOSTIC LARYNGOSCOPY,396.0,198.0,68.98,387.94,54
CPT,31576,LARYNGOSCOPY WITH BIOPSY,,,1729.64,3459.28,8
CPT,31577,LARGSC W/RMVL FOREIGN BDY(S),,,380.07,760.14,8
CPT,31578,LARGSC W/REMOVAL LESION,,,3623.06,7246.12,8
CPT,31579,LARYNGOSCOPY TELESCOPIC,,,380.07,760.14,8
CPT,31580,LARYNGOPLASTY LARYNGEAL WEB,,,5752.66,11505.32,8
CPT,31584,LARYNGOPLASTY FX RDCTJ FIXJ,,,5752.66,11505.32,8
CPT,31587,LARYNGOPLASTY CRICOID SPLIT,,,5752.66,11505.32,8
CPT,31590,REINNERVATE LARYNX,,,5752.66,11505.32,8
CPT,31591,LARYNGOPLASTY MEDIALIZATION,,,5752.66,11505.32,8
CPT,31592,CRICOTRACHEAL RESECTION,,,5752.66,11505.32,8
CPT,31599,UNLISTED PROCEDURE LARYNX,,,230.16,460.32,8
CPT,315U,ONC CUTAN SQ CLL CA MRNA 40,,,8500.0,17000.0,8
CPT,31600,INCISION OF WINDPIPE,,,3221.84,6443.68,8
CPT,31601,INCISION OF WINDPIPE,,,5752.66,11505.32,8
CPT,31603,INCISION OF WINDPIPE,,,1507.77,3015.54,8
CPT,31605,INCISION OF WINDPIPE,,,230.16,460.32,8
CPT,3160F,DOC FE+ STORES B/4 EPO THX,,,,,0
CPT,31610,INCISION OF WINDPIPE,,,5752.66,11505.32,8
CPT,31611,SURGERY/SPEECH PROSTHESIS,,,3221.84,6443.68,8
CPT,31612,PUNCTURE/CLEAR WINDPIPE,,,3221.84,6443.68,8
CPT,31613,REPAIR WINDPIPE OPENING,,,3221.84,6443.68,8
CPT,31614,REPAIR WINDPIPE OPENING,,,5752.66,11505.32,8
CPT,31615,VISUALIZATION OF WINDPIPE,,,524.1,1048.2,8
CPT,31622,DX BRONCHOSCOPE/WASH,,,1729.64,3459.28,8
CPT,31623,DX BRONCHOSCOPE/BRUSH,,,1729.64,3459.28,8
CPT,31624,DX BRONCHOSCOPE/LAVAGE,,,1729.64,3459.28,8
CPT,31625,BRONCHOSCOPY W/BIOPSY(S),,,1729.64,3459.28,8
CPT,31626,BRONCHOSCOPY W/MARKERS,,,6858.17,13716.34,8
CPT,31627,NAVIGATIONAL BRONCHOSCOPY,,,,,0
CPT,31628,BRONCHOSCOPY/LUNG BX EACH,,,3623.06,7246.12,8
CPT,31629,BRONCHOSCOPY/NEEDLE BX EACH,,,3623.06,7246.12,8
CPT,31630,BRONCHOSCOPY DILATE/FX REPR,,,3623.06,7246.12,8
CPT,31631,BRONCHOSCOPY DILATE W/STENT,,,6858.17,13716.34,8
CPT,31632,BRONCHOSCOPY/LUNG BX ADDL,,,,,0
CPT,31633,BRONCHOSCOPY/NEEDLE BX ADDL,,,,,0
CPT,31634,BRONCH W/BALLOON OCCLUSION,,,6858.17,13716.34,8
CPT,31635,BRONCHOSCOPY W/FB REMOVAL,,,1729.64,3459.28,8
CPT,31636,BRONCHOSCOPY BRONCH STENTS,,,6858.17,13716.34,8
CPT,31637,BRONCHOSCOPY STENT ADD-ON,,,,,0
CPT,31638,BRONCHOSCOPY REVISE STENT,,,6858.17,13716.34,8
CPT,31640,BRONCHOSCOPY W/TUMOR EXCISE,,,3623.06,7246.12,8
CPT,31641,BRONCHOSCOPY TREAT BLOCKAGE,,,3623.06,7246.12,8
CPT,31643,DIAG BRONCHOSCOPE/CATHETER,,,1729.64,3459.28,8
CPT,31645,BRNCHSC W/THER ASPIR 1ST,,,1729.64,3459.28,8
CPT,31646,BRNCHSC W/THER ASPIR SBSQ,,,380.07,760.14,8
CPT,31647,BRONCHIAL VALVE INIT INSERT,,,6858.17,13716.34,8
CPT,31648,BRONCHIAL VALVE REMOV INIT,,,3623.06,7246.12,8
CPT,31649,BRONCHIAL VALVE REMOV ADDL,,,1729.64,3459.28,8
CPT,31651,BRONCHIAL VALVE ADDL INSERT,,,,,0
CPT,31652,BRONCH EBUS SAMPLNG 1/2 NODE,,,3623.06,7246.12,8
CPT,31653,BRONCH EBUS SAMPLNG 3/> NODE,,,3623.06,7246.12,8
CPT,31654,BRONCH EBUS IVNTJ PERPH LES,,,,,0
CPT,31660,BRONCH THERMOPLSTY 1 LOBE,,,6858.17,13716.34,8
CPT,31661,BRONCH THERMOPLSTY 2/> LOBES,,,6858.17,13716.34,8
CPT,316U,B BRGDRFERI LYME DS OSPA EVL,,,18.66,37.32,8
CPT,3170F,BASELIN FLO CYTOMETRY B/4 TX,,,,,0
CPT,31717,BRONCHIAL BRUSH BIOPSY,,,380.07,760.14,8
CPT,31720,CATHETER ASPIRATION NASOTRACH,256.0,128.0,44.59,425.58,54
CPT,31720,CLEARANCE OF AIRWAYS,,,,,0
CPT,31725,CLEARANCE OF AIRWAYS,,,,,0
CPT,31730,INTRO WINDPIPE WIRE/TUBE,,,1729.64,3459.28,8
CPT,31750,REPAIR OF WINDPIPE,,,5752.66,11505.32,8
CPT,31755,REPAIR OF WINDPIPE,,,5752.66,11505.32,8
CPT,31760,REPAIR OF WINDPIPE,,,,,0
CPT,31766,RECONSTRUCTION OF WINDPIPE,,,,,0
CPT,31770,REPAIR/GRAFT OF BRONCHUS,,,,,0
CPT,31775,RECONSTRUCT BRONCHUS,,,,,0
CPT,31780,RECONSTRUCT WINDPIPE,,,,,0
CPT,31781,RECONSTRUCT WINDPIPE,,,,,0
CPT,31785,REMOVE WINDPIPE LESION,,,5752.66,11505.32,8
CPT,31786,REMOVE WINDPIPE LESION,,,,,0
CPT,317U,ONC LUNG CA 4-PRB FISH ASSAY,,,2030.0,4060.0,8
CPT,31800,REPAIR OF WINDPIPE INJURY,,,,,0
CPT,31805,REPAIR OF WINDPIPE INJURY,,,,,0
CPT,31820,CLOSURE OF WINDPIPE LESION,,,3221.84,6443.68,8
CPT,31825,REPAIR OF WINDPIPE DEFECT,,,3221.84,6443.68,8
CPT,31830,REVISE WINDPIPE SCAR,,,3221.84,6443.68,8
CPT,31899,UNLISTED PX TRACHEA BRONCHI,,,193.97,387.94,8
CPT,318U,PED WHL GEN MTHYLTN ALYS 50+,,,1770.48,3540.96,8
CPT,319U,NEPH RNA PRETRNSPL PERPH BLD,,,2650.0,5300.0,8
CPT,31U,CYP1A2 GENE,,,174.81,349.62,8
CPT,320,ANESTH NECK ORGAN 1YR/>,,,,,0
CPT,3200F,BARIUM SWALLOW TEST NOT REQ,,,,,0
CPT,32035,THORACOSTOMY W/RIB RESECTION,,,,,0
CPT,32036,THORACOSTOMY W/FLAP DRAINAGE,,,,,0
CPT,32096,OPEN WEDGE/BX LUNG INFILTR,,,,,0
CPT,32097,OPEN WEDGE/BX LUNG NODULE,,,,,0
CPT,32098,OPEN BIOPSY OF LUNG PLEURA,,,,,0
CPT,320U,NEPH RNA PSTTRNSPL PERPH BLD,,,2650.0,5300.0,8
CPT,32100,EXPLORATION OF CHEST,,,,,0
CPT,3210F,GRP A STREP TEST PERFORMED,,,,,0
CPT,32110,EXPLORE/REPAIR CHEST,,,,,0
CPT,32120,RE-EXPLORATION OF CHEST,,,,,0
CPT,32124,EXPLORE CHEST FREE ADHESIONS,,,,,0
CPT,32140,REMOVAL OF LUNG LESION(S),,,,,0
CPT,32141,REMOVE/TREAT LUNG LESIONS,,,,,0
CPT,32150,REMOVAL OF LUNG LESION(S),,,,,0
CPT,32151,REMOVE LUNG FOREIGN BODY,,,,,0
CPT,3215F,PT IMMUNITY TO HEP A DOCD,,,,,0
CPT,32160,OPEN CHEST HEART MASSAGE,,,,,0
CPT,3216F,PT IMMUNITY TO HEP B DOCD,,,,,0
CPT,3218F,RNA TSTNG HEP C DOCD DONE,,,,,0
CPT,321U,IADNA GU PTHGN 20BCT&FNG ORG,,,634.84,1269.68,8
CPT,322,ANESTH BIOPSY OF THYROID,,,,,0
CPT,32200,DRAIN OPEN LUNG LESION,,,,,0
CPT,3220F,HEP C QUANT RNA TSTNG DOCD,,,,,0
CPT,32215,TREAT CHEST LINING,,,,,0
CPT,32220,RELEASE OF LUNG,,,,,0
CPT,32225,PARTIAL RELEASE OF LUNG,,,,,0
CPT,322U,NEURO ASD MEAS 14 ACYL CARN,,,750.0,1500.0,8
CPT,3230F,NOTE HRING TST W/IN 6 MON,,,,,0
CPT,32310,REMOVAL OF CHEST LINING,,,,,0
CPT,32320,FREE/REMOVE CHEST LINING,,,,,0
CPT,323U,IADNA CNS PTHGN NEXT GEN SEQ,,,2126.2,4252.4,8
CPT,32400,NEEDLE BIOPSY CHEST LINING,,,1604.96,3209.92,8
CPT,32408,CORE NDL BX LNG/MED PERQ,,,1604.96,3209.92,8
CPT,32440,REMOVE LUNG PNEUMONECTOMY,,,,,0
CPT,32442,SLEEVE PNEUMONECTOMY,,,,,0
CPT,32445,REMOVAL OF LUNG EXTRAPLEURAL,,,,,0
CPT,32480,PARTIAL REMOVAL OF LUNG,,,,,0
CPT,32482,BILOBECTOMY,,,,,0
CPT,32484,SEGMENTECTOMY,,,,,0
CPT,32486,SLEEVE LOBECTOMY,,,,,0
CPT,32488,COMPLETION PNEUMONECTOMY,,,,,0
CPT,32491,LUNG VOLUME REDUCTION,,,,,0
CPT,32501,REPAIR BRONCHUS ADD-ON,,,,,0
CPT,32503,RESECT APICAL LUNG TUMOR,,,,,0
CPT,32504,RESECT APICAL LUNG TUM/CHEST,,,,,0
CPT,32505,WEDGE RESECT OF LUNG INITIAL,,,,,0
CPT,32506,WEDGE RESECT OF LUNG ADD-ON,,,,,0
CPT,32507,WEDGE RESECT OF LUNG DIAG,,,,,0
CPT,3250F,NONPRIM LOC ANAT BX SITE TUM,,,,,0
CPT,32540,REMOVAL OF LUNG LESION,,,,,0
CPT,32550,INSERT PLEURAL CATH,,,3479.3,6958.6,8
CPT,32551,INSERTION OF CHEST TUBE,,,1529.7,3059.4,8
CPT,32552,REMOVE LUNG CATHETER,,,609.59,1219.18,8
CPT,32553,INS MARK THOR FOR RT PERQ,,,1345.04,2690.08,8
CPT,32554,ASPIRATE PLEURA W/O IMAGING,,,609.59,1219.18,8
CPT,32555,ASPIRATE PLEURA W/ IMAGING,,,609.59,1219.18,8
CPT,32556,INSERT CATH PLEURA W/O IMAGE,,,1864.72,3729.44,8
CPT,32557,INSERT CATH PLEURA W/ IMAGE,,,1529.7,3059.4,8
CPT,32560,TREAT PLEURODESIS W/AGENT,,,609.59,1219.18,8
CPT,32561,LYSE CHEST FIBRIN INIT DAY,,,609.59,1219.18,8
CPT,32562,LYSE CHEST FIBRIN SUBQ DAY,,,609.59,1219.18,8
CPT,326,ANESTH LARYNX/TRACH < 1 YR,,,,,0
CPT,32601,THORACOSCOPY DIAGNOSTIC,,,5874.81,11749.62,8
CPT,32604,THORACOSCOPY WBX SAC,,,10329.66,20659.32,8
CPT,32606,THORACOSCOPY W/BX MED SPACE,,,5874.81,11749.62,8
CPT,32607,THORACOSCOPY W/BX INFILTRATE,,,10329.66,20659.32,8
CPT,32608,THORACOSCOPY W/BX NODULE,,,10329.66,20659.32,8
CPT,32609,THORACOSCOPY W/BX PLEURA,,,5874.81,11749.62,8
CPT,3260F,PT CAT/PN CAT/HIST GRD DOCD,,,,,0
CPT,32650,THORACOSCOPY W/PLEURODESIS,,,,,0
CPT,32651,THORACOSCOPY REMOVE CORTEX,,,,,0
CPT,32652,THORACOSCOPY REM TOTL CORTEX,,,,,0
CPT,32653,THORACOSCOPY REMOV FB/FIBRIN,,,,,0
CPT,32654,THORACOSCOPY CONTRL BLEEDING,,,,,0
CPT,32655,THORACOSCOPY RESECT BULLAE,,,,,0
CPT,32656,THORACOSCOPY W/PLEURECTOMY,,,,,0
CPT,32658,THORACOSCOPY W/SAC FB REMOVE,,,,,0
CPT,32659,THORACOSCOPY W/SAC DRAINAGE,,,,,0
CPT,3265F,RNA TSTNG HEPC VIR ORD/DOCD,,,,,0
CPT,32661,THORACOSCOPY W/PERICARD EXC,,,,,0
CPT,32662,THORACOSCOPY W/MEDIAST EXC,,,,,0
CPT,32663,THORACOSCOPY W/LOBECTOMY,,,,,0
CPT,32664,THORACOSCOPY W/ TH NRV EXC,,,,,0
CPT,32665,THORACOSCOP W/ESOPH MUSC EXC,,,,,0
CPT,32666,THORACOSCOPY W/WEDGE RESECT,,,,,0
CPT,32667,THORACOSCOPY W/W RESECT ADDL,,,,,0
CPT,32668,THORACOSCOPY W/W RESECT DIAG,,,,,0
CPT,32669,THORACOSCOPY REMOVE SEGMENT,,,,,0
CPT,3266F,HEPC GN TSTNG DOCD B/4TXMNT,,,,,0
CPT,32670,THORACOSCOPY BILOBECTOMY,,,,,0
CPT,32671,THORACOSCOPY PNEUMONECTOMY,,,,,0
CPT,32672,THORACOSCOPY FOR LVRS,,,,,0
CPT,32673,THORACOSCOPY W/THYMUS RESECT,,,,,0
CPT,32674,THORACOSCOPY LYMPH NODE EXC,,,,,0
CPT,3267F,PATH RPRT W/ PT PN CAT ET AL,,,,,0
CPT,3268F,PSA/T/GLSC DOCD B/4 TXMNT,,,,,0
CPT,3269F,BONE SCN B/4 TXMNT/AFTR DX,,,,,0
CPT,326U,TRGT GEN SEQ ALYS PNL 83+,,,5000.0,10000.0,8
CPT,32701,THORAX STEREO RAD TARGETW/TX,,,,,0
CPT,3270F,NO BONE SCN B/4 TXMNT/AFTRDX,,,,,0
CPT,3271F,LOW RISK PROSTATE CANCER,,,,,0
CPT,3272F,MED RISK PROSTATE CANCER,,,,,0
CPT,3273F,HIGH RISK PROSTATE CANCER,,,,,0
CPT,3274F,PROST CNCR RSK NOT LW/MD/HGH,,,,,0
CPT,3278F,SERUM LVLS CA/IPTH/LPD ORD,,,,,0
CPT,3279F,HGB LVL >= 13 G/DL,,,,,0
CPT,327U,FTL ANEUPLOIDY TRSMY DNA SEQ,,,795.0,1590.0,8
CPT,32800,REPAIR LUNG HERNIA,,,,,0
CPT,3280F,HGB LVL 11-12.9 G/DL,,,,,0
CPT,32810,CLOSE CHEST AFTER DRAINAGE,,,,,0
CPT,32815,CLOSE BRONCHIAL FISTULA,,,,,0
CPT,3281F,HGB LVL <11 G/DL,,,,,0
CPT,32820,RECONSTRUCT INJURED CHEST,,,,,0
CPT,3284F,IOP RED >=15% PRE-NTRV LVL,,,,,0
CPT,32850,DONOR PNEUMONECTOMY,,,,,0
CPT,32851,LUNG TRANSPLANT SINGLE,,,,,0
CPT,32852,LUNG TRANSPLANT WITH BYPASS,,,,,0
CPT,32853,LUNG TRANSPLANT DOUBLE,,,,,0
CPT,32854,LUNG TRANSPLANT WITH BYPASS,,,,,0
CPT,32855,PREPARE DONOR LUNG SINGLE,,,,,0
CPT,32856,PREPARE DONOR LUNG DOUBLE,,,,,0
CPT,3285F,IOP DOWN <15% OF PRE-SVC LVL,,,,,0
CPT,3288F,FALL RISK ASSESSMENT DOCD,,,,,0
CPT,328U,DRUG ASSAY 120+ RX&METABLT,,,114.43,228.86,8
CPT,32900,REMOVAL OF RIB(S),,,,,0
CPT,32905,REVISE & REPAIR CHEST WALL,,,,,0
CPT,32906,REVISE & REPAIR CHEST WALL,,,,,0
CPT,3290F,PT=D(RH)- AND UNSENSITIZED,,,,,0
CPT,3291F,PT=D(RH)+ OR SENSITIZED,,,,,0
CPT,3292F,HIV TSTNG ASKED/DOCD/REVWD,,,,,0
CPT,3293F,ABO RH BLOOD TYPING DOCD,,,,,0
CPT,32940,REVISION OF LUNG,,,,,0
CPT,3294F,GRP B STREP SCREENING DOCD,,,,,0
CPT,32960,THERAPEUTIC PNEUMOTHORAX,,,609.59,1219.18,8
CPT,32994,ABLATE PULM TUMOR PERQ CRYBL,,,10329.66,20659.32,8
CPT,32997,TOTAL LUNG LAVAGE,,,,,0
CPT,32998,ABLATE PULM TUMOR PERQ RF,,,5874.81,11749.62,8
CPT,32999,UNLISTED PX LUNGS & PLEURA,,,609.59,1219.18,8
CPT,329T,MNTR IO PRESS 24HRS/> UNI/BI,,,,,0
CPT,329U,ONC NEO XOME&TRNS SEQ ALYS,,,3437.98,6875.96,8
CPT,32U,COMT GENE,,,174.81,349.62,8
CPT,3300F,AJCC STAGE DOCD B/4 THXPY,,,,,0
CPT,33016,PERICARDIOCENTESIS W/IMAGING,,,1529.7,3059.4,8
CPT,33017,PRCRD DRG 6YR+ W/O CGEN CAR,,,,,0
CPT,33018,PRCRD DRG 0-5YR OR W/ANOMLY,,,,,0
CPT,33019,PERQ PRCRD DRG INSJ CATH CT,,,,,0
CPT,3301F,CANCER STAGE DOCD METAST,,,,,0
CPT,33020,INCISION OF HEART SAC,,,,,0
CPT,33025,INCISION OF HEART SAC,,,,,0
CPT,33030,PARTIAL REMOVAL OF HEART SAC,,,,,0
CPT,33031,PARTIAL REMOVAL OF HEART SAC,,,,,0
CPT,33050,RESECT HEART SAC LESION,,,,,0
CPT,330T,TEAR FILM IMG UNI/BI W/I&R,,,36.3,72.6,8
CPT,330U,IADNA VAG PTHGN PANEL 27 ORG,,,416.78,833.56,8
CPT,33120,REMOVAL OF HEART LESION,,,,,0
CPT,33130,REMOVAL OF HEART LESION,,,,,0
CPT,33140,HEART REVASCULARIZE (TMR),,,,,0
CPT,33141,HEART TMR W/OTHER PROCEDURE,,,,,0
CPT,3315F,ER+ OR PR+ BREAST CANCER,,,,,0
CPT,3316F,ER- OR PR- BREAST CANCER,,,,,0
CPT,3317F,PATH RPT MALIG CANCER DOCD,,,,,0
CPT,3318F,PATH RPT MALIG CANCER DOCD,,,,,0
CPT,3319F,X-RAY/CT/ULTRSND ET AL ORD,,,,,0
CPT,331T,HEART SYMP IMAGE PLNR,,,1258.09,2516.18,8
CPT,331U,ONC HL NEO OPT GEN MAPPING,,,1863.22,3726.44,8
CPT,33202,INSERT EPICARD ELTRD OPEN,,,,,0
CPT,33203,INSERT EPICARD ELTRD ENDO,,,,,0
CPT,33206,INSERT HEART PM ATRIAL,,,10156.85,20313.7,8
CPT,33207,INSERT HEART PM VENTRICULAR,,,10156.85,20313.7,8
CPT,33208,INSRT HEART PM ATRIAL & VENT,,,10156.85,20313.7,8
CPT,3320F,NO XRAY/CT/ ET AL ORDD,,,,,0
CPT,33210,INSERT ELECTRD/PM CATH SNGL,,,8041.71,16083.42,8
CPT,33211,INSERT CARD ELECTRODES DUAL,,,8041.71,16083.42,8
CPT,33212,INSERT PULSE GEN SNGL LEAD,,,8041.71,16083.42,8
CPT,33213,INSERT PULSE GEN DUAL LEADS,,,10156.85,20313.7,8
CPT,33214,UPGRADE OF PACEMAKER SYSTEM,,,10156.85,20313.7,8
CPT,33215,REPOSITION PACING-DEFIB LEAD,,,3068.32,6136.64,8
CPT,33216,INSERT 1 ELECTRODE PM-DEFIB,,,8041.71,16083.42,8
CPT,33217,INSERT 2 ELECTRODE PM-DEFIB,,,8041.71,16083.42,8
CPT,33218,REPAIR LEAD PACE-DEFIB ONE,,,3631.43,7262.86,8
CPT,3321F,AJCC CNCR 0/IA MELAN DOCD,,,,,0
CPT,33220,REPAIR LEAD PACE-DEFIB DUAL,,,3631.43,7262.86,8
CPT,33221,INSERT PULSE GEN MULT LEADS,,,18717.77,37435.54,8
CPT,33222,RELOCATION POCKET PACEMAKER,,,2005.02,4010.04,8
CPT,33223,RELOCATE POCKET FOR DEFIB,,,2005.02,4010.04,8
CPT,33224,INSERT PACING LEAD & CONNECT,,,10156.85,20313.7,8
CPT,33225,L VENTRIC PACING LEAD ADD-ON,,,,,0
CPT,33226,REPOSITION L VENTRIC LEAD,,,3068.32,6136.64,8
CPT,33227,REMOVE&REPLACE PM GEN SINGL,,,8041.71,16083.42,8
CPT,33228,REMV&REPLC PM GEN DUAL LEAD,,,10156.85,20313.7,8
CPT,33229,REMV&REPLC PM GEN MULT LEADS,,,18717.77,37435.54,8
CPT,3322F,MELANOMAAJCC STAGE 0 OR IA,,,,,0
CPT,33230,INSRT PULSE GEN W/DUAL LEADS,,,21615.45,43230.9,8
CPT,33231,INSRT PULSE GEN W/MULT LEADS,,,30502.49,61004.98,8
CPT,33233,REMOVAL OF PM GENERATOR,,,8041.71,16083.42,8
CPT,33234,REMOVAL OF PACEMAKER SYSTEM,,,3631.43,7262.86,8
CPT,33235,REMOVAL PACEMAKER ELECTRODE,,,3631.43,7262.86,8
CPT,33236,REMOVE ELECTRODE/THORACOTOMY,,,,,0
CPT,33237,REMOVE ELECTRODE/THORACOTOMY,,,,,0
CPT,33238,REMOVE ELECTRODE/THORACOTOMY,,,,,0
CPT,3323F,CLIN NODE STGNG DOCDB/4 SURG,,,,,0
CPT,33240,INSRT PULSE GEN W/SINGL LEAD,,,21615.45,43230.9,8
CPT,33241,REMOVE PULSE GENERATOR,,,3631.43,7262.86,8
CPT,33243,REMOVE ELTRD/THORACOTOMY,,,,,0
CPT,33244,REMOVE ELCTRD TRANSVENOUSLY,,,3631.43,7262.86,8
CPT,33249,INSJ/RPLCMT DEFIB W/LEAD(S),,,30502.49,61004.98,8
CPT,3324F,MRI CT SCAN ORD RVWD RQSTD,,,,,0
CPT,33250,ABLATE HEART DYSRHYTHM FOCUS,,,,,0
CPT,33251,ABLATE HEART DYSRHYTHM FOCUS,,,,,0
CPT,33254,ABLATE ATRIA LMTD,,,,,0
CPT,33255,ABLATE ATRIA W/O BYPASS EXT,,,,,0
CPT,33256,ABLATE ATRIA W/BYPASS EXTEN,,,,,0
CPT,33257,ABLATE ATRIA LMTD ADD-ON,,,,,0
CPT,33258,ABLATE ATRIA X10SV ADD-ON,,,,,0
CPT,33259,ABLATE ATRIA W/BYPASS ADD-ON,,,,,0
CPT,3325F,PREOP ASSES 4 CATARACT SURG,,,,,0
CPT,33261,ABLATE HEART DYSRHYTHM FOCUS,,,,,0
CPT,33262,RMVL& REPLC PULSE GEN 1 LEAD,,,21615.45,43230.9,8
CPT,33263,RMVL & RPLCMT DFB GEN 2 LEAD,,,21615.45,43230.9,8
CPT,33264,RMVL & RPLCMT DFB GEN MLT LD,,,30502.49,61004.98,8
CPT,33265,ABLATE ATRIA LMTD ENDO,,,,,0
CPT,33266,ABLATE ATRIA X10SV ENDO,,,,,0
CPT,33267,EXCL LAA OPEN ANY METHOD,,,,,0
CPT,33268,EXCL LAA OPN OTH PX ANY METH,,,,,0
CPT,33269,EXCL LAA THRSCP ANY METHOD,,,,,0
CPT,33270,INS/REP SUBQ DEFIBRILLATOR,,,30502.49,61004.98,8
CPT,33271,INSJ SUBQ IMPLTBL DFB ELCTRD,,,8041.71,16083.42,8
CPT,33272,RMVL OF SUBQ DEFIBRILLATOR,,,3631.43,7262.86,8
CPT,33273,REPOS PREV IMPLTBL SUBQ DFB,,,3631.43,7262.86,8
CPT,33274,TCAT INSJ/RPL PERM LDLS PM,,,18717.77,37435.54,8
CPT,33275,TCAT RMVL PERM LDLS PM W/IMG,,,3068.32,6136.64,8
CPT,33276,INSJ PHRNC NRV STIM SYS,,,42802.68,85605.36,8
CPT,33277,INSJ PHRNC NRV STIM TRANSVNS,,,,,0
CPT,33278,RMVL PHRNC NRV STIM SYS,,,3397.38,6794.76,8
CPT,33279,RMVL PHRNC NRV STIM TRANSVNS,,,3397.38,6794.76,8
CPT,33280,RMVL PHRNC NRV STIM PG ONLY,,,3397.38,6794.76,8
CPT,33281,REPOSG PHRNC NRV STIM TRNSVN,,,3397.38,6794.76,8
CPT,33285,INSJ SUBQ CAR RHYTHM MNTR,,,8041.71,16083.42,8
CPT,33286,RMVL SUBQ CAR RHYTHM MNTR,,,688.14,1376.28,8
CPT,33287,RMV&RPLCMT PHRNC NRV STIM PG,,,29986.33,59972.66,8
CPT,33288,RMV&RPLCMT PHRNC NRV STIM LD,,,10828.04,21656.08,8
CPT,33289,TCAT IMPL WRLS P-ART PRS SNR,,,27873.38,55746.76,8
CPT,3328F,PRFRMNC DOCD 2 WKS B/4 SURG,,,,,0
CPT,332T,HEART SYMP IMAGE PLNR SPECT,,,1258.09,2516.18,8
CPT,332U,ONC PAN TUM GEN PRFLG 8 DNA,,,1142.06,2284.12,8
CPT,33300,REPAIR OF HEART WOUND,,,,,0
CPT,33305,REPAIR OF HEART WOUND,,,,,0
CPT,3330F,IMAGING STUDY ORDERED (BKP),,,,,0
CPT,33310,EXPLORATORY HEART SURGERY,,,,,0
CPT,33315,EXPLORATORY HEART SURGERY,,,,,0
CPT,3331F,BK IMAGING TST NOT ORDERED,,,,,0
CPT,33320,REPAIR MAJOR BLOOD VESSEL(S),,,,,0
CPT,33321,REPAIR MAJOR VESSEL,,,,,0
CPT,33322,REPAIR MAJOR BLOOD VESSEL(S),,,,,0
CPT,33330,INSERT MAJOR VESSEL GRAFT,,,,,0
CPT,33335,INSERT MAJOR VESSEL GRAFT,,,,,0
CPT,33340,PERQ CLSR TCAT L ATR APNDGE,,,,,0
CPT,33361,REPLACE AORTIC VALVE PERQ,,,,,0
CPT,33362,REPLACE AORTIC VALVE OPEN,,,,,0
CPT,33363,REPLACE AORTIC VALVE OPEN,,,,,0
CPT,33364,REPLACE AORTIC VALVE OPEN,,,,,0
CPT,33365,REPLACE AORTIC VALVE OPEN,,,,,0
CPT,33366,TRCATH REPLACE AORTIC VALVE,,,,,0
CPT,33367,REPLACE AORTIC VALVE W/BYP,,,,,0
CPT,33368,REPLACE AORTIC VALVE W/BYP,,,,,0
CPT,33369,REPLACE AORTIC VALVE W/BYP,,,,,0
CPT,33370,TCAT PLMT&RMVL CEPD PERQ,,,,,0
CPT,33390,VALVULOPLASTY AORTIC VALVE,,,,,0
CPT,33391,VALVULOPLASTY AORTIC VALVE,,,,,0
CPT,333T,VISUAL EP SCR ACUITY AUTO,,,,,0
CPT,333U,ONC LVR SURVEILANC HCC CFDNA,,,662.32,1324.64,8
CPT,33404,PREPARE HEART-AORTA CONDUIT,,,,,0
CPT,33405,REPLACEMENT AORTIC VALVE OPN,,,,,0
CPT,33406,REPLACEMENT AORTIC VALVE OPN,,,,,0
CPT,3340F,MAMMO ASSESS INC XRAY DOCD,,,,,0
CPT,33410,REPLACEMENT AORTIC VALVE OPN,,,,,0
CPT,33411,REPLACEMENT OF AORTIC VALVE,,,,,0
CPT,33412,REPLACEMENT OF AORTIC VALVE,,,,,0
CPT,33413,REPLACEMENT OF AORTIC VALVE,,,,,0
CPT,33414,REPAIR OF AORTIC VALVE,,,,,0
CPT,33415,REVISION SUBVALVULAR TISSUE,,,,,0
CPT,33416,REVISE VENTRICLE MUSCLE,,,,,0
CPT,33417,REPAIR OF AORTIC VALVE,,,,,0
CPT,33418,REPAIR TCAT MITRAL VALVE,,,,,0
CPT,33419,REPAIR TCAT MITRAL VALVE,,,,,0
CPT,3341F,MAMMO ASSESS NEGATIVE DOCD,,,,,0
CPT,33420,REVISION OF MITRAL VALVE,,,,,0
CPT,33422,REVISION OF MITRAL VALVE,,,,,0
CPT,33425,REPAIR OF MITRAL VALVE,,,,,0
CPT,33426,REPAIR OF MITRAL VALVE,,,,,0
CPT,33427,REPAIR OF MITRAL VALVE,,,,,0
CPT,3342F,MAMMO ASSESS BENGN DOCD,,,,,0
CPT,33430,REPLACEMENT OF MITRAL VALVE,,,,,0
CPT,3343F,MAMMO PROBABLY BENGN DOCD,,,,,0
CPT,33440,RPLCMT A-VALVE TLCJ AUTOL PV,,,,,0
CPT,3344F,MAMMO ASSESS SUSP DOCD,,,,,0
CPT,3345F,MAMMO ASSESS HGHLYMALIG DOC,,,,,0
CPT,33460,REVISION OF TRICUSPID VALVE,,,,,0
CPT,33463,VALVULOPLASTY TRICUSPID,,,,,0
CPT,33464,VALVULOPLASTY TRICUSPID,,,,,0
CPT,33465,REPLACE TRICUSPID VALVE,,,,,0
CPT,33468,REVISION OF TRICUSPID VALVE,,,,,0
CPT,33474,REVISION OF PULMONARY VALVE,,,,,0
CPT,33475,REPLACEMENT PULMONARY VALVE,,,,,0
CPT,33476,REVISION OF HEART CHAMBER,,,,,0
CPT,33477,IMPLANT TCAT PULM VLV PERQ,,,,,0
CPT,33478,REVISION OF HEART CHAMBER,,,,,0
CPT,33496,REPAIR PROSTH VALVE CLOT,,,,,0
CPT,334U,ONC SLD ORGN TGSA DNA 84/+,,,3500.0,7000.0,8
CPT,33500,REPAIR HEART VESSEL FISTULA,,,,,0
CPT,33501,REPAIR HEART VESSEL FISTULA,,,,,0
CPT,33502,CORONARY ARTERY CORRECTION,,,,,0
CPT,33503,CORONARY ARTERY GRAFT,,,,,0
CPT,33504,CORONARY ARTERY GRAFT,,,,,0
CPT,33505,REPAIR ARTERY W/TUNNEL,,,,,0
CPT,33506,REPAIR ARTERY TRANSLOCATION,,,,,0
CPT,33507,REPAIR ART INTRAMURAL,,,,,0
CPT,33508,ENDOSCOPIC VEIN HARVEST,,,,,0
CPT,33509,NDSC HRV UXTR ART 1 SGM CAB,,,,,0
CPT,3350F,MAMMO BX PROVEN MALIG DOCD,,,,,0
CPT,33510,CABG VEIN SINGLE,,,,,0
CPT,33511,CABG VEIN TWO,,,,,0
CPT,33512,CABG VEIN THREE,,,,,0
CPT,33513,CABG VEIN FOUR,,,,,0
CPT,33514,CABG VEIN FIVE,,,,,0
CPT,33516,CABG VEIN SIX OR MORE,,,,,0
CPT,33517,CABG ARTERY-VEIN SINGLE,,,,,0
CPT,33518,CABG ARTERY-VEIN TWO,,,,,0
CPT,33519,CABG ARTERY-VEIN THREE,,,,,0
CPT,3351F,NEG SCRN DEP SYMP BY DEPTOOL,,,,,0
CPT,33521,CABG ARTERY-VEIN FOUR,,,,,0
CPT,33522,CABG ARTERY-VEIN FIVE,,,,,0
CPT,33523,CABG ART-VEIN SIX OR MORE,,,,,0
CPT,3352F,NO SIG DEP SYMP BY DEP TOOL,,,,,0
CPT,33530,CORONARY ARTERY BYPASS/REOP,,,,,0
CPT,33533,CABG ARTERIAL SINGLE,,,,,0
CPT,33534,CABG ARTERIAL TWO,,,,,0
CPT,33535,CABG ARTERIAL THREE,,,,,0
CPT,33536,CABG ARTERIAL FOUR OR MORE,,,,,0
CPT,3353F,MILD-MOD DEP SYMP BY DEPTOOL,,,,,0
CPT,33542,REMOVAL OF HEART LESION,,,,,0
CPT,33545,REPAIR OF HEART DAMAGE,,,,,0
CPT,33548,RESTORE/REMODEL VENTRICLE,,,,,0
CPT,3354F,CLIN SIG DEP SYM BY DEP TOOL,,,,,0
CPT,33572,OPEN CORONARY ENDARTERECTOMY,,,,,0
CPT,335T,INSJ SINUS TARSI IMPLANT,,,7051.31,14102.62,8
CPT,335U,RARE DS WHL GEN SEQ FETA,,,5224.6,10449.2,8
CPT,33600,CLOSURE OF VALVE,,,,,0
CPT,33602,CLOSURE OF VALVE,,,,,0
CPT,33606,ANASTOMOSIS/ARTERY-AORTA,,,,,0
CPT,33608,REPAIR ANOMALY W/CONDUIT,,,,,0
CPT,33610,REPAIR BY ENLARGEMENT,,,,,0
CPT,33611,REPAIR DOUBLE VENTRICLE,,,,,0
CPT,33612,REPAIR DOUBLE VENTRICLE,,,,,0
CPT,33615,REPAIR MODIFIED FONTAN,,,,,0
CPT,33617,REPAIR SINGLE VENTRICLE,,,,,0
CPT,33619,REPAIR SINGLE VENTRICLE,,,,,0
CPT,33620,APPLY R&L PULM ART BANDS,,,,,0
CPT,33621,TRANSTHOR CATH FOR STENT,,,,,0
CPT,33622,REDO COMPL CARDIAC ANOMALY,,,,,0
CPT,33641,REPAIR HEART SEPTUM DEFECT,,,,,0
CPT,33645,REVISION OF HEART VEINS,,,,,0
CPT,33647,REPAIR HEART SEPTUM DEFECTS,,,,,0
CPT,33660,REPAIR OF HEART DEFECTS,,,,,0
CPT,33665,REPAIR OF HEART DEFECTS,,,,,0
CPT,33670,REPAIR OF HEART CHAMBERS,,,,,0
CPT,33675,CLOSE MULT VSD,,,,,0
CPT,33676,CLOSE MULT VSD W/RESECTION,,,,,0
CPT,33677,CL MULT VSD W/REM PUL BAND,,,,,0
CPT,33681,REPAIR HEART SEPTUM DEFECT,,,,,0
CPT,33684,REPAIR HEART SEPTUM DEFECT,,,,,0
CPT,33688,REPAIR HEART SEPTUM DEFECT,,,,,0
CPT,33690,REINFORCE PULMONARY ARTERY,,,,,0
CPT,33692,REPAIR OF HEART DEFECTS,,,,,0
CPT,33694,REPAIR OF HEART DEFECTS,,,,,0
CPT,33697,REPAIR OF HEART DEFECTS,,,,,0
CPT,336U,RARE DS WHL GEN SEQ BLD/SLV,,,2574.65,5149.3,8
CPT,33702,REPAIR OF HEART DEFECTS,,,,,0
CPT,3370F,AJCC BRST CNCR STAGE 0 DOCD,,,,,0
CPT,33710,REPAIR OF HEART DEFECTS,,,,,0
CPT,33720,REPAIR OF HEART DEFECT,,,,,0
CPT,33724,REPAIR VENOUS ANOMALY,,,,,0
CPT,33726,REPAIR PUL VENOUS STENOSIS,,,,,0
CPT,3372F,AJCC BRST CNCR STAGE 1 DOCD,,,,,0
CPT,33730,REPAIR HEART-VEIN DEFECT(S),,,,,0
CPT,33732,REPAIR HEART-VEIN DEFECT,,,,,0
CPT,33735,REVISION OF HEART CHAMBER,,,,,0
CPT,33736,REVISION OF HEART CHAMBER,,,,,0
CPT,33741,TAS CONGENITAL CAR ANOMAL,,,,,0
CPT,33745,TIS CGEN CAR ANOMAL 1ST SHNT,,,,,0
CPT,33746,TIS CGEN CAR ANOMAL EA ADDL,,,,,0
CPT,3374F,AJCC BRST CNCR STAGE 1 DOCD,,,,,0
CPT,33750,MAJOR VESSEL SHUNT,,,,,0
CPT,33755,MAJOR VESSEL SHUNT,,,,,0
CPT,33762,MAJOR VESSEL SHUNT,,,,,0
CPT,33764,MAJOR VESSEL SHUNT & GRAFT,,,,,0
CPT,33766,MAJOR VESSEL SHUNT,,,,,0
CPT,33767,MAJOR VESSEL SHUNT,,,,,0
CPT,33768,CAVOPULMONARY SHUNTING,,,,,0
CPT,3376F,AJCC BRSTCNCR STAGE 2 DOCD,,,,,0
CPT,33770,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33771,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33774,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33775,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33776,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33777,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33778,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33779,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33780,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33781,REPAIR GREAT VESSELS DEFECT,,,,,0
CPT,33782,NIKAIDOH PROC,,,,,0
CPT,33783,NIKAIDOH PROC W/OSTIA IMPLT,,,,,0
CPT,33786,REPAIR ARTERIAL TRUNK,,,,,0
CPT,33788,REVISION OF PULMONARY ARTERY,,,,,0
CPT,3378F,AJCC BRSTCNCR STAGE 3 DOCD,,,,,0
CPT,337U,ONC PLSM CELL DO&MYELOMA ID,,,2435.0,4870.0,8
CPT,33800,AORTIC SUSPENSION,,,,,0
CPT,33802,REPAIR VESSEL DEFECT,,,,,0
CPT,33803,REPAIR VESSEL DEFECT,,,,,0
CPT,3380F,AJCC BRSTCNCR STAGE 4 DOCD,,,,,0
CPT,33814,REPAIR SEPTAL DEFECT,,,,,0
CPT,33820,REVISE MAJOR VESSEL,,,,,0
CPT,33822,REVISE MAJOR VESSEL,,,,,0
CPT,33824,REVISE MAJOR VESSEL,,,,,0
CPT,3382F,AJCC CLN CNCR STAGE 0 DOCD,,,,,0
CPT,33840,REMOVE AORTA CONSTRICTION,,,,,0
CPT,33845,REMOVE AORTA CONSTRICTION,,,,,0
CPT,3384F,AJCC CLN CNCR STAGE 1 DOCD,,,,,0
CPT,33851,REMOVE AORTA CONSTRICTION,,,,,0
CPT,33852,REPAIR SEPTAL DEFECT,,,,,0
CPT,33853,REPAIR SEPTAL DEFECT,,,,,0
CPT,33858,AS-AORT GRF F/AORTIC DSJ,,,,,0
CPT,33859,AS-AORT GRF F/DS OTH/THN DSJ,,,,,0
CPT,33863,ASCENDING AORTIC GRAFT,,,,,0
CPT,33864,ASCENDING AORTIC GRAFT,,,,,0
CPT,33866,AORTIC HEMIARCH GRAFT,,,,,0
CPT,3386F,AJCC CLN CNCR STAGE 2 DOCD,,,,,0
CPT,33871,TRANSVRS A-ARCH GRF HYPTHRM,,,,,0
CPT,33875,THORACIC AORTIC GRAFT,,,,,0
CPT,33877,THORACOABDOMINAL GRAFT,,,,,0
CPT,33880,ENDOVASC TAA REPR INCL SUBCL,,,,,0
CPT,33881,ENDOVASC TAA REPR W/O SUBCL,,,,,0
CPT,33883,INSERT ENDOVASC PROSTH TAA,,,,,0
CPT,33884,ENDOVASC PROSTH TAA ADD-ON,,,,,0
CPT,33886,ENDOVASC PROSTH DELAYED,,,,,0
CPT,33889,ARTERY TRANSPOSE/ENDOVAS TAA,,,,,0
CPT,3388F,AJCC CLN CNCR STAGE 3 DOCD,,,,,0
CPT,33891,CAR-CAR BP GRFT/ENDOVAS TAA,,,,,0
CPT,33894,EVASC ST RPR THRC/AA ACRS BR,,,,,0
CPT,33895,EVASC ST RPR THRC/AA X CRSG,,,,,0
CPT,33897,PERQ TRLUML ANGP NT/RECR COA,,,,,0
CPT,338T,TRNSCTH RENAL SYMP DENRV UNL,,,5530.84,11061.68,8
CPT,338U,ONC SLD TUM CRCG TUM CL SLCT,,,2435.0,4870.0,8
CPT,33900,PERQ P-ART REVSC 1 NM NT UNI,,,11218.2,22436.4,8
CPT,33901,PERQ P-ART REVSC 1 NM NT BI,,,11218.2,22436.4,8
CPT,33902,PERQ P-ART REVSC 1 ABNOR UNI,,,17813.98,35627.96,8
CPT,33903,PERQ P-ART REVSC 1 ABNOR BI,,,11218.2,22436.4,8
CPT,33904,PERQ P-ART REVSC EACH ADDL,,,,,0
CPT,3390F,AJCC CLN CNCR STAGE 4 DOCD,,,,,0
CPT,33910,REMOVE LUNG ARTERY EMBOLI,,,,,0
CPT,33915,REMOVE LUNG ARTERY EMBOLI,,,,,0
CPT,33916,SURGERY OF GREAT VESSEL,,,,,0
CPT,33917,REPAIR PULMONARY ARTERY,,,,,0
CPT,33920,REPAIR PULMONARY ATRESIA,,,,,0
CPT,33922,TRANSECT PULMONARY ARTERY,,,,,0
CPT,33924,REMOVE PULMONARY SHUNT,,,,,0
CPT,33925,RPR PUL ART UNIFOCAL W/O CPB,,,,,0
CPT,33926,REPR PUL ART UNIFOCAL W/CPB,,,,,0
CPT,33927,IMPLTJ TOT RPLCMT HRT SYS,,,,,0
CPT,33928,RMVL & RPLCMT TOT HRT SYS,,,,,0
CPT,33929,RMVL RPLCMT HRT SYS F/TRNSPL,,,,,0
CPT,33930,REMOVAL OF DONOR HEART/LUNG,,,,,0
CPT,33933,PREPARE DONOR HEART/LUNG,,,,,0
CPT,33935,TRANSPLANTATION HEART/LUNG,,,,,0
CPT,33940,REMOVAL OF DONOR HEART,,,,,0
CPT,33944,PREPARE DONOR HEART,,,,,0
CPT,33945,TRANSPLANTATION OF HEART,,,,,0
CPT,33946,ECMO/ECLS INITIATION VENOUS,,,,,0
CPT,33947,ECMO/ECLS INITIATION ARTERY,,,,,0
CPT,33948,ECMO/ECLS DAILY MGMT-VENOUS,,,,,0
CPT,33949,ECMO/ECLS DAILY MGMT ARTERY,,,,,0
CPT,3394F,QUANT HER2 IHC EVAL BRST CX,,,,,0
CPT,33951,ECMO/ECLS INSJ PRPH CANNULA,,,,,0
CPT,33952,ECMO/ECLS INSJ PRPH CANNULA,,,,,0
CPT,33953,ECMO/ECLS INSJ PRPH CANNULA,,,,,0
CPT,33954,ECMO/ECLS INSJ PRPH CANNULA,,,,,0
CPT,33955,ECMO/ECLS INSJ CTR CANNULA,,,,,0
CPT,33956,ECMO/ECLS INSJ CTR CANNULA,,,,,0
CPT,33957,ECMO/ECLS REPOS PERPH CNULA,,,,,0
CPT,33958,ECMO/ECLS REPOS PERPH CNULA,,,,,0
CPT,33959,ECMO/ECLS REPOS PERPH CNULA,,,,,0
CPT,3395F,QUANT NONHER2 IHC BRST CX,,,,,0
CPT,33962,ECMO/ECLS REPOS PERPH CNULA,,,,,0
CPT,33963,ECMO/ECLS REPOS PERPH CNULA,,,,,0
CPT,33964,ECMO/ECLS REPOS PERPH CNULA,,,,,0
CPT,33965,ECMO/ECLS RMVL PERPH CANNULA,,,,,0
CPT,33966,ECMO/ECLS RMVL PRPH CANNULA,,,,,0
CPT,33967,INSERT I-AORT PERCUT DEVICE,,,,,0
CPT,33968,REMOVE AORTIC ASSIST DEVICE,,,,,0
CPT,33969,ECMO/ECLS RMVL PERPH CANNULA,,,,,0
CPT,33970,AORTIC CIRCULATION ASSIST,,,,,0
CPT,33971,AORTIC CIRCULATION ASSIST,,,,,0
CPT,33973,INSERT BALLOON DEVICE,,,,,0
CPT,33974,REMOVE INTRA-AORTIC BALLOON,,,,,0
CPT,33975,IMPLANT VENTRICULAR DEVICE,,,,,0
CPT,33976,IMPLANT VENTRICULAR DEVICE,,,,,0
CPT,33977,REMOVE VENTRICULAR DEVICE,,,,,0
CPT,33978,REMOVE VENTRICULAR DEVICE,,,,,0
CPT,33979,INSERT INTRACORPOREAL DEVICE,,,,,0
CPT,33980,REMOVE INTRACORPOREAL DEVICE,,,,,0
CPT,33981,REPLACE VAD PUMP EXT,,,,,0
CPT,33982,REPLACE VAD INTRA W/O BP,,,,,0
CPT,33983,REPLACE VAD INTRA W/BP,,,,,0
CPT,33984,ECMO/ECLS RMVL PRPH CANNULA,,,,,0
CPT,33985,ECMO/ECLS RMVL CTR CANNULA,,,,,0
CPT,33986,ECMO/ECLS RMVL CTR CANNULA,,,,,0
CPT,33987,ARTERY EXPOS/GRAFT ARTERY,,,,,0
CPT,33988,INSERTION OF LEFT HEART VENT,,,,,0
CPT,33989,REMOVAL OF LEFT HEART VENT,,,,,0
CPT,33990,INSJ PERQ VAD L HRT ARTERIAL,,,,,0
CPT,33991,INSJ PERQ VAD L HRT ARTL&VEN,,,,,0
CPT,33992,RMVL PERQ LEFT HEART VAD,,,,,0
CPT,33993,REPOSG PERQ R/L HRT VAD,,,,,0
CPT,33995,INSJ PERQ VAD R HRT VENOUS,,,,,0
CPT,33997,RMVL PERQ RIGHT HEART VAD,,,,,0
CPT,33999,UNLISTED PX CARDIAC SURGERY,,,609.59,1219.18,8
CPT,339T,TRNSCTH RENAL SYMP DENRV BIL,,,5530.84,11061.68,8
CPT,339U,ONC PRST8 MRNA HOXC6 & DLX1,,,760.0,1520.0,8
CPT,33U,HTR2A HTR2C GENES,,,,,0
CPT,34001,REMOVAL OF ARTERY CLOT,,,,,0
CPT,34051,REMOVAL OF ARTERY CLOT,,,,,0
CPT,340U,ONC PAN CA ALYS MRD PLASMA,,,3590.0,7180.0,8
CPT,34101,REMOVAL OF ARTERY CLOT,,,5407.35,10814.7,8
CPT,34111,REMOVAL OF ARM ARTERY CLOT,,,5407.35,10814.7,8
CPT,34151,REMOVAL OF ARTERY CLOT,,,,,0
CPT,341U,FTL ANEUP DNA SEQ CMPR ALYS,,,1900.2,3800.4,8
CPT,34201,REMOVAL OF ARTERY CLOT,,,5407.35,10814.7,8
CPT,34203,REMOVAL OF LEG ARTERY CLOT,,,5407.35,10814.7,8
CPT,342T,THXP APHERESIS W/HDL DELIP,,,4232.51,8465.02,8
CPT,342U,ONC PNCRTC CA MULT IA ECLIA,,,897.0,1794.0,8
CPT,343U,ONC PRST8 XOM ALY 442 SNCRNA,,,760.0,1520.0,8
CPT,34401,REMOVAL OF VEIN CLOT,,,,,0
CPT,34421,REMOVAL OF VEIN CLOT,,,3068.32,6136.64,8
CPT,34451,REMOVAL OF VEIN CLOT,,,,,0
CPT,34471,REMOVAL OF VEIN CLOT,,,609.59,1219.18,8
CPT,34490,REMOVAL OF VEIN CLOT,,,3068.32,6136.64,8
CPT,344U,HEP NAFLD SEMIQ EVL 28 LIPID,,,792.17,1584.34,8
CPT,34501,REPAIR VALVE FEMORAL VEIN,,,5407.35,10814.7,8
CPT,34502,RECONSTRUCT VENA CAVA,,,,,0
CPT,3450F,DYSPNEA SCRND NO-MILD DYSP,,,,,0
CPT,34510,TRANSPOSITION OF VEIN VALVE,,,5407.35,10814.7,8
CPT,3451F,DYSPNEA SCRND MOD-HIGH DYSP,,,,,0
CPT,34520,CROSS-OVER VEIN GRAFT,,,5407.35,10814.7,8
CPT,3452F,DYSPNEA NOT SCREENED,,,,,0
CPT,34530,LEG VEIN FUSION,,,3068.32,6136.64,8
CPT,3455F,TB SCR PFRMD&INTERPD 6 MO,,,,,0
CPT,345T,TRANSCATH MTRAL VLVE REPAIR,,,,,0
CPT,345U,PSYC GENOM ALYS PNL 15 GEN,,,1336.09,2672.18,8
CPT,34701,EVASC RPR A-AO NDGFT,,,,,0
CPT,34702,EVASC RPR A-AO NDGFT RPT,,,,,0
CPT,34703,EVASC RPR A-UNILAC NDGFT,,,,,0
CPT,34704,EVASC RPR A-UNILAC NDGFT RPT,,,,,0
CPT,34705,EVAC RPR A-BIILIAC NDGFT,,,,,0
CPT,34706,EVASC RPR A-BIILIAC RPT,,,,,0
CPT,34707,EVASC RPR ILIO-ILIAC NDGFT,,,,,0
CPT,34708,EVASC RPR ILIO-ILIAC RPT,,,,,0
CPT,34709,PLMT XTN PROSTH EVASC RPR,,,,,0
CPT,3470F,RA DISEASE ACTIVITY LOW,,,,,0
CPT,34710,DLYD PLMT XTN PROSTH 1ST VSL,,,,,0
CPT,34711,DLYD PLMT XTN PROSTH EA ADDL,,,,,0
CPT,34712,TCAT DLVR ENHNCD FIXJ DEV,,,,,0
CPT,34713,PERQ ACCESS & CLSR FEM ART,,,,,0
CPT,34714,OPN FEM ART EXPOS CNDT CRTJ,,,,,0
CPT,34715,OPN AX/SUBCLA ART EXPOS,,,,,0
CPT,34716,OPN AX/SUBCLA ART EXPOS CNDT,,,,,0
CPT,34717,EVASC RPR A-ILIAC NDGFT,,,,,0
CPT,34718,EVASC RPR N/A A-ILIAC NDGFT,,,,,0
CPT,3471F,RA DISEASE ACTIVITY MOD,,,,,0
CPT,3472F,RA DISEASE ACTIVITY HIGH,,,,,0
CPT,3475F,DISEASE PROGN RA POOR DOCD,,,,,0
CPT,3476F,DISEASE PROGN RA GOOD DOCD,,,,,0
CPT,347T,INS BONE DEVICE FOR RSA,,,57.33,114.66,8
CPT,347U,RX METAB/PCX DNA 16 GEN ALYS,,,1336.09,2672.18,8
CPT,34808,ENDOVAS ILIAC A DEVICE ADDON,,,,,0
CPT,34812,OPN FEM ART EXPOS,,,,,0
CPT,34813,FEMORAL ENDOVAS GRAFT ADD-ON,,,,,0
CPT,34820,OPN ILIAC ART EXPOS,,,,,0
CPT,34830,OPEN AORTIC TUBE PROSTH REPR,,,,,0
CPT,34831,OPEN AORTOILIAC PROSTH REPR,,,,,0
CPT,34832,OPEN AORTOFEMOR PROSTH REPR,,,,,0
CPT,34833,OPN ILAC ART EXPOS CNDT CRTJ,,,,,0
CPT,34834,OPN BRACH ART EXPOS,,,,,0
CPT,34839,PLNNING PT SPEC FENEST GRAFT,,,,,0
CPT,34841,ENDOVASC VISC AORTA 1 GRAFT,,,,,0
CPT,34842,ENDOVASC VISC AORTA 2 GRAFT,,,,,0
CPT,34843,ENDOVASC VISC AORTA 3 GRAFT,,,,,0
CPT,34844,ENDOVASC VISC AORTA 4 GRAFT,,,,,0
CPT,34845,VISC & INFRAREN ABD 1 PROSTH,,,,,0
CPT,34846,VISC & INFRAREN ABD 2 PROSTH,,,,,0
CPT,34847,VISC & INFRAREN ABD 3 PROSTH,,,,,0
CPT,34848,VISC & INFRAREN ABD 4+ PROST,,,,,0
CPT,348T,RSA SPINE EXAM,,,101.59,203.18,8
CPT,348U,RX METAB/PCX DNA 25 GEN ALYS,,,742.27,1484.54,8
CPT,3490F,HISTORY AIDS-DEFINING COND,,,,,0
CPT,3491F,HIV UNSURE BABY OF HIV+MOMS,,,,,0
CPT,3492F,HISTORY CD4+ CELL COUNT <350,,,,,0
CPT,3493F,NO HIST CD4+ CELL COUNT <350,,,,,0
CPT,3494F,CD4+CELL COUNT <200CELLS/MM3,,,,,0
CPT,3495F,CD4+CELL CNT 200-499 CELLS,,,,,0
CPT,3496F,CD4+ CELL COUNT >= 500 CELLS,,,,,0
CPT,3497F,CD4+ CELL PERCENTAGE <15%,,,,,0
CPT,3498F,CD4+ CELL >=15% (HIV),,,,,0
CPT,349T,RSA UPPER EXTR EXAM,,,101.59,203.18,8
CPT,349U,RX METAB/PCX DNA 27GEN RX IA,,,742.27,1484.54,8
CPT,34U,TPMT NUDT15 GENES,,,466.17,932.34,8
CPT,350,ANESTH NECK VESSEL SURGERY,,,,,0
CPT,35001,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35002,REPAIR ARTERY RUPTURE NECK,,,,,0
CPT,35005,REPAIR DEFECT OF ARTERY,,,,,0
CPT,3500F,CD4+CELL CNT/% DOCD AS DONE,,,,,0
CPT,35011,REPAIR DEFECT OF ARTERY,,,5407.35,10814.7,8
CPT,35013,REPAIR ARTERY RUPTURE ARM,,,,,0
CPT,35021,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35022,REPAIR ARTERY RUPTURE CHEST,,,,,0
CPT,3502F,HIV RNA VRL LD <LMTS QUANTIF,,,,,0
CPT,3503F,HIV RNA VRL LDNOT<LMTS QUNTF,,,,,0
CPT,35045,REPAIR DEFECT OF ARM ARTERY,,,5407.35,10814.7,8
CPT,35081,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35082,REPAIR ARTERY RUPTURE AORTA,,,,,0
CPT,35091,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35092,REPAIR ARTERY RUPTURE AORTA,,,,,0
CPT,350T,RSA LOWER EXTR EXAM,,,84.57,169.14,8
CPT,350U,RX METAB/PCX DNA 27 GEN ALYS,,,1336.09,2672.18,8
CPT,35102,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35103,REPAIR ARTERY RUPTURE AORTA,,,,,0
CPT,3510F,DOC TB SCRNG-RSLTS INTERPD,,,,,0
CPT,35111,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35112,REPAIR ARTERY RUPTURE SPLEEN,,,,,0
CPT,3511F,CHLMYD/GONRH TSTS DOCD DONE,,,,,0
CPT,35121,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35122,REPAIR ARTERY RUPTURE BELLY,,,,,0
CPT,3512F,SYPH SCRNG DOCD AS DONE,,,,,0
CPT,35131,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35132,REPAIR ARTERY RUPTURE GROIN,,,,,0
CPT,3513F,HEP B SCRNG DOCD AS DONE,,,,,0
CPT,35141,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35142,REPAIR ARTERY RUPTURE THIGH,,,,,0
CPT,3514F,HEP C SCRNG DOCD AS DONE,,,,,0
CPT,35151,REPAIR DEFECT OF ARTERY,,,,,0
CPT,35152,REPAIR RUPTD POPLITEAL ART,,,,,0
CPT,3515F,PT HAS DOCD IMMUN TO HEP C,,,,,0
CPT,3517F,HBV ASSESS&RESULTS INTRP 1YR,,,,,0
CPT,35180,REPAIR BLOOD VESSEL LESION,,,1529.7,3059.4,8
CPT,35182,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35184,REPAIR BLOOD VESSEL LESION,,,3068.32,6136.64,8
CPT,35188,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,35189,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35190,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,351T,INTRAOP OCT BRST/NODE SPEC,,,,,0
CPT,351U,NFCT DS BCT/VIRAL TRAIL IP10,,,260.5,521.0,8
CPT,352,ANESTH NECK VESSEL SURGERY,,,,,0
CPT,35201,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,35206,REPAIR BLOOD VESSEL LESION,,,3068.32,6136.64,8
CPT,35207,REPAIR BLOOD VESSEL LESION,,,3068.32,6136.64,8
CPT,3520F,CDIFFICILE TESTING PERFORMED,,,,,0
CPT,35211,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35216,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35221,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35226,REPAIR BLOOD VESSEL LESION,,,688.14,1376.28,8
CPT,35231,REPAIR BLOOD VESSEL LESION,,,3068.32,6136.64,8
CPT,35236,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,35241,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35246,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35251,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35256,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,35261,REPAIR BLOOD VESSEL LESION,,,3068.32,6136.64,8
CPT,35266,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,35271,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35276,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35281,REPAIR BLOOD VESSEL LESION,,,,,0
CPT,35286,REPAIR BLOOD VESSEL LESION,,,5407.35,10814.7,8
CPT,352T,OCT BRST/NODE I&R PER SPEC,,,,,0
CPT,35301,RECHANNELING OF ARTERY,,,,,0
CPT,35302,RECHANNELING OF ARTERY,,,,,0
CPT,35303,RECHANNELING OF ARTERY,,,,,0
CPT,35304,RECHANNELING OF ARTERY,,,,,0
CPT,35305,RECHANNELING OF ARTERY,,,,,0
CPT,35306,RECHANNELING OF ARTERY,,,,,0
CPT,35311,RECHANNELING OF ARTERY,,,,,0
CPT,35321,RECHANNELING OF ARTERY,,,5407.35,10814.7,8
CPT,35331,RECHANNELING OF ARTERY,,,,,0
CPT,35341,RECHANNELING OF ARTERY,,,,,0
CPT,35351,RECHANNELING OF ARTERY,,,,,0
CPT,35355,RECHANNELING OF ARTERY,,,,,0
CPT,35361,RECHANNELING OF ARTERY,,,,,0
CPT,35363,RECHANNELING OF ARTERY,,,,,0
CPT,35371,RECHANNELING OF ARTERY,,,,,0
CPT,35372,RECHANNELING OF ARTERY,,,5407.35,10814.7,8
CPT,35390,REOPERATION CAROTID ADD-ON,,,,,0
CPT,353T,INTRAOP OCT BREAST CAVITY,,,,,0
CPT,35400,ANGIOSCOPY,,,,,0
CPT,354T,OCT BREAST SURG CAVITY I&R,,,,,0
CPT,35500,HARVEST VEIN FOR BYPASS,,,,,0
CPT,35501,ART BYP GRFT IPSILAT CAROTID,,,,,0
CPT,35506,ART BYP GRFT SUBCLAV-CAROTID,,,,,0
CPT,35508,ART BYP GRFT CAROTID-VERTBRL,,,,,0
CPT,35509,ART BYP GRFT CONTRAL CAROTID,,,,,0
CPT,3550F,LOW RSK THROMBOEMBOLISM,,,,,0
CPT,35510,ART BYP GRFT CAROTID-BRCHIAL,,,,,0
CPT,35511,ART BYP GRFT SUBCLAV-SUBCLAV,,,,,0
CPT,35512,ART BYP GRFT SUBCLAV-BRCHIAL,,,,,0
CPT,35515,ART BYP GRFT SUBCLAV-VERTBRL,,,,,0
CPT,35516,ART BYP GRFT SUBCLAV-AXILARY,,,,,0
CPT,35518,ART BYP GRFT AXILLARY-AXILRY,,,,,0
CPT,3551F,INTRMED RSK THROMBOEMBOLISM,,,,,0
CPT,35521,ART BYP GRFT AXILL-FEMORAL,,,,,0
CPT,35522,ART BYP GRFT AXILL-BRACHIAL,,,,,0
CPT,35523,ART BYP GRFT BRCHL-ULNR-RDL,,,,,0
CPT,35525,ART BYP GRFT BRACHIAL-BRCHL,,,,,0
CPT,35526,ART BYP GRFT AOR/CAROT/INNOM,,,,,0
CPT,3552F,HGH RISK FOR THROMBOEMBOLISM,,,,,0
CPT,35531,ART BYP GRFT AORCEL/AORMESEN,,,,,0
CPT,35533,ART BYP GRFT AXILL/FEM/FEM,,,,,0
CPT,35535,ART BYP GRFT HEPATORENAL,,,,,0
CPT,35536,ART BYP GRFT SPLENORENAL,,,,,0
CPT,35537,ART BYP GRFT AORTOILIAC,,,,,0
CPT,35538,ART BYP GRFT AORTOBI-ILIAC,,,,,0
CPT,35539,ART BYP GRFT AORTOFEMORAL,,,,,0
CPT,35540,ART BYP GRFT AORTBIFEMORAL,,,,,0
CPT,35556,ART BYP GRFT FEM-POPLITEAL,,,,,0
CPT,35558,ART BYP GRFT FEM-FEMORAL,,,,,0
CPT,3555F,PT INR MEASUREMENT PERFORMED,,,,,0
CPT,35560,ART BYP GRFT AORTORENAL,,,,,0
CPT,35563,ART BYP GRFT ILIOILIAC,,,,,0
CPT,35565,ART BYP GRFT ILIOFEMORAL,,,,,0
CPT,35566,ART BYP FEM-ANT-POST TIB/PRL,,,,,0
CPT,35570,ART BYP TIBIAL-TIB/PERONEAL,,,,,0
CPT,35571,ART BYP POP-TIBL-PRL-OTHER,,,,,0
CPT,35572,HARVEST FEMOROPOPLITEAL VEIN,,,,,0
CPT,35583,VEIN BYP GRFT FEM-POPLITEAL,,,,,0
CPT,35585,VEIN BYP FEM-TIBIAL PERONEAL,,,,,0
CPT,35587,VEIN BYP POP-TIBL PERONEAL,,,,,0
CPT,355U,APOL1 RISK VARIANTS,,,137.0,274.0,8
CPT,35600,OPEN HRV UXTR ART 1 SGM CAB,,,,,0
CPT,35601,ART BYP COMMON IPSI CAROTID,,,,,0
CPT,35606,ART BYP CAROTID-SUBCLAVIAN,,,,,0
CPT,35612,ART BYP SUBCLAV-SUBCLAVIAN,,,,,0
CPT,35616,ART BYP SUBCLAV-AXILLARY,,,,,0
CPT,35621,ART BYP AXILLARY-FEMORAL,,,,,0
CPT,35623,ART BYP AXILLARY-POP-TIBIAL,,,,,0
CPT,35626,ART BYP AORSUBCL/CAROT/INNOM,,,,,0
CPT,35631,ART BYP AOR-CELIAC-MSN-RENAL,,,,,0
CPT,35632,ART BYP ILIO-CELIAC,,,,,0
CPT,35633,ART BYP ILIO-MESENTERIC,,,,,0
CPT,35634,ART BYP ILIORENAL,,,,,0
CPT,35636,ART BYP SPENORENAL,,,,,0
CPT,35637,ART BYP AORTOILIAC,,,,,0
CPT,35638,ART BYP AORTOBI-ILIAC,,,,,0
CPT,35642,ART BYP CAROTID-VERTEBRAL,,,,,0
CPT,35645,ART BYP SUBCLAV-VERTEBRL,,,,,0
CPT,35646,ART BYP AORTOBIFEMORAL,,,,,0
CPT,35647,ART BYP AORTOFEMORAL,,,,,0
CPT,35650,ART BYP AXILLARY-AXILLARY,,,,,0
CPT,35654,ART BYP AXILL-FEM-FEMORAL,,,,,0
CPT,35656,ART BYP FEMORAL-POPLITEAL,,,,,0
CPT,35661,ART BYP FEMORAL-FEMORAL,,,,,0
CPT,35663,ART BYP ILIOILIAC,,,,,0
CPT,35665,ART BYP ILIOFEMORAL,,,,,0
CPT,35666,ART BYP FEM-ANT-POST TIB/PRL,,,,,0
CPT,35671,ART BYP POP-TIBL-PRL-OTHER,,,,,0
CPT,35681,COMPOSITE BYP GRFT PROS&VEIN,,,,,0
CPT,35682,COMPOSITE BYP GRFT 2 VEINS,,,,,0
CPT,35683,COMPOSITE BYP GRFT 3/> SEGMT,,,,,0
CPT,35685,BYPASS GRAFT PATENCY/PATCH,,,,,0
CPT,35686,BYPASS GRAFT/AV FIST PATENCY,,,,,0
CPT,35691,ART TRNSPOSJ VERTBRL CAROTID,,,,,0
CPT,35693,ART TRNSPOSJ SUBCLAVIAN,,,,,0
CPT,35694,ART TRNSPOSJ SUBCLAV CAROTID,,,,,0
CPT,35695,ART TRNSPOSJ CAROTID SUBCLAV,,,,,0
CPT,35697,REIMPLANT ARTERY EACH,,,,,0
CPT,356U,ONC OROP/ANAL 17 DNA DDPCR,,,1800.0,3600.0,8
CPT,35700,REOPERATION BYPASS GRAFT,,,,,0
CPT,35701,EXPL N/FLWD SURG NECK ART,,,,,0
CPT,35702,EXPL N/FLWD SURG UXTR ART,,,,,0
CPT,35703,EXPL N/FLWD SURG LXTR ART,,,,,0
CPT,3570F,RPRT BONE SCINT XREF W XRAY,,,,,0
CPT,3572F,PT CONSID POSS RISK FX,,,,,0
CPT,3573F,PT NOT CONSID POSS RISK FX,,,,,0
CPT,35800,EXPLORE NECK VESSELS,,,5407.35,10814.7,8
CPT,35820,EXPLORE CHEST VESSELS,,,,,0
CPT,35840,EXPLORE ABDOMINAL VESSELS,,,,,0
CPT,35860,EXPLORE LIMB VESSELS,,,3068.32,6136.64,8
CPT,35870,REPAIR VESSEL GRAFT DEFECT,,,,,0
CPT,35875,REMOVAL OF CLOT IN GRAFT,,,5407.35,10814.7,8
CPT,35876,REMOVAL OF CLOT IN GRAFT,,,5407.35,10814.7,8
CPT,35879,REVISE GRAFT W/VEIN,,,5407.35,10814.7,8
CPT,35881,REVISE GRAFT W/VEIN,,,5407.35,10814.7,8
CPT,35883,REVJ FEM ANAST NONAUTOG GRF,,,5407.35,10814.7,8
CPT,35884,REVJ FEM ANAST AUTOG VN GRF,,,5407.35,10814.7,8
CPT,358T,BIA WHOLE BODY,,,28.11,56.22,8
CPT,358U,NEURO ALYS B-AMYL 1-42&1-40,,,260.5,521.0,8
CPT,35901,EXCISION GRAFT NECK,,,,,0
CPT,35903,EXCISION GRAFT EXTREMITY,,,3068.32,6136.64,8
CPT,35905,EXCISION GRAFT THORAX,,,,,0
CPT,35907,EXCISION GRAFT ABDOMEN,,,,,0
CPT,359U,ONC PRST8 CA ALYS ALL PSA,,,760.0,1520.0,8
CPT,35U,NEURO CSF PRION PRTN QUAL,,,540.99,1081.98,8
CPT,36000,PLACE NEEDLE IN VEIN,,,,,0
CPT,36002,PSEUDOANEURYSM INJECTION TRT,2557.0,1278.5,442.81,2494.84,106
CPT,36005,INJECTION EXT VENOGRAPHY,,,286.93,333.21,16
CPT,36010,PLACE CATHETER IN VEIN,,,,,0
CPT,36011,PLACE CATHETER IN VEIN,,,,,0
CPT,36012,PLACE CATHETER IN VEIN,,,,,0
CPT,36013,PLACE CATHETER IN ARTERY,,,,,0
CPT,36014,PLACE CATHETER IN ARTERY,,,,,0
CPT,36015,PLACE CATHETER IN ARTERY,,,,,0
CPT,360U,ONC LUNG ELISA 7 AUTOANT ALG,,,840.65,1681.3,8
CPT,36100,ESTABLISH ACCESS TO ARTERY,,,,,0
CPT,36140,INTRO NDL ICATH UPR/LXTR ART,,,417.07,484.34,16
CPT,36160,ESTABLISH ACCESS TO AORTA,,,,,0
CPT,361U,NEURFLMNT LT CHN DIG IA QUAN,,,,,0
CPT,36200,PLACE CATHETER IN AORTA,,,,,0
CPT,36215,PLACE CATHETER IN ARTERY,,,,,0
CPT,36216,PLACE CATHETER IN ARTERY,,,,,0
CPT,36217,PLACE CATHETER IN ARTERY,,,,,0
CPT,36218,PLACE CATHETER IN ARTERY,,,,,0
CPT,36221,PLACE CATH THORACIC AORTA,,,3068.32,6136.64,8
CPT,36222,PLACE CATH CAROTID/INOM ART,,,3068.32,6136.64,8
CPT,36223,PLACE CATH CAROTID/INOM ART,,,5407.35,10814.7,8
CPT,36224,PLACE CATH CAROTD ART,,,5407.35,10814.7,8
CPT,36225,PLACE CATH SUBCLAVIAN ART,,,3068.32,6136.64,8
CPT,36226,PLACE CATH VERTEBRAL ART,,,5407.35,10814.7,8
CPT,36227,PLACE CATH XTRNL CAROTID,,,,,0
CPT,36228,PLACE CATH INTRACRANIAL ART,,,,,0
CPT,36245,INS CATH ABD/L-EXT ART 1ST,,,,,0
CPT,36246,INS CATH ABD/L-EXT ART 2ND,,,,,0
CPT,36247,INS CATH ABD/L-EXT ART 3RD,,,,,0
CPT,36248,INS CATH ABD/L-EXT ART ADDL,,,,,0
CPT,36251,INS CATH REN ART 1ST UNILAT,,,3068.32,6136.64,8
CPT,36252,INS CATH REN ART 1ST BILAT,,,3068.32,6136.64,8
CPT,36253,INS CATH REN ART 2ND+ UNILAT,,,5407.35,10814.7,8
CPT,36254,INS CATH REN ART 2ND+ BILAT,,,3068.32,6136.64,8
CPT,36260,INSERTION OF INFUSION PUMP,,,5407.35,10814.7,8
CPT,36261,REVISION OF INFUSION PUMP,,,3631.43,7262.86,8
CPT,36262,REMOVAL OF INFUSION PUMP,,,3631.43,7262.86,8
CPT,36299,UNLISTED PX VASCULAR NJX,,,,,0
CPT,362T,BHV ID SUPRT ASSMT EA 15 MIN,,,36.41,72.82,8
CPT,362U,ONC PAP THYR CA RNA 82&10,,,3600.0,7200.0,8
CPT,363U,ONC URTHL MRNA 5 GEN ALG,,,760.0,1520.0,8
CPT,36400,BL DRAW < 3 YRS FEM/JUGULAR,,,,,0
CPT,36405,BL DRAW <3 YRS SCALP VEIN,,,,,0
CPT,36406,BL DRAW <3 YRS OTHER VEIN,,,,,0
CPT,36410,CRNA-VNPNXR BL DRAW 3 YRS/>,134.0,67.0,23.34,129.98,47
CPT,36415,MUD ROUTINE VENIPUNCTURE NHCI,13543.0,6771.5,9.34,13136.71,53
CPT,36415,ROUTINE VENIPUNCTURE,,,,,0
CPT,36415,VENIPUNCTURE,31.0,15.5,5.22,31.04,270
CPT,36416,CAPILLARY BLOOD DRAW,34.0,17.0,5.74,33.95,94
CPT,36416,COLLJ CAPILLARY BLOOD SPEC,,,,,0
CPT,36416,NEWBORN METABOLIC SCRN CAPILLARY BLOOD DRAW,275.0,137.5,47.9,266.75,47
CPT,36420,VENIPUNCTURE CUTDOWN < 1 YR,,,129.29,258.58,8
CPT,36425,VENIPUNCTURE CUTDOWN 1 YR/>,,,434.11,868.22,8
CPT,36430,BLOOD ADMIN >0-2 HRS,757.0,378.5,131.86,857.44,106
CPT,36430,BLOOD ADMIN >2-4 HRS,1144.0,572.0,199.28,1109.68,106
CPT,36430,BLOOD ADMIN >4-6 HRS,1666.0,833.0,290.21,1616.02,106
CPT,36430,BLOOD ADMIN >6-12 HRS,2185.0,1092.5,380.62,2119.45,106
CPT,36430,TRANSFUSION BLD/BLD COMPNT,,,,,0
CPT,36440,BLD PUSH TFUJ 2 YR/<,,,428.72,857.44,8
CPT,36450,BLD EXCHANGE TRUJ NEWBORN,,,428.72,857.44,8
CPT,36455,ARC BLOOD EXCHANGE/TRANSFUSE NON-NB,5061.0,2530.5,428.72,4909.17,53
CPT,36455,BLD EXCHANGE TRUJ OTH THN NB,,,,,0
CPT,36456,PRTL EXCHANGE TRANSFUSE NB,,,428.72,857.44,8
CPT,36460,INTRAUTERINE TRANSFUSION FTL,,,428.72,857.44,8
CPT,36465,NJX NONCMPND SCLRSNT 1 VEIN,,,2005.02,4010.04,8
CPT,36466,NJX NONCMPND SCLRSNT MLT VN,,,2005.02,4010.04,8
CPT,36468,NJX SCLRSNT SPIDER VEINS,,,395.04,790.08,8
CPT,36470,NJX SCLRSNT 1 INCMPTNT VEIN,,,395.04,790.08,8
CPT,36471,NJX SCLRSNT MLT INCMPTNT VN,,,395.04,790.08,8
CPT,36473,ENDOVENOUS MCHNCHEM 1ST VEIN,,,3068.32,6136.64,8
CPT,36474,ENDOVENOUS MCHNCHEM ADD-ON,,,,,0
CPT,36475,ENDOVENOUS RF 1ST VEIN,,,3068.32,6136.64,8
CPT,36476,ENDOVENOUS RF VEIN ADD-ON,,,,,0
CPT,36478,ENDOVENOUS LASER 1ST VEIN,,,3068.32,6136.64,8
CPT,36479,ENDOVENOUS LASER VEIN ADDON,,,,,0
CPT,36481,INSERTION OF CATHETER VEIN,,,,,0
CPT,36482,ENDOVEN THER CHEM ADHES 1ST,,,5407.35,10814.7,8
CPT,36483,ENDOVEN THER CHEM ADHES SBSQ,,,,,0
CPT,364U,ONC HL NEO GEN SEQ ALYS ALG,,,2007.25,4014.5,8
CPT,36500,INSERTION OF CATHETER VEIN,,,,,0
CPT,3650F,EEG ORDERED RVWD REQSTD,,,,,0
CPT,36510,INSERTION OF CATHETER VEIN,,,,,0
CPT,36511,APHERESIS WBC,,,,,0
CPT,36511,ARC APHERESIS THERAPEUTIC WBC,4098.5,2049.25,669.1,4225.32,108
CPT,36511,MUD THERAPEUTIC APHERESIS WHITE BLOOD CELLS NHCI,4633.0,2316.5,807.06,4494.01,53
CPT,36512,APHERESIS RBC,,,,,0
CPT,36512,ARC APHERESIS THERAPEUTIC RBC,4430.5,2215.25,661.96,4909.17,108
CPT,36512,MUD THERAPEUTIC APHERESIS RED BLOOD CELLS NHCI,4633.0,2316.5,807.06,4494.01,53
CPT,36513,APHERESIS PLATELETS,,,,,0
CPT,36513,ARC APHERESIS THERAPEUTIC PLATELETS,4430.5,2215.25,428.72,4909.17,108
CPT,36513,MUD THERAPEUTIC APHERESIS PLATELETS NHCI,1389.0,694.5,241.96,1347.33,53
CPT,36514,APHERESIS PLASMA,,,,,0
CPT,36514,APHERESIS THERAPEUTIC PLASMA PHERESIS,5578.0,2789.0,841.21,6137.19,108
CPT,36514,ARC APHERESIS THERAPEUTIC PLASMA PHERESIS,6318.0,3159.0,1100.59,6128.46,54
CPT,36514,MUD THERAPEUTIC APHERESIS PLASMA PHERESIS NHCI,4633.0,2316.5,807.06,4494.01,53
CPT,36516,APHERESIS IMMUNOADS SLCTV,,,,,0
CPT,36516,MUD THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION NHCI,14173.0,7086.5,2468.93,13747.81,53
CPT,36522,MUD PHOTOPHERESIS EXTRACORPOREAL NHCI,14173.0,7086.5,2468.93,13747.81,53
CPT,36522,PHOTOPHERESIS,,,,,0
CPT,36522,PHOTOPHERESIS EXTRACORPOREAL,15395.0,7697.5,2681.8,14933.15,53
CPT,36555,INSERT NON-TUNNEL CV CATH,,,3068.32,6136.64,8
CPT,36556,INSERT NON-TUNNEL CV CATH,,,3068.32,6136.64,8
CPT,36557,INSERT TUNNELED CV CATH,,,5407.35,10814.7,8
CPT,36558,INSERT TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36560,INSERT TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36561,INSERT TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36563,INSERT TUNNELED CV CATH,,,5407.35,10814.7,8
CPT,36565,INSERT TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36566,INSERT TUNNELED CV CATH,,,5407.35,10814.7,8
CPT,36568,INSJ PICC <5 YR W/O IMAGING,,,1529.7,3059.4,8
CPT,36569,INSJ PICC 5 YR+ W/O IMAGING,,,1529.7,3059.4,8
CPT,36570,INSERT PICVAD CATH,,,3068.32,6136.64,8
CPT,36571,INSERT PICVAD CATH,,,3068.32,6136.64,8
CPT,36572,INSJ PICC RS&I <5 YR,,,609.59,1219.18,8
CPT,36573,INSJ PICC RS&I 5 YR+,,,1529.7,3059.4,8
CPT,36575,REPAIR TUNNELED CV CATH,,,609.59,1219.18,8
CPT,36576,REPAIR TUNNELED CV CATH,,,1529.7,3059.4,8
CPT,36578,REPLACE TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36580,REPLACE CVAD CATH,,,1529.7,3059.4,8
CPT,36581,REPLACE TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36582,REPLACE TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36583,REPLACE TUNNELED CV CATH,,,5407.35,10814.7,8
CPT,36584,COMPL RPLCMT PICC RS&I,,,1529.7,3059.4,8
CPT,36585,REPLACE PICVAD CATH,,,3068.32,6136.64,8
CPT,36589,REMOVAL TUNNELED CV CATH,,,609.59,1219.18,8
CPT,36590,REMOVAL TUNNELED CV CATH,2313.0,1156.5,402.92,3059.4,54
CPT,36591,DRAW BLOOD OFF VENOUS DEVICE,,,,,0
CPT,36591,VENOUS ACCESS DRAW,196.0,98.0,30.48,258.58,108
CPT,36592,COLLECT BLOOD FROM PICC,,,,,0
CPT,36592,PICC LINE DRAW,215.5,107.75,37.27,258.58,108
CPT,36593,DECLOT BY THROMBOLYTIC AGENT,744.5,372.25,107.82,843.9,108
CPT,36593,DECLOT VASCULAR DEVICE,,,,,0
CPT,36595,MECH REMOV TUNNELED CV CATH,,,3068.32,6136.64,8
CPT,36596,MECH REMOV TUNNELED CV CATH,,,1529.7,3059.4,8
CPT,36597,REPOSITION VENOUS CATHETER,,,1529.7,3059.4,8
CPT,36598,INJ W/FLUOR EVAL CV DEVICE,,,96.02,413.4,24
CPT,365U,ONC BLDR 10 PRB BLDR CA,,,897.0,1794.0,8
CPT,36600,ARTERIAL PUNCTURE,142.0,71.0,24.73,258.58,54
CPT,36600,WITHDRAWAL OF ARTERIAL BLOOD,,,,,0
CPT,36620,ARTERIAL LINE PLACEMENT,1060.0,530.0,184.65,1028.2,47
CPT,36620,CRNA-ARTERIAL LINE,276.0,138.0,48.07,267.72,46
CPT,36620,INSERTION CATHETER ARTERY,,,,,0
CPT,36625,INSERTION CATHETER ARTERY,,,,,0
CPT,36640,INSERTION CATHETER ARTERY,,,3068.32,6136.64,8
CPT,36660,INSERTION CATHETER ARTERY,,,,,0
CPT,36680,INSERT NEEDLE BONE CAVITY,,,434.11,868.22,8
CPT,366U,ONC BLDR 10 PRB RECR BLDR CA,,,897.0,1794.0,8
CPT,367U,ONC BLDR 10 FLWG TRURL RESCJ,,,902.18,1804.36,8
CPT,36800,INSERTION OF CANNULA,,,5407.35,10814.7,8
CPT,36810,INSERTION OF CANNULA,,,3068.32,6136.64,8
CPT,36815,INSERTION OF CANNULA,,,5407.35,10814.7,8
CPT,36818,AV FUSE UPPR ARM CEPHALIC,,,5407.35,10814.7,8
CPT,36819,AV FUSE UPPR ARM BASILIC,,,5407.35,10814.7,8
CPT,36820,AV FUSION/FOREARM VEIN,,,5407.35,10814.7,8
CPT,36821,AV FUSION DIRECT ANY SITE,,,3068.32,6136.64,8
CPT,36823,INSERTION OF CANNULA(S),,,,,0
CPT,36825,ARTERY-VEIN AUTOGRAFT,,,5407.35,10814.7,8
CPT,36830,ARTERY-VEIN NONAUTOGRAFT,,,5407.35,10814.7,8
CPT,36831,OPEN THROMBECT AV FISTULA,,,5407.35,10814.7,8
CPT,36832,AV FISTULA REVISION OPEN,,,5407.35,10814.7,8
CPT,36833,AV FISTULA REVISION,,,5407.35,10814.7,8
CPT,36835,ARTERY TO VEIN SHUNT,,,3068.32,6136.64,8
CPT,36836,PRQ AV FSTL CRTJ UXTR 1 ACS,,,17813.98,35627.96,8
CPT,36837,PRQ AV FSTL CRT UXTR SEP ACS,,,17813.98,35627.96,8
CPT,36838,DIST REVAS LIGATION HEMO,,,5407.35,10814.7,8
CPT,36860,EXTERNAL CANNULA DECLOTTING,,,1529.7,3059.4,8
CPT,36861,CANNULA DECLOTTING,,,5407.35,10814.7,8
CPT,368U,ONC CLRCT CA MUT&MTHYLTN MRK,,,416.78,833.56,8
CPT,36901,INTRO CATH DIALYSIS CIRCUIT,,,1529.7,3059.4,8
CPT,36902,INTRO CATH DIALYSIS CIRCUIT,,,5530.84,11061.68,8
CPT,36903,INTRO CATH DIALYSIS CIRCUIT,,,11218.2,22436.4,8
CPT,36904,THRMBC/NFS DIALYSIS CIRCUIT,,,5530.84,11061.68,8
CPT,36905,THRMBC/NFS DIALYSIS CIRCUIT,,,11218.2,22436.4,8
CPT,36906,THRMBC/NFS DIALYSIS CIRCUIT,,,17813.98,35627.96,8
CPT,36907,BALO ANGIOP CTR DIALYSIS SEG,,,,,0
CPT,36908,STENT PLMT CTR DIALYSIS SEG,,,,,0
CPT,36909,DIALYSIS CIRCUIT EMBOLJ,,,,,0
CPT,36U,XOME TUM & NML SPEC SEQ ALYS,,,4780.0,9560.0,8
CPT,3700F,PSYCH DISORDERS ASSESSED,,,,,0
CPT,37140,REVISION OF CIRCULATION,,,,,0
CPT,37145,REVISION OF CIRCULATION,,,,,0
CPT,37160,REVISION OF CIRCULATION,,,,,0
CPT,37180,REVISION OF CIRCULATION,,,,,0
CPT,37181,SPLICE SPLEEN/KIDNEY VEINS,,,,,0
CPT,37182,INSERT HEPATIC SHUNT (TIPS),,,17813.98,35627.96,8
CPT,37183,REVISION TIPS,,,5530.84,11061.68,8
CPT,37184,PRIM ART M-THRMBC 1ST VSL,,,17813.98,35627.96,8
CPT,37185,PRIM ART M-THRMBC SBSQ VSL,,,,,0
CPT,37186,SEC ART THROMBECTOMY ADD-ON,,,,,0
CPT,37187,VENOUS MECH THROMBECTOMY,,,11218.2,22436.4,8
CPT,37188,VEN MECHNL THRMBC REPEAT TX,,,3068.32,6136.64,8
CPT,37191,INS ENDOVAS VENA CAVA FILTR,,,5407.35,10814.7,8
CPT,37192,REDO ENDOVAS VENA CAVA FILTR,,,3068.32,6136.64,8
CPT,37193,REM ENDOVAS VENA CAVA FILTER,,,3068.32,6136.64,8
CPT,37195,THROMBOLYTIC THERAPY STROKE,,,320.98,641.96,8
CPT,37197,REMOVE INTRVAS FOREIGN BODY,,,3068.32,6136.64,8
CPT,371U,IADNA GU PTHGN SEMIQ DNA16&1,,,416.78,833.56,8
CPT,37200,TRANSCATHETER BIOPSY,,,5407.35,10814.7,8
CPT,3720F,COGNIT IMPAIRMENT ASSESSED,,,,,0
CPT,37211,THROMBOLYTIC ART THERAPY,,,5407.35,10814.7,8
CPT,37212,THROMBOLYTIC VENOUS THERAPY,,,3068.32,6136.64,8
CPT,37213,THROMBLYTIC ART/VEN THERAPY,,,3068.32,6136.64,8
CPT,37214,CESSJ THERAPY CATH REMOVAL,,,3068.32,6136.64,8
CPT,37215,TRANSCATH STENT CCA W/EPS,,,,,0
CPT,37216,TRANSCATH STENT CCA W/O EPS,,,,,0
CPT,37217,STENT PLACEMT RETRO CAROTID,,,,,0
CPT,37218,STENT PLACEMT ANTE CAROTID,,,,,0
CPT,37220,ILIAC REVASC,,,,,0
CPT,37221,ILIAC REVASC W/STENT,,,,,0
CPT,37222,ILIAC REVASC ADD-ON,,,,,0
CPT,37223,ILIAC REVASC W/STENT ADD-ON,,,,,0
CPT,37224,FEM/POPL REVAS W/TLA,,,,,0
CPT,37225,FEM/POPL REVAS W/ATHER,,,,,0
CPT,37226,FEM/POPL REVASC W/STENT,,,,,0
CPT,37227,FEM/POPL REVASC STNT & ATHER,,,,,0
CPT,37228,TIB/PER REVASC W/TLA,,,,,0
CPT,37229,TIB/PER REVASC W/ATHER,,,,,0
CPT,37230,TIB/PER REVASC W/STENT,,,,,0
CPT,37231,TIB/PER REVASC STENT & ATHER,,,,,0
CPT,37232,TIB/PER REVASC ADD-ON,,,,,0
CPT,37233,TIBPER REVASC W/ATHER ADD-ON,,,,,0
CPT,37234,REVSC OPN/PRQ TIB/PERO STENT,,,,,0
CPT,37235,TIB/PER REVASC STNT & ATHER,,,,,0
CPT,37236,OPEN/PERQ PLACE STENT 1ST,,,11218.2,22436.4,8
CPT,37237,OPEN/PERQ PLACE STENT EA ADD,,,,,0
CPT,37238,OPEN/PERQ PLACE STENT SAME,,,11218.2,22436.4,8
CPT,37239,OPEN/PERQ PLACE STENT EA ADD,,,,,0
CPT,37241,VASC EMBOLIZE/OCCLUDE VENOUS,,,11218.2,22436.4,8
CPT,37242,VASC EMBOLIZE/OCCLUDE ARTERY,,,17813.98,35627.96,8
CPT,37243,VASC EMBOLIZE/OCCLUDE ORGAN,,,11218.2,22436.4,8
CPT,37244,VASC EMBOLIZE/OCCLUDE BLEED,,,11218.2,22436.4,8
CPT,37246,TRLUML BALO ANGIOP 1ST ART,,,5530.84,11061.68,8
CPT,37247,TRLUML BALO ANGIOP ADDL ART,,,,,0
CPT,37248,TRLUML BALO ANGIOP 1ST VEIN,,,5530.84,11061.68,8
CPT,37249,TRLUML BALO ANGIOP ADDL VEIN,,,,,0
CPT,37252,INTRVASC US NONCORONARY 1ST,,,,,0
CPT,37253,INTRVASC US NONCORONARY ADDL,,,,,0
CPT,3725F,SCREEN DEPRESSION PERFORMED,,,,,0
CPT,372U,NFCT DS GU PTHGN ARG DETCJ,,,416.78,833.56,8
CPT,373T,ADAPT BHV TX EA 15 MIN,,,36.41,72.82,8
CPT,37500,ENDOSCOPY LIGATE PERF VEINS,,,,,0
CPT,37501,UNLISTED VASC ENDOSCOPY PX,,,609.59,1219.18,8
CPT,3750F,PTNOTRCVNGSTEROID>=10MG/DAY,,,,,0
CPT,3751F,ELECTRODIAG POLYNEURO 6 MN,,,,,0
CPT,3752F,NO ELECTRODIAG POLYNEURO 6MN,,,,,0
CPT,3753F,PT HAS SYMP&SIGNS NEUROPATHY,,,,,0
CPT,3754F,SCREENING TESTS DM DONE,,,,,0
CPT,3755F,COG&BEHAV IMPRMNT SCRNG DONE,,,,,0
CPT,37565,LIGATION OF NECK VEIN,,,3068.32,6136.64,8
CPT,3756F,PT W/PSEUDOBULB AFFECT/ALS,,,,,0
CPT,3757F,PT W/O PSEUDOBULBAFFECT/ALS,,,,,0
CPT,3758F,PT REF PULM FX TEST/PEAKFLOW,,,,,0
CPT,3759F,PT SCRN DYSPHAG/WT LOSS/NUTR,,,,,0
CPT,375U,ONC OVRN BCHM ASY 7 PRTN ALG,,,897.0,1794.0,8
CPT,37600,LIGATION OF NECK ARTERY,,,3068.32,6136.64,8
CPT,37605,LIGATION OF NECK ARTERY,,,3068.32,6136.64,8
CPT,37606,LIGATION OF NECK ARTERY,,,3068.32,6136.64,8
CPT,37607,LIGATION OF A-V FISTULA,,,3068.32,6136.64,8
CPT,37609,TEMPORAL ARTERY PROCEDURE,,,1604.96,3209.92,8
CPT,3760F,PT W/DYSPHAG/WT LOSS/NUTR,,,,,0
CPT,37615,LIGATION OF NECK ARTERY,,,3068.32,6136.64,8
CPT,37616,LIGATION OF CHEST ARTERY,,,,,0
CPT,37617,LIGATION OF ABDOMEN ARTERY,,,5407.35,10814.7,8
CPT,37618,LIGATION OF EXTREMITY ARTERY,,,,,0
CPT,37619,LIGATION OF INF VENA CAVA,,,5407.35,10814.7,8
CPT,3761F,PT W/O DYSPHAG/WT LOSS/NUTR,,,,,0
CPT,3762F,PATIENT IS DYSARTHRIC,,,,,0
CPT,3763F,PATIENT IS NOT DYSARTHRIC,,,,,0
CPT,37650,REVISION OF MAJOR VEIN,,,3068.32,6136.64,8
CPT,37660,REVISION OF MAJOR VEIN,,,,,0
CPT,376U,ONC PRST8 CA IMG ALYS 128,,,706.25,1412.5,8
CPT,37700,REVISE LEG VEIN,,,3068.32,6136.64,8
CPT,37718,LIGATE/STRIP SHORT LEG VEIN,,,3068.32,6136.64,8
CPT,37722,LIGATE/STRIP LONG LEG VEIN,,,3068.32,6136.64,8
CPT,37735,REMOVAL OF LEG VEINS/LESION,,,3068.32,6136.64,8
CPT,3775F,ADENOMA DETECTED SCREENING,,,,,0
CPT,37760,LIGATE LEG VEINS RADICAL,,,3068.32,6136.64,8
CPT,37761,LIGATE LEG VEINS OPEN,,,3068.32,6136.64,8
CPT,37765,STAB PHLEB VEINS XTR 10-20,,,3068.32,6136.64,8
CPT,37766,PHLEB VEINS - EXTREM 20+,,,3068.32,6136.64,8
CPT,3776F,ADENOMA NOT DETECT SCREENING,,,,,0
CPT,37780,REVISION OF LEG VEIN,,,3068.32,6136.64,8
CPT,37785,LIGATE/DIVIDE/EXCISE VEIN,,,3068.32,6136.64,8
CPT,37788,REVASCULARIZATION PENIS,,,,,0
CPT,37790,PENILE VENOUS OCCLUSION,,,3425.44,6850.88,8
CPT,37799,UNLISTED PX VASCULAR SURGERY,,,609.59,1219.18,8
CPT,377U,CV DS QUAN ADVSRM/PLSM LPRTN,,,47.58,95.16,8
CPT,378T,VISUAL FIELD ASSMNT REV/RPRT,,,,,0
CPT,378U,RFC1 REPEAT XPNSJ VRNT ALYS,,,137.0,274.0,8
CPT,379T,VIS FIELD ASSMNT TECH SUPPT,,,36.3,72.6,8
CPT,379U,TGSAP SL OR NEO DNA523&RNA55,,,3288.51,6577.02,8
CPT,37U,TRGT GEN SEQ DNA 324 GENES,,,3500.0,7000.0,8
CPT,38100,REMOVAL OF SPLEEN TOTAL,,,,,0
CPT,38101,REMOVAL OF SPLEEN PARTIAL,,,,,0
CPT,38102,REMOVAL OF SPLEEN TOTAL,,,,,0
CPT,38115,REPAIR OF RUPTURED SPLEEN,,,,,0
CPT,38120,LAPAROSCOPY SPLENECTOMY,,,10329.66,20659.32,8
CPT,38129,UNLISTED LAPS PX SPLEEN,,,5874.81,11749.62,8
CPT,381U,MAPLE SYRUP UR DS MNTR QUAN,,,44.12,88.24,8
CPT,38200,INJECTION FOR SPLEEN X-RAY,,,,,0
CPT,38204,BL DONOR SEARCH MANAGEMENT,,,,,0
CPT,38204,BL DONOR SEARCH MANAGEMENT (SEARCH & COLLECT),37463.0,18731.5,6526.05,36339.11,46
CPT,38204,BL DONOR SEARCH MANAGEMENT (SEARCH ONLY),3973.0,1986.5,692.09,3853.81,46
CPT,38204,MUD BL DONOR SEARCH MANAGEMENT (SEARCH ONLY) NHCI,11277.0,5638.5,1964.45,10938.69,46
CPT,38205,HARVEST ALLOGENEIC STEM CELL,,,,,0
CPT,38206,HARVEST AUTO STEM CELLS,,,,,0
CPT,38206,HARVEST BLOOD DERIVED PROGEN CELL/COLL AUTOL,7953.0,3976.5,1385.41,7714.41,54
CPT,38206,MUD HARVEST AUTO STEM CELLS NHCI,4632.0,2316.0,806.89,4493.04,53
CPT,38207,CRYOPRESERVE STEM CELLS,,,,,0
CPT,38207,MUD CRYOPRESERVE STEM CELLS NHCI,17035.0,8517.5,428.72,16523.95,53
CPT,38207,TRANSPLT PREP CRYO/STORE PROGEN CELL,8240.0,4120.0,428.72,8110.17,106
CPT,38208,MUD THAW PRESERVED STEM CELLS NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38208,THAW PRESERVED STEM CELLS,,,,,0
CPT,38208,TRANSPLT PREP PROGEN THAW FROZN WO WASH,977.5,488.75,167.05,966.12,106
CPT,38209,MUD WASH HARVEST STEM CELLS NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38209,TRANSPLT PREP PROGEN THAW FROZN W/WASH,1317.0,658.5,229.42,1277.49,106
CPT,38209,WASH HARVEST STEM CELLS,,,,,0
CPT,38210,MUD T-CELL DEPLETION OF HARVEST NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38210,T-CELL DEPLETION OF HARVEST,,,,,0
CPT,38210,TRANSPLT PREP T-CELL DEPLETION,1317.0,658.5,229.42,1277.49,106
CPT,38211,MUD TUMOR CELL DEPLETE OF HARVST NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38211,TRANSPLT PREP TUMOR CELL DEPLETION,1317.0,658.5,229.42,1277.49,106
CPT,38211,TUMOR CELL DEPLETE OF HARVST,,,,,0
CPT,38212,MUD RBC DEPLETION OF HARVEST NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38212,RBC DEPLETION OF HARVEST,,,,,0
CPT,38212,TRANSPLT PREP RED BLOOD CELL REMOVAL,1317.0,658.5,229.42,1277.49,106
CPT,38213,MUD PLATELET DEPLETE OF HARVESTNHCI,1389.0,694.5,241.96,1347.33,53
CPT,38213,PLATELET DEPLETE OF HARVEST,,,,,0
CPT,38213,TRANSPLT PREP PLATELET DEPLETION,1317.0,658.5,229.42,1277.49,106
CPT,38214,MUD VOLUME DEPLETE OF HARVEST NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38214,TRANSPLT PREP PLASMA DEPLETION,977.5,488.75,167.05,966.12,106
CPT,38214,VOLUME DEPLETE OF HARVEST,,,,,0
CPT,38215,HARVEST STEM CELL CONCENTRTE,,,,,0
CPT,38215,MUD HARVEST STEM CELL CONCENTRTE NHCI,1389.0,694.5,241.96,1347.33,53
CPT,38215,TRANSPLT PREP CELL CONCENTRTE IN PLASMA,1317.0,658.5,229.42,1277.49,106
CPT,38220,BONE MARROW ASPIRATION ONLY,5012.0,2506.0,873.09,4861.64,108
CPT,38220,DIAGNOSTIC BONE MARROW ASPIRATION,2292.0,1146.0,369.3,3209.92,108
CPT,38220,DX BONE MARROW ASPIRATIONS,,,,,0
CPT,38221,BONE MARROW ASP SAME INC BMBX,2464.0,1232.0,429.22,3209.92,108
CPT,38221,BONE MARROW BIOPSY,5012.0,2506.0,873.09,4861.64,108
CPT,38221,DIAGNOSTIC BONE MARROW BIOPSY/IES,2292.0,1146.0,369.3,3209.92,108
CPT,38221,DX BONE MARROW BIOPSIES,,,,,0
CPT,38222,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,3472.0,1736.0,604.82,5645.38,108
CPT,38222,DX BONE MARROW BX & ASPIR,,,,,0
CPT,38225,CAR-T HRV BLD-DRV T LYMPHCYT,4961.0,2480.5,864.2,4812.17,46
CPT,38225,"Chimeric antigen receptor T-cell (CAR-T) therapy; harvesting of blood-derived T lymphocytes for development of genetically modified autologous CAR-T cells, per day",,,,,0
CPT,38226,CAR-T PREP T LYMPHCYT F/TRNS,4621.0,2310.5,804.97,4482.37,46
CPT,38226,"Chimeric antigen receptor T-cell (CAR-T) therapy; preparation of blood-derived T lymphocytes for transportation (eg, cryopreservation, storage)",,,,,0
CPT,38227,CAR-T RECEIPT&PREPJ ADMN,4361.0,2180.5,759.68,4230.17,46
CPT,38227,Chimeric antigen receptor T-cell (CAR-T) therapy; receipt and preparation of CAR-T cells for administration,,,,,0
CPT,38228,CAR-T ADMN AUTOLOGOUS,5894.0,2947.0,320.98,5717.18,53
CPT,38228,"Chimeric antigen receptor T-cell (CAR-T) therapy; CAR-T cell administration, autologous",,,,,0
CPT,38230,BONE MARROW HARVEST ALLOGEN,,,1513.45,3026.9,8
CPT,38232,BONE MARROW HARVEST AUTOLOG,,,4232.51,8465.02,8
CPT,38240,TRANSPLT ALLO HCT/DONOR,,,,,0
CPT,38240,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,276154.0,138077.0,48106.02,267869.38,54
CPT,38241,MUD TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR NHCI,4633.0,2316.5,807.06,4494.01,53
CPT,38241,TRANSPLT AUTOL HCT/DONOR,,,,,0
CPT,38241,TRANSPLT AUTOL STEM CELLS HCT/DONOR,3246.0,1623.0,565.45,3148.62,53
CPT,38242,MUD ALLOGENEIC LYMPHOCYTE INFUSIONS NHCI,4633.0,2316.5,807.06,4494.01,53
CPT,38242,TRANSPLT ALLO LYMPHOCYTES,,,,,0
CPT,38242,TRANSPLT ALLO LYMPHOCYTES INFUSIONS,2436.0,1218.0,424.35,3026.9,54
CPT,38243,TRANSPLJ HEMATOPOIETIC BOOST,,,1513.45,3026.9,8
CPT,382U,HYPRPHENYLALNINMIA MNTR QUAN,,,51.64,103.28,8
CPT,38300,DRAINAGE LYMPH NODE LESION,,,2822.69,5645.38,8
CPT,38305,DRAINAGE LYMPH NODE LESION,,,2822.69,5645.38,8
CPT,38308,INCISION OF LYMPH CHANNELS,,,3804.87,7609.74,8
CPT,38380,THORACIC DUCT PROCEDURE,,,,,0
CPT,38381,THORACIC DUCT PROCEDURE,,,,,0
CPT,38382,THORACIC DUCT PROCEDURE,,,,,0
CPT,383U,TYROSINEMIA TYP I MNTR QUAN,,,52.05,104.1,8
CPT,384U,NEPH CKD RSK HI STG KDN DS,,,750.0,1500.0,8
CPT,38500,BIOPSY/REMOVAL LYMPH NODES,,,285.99,7609.74,24
CPT,38505,NEEDLE BIOPSY LYMPH NODES,3506.0,1753.0,107.02,3400.82,54
CPT,38510,BIOPSY/REMOVAL LYMPH NODES,,,3804.87,7609.74,8
CPT,38520,BIOPSY/REMOVAL LYMPH NODES,,,3804.87,7609.74,8
CPT,38525,BIOPSY/REMOVAL LYMPH NODES,,,3804.87,7609.74,8
CPT,38530,BIOPSY/REMOVAL LYMPH NODES,,,3804.87,7609.74,8
CPT,38531,OPEN BX/EXC INGUINOFEM NODES,,,,,0
CPT,38531,PR OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,9956.0,4978.0,1734.33,9657.32,54
CPT,38542,EXPLORE DEEP NODE(S) NECK,,,5874.81,11749.62,8
CPT,38550,REMOVAL NECK/ARMPIT LESION,,,3804.87,7609.74,8
CPT,38555,REMOVAL NECK/ARMPIT LESION,,,6452.66,12905.32,8
CPT,38562,REMOVAL PELVIC LYMPH NODES,,,7942.59,15885.18,8
CPT,38564,REMOVAL ABDOMEN LYMPH NODES,,,,,0
CPT,38570,LAPAROSCOPY LYMPH NODE BIOP,,,5874.81,11749.62,8
CPT,38571,LAPAROSCOPY LYMPHADENECTOMY,,,10329.66,20659.32,8
CPT,38572,LAPAROSCOPY LYMPHADENECTOMY,,,10329.66,20659.32,8
CPT,38573,LAPS PELVIC LYMPHADEC,,,10329.66,20659.32,8
CPT,38589,UNLISTED LAPS PX LYMPHTC SYS,,,5874.81,11749.62,8
CPT,385U,NEPH CKD ALG RSK DBTC KDN DS,,,390.75,781.5,8
CPT,38700,REMOVAL OF LYMPH NODES NECK,,,6452.66,12905.32,8
CPT,38720,REMOVAL OF LYMPH NODES NECK,,,6452.66,12905.32,8
CPT,38724,REMOVAL OF LYMPH NODES NECK,,,,,0
CPT,38740,REMOVE ARMPIT LYMPH NODES,,,5874.81,11749.62,8
CPT,38745,REMOVE ARMPIT LYMPH NODES,,,5874.81,11749.62,8
CPT,38746,REMOVE THORACIC LYMPH NODES,,,,,0
CPT,38747,REMOVE ABDOMINAL LYMPH NODES,,,,,0
CPT,38760,REMOVE GROIN LYMPH NODES,,,6452.66,12905.32,8
CPT,38765,REMOVE GROIN LYMPH NODES,,,,,0
CPT,38770,REMOVE PELVIS LYMPH NODES,,,,,0
CPT,38780,REMOVE ABDOMEN LYMPH NODES,,,,,0
CPT,38790,INJECT FOR LYMPHATIC X-RAY,,,,,0
CPT,38792,RA TRACER ID OF SENTINL NODE,,,388.48,776.96,8
CPT,38794,ACCESS THORACIC LYMPH DUCT,,,,,0
CPT,387U,ONC MLNMA AMBRA1&AMLO,,,948.5,1897.0,8
CPT,388U,ONC NONSM CLL LNG CA 37 GEN,,,3500.0,7000.0,8
CPT,38900,IO MAP OF SENT LYMPH NODE,,,,,0
CPT,38999,MUD WORKUP CANCELLATION NHCI,44547.0,22273.5,428.72,43210.59,53
CPT,38999,UNLISTD PX HEMIC/LYMPHTC SYS,,,,,0
CPT,389U,PED FBRL KD IFI27&MCEMP1 RNA,,,70.2,140.4,8
CPT,38U,VITAMIN D SRM MICROSAMP QUAN,,,29.6,59.2,8
CPT,39000,EXPLORATION OF CHEST,,,,,0
CPT,39010,EXPLORATION OF CHEST,,,,,0
CPT,390U,OB PE KDR ENG&RBP4 IA ALG,,,64.41,128.82,8
CPT,391U,ONC SLD TUM DNA&RNA 437 GEN,,,3600.0,7200.0,8
CPT,39200,RESECT MEDIASTINAL CYST,,,,,0
CPT,39220,RESECT MEDIASTINAL TUMOR,,,,,0
CPT,392U,RX METAB GENRX IA 16 GENES,,,1336.09,2672.18,8
CPT,393U,NEU PRKSN MSFL A-SYNCLN PRTN,,,540.99,1081.98,8
CPT,39401,MEDIASTINOSCPY W/MEDSTNL BX,,,5874.81,11749.62,8
CPT,39402,MEDIASTINOSCPY W/LMPH NOD BX,,,5874.81,11749.62,8
CPT,39499,UNLISTED PX MEDIASTINUM,,,,,0
CPT,394T,HDR ELCTRNC SKN SURF BRCHYTX,,,,,0
CPT,394U,NEU PRKSN MSFL _-SYNCLN PRTN,,,198.74,397.48,8
CPT,39501,REPAIR DIAPHRAGM LACERATION,,,,,0
CPT,39503,REPAIR OF DIAPHRAGM HERNIA,,,,,0
CPT,39540,REPAIR OF DIAPHRAGM HERNIA,,,,,0
CPT,39541,REPAIR OF DIAPHRAGM HERNIA,,,,,0
CPT,39545,REVISION OF DIAPHRAGM,,,,,0
CPT,39560,RESECT DIAPHRAGM SIMPLE,,,,,0
CPT,39561,RESECT DIAPHRAGM COMPLEX,,,,,0
CPT,39599,UNLISTED PX DIAPHRAGM,,,,,0
CPT,395T,HDR ELCTR NTRST/NTRCV BRCHTX,,,676.81,1353.62,8
CPT,395U,HDR ELCTRNC SKN SURF BRCHYTX,,,797.45,1594.9,8
CPT,397T,ERCP W/OPTICAL ENDOMICROSCPY,,,,,0
CPT,398U,PFAS 16 PFAS COMPND LC MS/MS,,,1755.0,3510.0,8
CPT,399U,PFAS 16 PFAS COMPND LC MS/MS,,,300.0,600.0,8
CPT,39U,DNA ANTB 2STRAND HI AVIDITY,,,13.74,27.48,8
CPT,3M,LIVER DIS 10 ASSAYS W/NASH,,,503.4,1006.8,8
CPT,3U,ONC OVAR 5 PRTN SER ALG SCOR,,,950.0,1900.0,8
CPT,400,ANESTH SKIN EXT/PER/ATRUNK,,,,,0
CPT,4000F,TOBACCO USE TXMNT COUNSELING,,,,,0
CPT,4001F,TOBACCO USE TXMNT PHARMACOL,,,,,0
CPT,4003F,PT ED WRITE/ORAL PTS W/ HF,,,,,0
CPT,4004F,PT TOBACCO SCREEN RCVD TLK,,,,,0
CPT,4005F,PHARM THX FOR OP RXD,,,,,0
CPT,4008F,BETA-BLOCKER THERAPY RXD/TKN,,,,,0
CPT,400U,HDR ELCTR NTRST/NTRCV BRCHTX,,,1456.88,2913.76,8
CPT,4010F,ACE/ARB THERAPY RXD/TAKEN,,,,,0
CPT,4011F,ORAL ANTIPLATELET THERAPY RX,,,,,0
CPT,4012F,WARFARIN THERAPY RX,,,,,0
CPT,4013F,STATIN THERAPY/CURRENTLY TKN,,,,,0
CPT,4014F,WRITTEN DISCHARGE INSTR PRVD,,,,,0
CPT,4015F,PERSIST ASTHMA MEDICINE CTRL,,,,,0
CPT,4016F,ANTI-INFLM/ANLGSC AGENT RX,,,,,0
CPT,4017F,GI PROPHYLAXIS FOR NSAID RX,,,,,0
CPT,4018F,THERAPY EXERCISE JOINT RX,,,,,0
CPT,4019F,DOC RECPT COUNSL VIT D/CALC+,,,,,0
CPT,401U,ONC LNG MULTIOMICS PLSM ALG,,,489.68,979.36,8
CPT,402,ANESTH SURGERY OF BREAST,,,,,0
CPT,4025F,INHALED BRONCHODILATOR RX,,,,,0
CPT,402T,COLGN CRS-LINK CRN&PACHYMTRY,,,2310.35,4620.7,8
CPT,402U,NFCT AGT STI MULT AMP PRB TQ,,,142.63,285.26,8
CPT,4030F,OXYGEN THERAPY RX,,,,,0
CPT,4033F,PULMONARY REHAB REC,,,,,0
CPT,4035F,INFLUENZA IMM REC,,,,,0
CPT,4037F,INFLUENZA IMM ORDER/ADMIN,,,,,0
CPT,403T,DIABETES PREV STANDARD CURR,,,,,0
CPT,403U,ONC LNG MULTIOMICS PLSM ALG,,,760.0,1520.0,8
CPT,404,ANESTH SURGERY OF BREAST,,,,,0
CPT,4040F,PNEUMOC VAC/ADMIN/RCVD,,,,,0
CPT,4041F,DOC ORDER CEFAZOLIN/CEFUROX,,,,,0
CPT,4042F,DOC ANTIBIO NOT GIVEN,,,,,0
CPT,4043F,DOC ORDER GIVEN STOP ANTIBIO,,,,,0
CPT,4044F,DOC ORDER GIVEN VTE PROPHYLX,,,,,0
CPT,4045F,EMPIRIC ANTIBIOTIC RX,,,,,0
CPT,4046F,DOC ANTIBIO GIVEN B/4 SURG,,,,,0
CPT,4047F,DOC ANTIBIO GIVEN B/4 SURG,,,,,0
CPT,4048F,DOC ANTIBIO GIVEN B/4 SURG,,,,,0
CPT,40490,BIOPSY OF LIP,,,230.16,460.32,8
CPT,4049F,DOC ORDER GIVEN STOP ANTIBIO,,,,,0
CPT,404U,OB PREIMPLTJ TST 300000 DNA,,,322.96,645.92,8
CPT,40500,PARTIAL EXCISION OF LIP,,,3221.84,6443.68,8
CPT,4050F,HT CARE PLAN DOC,,,,,0
CPT,40510,PARTIAL EXCISION OF LIP,,,3221.84,6443.68,8
CPT,4051F,REFERRED FOR AN AV FISTULA,,,,,0
CPT,40520,PARTIAL EXCISION OF LIP,,,3221.84,6443.68,8
CPT,40525,RECONSTRUCT LIP WITH FLAP,,,3221.84,6443.68,8
CPT,40527,RECONSTRUCT LIP WITH FLAP,,,5752.66,11505.32,8
CPT,4052F,HEMODIALYSIS VIA AV FISTULA,,,,,0
CPT,40530,PARTIAL REMOVAL OF LIP,,,3221.84,6443.68,8
CPT,4053F,HEMODIALYSIS VIA AV GRAFT,,,,,0
CPT,4054F,HEMODIALYSIS VIA CATHETER,,,,,0
CPT,4055F,PT RCVNG PERITON DIALYSIS,,,,,0
CPT,4056F,APPROP ORAL REHYD RECOMMD,,,,,0
CPT,4058F,PED GASTRO ED GIVEN CAREGVR,,,,,0
CPT,405U,ERCP W/OPTICAL ENDOMICROSCPY,,,1770.48,3540.96,8
CPT,406,ANESTH SURGERY OF BREAST,,,,,0
CPT,4060F,PSYCH SVCS PROVIDED,,,,,0
CPT,4062F,PT REFERRAL PSYCH DOCD,,,,,0
CPT,4063F,ANTIDEPRES RXTHXPY NOT RXD,,,,,0
CPT,4064F,ANTIDEPRESSANT RX,,,,,0
CPT,40650,RPR LIP FTH VERMILION ONLY,,,524.1,1048.2,8
CPT,40652,RPR LIP FTH<HALF VER HEIGHT,,,524.1,1048.2,8
CPT,40654,RPR LIP FTH>1HALF VER HT/CPX,,,1507.77,3015.54,8
CPT,4065F,ANTIPSYCHOTIC RX,,,,,0
CPT,4066F,ECT PROVIDED,,,,,0
CPT,4067F,PT REFERRAL FOR ECT DOCD,,,,,0
CPT,4069F,VTE PROPHYLAXIS RCVD,,,,,0
CPT,406U,MRGFUS STRTCTC LES ABLTJ,,,760.0,1520.0,8
CPT,40700,REPAIR CLEFT LIP/NASAL,,,5752.66,11505.32,8
CPT,40701,REPAIR CLEFT LIP/NASAL,,,5752.66,11505.32,8
CPT,40702,REPAIR CLEFT LIP/NASAL,,,5752.66,11505.32,8
CPT,4070F,DVT PROPHYLX RECVD DAY 2,,,,,0
CPT,40720,REPAIR CLEFT LIP/NASAL,,,3221.84,6443.68,8
CPT,4073F,ORAL ANTIPLAT THX RX DISCHRG,,,,,0
CPT,4075F,ANTICOAG THX RX AT DISCHRG,,,,,0
CPT,40761,REPAIR CLEFT LIP/NASAL,,,5752.66,11505.32,8
CPT,4077F,DOC T-PA ADMIN CONSIDERED,,,,,0
CPT,40799,UNLISTED PROCEDURE LIPS,,,230.16,460.32,8
CPT,4079F,DOC REHAB SVCS CONSIDERED,,,,,0
CPT,407U,GI BARET ESPH DNA MTHYLN ALY,,,950.0,1900.0,8
CPT,40800,DRAINAGE OF MOUTH LESION,,,688.14,1376.28,8
CPT,40801,DRAINAGE OF MOUTH LESION,,,524.1,1048.2,8
CPT,40804,REMOVAL FOREIGN BODY MOUTH,,,881.37,1762.74,8
CPT,40805,REMOVAL FOREIGN BODY MOUTH,,,524.1,1048.2,8
CPT,40806,INCISION OF LIP FOLD,,,524.1,1048.2,8
CPT,40808,BIOPSY OF MOUTH LESION,,,,,0
CPT,40808,BIOPSY VESTIBULE MOUTH,1127.0,563.5,196.32,1093.19,54
CPT,40810,EXCISION OF MOUTH LESION,,,3221.84,6443.68,8
CPT,40812,EXCISE/REPAIR MOUTH LESION,,,1507.77,3015.54,8
CPT,40814,EXCISE/REPAIR MOUTH LESION,,,3221.84,6443.68,8
CPT,40816,EXCISION OF MOUTH LESION,,,3221.84,6443.68,8
CPT,40818,EXCISE ORAL MUCOSA FOR GRAFT,,,524.1,1048.2,8
CPT,40819,EXCISE LIP OR CHEEK FOLD,,,1507.77,3015.54,8
CPT,40820,TREATMENT OF MOUTH LESION,,,3221.84,6443.68,8
CPT,40830,REPAIR MOUTH LACERATION,,,230.16,460.32,8
CPT,40831,REPAIR MOUTH LACERATION,,,524.1,1048.2,8
CPT,40840,RECONSTRUCTION OF MOUTH,,,5752.66,11505.32,8
CPT,40842,RECONSTRUCTION OF MOUTH,,,5752.66,11505.32,8
CPT,40843,RECONSTRUCTION OF MOUTH,,,5752.66,11505.32,8
CPT,40844,RECONSTRUCTION OF MOUTH,,,5752.66,11505.32,8
CPT,40845,RECONSTRUCTION OF MOUTH,,,5752.66,11505.32,8
CPT,4084F,ASPIRIN RECVD W/IN 24 HRS,,,,,0
CPT,4086F,ASPIRIN/CLOPIDOGREL RXD,,,,,0
CPT,40899,UNLISTED PX VESTIBULE MOUTH,,,230.16,460.32,8
CPT,408T,INSJ/RPLC CARDIAC MODULJ SYS,,,30502.49,61004.98,8
CPT,408U,IAAD BLK AC WV BSNSR SARSCV2,,,14.13,28.26,8
CPT,4090F,PT RCVNG EPO THXPY,,,,,0
CPT,4095F,PT NOT RCVNG EPO THXPY,,,,,0
CPT,409T,INSJ/RPLC CAR MODULJ PLS GN,,,21615.45,43230.9,8
CPT,409U,GI BARET ESPH DNA MTHYLN ALY,,,2919.6,5839.2,8
CPT,40U,BCR/ABL1 GENE MAJOR BP QUAN,,,409.9,819.8,8
CPT,410,ANESTH CORRECT HEART RHYTHM,,,,,0
CPT,41000,DRAINAGE OF MOUTH LESION,,,524.1,1048.2,8
CPT,41005,DRAINAGE OF MOUTH LESION,,,230.16,460.32,8
CPT,41006,DRAINAGE OF MOUTH LESION,,,1507.77,3015.54,8
CPT,41007,DRAINAGE OF MOUTH LESION,,,1507.77,3015.54,8
CPT,41008,DRAINAGE OF MOUTH LESION,,,3221.84,6443.68,8
CPT,41009,DRAINAGE OF MOUTH LESION,,,524.1,1048.2,8
CPT,4100F,BIPHOS THXPY VEIN ORD/RECVD,,,,,0
CPT,41010,INCISION OF TONGUE FOLD,,,1507.77,3015.54,8
CPT,41015,DRAINAGE OF MOUTH LESION,,,524.1,1048.2,8
CPT,41016,DRAINAGE OF MOUTH LESION,,,5752.66,11505.32,8
CPT,41017,DRAINAGE OF MOUTH LESION,,,3221.84,6443.68,8
CPT,41018,DRAINAGE OF MOUTH LESION,,,1507.77,3015.54,8
CPT,41019,PLACE NEEDLES H&N FOR RT,,,5752.66,11505.32,8
CPT,410T,INSJ/RPLC CAR MODULJ ATR ELT,,,8041.71,16083.42,8
CPT,410U,NEURO CERE FOLATE DEFNCY SRM,,,1160.0,2320.0,8
CPT,41100,BIOPSY OF TONGUE,,,,,0
CPT,41100,BIOPSY TONGUE ANTERIOR TWO-THIRDS,1513.0,756.5,263.56,1467.61,54
CPT,41105,BIOPSY OF TONGUE,,,,,0
CPT,41105,BIOPSY TONGUE POSTERIOR ONE-THIRD,6627.0,3313.5,1154.42,6443.68,54
CPT,41108,BIOPSY OF FLOOR OF MOUTH,3506.0,1753.0,610.74,3400.82,54
CPT,4110F,INT MAM ART USED FOR CABG,,,,,0
CPT,41110,EXCISION OF TONGUE LESION,,,3221.84,6443.68,8
CPT,41112,EXCISION OF TONGUE LESION,,,3221.84,6443.68,8
CPT,41113,EXCISION OF TONGUE LESION,,,3221.84,6443.68,8
CPT,41114,EXCISION OF TONGUE LESION,,,3221.84,6443.68,8
CPT,41115,EXCISION OF TONGUE FOLD,,,1507.77,3015.54,8
CPT,41116,EXCISION OF MOUTH LESION,,,3221.84,6443.68,8
CPT,41120,PARTIAL REMOVAL OF TONGUE,,,5752.66,11505.32,8
CPT,41130,PARTIAL REMOVAL OF TONGUE,,,,,0
CPT,41135,TONGUE AND NECK SURGERY,,,,,0
CPT,41140,REMOVAL OF TONGUE,,,,,0
CPT,41145,TONGUE REMOVAL NECK SURGERY,,,,,0
CPT,41150,TONGUE MOUTH JAW SURGERY,,,,,0
CPT,41153,TONGUE MOUTH NECK SURGERY,,,,,0
CPT,41155,TONGUE JAW & NECK SURGERY,,,,,0
CPT,4115F,BETA BLCKR ADMIN W/IN 24 HRS,,,,,0
CPT,411T,INSJ/RPLC CAR MODULJ VNT ELT,,,8041.71,16083.42,8
CPT,411U,PSYC GENOM ALYS PNL 15 GEN,,,1336.09,2672.18,8
CPT,4120F,ANTIBIOT RXD/GIVEN,,,,,0
CPT,4124F,ANTIBIOT NOT RXD/GIVEN,,,,,0
CPT,41250,REPAIR TONGUE LACERATION,,,434.11,868.22,8
CPT,41251,REPAIR TONGUE LACERATION,,,230.16,460.32,8
CPT,41252,REPAIR TONGUE LACERATION,,,230.16,460.32,8
CPT,412T,RMVL CARDIAC MODULJ PLS GEN,,,3631.43,7262.86,8
CPT,412U,NEURO CERE FOLATE DEFNCY SRM,,,750.0,1500.0,8
CPT,4130F,TOPICAL PREP RX AOE,,,,,0
CPT,4131F,SYST ANTIMICROBIAL THX RX,,,,,0
CPT,4132F,NO SYST ANTIMICROBIAL THX RX,,,,,0
CPT,4133F,ANTIHIST/DECONG RX/RECOM,,,,,0
CPT,4134F,NO ANTIHIST/DECONG RX/RECOM,,,,,0
CPT,4135F,SYSTEMIC CORTICOSTEROIDS RX,,,,,0
CPT,4136F,SYST CORTICOSTEROIDS NOT RX,,,,,0
CPT,413T,RMVL CAR MODULJ TRANVNS ELT,,,3631.43,7262.86,8
CPT,413U,OB XPND CAR SCR 145 GENES,,,1263.53,2527.06,8
CPT,4140F,INHALED CORTICOSTEROIDS RXD,,,,,0
CPT,4142F,CORTICOSTER SPARNG THRPY RXD,,,,,0
CPT,4144F,ALT LONG-TERM CNTRL MED RXD,,,,,0
CPT,4145F,2+ ANTI-HYPRTNSV AGENTS TKN,,,,,0
CPT,4148F,HEP A VAC INJXN ADMIN/RECVD,,,,,0
CPT,4149F,HEP B VAC INJXN ADMIN/RECVD,,,,,0
CPT,414T,RMVL & RPL CAR MODULJ PLS GN,,,21615.45,43230.9,8
CPT,414U,OB XPND CAR SCR 145 GENES,,,706.25,1412.5,8
CPT,4150F,PT RECVNG ANTIVIR TXMNT HEPC,,,,,0
CPT,41510,TONGUE TO LIP SURGERY,,,3221.84,6443.68,8
CPT,41512,TONGUE SUSPENSION,,,5752.66,11505.32,8
CPT,4151F,PT NOT RECVNG ANTIV HEP C,,,,,0
CPT,41520,RECONSTRUCTION TONGUE FOLD,,,3221.84,6443.68,8
CPT,41530,TONGUE BASE VOL REDUCTION,,,3221.84,6443.68,8
CPT,4153F,COMBO PEGINTF/RIB RX,,,,,0
CPT,4155F,HEP A VAC SERIES PREV RECVD,,,,,0
CPT,4157F,HEP B VAC SERIES PREV RECVD,,,,,0
CPT,4158F,PT EDU RE ALCOH DRNKNG DONE,,,,,0
CPT,41599,UNLISTED PX TONGUE FLR MOUTH,,,230.16,460.32,8
CPT,4159F,CONTRCP TALK B/4 ANTIV TXMNT,,,,,0
CPT,415T,REPOS CAR MODULJ TRANVNS ELT,,,609.59,1219.18,8
CPT,415U,CV DS ACS BLD ALG 5 YR SCORE,,,390.75,781.5,8
CPT,4163F,PT COUNS 4 TXMNT OPT PROST,,,,,0
CPT,4164F,ADJV HRMNL THXPY RXD,,,,,0
CPT,4165F,3D-CRT/IMRT RECEIVED,,,,,0
CPT,4167F,HD BED TILTED 1ST DAY VENT,,,,,0
CPT,4168F,PT CARE ICU&VENT W/IN 24HRS,,,,,0
CPT,4169F,NO PT CARE ICU/VENT IN 24HRS,,,,,0
CPT,416T,RELOC SKIN POCKET PLS GEN,,,2005.02,4010.04,8
CPT,4171F,PT RCVNG ESA THXPY,,,,,0
CPT,4172F,PT NOT RCVNG ESA THXPY,,,,,0
CPT,4174F,COUNS POTENT GLAUC IMPCT,,,,,0
CPT,4175F,VIS 20/40/> W/IN 90 DAYS,,,,,0
CPT,4176F,TALK RE UV LIGHT PT/CRGVR,,,,,0
CPT,4177F,TALK PT/CRGVR RE AREDS PREV,,,,,0
CPT,4178F,ANTID GLBLN RCVD W/IN 26WKS,,,,,0
CPT,4179F,TAMOXIFEN/AI PRESCRIBED,,,,,0
CPT,417T,PRGRMG EVAL CARDIAC MODULJ,,,36.27,72.54,8
CPT,417U,CRD C HRT DS 9 GEN 12 VRNTS,,,2842.53,5685.06,8
CPT,41800,DRAINAGE OF GUM LESION,,,129.29,258.58,8
CPT,41805,REMOVAL FOREIGN BODY GUM,,,1507.77,3015.54,8
CPT,41806,REMOVAL FOREIGN BODY JAWBONE,,,1507.77,3015.54,8
CPT,4180F,ADJV THXPYRXD/RCVD COLON CA,,,,,0
CPT,4181F,CONFORMAL RADN THXPY RCVD,,,,,0
CPT,41820,EXCISION GUM EACH QUADRANT,,,3221.84,6443.68,8
CPT,41821,EXCISION OF GUM FLAP,,,1507.77,3015.54,8
CPT,41822,EXCISION OF GUM LESION,,,1507.77,3015.54,8
CPT,41823,EXCISION OF GUM LESION,,,5752.66,11505.32,8
CPT,41825,EXCISION OF GUM LESION,,,3221.84,6443.68,8
CPT,41826,EXCISION OF GUM LESION,,,3221.84,6443.68,8
CPT,41827,EXCISION OF GUM LESION,,,5752.66,11505.32,8
CPT,41828,EXCISION OF GUM LESION,,,1507.77,3015.54,8
CPT,4182F,NO CONFORMAL RADN THXPY,,,,,0
CPT,41830,REMOVAL OF GUM TISSUE,,,3221.84,6443.68,8
CPT,41850,TREATMENT OF GUM LESION,,,1507.77,3015.54,8
CPT,4185F,CONTINUOUS PPI OR H2RA RCVD,,,,,0
CPT,4186F,NO CONT PPI OR H2RA RCVD,,,,,0
CPT,41870,GUM GRAFT,,,1507.77,3015.54,8
CPT,41872,REPAIR GUM,,,3221.84,6443.68,8
CPT,41874,REPAIR TOOTH SOCKET,,,3221.84,6443.68,8
CPT,4187F,ANTI RHEUM DRUGTHXPYRXD/GVN,,,,,0
CPT,4188F,APPROP ACE/ARB TSTNG DONE,,,,,0
CPT,41899,UNLISTED PX DENTALVLR STRUX,,,230.16,460.32,8
CPT,4189F,APPROP DIGOXIN TSTNG DONE,,,,,0
CPT,418T,INTERRO EVAL CARDIAC MODULJ,,,36.27,72.54,8
CPT,418U,COLGN CRS-LINK CRN&PACHYMTRY,,,706.25,1412.5,8
CPT,4190F,APPROP DIURETIC TSTNG DONE,,,,,0
CPT,4191F,APPROP ANTICONVULS TSTNG,,,,,0
CPT,4192F,PT NOT RCVNG GLUCOCO THXPY,,,,,0
CPT,4193F,PT RCV <10MG DAILY PREDNISO,,,,,0
CPT,4194F,PT RCV >=10MG DAILY PREDNISO,,,,,0
CPT,4195F,PT RCVNG ANTI-RHEUM THXPY RA,,,,,0
CPT,4196F,PTNOT RCVNG ANTI-RHM THXPYRA,,,,,0
CPT,419T,DSTRJ NEUROFIBROMA XTNSV,,,718.2,1436.4,8
CPT,419U,NRPSYC GEN SEQ VRNT ALY 13,,,1336.09,2672.18,8
CPT,41U,B BRGDRFERI ANTB 5 PRTN IGM,,,17.21,34.42,8
CPT,42000,DRAINAGE MOUTH ROOF LESION,,,230.16,460.32,8
CPT,4200F,EXTERNAL BEAM TO PROST ONLY,,,,,0
CPT,4201F,EXTRNL BEAM OTHER THAN PROST,,,,,0
CPT,420T,DSTRJ NEUROFIBROMA XTNSV,,,718.2,1436.4,8
CPT,420U,ONC URTHL MRNA XPRSN 6 SNP,,,1328.32,2656.64,8
CPT,42100,BIOPSY ROOF OF MOUTH,3447.0,1723.5,600.46,3343.59,54
CPT,42104,EXCISION LESION MOUTH ROOF,,,3221.84,6443.68,8
CPT,42106,EXCISION LESION MOUTH ROOF,,,3221.84,6443.68,8
CPT,42107,EXCISION LESION MOUTH ROOF,,,5752.66,11505.32,8
CPT,4210F,ACE/ARB THXPY FOR MOS/>,,,,,0
CPT,42120,REMOVE PALATE/LESION,,,5752.66,11505.32,8
CPT,42140,EXCISION OF UVULA,,,3221.84,6443.68,8
CPT,42145,REPAIR PALATE PHARYNX/UVULA,,,5752.66,11505.32,8
CPT,42160,TREATMENT MOUTH ROOF LESION,,,3221.84,6443.68,8
CPT,42180,REPAIR LAC PALATE<2 CM,,,524.1,1048.2,8
CPT,42182,REPAIR PALATE,,,5752.66,11505.32,8
CPT,421T,WATERJET PROSTATE ABLTJ CMPL,,,,,0
CPT,421U,ONC CLRCT SCR SGL AMP 8 RNA,,,508.87,1017.74,8
CPT,42200,RECONSTRUCT CLEFT PALATE,,,5752.66,11505.32,8
CPT,42205,RECONSTRUCT CLEFT PALATE,,,3221.84,6443.68,8
CPT,4220F,DIGOXIN THXPY FOR 6 MOS/>,,,,,0
CPT,42210,RECONSTRUCT CLEFT PALATE,,,5752.66,11505.32,8
CPT,42215,RECONSTRUCT CLEFT PALATE,,,5752.66,11505.32,8
CPT,4221F,DIURETIC THXPY FOR 6 MOS/>,,,,,0
CPT,42220,RECONSTRUCT CLEFT PALATE,,,5752.66,11505.32,8
CPT,42225,RECONSTRUCT CLEFT PALATE,,,5752.66,11505.32,8
CPT,42226,LENGTHENING OF PALATE,,,5752.66,11505.32,8
CPT,42227,LENGTHENING OF PALATE,,,5752.66,11505.32,8
CPT,42235,REPAIR PALATE,,,5752.66,11505.32,8
CPT,42260,REPAIR NOSE TO LIP FISTULA,,,5752.66,11505.32,8
CPT,42280,PREPARATION PALATE MOLD,,,524.1,1048.2,8
CPT,42281,INSERTION PALATE PROSTHESIS,,,5752.66,11505.32,8
CPT,42299,UNLISTED PX PALATE UVULA,,,230.16,460.32,8
CPT,422T,TACTILE BREAST IMG UNI/BI,,,84.57,169.14,8
CPT,422U,ONC PAN SOLID TUM ALYS DNA,,,1943.21,3886.42,8
CPT,42300,DRAINAGE OF SALIVARY GLAND,,,1507.77,3015.54,8
CPT,42305,DRAINAGE OF SALIVARY GLAND,,,3221.84,6443.68,8
CPT,4230F,ANTICONV THXPY FOR 6 MOS/>,,,,,0
CPT,42310,DRAINAGE OF SALIVARY GLAND,,,524.1,1048.2,8
CPT,42320,DRAINAGE OF SALIVARY GLAND,,,524.1,1048.2,8
CPT,42330,REMOVAL OF SALIVARY STONE,,,3221.84,6443.68,8
CPT,42335,REMOVAL OF SALIVARY STONE,,,3221.84,6443.68,8
CPT,42340,REMOVAL OF SALIVARY STONE,,,3221.84,6443.68,8
CPT,423U,PSYC GENOMIC ALYS PNL 26 GEN,,,416.78,833.56,8
CPT,42400,BIOPSY OF SALIVARY GLAND,,,89.68,1376.28,24
CPT,42405,BIOPSY OF SALIVARY GLAND,,,,,0
CPT,42405,BIOPSY SALIVARY GLAND INCISIONAL,4401.0,2200.5,766.65,4268.97,54
CPT,42408,EXCISION OF SALIVARY CYST,,,3221.84,6443.68,8
CPT,42409,DRAINAGE OF SALIVARY CYST,,,3221.84,6443.68,8
CPT,4240F,INSTR XRCZ BACK PAIN 12 WKS,,,,,0
CPT,42410,EXCISE PAROTID GLAND/LESION,,,5752.66,11505.32,8
CPT,42415,EXCISE PAROTID GLAND/LESION,,,5752.66,11505.32,8
CPT,42420,EXCISE PAROTID GLAND/LESION,,,5752.66,11505.32,8
CPT,42425,EXCISE PAROTID GLAND/LESION,,,5752.66,11505.32,8
CPT,42426,EXCISE PAROTID GLAND/LESION,,,,,0
CPT,4242F,SPRVSD XRCZ BACK PN >12 WKS,,,,,0
CPT,42440,EXCISE SUBMAXILLARY GLAND,,,5752.66,11505.32,8
CPT,42450,EXCISE SUBLINGUAL GLAND,,,5752.66,11505.32,8
CPT,4245F,PT INSTR NRML ACTIVITIES,,,,,0
CPT,4248F,PT INSTR NO BD REST 4 DAYS/>,,,,,0
CPT,424U,ONC PRST8 XOM ALYS 53 SNCRNA,,,760.0,1520.0,8
CPT,42500,REPAIR SALIVARY DUCT,,,5752.66,11505.32,8
CPT,42505,REPAIR SALIVARY DUCT,,,5752.66,11505.32,8
CPT,42507,PAROTID DUCT DIVERSION,,,5752.66,11505.32,8
CPT,42509,PAROTID DUCT DIVERSION,,,5752.66,11505.32,8
CPT,4250F,WRMNG 4 SURG NORMOTHERMIA,,,,,0
CPT,42510,PAROTID DUCT DIVERSION,,,3221.84,6443.68,8
CPT,42550,INJECTION FOR SALIVARY X-RAY,,,,,0
CPT,4255F,ANESTH 60 MIN/> AS DOCD,,,,,0
CPT,4256F,ANESTHE <60 MIN AS DOCD,,,,,0
CPT,425U,GENOM RPD SEQ ALYS EA CMPRTR,,,4094.39,8188.78,8
CPT,42600,CLOSURE OF SALIVARY FISTULA,,,3221.84,6443.68,8
CPT,4260F,WOUND SRFC CULTURETECH USED,,,,,0
CPT,4261F,TECH OTHER THAN SURFC CULTR,,,,,0
CPT,42650,DILATION OF SALIVARY DUCT,,,1507.77,3015.54,8
CPT,4265F,WET-DRY DRESSINGS RX RECMD,,,,,0
CPT,42660,DILATION OF SALIVARY DUCT,,,524.1,1048.2,8
CPT,42665,LIGATION OF SALIVARY DUCT,,,3221.84,6443.68,8
CPT,4266F,NO WET-DRY DRSSINGS RX RECMD,,,,,0
CPT,4267F,COMPRSSION THXPY PRESCRIBED,,,,,0
CPT,4268F,PT ED RE COMP THXPY RCVD,,,,,0
CPT,42699,UNLISTED PX SALIVRY GLND/DUX,,,230.16,460.32,8
CPT,4269F,APPROPOS MTHD OFFLOADING RXD,,,,,0
CPT,426U,GENOME ULTRA-RAPID SEQ ALYS,,,7582.2,15164.4,8
CPT,42700,DRAINAGE OF TONSIL ABSCESS,,,230.16,460.32,8
CPT,4270F,PT RCVNG ANTI R-VIRAL THXPY,,,,,0
CPT,4271F,PT RCVNG ANTI R-VIRAL THXPY,,,,,0
CPT,42720,DRAINAGE OF THROAT ABSCESS,,,3221.84,6443.68,8
CPT,42725,DRAINAGE OF THROAT ABSCESS,,,5752.66,11505.32,8
CPT,4274F,FLU IMMUNO ADMIND RCVD,,,,,0
CPT,4276F,POTENT ANTIVIR THXPY RXD,,,,,0
CPT,4279F,PCP PROPHYLAXIS RXD,,,,,0
CPT,427U,MONOCYTE DSTRBJ WDTH WHL BLD,,,4.48,8.96,8
CPT,42800,BIOPSY OF THROAT,4669.0,2334.5,813.33,4528.93,54
CPT,42804,BIOPSY OF UPPER NOSE/THROAT,,,3221.84,6443.68,8
CPT,42806,BIOPSY OF UPPER NOSE/THROAT,,,3221.84,6443.68,8
CPT,42808,EXCISE PHARYNX LESION,,,3221.84,6443.68,8
CPT,42809,REMOVE PHARYNX FOREIGN BODY,,,434.11,868.22,8
CPT,4280F,PCP PROPHYLAX RXD 3MON LOW %,,,,,0
CPT,42810,EXCISION OF NECK CYST,,,3221.84,6443.68,8
CPT,42815,EXCISION OF NECK CYST,,,5752.66,11505.32,8
CPT,42820,REMOVE TONSILS AND ADENOIDS,,,5752.66,11505.32,8
CPT,42821,REMOVE TONSILS AND ADENOIDS,,,3221.84,6443.68,8
CPT,42825,REMOVAL OF TONSILS,,,5752.66,11505.32,8
CPT,42826,REMOVAL OF TONSILS,,,3221.84,6443.68,8
CPT,42830,REMOVAL OF ADENOIDS,,,3221.84,6443.68,8
CPT,42831,REMOVAL OF ADENOIDS,,,3221.84,6443.68,8
CPT,42835,REMOVAL OF ADENOIDS,,,3221.84,6443.68,8
CPT,42836,REMOVAL OF ADENOIDS,,,3221.84,6443.68,8
CPT,42842,EXTENSIVE SURGERY OF THROAT,,,5752.66,11505.32,8
CPT,42844,EXTENSIVE SURGERY OF THROAT,,,5752.66,11505.32,8
CPT,42845,EXTENSIVE SURGERY OF THROAT,,,,,0
CPT,42860,EXCISION OF TONSIL TAGS,,,3221.84,6443.68,8
CPT,42870,EXCISION OF LINGUAL TONSIL,,,5752.66,11505.32,8
CPT,42890,PARTIAL REMOVAL OF PHARYNX,,,5752.66,11505.32,8
CPT,42892,REVISION OF PHARYNGEAL WALLS,,,5752.66,11505.32,8
CPT,42894,REVISION OF PHARYNGEAL WALLS,,,,,0
CPT,42900,REPAIR THROAT WOUND,,,1507.77,3015.54,8
CPT,4290F,PT SCRNED FOR INJ DRUG USE,,,,,0
CPT,4293F,PT SCRND HGH-RISK SEX BEHAV,,,,,0
CPT,42950,RECONSTRUCTION OF THROAT,,,5752.66,11505.32,8
CPT,42953,REPAIR THROAT ESOPHAGUS,,,,,0
CPT,42955,SURGICAL OPENING OF THROAT,,,1507.77,3015.54,8
CPT,42960,CONTROL THROAT BLEEDING,,,524.1,1048.2,8
CPT,42961,CONTROL THROAT BLEEDING,,,,,0
CPT,42962,CONTROL THROAT BLEEDING,,,3221.84,6443.68,8
CPT,42970,CONTROL NOSE/THROAT BLEEDING,,,230.16,460.32,8
CPT,42971,CONTROL NOSE/THROAT BLEEDING,,,,,0
CPT,42972,CONTROL NOSE/THROAT BLEEDING,,,3221.84,6443.68,8
CPT,42975,DISE EVAL SLP DO BRTH FLX DX,,,1729.64,3459.28,8
CPT,42999,UNLISTED PX PHRNX ADND/TNSL,,,230.16,460.32,8
CPT,429U,HPV OROP SWAB 14 HI-RISK TYP,,,35.09,70.18,8
CPT,42T,CT PERFUSION W/CONTRAST CBF,,,,,0
CPT,42U,B BRGDRFERI ANTB 12 PRTN IGG,,,17.21,34.42,8
CPT,4300F,PT RCVNG WARF THXPY,,,,,0
CPT,4301F,PT NOT RCVNG WARF THXPY,,,,,0
CPT,43020,INCISION OF ESOPHAGUS,,,1507.77,3015.54,8
CPT,43030,THROAT MUSCLE SURGERY,,,5752.66,11505.32,8
CPT,43045,INCISION OF ESOPHAGUS,,,,,0
CPT,4305F,PT ED RE FT CARE INSPCT RCVD,,,,,0
CPT,4306F,PT TLK PSYCH & RX OPD ADDIC,,,,,0
CPT,430U,GI MALABS AAT CALPRO PNCRTC,,,61.54,123.08,8
CPT,43100,EXCISION OF ESOPHAGUS LESION,,,,,0
CPT,43101,EXCISION OF ESOPHAGUS LESION,,,,,0
CPT,43107,REMOVAL OF ESOPHAGUS,,,,,0
CPT,43108,REMOVAL OF ESOPHAGUS,,,,,0
CPT,43112,ESPHG TOT W/THRCM,,,,,0
CPT,43113,REMOVAL OF ESOPHAGUS,,,,,0
CPT,43116,PARTIAL REMOVAL OF ESOPHAGUS,,,,,0
CPT,43117,PARTIAL REMOVAL OF ESOPHAGUS,,,,,0
CPT,43118,PARTIAL REMOVAL OF ESOPHAGUS,,,,,0
CPT,43121,PARTIAL REMOVAL OF ESOPHAGUS,,,,,0
CPT,43122,PARTIAL REMOVAL OF ESOPHAGUS,,,,,0
CPT,43123,PARTIAL REMOVAL OF ESOPHAGUS,,,,,0
CPT,43124,REMOVAL OF ESOPHAGUS,,,,,0
CPT,43130,REMOVAL OF ESOPHAGUS POUCH,,,5752.66,11505.32,8
CPT,43135,REMOVAL OF ESOPHAGUS POUCH,,,,,0
CPT,43180,ESOPHAGOSCOPY RIGID TRNSO,,,5752.66,11505.32,8
CPT,43191,ESOPHAGOSCOPY RIGID TRNSO DX,,,1864.72,3729.44,8
CPT,43192,ESOPHAGOSCP RIG TRNSO INJECT,,,1864.72,3729.44,8
CPT,43193,ESOPHAGOSCP RIG TRNSO BIOPSY,,,1864.72,3729.44,8
CPT,43194,ESOPHAGOSCP RIG TRNSO REM FB,,,1864.72,3729.44,8
CPT,43195,ESOPHAGOSCOPY RIGID BALLOON,,,3746.6,7493.2,8
CPT,43196,ESOPHAGOSCP GUIDE WIRE DILAT,,,1864.72,3729.44,8
CPT,43197,ESOPHAGOSCOPY FLEX DX BRUSH,,,881.37,1762.74,8
CPT,43198,ESOPHAGOSC FLEX TRNSN BIOPSY,,,881.37,1762.74,8
CPT,431U,GLY RCPTR ALPHA1 IGG SRM/CSF,,,36.57,73.14,8
CPT,43200,ESOPHAGOSCOPY FLEXIBLE BRUSH,,,881.37,1762.74,8
CPT,43201,ESOPH SCOPE W/SUBMUCOUS INJ,,,1864.72,3729.44,8
CPT,43202,ESOPHAGOSCOPY FLEX BIOPSY,,,1864.72,3729.44,8
CPT,43204,ESOPH SCOPE W/SCLEROSIS INJ,,,1864.72,3729.44,8
CPT,43205,ESOPHAGUS ENDOSCOPY/LIGATION,,,1864.72,3729.44,8
CPT,43206,ESOPH OPTICAL ENDOMICROSCOPY,,,1864.72,3729.44,8
CPT,4320F,PT TALK PSYCHSOC&RX OH DPND,,,,,0
CPT,43210,EGD ESOPHAGOGASTRC FNDOPLSTY,,,10329.66,20659.32,8
CPT,43211,ESOPHAGOSCOP MUCOSAL RESECT,,,1864.72,3729.44,8
CPT,43212,ESOPHAGOSCOP STENT PLACEMENT,,,5899.47,11798.94,8
CPT,43213,ESOPHAGOSCOPY RETRO BALLOON,,,1864.72,3729.44,8
CPT,43214,ESOPHAGOSC DILATE BALLOON 30,,,1864.72,3729.44,8
CPT,43215,ESOPHAGOSCOPY FLEX REMOVE FB,,,1864.72,3729.44,8
CPT,43216,ESOPHAGOSCOPY LESION REMOVAL,,,1864.72,3729.44,8
CPT,43217,ESOPHAGOSCOPY SNARE LES REMV,,,1864.72,3729.44,8
CPT,43220,ESOPHAGOSCOPY BALLOON <30MM,,,1864.72,3729.44,8
CPT,43226,ESOPH ENDOSCOPY DILATION,,,1864.72,3729.44,8
CPT,43227,ESOPHAGOSCOPY CONTROL BLEED,,,1864.72,3729.44,8
CPT,43229,ESOPHAGOSCOPY LESION ABLATE,,,3746.6,7493.2,8
CPT,4322F,CRGVR PROV W/ ED ADDL RSRCS,,,,,0
CPT,43231,ESOPHAGOSCOP ULTRASOUND EXAM,,,1864.72,3729.44,8
CPT,43232,ESOPHAGOSCOPY W/US NEEDLE BX,,,1864.72,3729.44,8
CPT,43233,EGD BALLOON DIL ESOPH30 MM/>,,,1864.72,3729.44,8
CPT,43235,EGD DIAGNOSTIC BRUSH WASH,,,881.37,1762.74,8
CPT,43236,UPPR GI SCOPE W/SUBMUC INJ,,,881.37,1762.74,8
CPT,43237,ENDOSCOPIC US EXAM ESOPH,,,1864.72,3729.44,8
CPT,43238,EGD US FINE NEEDLE BX/ASPIR,,,1864.72,3729.44,8
CPT,43239,EGD BIOPSY SINGLE/MULTIPLE,,,881.37,1762.74,8
CPT,43240,EGD W/TRANSMURAL DRAIN CYST,,,5899.47,11798.94,8
CPT,43241,EGD TUBE/CATH INSERTION,,,1864.72,3729.44,8
CPT,43242,EGD US FINE NEEDLE BX/ASPIR,,,1864.72,3729.44,8
CPT,43243,EGD INJECTION VARICES,,,1864.72,3729.44,8
CPT,43244,EGD VARICES LIGATION,,,1864.72,3729.44,8
CPT,43245,EGD DILATE STRICTURE,,,1864.72,3729.44,8
CPT,43246,EGD PLACE GASTROSTOMY TUBE,,,1864.72,3729.44,8
CPT,43247,EGD REMOVE FOREIGN BODY,,,881.37,1762.74,8
CPT,43248,EGD GUIDE WIRE INSERTION,,,881.37,1762.74,8
CPT,43249,ESOPH EGD DILATION <30 MM,,,1864.72,3729.44,8
CPT,4324F,PT QUERIED PRKNS COMPLIC,,,,,0
CPT,43250,EGD CAUTERY TUMOR POLYP,,,1864.72,3729.44,8
CPT,43251,EGD REMOVE LESION SNARE,,,1864.72,3729.44,8
CPT,43252,EGD OPTICAL ENDOMICROSCOPY,,,1864.72,3729.44,8
CPT,43253,EGD US TRANSMURAL INJXN/MARK,,,1864.72,3729.44,8
CPT,43254,EGD ENDO MUCOSAL RESECTION,,,1864.72,3729.44,8
CPT,43255,EGD CONTROL BLEEDING ANY,,,1864.72,3729.44,8
CPT,43257,EGD W/THRML TXMNT GERD,,,3746.6,7493.2,8
CPT,43259,EGD US EXAM DUODENUM/JEJUNUM,,,1864.72,3729.44,8
CPT,4325F,MED TXMNT OPTIONS RVWD W/PT,,,,,0
CPT,43260,ERCP W/SPECIMEN COLLECTION,,,3746.6,7493.2,8
CPT,43261,ENDO CHOLANGIOPANCREATOGRAPH,,,3746.6,7493.2,8
CPT,43262,ENDO CHOLANGIOPANCREATOGRAPH,,,3746.6,7493.2,8
CPT,43263,ERCP SPHINCTER PRESSURE MEAS,,,1864.72,3729.44,8
CPT,43264,ERCP REMOVE DUCT CALCULI,,,3746.6,7493.2,8
CPT,43265,ERCP LITHOTRIPSY CALCULI,,,5899.47,11798.94,8
CPT,43266,EGD ENDOSCOPIC STENT PLACE,,,5899.47,11798.94,8
CPT,4326F,PT ASKED RE SYMP AUTO DYSFXN,,,,,0
CPT,43270,EGD LESION ABLATION,,,1864.72,3729.44,8
CPT,43273,ENDOSCOPIC PANCREATOSCOPY,,,,,0
CPT,43274,ERCP DUCT STENT PLACEMENT,,,5899.47,11798.94,8
CPT,43275,ERCP REMOVE FORGN BODY DUCT,,,1864.72,3729.44,8
CPT,43276,ERCP STENT EXCHANGE W/DILATE,,,5899.47,11798.94,8
CPT,43277,ERCP EA DUCT/AMPULLA DILATE,,,3746.6,7493.2,8
CPT,43278,ERCP LESION ABLATE W/DILATE,,,3746.6,7493.2,8
CPT,43279,LAP MYOTOMY HELLER,,,,,0
CPT,43280,LAPAROSCOPY FUNDOPLASTY,,,10329.66,20659.32,8
CPT,43281,LAP PARAESOPHAG HERN REPAIR,,,10329.66,20659.32,8
CPT,43282,LAP PARAESOPH HER RPR W/MESH,,,10329.66,20659.32,8
CPT,43283,LAP ESOPH LENGTHENING,,,,,0
CPT,43284,LAPS ESOPHGL SPHNCTR AGMNTJ,,,10329.66,20659.32,8
CPT,43285,RMVL ESOPHGL SPHNCTR DEV,,,5874.81,11749.62,8
CPT,43286,ESPHG TOT W/LAPS MOBLJ,,,,,0
CPT,43287,ESPHG DSTL 2/3 W/LAPS MOBLJ,,,,,0
CPT,43288,ESPHG THRSC MOBLJ,,,,,0
CPT,43289,UNLISTED LAPS PX ESOPH,,,5874.81,11749.62,8
CPT,4328F,PT ASKED RE SLEEP DISTURB,,,,,0
CPT,43290,EGD FLX TRNSORL DPLMNT BALO,,,1864.72,3729.44,8
CPT,43291,EGD FLX TRNSORL RMVL BALO,,,881.37,1762.74,8
CPT,432U,KLHL11 ANTB SR/CSF ASY QUAL,,,36.57,73.14,8
CPT,43300,REPAIR OF ESOPHAGUS,,,,,0
CPT,43305,REPAIR ESOPHAGUS AND FISTULA,,,,,0
CPT,4330F,CNSLNG EPI SPEC SFTY ISSUES,,,,,0
CPT,43310,REPAIR OF ESOPHAGUS,,,,,0
CPT,43312,REPAIR ESOPHAGUS AND FISTULA,,,,,0
CPT,43313,ESOPHAGOPLASTY CONGENITAL,,,,,0
CPT,43314,TRACHEO-ESOPHAGOPLASTY CONG,,,,,0
CPT,43320,FUSE ESOPHAGUS & STOMACH,,,,,0
CPT,43325,REVISE ESOPHAGUS & STOMACH,,,,,0
CPT,43327,ESOPH FUNDOPLASTY LAP,,,,,0
CPT,43328,ESOPH FUNDOPLASTY THOR,,,,,0
CPT,43330,ESOPHAGOMYOTOMY ABDOMINAL,,,,,0
CPT,43331,ESOPHAGOMYOTOMY THORACIC,,,,,0
CPT,43332,TRANSAB ESOPH HIAT HERN RPR,,,,,0
CPT,43333,TRANSAB ESOPH HIAT HERN RPR,,,,,0
CPT,43334,TRANSTHOR DIAPHRAG HERN RPR,,,,,0
CPT,43335,TRANSTHOR DIAPHRAG HERN RPR,,,,,0
CPT,43336,THORABD DIAPHR HERN REPAIR,,,,,0
CPT,43337,THORABD DIAPHR HERN REPAIR,,,,,0
CPT,43338,ESOPH LENGTHENING,,,,,0
CPT,43340,FUSE ESOPHAGUS & INTESTINE,,,,,0
CPT,43341,FUSE ESOPHAGUS & INTESTINE,,,,,0
CPT,43351,SURGICAL OPENING ESOPHAGUS,,,,,0
CPT,43352,SURGICAL OPENING ESOPHAGUS,,,,,0
CPT,43360,GASTROINTESTINAL REPAIR,,,,,0
CPT,43361,GASTROINTESTINAL REPAIR,,,,,0
CPT,433U,ONC PRST8 5 DNA REG MRK PCR,,,760.0,1520.0,8
CPT,43400,LIGATE ESOPHAGUS VEINS,,,,,0
CPT,43405,LIGATE/STAPLE ESOPHAGUS,,,,,0
CPT,4340F,CNSLNG CHLDBRNG WOMEN EPI,,,,,0
CPT,43410,REPAIR ESOPHAGUS WOUND,,,,,0
CPT,43415,REPAIR ESOPHAGUS WOUND,,,,,0
CPT,43420,REPAIR ESOPHAGUS OPENING,,,3221.84,6443.68,8
CPT,43425,REPAIR ESOPHAGUS OPENING,,,,,0
CPT,43450,DILATE ESOPHAGUS 1/MULT PASS,,,881.37,1762.74,8
CPT,43453,DILATE ESOPHAGUS,,,1864.72,3729.44,8
CPT,43460,PRESSURE TREATMENT ESOPHAGUS,,,,,0
CPT,43496,FREE JEJUNUM FLAP MICROVASC,,,,,0
CPT,43497,TRANSORL LWR ESOPHGL MYOTOMY,,,5899.47,11798.94,8
CPT,43499,UNLISTED PROCEDURE ESOPHAGUS,,,881.37,1762.74,8
CPT,434U,RX METAB ADVRS VRNT ALYS 25,,,416.78,833.56,8
CPT,43500,SURGICAL OPENING OF STOMACH,,,,,0
CPT,43501,SURGICAL REPAIR OF STOMACH,,,,,0
CPT,43502,SURGICAL REPAIR OF STOMACH,,,,,0
CPT,4350F,CNSLNG PROVIDED SYMP MNGMNT,,,,,0
CPT,43510,SURGICAL OPENING OF STOMACH,,,881.37,1762.74,8
CPT,43520,INCISION OF PYLORIC MUSCLE,,,,,0
CPT,435U,ONC CHEMO RX CYTOX CSC 14 RX,,,3033.86,6067.72,8
CPT,43605,BIOPSY OF STOMACH,,,,,0
CPT,43610,EXCISION OF STOMACH LESION,,,,,0
CPT,43611,EXCISION OF STOMACH LESION,,,,,0
CPT,43620,REMOVAL OF STOMACH,,,,,0
CPT,43621,REMOVAL OF STOMACH,,,,,0
CPT,43622,REMOVAL OF STOMACH,,,,,0
CPT,43631,REMOVAL OF STOMACH PARTIAL,,,,,0
CPT,43632,REMOVAL OF STOMACH PARTIAL,,,,,0
CPT,43633,REMOVAL OF STOMACH PARTIAL,,,,,0
CPT,43634,REMOVAL OF STOMACH PARTIAL,,,,,0
CPT,43635,REMOVAL OF STOMACH PARTIAL,,,,,0
CPT,43640,VAGOTOMY & PYLORUS REPAIR,,,,,0
CPT,43641,VAGOTOMY & PYLORUS REPAIR,,,,,0
CPT,43644,LAP GASTRIC BYPASS/ROUX-EN-Y,,,,,0
CPT,43645,LAP GASTR BYPASS INCL SMLL I,,,,,0
CPT,43647,LAP IMPL ELECTRODE ANTRUM,,,10828.04,21656.08,8
CPT,43648,LAP REVISE/REMV ELTRD ANTRUM,,,10329.66,20659.32,8
CPT,43651,LAPAROSCOPY VAGUS NERVE,,,5874.81,11749.62,8
CPT,43652,LAPAROSCOPY VAGUS NERVE,,,5874.81,11749.62,8
CPT,43653,LAPAROSCOPY GASTROSTOMY,,,5874.81,11749.62,8
CPT,43659,UNLISTED LAPS PX STOMACH,,,5874.81,11749.62,8
CPT,436U,ONC LNG PLSM ALYS 388 PRTN,,,1504.24,3008.48,8
CPT,43752,NASAL/OROGASTRIC W/TUBE PLMT,,,434.11,868.22,8
CPT,43753,TX GASTRO INTUB W/ASP,,,209.83,419.66,8
CPT,43754,DX GASTR INTUB W/ASP SPEC,,,209.83,419.66,8
CPT,43755,DX GASTR INTUB W/ASP SPECS,,,125.04,250.08,8
CPT,43756,DX DUOD INTUB W/ASP SPEC,,,881.37,1762.74,8
CPT,43757,DX DUOD INTUB W/ASP SPECS,,,881.37,1762.74,8
CPT,43761,REPOSITION GASTROSTOMY TUBE,,,242.79,485.58,8
CPT,43762,RPLC GTUBE NO REVJ TRC,,,242.79,485.58,8
CPT,43763,RPLC GTUBE REVJ GSTRST TRC,,,242.79,485.58,8
CPT,43770,LAP PLACE GASTR ADJ DEVICE,,,10329.66,20659.32,8
CPT,43771,LAP REVISE GASTR ADJ DEVICE,,,,,0
CPT,43772,LAP RMVL GASTR ADJ DEVICE,,,3746.6,7493.2,8
CPT,43773,LAP REPLACE GASTR ADJ DEVICE,,,5874.81,11749.62,8
CPT,43774,LAP RMVL GASTR ADJ ALL PARTS,,,3746.6,7493.2,8
CPT,43775,LAP SLEEVE GASTRECTOMY,,,,,0
CPT,437T,IMPLTJ SYNTH RNFCMT ABDL WAL,,,,,0
CPT,437U,PSYC ANXIETY DO MRNA 15 BMRK,,,760.0,1520.0,8
CPT,43800,RECONSTRUCTION OF PYLORUS,,,,,0
CPT,43810,FUSION OF STOMACH AND BOWEL,,,,,0
CPT,43820,FUSION OF STOMACH AND BOWEL,,,,,0
CPT,43825,FUSION OF STOMACH AND BOWEL,,,,,0
CPT,43830,PLACE GASTROSTOMY TUBE,,,1864.72,3729.44,8
CPT,43831,PLACE GASTROSTOMY TUBE,,,881.37,1762.74,8
CPT,43832,PLACE GASTROSTOMY TUBE,,,,,0
CPT,43840,REPAIR OF STOMACH LESION,,,3746.6,7493.2,8
CPT,43842,V-BAND GASTROPLASTY,,,,,0
CPT,43843,GASTROPLASTY W/O V-BAND,,,,,0
CPT,43845,GASTROPLASTY DUODENAL SWITCH,,,,,0
CPT,43846,GASTRIC BYPASS FOR OBESITY,,,,,0
CPT,43847,GASTRIC BYPASS INCL SMALL I,,,,,0
CPT,43848,REVISION GASTROPLASTY,,,,,0
CPT,43860,REVISE STOMACH-BOWEL FUSION,,,,,0
CPT,43865,REVISE STOMACH-BOWEL FUSION,,,,,0
CPT,43870,REPAIR STOMACH OPENING,,,3746.6,7493.2,8
CPT,43880,REPAIR STOMACH-BOWEL FISTULA,,,,,0
CPT,43881,IMPL/REDO ELECTRD ANTRUM,,,,,0
CPT,43882,REVISE/REMOVE ELECTRD ANTRUM,,,,,0
CPT,43886,REVISE GASTRIC PORT OPEN,,,3443.66,6887.32,8
CPT,43887,REMOVE GASTRIC PORT OPEN,,,2005.02,4010.04,8
CPT,43888,CHANGE GASTRIC PORT OPEN,,,3443.66,6887.32,8
CPT,438U,RX METAB ADVRS VRNT ALYS 33,,,416.78,833.56,8
CPT,43999,UNLISTED PROCEDURE STOMACH,,,881.37,1762.74,8
CPT,439T,MYOCRD CONTRAST PRFUJ ECHO,,,,,0
CPT,439U,"Cardiology (coronary heart disease [CHD]), DNA, analysis of 5 single-nucleotide polymorphisms (SNPs) (rs11716050 [LOC105376934], rs6560711 [WDR37], rs3735222 [SCIN/LOC107986769], rs6820447 [intergenic",,,854.0,1708.0,8
CPT,43U,TBRF B GRP ANTB 4 PRTN IGM,,,14.86,29.72,8
CPT,44005,FREEING OF BOWEL ADHESION,,,,,0
CPT,4400F,REHAB THXPY OPTIONS W/PT,,,,,0
CPT,44010,INCISION OF SMALL BOWEL,,,,,0
CPT,44015,INSERT NEEDLE CATH BOWEL,,,,,0
CPT,44020,EXPLORE SMALL INTESTINE,,,,,0
CPT,44021,DECOMPRESS SMALL BOWEL,,,,,0
CPT,44025,INCISION OF LARGE BOWEL,,,,,0
CPT,44050,REDUCE BOWEL OBSTRUCTION,,,,,0
CPT,44055,CORRECT MALROTATION OF BOWEL,,,,,0
CPT,440T,ABLTJ PERC UXTR/PERPH NRV,,,1897.58,3795.16,8
CPT,440U,"Cardiology (coronary heart disease [CHD]), DNA, analysis of 10 single-nucleotide polymorphisms (SNPs) (rs710987 [LINC010019], rs1333048 [CDKN2B-AS1], rs12129789 [KCND3], rs942317 [KTN1-AS1], rs1441433",,,854.0,1708.0,8
CPT,44100,BIOPSY OF BOWEL,,,881.37,1762.74,8
CPT,44110,EXCISE INTESTINE LESION(S),,,,,0
CPT,44111,EXCISION OF BOWEL LESION(S),,,,,0
CPT,44120,REMOVAL OF SMALL INTESTINE,,,,,0
CPT,44121,REMOVAL OF SMALL INTESTINE,,,,,0
CPT,44125,REMOVAL OF SMALL INTESTINE,,,,,0
CPT,44126,ENTERECTOMY W/O TAPER CONG,,,,,0
CPT,44127,ENTERECTOMY W/TAPER CONG,,,,,0
CPT,44128,ENTERECTOMY CONG ADD-ON,,,,,0
CPT,44130,BOWEL TO BOWEL FUSION,,,,,0
CPT,44132,ENTERECTOMY CADAVER DONOR,,,,,0
CPT,44133,ENTERECTOMY LIVE DONOR,,,,,0
CPT,44135,INTESTINE TRANSPLNT CADAVER,,,,,0
CPT,44136,INTESTINE TRANSPLANT LIVE,,,,,0
CPT,44137,REMOVE INTESTINAL ALLOGRAFT,,,,,0
CPT,44139,MOBILIZATION OF COLON,,,,,0
CPT,44140,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44141,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44143,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44144,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44145,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44146,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44147,PARTIAL REMOVAL OF COLON,,,,,0
CPT,44150,REMOVAL OF COLON,,,,,0
CPT,44151,REMOVAL OF COLON/ILEOSTOMY,,,,,0
CPT,44155,REMOVAL OF COLON/ILEOSTOMY,,,,,0
CPT,44156,REMOVAL OF COLON/ILEOSTOMY,,,,,0
CPT,44157,COLECTOMY W/ILEOANAL ANAST,,,,,0
CPT,44158,COLECTOMY W/NEO-RECTUM POUCH,,,,,0
CPT,44160,REMOVAL OF COLON,,,,,0
CPT,44180,LAP ENTEROLYSIS,,,5874.81,11749.62,8
CPT,44186,LAP JEJUNOSTOMY,,,5874.81,11749.62,8
CPT,44187,LAP ILEO/JEJUNO-STOMY,,,,,0
CPT,44188,LAP COLOSTOMY,,,,,0
CPT,441T,ABLTJ PERC LXTR/PERPH NRV,,,1897.58,3795.16,8
CPT,441U,"Infectious disease (bacterial, fungal, or viral infection), semiquantitative biomechanical assessment (via deformability cytometry), whole blood, with algorithmic analysis and result reported as an in",,,444.08,888.16,8
CPT,44202,LAP ENTERECTOMY,,,,,0
CPT,44203,LAP RESECT S/INTESTINE ADDL,,,,,0
CPT,44204,LAPARO PARTIAL COLECTOMY,,,,,0
CPT,44205,LAP COLECTOMY PART W/ILEUM,,,,,0
CPT,44206,LAP PART COLECTOMY W/STOMA,,,,,0
CPT,44207,L COLECTOMY/COLOPROCTOSTOMY,,,,,0
CPT,44208,L COLECTOMY/COLOPROCTOSTOMY,,,,,0
CPT,44210,LAPARO TOTAL PROCTOCOLECTOMY,,,,,0
CPT,44211,LAP COLECTOMY W/PROCTECTOMY,,,,,0
CPT,44212,LAPARO TOTAL PROCTOCOLECTOMY,,,,,0
CPT,44213,LAP MOBIL SPLENIC FL ADD-ON,,,,,0
CPT,44227,LAP CLOSE ENTEROSTOMY,,,,,0
CPT,44238,UNLISTED LAPS PX INTESTINE,,,5874.81,11749.62,8
CPT,442T,ABLTJ PERC PLEX/TRNCL NRV,,,8528.03,17056.06,8
CPT,442U,"Infectious disease (respiratory infection), Myxovirus resistance protein A (MxA) and C-reactive protein (CRP), fingerstick whole blood specimen, each biomarker reported as present or absent",,,41.38,82.76,8
CPT,44300,OPEN BOWEL TO SKIN,,,1864.72,3729.44,8
CPT,44310,ILEOSTOMY/JEJUNOSTOMY,,,,,0
CPT,44312,REVISION OF ILEOSTOMY,,,3443.66,6887.32,8
CPT,44314,REVISION OF ILEOSTOMY,,,3443.66,6887.32,8
CPT,44316,DEVISE BOWEL POUCH,,,,,0
CPT,44320,COLOSTOMY,,,,,0
CPT,44322,COLOSTOMY WITH BIOPSIES,,,,,0
CPT,44340,REVISION OF COLOSTOMY,,,3443.66,6887.32,8
CPT,44345,REVISION OF COLOSTOMY,,,3443.66,6887.32,8
CPT,44346,REVISION OF COLOSTOMY,,,3443.66,6887.32,8
CPT,44360,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44361,SMALL BOWEL ENDOSCOPY/BIOPSY,,,1864.72,3729.44,8
CPT,44363,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44364,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44365,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44366,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44369,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44370,SMALL BOWEL ENDOSCOPY/STENT,,,5899.47,11798.94,8
CPT,44372,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44373,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44376,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44377,SMALL BOWEL ENDOSCOPY/BIOPSY,,,1864.72,3729.44,8
CPT,44378,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44379,S BOWEL ENDOSCOPE W/STENT,,,5899.47,11798.94,8
CPT,44380,SMALL BOWEL ENDOSCOPY BR/WA,,,881.37,1762.74,8
CPT,44381,SMALL BOWEL ENDOSCOPY BR/WA,,,1864.72,3729.44,8
CPT,44382,SMALL BOWEL ENDOSCOPY,,,881.37,1762.74,8
CPT,44384,SMALL BOWEL ENDOSCOPY,,,1864.72,3729.44,8
CPT,44385,ENDOSCOPY OF BOWEL POUCH,,,903.7,1807.4,8
CPT,44386,ENDOSCOPY BOWEL POUCH/BIOP,,,903.7,1807.4,8
CPT,44388,COLONOSCOPY THRU STOMA SPX,,,903.7,1807.4,8
CPT,44389,COLONOSCOPY WITH BIOPSY,,,1162.85,2325.7,8
CPT,44390,COLONOSCOPY FOR FOREIGN BODY,,,903.7,1807.4,8
CPT,44391,COLONOSCOPY FOR BLEEDING,,,1162.85,2325.7,8
CPT,44392,COLONOSCOPY & POLYPECTOMY,,,1162.85,2325.7,8
CPT,44394,COLONOSCOPY W/SNARE,,,1162.85,2325.7,8
CPT,443T,R-T SPCTRL ALYS PRST8 TISS,,,,,0
CPT,443U,"Neurofilament light chain (NfL), ultra-sensitive immunoassay, serum or cerebrospinal fluid",,,116.23,232.46,8
CPT,44401,COLONOSCOPY WITH ABLATION,,,1162.85,2325.7,8
CPT,44402,COLONOSCOPY W/STENT PLCMT,,,5899.47,11798.94,8
CPT,44403,COLONOSCOPY W/RESECTION,,,1162.85,2325.7,8
CPT,44404,COLONOSCOPY W/INJECTION,,,1162.85,2325.7,8
CPT,44405,COLONOSCOPY W/DILATION,,,1162.85,2325.7,8
CPT,44406,COLONOSCOPY W/ULTRASOUND,,,1162.85,2325.7,8
CPT,44407,COLONOSCOPY W/NDL ASPIR/BX,,,1162.85,2325.7,8
CPT,44408,COLONOSCOPY W/DECOMPRESSION,,,903.7,1807.4,8
CPT,444T,1ST PLMT DRUG ELUT OC INS,,,,,0
CPT,444U,"Oncology (solid organ neoplasia), targeted genomic sequence analysis panel of 361 genes, interrogation for gene fusions, translocations, or other rearrangements, using DNA from formalin-fixed paraffin",,,2919.6,5839.2,8
CPT,44500,INTRO GASTROINTESTINAL TUBE,,,881.37,1762.74,8
CPT,4450F,SELF-CARE ED PROVIDED TO PT,,,,,0
CPT,445T,SBSQT PLMT DRUG ELUT OC INS,,,,,0
CPT,445U,"β-amyloid (Abeta42) and phospho tau (181P) (pTau181), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology",,,260.5,521.0,8
CPT,44602,SUTURE SMALL INTESTINE,,,3746.6,7493.2,8
CPT,44603,SUTURE SMALL INTESTINE,,,,,0
CPT,44604,SUTURE LARGE INTESTINE,,,,,0
CPT,44605,REPAIR OF BOWEL LESION,,,,,0
CPT,44615,INTESTINAL STRICTUROPLASTY,,,,,0
CPT,44620,REPAIR BOWEL OPENING,,,,,0
CPT,44625,REPAIR BOWEL OPENING,,,,,0
CPT,44626,REPAIR BOWEL OPENING,,,,,0
CPT,44640,REPAIR BOWEL-SKIN FISTULA,,,,,0
CPT,44650,REPAIR BOWEL FISTULA,,,,,0
CPT,44660,REPAIR BOWEL-BLADDER FISTULA,,,,,0
CPT,44661,REPAIR BOWEL-BLADDER FISTULA,,,,,0
CPT,44680,SURGICAL REVISION INTESTINE,,,,,0
CPT,446T,INSJ IMPLTBL GLUCOSE SENSOR,,,4042.91,8085.82,8
CPT,446U,"Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 10 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic risk score for ",,,840.65,1681.3,8
CPT,44700,SUSPEND BOWEL W/PROSTHESIS,,,,,0
CPT,44701,INTRAOP COLON LAVAGE ADD-ON,,,,,0
CPT,44705,PREPARE FECAL MICROBIOTA,,,,,0
CPT,4470F,ICD COUNSELING PROVIDED,,,,,0
CPT,44715,PREPARE DONOR INTESTINE,,,,,0
CPT,44720,PREP DONOR INTESTINE/VENOUS,,,,,0
CPT,44721,PREP DONOR INTESTINE/ARTERY,,,,,0
CPT,44799,UNLISTED PX SMALL INTESTINE,,,881.37,1762.74,8
CPT,447T,RMVL IMPLTBL GLUCOSE SENSOR,,,194.97,389.94,8
CPT,447U,"Autoimmune diseases (systemic lupus erythematosus [SLE]), analysis of 11 cytokine soluble mediator biomarkers by immunoassay, plasma, individual components reported with an algorithmic prognostic risk",,,840.65,1681.3,8
CPT,44800,EXCISION OF BOWEL POUCH,,,,,0
CPT,4480F,PT RCVNG ACE/ARB B-BLOCKERTX,,,,,0
CPT,4481F,PT RCVNG ACE/ARB BLKER <3MOS,,,,,0
CPT,44820,EXCISION OF MESENTERY LESION,,,,,0
CPT,44850,REPAIR OF MESENTERY,,,,,0
CPT,44899,UNLISTED PX MECKEL'S DVRTCLM,,,,,0
CPT,448T,REMVL INSJ IMPLTBL GLUC SENS,,,4042.91,8085.82,8
CPT,44900,DRAIN APPENDIX ABSCESS OPEN,,,,,0
CPT,44950,APPENDECTOMY,,,6291.01,12582.02,8
CPT,44955,APPENDECTOMY ADD-ON,,,,,0
CPT,44960,APPENDECTOMY,,,,,0
CPT,44970,LAPAROSCOPY APPENDECTOMY,,,5874.81,11749.62,8
CPT,44979,UNLISTED LAPS PX APPENDIX,,,5874.81,11749.62,8
CPT,449T,INSJ AQUEOUS DRAIN DEV 1ST,,,5171.04,10342.08,8
CPT,449U,"Carrier screening for severe inherited conditions (eg, cystic fibrosis, spinal muscular atrophy, beta hemoglobinopathies [including sickle cell disease], alpha thalassemia), regardless of race or self",,,1824.88,3649.76,8
CPT,44U,TBRF B GRP ANTB 4 PRTN IGG,,,14.86,29.72,8
CPT,450,ANESTH SURGERY OF SHOULDER,,,,,0
CPT,45000,DRAINAGE OF PELVIC ABSCESS,,,1162.85,2325.7,8
CPT,45005,DRAINAGE OF RECTAL ABSCESS,,,1162.85,2325.7,8
CPT,4500F,REF TO OUTPT CARD REHAB PROG,,,,,0
CPT,45020,DRAINAGE OF RECTAL ABSCESS,,,2697.28,5394.56,8
CPT,450T,INSJ AQUEOUS DRAIN DEV EACH,,,,,0
CPT,450U,"Oncology (multiple myeloma), liquid chromatography with tandem mass spectrometry (LC-MS/MS), monoclonal paraprotein sequencing analysis, serum, results reported as baseline presence or absence of dete",,,,,0
CPT,45100,BIOPSY OF RECTUM,,,2697.28,5394.56,8
CPT,45108,REMOVAL OF ANORECTAL LESION,,,2697.28,5394.56,8
CPT,4510F,PREV CARDREHAB QUALCARDEVENT,,,,,0
CPT,45110,REMOVAL OF RECTUM,,,,,0
CPT,45111,PARTIAL REMOVAL OF RECTUM,,,,,0
CPT,45112,REMOVAL OF RECTUM,,,,,0
CPT,45113,PARTIAL PROCTECTOMY,,,,,0
CPT,45114,PARTIAL REMOVAL OF RECTUM,,,,,0
CPT,45116,PARTIAL REMOVAL OF RECTUM,,,,,0
CPT,45119,REMOVE RECTUM W/RESERVOIR,,,,,0
CPT,45120,REMOVAL OF RECTUM,,,,,0
CPT,45121,REMOVAL OF RECTUM AND COLON,,,,,0
CPT,45123,PARTIAL PROCTECTOMY,,,,,0
CPT,45126,PELVIC EXENTERATION,,,,,0
CPT,45130,EXCISION OF RECTAL PROLAPSE,,,,,0
CPT,45135,EXCISION OF RECTAL PROLAPSE,,,,,0
CPT,45136,EXCISE ILEOANAL RESERVIOR,,,,,0
CPT,45150,EXCISION OF RECTAL STRICTURE,,,1162.85,2325.7,8
CPT,45160,EXCISION OF RECTAL LESION,,,2697.28,5394.56,8
CPT,45171,EXC RECT TUM TRANSANAL PART,,,2697.28,5394.56,8
CPT,45172,EXC RECT TUM TRANSANAL FULL,,,2697.28,5394.56,8
CPT,45190,DESTRUCTION RECTAL TUMOR,,,2697.28,5394.56,8
CPT,451U,"Oncology (multiple myeloma), LC-MS/MS, peptide ion quantification, serum, results compared with baseline to determine monoclonal paraprotein abundance",,,,,0
CPT,4525F,NEUROPSYCHIA INTERVEN ORDER,,,,,0
CPT,4526F,NEUROPSYCHIA INTERVEN RCVD,,,,,0
CPT,452U,"Oncology (bladder), methylated PENK DNA detection by linear target enrichment-quantitative methylation-specific real-time PCR (LTE-qMSP), urine, reported as likelihood of bladder cancer",,,192.0,384.0,8
CPT,45300,PROCTOSIGMOIDOSCOPY DX,,,903.7,1807.4,8
CPT,45303,PROCTOSIGMOIDOSCOPY DILATE,,,1162.85,2325.7,8
CPT,45305,PROCTOSIGMOIDOSCOPY W/BX,,,1162.85,2325.7,8
CPT,45307,PROCTOSIGMOIDOSCOPY FB,,,2697.28,5394.56,8
CPT,45308,PROCTOSIGMOIDOSCOPY REMOVAL,,,2697.28,5394.56,8
CPT,45309,PROCTOSIGMOIDOSCOPY REMOVAL,,,1162.85,2325.7,8
CPT,45315,PROCTOSIGMOIDOSCOPY REMOVAL,,,1162.85,2325.7,8
CPT,45317,PROCTOSIGMOIDOSCOPY BLEED,,,1162.85,2325.7,8
CPT,45320,PROCTOSIGMOIDOSCOPY ABLATE,,,2697.28,5394.56,8
CPT,45321,PROCTOSIGMOIDOSCOPY VOLVUL,,,2697.28,5394.56,8
CPT,45327,PROCTOSIGMOIDOSCOPY W/STENT,,,5899.47,11798.94,8
CPT,45330,DIAGNOSTIC SIGMOIDOSCOPY,1932.0,966.0,336.55,1874.04,54
CPT,45331,SIGMOIDOSCOPY AND BIOPSY,1932.0,966.0,336.55,1874.04,54
CPT,45332,SIGMOIDOSCOPY W/FB REMOVAL,,,1162.85,2325.7,8
CPT,45333,SIGMOIDOSCOPY & POLYPECTOMY,,,903.7,1807.4,8
CPT,45334,SIGMOIDOSCOPY FOR BLEEDING,,,1162.85,2325.7,8
CPT,45335,PR SGMDSC FLX DIRED SBMCSL NJX ANY SBST,1932.0,966.0,336.55,1874.04,54
CPT,45335,SIGMOIDOSCOPY W/SUBMUC INJ,,,,,0
CPT,45337,SIGMOIDOSCOPY & DECOMPRESS,,,903.7,1807.4,8
CPT,45338,SIGMOIDOSCOPY W/TUMR REMOVE,,,1162.85,2325.7,8
CPT,45340,SIG W/TNDSC BALLOON DILATION,,,1162.85,2325.7,8
CPT,45341,SIGMOIDOSCOPY W/ULTRASOUND,,,903.7,1807.4,8
CPT,45342,SIGMOIDOSCOPY W/US GUIDE BX,,,1162.85,2325.7,8
CPT,45346,SIGMOIDOSCOPY W/ABLATION,,,1162.85,2325.7,8
CPT,45347,SIGMOIDOSCOPY W/PLCMT STENT,,,5899.47,11798.94,8
CPT,45349,SIGMOIDOSCOPY W/RESECTION,,,2697.28,5394.56,8
CPT,45350,SGMDSC W/BAND LIGATION,,,1162.85,2325.7,8
CPT,45378,DIAGNOSTIC COLONOSCOPY,,,903.7,1807.4,8
CPT,45379,COLONOSCOPY W/FB REMOVAL,,,1162.85,2325.7,8
CPT,45380,COLONOSCOPY AND BIOPSY,,,1162.85,2325.7,8
CPT,45381,COLONOSCOPY SUBMUCOUS NJX,,,1162.85,2325.7,8
CPT,45382,COLONOSCOPY W/CONTROL BLEED,,,1162.85,2325.7,8
CPT,45384,COLONOSCOPY W/LESION REMOVAL,,,1162.85,2325.7,8
CPT,45385,COLONOSCOPY W/LESION REMOVAL,,,1162.85,2325.7,8
CPT,45386,COLONOSCOPY W/BALLOON DILAT,,,1162.85,2325.7,8
CPT,45388,COLONOSCOPY W/ABLATION,,,1162.85,2325.7,8
CPT,45389,COLONOSCOPY W/STENT PLCMT,,,5899.47,11798.94,8
CPT,45390,COLONOSCOPY W/RESECTION,,,2697.28,5394.56,8
CPT,45391,COLONOSCOPY W/ENDOSCOPE US,,,1162.85,2325.7,8
CPT,45392,COLONOSCOPY W/ENDOSCOPIC FNB,,,1162.85,2325.7,8
CPT,45393,COLONOSCOPY W/DECOMPRESSION,,,1162.85,2325.7,8
CPT,45395,LAP REMOVAL OF RECTUM,,,,,0
CPT,45397,LAP REMOVE RECTUM W/POUCH,,,,,0
CPT,45398,COLONOSCOPY W/BAND LIGATION,,,1162.85,2325.7,8
CPT,45399,UNLISTED PROCEDURE COLON,,,903.7,1807.4,8
CPT,453U,"Oncology (colorectal cancer), cell-free DNA (cfDNA), methylation-based quantitative PCR assay (SEPTIN9, IKZF1, BCAT1, Septin9-2, VAV3, BCAN), plasma, reported as presence or absence of circulating tum",,,192.0,384.0,8
CPT,454,ANESTH COLLAR BONE BIOPSY,,,,,0
CPT,45400,LAPAROSCOPIC PROC,,,,,0
CPT,45402,LAP PROCTOPEXY W/SIG RESECT,,,,,0
CPT,4540F,DISEASE MODIF PHARMACOTHXPY,,,,,0
CPT,4541F,PT OFFERED TX FOR PSEUDOBULB,,,,,0
CPT,45499,LAPAROSCOPE PROC RECTUM,,,5874.81,11749.62,8
CPT,454U,"Rare diseases (constitutional/heritable disorders), identification of copy number variations, inversions, insertions, translocations, and other structural variants by optical genome mapping",,,1263.53,2527.06,8
CPT,45500,REPAIR OF RECTUM,,,2697.28,5394.56,8
CPT,45505,REPAIR OF RECTUM,,,2697.28,5394.56,8
CPT,4550F,NONINVAS RESP SUPPORT TALK,,,,,0
CPT,4551F,NUTRITIONAL SUPPORT OFFERED,,,,,0
CPT,45520,TREATMENT OF RECTAL PROLAPSE,,,903.7,1807.4,8
CPT,4552F,PT REF FOR SPEECH LANG PATH,,,,,0
CPT,4553F,PT ASST RE END LIFE ISSUES,,,,,0
CPT,45540,CORRECT RECTAL PROLAPSE,,,,,0
CPT,45541,CORRECT RECTAL PROLAPSE,,,2697.28,5394.56,8
CPT,4554F,PT RECVD INHAL ANESTHETIC,,,,,0
CPT,45550,REPAIR RECTUM/REMOVE SIGMOID,,,,,0
CPT,4555F,PT RECVD NO INHAL ANESTHIC,,,,,0
CPT,45560,REPAIR OF RECTOCELE,,,2697.28,5394.56,8
CPT,45562,EXPLORATION/REPAIR OF RECTUM,,,,,0
CPT,45563,EXPLORATION/REPAIR OF RECTUM,,,,,0
CPT,4556F,PT W/3+ POST-OP NAUSEA&VOM,,,,,0
CPT,4557F,PT W/O 3+ POST-OPNAUSEA&VOM,,,,,0
CPT,4558F,PT RECVD 2 RX ANTI-EMET AGT,,,,,0
CPT,4559F,1 BODYTEMP >=35.5CW/IN 30MIN,,,,,0
CPT,455U,"Infectious agents (sexually transmitted infection), Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis, multiplex amplified probe technique, vaginal, endocervical, gynecological s",,,142.63,285.26,8
CPT,4560F,ANESTH W/O GEN/NEURAX ANESTH,,,,,0
CPT,4561F,PT W/ CORONARY ARTERY STENT,,,,,0
CPT,4562F,PT W/O CORONARY ARTERY STENT,,,,,0
CPT,4563F,PT RECVD ASPIRIN W/IN 24 HRS,,,,,0
CPT,457U,"Perfluoroalkyl substances (PFAS) (eg, perfluorooctanoic acid, perfluorooctane sulfonic acid), 9 PFAS compounds by LC-MS/MS, plasma or serum, quantitative",,,198.74,397.48,8
CPT,45800,REPAIR RECT/BLADDER FISTULA,,,,,0
CPT,45805,REPAIR FISTULA W/COLOSTOMY,,,,,0
CPT,45820,REPAIR RECTOURETHRAL FISTULA,,,,,0
CPT,45825,REPAIR FISTULA W/COLOSTOMY,,,,,0
CPT,458U,"Oncology (breast cancer), S100A8 and S100A9, by enzyme-linked immunosorbent assay (ELISA), tear fluid with age, algorithm reported as a risk score",,,260.5,521.0,8
CPT,45900,REDUCTION OF RECTAL PROLAPSE,,,903.7,1807.4,8
CPT,45905,DILATION OF ANAL SPHINCTER,,,1162.85,2325.7,8
CPT,45910,DILATION OF RECTAL NARROWING,,,1162.85,2325.7,8
CPT,45915,REMOVE RECTAL OBSTRUCTION,,,1162.85,2325.7,8
CPT,45990,SURG DX EXAM ANORECTAL,,,2697.28,5394.56,8
CPT,45999,UNLISTED PROCEDURE RECTUM,,,903.7,1807.4,8
CPT,459U,"β-amyloid (Abeta42) and total tau (tTau), electrochemiluminescent immunoassay (ECLIA), cerebral spinal fluid, ratio reported as positive or negative for amyloid pathology",,,260.5,521.0,8
CPT,45U,ONC BRST DUX CARC IS 12 GENE,,,3873.0,7746.0,8
CPT,46020,PLACEMENT OF SETON,,,2697.28,5394.56,8
CPT,46030,REMOVAL OF RECTAL MARKER,,,1162.85,2325.7,8
CPT,46040,INCISION OF RECTAL ABSCESS,,,1162.85,2325.7,8
CPT,46045,INCISION OF RECTAL ABSCESS,,,2697.28,5394.56,8
CPT,46050,INCISION OF ANAL ABSCESS,,,903.7,1807.4,8
CPT,46060,INCISION OF RECTAL ABSCESS,,,2697.28,5394.56,8
CPT,46070,INCISION OF ANAL SEPTUM,,,2697.28,5394.56,8
CPT,46080,INCISION OF ANAL SPHINCTER,,,2697.28,5394.56,8
CPT,46083,INCISE EXTERNAL HEMORRHOID,,,242.79,485.58,8
CPT,460U,"Oncology, whole blood or buccal, DNA single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes, with variant analysis and reported phenotypes",,,917.08,1834.16,8
CPT,461U,"Oncology, pharmacogenomic analysis of single-nucleotide polymorphism (SNP) genotyping by real-time PCR of 24 genes, whole blood or buccal swab, with variant analysis, including impacted gene-drug inte",,,917.08,1834.16,8
CPT,46200,REMOVAL OF ANAL FISSURE,,,2697.28,5394.56,8
CPT,46220,EXCISE ANAL EXT TAG/PAPILLA,,,1162.85,2325.7,8
CPT,46221,LIGATION OF HEMORRHOID(S),,,903.7,1807.4,8
CPT,46230,REMOVAL OF ANAL TAGS,,,2697.28,5394.56,8
CPT,46250,REMOVE EXT HEM GROUPS 2+,,,2697.28,5394.56,8
CPT,46255,REMOVE INT/EXT HEM 1 GROUP,,,2697.28,5394.56,8
CPT,46257,REMOVE IN/EX HEM GRP & FISS,,,2697.28,5394.56,8
CPT,46258,REMOVE IN/EX HEM GRP W/FISTU,,,2697.28,5394.56,8
CPT,46260,REMOVE IN/EX HEM GROUPS 2+,,,2697.28,5394.56,8
CPT,46261,REMOVE IN/EX HEM GRPS & FISS,,,2697.28,5394.56,8
CPT,46262,REMOVE IN/EX HEM GRPS W/FIST,,,2697.28,5394.56,8
CPT,46270,REMOVE ANAL FIST SUBQ,,,2697.28,5394.56,8
CPT,46275,REMOVE ANAL FIST INTER,,,2697.28,5394.56,8
CPT,46280,REMOVE ANAL FIST COMPLEX,,,2697.28,5394.56,8
CPT,46285,REMOVE ANAL FIST 2 STAGE,,,2697.28,5394.56,8
CPT,46288,REPAIR ANAL FISTULA,,,2697.28,5394.56,8
CPT,462U,"Melatonin levels test, sleep study, 7 or 9 sample melatonin profile (cortisol optional), enzyme-linked immunosorbent assay (ELISA), saliva, screening/preliminary",,,17.27,34.54,8
CPT,46320,REMOVAL OF HEMORRHOID CLOT,,,1162.85,2325.7,8
CPT,463U,"Oncology (cervix), mRNA gene expression profiling of 14 biomarkers (E6 and E7 of the highest-risk human papillomavirus [HPV] types 16, 18, 31, 33, 45, 52, 58), by real-time nucleic acid sequence-based",,,760.0,1520.0,8
CPT,464T,VISUAL EP TEST FOR GLAUCOMA,,,125.04,250.08,8
CPT,464U,"Oncology (colorectal) screening, quantitative real-time target and signal amplification, methylated DNA markers, including LASS4, LRRC4 and PPP2R5C, a reference marker ZDHHC1, and a protein marker (fe",,,591.92,1183.84,8
CPT,46500,INJECTION INTO HEMORRHOID(S),,,903.7,1807.4,8
CPT,46505,CHEMODENERVATION ANAL MUSC,,,1162.85,2325.7,8
CPT,465U,"Oncology (urothelial carcinoma), DNA, quantitative methylation-specific PCR of 2 genes (ONECUT2, VIM), algorithmic analysis reported as positive or negative",,,1938.01,3876.02,8
CPT,46600,DIAGNOSTIC ANOSCOPY SPX,,,,,0
CPT,46600,PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,277.0,138.5,48.25,268.69,54
CPT,46601,DIAGNOSTIC ANOSCOPY,,,434.11,868.22,8
CPT,46604,ANOSCOPY AND DILATION,,,1162.85,2325.7,8
CPT,46606,ANOSCOPY AND BIOPSY,2539.0,1269.5,442.29,2462.83,54
CPT,46607,DIAGNOSTIC ANOSCOPY & BIOPSY,,,1162.85,2325.7,8
CPT,46608,ANOSCOPY REMOVE FOR BODY,,,903.7,1807.4,8
CPT,46610,ANOSCOPY REMOVE LESION,,,2697.28,5394.56,8
CPT,46611,ANOSCOPY,,,903.7,1807.4,8
CPT,46612,ANOSCOPY REMOVE LESIONS,,,2697.28,5394.56,8
CPT,46614,ANOSCOPY CONTROL BLEEDING,,,1162.85,2325.7,8
CPT,46615,ANOSCOPY,,,2697.28,5394.56,8
CPT,466U,"Cardiology (coronary artery disease [CAD]), DNA, genome-wide association studies (564856 single-nucleotide polymorphisms [SNPs], targeted variant genotyping), patient lifestyle and clinical data, bucc",,,345.43,690.86,8
CPT,46700,REPAIR OF ANAL STRICTURE,,,2697.28,5394.56,8
CPT,46705,REPAIR OF ANAL STRICTURE,,,,,0
CPT,46706,REPR OF ANAL FISTULA W/GLUE,,,2697.28,5394.56,8
CPT,46707,REPAIR ANORECTAL FIST W/PLUG,,,2697.28,5394.56,8
CPT,46710,REPR PER/VAG POUCH SNGL PROC,,,,,0
CPT,46712,REPR PER/VAG POUCH DBL PROC,,,,,0
CPT,46715,REP PERF ANOPER FISTU,,,,,0
CPT,46716,REP PERF ANOPER/VESTIB FISTU,,,,,0
CPT,46730,CONSTRUCTION OF ABSENT ANUS,,,,,0
CPT,46735,CONSTRUCTION OF ABSENT ANUS,,,,,0
CPT,46740,CONSTRUCTION OF ABSENT ANUS,,,,,0
CPT,46742,REPAIR OF IMPERFORATED ANUS,,,,,0
CPT,46744,REPAIR OF CLOACAL ANOMALY,,,,,0
CPT,46746,REPAIR OF CLOACAL ANOMALY,,,,,0
CPT,46748,REPAIR OF CLOACAL ANOMALY,,,,,0
CPT,46750,REPAIR OF ANAL SPHINCTER,,,2697.28,5394.56,8
CPT,46751,REPAIR OF ANAL SPHINCTER,,,,,0
CPT,46753,RECONSTRUCTION OF ANUS,,,2697.28,5394.56,8
CPT,46754,REMOVAL OF SUTURE FROM ANUS,,,2697.28,5394.56,8
CPT,46760,REPAIR OF ANAL SPHINCTER,,,2697.28,5394.56,8
CPT,46761,REPAIR OF ANAL SPHINCTER,,,2697.28,5394.56,8
CPT,467U,"Oncology (bladder), DNA, next-generation sequencing (NGS) of 60 genes and whole genome aneuploidy, urine, algorithms reported as minimal residual disease (MRD) status positive or negative and quantita",,,1519.06,3038.12,8
CPT,468U,"Hepatology (nonalcoholic steatohepatitis [NASH]), miR-34a-5p, alpha 2-macroglobulin, YKL40, HbA1c, serum and whole blood, algorithm reported as a single score for NASH activity and fibrosis",,,251.7,503.4,8
CPT,46900,DESTRUCTION ANAL LESION(S),,,395.04,790.08,8
CPT,46910,DESTRUCTION ANAL LESION(S),,,2005.02,4010.04,8
CPT,46916,CRYOSURGERY ANAL LESION(S),,,194.97,389.94,8
CPT,46917,LASER SURGERY ANAL LESIONS,,,2697.28,5394.56,8
CPT,46922,EXCISION OF ANAL LESION(S),5986.0,2993.0,1042.76,5806.42,54
CPT,46924,DESTRUCTION ANAL LESION(S),,,2697.28,5394.56,8
CPT,46930,DESTROY INTERNAL HEMORRHOIDS,,,1162.85,2325.7,8
CPT,46940,TREATMENT OF ANAL FISSURE,,,2697.28,5394.56,8
CPT,46942,TREATMENT OF ANAL FISSURE,,,903.7,1807.4,8
CPT,46945,INT HRHC LIG 1 HROID W/O IMG,,,2697.28,5394.56,8
CPT,46946,INT HRHC LIG 2+HROID W/O IMG,,,2697.28,5394.56,8
CPT,46947,HEMORRHOIDOPEXY BY STAPLING,,,2697.28,5394.56,8
CPT,46948,INT HRHC TRANAL DARTLZJ 2+,,,2697.28,5394.56,8
CPT,46999,UNLISTED PROCEDURE ANUS,,,903.7,1807.4,8
CPT,469T,RTA POLARIZE SCAN OC SCR BI,,,,,0
CPT,469U,"Rare diseases (constitutional/heritable disorders), whole genome sequence analysis for chromosomal abnormalities, copy number variants, duplications/deletions, inversions, unbalanced translocations, r",,,1197.94,2395.88,8
CPT,46U,FLT3 GENE ITD VARIANTS QUAN,,,407.43,814.86,8
CPT,470,ANESTH REMOVAL OF RIB,,,,,0
CPT,47000,NEEDLE BIOPSY OF LIVER,,,276.87,3209.92,24
CPT,47001,NEEDLE BIOPSY LIVER ADD-ON,,,99.97,116.09,16
CPT,47010,OPEN DRAINAGE LIVER LESION,,,,,0
CPT,47015,INJECT/ASPIRATE LIVER CYST,,,,,0
CPT,470U,"Oncology (oropharyngeal), detection of minimal residual disease by next-generation sequencing (NGS) based quantitative evaluation of 8 DNA targets, cell-free HPV 16 and 18 DNA from plasma",,,597.91,1195.82,8
CPT,47100,WEDGE BIOPSY OF LIVER,,,,,0
CPT,47120,PARTIAL REMOVAL OF LIVER,,,,,0
CPT,47122,EXTENSIVE REMOVAL OF LIVER,,,,,0
CPT,47125,PARTIAL REMOVAL OF LIVER,,,,,0
CPT,47130,PARTIAL REMOVAL OF LIVER,,,,,0
CPT,47133,REMOVAL OF DONOR LIVER,,,,,0
CPT,47135,TRANSPLANTATION OF LIVER,,,,,0
CPT,47140,PARTIAL REMOVAL DONOR LIVER,,,,,0
CPT,47141,PARTIAL REMOVAL DONOR LIVER,,,,,0
CPT,47142,PARTIAL REMOVAL DONOR LIVER,,,,,0
CPT,47143,PREP DONOR LIVER WHOLE,,,,,0
CPT,47144,PREP DONOR LIVER 3-SEGMENT,,,,,0
CPT,47145,PREP DONOR LIVER LOBE SPLIT,,,,,0
CPT,47146,PREP DONOR LIVER/VENOUS,,,,,0
CPT,47147,PREP DONOR LIVER/ARTERIAL,,,,,0
CPT,471U,"Oncology (colorectal cancer), qualitative real-time PCR of 35 variants of KRAS and NRAS genes (exons 2, 3, 4), formalin-fixed paraffin-embedded (FFPE), predictive, identification of detected mutations",,,760.0,1520.0,8
CPT,472,ANESTH CHEST WALL REPAIR,,,,,0
CPT,472T,PRGRMG IO RTA ELTRD RA,,,298.46,596.92,8
CPT,472U,"Carbonic anhydrase VI (CA VI), parotid specific/secretory protein (PSP) and salivary protein (SP1) IgG, IgM, and IgA antibodies, enzyme-linked immunosorbent assay (ELISA), semiqualitative, blood, repo",,,27.9,55.8,8
CPT,47300,SURGERY FOR LIVER LESION,,,,,0
CPT,47350,REPAIR LIVER WOUND,,,,,0
CPT,47360,REPAIR LIVER WOUND,,,,,0
CPT,47361,REPAIR LIVER WOUND,,,,,0
CPT,47362,REPAIR LIVER WOUND,,,,,0
CPT,47370,LAPARO ABLATE LIVER TUMOR RF,,,10329.66,20659.32,8
CPT,47371,LAPARO ABLATE LIVER CRYOSURG,,,10329.66,20659.32,8
CPT,47379,UNLISTED LAPS PX LIVER,,,5874.81,11749.62,8
CPT,47380,OPEN ABLATE LIVER TUMOR RF,,,,,0
CPT,47381,OPEN ABLATE LIVER TUMOR CRYO,,,,,0
CPT,47382,PERCUT ABLATE LIVER RF,,,5874.81,11749.62,8
CPT,47383,PERQ ABLTJ LVR CRYOABLATION,,,10329.66,20659.32,8
CPT,47399,UNLISTED PROCEDURE LIVER,,,688.14,1376.28,8
CPT,473T,REPRGRMG IO RTA ELTRD RA,,,92.39,184.78,8
CPT,473U,"Oncology (solid tumor), next-generation sequencing (NGS) of DNA from formalin-fixed paraffin-embedded (FFPE) tissue with comparative sequence analysis from a matched normal specimen (blood or saliva),",,,4500.0,9000.0,8
CPT,474,ANESTH SURGERY OF RIB,,,,,0
CPT,47400,INCISION OF LIVER DUCT,,,,,0
CPT,47420,INCISION OF BILE DUCT,,,,,0
CPT,47425,INCISION OF BILE DUCT,,,,,0
CPT,47460,INCISE BILE DUCT SPHINCTER,,,,,0
CPT,47480,INCISION OF GALLBLADDER,,,,,0
CPT,47490,INCISION OF GALLBLADDER,,,3479.3,6958.6,8
CPT,474T,INSJ AQUEOUS DRG DEV IO RSVR,,,,,0
CPT,474U,"Hereditary pan-cancer (eg, hereditary sarcomas, hereditary endocrine tumors, hereditary neuroendocrine tumors, hereditary cutaneous melanoma), genomic sequence analysis panel of 88 genes with 20 dupli",,,1303.95,2607.9,8
CPT,47531,INJECTION FOR CHOLANGIOGRAM,,,3479.3,6958.6,8
CPT,47532,INJECTION FOR CHOLANGIOGRAM,,,3479.3,6958.6,8
CPT,47533,PLMT BILIARY DRAINAGE CATH,,,3479.3,6958.6,8
CPT,47534,PLMT BILIARY DRAINAGE CATH,,,3479.3,6958.6,8
CPT,47535,CONVERSION EXT BIL DRG CATH,,,3479.3,6958.6,8
CPT,47536,EXCHANGE BILIARY DRG CATH,,,3479.3,6958.6,8
CPT,47537,REMOVAL BILIARY DRG CATH,,,881.37,1762.74,8
CPT,47538,PERQ PLMT BILE DUCT STENT,,,5874.81,11749.62,8
CPT,47539,PERQ PLMT BILE DUCT STENT,,,5874.81,11749.62,8
CPT,47540,PERQ PLMT BILE DUCT STENT,,,5874.81,11749.62,8
CPT,47541,PLMT ACCESS BIL TREE SM BWL,,,6291.01,12582.02,8
CPT,47542,DILATE BILIARY DUCT/AMPULLA,,,,,0
CPT,47543,ENDOLUMINAL BX BILIARY TREE,,,,,0
CPT,47544,REMOVAL DUCT GLBLDR CALCULI,,,,,0
CPT,47550,BILE DUCT ENDOSCOPY ADD-ON,,,,,0
CPT,47552,BILIARY ENDO PERQ DX W/SPECI,,,6291.01,12582.02,8
CPT,47553,BILIARY ENDOSCOPY THRU SKIN,,,6291.01,12582.02,8
CPT,47554,BILIARY ENDOSCOPY THRU SKIN,,,10329.66,20659.32,8
CPT,47555,BILIARY ENDOSCOPY THRU SKIN,,,6291.01,12582.02,8
CPT,47556,BILIARY ENDOSCOPY THRU SKIN,,,10329.66,20659.32,8
CPT,47562,LAPAROSCOPIC CHOLECYSTECTOMY,,,5874.81,11749.62,8
CPT,47563,LAPARO CHOLECYSTECTOMY/GRAPH,,,5874.81,11749.62,8
CPT,47564,LAPARO CHOLECYSTECTOMY/EXPLR,,,10329.66,20659.32,8
CPT,47570,LAPARO CHOLECYSTOENTEROSTOMY,,,,,0
CPT,47579,UNLISTED LAPS PX BILIARY TRC,,,5874.81,11749.62,8
CPT,475U,"Hereditary prostate cancer-related disorders, genomic sequence analysis panel using next-generation sequencing (NGS), Sanger sequencing, multiplex ligation-dependent probe amplification (MLPA), and ar",,,1303.95,2607.9,8
CPT,47600,REMOVAL OF GALLBLADDER,,,,,0
CPT,47605,REMOVAL OF GALLBLADDER,,,,,0
CPT,47610,REMOVAL OF GALLBLADDER,,,,,0
CPT,47612,REMOVAL OF GALLBLADDER,,,,,0
CPT,47620,REMOVAL OF GALLBLADDER,,,,,0
CPT,476U,"Drug metabolism, psychiatry (eg, major depressive disorder, general anxiety disorder, attention deficit hyperactivity disorder [ADHD], schizophrenia), whole blood, buccal swab, and pharmacogenomic gen",,,416.78,833.56,8
CPT,47700,EXPLORATION OF BILE DUCTS,,,,,0
CPT,47701,BILE DUCT REVISION,,,,,0
CPT,47711,EXCISION OF BILE DUCT TUMOR,,,,,0
CPT,47712,EXCISION OF BILE DUCT TUMOR,,,,,0
CPT,47715,EXCISION OF BILE DUCT CYST,,,,,0
CPT,47720,FUSE GALLBLADDER & BOWEL,,,,,0
CPT,47721,FUSE UPPER GI STRUCTURES,,,,,0
CPT,47740,FUSE GALLBLADDER & BOWEL,,,,,0
CPT,47741,FUSE GALLBLADDER & BOWEL,,,,,0
CPT,47760,FUSE BILE DUCTS AND BOWEL,,,,,0
CPT,47765,FUSE LIVER DUCTS & BOWEL,,,,,0
CPT,47780,FUSE BILE DUCTS AND BOWEL,,,,,0
CPT,47785,FUSE BILE DUCTS AND BOWEL,,,,,0
CPT,477U,"Drug metabolism, psychiatry (eg, major depressive disorder, general anxiety disorder, attention deficit hyperactivity disorder [ADHD], schizophrenia), whole blood, buccal swab, and pharmacogenomic gen",,,416.78,833.56,8
CPT,47800,RECONSTRUCTION OF BILE DUCTS,,,,,0
CPT,47801,PLACEMENT BILE DUCT SUPPORT,,,,,0
CPT,478U,"Oncology (non-small cell lung cancer), DNA and RNA, digital PCR analysis of 9 genes (EGFR, KRAS, BRAF, ALK, ROS1, RET, NTRK 1/2/3, ERBB2, and MET) in formalin-fixed paraffin-embedded (FFPE) tissue, in",,,552.99,1105.98,8
CPT,47900,SUTURE BILE DUCT INJURY,,,,,0
CPT,47999,UNLISTED PX BILIARY TRACT,,,881.37,1762.74,8
CPT,479T,FXJL ABL LSR 1ST 100 SQ CM,,,718.2,1436.4,8
CPT,479U,"Tau, phosphorylated, pTau217",,,17.27,34.54,8
CPT,47U,ONC PRST8 MRNA 17 GENE ALG,,,3873.0,7746.0,8
CPT,48000,DRAINAGE OF ABDOMEN,,,,,0
CPT,48001,PLACEMENT OF DRAIN PANCREAS,,,,,0
CPT,48020,REMOVAL OF PANCREATIC STONE,,,,,0
CPT,480T,FXJL ABL LSR EA ADDL 100SQCM,,,,,0
CPT,480U,"Infectious disease (bacteria, viruses, fungi, and parasites), cerebrospinal fluid (CSF), metagenomic next-generation sequencing (DNA and RNA), bioinformatic analysis, with positive pathogen identifica",,,2126.2,4252.4,8
CPT,48100,BIOPSY OF PANCREAS OPEN,,,,,0
CPT,48102,NEEDLE BIOPSY PANCREAS,,,454.95,3209.92,24
CPT,48105,RESECT/DEBRIDE PANCREAS,,,,,0
CPT,48120,REMOVAL OF PANCREAS LESION,,,,,0
CPT,48140,PARTIAL REMOVAL OF PANCREAS,,,,,0
CPT,48145,PARTIAL REMOVAL OF PANCREAS,,,,,0
CPT,48146,PANCREATECTOMY,,,,,0
CPT,48148,REMOVAL OF PANCREATIC DUCT,,,,,0
CPT,48150,PARTIAL REMOVAL OF PANCREAS,,,,,0
CPT,48152,PANCREATECTOMY,,,,,0
CPT,48153,PANCREATECTOMY,,,,,0
CPT,48154,PANCREATECTOMY,,,,,0
CPT,48155,REMOVAL OF PANCREAS,,,,,0
CPT,48160,PANCREAS REMOVAL/TRANSPLANT,,,,,0
CPT,481T,NJX AUTOL WBC CONCENTRATE,,,434.11,868.22,8
CPT,481U,"IDH1 (isocitrate dehydrogenase 1 [NADP+]), IDH2 (isocitrate dehydrogenase 2 [NADP+]), and TERT (telomerase reverse transcriptase) promoter (eg, central nervous system [CNS] tumors), next-generation se",,,674.24,1348.48,8
CPT,482U,"Obstetrics (preeclampsia), biochemical assay of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), serum, ratio reported for sFlt-1/PlGF, with risk of progression for pree",,,128.82,257.64,8
CPT,483T,TMVI PERCUTANEOUS APPROACH,,,,,0
CPT,483U,"Infectious disease (Neisseria gonorrhoeae), sensitivity, ciprofloxacin resistance (gyrA S91F point mutation), oral, rectal, or vaginal swab, algorithm reported as probability of fluoroquinolone resist",,,35.09,70.18,8
CPT,48400,INJECTION INTRAOP ADD-ON,,,,,0
CPT,484T,TMVI TRANSTHORACIC EXPOSURE,,,,,0
CPT,484U,"Infectious disease (Mycoplasma genitalium), macrolide sensitivity (23S rRNA point mutation), oral, rectal, or vaginal swab, algorithm reported as probability of macrolide resistance",,,35.09,70.18,8
CPT,48500,SURGERY OF PANCREATIC CYST,,,,,0
CPT,48510,DRAIN PANCREATIC PSEUDOCYST,,,,,0
CPT,48520,FUSE PANCREAS CYST AND BOWEL,,,,,0
CPT,48540,FUSE PANCREAS CYST AND BOWEL,,,,,0
CPT,48545,PANCREATORRHAPHY,,,,,0
CPT,48547,DUODENAL EXCLUSION,,,,,0
CPT,48548,FUSE PANCREAS AND BOWEL,,,,,0
CPT,48550,DONOR PANCREATECTOMY,,,,,0
CPT,48551,PREP DONOR PANCREAS,,,,,0
CPT,48552,PREP DONOR PANCREAS/VENOUS,,,,,0
CPT,48554,TRANSPL ALLOGRAFT PANCREAS,,,,,0
CPT,48556,REMOVAL ALLOGRAFT PANCREAS,,,,,0
CPT,485T,OCT MID EAR I&R UNILATERAL,,,36.3,72.6,8
CPT,485U,"Oncology (solid tumor), cell-free DNA and RNA by next-generation sequencing, interpretative report for germline mutations, clonal hematopoiesis of indeterminate potential, and tumor-derived single-nuc",,,3649.48,7298.96,8
CPT,486T,OCT MID EAR I&R BILATERAL,,,36.3,72.6,8
CPT,486U,"Oncology (pan-solid tumor), next-generation sequencing analysis of tumor methylation markers present in cell-free circulating tumor DNA, algorithm reported as quantitative measurement of methylation a",,,1644.25,3288.5,8
CPT,487U,"Oncology (solid tumor), cell-free circulating DNA, targeted genomic sequence analysis panel of 84 genes, interrogation for sequence variants, aneuploidy-corrected gene copy number amplifications and l",,,2919.6,5839.2,8
CPT,488T,DIABETES PREV ONLINE/ELEC,,,,,0
CPT,488U,"Obstetrics (fetal antigen noninvasive prenatal test), cell-free DNA sequence analysis for detection of fetal presence or absence of 1 or more of the Rh, C, c, D, E, Duffy (Fya), or Kell (K) antigen in",,,759.05,1518.1,8
CPT,48999,UNLISTED PROCEDURE PANCREAS,,,688.14,1376.28,8
CPT,489T,REGN CELL TX SCLDR HANDS,,,,,0
CPT,489U,"Obstetrics (single-gene noninvasive prenatal test), cell-free DNA sequence analysis of 1 or more targets (eg, CFTR, SMN1, HBB, HBA1, HBA2) to identify paternally inherited pathogenic variants, and rel",,,1153.62,2307.24,8
CPT,48U,ONC SLD ORG NEO DNA 468 GENE,,,2919.6,5839.2,8
CPT,49000,EXPLORATION OF ABDOMEN,,,,,0
CPT,49002,REOPENING OF ABDOMEN,,,,,0
CPT,49010,EXPLORATION BEHIND ABDOMEN,,,6291.01,12582.02,8
CPT,49013,PRPERTL PEL PACK HEMRRG TRMA,,,,,0
CPT,49014,REEXPLORATION PELVIC WOUND,,,,,0
CPT,49020,DRAINAGE ABDOM ABSCESS OPEN,,,,,0
CPT,49040,DRAIN OPEN ABDOM ABSCESS,,,,,0
CPT,49060,DRAIN OPEN RETROPERI ABSCESS,,,,,0
CPT,49062,DRAIN TO PERITONEAL CAVITY,,,,,0
CPT,49082,ABD PARACENTESIS,,,881.37,1762.74,8
CPT,49083,ABD PARACENTESIS W/IMAGING,,,256.39,1762.74,24
CPT,49084,PERITONEAL LAVAGE,,,85.24,1762.74,24
CPT,490T,REGN CELL TX SCLDR H MLT INJ,,,,,0
CPT,490U,"Oncology (cutaneous or uveal melanoma), circulating tumor cell selection, morphological characterization and enumeration based on differential CD146, high molecular-weight melanoma-associated antigen,",,,2435.0,4870.0,8
CPT,49180,BIOPSY ABDOMINAL MASS,,,142.58,3209.92,24
CPT,49185,SCLEROTX FLUID COLLECTION,,,1604.96,3209.92,8
CPT,49186,"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 cm or less",,,,,0
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",,,,,0
CPT,49188,"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); 10.1 to 20 cm",,,,,0
CPT,49189,"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); 20.1 to 30 cm",,,,,0
CPT,49190,"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); greater than 3",,,,,0
CPT,491U,"Oncology (solid tumor), circulating tumor cell selection, morphological characterization and enumeration based on differential epithelial cell adhesion molecule (EpCAM), cytokeratins 8, 18, and 19, CD",,,2435.0,4870.0,8
CPT,49215,EXCISE SACRAL SPINE TUMOR,,,,,0
CPT,49250,EXCISION OF UMBILICUS,,,3479.3,6958.6,8
CPT,49255,REMOVAL OF OMENTUM,,,6291.01,12582.02,8
CPT,492U,"Oncology (solid tumor), circulating tumor cell selection, morphological characterization and enumeration based on differential epithelial cell adhesion molecule (EpCAM), cytokeratins 8, 18, and 19, CD",,,2435.0,4870.0,8
CPT,49320,DIAG LAPARO SEPARATE PROC,,,5874.81,11749.62,8
CPT,49321,LAPAROSCOPY BIOPSY,,,5874.81,11749.62,8
CPT,49322,LAPAROSCOPY ASPIRATION,,,5874.81,11749.62,8
CPT,49323,LAPARO DRAIN LYMPHOCELE,,,5874.81,11749.62,8
CPT,49324,LAP INSERT TUNNEL IP CATH,,,5874.81,11749.62,8
CPT,49325,LAP REVISION PERM IP CATH,,,5874.81,11749.62,8
CPT,49326,LAP W/OMENTOPEXY ADD-ON,,,,,0
CPT,49327,LAP INS DEVICE FOR RT,,,,,0
CPT,49329,UNLSTD LAPS PX ABD PERTM&OMN,,,5874.81,11749.62,8
CPT,493U,"Transplantation medicine, quantification of donor-derived cell-free DNA (cfDNA) using next-generation sequencing, plasma, reported as percentage of donor-derived cell-free DNA",,,2753.25,5506.5,8
CPT,49400,AIR INJECTION INTO ABDOMEN,,,,,0
CPT,49402,REMOVE FOREIGN BODY ADBOMEN,,,3479.3,6958.6,8
CPT,49405,IMAGE CATH FLUID COLXN VISC,,,1604.96,3209.92,8
CPT,49406,IMAGE CATH FLUID PERI/RETRO,,,718.79,3209.92,24
CPT,49407,IMAGE CATH FLUID TRNS/VGNL,,,610.23,3209.92,24
CPT,49411,INS MARK ABD/PEL FOR RT PERQ,,,,,0
CPT,49411,TISSUE MARKER PLACEMNT FOR RT,3290.0,1645.0,573.11,3191.3,54
CPT,49412,INS DEVICE FOR RT GUIDE OPEN,,,,,0
CPT,49418,INSERT TUN IP CATH PERC,,,3479.3,6958.6,8
CPT,49419,INSERT TUN IP CATH W/PORT,,,5407.35,10814.7,8
CPT,49421,INS TUN IP CATH FOR DIAL OPN,,,3479.3,6958.6,8
CPT,49422,REMOVE TUNNELED IP CATH,,,3068.32,6136.64,8
CPT,49423,EXCHANGE DRAINAGE CATHETER,,,1864.72,3729.44,8
CPT,49424,ASSESS CYST CONTRAST INJECT,,,,,0
CPT,49425,INSERT ABDOMEN-VENOUS DRAIN,,,,,0
CPT,49426,REVISE ABDOMEN-VENOUS SHUNT,,,3479.3,6958.6,8
CPT,49427,INJECTION ABDOMINAL SHUNT,,,,,0
CPT,49428,LIGATION OF SHUNT,,,,,0
CPT,49429,REMOVAL OF SHUNT,,,3068.32,6136.64,8
CPT,49435,INSERT SUBQ EXTEN TO IP CATH,,,,,0
CPT,49436,EMBEDDED IP CATH EXIT-SITE,,,1864.72,3729.44,8
CPT,49440,PLACE GASTROSTOMY TUBE PERC,,,1864.72,3729.44,8
CPT,49441,PLACE DUOD/JEJ TUBE PERC,,,1864.72,3729.44,8
CPT,49442,PLACE CECOSTOMY TUBE PERC,,,1162.85,2325.7,8
CPT,49446,CHANGE G-TUBE TO G-J PERC,,,1864.72,3729.44,8
CPT,49450,REPLACE G/C TUBE PERC,,,881.37,1762.74,8
CPT,49451,REPLACE DUOD/JEJ TUBE PERC,,,881.37,1762.74,8
CPT,49452,REPLACE G-J TUBE PERC,,,881.37,1762.74,8
CPT,49460,FIX G/COLON TUBE W/DEVICE,,,881.37,1762.74,8
CPT,49465,FLUORO EXAM OF G/COLON TUBE,,,136.13,463.72,24
CPT,49491,RPR HERN PREEMIE REDUC,,,5874.81,11749.62,8
CPT,49492,RPR ING HERN PREMIE BLOCKED,,,3479.3,6958.6,8
CPT,49495,RPR ING HERNIA BABY REDUC,,,3479.3,6958.6,8
CPT,49496,RPR ING HERNIA BABY BLOCKED,,,3479.3,6958.6,8
CPT,494T,PREP & CANNULJ CDVR DON LUNG,,,,,0
CPT,494U,"Red blood cell antigen (fetal RhD gene analysis), next-generation sequencing of circulating cell-free DNA (cfDNA) of blood in pregnant individuals known to be RhD negative, reported as positive or neg",,,759.05,1518.1,8
CPT,49500,RPR ING HERNIA INIT REDUCE,,,6291.01,12582.02,8
CPT,49501,RPR ING HERNIA INIT BLOCKED,,,3479.3,6958.6,8
CPT,49505,PRP I/HERN INIT REDUC >5 YR,,,3479.3,6958.6,8
CPT,49507,PRP I/HERN INIT BLOCK >5 YR,,,3479.3,6958.6,8
CPT,49520,REREPAIR ING HERNIA REDUCE,,,3479.3,6958.6,8
CPT,49521,REREPAIR ING HERNIA BLOCKED,,,6291.01,12582.02,8
CPT,49525,REPAIR ING HERNIA SLIDING,,,3479.3,6958.6,8
CPT,49540,REPAIR LUMBAR HERNIA,,,5874.81,11749.62,8
CPT,49550,RPR REM HERNIA INIT REDUCE,,,3479.3,6958.6,8
CPT,49553,RPR FEM HERNIA INIT BLOCKED,,,3479.3,6958.6,8
CPT,49555,REREPAIR FEM HERNIA REDUCE,,,3479.3,6958.6,8
CPT,49557,REREPAIR FEM HERNIA BLOCKED,,,3479.3,6958.6,8
CPT,49591,RPR AA HRN 1ST < 3 CM RDC,,,3479.3,6958.6,8
CPT,49592,RPR AA HRN 1ST < 3 NCR/STRN,,,5874.81,11749.62,8
CPT,49593,RPR AA HRN 1ST 3-10 RDC,,,6291.01,12582.02,8
CPT,49594,RPR AA HRN 1ST 3-10 NCR/STRN,,,5874.81,11749.62,8
CPT,49595,RPR AA HRN 1ST > 10 RDC,,,6291.01,12582.02,8
CPT,49596,RPR AA HRN 1ST > 10 NCR/STRN,,,,,0
CPT,495T,MNTR CDVR DON LNG 1ST 2 HRS,,,,,0
CPT,495U,"Oncology (prostate), analysis of circulating plasma proteins (tPSA, fPSA, KLK2, PSP94, and GDF15), germline polygenic risk score (60 variants), clinical information (age, family history of prostate ca",,,760.0,1520.0,8
CPT,49600,REPAIR UMBILICAL LESION,,,3479.3,6958.6,8
CPT,49605,REPAIR UMBILICAL LESION,,,,,0
CPT,49606,REPAIR UMBILICAL LESION,,,,,0
CPT,49610,REPAIR UMBILICAL LESION,,,,,0
CPT,49611,REPAIR UMBILICAL LESION,,,,,0
CPT,49613,RPR AA HRN RCR < 3 RDC,,,3479.3,6958.6,8
CPT,49614,RPR AA HRN RCR < 3 NCR/STRN,,,5874.81,11749.62,8
CPT,49615,RPR AA HRN RCR 3-10 RDC,,,6291.01,12582.02,8
CPT,49616,RPR AA HRN RCR 3-10 NCR/STRN,,,,,0
CPT,49617,RPR AA HRN RCR > 10 RDC,,,,,0
CPT,49618,RPR AA HRN RCR > 10 NCR/STRN,,,,,0
CPT,49621,RPR PARASTOMAL HERNIA RDC,,,,,0
CPT,49622,RPR PARASTOMAL HRNA NCR/STRN,,,,,0
CPT,49623,RMVL NINFCT MESH HERNIA RPR,,,,,0
CPT,49650,LAP ING HERNIA REPAIR INIT,,,5874.81,11749.62,8
CPT,49651,LAP ING HERNIA REPAIR RECUR,,,5874.81,11749.62,8
CPT,49659,UNLSTD LAPS PX HRNAP HRNRPHY,,,5874.81,11749.62,8
CPT,496T,MNTR CDVR DON LNG EA ADDL HR,,,,,0
CPT,496U,"Oncology (colorectal), cell-free DNA, 8 genes for mutations, 7 genes for methylation by real-time RT-PCR, and 4 proteins by enzyme-linked immunosorbent assay, blood, reported positive or negative for ",,,485.86,971.72,8
CPT,497U,"Oncology (prostate), mRNA gene-expression profiling by real-time RT-PCR of 6 genes (FOXM1, MCM3, MTUS1, TTC21B, ALAS1, and PPP2CA), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm ",,,3873.0,7746.0,8
CPT,498U,"Oncology (colorectal), next-generation sequencing for mutation detection in 43 genes and methylation pattern in 45 genes, blood, and formalin-fixed paraffin-embedded (FFPE) tissue, report of variants ",,,1345.31,2690.62,8
CPT,49900,REPAIR OF ABDOMINAL WALL,,,,,0
CPT,49904,OMENTAL FLAP EXTRA-ABDOM,,,,,0
CPT,49905,OMENTAL FLAP INTRA-ABDOM,,,,,0
CPT,49906,FREE OMENTAL FLAP MICROVASC,,,,,0
CPT,49999,UNLISTED PX ABD PERTM&OMN,,,881.37,1762.74,8
CPT,499U,"Oncology (colorectal and lung), DNA from formalin-fixed paraffin-embedded (FFPE) tissue, next-generation sequencing of 8 genes (NRAS, EGFR, CTNNB1, PIK3CA, APC, BRAF, KRAS, and TP53), mutation detecti",,,597.91,1195.82,8
CPT,49U,NPM1 GENE ANALYSIS QUAN,,,407.43,814.86,8
CPT,4M,SCOLIOSIS DNA ALYS,,,79.0,158.0,8
CPT,500,ANESTH ESOPHAGEAL SURGERY,,,,,0
CPT,50010,EXPLORATION OF KIDNEY,,,,,0
CPT,50020,RENAL ABSCESS OPEN DRAIN,,,2031.35,4062.7,8
CPT,50040,NFROS NFROT W/DRG,,,,,0
CPT,50045,NEPHROTOMY W/EXPLORATION,,,,,0
CPT,5005F,PT COUNSLD ON EXAM FOR MOLES,,,,,0
CPT,50060,NL REMOVAL CALCULUS,,,,,0
CPT,50065,NL SEC SURG OPERJ CALCULUS,,,,,0
CPT,50070,NL COMP CGEN KDN ABNORMALITY,,,,,0
CPT,50075,NL RMVL LG STAGHORN CALCULUS,,,,,0
CPT,50080,PERQ NL/PL LITHOTRP SMPL<2CM,,,9199.14,18398.28,8
CPT,50081,PERQ NL/PL LITHOTRP CPLX>2CM,,,9199.14,18398.28,8
CPT,500F,INITIAL PRENATAL CARE VISIT,,,,,0
CPT,500U,"Autoinflammatory disease (VEXAS syndrome), DNA, UBA1 gene mutations, targeted variant analysis (M41T, M41V, M41L, c.118-2A>C, c.118-1G>C, c.118-9_118-2del, S56F, S621C)",,,175.4,350.8,8
CPT,50100,TRNSXJ/REPOS ABRRNT RNL VSLS,,,,,0
CPT,5010F,MACUL RESULT PHY/QHP MNG DM,,,,,0
CPT,50120,PYELOTOMY W/EXPLORATION,,,,,0
CPT,50125,PYELOTOMY W/DRG PYELOSTOMY,,,,,0
CPT,50130,PYELOTOMY W/REMOVAL CALCULUS,,,,,0
CPT,5015F,DOC FX & TEST/TXMNT FOR OP,,,,,0
CPT,501F,PRENATAL FLOW SHEET,,,,,0
CPT,501U,"Oncology (colorectal), blood, quantitative measurement of cell-free DNA (cfDNA)",,,192.0,384.0,8
CPT,50200,RENAL BIOPSY PERQ,,,474.5,3209.92,24
CPT,50205,RENAL BX SURG EXPOSURE KDN,,,,,0
CPT,5020F,TXMNTS 2 PHYS/QHP BY 1 MON,,,,,0
CPT,50220,REMOVE KIDNEY OPEN,,,,,0
CPT,50225,REMOVAL KIDNEY OPEN COMPLEX,,,,,0
CPT,50230,REMOVAL KIDNEY OPEN RADICAL,,,,,0
CPT,50234,REMOVAL OF KIDNEY & URETER,,,,,0
CPT,50236,REMOVAL OF KIDNEY & URETER,,,,,0
CPT,50240,PARTIAL REMOVAL OF KIDNEY,,,,,0
CPT,50250,CRYOABLATE RENAL MASS OPEN,,,,,0
CPT,50280,REMOVAL OF KIDNEY LESION,,,,,0
CPT,50290,REMOVAL OF KIDNEY LESION,,,,,0
CPT,502F,SUBSEQUENT PRENATAL CARE,,,,,0
CPT,502U,"Human papillomavirus (HPV), E6/E7 markers for high-risk types (16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68), cervical cells, branched-chain capture hybridization, reported as negative o",,,35.09,70.18,8
CPT,50300,REMOVE CADAVER DONOR KIDNEY,,,,,0
CPT,50320,REMOVE KIDNEY LIVING DONOR,,,,,0
CPT,50323,PREP CADAVER RENAL ALLOGRAFT,,,,,0
CPT,50325,PREP DONOR RENAL GRAFT,,,,,0
CPT,50327,PREP RENAL GRAFT/VENOUS,,,,,0
CPT,50328,PREP RENAL GRAFT/ARTERIAL,,,,,0
CPT,50329,PREP RENAL GRAFT/URETERAL,,,,,0
CPT,50340,REMOVAL OF KIDNEY,,,,,0
CPT,50360,TRANSPLANTATION OF KIDNEY,,,,,0
CPT,50365,TRANSPLANTATION OF KIDNEY,,,,,0
CPT,50370,REMOVE TRANSPLANTED KIDNEY,,,,,0
CPT,50380,REIMPLANTATION OF KIDNEY,,,,,0
CPT,50382,CHANGE URETER STENT PERCUT,,,2031.35,4062.7,8
CPT,50384,REMOVE URETER STENT PERCUT,,,2031.35,4062.7,8
CPT,50385,CHANGE STENT VIA TRANSURETH,,,2031.35,4062.7,8
CPT,50386,REMOVE STENT VIA TRANSURETH,,,2031.35,4062.7,8
CPT,50387,CHANGE NEPHROURETERAL CATH,,,2031.35,4062.7,8
CPT,50389,REMOVE RENAL TUBE W/FLUORO,,,677.61,1355.22,8
CPT,50390,DRAINAGE OF KIDNEY LESION,,,91.61,1376.28,24
CPT,50391,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,885.0,442.5,154.16,858.45,54
CPT,50391,INSTLL RX AGNT INTO RNAL NEPHROSTOMY TUBE,506.0,253.0,88.14,490.82,53
CPT,50391,INSTLL RX AGNT INTO RNAL TUB,,,,,0
CPT,50396,MEASURE KIDNEY PRESSURE,,,677.61,1355.22,8
CPT,503F,POSTPARTUM CARE VISIT,,,,,0
CPT,503U,"Neurology (Alzheimer disease), beta amyloid (Aβ40, Aβ42, Aβ42/40 ratio) and tau-protein (ptau217, np-tau217, ptau217/np-tau217 ratio), blood, immunoprecipitation with quantitation by liquid chromatogr",,,750.0,1500.0,8
CPT,50400,REVISION OF KIDNEY/URETER,,,,,0
CPT,50405,REVISION OF KIDNEY/URETER,,,,,0
CPT,50430,NJX PX NFROSGRM &/URTRGRM,,,677.61,1355.22,8
CPT,50431,NJX PX NFROSGRM &/URTRGRM,,,677.61,1355.22,8
CPT,50432,PLMT NEPHROSTOMY CATHETER,,,2031.35,4062.7,8
CPT,50433,PLMT NEPHROURETERAL CATHETER,,,3425.44,6850.88,8
CPT,50434,CONVERT NEPHROSTOMY CATHETER,,,2031.35,4062.7,8
CPT,50435,EXCHANGE NEPHROSTOMY CATH,,,2031.35,4062.7,8
CPT,50436,DILAT XST TRC NDURLGC PX,,,3425.44,6850.88,8
CPT,50437,DILAT XST TRC NEW ACCESS RCS,,,3425.44,6850.88,8
CPT,504U,"Infectious disease (urinary tract infection), identification of 17 pathologic organisms, urine, real-time PCR, reported as positive or negative for each organism",,,416.78,833.56,8
CPT,50500,REPAIR OF KIDNEY WOUND,,,,,0
CPT,5050F,PLAN 2 MAIN DR BY 1 MONTH,,,,,0
CPT,50520,CLOSE KIDNEY-SKIN FISTULA,,,,,0
CPT,50525,CLOSE NEPHROVISCERAL FISTULA,,,,,0
CPT,50526,CLOSE NEPHROVISCERAL FISTULA,,,,,0
CPT,50540,REVISION OF HORSESHOE KIDNEY,,,,,0
CPT,50541,LAPARO ABLATE RENAL CYST,,,10329.66,20659.32,8
CPT,50542,LAPARO ABLATE RENAL MASS,,,10329.66,20659.32,8
CPT,50543,LAPARO PARTIAL NEPHRECTOMY,,,10329.66,20659.32,8
CPT,50544,LAPAROSCOPY PYELOPLASTY,,,10329.66,20659.32,8
CPT,50545,LAPARO RADICAL NEPHRECTOMY,,,,,0
CPT,50546,LAPAROSCOPIC NEPHRECTOMY,,,,,0
CPT,50547,LAPARO REMOVAL DONOR KIDNEY,,,,,0
CPT,50548,LAPARO REMOVE W/URETER,,,,,0
CPT,50549,UNLISTED LAPS PX RENAL,,,5874.81,11749.62,8
CPT,50551,KIDNEY ENDOSCOPY,,,5210.39,10420.78,8
CPT,50553,KIDNEY ENDOSCOPY,,,5210.39,10420.78,8
CPT,50555,KIDNEY ENDOSCOPY & BIOPSY,,,9199.14,18398.28,8
CPT,50557,KIDNEY ENDOSCOPY & TREATMENT,,,9199.14,18398.28,8
CPT,50561,KIDNEY ENDOSCOPY & TREATMENT,,,5210.39,10420.78,8
CPT,50562,RENAL SCOPE W/TUMOR RESECT,,,9199.14,18398.28,8
CPT,50570,KIDNEY ENDOSCOPY,,,3425.44,6850.88,8
CPT,50572,KIDNEY ENDOSCOPY,,,677.61,1355.22,8
CPT,50574,KIDNEY ENDOSCOPY & BIOPSY,,,3425.44,6850.88,8
CPT,50575,KIDNEY ENDOSCOPY,,,5210.39,10420.78,8
CPT,50576,KIDNEY ENDOSCOPY & TREATMENT,,,9199.14,18398.28,8
CPT,50580,KIDNEY ENDOSCOPY & TREATMENT,,,5210.39,10420.78,8
CPT,50590,FRAGMENTING OF KIDNEY STONE,,,3425.44,6850.88,8
CPT,50592,PERC RF ABLATE RENAL TUMOR,,,5874.81,11749.62,8
CPT,50593,PERC CRYO ABLATE RENAL TUM,,,10329.66,20659.32,8
CPT,505F,HEMODIALYSIS PLAN DOCD,,,,,0
CPT,505T,EV FEMPOP ARTL REVSC,,,11218.2,22436.4,8
CPT,505U,"Infectious disease (vaginal infection), identification of 32 pathogenic organisms, swab, real-time PCR, reported as positive or negative for each organism",,,679.77,1359.54,8
CPT,50600,EXPLORATION OF URETER,,,,,0
CPT,50605,INSERT URETERAL SUPPORT,,,,,0
CPT,50606,ENDOLUMINAL BX URTR RNL PLVS,,,,,0
CPT,5060F,FNDNGS MAMMO 2PT W/IN 3 DAYS,,,,,0
CPT,50610,REMOVAL OF URETER STONE,,,,,0
CPT,50620,REMOVAL OF URETER STONE,,,,,0
CPT,5062F,MAMMO RESULT COM TO PT 5 DAY,,,,,0
CPT,50630,REMOVAL OF URETER STONE,,,,,0
CPT,50650,REMOVAL OF URETER,,,,,0
CPT,50660,REMOVAL OF URETER,,,,,0
CPT,50684,INJECTION FOR URETER X-RAY,,,,,0
CPT,50686,MEASURE URETER PRESSURE,,,125.04,250.08,8
CPT,50688,CHANGE OF URETER TUBE/STENT,,,2031.35,4062.7,8
CPT,50690,INJECTION FOR URETER X-RAY,,,88.6,102.89,16
CPT,50693,PLMT URETERAL STENT PRQ,,,3425.44,6850.88,8
CPT,50694,PLMT URETERAL STENT PRQ,,,3425.44,6850.88,8
CPT,50695,PLMT URETERAL STENT PRQ,,,3425.44,6850.88,8
CPT,506T,MAC PGMT OPT DNS MEAS HFP,,,57.33,114.66,8
CPT,506U,"Gastroenterology (Barrett's esophagus), esophageal cells, DNA methylation analysis by next-generation sequencing of at least 89 differentially methylated genomic regions, algorithm reported as likelih",,,1938.01,3876.02,8
CPT,50700,REVISION OF URETER,,,,,0
CPT,50705,URETERAL EMBOLIZATION/OCCL,,,,,0
CPT,50706,BALLOON DILATE URTRL STRIX,,,,,0
CPT,50715,RELEASE OF URETER,,,,,0
CPT,50722,RELEASE OF URETER,,,,,0
CPT,50725,RELEASE/REVISE URETER,,,,,0
CPT,50727,REVISE URETER,,,3425.44,6850.88,8
CPT,50728,REVISE URETER,,,,,0
CPT,50740,FUSION OF URETER & KIDNEY,,,,,0
CPT,50750,FUSION OF URETER & KIDNEY,,,,,0
CPT,50760,FUSION OF URETERS,,,,,0
CPT,50770,SPLICING OF URETERS,,,,,0
CPT,50780,REIMPLANT URETER IN BLADDER,,,,,0
CPT,50782,REIMPLANT URETER IN BLADDER,,,,,0
CPT,50783,REIMPLANT URETER IN BLADDER,,,,,0
CPT,50785,REIMPLANT URETER IN BLADDER,,,,,0
CPT,507F,PERITON DIALYSIS PLAN DOCD,,,,,0
CPT,507T,NEAR IFR 2IMG MIBMN GLND I&R,,,57.33,114.66,8
CPT,507U,"Oncology (ovarian), DNA, whole-genome sequencing with 5-hydroxymethylcytosine (5hmC) enrichment, using whole blood or plasma, algorithm reported as cancer detected or not detected",,,1160.0,2320.0,8
CPT,50800,IMPLANT URETER IN BOWEL,,,,,0
CPT,50810,FUSION OF URETER & BOWEL,,,,,0
CPT,50815,URINE SHUNT TO INTESTINE,,,,,0
CPT,50820,CONSTRUCT BOWEL BLADDER,,,,,0
CPT,50825,CONSTRUCT BOWEL BLADDER,,,,,0
CPT,50830,REVISE URINE FLOW,,,,,0
CPT,50840,REPLACE URETER BY BOWEL,,,,,0
CPT,50845,APPENDICO-VESICOSTOMY,,,,,0
CPT,50860,TRANSPLANT URETER TO SKIN,,,,,0
CPT,508U,"Transplantation medicine, quantification of donor-derived cell-free DNA using 40 single-nucleotide polymorphisms (SNPs), plasma, and urine, initial evaluation reported as percentage of donor-derived c",,,,,0
CPT,50900,REPAIR OF URETER,,,,,0
CPT,50920,CLOSURE URETER/SKIN FISTULA,,,,,0
CPT,50930,CLOSURE URETER/BOWEL FISTULA,,,,,0
CPT,50940,RELEASE OF URETER,,,,,0
CPT,50945,LAPAROSCOPY URETEROLITHOTOMY,,,5874.81,11749.62,8
CPT,50947,LAPARO NEW URETER/BLADDER,,,10329.66,20659.32,8
CPT,50948,LAPARO NEW URETER/BLADDER,,,10329.66,20659.32,8
CPT,50949,UNLISTED LAPS PX URETER,,,5874.81,11749.62,8
CPT,50951,ENDOSCOPY OF URETER,,,3425.44,6850.88,8
CPT,50953,ENDOSCOPY OF URETER,,,3425.44,6850.88,8
CPT,50955,URETER ENDOSCOPY & BIOPSY,,,5210.39,10420.78,8
CPT,50957,URETER ENDOSCOPY & TREATMENT,,,5210.39,10420.78,8
CPT,50961,URETER ENDOSCOPY & TREATMENT,,,5210.39,10420.78,8
CPT,50970,URETER ENDOSCOPY,,,3425.44,6850.88,8
CPT,50972,URETER ENDOSCOPY & CATHETER,,,3425.44,6850.88,8
CPT,50974,URETER ENDOSCOPY & BIOPSY,,,5210.39,10420.78,8
CPT,50976,URETER ENDOSCOPY & TREATMENT,,,5210.39,10420.78,8
CPT,50980,URETER ENDOSCOPY & TREATMENT,,,5210.39,10420.78,8
CPT,509F,URINE INCON PLAN DOCD,,,,,0
CPT,509T,PATTERN ERG W/I&R,,,209.83,419.66,8
CPT,509U,"Transplantation medicine, quantification of donor-derived cell-free DNA using up to 12 single-nucleotide polymorphisms (SNPs) previously identified, plasma, reported as percentage of donor-derived cel",,,,,0
CPT,50U,TRGT GEN SEQ DNA 194 GENES,,,2916.6,5833.2,8
CPT,5100F,RSK FX REF W/N 24 HRS XRAY,,,,,0
CPT,51020,INCISE & TREAT BLADDER,,,3425.44,6850.88,8
CPT,51040,INCISE & DRAIN BLADDER,,,2031.35,4062.7,8
CPT,51045,INCISE BLADDER/DRAIN URETER,,,2031.35,4062.7,8
CPT,51050,REMOVAL OF BLADDER STONE,,,5210.39,10420.78,8
CPT,51060,REMOVAL OF URETER STONE,,,2031.35,4062.7,8
CPT,51065,REMOVE URETER CALCULUS,,,3425.44,6850.88,8
CPT,51080,DRAINAGE OF BLADDER ABSCESS,,,2822.69,5645.38,8
CPT,510T,RMVL SINUS TARSI IMPLANT,,,3179.6,6359.2,8
CPT,510U,"Oncology (pancreatic cancer), augmentative algorithmic analysis of 16 genes from previously sequenced RNA whole-transcriptome data, reported as probability of predicted molecular subtype",,,473.91,947.82,8
CPT,51100,DRAIN BLADDER BY NEEDLE,,,242.79,485.58,8
CPT,51101,DRAIN BLADDER BY TROCAR/CATH,,,834.49,1668.98,8
CPT,51102,DRAIN BL W/CATH INSERTION,,,2031.35,4062.7,8
CPT,511T,RMVL&RINSJ SINUS TARSI IMPLT,,,7051.31,14102.62,8
CPT,511U,"Oncology (solid tumor), tumor cell culture in 3D microenvironment, 36 or more drug panel, reported as tumor-response prediction for each drug",,,3033.86,6067.72,8
CPT,512T,ESW INTEG WND HLG 1ST WND,,,194.97,389.94,8
CPT,512U,"Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (MSI) status, formalin-fixed paraffin-embedded (FFPE) tiss",,,706.25,1412.5,8
CPT,513F,ELEV BP PLAN OF CARE DOCD,,,,,0
CPT,513T,ESW INTEG WND HLG EA ADDL,,,,,0
CPT,513U,"Oncology (prostate), augmentative algorithmic analysis of digitized whole-slide imaging of histologic features for microsatellite instability (MSI) and homologous recombination deficiency (HRD) status",,,706.25,1412.5,8
CPT,514F,CARE PLAN HGB DOCD ESA PT,,,,,0
CPT,514U,"Gastroenterology (irritable bowel disease [IBD]), immunoassay for quantitative determination of adalimumab (ADL) levels in venous serum in patients undergoing adalimumab therapy, results reported as a",,,38.57,77.14,8
CPT,51500,REMOVAL OF BLADDER CYST,,,5874.81,11749.62,8
CPT,51520,REMOVAL OF BLADDER LESION,,,3425.44,6850.88,8
CPT,51525,REMOVAL OF BLADDER LESION,,,,,0
CPT,51530,REMOVAL OF BLADDER LESION,,,,,0
CPT,51535,REPAIR OF URETER LESION,,,3425.44,6850.88,8
CPT,51550,PARTIAL REMOVAL OF BLADDER,,,,,0
CPT,51555,PARTIAL REMOVAL OF BLADDER,,,,,0
CPT,51565,REVISE BLADDER & URETER(S),,,,,0
CPT,51570,REMOVAL OF BLADDER,,,,,0
CPT,51575,REMOVAL OF BLADDER & NODES,,,,,0
CPT,51580,REMOVE BLADDER/REVISE TRACT,,,,,0
CPT,51585,REMOVAL OF BLADDER & NODES,,,,,0
CPT,51590,REMOVE BLADDER/REVISE TRACT,,,,,0
CPT,51595,REMOVE BLADDER/REVISE TRACT,,,,,0
CPT,51596,REMOVE BLADDER/CREATE POUCH,,,,,0
CPT,51597,REMOVAL OF PELVIC STRUCTURES,,,,,0
CPT,515T,INSJ WCS LV COMPL SYS,,,21615.45,43230.9,8
CPT,515U,"Gastroenterology (irritable bowel disease [IBD]), immunoassay for quantitative determination of infliximab (IFX) levels in venous serum in patients undergoing infliximab therapy, results reported as a",,,38.57,77.14,8
CPT,51600,INJECTION FOR BLADDER X-RAY,,,164.93,191.53,16
CPT,51605,PREPARATION FOR BLADDER XRAY,,,35.14,40.8,16
CPT,51610,INJECTION FOR BLADDER X-RAY,,,97.56,113.29,16
CPT,516F,ANEMIA PLAN OF CARE DOCD,,,,,0
CPT,516T,INSJ WCS LV ELTRD ONLY,,,10156.85,20313.7,8
CPT,516U,"Drug metabolism, whole blood, pharmacogenomic genotyping of 40 genes and CYP2D6 copy number variant analysis, reported as metabolizer status",,,416.78,833.56,8
CPT,51700,IRRIGATION OF BLADDER,752.0,376.0,130.99,729.44,54
CPT,51701,INSERT BLADDER CATHETER,,,,,0
CPT,51701,STRAIGHT CATH INSERTION,655.0,327.5,114.1,635.35,54
CPT,51702,FOLEY INSERTION SIMPLE,268.0,134.0,24.73,266.75,161
CPT,51702,INSERT TEMP BLADDER CATH,,,,,0
CPT,51703,FOLEY INSERTION COMPLICATED,457.5,228.75,78.73,449.11,107
CPT,51703,INSERT BLADDER CATH COMPLEX,,,,,0
CPT,51705,CHANGE OF BLADDER TUBE,,,242.79,485.58,8
CPT,51710,CHANGE OF BLADDER TUBE,,,677.61,1355.22,8
CPT,51715,ENDOSCOPIC INJECTION/IMPLANT,,,3425.44,6850.88,8
CPT,51720,BLADDER INSTILL ANTICARCINO,774.0,387.0,134.83,1355.22,54
CPT,51720,TREATMENT OF BLADDER LESION,,,,,0
CPT,51721,"Insertion of transurethral ablation transducer for delivery of thermal ultrasound for prostate tissue ablation, including suprapubic tube placement during the same session and placement of an endorect",,,,,0
CPT,51725,SIMPLE CYSTOMETROGRAM,,,242.79,485.58,8
CPT,51726,COMPLEX CYSTOMETROGRAM,,,242.79,485.58,8
CPT,51727,CYSTOMETROGRAM W/UP,,,677.61,1355.22,8
CPT,51728,CYSTOMETROGRAM W/VP,,,677.61,1355.22,8
CPT,51729,CYSTOMETROGRAM W/VP&UP,,,677.61,1355.22,8
CPT,51736,URINE FLOW MEASUREMENT,,,129.29,258.58,8
CPT,51741,ELECTRO-UROFLOWMETRY FIRST,,,209.83,419.66,8
CPT,51784,ANAL/URINARY MUSCLE STUDY,,,125.04,250.08,8
CPT,51785,ANAL/URINARY MUSCLE STUDY,,,,,0
CPT,51785,NEEDLE EMG ANAL/URETHRAL SPHINCTER ANY TEC,679.0,339.5,118.28,658.63,53
CPT,51792,URINARY REFLEX STUDY,,,57.33,114.66,8
CPT,51797,INTRAABDOMINAL PRESSURE TEST,,,,,0
CPT,51798,US URINE CAPACITY MEASURE,,,16.91,114.66,24
CPT,517F,GLAUCOMA PLAN OF CARE DOCD,,,,,0
CPT,517T,INSJ WCS LV BOTH COMPNT PG,,,10156.85,20313.7,8
CPT,517U,"Therapeutic drug monitoring, 80 or more psychoactive drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally and maximally effective dose of prescribed and non-prescr",,,246.92,493.84,8
CPT,51800,REVISION OF BLADDER/URETHRA,,,,,0
CPT,51820,REVISION OF URINARY TRACT,,,,,0
CPT,51840,ATTACH BLADDER/URETHRA,,,4861.19,9722.38,8
CPT,51841,ATTACH BLADDER/URETHRA,,,,,0
CPT,51845,REPAIR BLADDER NECK,,,4861.19,9722.38,8
CPT,51860,REPAIR OF BLADDER WOUND,,,9199.14,18398.28,8
CPT,51865,REPAIR OF BLADDER WOUND,,,,,0
CPT,51880,REPAIR OF BLADDER OPENING,,,3425.44,6850.88,8
CPT,518F,FALL PLAN OF CARE DOCD,,,,,0
CPT,518T,RMVL PG WCS LV BATTERY ONLY,,,3631.43,7262.86,8
CPT,518U,"Therapeutic drug monitoring, 90 or more pain and mental health drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally effective range of prescribed and non-prescribe",,,246.92,493.84,8
CPT,51900,REPAIR BLADDER/VAGINA LESION,,,,,0
CPT,51920,CLOSE BLADDER-UTERUS FISTULA,,,,,0
CPT,51925,HYSTERECTOMY/BLADDER REPAIR,,,,,0
CPT,51940,CORRECTION OF BLADDER DEFECT,,,,,0
CPT,51960,REVISION OF BLADDER & BOWEL,,,,,0
CPT,51980,CONSTRUCT BLADDER OPENING,,,,,0
CPT,51990,LAPARO URETHRAL SUSPENSION,,,5874.81,11749.62,8
CPT,51992,LAPARO SLING OPERATION,,,5874.81,11749.62,8
CPT,51999,UNLISTED LAPS PX BLADDER,,,5874.81,11749.62,8
CPT,519F,PLAND CHEMO DOCD B/4 TXMNT,,,,,0
CPT,519T,RMV&RPLCMT PG WCS LV BOTH,,,10156.85,20313.7,8
CPT,519U,"Therapeutic drug monitoring, medications specific to pain, depression, and anxiety, LC-MS/MS, plasma, 110 or more drugs or substances, qualitative and quantitative therapeutic minimally effective rang",,,246.92,493.84,8
CPT,51U,RX MNTR LC-MS/MS UR/BLD 31,,,246.92,493.84,8
CPT,520,ANESTH CHEST PROCEDURE,,,,,0
CPT,52000,CYSTOSCOPY,1407.0,703.5,245.09,1364.79,54
CPT,52001,CYSTOSCOPY REMOVAL OF CLOTS,,,3425.44,6850.88,8
CPT,52005,CYSTOSCOPY & URETER CATHETER,,,2031.35,4062.7,8
CPT,52007,CYSTOSCOPY AND BIOPSY,,,3425.44,6850.88,8
CPT,5200F,EVAL APPROS SURG THXPY EPI,,,,,0
CPT,52010,CYSTOSCOPY & DUCT CATHETER,,,677.61,1355.22,8
CPT,520F,RAD DOS LIMTS B/4 3D RAD,,,,,0
CPT,520T,RMV&RPLCMT PG WCS LV BATTERY,,,10156.85,20313.7,8
CPT,520U,"Therapeutic drug monitoring, 200 or more drugs or substances, LC-MS/MS, plasma, qualitative and quantitative therapeutic minimally effective range of prescribed and non-prescribed medications",,,246.92,493.84,8
CPT,521F,PLAN OF CARE 4 PAIN DOCD,,,,,0
CPT,521T,INTERROG DEV EVAL WCS IP,,,28.11,56.22,8
CPT,521U,"Rheumatoid factor IgA and IgM, cyclic citrullinated peptide (CCP) antibodies, and scavenger receptor A (SR-A) by immunoassay, blood",,,51.8,103.6,8
CPT,522,ANESTH CHEST LINING BIOPSY,,,,,0
CPT,52204,CYSTOSCOPY W/BIOPSY(S),,,2031.35,4062.7,8
CPT,52214,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52224,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52234,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52235,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52240,CYSTOSCOPY AND TREATMENT,,,5210.39,10420.78,8
CPT,52250,CYSTOSCOPY AND RADIOTRACER,,,3425.44,6850.88,8
CPT,52260,CYSTOSCOPY AND TREATMENT,,,2031.35,4062.7,8
CPT,52265,CYSTOSCOPY AND TREATMENT,,,2031.35,4062.7,8
CPT,52270,CYSTOSCOPY & REVISE URETHRA,,,2031.35,4062.7,8
CPT,52275,CYSTOSCOPY & REVISE URETHRA,,,2031.35,4062.7,8
CPT,52276,CYSTOSCOPY AND TREATMENT,,,2031.35,4062.7,8
CPT,52277,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52281,CYSTOSCOPY AND TREATMENT,,,2031.35,4062.7,8
CPT,52282,CYSTOSCOPY IMPLANT STENT,,,3425.44,6850.88,8
CPT,52283,CYSTOSCOPY AND TREATMENT,,,2031.35,4062.7,8
CPT,52284,CYSTO RX BALO CATH URTL STRX,,,5210.39,10420.78,8
CPT,52285,CYSTOSCOPY AND TREATMENT,,,677.61,1355.22,8
CPT,52287,CYSTOSCOPY CHEMODENERVATION,,,2031.35,4062.7,8
CPT,52290,CYSTOSCOPY AND TREATMENT,,,2031.35,4062.7,8
CPT,522T,PRGRMG DEV EVAL WCS IP,,,36.27,72.54,8
CPT,522U,"Carbonic anhydrase VI, parotid specific/secretory protein and salivary protein 1 (SP1), IgG, IgM, and IgA antibodies, chemiluminescence, semiqualitative, blood",,,260.5,521.0,8
CPT,52300,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52301,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52305,CYSTOSCOPY AND TREATMENT,,,5210.39,10420.78,8
CPT,52310,"CYSTO W/ REM FB, CALCULUS, STENT-SIMPLE",4480.0,2240.0,780.41,4345.6,54
CPT,52310,CYSTOSCOPY AND TREATMENT,,,,,0
CPT,52315,"CYSTO W/ REM FB, CALCULUS, STENT-COMPLICATED",5326.0,2663.0,927.78,5166.22,54
CPT,52315,CYSTOSCOPY AND TREATMENT,,,,,0
CPT,52317,REMOVE BLADDER STONE,,,3425.44,6850.88,8
CPT,52318,REMOVE BLADDER STONE,,,3425.44,6850.88,8
CPT,52320,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52325,CYSTOSCOPY STONE REMOVAL,,,5210.39,10420.78,8
CPT,52327,CYSTOSCOPY INJECT MATERIAL,,,5210.39,10420.78,8
CPT,52330,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52332,CYSTOSCOPY AND TREATMENT,,,3425.44,6850.88,8
CPT,52334,CREATE PASSAGE TO KIDNEY,,,3425.44,6850.88,8
CPT,52341,CYSTO W/URETER STRICTURE TX,,,3425.44,6850.88,8
CPT,52342,CYSTO W/UP STRICTURE TX,,,3425.44,6850.88,8
CPT,52343,CYSTO W/RENAL STRICTURE TX,,,3425.44,6850.88,8
CPT,52344,CYSTO/URETERO STRICTURE TX,,,3425.44,6850.88,8
CPT,52345,CYSTO/URETERO W/UP STRICTURE,,,3425.44,6850.88,8
CPT,52346,CYSTOURETERO W/RENAL STRICT,,,5210.39,10420.78,8
CPT,52351,CYSTOURETERO & OR PYELOSCOPE,,,3425.44,6850.88,8
CPT,52352,CYSTOURETERO W/STONE REMOVE,,,3425.44,6850.88,8
CPT,52353,CYSTOURETERO W/LITHOTRIPSY,,,5210.39,10420.78,8
CPT,52354,CYSTOURETERO W/BIOPSY,,,5210.39,10420.78,8
CPT,52355,CYSTOURETERO W/EXCISE TUMOR,,,5210.39,10420.78,8
CPT,52356,CYSTO/URETERO W/LITHOTRIPSY,,,5210.39,10420.78,8
CPT,523T,NTRAPX C FFR W/3D FUNCJL MAP,,,,,0
CPT,523U,"Oncology (solid tumor), DNA, qualitative, next-generation sequencing (NGS) of single-nucleotide variants (SNV) and insertion/deletions in 22 genes utilizing formalin-fixed paraffin-embedded tissue, re",,,1352.09,2704.18,8
CPT,524,ANESTH CHEST DRAINAGE,,,,,0
CPT,52400,CYSTOURETERO W/CONGEN REPR,,,3425.44,6850.88,8
CPT,52402,CYSTOURETHRO CUT EJACUL DUCT,,,3425.44,6850.88,8
CPT,52441,CYSTOURETHRO W/IMPLANT,,,,,0
CPT,52442,CYSTOURETHRO W/ADDL IMPLANT,,,,,0
CPT,52450,INCISION OF PROSTATE,,,3425.44,6850.88,8
CPT,524T,EV CATH DIR CHEM ABLTJ W/IMG,,,3068.32,6136.64,8
CPT,524U,"Obstetrics (preeclampsia), sFlt-1/PlGF ratio, immunoassay, utilizing serum or plasma, reported as a value",,,128.82,257.64,8
CPT,52500,REVISION OF BLADDER NECK,,,3425.44,6850.88,8
CPT,5250F,ASTHMA DISCHARGE PLAN PRESNT,,,,,0
CPT,525F,INITIAL VISIT FOR EPISODE,,,,,0
CPT,525T,INSJ/RPLCMT COMPL IIMS,,,18717.77,37435.54,8
CPT,525U,"Oncology, spheroid cell culture, 11-drug panel (carboplatin, docetaxel, doxorubicin, etoposide, gemcitabine, niraparib, olaparib, paclitaxel, rucaparib, topotecan, veliparib) ovarian, fallopian, or pe",,,3033.86,6067.72,8
CPT,52601,PROSTATECTOMY (TURP),,,5210.39,10420.78,8
CPT,52630,REMOVE PROSTATE REGROWTH,,,5210.39,10420.78,8
CPT,52640,RELIEVE BLADDER CONTRACTURE,,,3425.44,6850.88,8
CPT,52647,LASER SURGERY OF PROSTATE,,,,,0
CPT,52648,LASER SURGERY OF PROSTATE,,,5210.39,10420.78,8
CPT,52649,PROSTATE LASER ENUCLEATION,,,5210.39,10420.78,8
CPT,526F,SUBS VISIT FOR EPISODE,,,,,0
CPT,526T,INSJ/RPLCMT IIMS ELTRD ONLY,,,8041.71,16083.42,8
CPT,526U,"Nephrology (renal transplant), quantification of CXCL10 chemokines, flow cytometry, urine, reported as pg/mL creatinine baseline and monitoring over time",,,,,0
CPT,52700,DRAINAGE OF PROSTATE ABSCESS,,,3425.44,6850.88,8
CPT,527T,INSJ/RPLCMT IIMS IMPLT MNTR,,,8041.71,16083.42,8
CPT,527U,"Herpes simplex virus (HSV) types 1 and 2 and Varicella zoster virus (VZV), amplified probe technique, each pathogen reported as detected or not detected",,,142.63,285.26,8
CPT,528,ANES MEDIASCPY & DX THORSCPY,,,,,0
CPT,528F,RCMND FLW-UP 10 YRS DOCD,,,,,0
CPT,528T,PRGRMG DEV EVAL IIMS IP,,,36.27,72.54,8
CPT,528U,"Lower respiratory tract infectious agent detection, 18 bacteria, 8 viruses, and 7 antimicrobial-resistance genes, amplified probe technique, including reverse transcription for RNA targets, each analy",,,634.84,1269.68,8
CPT,529,ANES MEDSCPY&THORSCPY 1 LUNG,,,,,0
CPT,529F,INTRVL 3/>YR PTS CLNSCP DOCD,,,,,0
CPT,529T,INTERROG DEV EVAL IIMS IP,,,36.27,72.54,8
CPT,529U,"Hematology (venous thromboembolism [VTE]), genome-wide single-nucleotide polymorphism variants, including F2 and F5 gene analysis, and Leiden variant, by microarray analysis, saliva, report as risk sc",,,,,0
CPT,52U,LPOPRTN BLD W/5 MAJ CLASSES,,,33.86,67.72,8
CPT,530,ANESTH PACEMAKER INSERTION,,,,,0
CPT,53000,INCISION OF URETHRA,,,2031.35,4062.7,8
CPT,53010,INCISION OF URETHRA,,,5210.39,10420.78,8
CPT,53020,INCISION OF URETHRA,,,2031.35,4062.7,8
CPT,53025,INCISION OF URETHRA,,,2031.35,4062.7,8
CPT,53040,DRAINAGE OF URETHRA ABSCESS,,,3425.44,6850.88,8
CPT,53060,DRAINAGE OF URETHRA ABSCESS,,,2031.35,4062.7,8
CPT,53080,DRAINAGE OF URINARY LEAKAGE,,,677.61,1355.22,8
CPT,53085,DRAINAGE OF URINARY LEAKAGE,,,2031.35,4062.7,8
CPT,530T,REMOVAL COMPLETE IIMS,,,3631.43,7262.86,8
CPT,530U,"Oncology (pan-solid tumor), ctDNA, utilizing plasma, next-generation sequencing (NGS) of 77 genes, 8 fusions, microsatellite instability, and tumor mutation burden, interpretative report for single-nu",,,2919.6,5839.2,8
CPT,531T,REMOVAL IIMS ELECTRODE ONLY,,,3631.43,7262.86,8
CPT,531U,"Infectious disease (acid-fast bacteria and invasive fungi), DNA (673 organisms), next-generation sequencing, plasma",,,,,0
CPT,532,ANESTH VASCULAR ACCESS,,,,,0
CPT,53200,BIOPSY OF URETHRA,,,,,0
CPT,53200,BIOPSY URETHRA,4133.0,2066.5,719.96,4062.7,54
CPT,53210,REMOVAL OF URETHRA,,,3425.44,6850.88,8
CPT,53215,REMOVAL OF URETHRA,,,5210.39,10420.78,8
CPT,53220,TREATMENT OF URETHRA LESION,,,3425.44,6850.88,8
CPT,53230,REMOVAL OF URETHRA LESION,,,5210.39,10420.78,8
CPT,53235,REMOVAL OF URETHRA LESION,,,5210.39,10420.78,8
CPT,53240,SURGERY FOR URETHRA POUCH,,,3425.44,6850.88,8
CPT,53250,REMOVAL OF URETHRA GLAND,,,3425.44,6850.88,8
CPT,53260,TREATMENT OF URETHRA LESION,,,3425.44,6850.88,8
CPT,53265,TREATMENT OF URETHRA LESION,,,2031.35,4062.7,8
CPT,53270,REMOVAL OF URETHRA GLAND,,,3425.44,6850.88,8
CPT,53275,REPAIR OF URETHRA DEFECT,,,3425.44,6850.88,8
CPT,532T,REMOVAL IIMS IMPLT MNTR ONLY,,,3631.43,7262.86,8
CPT,532U,"Rare diseases (constitutional disease/hereditary disorders), rapid whole genome and mitochondrial DNA sequencing for single-nucleotide variants, insertions/deletions, copy number variations, periphera",,,5031.2,10062.4,8
CPT,533U,"Drug metabolism (adverse drug reactions and drug response), genotyping of 16 genes (ie, ABCG2, CYP2B6, CYP2C9, CYP2C19, CYP2C, CYP2D6, CYP3A5, CYP4F2, DPYD, G6PD, GGCX, NUDT15, SLCO1B1, TPMT, UGT1A1, ",,,416.78,833.56,8
CPT,534,ANESTH CARDIOVERTER/DEFIB,,,,,0
CPT,53400,REVISE URETHRA STAGE 1,,,5210.39,10420.78,8
CPT,53405,REVISE URETHRA STAGE 2,,,5210.39,10420.78,8
CPT,53410,RECONSTRUCTION OF URETHRA,,,5210.39,10420.78,8
CPT,53415,RECONSTRUCTION OF URETHRA,,,,,0
CPT,53420,RECONSTRUCT URETHRA STAGE 1,,,5210.39,10420.78,8
CPT,53425,RECONSTRUCT URETHRA STAGE 2,,,5210.39,10420.78,8
CPT,53430,RECONSTRUCTION OF URETHRA,,,5210.39,10420.78,8
CPT,53431,RECONSTRUCT URETHRA/BLADDER,,,5210.39,10420.78,8
CPT,53440,MALE SLING PROCEDURE,,,12820.89,25641.78,8
CPT,53442,REMOVE/REVISE MALE SLING,,,5210.39,10420.78,8
CPT,53444,INSERT TANDEM CUFF,,,20140.85,40281.7,8
CPT,53445,INSERT URO/VES NCK SPHINCTER,,,20140.85,40281.7,8
CPT,53446,REMOVE URO SPHINCTER,,,5210.39,10420.78,8
CPT,53447,REMOVE/REPLACE UR SPHINCTER,,,20140.85,40281.7,8
CPT,53448,REMOV/REPLC UR SPHINCTR COMP,,,,,0
CPT,53449,REPAIR URO SPHINCTER,,,9199.14,18398.28,8
CPT,53450,REVISION OF URETHRA,,,3425.44,6850.88,8
CPT,53451,TPRNL BALO CNTNC DEV BI,,,12820.89,25641.78,8
CPT,53452,TPRNL BALO CNTNC DEV UNI,,,9199.14,18398.28,8
CPT,53453,TPRNL BALO CNTNC DEV RMVL EA,,,3425.44,6850.88,8
CPT,53454,TPRNL BALO CNTNC DEV ADJMT,,,242.79,485.58,8
CPT,53460,REVISION OF URETHRA,,,3425.44,6850.88,8
CPT,534U,"Oncology (prostate), microRNA, single-nucleotide polymorphisms (SNPs) analysis by RT-PCR of 32 variants, using buccal swab, algorithm reported as a risk score",,,,,0
CPT,53500,URETHRLYS TRANSVAG W/ SCOPE,,,3425.44,6850.88,8
CPT,53502,REPAIR OF URETHRA INJURY,,,3425.44,6850.88,8
CPT,53505,REPAIR OF URETHRA INJURY,,,5210.39,10420.78,8
CPT,53510,REPAIR OF URETHRA INJURY,,,5210.39,10420.78,8
CPT,53515,REPAIR OF URETHRA INJURY,,,5210.39,10420.78,8
CPT,53520,REPAIR OF URETHRA DEFECT,,,5210.39,10420.78,8
CPT,535F,DYSPNEA MNGMNT PLAN DOCD,,,,,0
CPT,535U,"Perfluoroalkyl substances (PFAS) (eg, perfluorooctanoic acid, perfluorooctane sulfonic acid), by liquid chromatography with tandem mass spectrometry (LC-MS/MS), plasma or serum, quantitative",,,62.14,124.28,8
CPT,53600,DILATE URETHRA STRICTURE,,,242.79,485.58,8
CPT,53601,DILATE URETHRA STRICTURE,,,129.29,258.58,8
CPT,53605,DILATE URETHRA STRICTURE,,,3425.44,6850.88,8
CPT,53620,DILATE URETHRA STRICTURE,,,677.61,1355.22,8
CPT,53621,DILATE URETHRA STRICTURE,,,242.79,485.58,8
CPT,53660,DILATION OF URETHRA,,,125.04,250.08,8
CPT,53661,DILATION OF URETHRA,,,129.29,258.58,8
CPT,53665,DILATION OF URETHRA,,,2031.35,4062.7,8
CPT,536U,"Red blood cell antigen (fetal RhD), PCR analysis of exon 4 of RHD gene and housekeeping control gene GAPDH from whole blood in pregnant individuals at 10+ weeks gestation known to be RhD negative, rep",,,192.0,384.0,8
CPT,537,ANESTH CARDIAC ELECTROPHYS,,,,,0
CPT,537U,"Oncology (colorectal cancer), analysis of cell-free DNA for epigenomic patterns, next-generation sequencing, >2500 differentially methylated regions (DMRs), plasma, algorithm reported as positive or n",,,1495.0,2990.0,8
CPT,53850,PROSTATIC MICROWAVE THERMOTX,,,3425.44,6850.88,8
CPT,53852,PROSTATIC RF THERMOTX,,,3425.44,6850.88,8
CPT,53854,TRURL DSTRJ PRST8 TISS RF WV,,,3425.44,6850.88,8
CPT,53855,INSERT PROST URETHRAL STENT,,,2031.35,4062.7,8
CPT,53860,TRANSURETHRAL RF TREATMENT,,,2031.35,4062.7,8
CPT,53865,"Cystourethroscopy with insertion of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate",,,9199.14,18398.28,8
CPT,53866,"Catheterization with removal of temporary device for ischemic remodeling (ie, pressure necrosis) of bladder neck and prostate",,,242.79,485.58,8
CPT,53899,UNLISTED PX URINARY SYSTEM,,,242.79,485.58,8
CPT,538U,"Oncology (solid tumor), next-generation targeted sequencing analysis, formalin-fixed paraffin-embedded (FFPE) tumor tissue, DNA analysis of 600 genes, interrogation for single-nucleotide variants, ins",,,2989.55,5979.1,8
CPT,539,ANESTH TRACH-BRONCH RECONST,,,,,0
CPT,539U,"Oncology (solid tumor), cell-free circulating tumor DNA (ctDNA), 152 genes, next-generation sequencing, interrogation for single-nucleotide variants, insertions/deletions, gene rearrangements, copy nu",,,3288.51,6577.02,8
CPT,540,ANESTH CHEST SURGERY,,,,,0
CPT,54000,SLITTING OF PREPUCE,,,3425.44,6850.88,8
CPT,54001,SLITTING OF PREPUCE,,,2031.35,4062.7,8
CPT,54015,DRAIN PENIS LESION,,,1604.96,3209.92,8
CPT,54050,DESTRUCTION PENIS LESION(S),,,395.04,790.08,8
CPT,54055,DESTRUCTION PENIS LESION(S),,,2005.02,4010.04,8
CPT,54056,CRYOSURGERY PENIS LESION(S),,,194.97,389.94,8
CPT,54057,LASER SURG PENIS LESION(S),,,2005.02,4010.04,8
CPT,54060,EXCISION OF PENIS LESION(S),,,2005.02,4010.04,8
CPT,54065,DESTRUCTION PENIS LESION(S),,,2005.02,4010.04,8
CPT,540F,GLUCO MNGMNT PLAN DOCD,,,,,0
CPT,540U,"Transplantation medicine, quantification of donor-derived cell-free DNA using next-generation sequencing analysis of plasma, reported as percentage of donor-derived cell-free DNA to determine probabil",,,2753.25,5506.5,8
CPT,541,ANESTH ONE LUNG VENTILATION,,,,,0
CPT,54100,BIOPSY OF PENIS,,,1604.96,3209.92,8
CPT,54105,BIOPSY OF PENIS,,,2822.69,5645.38,8
CPT,54110,TREATMENT OF PENIS LESION,,,3425.44,6850.88,8
CPT,54111,TREAT PENIS LESION GRAFT,,,5210.39,10420.78,8
CPT,54112,TREAT PENIS LESION GRAFT,,,9199.14,18398.28,8
CPT,54115,TREATMENT OF PENIS LESION,,,2822.69,5645.38,8
CPT,54120,PARTIAL REMOVAL OF PENIS,,,3425.44,6850.88,8
CPT,54125,REMOVAL OF PENIS,,,,,0
CPT,54130,REMOVE PENIS & NODES,,,,,0
CPT,54135,REMOVE PENIS & NODES,,,,,0
CPT,54150,CIRCUMCISION W/REGIONL BLOCK,,,2031.35,4062.7,8
CPT,54160,CIRCUMCISION NEONATE,,,677.61,1355.22,8
CPT,54161,CIRCUM 28 DAYS OR OLDER,,,2031.35,4062.7,8
CPT,54162,LYSIS PENIL CIRCUMIC LESION,,,2031.35,4062.7,8
CPT,54163,REPAIR OF CIRCUMCISION,,,2031.35,4062.7,8
CPT,54164,FRENULOTOMY OF PENIS,,,2031.35,4062.7,8
CPT,541T,MYOCARDIAL IMAGING MCG,,,362.62,725.24,8
CPT,541U,"Cardiovascular disease (HDL reverse cholesterol transport), cholesterol efflux capacity, LC-MS/MS, quantitative measurement of 5 distinct HDL-bound apolipoproteins (apolipoproteins A1, C1, C2, C3, and",,,,,0
CPT,542,ANESTHESIA REMOVAL PLEURA,,,,,0
CPT,54200,TREATMENT OF PENIS LESION,,,242.79,485.58,8
CPT,54205,TREATMENT OF PENIS LESION,,,5210.39,10420.78,8
CPT,54220,TREATMENT OF PENIS LESION,,,242.79,485.58,8
CPT,54230,PREPARE PENIS STUDY,,,,,0
CPT,54231,DYNAMIC CAVERNOSOMETRY,,,242.79,485.58,8
CPT,54235,PENILE INJECTION,,,242.79,485.58,8
CPT,54240,PENIS STUDY,,,209.83,419.66,8
CPT,54250,PENIS STUDY,,,242.79,485.58,8
CPT,542T,MYOCARDIAL IMAGING MCG I&R,,,,,0
CPT,542U,"Nephrology (renal transplant), urine, nuclear magnetic resonance (NMR) spectroscopy measurement of 84 urinary metabolites, combined with patient data, quantification of BK virus (human polyomavirus 1)",,,,,0
CPT,54300,REVISION OF PENIS,,,3425.44,6850.88,8
CPT,54304,REVISION OF PENIS,,,3425.44,6850.88,8
CPT,54308,RECONSTRUCTION OF URETHRA,,,5210.39,10420.78,8
CPT,54312,RECONSTRUCTION OF URETHRA,,,3425.44,6850.88,8
CPT,54316,RECONSTRUCTION OF URETHRA,,,9199.14,18398.28,8
CPT,54318,RECONSTRUCTION OF URETHRA,,,3425.44,6850.88,8
CPT,54322,RECONSTRUCTION OF URETHRA,,,3425.44,6850.88,8
CPT,54324,RECONSTRUCTION OF URETHRA,,,3425.44,6850.88,8
CPT,54326,RECONSTRUCTION OF URETHRA,,,3425.44,6850.88,8
CPT,54328,REVISE PENIS/URETHRA,,,3425.44,6850.88,8
CPT,54332,REVISE PENIS/URETHRA,,,3425.44,6850.88,8
CPT,54336,REVISE PENIS/URETHRA,,,3425.44,6850.88,8
CPT,54340,RPR HYPSPAD COMP SIMPLE,,,3425.44,6850.88,8
CPT,54344,RRP HYPSPAD COMP MOBLJ&URTP,,,9199.14,18398.28,8
CPT,54348,RPR HYPSPAD COMP DSJ & URTP,,,5210.39,10420.78,8
CPT,54352,REVJ PRIOR HYPSPAD REPAIR,,,5210.39,10420.78,8
CPT,54360,PENIS PLASTIC SURGERY,,,3425.44,6850.88,8
CPT,54380,REPAIR PENIS,,,2031.35,4062.7,8
CPT,54385,REPAIR PENIS,,,2031.35,4062.7,8
CPT,54390,REPAIR PENIS AND BLADDER,,,,,0
CPT,543T,TA MV RPR W/ARTIF CHORD TEND,,,,,0
CPT,543U,"Oncology (solid tumor), next-generation sequencing of DNA from formalin-fixed paraffin-embedded (FFPE) tissue of 517 genes, interrogation for single- nucleotide variants, multi-nucleotide variants, in",,,2989.55,5979.1,8
CPT,54400,INSERT SEMI-RIGID PROSTHESIS,,,12820.89,25641.78,8
CPT,54401,INSERT SELF-CONTD PROSTHESIS,,,20140.85,40281.7,8
CPT,54405,INSERT MULTI-COMP PENIS PROS,,,20140.85,40281.7,8
CPT,54406,REMOVE MUTI-COMP PENIS PROS,,,3425.44,6850.88,8
CPT,54408,REPAIR MULTI-COMP PENIS PROS,,,5210.39,10420.78,8
CPT,54410,REMOVE/REPLACE PENIS PROSTH,,,20140.85,40281.7,8
CPT,54411,REMOV/REPLC PENIS PROS COMP,,,20140.85,40281.7,8
CPT,54415,REMOVE SELF-CONTD PENIS PROS,,,3425.44,6850.88,8
CPT,54416,REMV/REPL PENIS CONTAIN PROS,,,20140.85,40281.7,8
CPT,54417,REMV/REPLC PENIS PROS COMPL,,,20140.85,40281.7,8
CPT,54420,REVISION OF PENIS,,,3425.44,6850.88,8
CPT,54430,REVISION OF PENIS,,,,,0
CPT,54435,REVISION OF PENIS,,,3425.44,6850.88,8
CPT,54437,REPAIR CORPOREAL TEAR,,,3425.44,6850.88,8
CPT,54440,REPAIR OF PENIS,,,3425.44,6850.88,8
CPT,54450,PREPUTIAL STRETCHING,,,242.79,485.58,8
CPT,544T,TCAT MV ANNULUS RCNSTJ,,,,,0
CPT,54500,BIOPSY OF TESTIS,,,2822.69,5645.38,8
CPT,54505,BIOPSY OF TESTIS,,,3425.44,6850.88,8
CPT,54512,EXCISE LESION TESTIS,,,3425.44,6850.88,8
CPT,54520,REMOVAL OF TESTIS,,,3425.44,6850.88,8
CPT,54522,ORCHIECTOMY PARTIAL,,,3425.44,6850.88,8
CPT,54530,REMOVAL OF TESTIS,,,3479.3,6958.6,8
CPT,54535,EXTENSIVE TESTIS SURGERY,,,3425.44,6850.88,8
CPT,54550,EXPLORATION FOR TESTIS,,,3479.3,6958.6,8
CPT,54560,EXPLORATION FOR TESTIS,,,2031.35,4062.7,8
CPT,545F,FOLLOW UP CARE PLAN MDD DOCD,,,,,0
CPT,545T,TCAT TV ANNULUS RCNSTJ,,,,,0
CPT,545U,"Acetylcholine receptor (AChR), antibody identification by immunofluorescence, using live cells, reported as positive or negative",,,37.73,75.46,8
CPT,546,ANESTH LUNG CHEST WALL SURG,,,,,0
CPT,54600,REDUCE TESTIS TORSION,,,3425.44,6850.88,8
CPT,54620,SUSPENSION OF TESTIS,,,3425.44,6850.88,8
CPT,54640,ORCHIOPEXY INGUN/SCROT APPR,,,3479.3,6958.6,8
CPT,54650,ORCHIOPEXY (FOWLER-STEPHENS),,,3479.3,6958.6,8
CPT,54660,REVISION OF TESTIS,,,5210.39,10420.78,8
CPT,54670,REPAIR TESTIS INJURY,,,3425.44,6850.88,8
CPT,54680,RELOCATION OF TESTIS(ES),,,3425.44,6850.88,8
CPT,54690,LAPAROSCOPY ORCHIECTOMY,,,5874.81,11749.62,8
CPT,54692,LAPAROSCOPY ORCHIOPEXY,,,5874.81,11749.62,8
CPT,54699,UNLISTED LAPS PX TESTIS,,,5874.81,11749.62,8
CPT,546T,RF SPECTRSC NTRAOP MRGN ASMT,,,,,0
CPT,546U,"Low-density lipoprotein receptor-related protein 4 (LRP4), antibody identification by immunofluorescence, using live cells, reported as positive or negative",,,37.73,75.46,8
CPT,54700,DRAINAGE OF SCROTUM,,,2031.35,4062.7,8
CPT,547T,B1 MATRL QUAL TST MCRIND TIB,,,,,0
CPT,547U,"Neurofilament light chain (NfL), chemiluminescent enzyme immunoassay, plasma, quantitative",,,116.23,232.46,8
CPT,548,ANESTH TRACHEA BRONCHI SURG,,,,,0
CPT,54800,BIOPSY OF EPIDIDYMIS,,,1604.96,3209.92,8
CPT,54830,REMOVE EPIDIDYMIS LESION,,,3425.44,6850.88,8
CPT,54840,REMOVE EPIDIDYMIS LESION,,,2031.35,4062.7,8
CPT,54860,REMOVAL OF EPIDIDYMIS,,,3425.44,6850.88,8
CPT,54861,REMOVAL OF EPIDIDYMIS,,,3425.44,6850.88,8
CPT,54865,EXPLORE EPIDIDYMIS,,,3425.44,6850.88,8
CPT,548U,"Glial fibrillary acidic protein (GFAP), chemiluminescent enzyme immunoassay, using plasma",,,116.23,232.46,8
CPT,54900,FUSION OF SPERMATIC DUCTS,,,2031.35,4062.7,8
CPT,54901,FUSION OF SPERMATIC DUCTS,,,3425.44,6850.88,8
CPT,549U,"Oncology (urothelial), DNA, quantitative methylated real-time PCR of TRNA-Cys, SIM2, and NKX1-1, using urine, diagnostic algorithm reported as a probability index for bladder cancer and/or upper tract",,,760.0,1520.0,8
CPT,54T,BONE SRGRY CMPTR FLUOR IMAGE,,,,,0
CPT,54U,RX MNTR 14+ DRUGS & SBSTS,,,198.74,397.48,8
CPT,550,ANESTH STERNAL DEBRIDEMENT,,,,,0
CPT,55000,DRAINAGE OF HYDROCELE,,,688.14,1376.28,8
CPT,55040,REMOVAL OF HYDROCELE,,,3479.3,6958.6,8
CPT,55041,REMOVAL OF HYDROCELES,,,3479.3,6958.6,8
CPT,55060,REPAIR OF HYDROCELE,,,3425.44,6850.88,8
CPT,550F,CYTOPATH REPORT NONGYN SPCMN,,,,,0
CPT,55100,DRAINAGE OF SCROTUM ABSCESS,,,1604.96,3209.92,8
CPT,55110,EXPLORE SCROTUM,,,3425.44,6850.88,8
CPT,55120,REMOVAL OF SCROTUM LESION,,,2031.35,4062.7,8
CPT,55150,REMOVAL OF SCROTUM,,,3425.44,6850.88,8
CPT,55175,REVISION OF SCROTUM,,,3425.44,6850.88,8
CPT,55180,REVISION OF SCROTUM,,,5210.39,10420.78,8
CPT,551F,CYTOPATH REPORT NON ROUTINE,,,,,0
CPT,55200,INCISION OF SPERM DUCT,,,3425.44,6850.88,8
CPT,55250,REMOVAL OF SPERM DUCT(S),,,2031.35,4062.7,8
CPT,552T,LOW-LEVEL LASER THERAPY,,,,,0
CPT,552U,"Reproductive medicine (preimplantation genetic assessment), analysis for known genetic disorders from trophectoderm biopsy, linkage analysis of disease-causing locus, and when possible, targeted mutat",,,,,0
CPT,55300,PREPARE SPERM DUCT X-RAY,,,,,0
CPT,553U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from embryonic trophectoderm for structural rearrangements, aneuploidy, and a",,,759.05,1518.1,8
CPT,55400,REPAIR OF SPERM DUCT,,,3425.44,6850.88,8
CPT,554T,B1 STR & FX RSK ANALYSIS,,,,,0
CPT,554U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from trophectoderm biopsy for aneuploidy, ploidy, a mitochondrial DNA score, ",,,759.05,1518.1,8
CPT,55500,REMOVAL OF HYDROCELE,,,3425.44,6850.88,8
CPT,55520,REMOVAL OF SPERM CORD LESION,,,3425.44,6850.88,8
CPT,55530,REVISE SPERMATIC CORD VEINS,,,3425.44,6850.88,8
CPT,55535,REVISE SPERMATIC CORD VEINS,,,6291.01,12582.02,8
CPT,55540,REVISE HERNIA & SPERM VEINS,,,3479.3,6958.6,8
CPT,55550,LAPARO LIGATE SPERMATIC VEIN,,,5874.81,11749.62,8
CPT,55559,UNLSTD LAPS PX SPRMATIC CORD,,,5874.81,11749.62,8
CPT,555F,SYMPTOM MGMNT PLAN CARE DOCD,,,,,0
CPT,555T,B1 STR&FX RSK TRANSMIS DATA,,,28.11,56.22,8
CPT,555U,"Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using DNA genomic sequence analysis from embryonic trophectoderm for structural rearrangements, aneuploidy, ploid",,,759.05,1518.1,8
CPT,55600,INCISE SPERM DUCT POUCH,,,2031.35,4062.7,8
CPT,55605,INCISE SPERM DUCT POUCH,,,,,0
CPT,55650,REMOVE SPERM DUCT POUCH,,,,,0
CPT,55680,REMOVE SPERM POUCH LESION,,,3425.44,6850.88,8
CPT,556F,PLAN CARE LIPID CONTROL DOCD,,,,,0
CPT,556T,B1 STR & FX RSK ASSESSMENT,,,231.86,463.72,8
CPT,556U,"Infectious disease (bacterial or viral respiratory tract infection), pathogen-specific DNA and RNA by real-time PCR, 12 targets, nasopharyngeal or oropharyngeal swab, including multiplex reverse trans",,,142.63,285.26,8
CPT,55700,BIOPSY OF PROSTATE,4480.0,2240.0,206.26,4345.6,47
CPT,55705,BIOPSY OF PROSTATE,,,3425.44,6850.88,8
CPT,55706,PROSTATE SATURATION SAMPLING,,,3425.44,6850.88,8
CPT,55720,DRAINAGE OF PROSTATE ABSCESS,,,3425.44,6850.88,8
CPT,55725,DRAINAGE OF PROSTATE ABSCESS,,,3425.44,6850.88,8
CPT,557F,PLAN CAREMNG ANGNL SYMPTDOCD,,,,,0
CPT,557T,B1 STR & FX RSK I&R,,,,,0
CPT,557U,"Infectious disease (bacterial vaginosis and vaginitis), real-time amplification of DNA markers for Atopobium vaginae, Gardnerella vaginalis, Megasphaera types 1 and 2, bacterial vaginosis associated b",,,262.99,525.98,8
CPT,55801,REMOVAL OF PROSTATE,,,,,0
CPT,55810,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55812,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55815,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55821,REMOVAL OF PROSTATE,,,,,0
CPT,55831,REMOVAL OF PROSTATE,,,,,0
CPT,55840,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55842,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55845,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55860,SURGICAL EXPOSURE PROSTATE,,,5210.39,10420.78,8
CPT,55862,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55865,EXTENSIVE PROSTATE SURGERY,,,,,0
CPT,55866,LAPS SURG PRST8ECT RPBIC RAD,,,10329.66,20659.32,8
CPT,55867,LAPS SURG PRST8ECT SMPL STOT,,,10329.66,20659.32,8
CPT,55870,ELECTROEJACULATION,,,895.04,1790.08,8
CPT,55873,CRYOABLATE PROSTATE,,,9199.14,18398.28,8
CPT,55874,TPRNL PLMT BIODEGRDABL MATRL,,,,,0
CPT,55874,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,26423.0,13211.5,4602.88,25630.31,53
CPT,55875,TRANSPERI NEEDLE PLACE PROS,,,5210.39,10420.78,8
CPT,55876,PLACE RT DEVICE/MARKER PROS,,,1345.04,2690.08,8
CPT,55880,ABLTJ MAL PRST8 TISS HIFU,,,9199.14,18398.28,8
CPT,55881,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation",,,,,0
CPT,55882,"Ablation of prostate tissue, transurethral, using thermal ultrasound, including magnetic resonance imaging guidance for, and monitoring of, tissue ablation; with insertion of transurethral ultrasound ",,,12820.89,25641.78,8
CPT,55899,UNLISTED PX MALE GENITAL SYS,,,242.79,485.58,8
CPT,558T,CT SCAN F/BIOMCHN CT ALYS,,,84.57,169.14,8
CPT,558U,"Oncology (colorectal), quantitative enzyme-linked immunosorbent assay (ELISA) for secreted colorectal cancer protein marker (BF7 antigen), using serum, result reported as indicative of response/no res",,,20.81,41.62,8
CPT,55920,PLACE NEEDLES PELVIC FOR RT,,,4861.19,9722.38,8
CPT,55970,SEX TRANSFORMATION M TO F,,,4861.19,9722.38,8
CPT,55980,SEX TRANSFORMATION F TO M,,,3425.44,6850.88,8
CPT,559T,ANTMC MDL 3D PRINT 1ST CMPNT,,,129.29,258.58,8
CPT,559U,"Oncology (breast), quantitative enzyme-linked immunosorbent assay (ELISA) for secreted breast cancer protein marker (BF9 antigen), serum, result reported as indicative of response/no response to thera",,,20.81,41.62,8
CPT,55T,BONE SRGRY CMPTR CT/MRI IMAG,,,,,0
CPT,55U,CARD HRT TRNSPL 96 DNA SEQ,,,3240.0,6480.0,8
CPT,560,ANESTH HEART SURG W/O PUMP,,,,,0
CPT,560T,ANTMC MDL 3D PRINT EA ADDL,,,,,0
CPT,560U,"Oncology (minimal residual disease [MRD]), genomic sequence analysis, cell-free DNA, whole blood and tumor tissue, baseline assessment for design and construction of a personalized variant panel to ev",,,3878.45,7756.9,8
CPT,561,ANESTH HEART SURG <1 YR,,,,,0
CPT,561T,ANTMC GUIDE 3D PRINT 1ST GD,,,129.29,258.58,8
CPT,561U,"Oncology (minimal residual disease [MRD]), genomic sequence analysis, cell-free DNA, whole blood, subsequent assessment with comparison to initial assessment to evaluate for MRD",,,794.49,1588.98,8
CPT,562,ANESTH HRT SURG W/PMP AGE 1+,,,,,0
CPT,562T,ANTMC GUIDE 3D PRINT EA ADDL,,,,,0
CPT,562U,"Oncology (solid tumor), targeted genomic sequence analysis, 33 genes, detection of single-nucleotide variants (SNVs), insertions and deletions, copy-number amplifications, and translocations in human ",,,597.91,1195.82,8
CPT,563,ANESTH HEART SURG W/ARREST,,,,,0
CPT,563T,EVAC MEIBOMIAN GLND HEAT BI,,,57.33,114.66,8
CPT,563U,"Infectious disease (bacterial and/or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 11 viral targets and 4 bacterial targets, qualitative RT-PCR, upper respiratory sp",,,416.78,833.56,8
CPT,56405,I & D OF VULVA/PERINEUM,,,,,0
CPT,56405,I&D VULVA/PERINEAL ABSCESS,1196.0,598.0,208.34,1160.12,54
CPT,56420,DRAINAGE OF GLAND ABSCESS,424.0,212.0,73.86,411.28,54
CPT,56440,SURGERY FOR VULVA LESION,,,3145.71,6291.42,8
CPT,56441,LYSIS OF LABIAL LESION(S),,,3145.71,6291.42,8
CPT,56442,HYMENOTOMY,,,3145.71,6291.42,8
CPT,564U,"Infectious disease (bacterial and/or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 10 viral targets and 4 bacterial targets, qualitative RT-PCR, upper respiratory sp",,,416.78,833.56,8
CPT,56501,DESTROY VULVA LES SIMPLE,2222.0,1111.0,387.07,4010.04,54
CPT,56501,DESTROY VULVA LESIONS SIM,,,,,0
CPT,56515,DESTROY VULVA LESION/S COMPL,4104.0,2052.0,714.91,4010.04,54
CPT,565T,AUTOL CELL IMPLT ADPS HRVG,,,,,0
CPT,565U,"Oncology (hepatocellular carcinoma), next-generation sequencing methylation pattern assay to detect 6626 epigenetic alterations, cell-free DNA, plasma, algorithm reported as cancer signal detected or ",,,1160.0,2320.0,8
CPT,566,ANESTH CABG W/O PUMP,,,,,0
CPT,56605,BIOPSY OF VULVA/PERINEUM,,,,,0
CPT,56605,BIOPSY VULVA/PERINEUM 1 LES SPX,1704.0,852.0,296.83,1790.08,54
CPT,56606,BIOPSY OF VULVA/PERINEUM,,,,,0
CPT,56606,VULVAR BIOPSY ADDL LESION,346.0,173.0,60.27,335.62,47
CPT,56620,PARTIAL REMOVAL OF VULVA,,,,,0
CPT,56620,VULVECTOMY SIMPLE PARTIAL,6143.0,3071.5,1070.11,6291.42,54
CPT,56625,COMPLETE REMOVAL OF VULVA,,,3145.71,6291.42,8
CPT,56630,EXTENSIVE VULVA SURGERY,,,4861.19,9722.38,8
CPT,56631,EXTENSIVE VULVA SURGERY,,,,,0
CPT,56632,EXTENSIVE VULVA SURGERY,,,,,0
CPT,56633,EXTENSIVE VULVA SURGERY,,,,,0
CPT,56634,EXTENSIVE VULVA SURGERY,,,,,0
CPT,56637,EXTENSIVE VULVA SURGERY,,,,,0
CPT,56640,EXTENSIVE VULVA SURGERY,,,,,0
CPT,566T,AUTOL CELL IMPLT ADPS NJX,,,,,0
CPT,566U,"Oncology (lung), qPCR-based analysis of 13 differentially methylated regions (CCDC181, HOXA7, LRRC8A, MARCHF11, MIR129-2, NCOR2, PANTR1, PRKCB, SLC9A3, TBR1_2, TRAP1, VWC2, ZNF781), pleural fluid, alg",,,416.78,833.56,8
CPT,567,ANESTH CABG W/PUMP,,,,,0
CPT,56700,PARTIAL REMOVAL OF HYMEN,,,3145.71,6291.42,8
CPT,56740,REMOVE VAGINA GLAND LESION,,,3145.71,6291.42,8
CPT,567U,"Rare diseases (constitutional/heritable disorders), whole-genome sequence analysis combination of short and long reads, for single-nucleotide variants, insertions/deletions and characterized intronic ",,,5031.2,10062.4,8
CPT,56800,REPAIR OF VAGINA,,,3145.71,6291.42,8
CPT,56805,REPAIR CLITORIS,,,3145.71,6291.42,8
CPT,56810,REPAIR OF PERINEUM,,,3145.71,6291.42,8
CPT,56820,COLPO VULVA,458.0,229.0,79.78,444.26,54
CPT,56820,EXAM OF VULVA W/SCOPE,,,,,0
CPT,56821,COLPO W/VULV BIOP,790.0,395.0,137.61,766.3,54
CPT,56821,EXAM/BIOPSY OF VULVA W/SCOPE,,,,,0
CPT,568U,"Neurology (dementia), beta amyloid (Aβ40, Aβ42, Aβ42/40 ratio), tau-protein phosphorylated at residue (eg, pTau217), neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP), by ult",,,897.0,1794.0,8
CPT,569T,TTVR PERQ APPR 1ST PROSTH,,,,,0
CPT,569U,"Oncology (solid tumor), next-generation sequencing analysis of tumor methylation markers (>20000 differentially methylated regions) present in cell-free circulating tumor DNA (ctDNA), whole blood, alg",,,,,0
CPT,57000,EXPLORATION OF VAGINA,,,3145.71,6291.42,8
CPT,57010,DRAINAGE OF PELVIC ABSCESS,,,3145.71,6291.42,8
CPT,57020,DRAINAGE OF PELVIC FLUID,,,4861.19,9722.38,8
CPT,57022,I & D VAGINAL HEMATOMA PP,,,2822.69,5645.38,8
CPT,57023,I & D VAG HEMATOMA NON-OB,,,2822.69,5645.38,8
CPT,57061,DESTROY VAG LESIONS SIMPLE,,,3145.71,6291.42,8
CPT,57065,DESTROY VAG LESIONS COMPLEX,,,3145.71,6291.42,8
CPT,570T,TTVR PERQ EA ADDL PROSTH,,,,,0
CPT,570U,"Neurology (traumatic brain injury), analysis of glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl-terminal hydrolase L1 (UCH-L1), immunoassay, whole blood or plasma, individual components ",,,260.5,521.0,8
CPT,57100,BIOPSY OF VAGINA,,,,,0
CPT,57100,BIOPSY VAGINAL MUCOSA SIMPLE,1704.0,852.0,296.83,1790.08,54
CPT,57105,BIOPSY OF VAGINA,6320.0,3160.0,1100.94,6291.42,54
CPT,57106,REMOVE VAGINA WALL PARTIAL,,,3145.71,6291.42,8
CPT,57107,REMOVE VAGINA TISSUE PART,,,3145.71,6291.42,8
CPT,57109,VAGINECTOMY PARTIAL W/NODES,,,3145.71,6291.42,8
CPT,57110,REMOVE VAGINA WALL COMPLETE,,,,,0
CPT,57111,REMOVE VAGINA TISSUE COMPL,,,,,0
CPT,57120,CLOSURE OF VAGINA,,,4861.19,9722.38,8
CPT,57130,REMOVE VAGINA LESION,,,3145.71,6291.42,8
CPT,57135,EXCISION VAGINAL CYST/TUMOR,8267.0,4133.5,1440.11,8018.99,54
CPT,57135,REMOVE VAGINA LESION,,,,,0
CPT,57150,TREAT VAGINA INFECTION,,,57.33,114.66,8
CPT,57155,INSERT UTERI TANDEM/OVOIDS,,,4861.19,9722.38,8
CPT,57156,INS VAG BRACHYTX DEVICE,,,296.12,592.24,8
CPT,57160,INSERT PESSARY/OTHER DEVICE,,,196.46,392.92,8
CPT,57170,FITTING OF DIAPHRAGM/CAP,,,196.46,392.92,8
CPT,57180,TREAT VAGINAL BLEEDING,,,196.46,392.92,8
CPT,571T,INSJ/RPLCMT ICDS SS ELTRD,,,30502.49,61004.98,8
CPT,571U,"Oncology (solid tumor), DNA (80 genes) and RNA (10 genes), by next-generation sequencing, plasma, including single-nucleotide variants, insertions/deletions, copy-number alterations, microsatellite in",,,2919.6,5839.2,8
CPT,57200,REPAIR OF VAGINA,,,3145.71,6291.42,8
CPT,57210,REPAIR VAGINA/PERINEUM,,,3145.71,6291.42,8
CPT,57220,REVISION OF URETHRA,,,4861.19,9722.38,8
CPT,57230,REPAIR OF URETHRAL LESION,,,3145.71,6291.42,8
CPT,57240,ANTERIOR COLPORRHAPHY,,,4861.19,9722.38,8
CPT,57250,REPAIR RECTUM & VAGINA,,,4861.19,9722.38,8
CPT,57260,CMBN ANT PST COLPRHY,,,4861.19,9722.38,8
CPT,57265,CMBN AP COLPRHY W/NTRCL RPR,,,4861.19,9722.38,8
CPT,57267,INSERT MESH/PELVIC FLR ADDON,,,,,0
CPT,57268,REPAIR OF BOWEL BULGE,,,4861.19,9722.38,8
CPT,57270,REPAIR OF BOWEL POUCH,,,,,0
CPT,57280,SUSPENSION OF VAGINA,,,,,0
CPT,57282,COLPOPEXY EXTRAPERITONEAL,,,7206.04,14412.08,8
CPT,57283,COLPOPEXY INTRAPERITONEAL,,,7206.04,14412.08,8
CPT,57284,REPAIR PARAVAG DEFECT OPEN,,,4861.19,9722.38,8
CPT,57285,REPAIR PARAVAG DEFECT VAG,,,7206.04,14412.08,8
CPT,57287,REVISE/REMOVE SLING REPAIR,,,3145.71,6291.42,8
CPT,57288,REPAIR BLADDER DEFECT,,,4861.19,9722.38,8
CPT,57289,REPAIR BLADDER & VAGINA,,,7206.04,14412.08,8
CPT,57291,CONSTRUCTION OF VAGINA,,,4861.19,9722.38,8
CPT,57292,CONSTRUCT VAGINA WITH GRAFT,,,4861.19,9722.38,8
CPT,57295,REVISE VAG GRAFT VIA VAGINA,,,3145.71,6291.42,8
CPT,57296,REVISE VAG GRAFT OPEN ABD,,,,,0
CPT,572T,INSERTION SS DFB ELECTRODE,,,8041.71,16083.42,8
CPT,572U,"Oncology (prostate), high-throughput telomere length quantification by FISH, whole blood, diagnostic algorithm reported as risk of prostate cancer",,,,,0
CPT,57300,REPAIR RECTUM-VAGINA FISTULA,,,3145.71,6291.42,8
CPT,57305,REPAIR RECTUM-VAGINA FISTULA,,,,,0
CPT,57307,FISTULA REPAIR & COLOSTOMY,,,,,0
CPT,57308,FISTULA REPAIR TRANSPERINE,,,,,0
CPT,57310,REPAIR URETHROVAGINAL LESION,,,7206.04,14412.08,8
CPT,57311,REPAIR URETHROVAGINAL LESION,,,,,0
CPT,57320,REPAIR BLADDER-VAGINA LESION,,,4861.19,9722.38,8
CPT,57330,REPAIR BLADDER-VAGINA LESION,,,7206.04,14412.08,8
CPT,57335,REPAIR VAGINA,,,4861.19,9722.38,8
CPT,573T,REMOVAL SS DFB ELECTRODE,,,3631.43,7262.86,8
CPT,573U,"Oncology (pancreas), 3 biomarkers (glucose, carcinoembryonic antigen, and gastricsin), pancreatic cyst lesion fluid, algorithm reported as categorical mucinous or non-mucinous",,,,,0
CPT,57400,DILATION OF VAGINA,,,3145.71,6291.42,8
CPT,57410,PELVIC EXAMINATION,,,,,0
CPT,57410,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,6320.0,3160.0,1100.94,6291.42,54
CPT,57415,REMOVE VAGINAL FOREIGN BODY,,,3145.71,6291.42,8
CPT,57420,COLPO VAGINA,790.0,395.0,137.61,766.3,54
CPT,57420,EXAM OF VAGINA W/SCOPE,,,,,0
CPT,57421,COLPO W/VAG/C BIOPSY,1704.0,852.0,296.83,1790.08,54
CPT,57421,EXAM/BIOPSY OF VAG W/SCOPE,,,,,0
CPT,57423,REPAIR PARAVAG DEFECT LAP,,,10329.66,20659.32,8
CPT,57425,LAPAROSCOPY SURG COLPOPEXY,,,10329.66,20659.32,8
CPT,57426,REVISE PROSTH VAG GRAFT LAP,,,7206.04,14412.08,8
CPT,57452,COLPO CERVIX/VAGINA,458.0,229.0,79.78,444.26,54
CPT,57452,EXAM OF CERVIX W/SCOPE,,,,,0
CPT,57454,BX/CURETT OF CERVIX W/SCOPE,,,,,0
CPT,57454,COLPO CERVIX W/CURET,790.0,395.0,137.61,766.3,54
CPT,57455,BIOPSY OF CERVIX W/SCOPE,828.0,414.0,144.23,803.16,54
CPT,57456,COLPO W/ ECC,768.0,384.0,133.78,744.96,54
CPT,57456,ENDOCERV CURETTAGE W/SCOPE,,,,,0
CPT,57460,BX OF CERVIX W/SCOPE LEEP,4380.0,2190.0,762.99,6291.42,54
CPT,57461,CONZ OF CERVIX W/SCOPE LEEP,4960.0,2480.0,864.03,6291.42,54
CPT,57465,CAM CERVIX UTERI DRG COLP,,,,,0
CPT,574T,REPOS PREV SS IMPL DFB ELTRD,,,3631.43,7262.86,8
CPT,574U,"Mycobacterium tuberculosis, culture filtrate protein-10-kDa (CFP-10), serum or plasma, liquid chromatography mass spectrometry (LC-MS)",,,,,0
CPT,57500,BIOPSY OF CERVIX,,,,,0
CPT,57500,CERVICAL BIOPSY,1704.0,852.0,296.83,1790.08,54
CPT,57505,ENDOCERVICAL CURETTAGE,1388.0,694.0,241.78,1790.08,54
CPT,57510,CAUTERIZATION OF CERVIX,,,3145.71,6291.42,8
CPT,57511,CRYOCAUTERY OF CERVIX,,,296.12,592.24,8
CPT,57513,LASER SURGERY OF CERVIX,,,3145.71,6291.42,8
CPT,57520,CONIZATION OF CERVIX,,,3145.71,6291.42,8
CPT,57522,CONIZATION OF CERVIX,6320.0,3160.0,1100.94,6291.42,54
CPT,57530,REMOVAL OF CERVIX,,,4861.19,9722.38,8
CPT,57531,REMOVAL OF CERVIX RADICAL,,,,,0
CPT,57540,REMOVAL OF RESIDUAL CERVIX,,,,,0
CPT,57545,REMOVE CERVIX/REPAIR PELVIS,,,,,0
CPT,57550,REMOVAL OF RESIDUAL CERVIX,,,4861.19,9722.38,8
CPT,57555,REMOVE CERVIX/REPAIR VAGINA,,,4861.19,9722.38,8
CPT,57556,REMOVE CERVIX REPAIR BOWEL,,,4861.19,9722.38,8
CPT,57558,D&C OF CERVICAL STUMP,,,3145.71,6291.42,8
CPT,575F,HIV RNA PLAN CARE DOCD,,,,,0
CPT,575T,PRGRMG DEV EVAL ICDS SS IP,,,36.27,72.54,8
CPT,576T,INTERROG DEV EVAL ICDS SS IP,,,36.27,72.54,8
CPT,57700,REVISION OF CERVIX,,,3145.71,6291.42,8
CPT,57720,REVISION OF CERVIX,,,3145.71,6291.42,8
CPT,577T,EPHYS EVAL ICDS SS,,,1183.16,2366.32,8
CPT,57800,DILATION OF CERVICAL CANAL,,,3145.71,6291.42,8
CPT,578T,REM INTERROG DEV ICDS PHYS,,,,,0
CPT,579T,REM INTERROG DEV ICDS TECH,,,36.27,72.54,8
CPT,580,ANESTH HEART/LUNG TRANSPLNT,,,,,0
CPT,580F,MULTIDISCIPLINARY CARE PLAN,,,,,0
CPT,580T,RMVL SS IMPL DFB PG ONLY,,,3631.43,7262.86,8
CPT,58100,BIOPSY OF UTERUS LINING,,,,,0
CPT,58100,ENDOMET BIOP,790.0,395.0,137.61,766.3,54
CPT,58110,BX DONE W/COLPOSCOPY ADD-ON,,,,,0
CPT,58110,ENDO BX WITH COLPO,470.0,235.0,81.87,455.9,47
CPT,58120,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,8267.0,4133.5,1440.11,8018.99,54
CPT,58120,DILATION AND CURETTAGE,,,,,0
CPT,58140,MYOMECTOMY ABDOM METHOD,,,,,0
CPT,58145,MYOMECTOMY VAG METHOD,,,3145.71,6291.42,8
CPT,58146,MYOMECTOMY ABDOM COMPLEX,,,,,0
CPT,58150,TOTAL HYSTERECTOMY,,,,,0
CPT,58152,TOTAL HYSTERECTOMY,,,,,0
CPT,58180,PARTIAL HYSTERECTOMY,,,,,0
CPT,581F,PT TRNSFRD FROM ANESTH TO CC,,,,,0
CPT,581T,ABLTJ MAL BRST TUM PERQ CRTX,,,3804.87,7609.74,8
CPT,58200,EXTENSIVE HYSTERECTOMY,,,,,0
CPT,58210,EXTENSIVE HYSTERECTOMY,,,,,0
CPT,58240,REMOVAL OF PELVIS CONTENTS,,,,,0
CPT,58260,VAGINAL HYSTERECTOMY,,,4861.19,9722.38,8
CPT,58262,VAG HYST INCLUDING T/O,,,4861.19,9722.38,8
CPT,58263,VAG HYST W/T/O & VAG REPAIR,,,4861.19,9722.38,8
CPT,58267,VAG HYST W/URINARY REPAIR,,,,,0
CPT,58270,VAG HYST W/ENTEROCELE REPAIR,,,4861.19,9722.38,8
CPT,58275,HYSTERECTOMY/REVISE VAGINA,,,,,0
CPT,58280,HYSTERECTOMY/REVISE VAGINA,,,,,0
CPT,58285,EXTENSIVE HYSTERECTOMY,,,,,0
CPT,58290,VAG HYST COMPLEX,,,7206.04,14412.08,8
CPT,58291,VAG HYST INCL T/O COMPLEX,,,4861.19,9722.38,8
CPT,58292,VAG HYST T/O & REPAIR COMPL,,,7206.04,14412.08,8
CPT,58294,VAG HYST W/ENTEROCELE COMPL,,,4861.19,9722.38,8
CPT,582F,NO TRNSFR FROM ANESTH TO CC,,,,,0
CPT,582T,TRURL ABLTJ MAL PRST8 TISS,,,12820.89,25641.78,8
CPT,58300,INSERT INTRAUTERINE DEVICE,,,,,0
CPT,58300,INSERTION OF IUD,646.0,323.0,112.53,626.62,47
CPT,58301,REMOVE INTRAUTERINE DEVICE,684.0,342.0,119.15,663.48,54
CPT,58321,ARTIFICIAL INSEMINATION,,,296.12,592.24,8
CPT,58322,ARTIFICIAL INSEMINATION,,,196.46,392.92,8
CPT,58323,SPERM WASHING,,,196.46,392.92,8
CPT,58340,CATHETER FOR HYSTEROGRAPHY,,,107.53,124.87,16
CPT,58345,REOPEN FALLOPIAN TUBE,,,3145.71,6291.42,8
CPT,58346,INSERT HEYMAN UTERI CAPSULE,,,4861.19,9722.38,8
CPT,58350,REOPEN FALLOPIAN TUBE,,,4861.19,9722.38,8
CPT,58353,ENDOMETR ABLATE THERMAL,,,4861.19,9722.38,8
CPT,58356,ENDOMETRIAL CRYOABLATION,,,4861.19,9722.38,8
CPT,583F,TRANSFER CARE CHECKLIST USED,,,,,0
CPT,583T,TMPST AUTO TUBE DLVR SYS,,,1507.77,3015.54,8
CPT,58400,SUSPENSION OF UTERUS,,,,,0
CPT,58410,SUSPENSION OF UTERUS,,,,,0
CPT,584F,NO TRANSFERCARE CHKLIST USED,,,,,0
CPT,584T,PERQ ISLET CELL TRANSPLANT,,,,,0
CPT,58520,REPAIR OF RUPTURED UTERUS,,,,,0
CPT,58540,REVISION OF UTERUS,,,,,0
CPT,58541,LSH UTERUS 250 G OR LESS,,,10329.66,20659.32,8
CPT,58542,LSH W/T/O UT 250 G OR LESS,,,10329.66,20659.32,8
CPT,58543,LSH UTERUS ABOVE 250 G,,,10329.66,20659.32,8
CPT,58544,LSH W/T/O UTERUS ABOVE 250 G,,,10329.66,20659.32,8
CPT,58545,LAPAROSCOPIC MYOMECTOMY,,,5874.81,11749.62,8
CPT,58546,LAPARO-MYOMECTOMY COMPLEX,,,10329.66,20659.32,8
CPT,58548,LAP RADICAL HYST,,,,,0
CPT,58550,LAPARO-ASST VAG HYSTERECTOMY,,,5874.81,11749.62,8
CPT,58552,LAPARO-VAG HYST INCL T/O,,,10329.66,20659.32,8
CPT,58553,LAPARO-VAG HYST COMPLEX,,,10329.66,20659.32,8
CPT,58554,LAPARO-VAG HYST W/T/O COMPL,,,10329.66,20659.32,8
CPT,58555,HYSTEROSCOPY DX SEP PROC,,,3145.71,6291.42,8
CPT,58558,HYSTEROSCOPY BIOPSY,,,,,0
CPT,58558,HYSTEROSPY BX ENDOMETRIUM&/POLYPC W/WO D&C,6300.0,3150.0,1097.46,6291.42,54
CPT,58559,HYSTEROSCOPY LYSIS,,,4861.19,9722.38,8
CPT,58560,HYSTEROSCOPY RESECT SEPTUM,,,4861.19,9722.38,8
CPT,58561,HYSTEROSCOPY REMOVE MYOMA,,,4861.19,9722.38,8
CPT,58562,HYSTEROSCOPY REMOVE FB,,,3145.71,6291.42,8
CPT,58563,HYSTEROSCOPY ABLATION,,,4861.19,9722.38,8
CPT,58565,HYSTEROSCOPY STERILIZATION,,,4861.19,9722.38,8
CPT,58570,TLH UTERUS 250 G OR LESS,,,10329.66,20659.32,8
CPT,58571,TLH W/T/O 250 G OR LESS,,,10329.66,20659.32,8
CPT,58572,TLH UTERUS OVER 250 G,,,10329.66,20659.32,8
CPT,58573,TLH W/T/O UTERUS OVER 250 G,,,10329.66,20659.32,8
CPT,58575,LAPS TOT HYST RESJ MAL,,,,,0
CPT,58578,UNLISTED LAPS PX UTERUS,,,5874.81,11749.62,8
CPT,58579,UNLISTED HYSTSC PX UTERUS,,,196.46,392.92,8
CPT,58580,TRANSCRV ABLTJ UTRN FIBRD RF,,,7206.04,14412.08,8
CPT,585T,LAPS ISLET CELL TRANSPLANT,,,,,0
CPT,58600,DIVISION OF FALLOPIAN TUBE,,,3145.71,6291.42,8
CPT,58605,DIVISION OF FALLOPIAN TUBE,,,,,0
CPT,58611,LIGATE OVIDUCT(S) ADD-ON,,,,,0
CPT,58615,OCCLUDE FALLOPIAN TUBE(S),,,3145.71,6291.42,8
CPT,58660,LAPAROSCOPY LYSIS,,,5874.81,11749.62,8
CPT,58661,LAPAROSCOPY REMOVE ADNEXA,,,5874.81,11749.62,8
CPT,58662,LAPAROSCOPY EXCISE LESIONS,,,5874.81,11749.62,8
CPT,58670,LAPAROSCOPY TUBAL CAUTERY,,,5874.81,11749.62,8
CPT,58671,LAPAROSCOPY TUBAL BLOCK,,,5874.81,11749.62,8
CPT,58672,LAPAROSCOPY FIMBRIOPLASTY,,,5874.81,11749.62,8
CPT,58673,LAPAROSCOPY SALPINGOSTOMY,,,10329.66,20659.32,8
CPT,58674,LAPS ABLTJ UTERINE FIBROIDS,,,10329.66,20659.32,8
CPT,58679,UNLISTED LAPS PX OVIDCT OVRY,,,5874.81,11749.62,8
CPT,586T,OPEN ISLET CELL TRANSPLANT,,,,,0
CPT,58700,REMOVAL OF FALLOPIAN TUBE,,,,,0
CPT,58720,REMOVAL OF OVARY/TUBE(S),,,,,0
CPT,58740,ADHESIOLYSIS TUBE OVARY,,,,,0
CPT,58750,REPAIR OVIDUCT,,,,,0
CPT,58752,REVISE OVARIAN TUBE(S),,,,,0
CPT,58760,FIMBRIOPLASTY,,,,,0
CPT,58770,CREATE NEW TUBAL OPENING,,,3145.71,6291.42,8
CPT,587T,PERQ IMPLTJ/RPLCMT ISDNS PTN,,,6193.03,12386.06,8
CPT,58800,DRAINAGE OF OVARIAN CYST(S),,,3145.71,6291.42,8
CPT,58805,DRAINAGE OF OVARIAN CYST(S),,,3145.71,6291.42,8
CPT,58820,DRAIN OVARY ABSCESS OPEN,,,3145.71,6291.42,8
CPT,58822,DRAIN OVARY ABSCESS PERCUT,,,,,0
CPT,58825,TRANSPOSITION OVARY(S),,,,,0
CPT,588T,REVISION/REMOVAL ISDNS PTN,,,3397.38,6794.76,8
CPT,58900,BIOPSY OF OVARY(S),,,3145.71,6291.42,8
CPT,58920,PARTIAL REMOVAL OF OVARY(S),,,7206.04,14412.08,8
CPT,58925,REMOVAL OF OVARIAN CYST(S),,,4861.19,9722.38,8
CPT,58940,REMOVAL OF OVARY(S),,,,,0
CPT,58943,REMOVAL OF OVARY(S),,,,,0
CPT,58950,RESECT OVARIAN MALIGNANCY,,,,,0
CPT,58951,RESECT OVARIAN MALIGNANCY,,,,,0
CPT,58952,RESECT OVARIAN MALIGNANCY,,,,,0
CPT,58953,TAH RAD DISSECT FOR DEBULK,,,,,0
CPT,58954,TAH RAD DEBULK/LYMPH REMOVE,,,,,0
CPT,58956,BSO OMENTECTOMY W/TAH,,,,,0
CPT,58958,RESECT RECUR GYN MAL W/LYM,,,,,0
CPT,58960,EXPLORATION OF ABDOMEN,,,,,0
CPT,58970,RETRIEVAL OF OOCYTE,,,895.04,1790.08,8
CPT,58974,TRANSFER OF EMBRYO,,,895.04,1790.08,8
CPT,58976,TRANSFER OF EMBRYO,,,296.12,592.24,8
CPT,58999,UNLISTED PX FML GENITAL SYS,,,196.46,392.92,8
CPT,589T,ELEC ALYS SMPL PRGRMG IINS,,,92.39,184.78,8
CPT,58U,ONC MERKEL CLL CARC SRM QUAN,,,322.96,645.92,8
CPT,59000,AMNIOCENTESIS DIAGNOSTIC,934.0,467.0,119.89,1790.08,54
CPT,59000,US AMNIOCENTESIS DIAGNOSTIC,1123.0,561.5,119.89,1790.08,108
CPT,59001,US AMNIOCENTESIS THERAPEUTIC,1613.0,806.5,263.04,1664.52,108
CPT,59012,FETAL CORD PUNCTURE PRENATAL,,,,,0
CPT,59012,US PUBS (CORDOCENTESIS),1310.0,655.0,213.56,1352.18,106
CPT,59015,CHORION BIOPSY,,,153.09,1790.08,24
CPT,59020,FETAL CONTRACT STRESS TEST,,,,,0
CPT,59020,US OXYTOCIN CHALLENGE TEST,556.5,278.25,90.75,574.24,106
CPT,59025,FETAL NON-STRESS TEST MULT,666.0,333.0,116.01,646.02,54
CPT,59025,FETAL NON-STRESS TEST SINGLE,612.0,306.0,106.61,593.64,54
CPT,59025,US FETAL NON-STRESS TEST MULT,638.5,319.25,104.17,658.63,108
CPT,59025,US FETAL NON-STRESS TEST SINGLE,585.5,292.75,95.46,604.31,108
CPT,59030,FETAL SCALP BLOOD SAMPLE,,,296.12,592.24,8
CPT,59050,FETAL MONITOR W/REPORT,,,,,0
CPT,59051,FETAL MONITOR/INTERPRET ONLY,,,,,0
CPT,59070,AMNIOFUSION TRANSABD W/US,1446.0,723.0,251.89,1402.62,53
CPT,59070,TRANSABDOM AMNIOINFUS W/US,,,,,0
CPT,59070,US AMNIOFUSION TRANSABD W/US,1385.5,692.75,225.93,1429.78,106
CPT,59072,UMBILICAL CORD OCCLUD W/US,,,296.12,592.24,8
CPT,59074,FETAL FLUID DRAINAGE W/US,,,296.12,592.24,8
CPT,59076,FETAL SHUNT PLACEMENT W/US,,,296.12,592.24,8
CPT,590T,ELEC ALYS CPLX PRGRMG IINS,,,92.39,184.78,8
CPT,59100,REMOVE UTERUS LESION,,,4861.19,9722.38,8
CPT,59120,TREAT ECTOPIC PREGNANCY,,,,,0
CPT,59121,TREAT ECTOPIC PREGNANCY,,,,,0
CPT,59130,TREAT ECTOPIC PREGNANCY,,,,,0
CPT,59136,TREAT ECTOPIC PREGNANCY,,,,,0
CPT,59140,TREAT ECTOPIC PREGNANCY,,,,,0
CPT,59150,TREAT ECTOPIC PREGNANCY,,,5874.81,11749.62,8
CPT,59151,TREAT ECTOPIC PREGNANCY,,,5874.81,11749.62,8
CPT,59160,D & C AFTER DELIVERY,,,3145.71,6291.42,8
CPT,591T,HLTH&WB COACHING INDIV 1ST,,,,,0
CPT,59200,INSERT CERVICAL DILATOR,,,,,0
CPT,59200,"INSERT CERVICAL DILATOR(LAMINARIA, PROSTAGLANDIN)",405.0,202.5,70.55,592.24,53
CPT,592T,HLTH&WB COACHING INDIV F-UP,,,,,0
CPT,59300,EPISIOTOMY OR VAGINAL REPAIR,,,3145.71,6291.42,8
CPT,59320,REVISION OF CERVIX,,,3145.71,6291.42,8
CPT,59325,REVISION OF CERVIX,,,,,0
CPT,59350,REPAIR OF UTERUS,,,,,0
CPT,593T,HLTH&WB COACHING GROUP,,,,,0
CPT,59400,OBSTETRICAL CARE,,,,,0
CPT,59409,OBSTETRICAL CARE,,,3145.71,6291.42,8
CPT,59410,OBSTETRICAL CARE,,,,,0
CPT,59412,ANTEPARTUM MANIPULATION,,,,,0
CPT,59412,EXTERNAL CEPHALIC VERSION,5480.0,2740.0,954.61,6291.42,53
CPT,59412,US EXTERNAL CEPHALIC VERSION,5824.5,2912.25,949.91,6291.42,106
CPT,59414,DELIVER PLACENTA,,,3145.71,6291.42,8
CPT,59425,ANTEPARTUM CARE ONLY,,,,,0
CPT,59426,ANTEPARTUM CARE ONLY,,,,,0
CPT,59430,CARE AFTER DELIVERY,,,,,0
CPT,594T,OSTEOT HUM XTRNL LNGTH DEV,,,7051.31,14102.62,8
CPT,59510,CESAREAN DELIVERY,,,,,0
CPT,59514,CESAREAN DELIVERY ONLY,,,,,0
CPT,59515,CESAREAN DELIVERY,,,,,0
CPT,59525,REMOVE UTERUS AFTER CESAREAN,,,,,0
CPT,59610,VBAC DELIVERY,,,,,0
CPT,59612,VBAC DELIVERY ONLY,,,3145.71,6291.42,8
CPT,59614,VBAC CARE AFTER DELIVERY,,,,,0
CPT,59618,ATTEMPTED VBAC DELIVERY,,,,,0
CPT,59620,ATTEMPTED VBAC DELIVERY ONLY,,,,,0
CPT,59622,ATTEMPTED VBAC AFTER CARE,,,,,0
CPT,596T,TEMP FML IU VLV-PMP 1ST INSJ,,,677.61,1355.22,8
CPT,597T,TEMP FML IU VALVE-PMP RPLCMT,,,677.61,1355.22,8
CPT,59812,TREATMENT OF MISCARRIAGE,,,3145.71,6291.42,8
CPT,59820,CARE OF MISCARRIAGE,,,3145.71,6291.42,8
CPT,59821,TREATMENT OF MISCARRIAGE,,,3145.71,6291.42,8
CPT,59830,TREAT UTERUS INFECTION,,,,,0
CPT,59840,ABORTION,,,3145.71,6291.42,8
CPT,59841,ABORTION,,,3145.71,6291.42,8
CPT,59850,ABORTION,,,,,0
CPT,59851,ABORTION,,,,,0
CPT,59852,ABORTION,,,,,0
CPT,59855,ABORTION,,,,,0
CPT,59856,ABORTION,,,,,0
CPT,59857,ABORTION,,,,,0
CPT,59866,ABORTION (MPR),,,296.12,592.24,8
CPT,59870,EVACUATE MOLE OF UTERUS,,,3145.71,6291.42,8
CPT,59871,REMOVE CERCLAGE SUTURE,,,3145.71,6291.42,8
CPT,59897,UNLISTED FETAL INVAS PX W/US,,,196.46,392.92,8
CPT,59898,UNLSTD LAPS PX MAT CARE&DLVR,,,5874.81,11749.62,8
CPT,59899,UNLISTED PX MAT CARE&DLVR,,,196.46,392.92,8
CPT,598T,NCNTC R-T FLUOR WND IMG 1ST,,,209.83,419.66,8
CPT,599T,NCNTC R-T FLUOR WND IMG EA,,,,,0
CPT,59U,ONC MERKEL CLL CARC SRM +/-,,,322.96,645.92,8
CPT,5F,OSTEOARTHRITIS COMPOSITE,,,,,0
CPT,5U,ONCO PRST8 3 GENE UR ALG,,,760.0,1520.0,8
CPT,600,ANESTH SPINE CORD SURGERY,,,,,0
CPT,60000,DRAIN THYROID/TONGUE CYST,,,1507.77,3015.54,8
CPT,6005F,CARE LEVEL RATIONALE DOC,,,,,0
CPT,600T,IRE ABLTJ 1+TUM ORGAN PERQ,,,10329.66,20659.32,8
CPT,60100,BIOPSY OF THYROID,,,98.96,1376.28,24
CPT,6010F,DYSPHAG TEST DONE B/4 EATING,,,,,0
CPT,6015F,DYSPHAG TEST DONE B/4 EATING,,,,,0
CPT,601T,IRE ABLTJ 1+TUMORS OPEN,,,10329.66,20659.32,8
CPT,60200,REMOVE THYROID LESION,,,5874.81,11749.62,8
CPT,6020F,NPO (NOTHING-MOUTH) ORDERED,,,,,0
CPT,60210,PARTIAL THYROID EXCISION,,,5874.81,11749.62,8
CPT,60212,PARTIAL THYROID EXCISION,,,5874.81,11749.62,8
CPT,60220,PARTIAL REMOVAL OF THYROID,,,5874.81,11749.62,8
CPT,60225,PARTIAL REMOVAL OF THYROID,,,5874.81,11749.62,8
CPT,60240,REMOVAL OF THYROID,,,5874.81,11749.62,8
CPT,60252,REMOVAL OF THYROID,,,5752.66,11505.32,8
CPT,60254,EXTENSIVE THYROID SURGERY,,,,,0
CPT,60260,REPEAT THYROID SURGERY,,,5752.66,11505.32,8
CPT,60270,REMOVAL OF THYROID,,,,,0
CPT,60271,REMOVAL OF THYROID,,,5752.66,11505.32,8
CPT,60280,REMOVE THYROID DUCT LESION,,,5874.81,11749.62,8
CPT,60281,REMOVE THYROID DUCT LESION,,,5874.81,11749.62,8
CPT,602T,TRANSDERMAL GFR MEASUREMENTS,,,,,0
CPT,60300,ASPIR/INJ THYROID CYST,,,688.14,1376.28,8
CPT,6030F,MAX STERILE BARRIERS FLWD,,,,,0
CPT,603T,TRANSDERMAL GFR MONITORING,,,,,0
CPT,604,ANESTH SITTING PROCEDURE,,,,,0
CPT,6040F,APPRO RAD DS DVCS TECHS DOCD,,,,,0
CPT,6045F,RADXPS IN END RPRT4FLURO PXD,,,,,0
CPT,604T,REM OCT RTA DEV SETUP&EDUCAJ,,,,,0
CPT,60500,EXPLORE PARATHYROID GLANDS,,,5752.66,11505.32,8
CPT,60502,RE-EXPLORE PARATHYROIDS,,,5752.66,11505.32,8
CPT,60505,EXPLORE PARATHYROID GLANDS,,,,,0
CPT,60512,AUTOTRANSPLANT PARATHYROID,,,,,0
CPT,60520,REMOVAL OF THYMUS GLAND,,,5752.66,11505.32,8
CPT,60521,REMOVAL OF THYMUS GLAND,,,,,0
CPT,60522,REMOVAL OF THYMUS GLAND,,,,,0
CPT,60540,EXPLORE ADRENAL GLAND,,,,,0
CPT,60545,EXPLORE ADRENAL GLAND,,,,,0
CPT,605T,REM OCT RTA TECHL SPRT MIN 8,,,,,0
CPT,60600,REMOVE CAROTID BODY LESION,,,,,0
CPT,60605,REMOVE CAROTID BODY LESION,,,,,0
CPT,60650,LAPAROSCOPY ADRENALECTOMY,,,,,0
CPT,60659,UNLISTED LAPS PX ENDOC SYS,,,5874.81,11749.62,8
CPT,60660,"Ablation of 1 or more thyroid nodule(s), one lobe or the isthmus, percutaneous, including imaging guidance, radiofrequency",,,1604.96,3209.92,8
CPT,60661,"Ablation of 1 or more thyroid nodule(s), additional lobe, percutaneous, including imaging guidance, radiofrequency (List separately in addition to code for primary procedure)",,,,,0
CPT,60699,UNLISTED PX ENDOCRINE SYSTEM,,,5874.81,11749.62,8
CPT,606T,REM OCT RTA PHYS/QHP EA 30D,,,,,0
CPT,6070F,PT ASKED/CNSLD AED EFFECTS,,,,,0
CPT,607T,REM MNTR PULM FLU MNTR SETUP,,,,,0
CPT,6080F,PT/CAREGIVER QUERIED FALLS,,,,,0
CPT,608T,REM MNTR PULM FLU MNTR ALYS,,,,,0
CPT,6090F,PT/CAREGIVER COUNSEL SAFETY,,,,,0
CPT,609T,MRS DISC PAIN ACQUISJ DATA,,,231.86,463.72,8
CPT,60U,TWN ZYG GEN SEQ ALYS CHRMS2,,,759.05,1518.1,8
CPT,61000,REMOVE CRANIAL CAVITY FLUID,,,685.95,1371.9,8
CPT,61001,REMOVE CRANIAL CAVITY FLUID,,,685.95,1371.9,8
CPT,6100F,VERIFY PT SITE PXD DOCD,,,,,0
CPT,6101F,SAFETY COUNSELING DEMENTIA,,,,,0
CPT,61020,REMOVE BRAIN CAVITY FLUID,,,859.5,1719.0,8
CPT,61026,INJECTION INTO BRAIN CANAL,,,685.95,1371.9,8
CPT,6102F,SAFETY COUNSELING DEM ORDER,,,,,0
CPT,61050,REMOVE BRAIN CANAL FLUID,,,298.28,596.56,8
CPT,61055,INJECTION INTO BRAIN CANAL,,,298.28,596.56,8
CPT,61070,BRAIN CANAL SHUNT PROCEDURE,,,,,0
CPT,61070,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,1446.0,723.0,251.89,1402.62,54
CPT,610T,MRS DISC PAIN TRANSMIS DATA,,,,,0
CPT,61105,TWIST DRILL HOLE,,,,,0
CPT,61107,DRILL SKULL FOR IMPLANTATION,,,,,0
CPT,61108,DRILL SKULL FOR DRAINAGE,,,,,0
CPT,6110F,COUNSEL PROV DRIVING RISKS,,,,,0
CPT,61120,BURR HOLE FOR PUNCTURE,,,,,0
CPT,61140,PIERCE SKULL FOR BIOPSY,,,,,0
CPT,61150,PIERCE SKULL FOR DRAINAGE,,,,,0
CPT,61151,PIERCE SKULL FOR DRAINAGE,,,,,0
CPT,61154,PIERCE SKULL & REMOVE CLOT,,,,,0
CPT,61156,PIERCE SKULL FOR DRAINAGE,,,,,0
CPT,611T,MRS DISC PAIN ALG ALYS DATA,,,231.86,463.72,8
CPT,61210,PIERCE SKULL IMPLANT DEVICE,,,,,0
CPT,61215,INSERT BRAIN-FLUID DEVICE,,,8528.03,17056.06,8
CPT,61250,PIERCE SKULL & EXPLORE,,,,,0
CPT,61253,PIERCE SKULL & EXPLORE,,,,,0
CPT,612T,MRS DISCOGENIC PAIN I&R,,,,,0
CPT,61304,OPEN SKULL FOR EXPLORATION,,,,,0
CPT,61305,OPEN SKULL FOR EXPLORATION,,,,,0
CPT,61312,OPEN SKULL FOR DRAINAGE,,,,,0
CPT,61313,OPEN SKULL FOR DRAINAGE,,,,,0
CPT,61314,OPEN SKULL FOR DRAINAGE,,,,,0
CPT,61315,OPEN SKULL FOR DRAINAGE,,,,,0
CPT,61316,IMPLT CRAN BONE FLAP TO ABDO,,,,,0
CPT,61320,OPEN SKULL FOR DRAINAGE,,,,,0
CPT,61321,OPEN SKULL FOR DRAINAGE,,,,,0
CPT,61322,DECOMPRESSIVE CRANIOTOMY,,,,,0
CPT,61323,DECOMPRESSIVE LOBECTOMY,,,,,0
CPT,61330,DECOMPRESS EYE SOCKET,,,3221.84,6443.68,8
CPT,61333,EXPLORE ORBIT/REMOVE LESION,,,,,0
CPT,61340,SUBTEMPORAL DECOMPRESSION,,,,,0
CPT,61343,INCISE SKULL (PRESS RELIEF),,,,,0
CPT,61345,RELIEVE CRANIAL PRESSURE,,,,,0
CPT,613T,PERQ TCAT INTRATRL SEPTL SHT,,,,,0
CPT,61450,INCISE SKULL FOR SURGERY,,,,,0
CPT,61458,INCISE SKULL FOR BRAIN WOUND,,,,,0
CPT,61460,INCISE SKULL FOR SURGERY,,,,,0
CPT,614T,RMVL&RPLCMT SS IMPL DFB PG,,,21615.45,43230.9,8
CPT,61500,REMOVAL OF SKULL LESION,,,,,0
CPT,61501,REMOVE INFECTED SKULL BONE,,,,,0
CPT,6150F,PT NOTRCVNG1ST ANTITNF TXMNT,,,,,0
CPT,61510,REMOVAL OF BRAIN LESION,,,,,0
CPT,61512,REMOVE BRAIN LINING LESION,,,,,0
CPT,61514,REMOVAL OF BRAIN ABSCESS,,,,,0
CPT,61516,REMOVAL OF BRAIN LESION,,,,,0
CPT,61517,IMPLT BRAIN CHEMOTX ADD-ON,,,,,0
CPT,61518,REMOVAL OF BRAIN LESION,,,,,0
CPT,61519,REMOVE BRAIN LINING LESION,,,,,0
CPT,61520,REMOVAL OF BRAIN LESION,,,,,0
CPT,61521,REMOVAL OF BRAIN LESION,,,,,0
CPT,61522,REMOVAL OF BRAIN ABSCESS,,,,,0
CPT,61524,REMOVAL OF BRAIN LESION,,,,,0
CPT,61526,REMOVAL OF BRAIN LESION,,,,,0
CPT,61530,REMOVAL OF BRAIN LESION,,,,,0
CPT,61531,IMPLANT BRAIN ELECTRODES,,,,,0
CPT,61533,IMPLANT BRAIN ELECTRODES,,,,,0
CPT,61534,REMOVAL OF BRAIN LESION,,,,,0
CPT,61535,REMOVE BRAIN ELECTRODES,,,,,0
CPT,61536,REMOVAL OF BRAIN LESION,,,,,0
CPT,61537,REMOVAL OF BRAIN TISSUE,,,,,0
CPT,61538,REMOVAL OF BRAIN TISSUE,,,,,0
CPT,61539,REMOVAL OF BRAIN TISSUE,,,,,0
CPT,61540,REMOVAL OF BRAIN TISSUE,,,,,0
CPT,61541,INCISION OF BRAIN TISSUE,,,,,0
CPT,61543,REMOVAL OF BRAIN TISSUE,,,,,0
CPT,61544,REMOVE & TREAT BRAIN LESION,,,,,0
CPT,61545,EXCISION OF BRAIN TUMOR,,,,,0
CPT,61546,REMOVAL OF PITUITARY GLAND,,,,,0
CPT,61548,REMOVAL OF PITUITARY GLAND,,,,,0
CPT,61550,RELEASE OF SKULL SEAMS,,,,,0
CPT,61552,RELEASE OF SKULL SEAMS,,,,,0
CPT,61556,INCISE SKULL/SUTURES,,,,,0
CPT,61557,INCISE SKULL/SUTURES,,,,,0
CPT,61558,EXCISION OF SKULL/SUTURES,,,,,0
CPT,61559,EXCISION OF SKULL/SUTURES,,,,,0
CPT,61563,EXCISION OF SKULL TUMOR,,,,,0
CPT,61564,EXCISION OF SKULL TUMOR,,,,,0
CPT,61566,REMOVAL OF BRAIN TISSUE,,,,,0
CPT,61567,INCISION OF BRAIN TISSUE,,,,,0
CPT,61570,REMOVE FOREIGN BODY BRAIN,,,,,0
CPT,61571,INCISE SKULL FOR BRAIN WOUND,,,,,0
CPT,61575,SKULL BASE/BRAINSTEM SURGERY,,,,,0
CPT,61576,SKULL BASE/BRAINSTEM SURGERY,,,,,0
CPT,61580,CRANIOFACIAL APPROACH SKULL,,,,,0
CPT,61581,CRANIOFACIAL APPROACH SKULL,,,,,0
CPT,61582,CRANIOFACIAL APPROACH SKULL,,,,,0
CPT,61583,CRANIOFACIAL APPROACH SKULL,,,,,0
CPT,61584,ORBITOCRANIAL APPROACH/SKULL,,,,,0
CPT,61585,ORBITOCRANIAL APPROACH/SKULL,,,,,0
CPT,61586,RESECT NASOPHARYNX SKULL,,,,,0
CPT,61590,INFRATEMPORAL APPROACH/SKULL,,,,,0
CPT,61591,INFRATEMPORAL APPROACH/SKULL,,,,,0
CPT,61592,ORBITOCRANIAL APPROACH/SKULL,,,,,0
CPT,61595,TRANSTEMPORAL APPROACH/SKULL,,,,,0
CPT,61596,TRANSCOCHLEAR APPROACH/SKULL,,,,,0
CPT,61597,TRANSCONDYLAR APPROACH/SKULL,,,,,0
CPT,61598,TRANSPETROSAL APPROACH/SKULL,,,,,0
CPT,615T,EYE MVMT ALYS W/O CALBRJ I&R,,,129.29,258.58,8
CPT,61600,RESECT/EXCISE CRANIAL LESION,,,,,0
CPT,61601,RESECT/EXCISE CRANIAL LESION,,,,,0
CPT,61605,RESECT/EXCISE CRANIAL LESION,,,,,0
CPT,61606,RESECT/EXCISE CRANIAL LESION,,,,,0
CPT,61607,RESECT/EXCISE CRANIAL LESION,,,,,0
CPT,61608,RESECT/EXCISE CRANIAL LESION,,,,,0
CPT,61611,TRANSECT ARTERY SINUS,,,,,0
CPT,61613,REMOVE ANEURYSM SINUS,,,,,0
CPT,61615,RESECT/EXCISE LESION SKULL,,,,,0
CPT,61616,RESECT/EXCISE LESION SKULL,,,,,0
CPT,61618,REPAIR DURA,,,,,0
CPT,61619,REPAIR DURA,,,,,0
CPT,61623,ENDOVASC TEMPORY VESSEL OCCL,,,11218.2,22436.4,8
CPT,61624,TRANSCATH OCCLUSION CNS,,,17813.98,35627.96,8
CPT,61626,TRANSCATH OCCLUSION NON-CNS,,,11218.2,22436.4,8
CPT,61630,INTRACRANIAL ANGIOPLASTY,,,,,0
CPT,61635,INTRACRAN ANGIOPLSTY W/STENT,,,,,0
CPT,61640,DILATE IC VASOSPASM INIT,,,,,0
CPT,61641,DILAT IC VSPSM EA VSL SM TER,,,,,0
CPT,61642,DILAT IC VSPSM EA DIFF TER,,,,,0
CPT,61645,PERQ ART M-THROMBECT &/NFS,,,,,0
CPT,61650,EVASC PRLNG ADMN RX AGNT 1ST,,,,,0
CPT,61651,EVASC PRLNG ADMN RX AGNT ADD,,,,,0
CPT,61680,INTRACRANIAL VESSEL SURGERY,,,,,0
CPT,61682,INTRACRANIAL VESSEL SURGERY,,,,,0
CPT,61684,INTRACRANIAL VESSEL SURGERY,,,,,0
CPT,61686,INTRACRANIAL VESSEL SURGERY,,,,,0
CPT,61690,INTRACRANIAL VESSEL SURGERY,,,,,0
CPT,61692,INTRACRANIAL VESSEL SURGERY,,,,,0
CPT,61697,BRAIN ANEURYSM REPR COMPLX,,,,,0
CPT,61698,BRAIN ANEURYSM REPR COMPLX,,,,,0
CPT,61700,BRAIN ANEURYSM REPR SIMPLE,,,,,0
CPT,61702,INNER SKULL VESSEL SURGERY,,,,,0
CPT,61703,CLAMP NECK ARTERY,,,,,0
CPT,61705,REVISE CIRCULATION TO HEAD,,,,,0
CPT,61708,REVISE CIRCULATION TO HEAD,,,,,0
CPT,61710,REVISE CIRCULATION TO HEAD,,,,,0
CPT,61711,FUSION OF SKULL ARTERIES,,,,,0
CPT,61715,"Magnetic resonance image guided high intensity focused ultrasound (MRgFUS), stereotactic ablation of target, intracranial, including stereotactic navigation and frame placement, when performed",,,10828.04,21656.08,8
CPT,61720,INCISE SKULL/BRAIN SURGERY,,,8528.03,17056.06,8
CPT,61735,INCISE SKULL/BRAIN SURGERY,,,,,0
CPT,61736,LITT ICR 1 TRAJ 1 SMPL LES,,,,,0
CPT,61737,LITT ICR MLT TRJ MLT/CPLX LS,,,,,0
CPT,61750,INCISE SKULL/BRAIN BIOPSY,,,,,0
CPT,61751,BRAIN BIOPSY W/CT/MR GUIDE,,,,,0
CPT,61760,IMPLANT BRAIN ELECTRODES,,,,,0
CPT,61770,INCISE SKULL FOR TREATMENT,,,3319.68,6639.36,8
CPT,61781,SCAN PROC CRANIAL INTRA,,,,,0
CPT,61782,SCAN PROC CRANIAL EXTRA,,,,,0
CPT,61783,SCAN PROC SPINAL,,,,,0
CPT,61790,TREAT TRIGEMINAL NERVE,,,1897.58,3795.16,8
CPT,61791,TREAT TRIGEMINAL TRACT,,,1897.58,3795.16,8
CPT,61796,SRS CRANIAL LESION SIMPLE,,,,,0
CPT,61797,SRS CRAN LES SIMPLE ADDL,,,,,0
CPT,61798,SRS CRANIAL LESION COMPLEX,,,,,0
CPT,61799,SRS CRAN LES COMPLEX ADDL,,,,,0
CPT,61800,APPLY SRS HEADFRAME ADD-ON,,,,,0
CPT,61850,IMPLANT NEUROELECTRODES,,,,,0
CPT,61860,IMPLANT NEUROELECTRODES,,,,,0
CPT,61863,IMPLANT NEUROELECTRODE,,,,,0
CPT,61864,IMPLANT NEUROELECTRDE ADDL,,,,,0
CPT,61867,IMPLANT NEUROELECTRODE,,,,,0
CPT,61868,IMPLANT NEUROELECTRDE ADDL,,,,,0
CPT,61880,REVISE/REMOVE NEUROELECTRODE,,,3397.38,6794.76,8
CPT,61885,INSRT/REDO NEUROSTIM 1 ARRAY,,,29986.33,59972.66,8
CPT,61886,IMPLANT NEUROSTIM ARRAYS,,,29986.33,59972.66,8
CPT,61888,REVISE/REMOVE NEURORECEIVER,,,10828.04,21656.08,8
CPT,61889,INS SK-MNT CRNL NSTM PG/RCVR,,,,,0
CPT,61891,REV/RPLCMT SK-MNT CRNL NSTM,,,29986.33,59972.66,8
CPT,61892,RMV SK-MNT CRNL NSTM PG/RCVR,,,3179.6,6359.2,8
CPT,619T,CYSTO W/PRST8 COMMISSUROTOMY,,,,,0
CPT,61U,TC MEAS 5 BMRK SFDI M-S ALYS,,,25.1,50.2,8
CPT,620,ANESTH SPINE CORD SURGERY,,,,,0
CPT,62000,TREAT SKULL FRACTURE,,,3221.84,6443.68,8
CPT,62005,TREAT SKULL FRACTURE,,,,,0
CPT,62010,TREATMENT OF HEAD INJURY,,,,,0
CPT,620T,EVASC VEN ARTLZ TIBL/PRNL VN,,,42802.68,85605.36,8
CPT,62100,REPAIR BRAIN FLUID LEAKAGE,,,,,0
CPT,62115,REDUCTION OF SKULL DEFECT,,,,,0
CPT,62117,REDUCTION OF SKULL DEFECT,,,,,0
CPT,62120,REPAIR SKULL CAVITY LESION,,,,,0
CPT,62121,INCISE SKULL REPAIR,,,,,0
CPT,62140,CRNOP SKULL DEFECT<5 CM DIAM,,,,,0
CPT,62141,CRNOP SKULL DEFECT>5 CM DIAM,,,,,0
CPT,62142,RMVL B1 FLP/PROSTC PLATE SKL,,,,,0
CPT,62143,RPL B1 FLP/PROSTC PLATE SKL,,,,,0
CPT,62145,REPAIR OF SKULL & BRAIN,,,,,0
CPT,62146,CRNOP W/AUTOGRAFT<5 CM DIAM,,,,,0
CPT,62147,CRNOP W/AUTOGRAFT>5 CM DIAM,,,,,0
CPT,62148,RETR BONE FLAP TO FIX SKULL,,,,,0
CPT,62160,NEUROENDOSCOPY ADD-ON,,,,,0
CPT,62161,DISSECT BRAIN W/SCOPE,,,,,0
CPT,62162,REMOVE COLLOID CYST W/SCOPE,,,,,0
CPT,62164,REMOVE BRAIN TUMOR W/SCOPE,,,,,0
CPT,62165,REMOVE PITUIT TUMOR W/SCOPE,,,,,0
CPT,62180,ESTABLISH BRAIN CAVITY SHUNT,,,,,0
CPT,62190,ESTABLISH BRAIN CAVITY SHUNT,,,,,0
CPT,62192,ESTABLISH BRAIN CAVITY SHUNT,,,,,0
CPT,62194,REPLACE/IRRIGATE CATHETER,,,1897.58,3795.16,8
CPT,621T,TRABECULOSTOMY INTERNO LASER,,,4016.7,8033.4,8
CPT,62200,ESTABLISH BRAIN CAVITY SHUNT,,,,,0
CPT,62201,BRAIN CAVITY SHUNT W/SCOPE,,,,,0
CPT,62220,ESTABLISH BRAIN CAVITY SHUNT,,,,,0
CPT,62223,ESTABLISH BRAIN CAVITY SHUNT,,,,,0
CPT,62225,REPLACE/IRRIGATE CATHETER,,,3319.68,6639.36,8
CPT,62230,REPLACE/REVISE BRAIN SHUNT,,,8528.03,17056.06,8
CPT,62252,CSF SHUNT REPROGRAM,,,298.46,596.92,8
CPT,62256,REMOVE BRAIN CAVITY SHUNT,,,,,0
CPT,62258,REPLACE BRAIN CAVITY SHUNT,,,,,0
CPT,62263,EPIDURAL LYSIS MULT SESSIONS,,,859.5,1719.0,8
CPT,62264,EPIDURAL LYSIS ON SINGLE DAY,,,859.5,1719.0,8
CPT,62267,INTERDISCAL PERQ ASPIR DX,,,688.14,1376.28,8
CPT,62268,DRAIN SPINAL CORD CYST,,,859.5,1719.0,8
CPT,62269,NEEDLE BIOPSY SPINAL CORD,,,1604.96,3209.92,8
CPT,62270,DX LMBR SPI PNXR,,,,,0
CPT,62270,DX LUMBAR SPINAL PUNCTURE,1405.0,702.5,244.75,1371.9,54
CPT,62272,THER SPI PNXR DRG CSF,,,685.95,1371.9,8
CPT,62273,EPIDURAL BLOOD PATCH L&D,2354.0,1177.0,410.06,2283.38,54
CPT,62273,INJECT EPIDURAL PATCH,,,,,0
CPT,62280,TREAT SPINAL CORD LESION,,,859.5,1719.0,8
CPT,62281,TREAT SPINAL CORD LESION,,,859.5,1719.0,8
CPT,62282,TREAT SPINAL CANAL LESION,,,859.5,1719.0,8
CPT,62284,INJECTION FOR MYELOGRAM,,,181.6,210.9,16
CPT,62287,DCMPRN PX PERQ 1/MLT LUMBAR,,,470.56,3795.16,24
CPT,62290,NJX PX DISCOGRAPHY LUMBAR,,,273.02,317.06,16
CPT,62291,NJX PX DISCOGRAPHY CRV/THRC,,,255.46,296.66,16
CPT,62292,NJX CHEMONUCLEOLYSIS LMBR,,,1897.58,3795.16,8
CPT,62294,INJECTION INTO SPINAL ARTERY,,,859.5,1719.0,8
CPT,622T,TRABECULOSTOMY INT LSR W/SCP,,,,,0
CPT,62302,MYELOGRAPHY LUMBAR INJECTION,,,761.78,1523.56,8
CPT,62303,MYELOGRAPHY LUMBAR INJECTION,,,761.78,1523.56,8
CPT,62304,MYELOGRAPHY LUMBAR INJECTION,,,761.78,1523.56,8
CPT,62305,MYELOGRAPHY LUMBAR INJECTION,,,761.78,1523.56,8
CPT,62320,NJX INTERLAMINAR CRV/THRC,,,685.95,1371.9,8
CPT,62321,NJX INTERLAMINAR CRV/THRC,,,685.95,1371.9,8
CPT,62322,NJX INTERLAMINAR LMBR/SAC,,,859.5,1719.0,8
CPT,62323,NJX INTERLAMINAR LMBR/SAC,,,685.95,1371.9,8
CPT,62324,NJX INTERLAMINAR CRV/THRC,,,859.5,1719.0,8
CPT,62325,NJX INTERLAMINAR CRV/THRC,,,859.5,1719.0,8
CPT,62326,NJX INTERLAMINAR LMBR/SAC,,,859.5,1719.0,8
CPT,62327,NJX INTERLAMINAR LMBR/SAC,,,859.5,1719.0,8
CPT,62328,DX LMBR SPI PNXR W/FLUOR/CT,,,685.95,1371.9,8
CPT,62329,THER SPI PNXR CSF FLUOR/CT,,,685.95,1371.9,8
CPT,62350,IMPLANT SPINAL CANAL CATH,,,8528.03,17056.06,8
CPT,62351,IMPLANT SPINAL CANAL CATH,,,7051.31,14102.62,8
CPT,62355,REMOVE SPINAL CANAL CATHETER,,,1897.58,3795.16,8
CPT,62360,INSERT SPINE INFUSION DEVICE,,,17514.89,35029.78,8
CPT,62361,IMPLANT SPINE INFUSION PUMP,,,17514.89,35029.78,8
CPT,62362,IMPLANT SPINE INFUSION PUMP,,,17514.89,35029.78,8
CPT,62365,REMOVE SPINE INFUSION DEVICE,,,3319.68,6639.36,8
CPT,62367,ANALYZE SPINE INFUS PUMP,,,298.46,596.92,8
CPT,62368,ANALYZE SP INF PUMP W/REPROG,,,298.46,596.92,8
CPT,62369,ANAL SP INF PMP W/REPRG&FILL,,,298.46,596.92,8
CPT,62370,ANL SP INF PMP W/MDREPRG&FIL,,,298.46,596.92,8
CPT,62380,NDSC DCMPRN 1 NTRSPC LUMBAR,,,7051.31,14102.62,8
CPT,623T,AUTO QUANTIFICATION C PLAQUE,,,,,0
CPT,624T,AUTO QUAN C PLAQ DATA PREP,,,,,0
CPT,625,ANES SPINE TRANTHOR W/O VENT,,,,,0
CPT,625T,AUTO QUAN C PLAQ CPTR ALYS,,,,,0
CPT,626,ANES SPINE TRANSTHOR W/VENT,,,,,0
CPT,626T,AUTO QUAN C PLAQ I&R,,,,,0
CPT,627T,PERQ NJX ALGC FLUOR LMBR 1ST,,,12476.14,24952.28,8
CPT,628T,PERQ NJX ALGC FLUOR LMBR EA,,,,,0
CPT,629T,PERQ NJX ALGC CT LMBR 1ST,,,12476.14,24952.28,8
CPT,62U,AI SLE IGG&IGM ALYS 80 BMRK,,,380.72,761.44,8
CPT,630,ANESTH SPINE CORD SURGERY,,,,,0
CPT,63001,REMOVE SPINE LAMINA 1/2 CRVL,,,7051.31,14102.62,8
CPT,63003,REMOVE SPINE LAMINA 1/2 THRC,,,7051.31,14102.62,8
CPT,63005,REMOVE SPINE LAMINA 1/2 LMBR,,,7051.31,14102.62,8
CPT,63011,REMOVE SPINE LAMINA 1/2 SCRL,,,7051.31,14102.62,8
CPT,63012,REMOVE LAMINA/FACETS LUMBAR,,,7051.31,14102.62,8
CPT,63015,REMOVE SPINE LAMINA >2 CRVCL,,,7051.31,14102.62,8
CPT,63016,REMOVE SPINE LAMINA >2 THRC,,,7051.31,14102.62,8
CPT,63017,REMOVE SPINE LAMINA >2 LMBR,,,7051.31,14102.62,8
CPT,63020,NECK SPINE DISK SURGERY,,,7051.31,14102.62,8
CPT,63030,LOW BACK DISK SURGERY,,,7051.31,14102.62,8
CPT,63035,SPINAL DISK SURGERY ADD-ON,,,,,0
CPT,63040,LAMINOTOMY SINGLE CERVICAL,,,7051.31,14102.62,8
CPT,63042,LAMINOTOMY SINGLE LUMBAR,,,7051.31,14102.62,8
CPT,63043,LAMINOTOMY ADDL CERVICAL,,,,,0
CPT,63044,LAMINOTOMY ADDL LUMBAR,,,,,0
CPT,63045,LAM FACETEC & FORAMOT CRV,,,7051.31,14102.62,8
CPT,63046,LAM FACETEC & FORAMOT THRC,,,7051.31,14102.62,8
CPT,63047,LAM FACETEC & FORAMOT LUMBAR,,,7051.31,14102.62,8
CPT,63048,LAM FACETEC &FORAMOT EA ADDL,,,,,0
CPT,63050,CERVICAL LAMINOPLSTY 2/> SEG,,,,,0
CPT,63051,C-LAMINOPLASTY W/GRAFT/PLATE,,,,,0
CPT,63052,LAM FACETC/FRMT ARTHRD LUM 1,,,,,0
CPT,63053,LAM FACTC/FRMT ARTHRD LUM EA,,,,,0
CPT,63055,DECOMPRESS SPINAL CORD THRC,,,7051.31,14102.62,8
CPT,63056,DECOMPRESS SPINAL CORD LMBR,,,7051.31,14102.62,8
CPT,63057,DECOMPRESS SPINE CORD ADD-ON,,,,,0
CPT,63064,DECOMPRESS SPINAL CORD THRC,,,7051.31,14102.62,8
CPT,63066,DECOMPRESS SPINE CORD ADD-ON,,,,,0
CPT,63075,NECK SPINE DISK SURGERY,,,7051.31,14102.62,8
CPT,63076,NECK SPINE DISK SURGERY,,,,,0
CPT,63077,SPINE DISK SURGERY THORAX,,,,,0
CPT,63078,SPINE DISK SURGERY THORAX,,,,,0
CPT,63081,REMOVE VERT BODY DCMPRN CRVL,,,,,0
CPT,63082,REMOVE VERTEBRAL BODY ADD-ON,,,,,0
CPT,63085,REMOVE VERT BODY DCMPRN THRC,,,,,0
CPT,63086,REMOVE VERTEBRAL BODY ADD-ON,,,,,0
CPT,63087,REMOV VERTBR DCMPRN THRCLMBR,,,,,0
CPT,63088,REMOVE VERTEBRAL BODY ADD-ON,,,,,0
CPT,63090,REMOVE VERT BODY DCMPRN LMBR,,,,,0
CPT,63091,REMOVE VERTEBRAL BODY ADD-ON,,,,,0
CPT,630T,PERQ NJX ALGC CT LMBR EA,,,,,0
CPT,63101,REMOVE VERT BODY DCMPRN THRC,,,,,0
CPT,63102,REMOVE VERT BODY DCMPRN LMBR,,,,,0
CPT,63103,REMOVE VERTEBRAL BODY ADD-ON,,,,,0
CPT,63170,INCISE SPINAL CORD TRACT(S),,,,,0
CPT,63172,DRAINAGE OF SPINAL CYST,,,,,0
CPT,63173,DRAINAGE OF SPINAL CYST,,,,,0
CPT,63185,INCISE SPINE NRV HALF SEGMNT,,,,,0
CPT,63190,INCISE SPINE NRV >2 SEGMNTS,,,,,0
CPT,63191,INCISE SPINE ACCESSORY NERVE,,,,,0
CPT,63197,LAM W/CORDOTOMY 1STG THRC,,,,,0
CPT,631T,TC VIS LIT HYPERSPECTRAL IMG,,,,,0
CPT,632,ANESTH REMOVAL OF NERVES,,,,,0
CPT,63200,RELEASE SPINAL CORD LUMBAR,,,,,0
CPT,63250,REVISE SPINAL CORD VSLS CRVL,,,,,0
CPT,63251,REVISE SPINAL CORD VSLS THRC,,,,,0
CPT,63252,REVISE SPINE CORD VSL THRLMB,,,,,0
CPT,63265,EXCISE INTRASPINL LESION CRV,,,7051.31,14102.62,8
CPT,63266,EXCISE INTRSPINL LESION THRC,,,7051.31,14102.62,8
CPT,63267,EXCISE INTRSPINL LESION LMBR,,,7051.31,14102.62,8
CPT,63268,EXCISE INTRSPINL LESION SCRL,,,7051.31,14102.62,8
CPT,63270,EXCISE INTRSPINL LESION CRVL,,,,,0
CPT,63271,EXCISE INTRSPINL LESION THRC,,,,,0
CPT,63272,EXCISE INTRSPINL LESION LMBR,,,,,0
CPT,63273,EXCISE INTRSPINL LESION SCRL,,,,,0
CPT,63275,BX/EXC XDRL SPINE LESN CRVL,,,,,0
CPT,63276,BX/EXC XDRL SPINE LESN THRC,,,,,0
CPT,63277,BX/EXC XDRL SPINE LESN LMBR,,,,,0
CPT,63278,BX/EXC XDRL SPINE LESN SCRL,,,,,0
CPT,63280,BX/EXC IDRL SPINE LESN CRVL,,,,,0
CPT,63281,BX/EXC IDRL SPINE LESN THRC,,,,,0
CPT,63282,BX/EXC IDRL SPINE LESN LMBR,,,,,0
CPT,63283,BX/EXC IDRL SPINE LESN SCRL,,,,,0
CPT,63285,BX/EXC IDRL IMED LESN CERVL,,,,,0
CPT,63286,BX/EXC IDRL IMED LESN THRC,,,,,0
CPT,63287,BX/EXC IDRL IMED LESN THRLMB,,,,,0
CPT,63290,BX/EXC XDRL/IDRL LSN ANY LVL,,,,,0
CPT,63295,REPAIR LAMINECTOMY DEFECT,,,,,0
CPT,632T,PERQ TCAT US ABLTJ NRV P-ART,,,17813.98,35627.96,8
CPT,63300,REMOVE VERT XDRL BODY CRVCL,,,,,0
CPT,63301,REMOVE VERT XDRL BODY THRC,,,,,0
CPT,63302,REMOVE VERT XDRL BODY THRLMB,,,,,0
CPT,63303,REMOV VERT XDRL BDY LMBR/SAC,,,,,0
CPT,63304,REMOVE VERT IDRL BODY CRVCL,,,,,0
CPT,63305,REMOVE VERT IDRL BODY THRC,,,,,0
CPT,63306,REMOV VERT IDRL BDY THRCLMBR,,,,,0
CPT,63307,REMOV VERT IDRL BDY LMBR/SAC,,,,,0
CPT,63308,REMOVE VERTEBRAL BODY ADD-ON,,,,,0
CPT,633T,CT BREAST W/3D UNI C-,,,101.59,203.18,8
CPT,634T,CT BREAST W/3D UNI C+,,,170.45,340.9,8
CPT,635,ANESTH LUMBAR PUNCTURE,,,,,0
CPT,635T,CT BREAST W/3D UNI C-/C+,,,170.45,340.9,8
CPT,63600,REMOVE SPINAL CORD LESION,,,1897.58,3795.16,8
CPT,63610,STIMULATION OF SPINAL CORD,,,1897.58,3795.16,8
CPT,63620,SRS SPINAL LESION,,,,,0
CPT,63621,SRS SPINAL LESION ADDL,,,,,0
CPT,63650,IMPLANT NEUROELECTRODES,,,6193.03,12386.06,8
CPT,63655,IMPLANT NEUROELECTRODES,,,18852.29,37704.58,8
CPT,63661,REMOVE SPINE ELTRD PERQ ARAY,,,1897.58,3795.16,8
CPT,63662,REMOVE SPINE ELTRD PLATE,,,3397.38,6794.76,8
CPT,63663,REVISE SPINE ELTRD PERQ ARAY,,,6193.03,12386.06,8
CPT,63664,REVISE SPINE ELTRD PLATE,,,10828.04,21656.08,8
CPT,63685,INS/RPLC SPI NPG/RCVR POCKET,,,29986.33,59972.66,8
CPT,63688,REV/RMV IMP SP NPG/R DTCH CN,,,3397.38,6794.76,8
CPT,636T,CT BREAST W/3D BI C-,,,231.86,463.72,8
CPT,63700,REPAIR OF SPINAL HERNIATION,,,,,0
CPT,63702,REPAIR OF SPINAL HERNIATION,,,,,0
CPT,63704,REPAIR OF SPINAL HERNIATION,,,,,0
CPT,63706,REPAIR OF SPINAL HERNIATION,,,,,0
CPT,63707,REPAIR SPINAL FLUID LEAKAGE,,,,,0
CPT,63709,REPAIR SPINAL FLUID LEAKAGE,,,,,0
CPT,63710,GRAFT REPAIR OF SPINE DEFECT,,,,,0
CPT,63740,INSTALL SPINAL SHUNT,,,,,0
CPT,63741,INSTALL SPINAL SHUNT,,,8528.03,17056.06,8
CPT,63744,REVISION OF SPINAL SHUNT,,,3319.68,6639.36,8
CPT,63746,REMOVAL OF SPINAL SHUNT,,,1897.58,3795.16,8
CPT,637T,CT BREAST W/3D BI C+,,,339.02,678.04,8
CPT,638T,CT BREAST W/3D BI C-/C+,,,339.02,678.04,8
CPT,639T,WRLS SKN SNR ANISOTROPY MEAS,,,,,0
CPT,63U,NEURO AUTISM 32 AMINES ALG,,,750.0,1500.0,8
CPT,640,ANESTH SPINE MANIPULATION,,,,,0
CPT,640T,NCNTC IFR SPCTRSC O/T PAD 1,,,36.3,72.6,8
CPT,643T,TCAT L VENTR RSTRJ DEV IMPLT,,,,,0
CPT,64400,NJX AA&/STRD TRIGEMINAL NRV,,,298.28,596.56,8
CPT,64405,NJX AA&/STRD GR OCPL NRV,,,298.28,596.56,8
CPT,64408,NJX AA&/STRD VAGUS NRV,,,298.28,596.56,8
CPT,64415,BRACHEAL PLEXIS BLOCK,2616.0,1308.0,455.7,2537.52,53
CPT,64415,INFRA SUPRA NERVE BLOCK,1037.0,518.5,180.64,1719.0,53
CPT,64415,INJ ANES NERVE INFRA/SUPRA CON,1857.0,928.5,323.48,1801.29,53
CPT,64415,INTERSCALENE NERVE BLOCK,1037.0,518.5,180.64,1719.0,53
CPT,64415,NJX AA&/STRD BRCH PLXS IMG,,,,,0
CPT,64416,INJ ANES NERVE BRACHEAL CONT,3398.0,1699.0,591.93,3296.06,53
CPT,64416,INJ ANES NERVE INTERSCALE CONT,1857.0,928.5,323.48,1801.29,53
CPT,64416,NJX AA&/STRD BRCH PL NFS IMG,,,,,0
CPT,64417,AXILLARY NERVE BLOCK,2616.0,1308.0,455.7,2537.52,53
CPT,64417,INJ ANES NERVE AXILLARY CONT,1601.0,800.5,278.89,1719.0,53
CPT,64417,NJX AA&/STRD AX NERVE IMG,,,,,0
CPT,64418,NJX AA&/STRD SPRSCAP NRV,,,685.95,1371.9,8
CPT,64420,NJX AA&/STRD NTRCOST NRV 1,,,685.95,1371.9,8
CPT,64421,NJX AA&/STRD NTRCOST NRV EA,,,859.5,1719.0,8
CPT,64425,NJX AA&/STRD II IH NERVES,,,685.95,1371.9,8
CPT,64430,NJX AA&/STRD PUDENDAL NERVE,,,859.5,1719.0,8
CPT,64435,NJX AA&/STRD PARACRV NRV,,,685.95,1371.9,8
CPT,64445,NJX AA&/STRD SCIATIC NRV IMG,,,,,0
CPT,64445,SCIATIC NERVE BLOCK,2027.0,1013.5,353.1,1966.19,53
CPT,64446,INJ ANES NERVE SCIATIC CONT,3398.0,1699.0,591.93,3296.06,53
CPT,64446,NJX AA&/STRD SC NRV NFS IMG,,,,,0
CPT,64447,ADDUCTOR CANAL NERVE BLOCK,1037.0,518.5,180.64,1371.9,53
CPT,64447,FEMORAL NERVE BLOCK SINGLE,2558.0,1279.0,445.6,2481.26,53
CPT,64447,NJX AA&/STRD FEMORAL NRV IMG,,,,,0
CPT,64448,ADDUCTOR CANAL NERVE BLOCK CONT,1728.0,864.0,301.01,1719.0,53
CPT,64448,INJ ANES NERVE FEMORAL CONT,3398.0,1699.0,591.93,3296.06,53
CPT,64448,NJX AA&/STRD FEM NRV NFS IMG,,,,,0
CPT,64449,INJ ANES NERVE LUMB PLEXIS CON,1857.0,928.5,323.48,1801.29,53
CPT,64449,LUMBAR PLEXIS BLOCK,1037.0,518.5,180.64,1719.0,53
CPT,64449,NJX AA&/STRD LMBR PLEX NFS,,,,,0
CPT,64450,ANKLE NERVE BLOCK,1018.0,509.0,177.33,1371.9,53
CPT,64450,INJ ANES NERVE POPLITEAL CONT,1857.0,928.5,323.48,1801.29,53
CPT,64450,INJ ANES NERVE SAPHENOUS CONT,1728.0,864.0,301.01,1676.16,53
CPT,64450,NERVE BLOCK OTHER,984.0,492.0,171.41,1371.9,53
CPT,64450,NERVE BLOCK OTHER CONT,1538.0,769.0,267.91,1491.86,53
CPT,64450,NJX AA&/STRD OTHER PN/BRANCH,,,,,0
CPT,64450,POPLITEAL NERVE BLOCK,2027.0,1013.5,353.1,1966.19,53
CPT,64450,SAPHENOUS NERVE BLOCK,1037.0,518.5,180.64,1371.9,53
CPT,64451,NJX AA&/STRD NRV NRVTG SI JT,,,685.95,1371.9,8
CPT,64454,KNEE NERVE BLOCK,2027.0,1013.5,353.1,1966.19,53
CPT,64454,KNEE NERVE BLOCK CONT,1857.0,928.5,323.48,1801.29,53
CPT,64454,NJX AA&/STRD GNCLR NRV BRNCH,,,,,0
CPT,64455,NJX AA&/STRD PLTR COM DG NRV,,,298.28,596.56,8
CPT,64461,PVB THORACIC SINGLE INJ SITE,,,685.95,1371.9,8
CPT,64462,PVB THORACIC 2ND+ INJ SITE,,,,,0
CPT,64463,PVB THORACIC CONT INFUSION,,,685.95,1371.9,8
CPT,64466,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,1640.0,820.0,285.68,1590.8,46
CPT,64466,"Thoracic fascial plane block, unilateral; by injection(s), including imaging guidance, when performed",,,,,0
CPT,64467,"Thoracic fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed",,,,,0
CPT,64468,THORACIC FASCIAL PLANE BLOCK BI INJECTION,1640.0,820.0,285.68,1590.8,46
CPT,64468,"Thoracic fascial plane block, bilateral; by injection(s), including imaging guidance, when performed",,,,,0
CPT,64469,"Thoracic fascial plane block, bilateral; by continuous infusion(s), including imaging guidance, when performed",,,,,0
CPT,64473,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,2027.0,1013.5,353.1,1966.19,46
CPT,64473,"Lower extremity fascial plane block, unilateral; by injection(s), including imaging guidance, when performed",,,,,0
CPT,64474,"Lower extremity fascial plane block, unilateral; by continuous infusion(s), including imaging guidance, when performed",,,,,0
CPT,64479,EPIDURA NERVE BLOCK THORA/CERV,1545.0,772.5,269.13,1719.0,53
CPT,64479,NJX AA&/STRD TFRM EPI C/T 1,,,,,0
CPT,64480,NJX AA&/STRD TFRM EPI C/T EA,,,,,0
CPT,64483,NJX AA&/STRD TFRM EPI L/S 1,,,859.5,1719.0,8
CPT,64484,NJX AA&/STRD TFRM EPI L/S EA,,,,,0
CPT,64486,TAP BLOCK UNIL BY INJECTION,,,,,0
CPT,64487,TAP BLOCK UNI BY INFUSION,,,,,0
CPT,64488,TAP BLOCK BI INJECTION,,,,,0
CPT,64489,TAP BLOCK BI BY INFUSION,,,,,0
CPT,64490,INJ PARAVERT F JNT C/T 1 LEV,,,859.5,1719.0,8
CPT,64491,INJ PARAVERT F JNT C/T 2 LEV,,,,,0
CPT,64492,INJ PARAVERT F JNT C/T 3 LEV,,,,,0
CPT,64493,INJ PARAVERT F JNT L/S 1 LEV,,,859.5,1719.0,8
CPT,64494,INJ PARAVERT F JNT L/S 2 LEV,,,,,0
CPT,64495,INJ PARAVERT F JNT L/S 3 LEV,,,,,0
CPT,644T,TCAT RMVL/DBLK ICAR MAS PERQ,,,5530.84,11061.68,8
CPT,64505,N BLOCK SPENOPALATINE GANGL,,,298.28,596.56,8
CPT,64510,N BLOCK STELLATE GANGLION,,,859.5,1719.0,8
CPT,64517,N BLOCK INJ HYPOGAS PLXS,,,859.5,1719.0,8
CPT,64520,N BLOCK LUMBAR/THORACIC,,,859.5,1719.0,8
CPT,64530,N BLOCK INJ CELIAC PELUS,,,859.5,1719.0,8
CPT,64553,IMPLANT NEUROELECTRODES,,,10828.04,21656.08,8
CPT,64555,IMPLANT NEUROELECTRODES,,,6193.03,12386.06,8
CPT,64561,IMPLANT NEUROELECTRODES,,,6193.03,12386.06,8
CPT,64566,NEUROELTRD STIM POST TIBIAL,,,298.28,596.56,8
CPT,64568,OPN IMPLTJ CRNL NRV NEA&PG,,,42802.68,85605.36,8
CPT,64569,REVISE/REPL VAGUS N ELTRD,,,10828.04,21656.08,8
CPT,64570,REMOVE VAGUS N ELTRD,,,3319.68,6639.36,8
CPT,64575,OPN IMPLTJ NEA PERPH NERVE,,,10828.04,21656.08,8
CPT,64580,OPN IMPLTJ NEA NEUROMUSCULAR,,,18852.29,37704.58,8
CPT,64581,OPN IMPLTJ NEA SACRAL NERVE,,,6193.03,12386.06,8
CPT,64582,OPN MPLTJ HPGLSL NSTM ARY PG,,,29986.33,59972.66,8
CPT,64583,REV/RPLCT HPGLSL NSTM ARY PG,,,10828.04,21656.08,8
CPT,64584,RMVL HPGLSL NSTIM ARY PG,,,3319.68,6639.36,8
CPT,64585,REV/RMV PERPH NSTIM ELTRD RA,,,3397.38,6794.76,8
CPT,64590,INS/RPL PRPH SAC/GSTR NPG/R,,,18852.29,37704.58,8
CPT,64595,REV/RMV PRPH SAC/GSTR NPG/R,,,3397.38,6794.76,8
CPT,64596,INS/RPLCMT PRQ ELTRD RA PN 1,,,10828.04,21656.08,8
CPT,64597,INS/RPLCM PRQ ELTRD RA PN EA,,,,,0
CPT,64598,REVJ/RMVL NEA PN W/INT NSTIM,,,3397.38,6794.76,8
CPT,645T,TCAT IMPLTJ C SINS RDCTJ DEV,,,17813.98,35627.96,8
CPT,64600,INJECTION TREATMENT OF NERVE,,,859.5,1719.0,8
CPT,64605,INJECTION TREATMENT OF NERVE,,,1897.58,3795.16,8
CPT,64610,INJECTION TREATMENT OF NERVE,,,1897.58,3795.16,8
CPT,64611,CHEMODENERV SALIV GLANDS,,,298.28,596.56,8
CPT,64612,DESTROY NERVE FACE MUSCLE,,,298.28,596.56,8
CPT,64615,CHEMODENERV MUSC MIGRAINE,,,298.28,596.56,8
CPT,64616,CHEMODENERV MUSC NECK DYSTON,,,298.28,596.56,8
CPT,64617,CHEMODENER MUSCLE LARYNX EMG,,,685.95,1371.9,8
CPT,64620,INJECTION TREATMENT OF NERVE,,,859.5,1719.0,8
CPT,64624,DSTRJ NULYT AGT GNCLR NRV,,,1897.58,3795.16,8
CPT,64625,RF ABLTJ NRV NRVTG SI JT,,,1897.58,3795.16,8
CPT,64628,TRML DSTRJ IOS BVN 1ST 2 L/S,,,12476.14,24952.28,8
CPT,64629,TRML DSTRJ IOS BVN EA ADDL,,,,,0
CPT,64630,INJECTION TREATMENT OF NERVE,,,859.5,1719.0,8
CPT,64632,N BLOCK INJ COMMON DIGIT,,,298.28,596.56,8
CPT,64633,DESTROY CERV/THOR FACET JNT,,,1897.58,3795.16,8
CPT,64634,DESTROY C/TH FACET JNT ADDL,,,,,0
CPT,64635,DESTROY LUMB/SAC FACET JNT,,,1897.58,3795.16,8
CPT,64636,DESTROY L/S FACET JNT ADDL,,,,,0
CPT,64640,INJECTION TREATMENT OF NERVE,,,859.5,1719.0,8
CPT,64642,CHEMODENERV 1 EXTREMITY 1-4,,,685.95,1371.9,8
CPT,64643,CHEMODENERV 1 EXTREM 1-4 EA,,,,,0
CPT,64644,CHEMODENERV 1 EXTREM 5/> MUS,,,685.95,1371.9,8
CPT,64645,CHEMODENERV 1 EXTREM 5/> EA,,,,,0
CPT,64646,CHEMODENERV TRUNK MUSC 1-5,,,685.95,1371.9,8
CPT,64647,CHEMODENERV TRUNK MUSC 6/>,,,685.95,1371.9,8
CPT,64650,CHEMODENERV ECCRINE GLANDS,,,298.28,596.56,8
CPT,64653,CHEMODENERV ECCRINE GLANDS,,,298.28,596.56,8
CPT,64680,INJECTION TREATMENT OF NERVE,,,859.5,1719.0,8
CPT,64681,INJECTION TREATMENT OF NERVE,,,859.5,1719.0,8
CPT,646T,TTVI/RPLCMT W/PRSTC VLV PERQ,,,,,0
CPT,64702,REVISE FINGER/TOE NERVE,,,1897.58,3795.16,8
CPT,64704,REVISE HAND/FOOT NERVE,,,1897.58,3795.16,8
CPT,64708,REVISE ARM/LEG NERVE,,,1897.58,3795.16,8
CPT,64712,REVISION OF SCIATIC NERVE,,,1897.58,3795.16,8
CPT,64713,REVISION OF ARM NERVE(S),,,1897.58,3795.16,8
CPT,64714,REVISE LOW BACK NERVE(S),,,1897.58,3795.16,8
CPT,64716,REVISION OF CRANIAL NERVE,,,1897.58,3795.16,8
CPT,64718,REVISE ULNAR NERVE AT ELBOW,,,1897.58,3795.16,8
CPT,64719,REVISE ULNAR NERVE AT WRIST,,,1897.58,3795.16,8
CPT,64721,CARPAL TUNNEL SURGERY,,,1897.58,3795.16,8
CPT,64722,RELIEVE PRESSURE ON NERVE(S),,,1897.58,3795.16,8
CPT,64726,RELEASE FOOT/TOE NERVE,,,1897.58,3795.16,8
CPT,64727,INTERNAL NERVE REVISION,,,,,0
CPT,64732,INCISION OF BROW NERVE,,,1897.58,3795.16,8
CPT,64734,INCISION OF CHEEK NERVE,,,1897.58,3795.16,8
CPT,64736,INCISION OF CHIN NERVE,,,1897.58,3795.16,8
CPT,64738,INCISION OF JAW NERVE,,,1897.58,3795.16,8
CPT,64740,INCISION OF TONGUE NERVE,,,1897.58,3795.16,8
CPT,64742,INCISION OF FACIAL NERVE,,,1897.58,3795.16,8
CPT,64744,INCISE NERVE BACK OF HEAD,,,1897.58,3795.16,8
CPT,64746,INCISE DIAPHRAGM NERVE,,,1897.58,3795.16,8
CPT,64755,INCISION OF STOMACH NERVES,,,,,0
CPT,64760,INCISION OF VAGUS NERVE,,,,,0
CPT,64763,INCISE HIP/THIGH NERVE,,,1897.58,3795.16,8
CPT,64766,INCISE HIP/THIGH NERVE,,,1897.58,3795.16,8
CPT,64771,SEVER CRANIAL NERVE,,,1897.58,3795.16,8
CPT,64772,INCISION OF SPINAL NERVE,,,1897.58,3795.16,8
CPT,64774,REMOVE SKIN NERVE LESION,,,1897.58,3795.16,8
CPT,64776,REMOVE DIGIT NERVE LESION,,,1897.58,3795.16,8
CPT,64778,DIGIT NERVE SURGERY ADD-ON,,,,,0
CPT,64782,REMOVE LIMB NERVE LESION,,,1897.58,3795.16,8
CPT,64783,LIMB NERVE SURGERY ADD-ON,,,,,0
CPT,64784,REMOVE NERVE LESION,,,1897.58,3795.16,8
CPT,64786,REMOVE SCIATIC NERVE LESION,,,3319.68,6639.36,8
CPT,64787,IMPLANT NERVE END,,,,,0
CPT,64788,REMOVE SKIN NERVE LESION,,,1897.58,3795.16,8
CPT,64790,REMOVAL OF NERVE LESION,,,1897.58,3795.16,8
CPT,64792,REMOVAL OF NERVE LESION,,,3319.68,6639.36,8
CPT,64795,BIOPSY OF NERVE,,,1897.58,3795.16,8
CPT,647T,INSJ GTUBE PERQ MAG GASTRPXY,,,1864.72,3729.44,8
CPT,64802,SYMPATHECTOMY CERVICAL,,,1897.58,3795.16,8
CPT,64804,REMOVE SYMPATHETIC NERVES,,,1897.58,3795.16,8
CPT,64809,REMOVE SYMPATHETIC NERVES,,,,,0
CPT,64818,REMOVE SYMPATHETIC NERVES,,,,,0
CPT,64820,SYMPATHECTOMY DIGITAL ARTERY,,,1897.58,3795.16,8
CPT,64821,REMOVE SYMPATHETIC NERVES,,,3179.6,6359.2,8
CPT,64822,REMOVE SYMPATHETIC NERVES,,,3179.6,6359.2,8
CPT,64823,SYMPATHECTOMY SUPFC PALMAR,,,3179.6,6359.2,8
CPT,64831,REPAIR OF DIGIT NERVE,,,1897.58,3795.16,8
CPT,64832,REPAIR NERVE ADD-ON,,,,,0
CPT,64834,REPAIR OF HAND OR FOOT NERVE,,,3319.68,6639.36,8
CPT,64835,REPAIR OF HAND OR FOOT NERVE,,,3319.68,6639.36,8
CPT,64836,REPAIR OF HAND OR FOOT NERVE,,,3319.68,6639.36,8
CPT,64837,REPAIR NERVE ADD-ON,,,,,0
CPT,64840,REPAIR OF LEG NERVE,,,8528.03,17056.06,8
CPT,64856,REPAIR/TRANSPOSE NERVE,,,8528.03,17056.06,8
CPT,64857,REPAIR ARM/LEG NERVE,,,3319.68,6639.36,8
CPT,64858,REPAIR SCIATIC NERVE,,,1897.58,3795.16,8
CPT,64859,NERVE SURGERY,,,,,0
CPT,64861,REPAIR OF ARM NERVES,,,1897.58,3795.16,8
CPT,64862,REPAIR OF LOW BACK NERVES,,,3319.68,6639.36,8
CPT,64864,REPAIR OF FACIAL NERVE,,,8528.03,17056.06,8
CPT,64865,REPAIR OF FACIAL NERVE,,,3319.68,6639.36,8
CPT,64866,FUSION OF FACIAL/OTHER NERVE,,,,,0
CPT,64868,FUSION OF FACIAL/OTHER NERVE,,,,,0
CPT,64872,SUBSEQUENT REPAIR OF NERVE,,,,,0
CPT,64874,REPAIR & REVISE NERVE ADD-ON,,,,,0
CPT,64876,REPAIR NERVE/SHORTEN BONE,,,,,0
CPT,64885,NERVE GRAFT HEAD/NECK <4 CM,,,8528.03,17056.06,8
CPT,64886,NERVE GRAFT HEAD/NECK >4 CM,,,8528.03,17056.06,8
CPT,64890,NRV GRF 1STRND HND/FOOT <4CM,,,8528.03,17056.06,8
CPT,64891,NRV GRF 1STRND HND/FOOT >4CM,,,8528.03,17056.06,8
CPT,64892,NRV GRF 1STRND ARM/LEG <4CM,,,8528.03,17056.06,8
CPT,64893,NRV GRF 1STRND ARM/LEG >4 CM,,,3319.68,6639.36,8
CPT,64895,NRV GRF MLTST HND/FOOT <4 CM,,,8528.03,17056.06,8
CPT,64896,NRV GRF MLTST HND/FOOT >4 CM,,,8528.03,17056.06,8
CPT,64897,NRV GRF MLTST ARM/LEG <4 CM,,,8528.03,17056.06,8
CPT,64898,NRV GRF MLTST ARM/LEG >4 CM,,,8528.03,17056.06,8
CPT,648T,QUAN MR TIS WO MRI 1ORGN,,,904.08,1808.16,8
CPT,64901,NERVE GRAFT ADD-ON,,,,,0
CPT,64902,NERVE GRAFT ADD-ON,,,,,0
CPT,64905,NERVE PEDICLE TRANSFER,,,8528.03,17056.06,8
CPT,64907,NERVE PEDICLE TRANSFER,,,8528.03,17056.06,8
CPT,64910,NERVE REPAIR W/ALLOGRAFT,,,8528.03,17056.06,8
CPT,64911,NEURORRAPHY W/VEIN AUTOGRAFT,,,8528.03,17056.06,8
CPT,64912,NRV RPR W/NRV ALGRFT 1ST,,,8528.03,17056.06,8
CPT,64913,NRV RPR W/NRV ALGRFT EA ADDL,,,,,0
CPT,64999,CERV PLEXUS NERVE BLOCK,1046.0,523.0,182.21,1014.62,53
CPT,64999,PECTORALIS PLANE BLOCK,1640.0,820.0,285.68,1590.8,53
CPT,64999,PECTORALIS PLANE BLOCK CONT,2381.0,1190.5,298.28,2309.57,53
CPT,64999,SERRATUS PLANE BLOCK,1304.0,652.0,227.15,1264.88,53
CPT,64999,SERRATUS PLANE BLOCK CONT,1891.0,945.5,298.28,1834.27,53
CPT,64999,UNLISTED PX NERVOUS SYSTEM,,,,,0
CPT,649T,QUAN MR TISS W/MRI 1ORGN,,,904.08,1808.16,8
CPT,64U,ANTB TP TOTAL&RPR IA QUAL,,,31.33,62.66,8
CPT,65091,REVISE EYE,,,3820.38,7640.76,8
CPT,65093,REVISE EYE WITH IMPLANT,,,3820.38,7640.76,8
CPT,650T,PRGRMG DEV EVAL SCRMS REMOTE,,,36.27,72.54,8
CPT,65101,REMOVAL OF EYE,,,3820.38,7640.76,8
CPT,65103,REMOVE EYE/INSERT IMPLANT,,,3820.38,7640.76,8
CPT,65105,REMOVE EYE/ATTACH IMPLANT,,,3820.38,7640.76,8
CPT,65110,REMOVAL OF EYE,,,3820.38,7640.76,8
CPT,65112,REMOVE EYE/REVISE SOCKET,,,3820.38,7640.76,8
CPT,65114,REMOVE EYE/REVISE SOCKET,,,3820.38,7640.76,8
CPT,65125,REVISE OCULAR IMPLANT,,,2310.35,4620.7,8
CPT,65130,INSERT OCULAR IMPLANT,,,3820.38,7640.76,8
CPT,65135,INSERT OCULAR IMPLANT,,,3820.38,7640.76,8
CPT,65140,ATTACH OCULAR IMPLANT,,,3820.38,7640.76,8
CPT,65150,REVISE OCULAR IMPLANT,,,3820.38,7640.76,8
CPT,65155,REINSERT OCULAR IMPLANT,,,3820.38,7640.76,8
CPT,65175,REMOVAL OF OCULAR IMPLANT,,,3820.38,7640.76,8
CPT,651T,MAG CTRLD CAPSULE ENDOSCOPY,,,881.37,1762.74,8
CPT,65205,REMOVE FOREIGN BODY FROM EYE,,,129.29,258.58,8
CPT,65210,REMOVE FOREIGN BODY FROM EYE,,,434.11,868.22,8
CPT,65220,REMOVE FOREIGN BODY FROM EYE,,,434.11,868.22,8
CPT,65222,REMOVE FOREIGN BODY FROM EYE,,,129.29,258.58,8
CPT,65235,REMOVE FOREIGN BODY FROM EYE,,,2242.65,4485.3,8
CPT,65260,REMOVE FOREIGN BODY FROM EYE,,,2242.65,4485.3,8
CPT,65265,REMOVE FOREIGN BODY FROM EYE,,,2242.65,4485.3,8
CPT,65270,REPAIR OF EYE WOUND,,,2310.35,4620.7,8
CPT,65272,REPAIR OF EYE WOUND,,,2310.35,4620.7,8
CPT,65273,REPAIR OF EYE WOUND,,,,,0
CPT,65275,REPAIR OF EYE WOUND,,,3820.38,7640.76,8
CPT,65280,REPAIR OF EYE WOUND,,,5171.04,10342.08,8
CPT,65285,REPAIR OF EYE WOUND,,,5171.04,10342.08,8
CPT,65286,REPAIR OF EYE WOUND,,,2242.65,4485.3,8
CPT,65290,REPAIR OF EYE SOCKET WOUND,,,3820.38,7640.76,8
CPT,652T,EGD FLX TRANSNASAL DX BR/WA,,,1864.72,3729.44,8
CPT,653T,EGD FLX TRANSNASAL BX 1/MLT,,,1864.72,3729.44,8
CPT,65400,REMOVAL OF EYE LESION,,,968.73,1937.46,8
CPT,65410,BIOPSY OF CORNEA,,,2310.35,4620.7,8
CPT,65420,REMOVAL OF EYE LESION,,,2310.35,4620.7,8
CPT,65426,REMOVAL OF EYE LESION,,,2310.35,4620.7,8
CPT,65430,CORNEAL SMEAR,,,434.11,868.22,8
CPT,65435,CURETTE/TREAT CORNEA,,,968.73,1937.46,8
CPT,65436,CURETTE/TREAT CORNEA,,,2310.35,4620.7,8
CPT,65450,TREATMENT OF CORNEAL LESION,,,308.44,616.88,8
CPT,654T,EGD FLX TRANSNASAL TUBE/CATH,,,3746.6,7493.2,8
CPT,655T,TPRNL FOCAL ABLTJ MAL PRST8,,,5210.39,10420.78,8
CPT,65600,REVISION OF CORNEA,,,2310.35,4620.7,8
CPT,656T,VRT BDY TETHERING ANT <7 SEG,,,17038.69,34077.38,8
CPT,65710,CORNEAL TRANSPLANT,,,5171.04,10342.08,8
CPT,65730,CORNEAL TRANSPLANT,,,4016.7,8033.4,8
CPT,65750,CORNEAL TRANSPLANT,,,5171.04,10342.08,8
CPT,65755,CORNEAL TRANSPLANT,,,4016.7,8033.4,8
CPT,65756,CORNEAL TRNSPL ENDOTHELIAL,,,4016.7,8033.4,8
CPT,65757,PREP CORNEAL ENDO ALLOGRAFT,,,,,0
CPT,65760,REVISION OF CORNEA,,,,,0
CPT,65765,REVISION OF CORNEA,,,,,0
CPT,65767,CORNEAL TISSUE TRANSPLANT,,,,,0
CPT,65770,REVISE CORNEA WITH IMPLANT,,,14096.48,28192.96,8
CPT,65771,RADIAL KERATOTOMY,,,,,0
CPT,65772,CORRECTION OF ASTIGMATISM,,,968.73,1937.46,8
CPT,65775,CORRECTION OF ASTIGMATISM,,,2310.35,4620.7,8
CPT,65778,COVER EYE W/MEMBRANE,,,968.73,1937.46,8
CPT,65779,COVER EYE W/MEMBRANE SUTURE,,,3820.38,7640.76,8
CPT,65780,OCULAR RECONST TRANSPLANT,,,3820.38,7640.76,8
CPT,65781,OCULAR RECONST TRANSPLANT,,,5171.04,10342.08,8
CPT,65782,OCULAR RECONST TRANSPLANT,,,3820.38,7640.76,8
CPT,65785,IMPLTJ NTRSTRML CRNL RNG SEG,,,4016.7,8033.4,8
CPT,657T,VRT BDY TETHERING ANT 8+ SEG,,,17038.69,34077.38,8
CPT,65800,DRAINAGE OF EYE,,,2242.65,4485.3,8
CPT,65810,DRAINAGE OF EYE,,,2242.65,4485.3,8
CPT,65815,DRAINAGE OF EYE,,,2242.65,4485.3,8
CPT,65820,RELIEVE INNER EYE PRESSURE,,,4016.7,8033.4,8
CPT,65850,INCISION OF EYE,,,2242.65,4485.3,8
CPT,65855,TRABECULOPLASTY LASER SURG,,,534.47,1068.94,8
CPT,65860,INCISE INNER EYE ADHESIONS,,,534.47,1068.94,8
CPT,65865,INCISE INNER EYE ADHESIONS,,,2242.65,4485.3,8
CPT,65870,INCISE INNER EYE ADHESIONS,,,2242.65,4485.3,8
CPT,65875,INCISE INNER EYE ADHESIONS,,,2242.65,4485.3,8
CPT,65880,INCISE INNER EYE ADHESIONS,,,4016.7,8033.4,8
CPT,658T,ELEC IMPD SPECTRSC 1+SKN LES,,,57.33,114.66,8
CPT,65900,REMOVE EYE LESION,,,2242.65,4485.3,8
CPT,65920,REMOVE IMPLANT OF EYE,,,2242.65,4485.3,8
CPT,65930,REMOVE BLOOD CLOT FROM EYE,,,2242.65,4485.3,8
CPT,659T,TCAT INTRA-C NFS SUPERSAT O2,,,,,0
CPT,65U,SYFLS TST NONTREPONEMAL ANTB,,,18.09,36.18,8
CPT,66020,INJECTION TREATMENT OF EYE,,,2242.65,4485.3,8
CPT,66030,INJECTION TREATMENT OF EYE,,,2242.65,4485.3,8
CPT,660T,IMPLT ANT SGM IO NBIO RX SYS,,,4016.7,8033.4,8
CPT,66130,REMOVE EYE LESION,,,2310.35,4620.7,8
CPT,66150,GLAUCOMA SURGERY,,,4016.7,8033.4,8
CPT,66155,GLAUCOMA SURGERY,,,4016.7,8033.4,8
CPT,66160,GLAUCOMA SURGERY,,,2242.65,4485.3,8
CPT,66170,GLAUCOMA SURGERY,,,2242.65,4485.3,8
CPT,66172,INCISION OF EYE,,,2242.65,4485.3,8
CPT,66174,TRLUML DIL AQ O/F CAN W/O ST,,,4016.7,8033.4,8
CPT,66175,TRLUML DIL AQ O/F CAN W/ST,,,5171.04,10342.08,8
CPT,66179,AQUEOUS SHUNT EYE W/O GRAFT,,,5171.04,10342.08,8
CPT,66180,AQUEOUS SHUNT EYE W/GRAFT,,,5171.04,10342.08,8
CPT,66183,INSERT ANT DRAINAGE DEVICE,,,4016.7,8033.4,8
CPT,66184,REVISION OF AQUEOUS SHUNT,,,2242.65,4485.3,8
CPT,66185,REVISE AQUEOUS SHUNT EYE,,,2242.65,4485.3,8
CPT,661T,RMVL&RIMPLTJ ANT SGM IMPLT,,,4016.7,8033.4,8
CPT,66225,REPAIR/GRAFT EYE LESION,,,5171.04,10342.08,8
CPT,66250,FOLLOW-UP SURGERY OF EYE,,,2310.35,4620.7,8
CPT,662T,SCALP COOL 1ST MEAS&CALBRJ,,,,,0
CPT,663T,SCALP COOL PLMT MNTR RMVL,,,,,0
CPT,664T,DON HYSTERECTOMY OPEN CDVR,,,,,0
CPT,66500,INCISION OF IRIS,,,2242.65,4485.3,8
CPT,66505,INCISION OF IRIS,,,2242.65,4485.3,8
CPT,665T,DON HYSTERECTOMY OPEN LIV,,,,,0
CPT,66600,REMOVE IRIS AND LESION,,,4016.7,8033.4,8
CPT,66605,REMOVAL OF IRIS,,,2242.65,4485.3,8
CPT,66625,REMOVAL OF IRIS,,,2242.65,4485.3,8
CPT,66630,REMOVAL OF IRIS,,,2242.65,4485.3,8
CPT,66635,REMOVAL OF IRIS,,,2242.65,4485.3,8
CPT,66680,REPAIR IRIS & CILIARY BODY,,,2242.65,4485.3,8
CPT,66682,REPAIR IRIS & CILIARY BODY,,,2242.65,4485.3,8
CPT,66683,"Implantation of iris prosthesis, including suture fixation and repair or removal of iris, when performed",,,15996.0,31992.0,8
CPT,666T,DON HYSTERECTOMY LAPS LIV,,,,,0
CPT,66700,DESTRUCTION CILIARY BODY,,,2242.65,4485.3,8
CPT,66710,CILIARY TRANSSLERAL THERAPY,,,2310.35,4620.7,8
CPT,66711,ECP CILIARY BODY DESTRUCTION,,,2242.65,4485.3,8
CPT,66720,DESTRUCTION CILIARY BODY,,,2310.35,4620.7,8
CPT,66740,DESTRUCTION CILIARY BODY,,,2310.35,4620.7,8
CPT,66761,REVISION OF IRIS,,,534.47,1068.94,8
CPT,66762,REVISION OF IRIS,,,534.47,1068.94,8
CPT,66770,REMOVAL OF INNER EYE LESION,,,534.47,1068.94,8
CPT,667T,DON HYSTERECTOMY RCP UTER,,,,,0
CPT,66820,INCISION SECONDARY CATARACT,,,2242.65,4485.3,8
CPT,66821,AFTER CATARACT LASER SURGERY,,,534.47,1068.94,8
CPT,66825,REPOSITION INTRAOCULAR LENS,,,2242.65,4485.3,8
CPT,66830,REMOVAL OF LENS LESION,,,2242.65,4485.3,8
CPT,66840,REMOVAL OF LENS MATERIAL,,,2242.65,4485.3,8
CPT,66850,REMOVAL OF LENS MATERIAL,,,2242.65,4485.3,8
CPT,66852,REMOVAL OF LENS MATERIAL,,,4016.7,8033.4,8
CPT,668T,BKBENCH PREP DON UTER ALGRFT,,,,,0
CPT,66920,EXTRACTION OF LENS,,,2242.65,4485.3,8
CPT,66930,EXTRACTION OF LENS,,,4016.7,8033.4,8
CPT,66940,EXTRACTION OF LENS,,,2242.65,4485.3,8
CPT,66982,XCAPSL CTRC RMVL CPLX WO ECP,,,2242.65,4485.3,8
CPT,66983,CATARACT SURG W/IOL 1 STAGE,,,2242.65,4485.3,8
CPT,66984,XCAPSL CTRC RMVL W/O ECP,,,2242.65,4485.3,8
CPT,66985,INSERT LENS PROSTHESIS,,,2242.65,4485.3,8
CPT,66986,EXCHANGE LENS PROSTHESIS,,,2242.65,4485.3,8
CPT,66987,XCAPSL CTRC RMVL CPLX W/ECP,,,4016.7,8033.4,8
CPT,66988,XCAPSL CTRC RMVL W/ECP,,,4016.7,8033.4,8
CPT,66989,XCPSL CTRC RMVL CPLX INSJ 1+,,,5171.04,10342.08,8
CPT,66990,OPHTHALMIC ENDOSCOPE ADD-ON,,,,,0
CPT,66991,XCAPSL CTRC RMVL INSJ 1+,,,5171.04,10342.08,8
CPT,66999,UNLISTED PX ANT SEGMENT EYE,,,2242.65,4485.3,8
CPT,669T,BKBENCH RCNSTJ DON UTER VEN,,,,,0
CPT,670,ANESTH SPINE CORD SURGERY,,,,,0
CPT,67005,PARTIAL REMOVAL OF EYE FLUID,,,2242.65,4485.3,8
CPT,67010,PARTIAL REMOVAL OF EYE FLUID,,,2242.65,4485.3,8
CPT,67015,RELEASE OF EYE FLUID,,,2242.65,4485.3,8
CPT,67025,REPLACE EYE FLUID,,,2242.65,4485.3,8
CPT,67027,IMPLANT EYE DRUG SYSTEM,,,13558.95,27117.9,8
CPT,67028,INJECTION EYE DRUG,,,320.98,641.96,8
CPT,67030,INCISE INNER EYE STRANDS,,,2242.65,4485.3,8
CPT,67031,LASER SURGERY EYE STRANDS,,,534.47,1068.94,8
CPT,67036,REMOVAL OF INNER EYE FLUID,,,4016.7,8033.4,8
CPT,67039,LASER TREATMENT OF RETINA,,,4016.7,8033.4,8
CPT,67040,LASER TREATMENT OF RETINA,,,4016.7,8033.4,8
CPT,67041,VIT FOR MACULAR PUCKER,,,4016.7,8033.4,8
CPT,67042,VIT FOR MACULAR HOLE,,,4016.7,8033.4,8
CPT,67043,VIT FOR MEMBRANE DISSECT,,,4016.7,8033.4,8
CPT,670T,BKBENCH RCNSTJ DON UTER ARTL,,,,,0
CPT,67101,REPAIR DETACHED RETINA CRTX,,,2242.65,4485.3,8
CPT,67105,REPAIR DETACHED RETINA PC,,,534.47,1068.94,8
CPT,67107,REPAIR DETACHED RETINA,,,4016.7,8033.4,8
CPT,67108,REPAIR DETACHED RETINA,,,4016.7,8033.4,8
CPT,67110,REPAIR DETACHED RETINA,,,2242.65,4485.3,8
CPT,67113,REPAIR RETINAL DETACH CPLX,,,5171.04,10342.08,8
CPT,67115,RELEASE ENCIRCLING MATERIAL,,,4016.7,8033.4,8
CPT,67120,REMOVE EYE IMPLANT MATERIAL,,,2242.65,4485.3,8
CPT,67121,REMOVE EYE IMPLANT MATERIAL,,,2242.65,4485.3,8
CPT,67141,PROPH RTA DTCHMNT CRTX DTHRM,,,308.44,616.88,8
CPT,67145,PROPH RTA DTCHMNT PC,,,534.47,1068.94,8
CPT,671T,INSJ ANT SGM AQ DRG DEV 1+,,,5171.04,10342.08,8
CPT,67208,TREATMENT OF RETINAL LESION,,,308.44,616.88,8
CPT,67210,TREATMENT OF RETINAL LESION,,,534.47,1068.94,8
CPT,67218,TREATMENT OF RETINAL LESION,,,3820.38,7640.76,8
CPT,67220,TREATMENT OF CHOROID LESION,,,534.47,1068.94,8
CPT,67221,OCULAR PHOTODYNAMIC THER,,,534.47,1068.94,8
CPT,67225,EYE PHOTODYNAMIC THER ADD-ON,,,,,0
CPT,67227,DSTRJ EXTENSIVE RETINOPATHY,,,3820.38,7640.76,8
CPT,67228,TREATMENT X10SV RETINOPATHY,,,534.47,1068.94,8
CPT,67229,TR RETINAL LES PRETERM INF,,,534.47,1068.94,8
CPT,67250,REINFORCE EYE WALL,,,2310.35,4620.7,8
CPT,67255,REINFORCE/GRAFT EYE WALL,,,4016.7,8033.4,8
CPT,67299,UNLISTED PX POSTERIOR SEGMNT,,,2242.65,4485.3,8
CPT,672T,NDOVAG CRYG RF REMDL TISS,,,,,0
CPT,67311,REVISE EYE MUSCLE,,,2310.35,4620.7,8
CPT,67312,REVISE TWO EYE MUSCLES,,,3820.38,7640.76,8
CPT,67314,REVISE EYE MUSCLE,,,2310.35,4620.7,8
CPT,67316,REVISE TWO EYE MUSCLES,,,2310.35,4620.7,8
CPT,67318,REVISE EYE MUSCLE(S),,,2310.35,4620.7,8
CPT,67320,REVISE EYE MUSCLE(S) ADD-ON,,,,,0
CPT,67331,EYE SURGERY FOLLOW-UP ADD-ON,,,,,0
CPT,67332,REREVISE EYE MUSCLES ADD-ON,,,,,0
CPT,67334,REVISE EYE MUSCLE W/SUTURE,,,,,0
CPT,67335,EYE SUTURE DURING SURGERY,,,,,0
CPT,67340,REVISE EYE MUSCLE ADD-ON,,,,,0
CPT,67343,RELEASE EYE TISSUE,,,2310.35,4620.7,8
CPT,67345,DESTROY NERVE OF EYE MUSCLE,,,308.44,616.88,8
CPT,67346,BIOPSY EYE MUSCLE,,,3820.38,7640.76,8
CPT,67399,UNLISTED PX EXTRAOCULAR MUSC,,,308.44,616.88,8
CPT,673T,ABLTJ B9 THYR NDUL PERQ LASR,,,1604.96,3209.92,8
CPT,67400,EXPLORE/BIOPSY EYE SOCKET,,,3820.38,7640.76,8
CPT,67405,EXPLORE/DRAIN EYE SOCKET,,,2310.35,4620.7,8
CPT,67412,EXPLORE/TREAT EYE SOCKET,,,2310.35,4620.7,8
CPT,67413,EXPLORE/TREAT EYE SOCKET,,,2310.35,4620.7,8
CPT,67414,EXPLR/DECOMPRESS EYE SOCKET,,,3820.38,7640.76,8
CPT,67415,ASPIRATION ORBITAL CONTENTS,,,2310.35,4620.7,8
CPT,67420,EXPLORE/TREAT EYE SOCKET,,,3820.38,7640.76,8
CPT,67430,EXPLORE/TREAT EYE SOCKET,,,3820.38,7640.76,8
CPT,67440,EXPLORE/DRAIN EYE SOCKET,,,3820.38,7640.76,8
CPT,67445,EXPLR/DECOMPRESS EYE SOCKET,,,3820.38,7640.76,8
CPT,67450,EXPLORE/BIOPSY EYE SOCKET,,,3820.38,7640.76,8
CPT,674T,LAPS INSJ NW/RPCMT PRM ISDSS,,,29986.33,59972.66,8
CPT,67500,INJECT/TREAT EYE SOCKET,,,308.44,616.88,8
CPT,67505,INJECT/TREAT EYE SOCKET,,,308.44,616.88,8
CPT,67515,INJECT/TREAT EYE SOCKET,,,308.44,616.88,8
CPT,67516,SPRCHOROIDAL SPC NJX RX AGT,,,320.98,641.96,8
CPT,67550,INSERT EYE SOCKET IMPLANT,,,3820.38,7640.76,8
CPT,67560,REVISE EYE SOCKET IMPLANT,,,3820.38,7640.76,8
CPT,67570,DECOMPRESS OPTIC NERVE,,,3820.38,7640.76,8
CPT,67599,UNLISTED PROCEDURE ORBIT,,,308.44,616.88,8
CPT,675T,LAPS INSJ NW/RPCMT ISDSS 1LD,,,10828.04,21656.08,8
CPT,676T,LAPS INSJ NW/RPCMT ISDSS EA,,,,,0
CPT,67700,DRAINAGE OF EYELID ABSCESS,,,308.44,616.88,8
CPT,67710,INCISION OF EYELID,,,968.73,1937.46,8
CPT,67715,INCISION OF EYELID FOLD,,,2310.35,4620.7,8
CPT,677T,LAPS REPOS LEAD ISDSS 1ST LD,,,10329.66,20659.32,8
CPT,67800,REMOVE EYELID LESION,,,308.44,616.88,8
CPT,67801,REMOVE EYELID LESIONS,,,968.73,1937.46,8
CPT,67805,REMOVE EYELID LESIONS,,,308.44,616.88,8
CPT,67808,REMOVE EYELID LESION(S),,,2310.35,4620.7,8
CPT,67810,BIOPSY EYELID & LID MARGIN,,,308.44,616.88,8
CPT,67820,REVISE EYELASHES,,,129.29,258.58,8
CPT,67825,REVISE EYELASHES,,,308.44,616.88,8
CPT,67830,REVISE EYELASHES,,,968.73,1937.46,8
CPT,67835,REVISE EYELASHES,,,2310.35,4620.7,8
CPT,67840,REMOVE EYELID LESION,,,968.73,1937.46,8
CPT,67850,DSTRJ LESION LID MARGIN <1CM,,,968.73,1937.46,8
CPT,67875,CLOSURE OF EYELID BY SUTURE,,,968.73,1937.46,8
CPT,67880,REVISION OF EYELID,,,2310.35,4620.7,8
CPT,67882,REVISION OF EYELID,,,2310.35,4620.7,8
CPT,678T,LAPS REPOS LEAD ISDSS EA ADD,,,,,0
CPT,67900,REPAIR BROW DEFECT,,,2310.35,4620.7,8
CPT,67901,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67902,REPAIR EYELID DEFECT,,,3820.38,7640.76,8
CPT,67903,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67904,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67906,REPAIR EYELID DEFECT,,,3820.38,7640.76,8
CPT,67908,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67909,REVISE EYELID DEFECT,,,2310.35,4620.7,8
CPT,67911,REVISE EYELID DEFECT,,,2310.35,4620.7,8
CPT,67912,CORRECTION EYELID W/IMPLANT,,,2310.35,4620.7,8
CPT,67914,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67915,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67916,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67917,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67921,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67922,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67923,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67924,REPAIR EYELID DEFECT,,,2310.35,4620.7,8
CPT,67930,REPAIR EYELID WOUND,,,2310.35,4620.7,8
CPT,67935,REPAIR EYELID WOUND,,,2310.35,4620.7,8
CPT,67938,REMOVE EYELID FOREIGN BODY,,,308.44,616.88,8
CPT,67950,REVISION OF EYELID,,,2310.35,4620.7,8
CPT,67961,REVISION OF EYELID,,,2310.35,4620.7,8
CPT,67966,REVISION OF EYELID,,,2310.35,4620.7,8
CPT,67971,RECONSTRUCTION OF EYELID,,,2310.35,4620.7,8
CPT,67973,RECONSTRUCTION OF EYELID,,,2310.35,4620.7,8
CPT,67974,RECONSTRUCTION OF EYELID,,,3820.38,7640.76,8
CPT,67975,RECONSTRUCTION OF EYELID,,,2310.35,4620.7,8
CPT,67999,UNLISTED PROCEDURE EYELIDS,,,308.44,616.88,8
CPT,679T,LAPS RMVL LEAD ISDSS,,,10329.66,20659.32,8
CPT,67U,ONC BRST IMHCHEM PRFL 4 BMRK,,,1897.0,3794.0,8
CPT,68020,INCISE/DRAIN EYELID LINING,,,968.73,1937.46,8
CPT,68040,TREATMENT OF EYELID LESIONS,,,308.44,616.88,8
CPT,680T,INSJ/RPLCMT PG ONLY ISDSS,,,18852.29,37704.58,8
CPT,68100,BIOPSY OF EYELID LINING,,,2310.35,4620.7,8
CPT,68110,REMOVE EYELID LINING LESION,,,2310.35,4620.7,8
CPT,68115,REMOVE EYELID LINING LESION,,,2310.35,4620.7,8
CPT,68130,REMOVE EYELID LINING LESION,,,2310.35,4620.7,8
CPT,68135,REMOVE EYELID LINING LESION,,,2310.35,4620.7,8
CPT,681T,RLCJ PULSE GEN ONLY ISDSS,,,3397.38,6794.76,8
CPT,68200,TREAT EYELID BY INJECTION,,,434.11,868.22,8
CPT,682T,REMOVAL PULSE GEN ONLY ISDSS,,,3397.38,6794.76,8
CPT,68320,REVISE/GRAFT EYELID LINING,,,2310.35,4620.7,8
CPT,68325,REVISE/GRAFT EYELID LINING,,,3820.38,7640.76,8
CPT,68326,REVISE/GRAFT EYELID LINING,,,3820.38,7640.76,8
CPT,68328,REVISE/GRAFT EYELID LINING,,,2310.35,4620.7,8
CPT,68330,REVISE EYELID LINING,,,2242.65,4485.3,8
CPT,68335,REVISE/GRAFT EYELID LINING,,,3820.38,7640.76,8
CPT,68340,SEPARATE EYELID ADHESIONS,,,2310.35,4620.7,8
CPT,68360,REVISE EYELID LINING,,,3820.38,7640.76,8
CPT,68362,REVISE EYELID LINING,,,2310.35,4620.7,8
CPT,68371,HARVEST EYE TISSUE ALOGRAFT,,,2310.35,4620.7,8
CPT,68399,UNLISTED PX CONJUNCTIVA,,,308.44,616.88,8
CPT,683T,PRGRMG DEV EVAL ISDSS IP,,,36.27,72.54,8
CPT,68400,INCISE/DRAIN TEAR GLAND,,,968.73,1937.46,8
CPT,68420,INCISE/DRAIN TEAR SAC,,,2310.35,4620.7,8
CPT,68440,INCISE TEAR DUCT OPENING,,,308.44,616.88,8
CPT,684T,PERI-PX DEV EVAL ISDSS IP,,,,,0
CPT,68500,REMOVAL OF TEAR GLAND,,,3820.38,7640.76,8
CPT,68505,PARTIAL REMOVAL TEAR GLAND,,,3820.38,7640.76,8
CPT,68510,BIOPSY OF TEAR GLAND,,,2310.35,4620.7,8
CPT,68520,REMOVAL OF TEAR SAC,,,3820.38,7640.76,8
CPT,68525,BIOPSY OF TEAR SAC,,,2310.35,4620.7,8
CPT,68530,CLEARANCE OF TEAR DUCT,,,308.44,616.88,8
CPT,68540,REMOVE TEAR GLAND LESION,,,2310.35,4620.7,8
CPT,68550,REMOVE TEAR GLAND LESION,,,3820.38,7640.76,8
CPT,685T,INTERROG DEV EVAL ISDSS IP,,,36.27,72.54,8
CPT,686T,HISTOTRIPSY MAL HEPATCEL TIS,,,16645.78,33291.56,8
CPT,68700,REPAIR TEAR DUCTS,,,2310.35,4620.7,8
CPT,68705,REVISE TEAR DUCT OPENING,,,308.44,616.88,8
CPT,68720,CREATE TEAR SAC DRAIN,,,3820.38,7640.76,8
CPT,68745,CREATE TEAR DUCT DRAIN,,,3820.38,7640.76,8
CPT,68750,CREATE TEAR DUCT DRAIN,,,3820.38,7640.76,8
CPT,68760,CLOSE TEAR DUCT OPENING,,,308.44,616.88,8
CPT,68761,CLOSE TEAR DUCT OPENING,,,308.44,616.88,8
CPT,68770,CLOSE TEAR SYSTEM FISTULA,,,2310.35,4620.7,8
CPT,687T,TX AMBLYOPIA DEV SETUP 1ST,,,,,0
CPT,68801,DILATE TEAR DUCT OPENING,,,434.11,868.22,8
CPT,68810,PROBE NASOLACRIMAL DUCT,,,308.44,616.88,8
CPT,68811,PROBE NASOLACRIMAL DUCT,,,2310.35,4620.7,8
CPT,68815,PROBE NASOLACRIMAL DUCT,,,2310.35,4620.7,8
CPT,68816,PROBE NL DUCT W/BALLOON,,,2310.35,4620.7,8
CPT,68840,EXPLORE/IRRIGATE TEAR DUCTS,,,308.44,616.88,8
CPT,68841,INSJ RX ELUT IMPLT LAC CANAL,,,2310.35,4620.7,8
CPT,68850,INJECTION FOR TEAR SAC X-RAY,,,,,0
CPT,68899,UNLISTED PX LACRIMAL SYSTEM,,,308.44,616.88,8
CPT,688T,TX AMBLYOPIA ASSMT W/REPORT,,,,,0
CPT,689T,QUAN US TIS CHARAC W/O DX US,,,84.57,169.14,8
CPT,68U,CANDIDA SPECIES PNL AMP PRB,,,142.63,285.26,8
CPT,69000,DRAIN EXTERNAL EAR LESION,,,688.14,1376.28,8
CPT,69005,DRAIN EXTERNAL EAR LESION,,,1604.96,3209.92,8
CPT,69020,DRAIN OUTER EAR CANAL LESION,,,688.14,1376.28,8
CPT,69090,PIERCE EARLOBES,,,,,0
CPT,690T,QUAN US TIS CHARAC W/DX US,,,,,0
CPT,69100,BIOPSY OF EXTERNAL EAR,,,230.16,460.32,8
CPT,69105,BIOPSY OF EXTERNAL EAR CANAL,,,1507.77,3015.54,8
CPT,69110,REMOVE EXTERNAL EAR PARTIAL,,,2822.69,5645.38,8
CPT,69120,REMOVAL OF EXTERNAL EAR,,,5752.66,11505.32,8
CPT,69140,REMOVE EAR CANAL LESION(S),,,5752.66,11505.32,8
CPT,69145,REMOVE EAR CANAL LESION(S),,,2822.69,5645.38,8
CPT,69150,EXTENSIVE EAR CANAL SURGERY,,,5752.66,11505.32,8
CPT,69155,EXTENSIVE EAR/NECK SURGERY,,,,,0
CPT,691T,AUTO ALYS XST CT STD VRT FX,,,,,0
CPT,69200,CLEAR OUTER EAR CANAL,,,129.29,258.58,8
CPT,69205,CLEAR OUTER EAR CANAL,,,1604.96,3209.92,8
CPT,69209,REMOVE IMPACTED EAR WAX UNI,,,57.33,114.66,8
CPT,69210,REMOVE IMPACT CERUMEN UNI,190.0,95.0,33.09,184.3,108
CPT,69210,REMOVE IMPACTED EAR WAX UNI,,,,,0
CPT,69220,CLEAN OUT MASTOID CAVITY,,,194.97,389.94,8
CPT,69222,CLEAN OUT MASTOID CAVITY,,,524.1,1048.2,8
CPT,692T,THERAPEUTIC ULTRAFILTRATION,,,1513.45,3026.9,8
CPT,69300,REVISE EXTERNAL EAR,,,3221.84,6443.68,8
CPT,69310,REBUILD OUTER EAR CANAL,,,5752.66,11505.32,8
CPT,69320,REBUILD OUTER EAR CANAL,,,5752.66,11505.32,8
CPT,69399,UNLISTED PX EXTERNAL EAR,,,230.16,460.32,8
CPT,693T,COMPRE FUL BDY 3D MTN ALYS,,,333.38,666.76,8
CPT,69420,INCISION OF EARDRUM,,,230.16,460.32,8
CPT,69421,INCISION OF EARDRUM,,,3221.84,6443.68,8
CPT,69424,REMOVE VENTILATING TUBE,,,3221.84,6443.68,8
CPT,69433,CREATE EARDRUM OPENING,,,524.1,1048.2,8
CPT,69436,CREATE EARDRUM OPENING,,,1507.77,3015.54,8
CPT,69440,EXPLORATION OF MIDDLE EAR,,,3221.84,6443.68,8
CPT,69450,EARDRUM REVISION,,,3221.84,6443.68,8
CPT,694T,3D VOL IMG&RCNSTJ BRST/AX,,,,,0
CPT,69501,MASTOIDECTOMY,,,5752.66,11505.32,8
CPT,69502,MASTOIDECTOMY,,,5752.66,11505.32,8
CPT,69505,REMOVE MASTOID STRUCTURES,,,5752.66,11505.32,8
CPT,69511,EXTENSIVE MASTOID SURGERY,,,5752.66,11505.32,8
CPT,69530,EXTENSIVE MASTOID SURGERY,,,5752.66,11505.32,8
CPT,69535,REMOVE PART OF TEMPORAL BONE,,,,,0
CPT,69540,REMOVE EAR LESION,,,1507.77,3015.54,8
CPT,69550,REMOVE EAR LESION,,,5752.66,11505.32,8
CPT,69552,REMOVE EAR LESION,,,5752.66,11505.32,8
CPT,69554,REMOVE EAR LESION,,,,,0
CPT,695T,BDY SRF MPG PM/CVDFB TM IMPL,,,,,0
CPT,69601,MASTOID SURGERY REVISION,,,5752.66,11505.32,8
CPT,69602,MASTOID SURGERY REVISION,,,5752.66,11505.32,8
CPT,69603,MASTOID SURGERY REVISION,,,5752.66,11505.32,8
CPT,69604,MASTOID SURGERY REVISION,,,5752.66,11505.32,8
CPT,69610,REPAIR OF EARDRUM,,,1507.77,3015.54,8
CPT,69620,REPAIR OF EARDRUM,,,3221.84,6443.68,8
CPT,69631,REPAIR EARDRUM STRUCTURES,,,5752.66,11505.32,8
CPT,69632,REBUILD EARDRUM STRUCTURES,,,5752.66,11505.32,8
CPT,69633,REBUILD EARDRUM STRUCTURES,,,5752.66,11505.32,8
CPT,69635,REPAIR EARDRUM STRUCTURES,,,5752.66,11505.32,8
CPT,69636,REBUILD EARDRUM STRUCTURES,,,5752.66,11505.32,8
CPT,69637,REBUILD EARDRUM STRUCTURES,,,5752.66,11505.32,8
CPT,69641,REVISE MIDDLE EAR & MASTOID,,,5752.66,11505.32,8
CPT,69642,REVISE MIDDLE EAR & MASTOID,,,5752.66,11505.32,8
CPT,69643,REVISE MIDDLE EAR & MASTOID,,,5752.66,11505.32,8
CPT,69644,REVISE MIDDLE EAR & MASTOID,,,5752.66,11505.32,8
CPT,69645,REVISE MIDDLE EAR & MASTOID,,,5752.66,11505.32,8
CPT,69646,REVISE MIDDLE EAR & MASTOID,,,5752.66,11505.32,8
CPT,69650,RELEASE MIDDLE EAR BONE,,,3221.84,6443.68,8
CPT,69660,REVISE MIDDLE EAR BONE,,,5752.66,11505.32,8
CPT,69661,REVISE MIDDLE EAR BONE,,,5752.66,11505.32,8
CPT,69662,REVISE MIDDLE EAR BONE,,,5752.66,11505.32,8
CPT,69666,REPAIR MIDDLE EAR STRUCTURES,,,3221.84,6443.68,8
CPT,69667,REPAIR MIDDLE EAR STRUCTURES,,,3221.84,6443.68,8
CPT,69670,REMOVE MASTOID AIR CELLS,,,5752.66,11505.32,8
CPT,69676,REMOVE MIDDLE EAR NERVE,,,3221.84,6443.68,8
CPT,696T,BDY SURF MAPG PM/CVDFB F/UP,,,36.27,72.54,8
CPT,69700,CLOSE MASTOID FISTULA,,,1507.77,3015.54,8
CPT,69705,NPS SURG DILAT EUST TUBE UNI,,,5752.66,11505.32,8
CPT,69706,NPS SURG DILAT EUST TUBE BI,,,5752.66,11505.32,8
CPT,69710,IMPLANT/REPLACE HEARING AID,,,,,0
CPT,69711,REMOVE/REPAIR HEARING AID,,,3221.84,6443.68,8
CPT,69714,IMPL OI IMPLT SKULL PERQ ESP,,,12476.14,24952.28,8
CPT,69716,IMPL OI IMPLT SK TC ESP<100,,,12476.14,24952.28,8
CPT,69717,RPLCMT OI IMPLT SKL PRQ ESP,,,7051.31,14102.62,8
CPT,69719,RPLCM OI IMPLT SK TC ESP<100,,,12476.14,24952.28,8
CPT,69720,RELEASE FACIAL NERVE,,,5752.66,11505.32,8
CPT,69725,RELEASE FACIAL NERVE,,,5752.66,11505.32,8
CPT,69726,RMV NTR OI IMPLT SKL PRQ ESP,,,3179.6,6359.2,8
CPT,69727,RMV NTR OI IMP SK TC ESP<100,,,3179.6,6359.2,8
CPT,69728,RMV NTR OI IMP SK TC>=100,,,3179.6,6359.2,8
CPT,69729,IMPL OI IMPLT SK TC ESP>=100,,,12476.14,24952.28,8
CPT,69730,RPLC OI IMPLT SK TC ESP>=100,,,12476.14,24952.28,8
CPT,69740,REPAIR FACIAL NERVE,,,5752.66,11505.32,8
CPT,69745,REPAIR FACIAL NERVE,,,5752.66,11505.32,8
CPT,69799,UNLISTED PX MIDDLE EAR,,,230.16,460.32,8
CPT,697T,QUAN MR TIS WO MRI MLT ORGN,,,904.08,1808.16,8
CPT,69801,INCISE INNER EAR,,,1507.77,3015.54,8
CPT,69805,EXPLORE INNER EAR,,,5752.66,11505.32,8
CPT,69806,EXPLORE INNER EAR,,,5752.66,11505.32,8
CPT,698T,QUAN MR TISS W/MRI MLT ORGN,,,904.08,1808.16,8
CPT,69905,REMOVE INNER EAR,,,5752.66,11505.32,8
CPT,69910,REMOVE INNER EAR & MASTOID,,,5752.66,11505.32,8
CPT,69915,INCISE INNER EAR NERVE,,,3221.84,6443.68,8
CPT,69930,IMPLANT COCHLEAR DEVICE,,,32041.04,64082.08,8
CPT,69949,UNLISTED PX INNER EAR,,,230.16,460.32,8
CPT,69950,INCISE INNER EAR NERVE,,,,,0
CPT,69955,RELEASE FACIAL NERVE,,,5752.66,11505.32,8
CPT,69960,RELEASE INNER EAR CANAL,,,5752.66,11505.32,8
CPT,69970,REMOVE INNER EAR LESION,,,5752.66,11505.32,8
CPT,69979,UNLISTED PX TEMPORAL BONE,,,230.16,460.32,8
CPT,69990,MICROSURGERY ADD-ON,,,,,0
CPT,699T,NJX PST CHMBR EYE MEDICATION,,,2242.65,4485.3,8
CPT,69U,ONC CLRCT MICRORNA MIR-31-3P,,,380.0,760.0,8
CPT,6M,ONC HEP GENE RISK CLASSIFIER,,,150.0,300.0,8
CPT,700,ANESTH ABDOMINAL WALL SURG,,,,,0
CPT,70010,CONTRAST X-RAY OF BRAIN,,,,,0
CPT,70010,S&I MYELOGRAM POST FOSSA,1224.0,612.0,145.81,1236.75,108
CPT,70015,CONTRAST X-RAY OF BRAIN,,,122.23,1523.56,24
CPT,70030,EYE FOR FOREIGN BODY,341.5,170.75,24.57,380.24,108
CPT,70030,X-RAY EYE FOR FOREIGN BODY,,,,,0
CPT,700T,MOLEC FLUOR IMG SUS NEV 1ST,,,,,0
CPT,70100,MANDIBLE < 4 VIEWS,518.0,259.0,26.73,577.15,108
CPT,70100,X-RAY EXAM OF JAW <4VIEWS,,,,,0
CPT,7010F,PT INFO INTO RECALL SYSTEM,,,,,0
CPT,70110,MANDIBLE 4 VW MIN COMPL,518.0,259.0,33.45,577.15,108
CPT,70110,X-RAY EXAM OF JAW 4/> VIEWS,,,,,0
CPT,70120,MASTOIDS < 3 VIEWS PER SIDE,404.5,202.25,28.92,451.05,108
CPT,70120,X-RAY EXAM OF MASTOIDS,,,,,0
CPT,70130,MASTOIDS 3 VIEWS MIN COMPL,487.5,243.75,46.05,543.2,108
CPT,70130,X-RAY EXAM OF MASTOIDS,,,,,0
CPT,70134,INTERNAL AUDITORY,683.0,341.5,39.8,1061.98,54
CPT,70134,X-RAY EXAM OF MIDDLE EAR,,,,,0
CPT,70140,FACIAL BONES LTD < 3 VIEWS,404.5,202.25,25.47,451.05,108
CPT,70140,X-RAY EXAM OF FACIAL BONES,,,,,0
CPT,70150,FACIAL BONES 3 VW MIN COMPL,487.5,243.75,35.92,543.2,108
CPT,70150,X-RAY EXAM OF FACIAL BONES,,,,,0
CPT,70160,NASAL BONES 3 VW MIN COMPL,487.5,243.75,27.69,543.2,108
CPT,70160,X-RAY EXAM OF NASAL BONES,,,,,0
CPT,70170,S&I DACRYOCYSTOGRAM,682.5,341.25,47.92,689.67,108
CPT,70170,X-RAY EXAM OF TEAR DUCT,,,,,0
CPT,70190,OPTIC FORAMINA (OPTICS),202.0,101.0,27.69,237.65,108
CPT,70190,X-RAY EXAM OF EYE SOCKETS,,,,,0
CPT,701T,MOLEC FLUOR IMG SUS NEV EA,,,,,0
CPT,702,ANESTH FOR LIVER BIOPSY,,,,,0
CPT,70200,ORBITS 4 VIEWS MIN COMPL,518.0,259.0,37.13,577.15,108
CPT,70200,X-RAY EXAM OF EYE SOCKETS,,,,,0
CPT,7020F,MAMMO ASSESS CAT IN DBASE,,,,,0
CPT,70210,SINUSES < 3 VIEWS LTD,316.0,158.0,25.82,306.52,108
CPT,70210,X-RAY EXAM OF SINUSES,,,,,0
CPT,70220,SINUSES 3 VIEWS MIN COMPL,487.5,243.75,32.83,543.2,108
CPT,70220,X-RAY EXAM OF SINUSES,,,,,0
CPT,70240,SELLA TURCICA,229.0,114.5,25.47,255.11,108
CPT,70240,X-RAY EXAM PITUITARY SADDLE,,,,,0
CPT,70250,SKULL < 4 VIEWS LTD,487.5,243.75,30.67,543.2,108
CPT,70250,X-RAY EXAM OF SKULL,,,,,0
CPT,7025F,PT INFOSYS ALARM 4 NXT MAMMO,,,,,0
CPT,70260,SKULL 4 VIEWS MIN COMPL,518.0,259.0,39.51,577.15,108
CPT,70260,X-RAY EXAM OF SKULL,,,,,0
CPT,70300,TEETH SINGLE VIEW,94.0,47.0,12.87,169.14,108
CPT,70300,X-RAY EXAM OF TEETH,,,,,0
CPT,70310,TEETH PARTIAL < FULL MOUTH,292.0,146.0,30.52,463.72,108
CPT,70310,X-RAY EXAM OF TEETH,,,,,0
CPT,70320,FULL MOUTH X-RAY OF TEETH,,,40.99,463.72,24
CPT,70328,TMJ UNILATERAL,341.5,170.75,26.11,380.24,108
CPT,70328,X-RAY EXAM OF JAW JOINT,,,,,0
CPT,70330,TMJ BILATERAL,375.5,187.75,39.7,418.07,108
CPT,70330,X-RAY EXAM OF JAW JOINTS,,,,,0
CPT,70332,TMJ S&I ARTHROGRAM BILAT,1129.5,564.75,70.26,1404.56,108
CPT,70332,TMJ S&I ARTHROGRAM UNILAT,876.5,438.25,70.26,1025.29,108
CPT,70332,X-RAY EXAM OF JAW JOINT,,,,,0
CPT,70336,MAGNETIC IMAGE JAW JOINT,,,,,0
CPT,70336,MRI TMJ BILATERAL,3494.0,1747.0,231.86,3784.94,108
CPT,70336,MRI TMJ UNILATERAL,2923.0,1461.5,231.86,2835.31,54
CPT,70350,CEPHALOGRAM,240.5,120.25,18.34,267.72,108
CPT,70350,X-RAY HEAD FOR ORTHODONTIA,,,,,0
CPT,70355,PANORAMIC X-RAY OF JAWS,,,,,0
CPT,70355,PANOREX ORTHOPANTOGRAM,492.5,246.25,19.21,497.61,108
CPT,70360,NECK SOFT TISSUE EXAM,341.5,170.75,23.63,380.24,108
CPT,70360,X-RAY EXAM OF NECK,,,,,0
CPT,70370,THROAT X-RAY & FLUOROSCOPY,,,63.86,169.14,24
CPT,70371,SPEECH EVALUATION COMPLEX,,,79.32,463.72,24
CPT,70380,SALIVARY GLAND FOR CALCULI,113.5,56.75,19.51,169.14,108
CPT,70380,X-RAY EXAM OF SALIVARY GLAND,,,,,0
CPT,70390,S&I SIALOGRAM,559.0,279.5,83.06,564.54,108
CPT,70390,S&I SIALOGRAM BILATERAL,600.0,300.0,83.06,582.0,54
CPT,70390,X-RAY EXAM OF SALIVARY DUCT,,,,,0
CPT,70450,CT HEAD BRAIN ORBITS WO CONTRST,1923.0,961.5,101.59,2083.56,162
CPT,70450,CT HEAD/BRAIN W/O DYE,,,,,0
CPT,70460,CT HEAD BRAIN ORBITS W CONTRST,2284.0,1142.0,170.45,2474.47,162
CPT,70460,CT HEAD/BRAIN W/DYE,,,,,0
CPT,70470,CT HEAD BRAIN ORBITS W&WO CONTR,2343.0,1171.5,170.45,2841.13,162
CPT,70470,CT HEAD/BRAIN W/O & W/DYE,,,,,0
CPT,70480,CT ORBIT/EAR/FOSSA W/O DYE,,,,,0
CPT,70480,CT SKULL BASE ORBITS WO CONTR,2271.5,1135.75,101.59,2460.89,108
CPT,70481,CT ORBIT/EAR/FOSSA W/DYE,,,,,0
CPT,70481,CT SKULL BASE ORBITS W CONTR,2565.5,1282.75,170.45,2779.05,108
CPT,70482,CT ORBIT/EAR/FOSSA W/O&W/DYE,,,,,0
CPT,70482,CT SKULL BASE ORBITS W&WO CON,2784.5,1392.25,170.45,3016.7,108
CPT,70486,CT MAXILLOFACIAL W/O DYE,,,,,0
CPT,70486,CT SINUS MAXFACIAL WO CON LTD,1721.0,860.5,101.59,1826.51,108
CPT,70486,CT SINUS MAXFACIAL WO CONTRST,1983.5,991.75,101.59,2148.55,108
CPT,70487,CT MAXILLOFACIAL W/DYE,,,,,0
CPT,70487,CT SINUS MAXILLOFACIAL W CONT,1959.0,979.5,170.45,2122.36,162
CPT,70488,CT MAXILLOFACIAL W/O & W/DYE,,,,,0
CPT,70488,CT SINUS MAXFACIAL W&WO CONT,3085.0,1542.5,170.45,3342.62,108
CPT,70490,CT NECK WO CONTRAST,2167.0,1083.5,101.59,2347.4,162
CPT,70490,CT SOFT TISSUE NECK W/O DYE,,,,,0
CPT,70491,CT NECK W CONTRAST,2666.0,1333.0,170.45,2888.66,162
CPT,70491,CT SOFT TISSUE NECK W/DYE,,,,,0
CPT,70492,CT NECK W&WO CONTRAST,2944.5,1472.25,170.45,3189.36,108
CPT,70492,CT SFT TSUE NCK W/O & W/DYE,,,,,0
CPT,70496,CT ANGIOGRAPHY HEAD,,,,,0
CPT,70496,CTA HEAD BRAIN W 3D,3087.0,1543.5,170.45,3344.56,108
CPT,70498,CT ANGIOGRAPHY NECK,,,,,0
CPT,70498,CTA NECK W 3D,3265.0,1632.5,170.45,3536.62,108
CPT,704T,REM TX AMBLYOPIA SETUP&EDU,,,,,0
CPT,70540,MRI ORBIT FACE NECK WO CONT,2928.5,1464.25,231.86,3172.87,108
CPT,70540,MRI ORBIT/FACE/NECK W/O DYE,,,,,0
CPT,70542,MRI ORBIT FACE NECK W CONT,3190.5,1595.25,339.02,3456.11,108
CPT,70542,MRI ORBIT/FACE/NECK W/DYE,,,,,0
CPT,70543,MRI ORBIT FACE NECK W&WO CONT,4037.5,2018.75,339.02,4373.73,108
CPT,70543,MRI ORBT/FAC/NCK W/O &W/DYE,,,,,0
CPT,70544,MR ANGIOGRAPHY HEAD W/O DYE,,,,,0
CPT,70544,MRA HEAD WO CONTRAST,3178.0,1589.0,231.86,3443.5,108
CPT,70545,MR ANGIOGRAPHY HEAD W/DYE,,,,,0
CPT,70545,MRA HEAD W CONTRAST,4287.0,2143.5,339.02,4158.39,54
CPT,70546,MR ANGIOGRAPH HEAD W/O&W/DYE,,,,,0
CPT,70546,MRA HEAD W&WO CONTRAST,4274.5,2137.25,339.02,4630.78,108
CPT,70547,MR ANGIOGRAPHY NECK W/O DYE,,,,,0
CPT,70547,MRA NECK WO CONTRAST,2829.0,1414.5,231.86,3065.2,108
CPT,70548,MR ANGIOGRAPHY NECK W/DYE,,,,,0
CPT,70548,MRA NECK W CONTRAST,4137.0,2068.5,339.02,4012.89,54
CPT,70549,MR ANGIOGRAPH NECK W/O&W/DYE,,,,,0
CPT,70549,MRA NECK W&WO CONTRAST,4129.5,2064.75,339.02,4473.64,108
CPT,70551,MRI BRAIN STEM W/O DYE,,,,,0
CPT,70551,MRI BRAIN WO CONTRAST,2903.5,1451.75,231.86,3145.71,108
CPT,70551,MRI BRAIN WO CONTRAST LTD,3099.0,1549.5,231.86,3006.03,54
CPT,70552,MRI BRAIN STEM W/DYE,,,,,0
CPT,70552,MRI BRAIN W CONTRAST,3403.5,1701.75,339.02,3686.97,108
CPT,70553,MRI BRAIN STEM W/O & W/DYE,,,,,0
CPT,70553,MRI HEAD W&WO CONTRAST,4509.0,2254.5,339.02,4884.92,108
CPT,70554,FMRI BRAIN BY TECH,,,,,0
CPT,70554,MRI BRAIN FUNCTN WO PHYSICIAN,1522.0,761.0,231.86,1476.34,54
CPT,70555,FMRI BRAIN BY PHYS/PSYCH,,,,,0
CPT,70555,MRI BRAIN FUNCTN W PHYSICIAN,1522.0,761.0,231.86,1476.34,54
CPT,70557,MRI BRAIN W/O DYE,,,530.99,1061.98,8
CPT,70558,MRI BRAIN W/DYE,,,170.45,340.9,8
CPT,70559,MRI BRAIN W/O & W/DYE,,,170.45,340.9,8
CPT,705T,REM TX AMBLYOPIA TECH SPRT,,,,,0
CPT,706T,REM TX AMBLYOPIA I&R PHY/QHP,,,,,0
CPT,707T,NJX B1 SUB MTRL SBCHDRL DFCT,,,3179.6,6359.2,8
CPT,708T,ID CA IMMNTX PREP & 1ST NJX,,,,,0
CPT,709T,ID CA IMMNTX EACH ADDL NJX,,,,,0
CPT,70U,CYP2D6 GEN COM&SLCT RAR VRNT,,,676.37,1352.74,8
CPT,71045,RADIOLOGIC EXAM CHEST SINGLE VIEW,341.5,170.75,50.69,380.24,108
CPT,71045,X-RAY EXAM CHEST 1 VIEW,,,,,0
CPT,71046,MUD RADIOLOGIC EXAM CHEST 2 VIEWS NHCI,2616.0,1308.0,84.57,2537.52,53
CPT,71046,RADIOLOGIC EXAM CHEST 2 VIEWS,404.5,202.25,59.92,451.05,108
CPT,71046,X-RAY EXAM CHEST 2 VIEWS,,,,,0
CPT,71047,RADIOLOGIC EXAM CHEST 3 VIEWS,487.5,243.75,72.29,543.2,108
CPT,71047,X-RAY EXAM CHEST 3 VIEWS,,,,,0
CPT,71048,RADIOLOGIC EXAM CHEST 4+ VIEWS,518.0,259.0,76.82,577.15,108
CPT,71048,X-RAY EXAM CHEST 4+ VIEWS,,,,,0
CPT,710T,N-INVAS ARTL PLAQ ALYS,,,,,0
CPT,71100,RIBS UNILAT,357.5,178.75,27.9,380.24,108
CPT,71100,X-RAY EXAM RIBS UNI 2 VIEWS,,,,,0
CPT,71101,RIBS UNILAT W PA CHEST,432.5,216.25,33.41,451.05,108
CPT,71101,X-RAY EXAM UNILAT RIBS/CHEST,,,,,0
CPT,71110,RIBS BILATERAL 3 VIEWS,487.5,243.75,34.35,543.2,108
CPT,71110,X-RAY EXAM RIBS BIL 3 VIEWS,,,,,0
CPT,71111,RIBS BILAT W PA CHEST 3V MN,502.5,251.25,43.6,543.2,108
CPT,71111,X-RAY EXAM RIBS/CHEST4/> VWS,,,,,0
CPT,71120,STERNUM 2 VIEWS MIN,404.5,202.25,27.63,451.05,108
CPT,71120,X-RAY EXAM BREASTBONE 2/>VWS,,,,,0
CPT,71130,STERNOCLAVICULAR JTS 3V MIN,487.5,243.75,31.95,543.2,108
CPT,71130,X-RAY STRENOCLAVIC JT 3/>VWS,,,,,0
CPT,711T,N-NVS ARTL PLAQ ALYS DAT PRP,,,,,0
CPT,71250,CT DX CHEST WO CONTRAST,1901.0,950.5,101.59,2059.31,108
CPT,71250,CT DX CHEST WO CONTRAST LTD,1615.5,807.75,101.59,1749.88,108
CPT,71250,CT THORAX DX C-,,,,,0
CPT,71260,CT DX CHEST W CONTRAST,2565.5,1282.75,170.45,2779.05,162
CPT,71260,CT THORAX DX C+,,,,,0
CPT,71270,CT DX CHEST W&WO CONTRAST,3137.0,1568.5,170.45,3398.88,108
CPT,71270,CT THORAX DX C-/C+,,,,,0
CPT,71271,CT THORAX LUNG CANCER SCR C-,,,,,0
CPT,71271,LOW DOSE CT SCAN LUNG CANCER SCREENING,366.0,183.0,63.75,355.02,108
CPT,71275,CT ANGIOGRAPHY CHEST,,,,,0
CPT,71275,CTA CHEST W 3D,3101.0,1550.5,170.45,3359.11,162
CPT,712T,N-NVS ARTL PLAQ ALYS QUAN,,,209.83,419.66,8
CPT,713T,N-NVS ARTL PLAQ ALYS RVW I&R,,,,,0
CPT,714T,TPRNL LSR ABLT B9 PRST8 HYPR,,,5210.39,10420.78,8
CPT,71550,MRI CHEST W/O DYE,,,,,0
CPT,71550,MRI CHEST WO CONTRAST,2876.5,1438.25,231.86,3116.61,108
CPT,71551,MRI CHEST W CONTRAST,3369.0,1684.5,532.58,3267.93,54
CPT,71551,MRI CHEST W/DYE,,,,,0
CPT,71552,MRI CHEST W&WO CONTRAST,4065.0,2032.5,339.02,4403.8,108
CPT,71552,MRI CHEST W/O & W/DYE,,,,,0
CPT,71555,MRA CHEST W CONTRAST,2688.0,1344.0,468.24,2607.36,47
CPT,71555,MRA CHEST W&WO CONTRAST,3701.0,1850.5,504.38,3589.97,47
CPT,71555,MRA CHEST WO CONTRAST,1792.0,896.0,312.16,1738.24,47
CPT,71555,MRI ANGIO CHEST W OR W/O DYE,,,,,0
CPT,716T,CAR ACOUS WAVFRM REC CAD RSK,,,57.33,114.66,8
CPT,717T,ADRC THER PRTL RC TEAR,,,3443.66,6887.32,8
CPT,718T,ADRC THER PRTL RC TEAR NJX,,,3443.66,6887.32,8
CPT,719T,PST VRT JT RPLCMT LMBR 1 SGM,,,,,0
CPT,71T,US LEIOMYOMATA ABLATE <200,,,3145.71,6291.42,8
CPT,71U,CYP2D6 FULL GENE SEQUENCE,,,600.0,1200.0,8
CPT,72020,SPINE 1 VIEW,341.5,170.75,20.87,380.24,108
CPT,72020,SPINE LATERAL VW EA ADDL,341.5,170.75,20.87,380.24,108
CPT,72020,X-RAY EXAM OF SPINE 1 VIEW,,,,,0
CPT,72040,CERVICAL SPINE 2 OR 3 VIEWS,487.5,243.75,32.56,543.2,108
CPT,72040,X-RAY EXAM NECK SPINE 2-3 VW,,,,,0
CPT,72050,CERVICAL SPINE 4 VIEWS MIN,518.0,259.0,44.54,577.15,108
CPT,72050,X-RAY EXAM NECK SPINE 4/5VWS,,,,,0
CPT,72052,RADEX SPINE CERVICAL 6 OR MORE VIEWS,647.5,323.75,55.66,721.68,108
CPT,72052,X-RAY EXAM NECK SPINE 6/>VWS,,,,,0
CPT,72070,THORACIC SPINE 2 VIEWS,404.5,202.25,28.84,451.05,108
CPT,72070,X-RAY EXAM THORAC SPINE 2VWS,,,,,0
CPT,72072,THORACIC SPINE 3 VIEWS,487.5,243.75,32.26,543.2,108
CPT,72072,X-RAY EXAM THORAC SPINE 3VWS,,,,,0
CPT,72074,THORACIC SPINE 4 VIEWS MIN,518.0,259.0,37.57,577.15,108
CPT,72074,X-RAY EXAM THORAC SPINE4/>VW,,,,,0
CPT,72080,THORACOLUMBAR SPINE MIN 2 VIEWS,404.5,202.25,31.01,451.05,108
CPT,72080,X-RAY EXAM THORACOLMB 2/> VW,,,,,0
CPT,72081,"SPINE, ENT THOR,LUMB, INCLU SKULL, CERV, SAC SPINE IF PERF ONE VIEW",303.0,151.5,44.94,337.56,108
CPT,72081,X-RAY EXAM ENTIRE SPI 1 VW,,,,,0
CPT,72082,"SPINE, ENT THOR,LUM,INCLU SKULL, CERV,SAC SPINE IF PERF 2OR3VIEWS",390.0,195.0,67.93,378.3,108
CPT,72082,X-RAY EXAM ENTIRE SPI 2/3 VW,,,,,0
CPT,72083,"SPINE, ENT THOR,LUM,INCLU SKULL, CERV,SACR SPINE IF PERF 4OR5 VIEWS",430.0,215.0,74.9,417.1,108
CPT,72083,X-RAY EXAM ENTIRE SPI 4/5 VW,,,,,0
CPT,72084,"SPINE,ENT THOR,LUM,INCL SKULL,CERV SACRL SPINE IF PERF MIN OF6VIEWS",590.0,295.0,101.59,572.3,108
CPT,72084,X-RAY EXAM ENTIRE SPI 6/> VW,,,,,0
CPT,720T,PRQ ELC NRV STIM CN WO IMPLT,,,,,0
CPT,72100,LUMBAR SPINE 2 OR 3 VIEWS,487.5,243.75,34.12,543.2,108
CPT,72100,X-RAY EXAM L-S SPINE 2/3 VWS,,,,,0
CPT,72110,LUMBAR SPINE 4 VIEWS MIN,518.0,259.0,46.41,577.15,108
CPT,72110,X-RAY EXAM L-2 SPINE 4/>VWS,,,,,0
CPT,72114,LUMBAR SPINE W BEND COMPL,677.5,338.75,61.57,754.66,108
CPT,72114,X-RAY EXAM L-S SPINE BENDING,,,,,0
CPT,72120,LUMBAR SPINE BEND VIEWS ONLY,518.0,259.0,42.23,577.15,108
CPT,72120,X-RAY BEND ONLY L-S SPINE,,,,,0
CPT,72125,CT CERVICAL SPINE WO CONTRAST,2080.0,1040.0,101.59,2522.0,162
CPT,72125,CT NECK SPINE W/O DYE,,,,,0
CPT,72126,CT CERVICAL SPINE W CONTRAST,2879.5,1439.75,263.36,3119.52,108
CPT,72126,CT NECK SPINE W/DYE,,,,,0
CPT,72127,CT CERVICAL SPINE W&WO CONTR,3426.5,1713.25,170.45,3712.19,108
CPT,72127,CT NECK SPINE W/O & W/DYE,,,,,0
CPT,72128,CT CHEST SPINE W/O DYE,,,,,0
CPT,72128,CT THORACIC SPINE WO CONTRAST,2000.0,1000.0,101.59,2166.98,162
CPT,72129,CT CHEST SPINE W/DYE,,,,,0
CPT,72129,CT THORACIC SPINE W CONTRAST,2298.0,1149.0,170.45,2787.78,162
CPT,72130,CT CHEST SPINE W/O & W/DYE,,,,,0
CPT,72130,CT THORACIC SPINE W&WO CONTR,2865.5,1432.75,170.45,3104.0,108
CPT,72131,CT LUMBAR SPINE W/O DYE,,,,,0
CPT,72131,CT LUMBAR SPINE WO CONTRAST,2479.0,1239.5,101.59,2684.96,162
CPT,72132,CT LUMBAR SPINE W CONTRAST,3071.0,1535.5,263.05,3327.1,162
CPT,72132,CT LUMBAR SPINE W/DYE,,,,,0
CPT,72133,CT LUMBAR SPINE W&WO CONTRAST,3829.0,1914.5,170.45,4147.72,108
CPT,72133,CT LUMBAR SPINE W/O & W/DYE,,,,,0
CPT,72141,MRI CERVICAL SPINE WO CONTRA,3511.5,1755.75,231.86,3804.34,108
CPT,72141,MRI NECK SPINE W/O DYE,,,,,0
CPT,72142,MRI CERVICAL SPINE W CONTRAST,3826.0,1913.0,339.02,4144.81,108
CPT,72142,MRI NECK SPINE W/DYE,,,,,0
CPT,72146,MRI CHEST SPINE W/O DYE,,,,,0
CPT,72146,MRI THORACIC SPINE WO CONTRAS,3511.5,1755.75,231.86,3804.34,108
CPT,72147,MRI CHEST SPINE W/DYE,,,,,0
CPT,72147,MRI THORACIC SPINE W CONTRAST,3861.5,1930.75,339.02,4144.81,108
CPT,72148,MRI LUMBAR SPINE W/O DYE,,,,,0
CPT,72148,MRI LUMBAR SPINE WO CONTRAST,3511.5,1755.75,231.86,3804.34,108
CPT,72149,MRI LUMBAR SPINE W CO,3826.0,1913.0,339.02,4144.81,108
CPT,72149,MRI LUMBAR SPINE W/DYE,,,,,0
CPT,72156,MRI CERVICAL SPINE W&WO CONT,4460.5,2230.25,339.02,4832.54,108
CPT,72156,MRI NECK SPINE W/O & W/DYE,,,,,0
CPT,72157,MRI CHEST SPINE W/O & W/DYE,,,,,0
CPT,72157,MRI THORACIC SPINE W&WO CONT,4460.5,2230.25,339.02,4832.54,108
CPT,72158,MRI LUMBAR SPINE W&WO CONTRAS,4460.5,2230.25,339.02,4832.54,108
CPT,72158,MRI LUMBAR SPINE W/O & W/DYE,,,,,0
CPT,72159,MR ANGIO SPINE W/O&W/DYE,,,,,0
CPT,72159,MRA SPINE W&WO CONTRAST,5454.0,2727.0,550.55,5290.38,47
CPT,72170,PELVIS 1 OR 2 VIEWS,404.5,202.25,23.63,451.05,108
CPT,72170,X-RAY EXAM OF PELVIS,,,,,0
CPT,72190,PELVIS 3 VIEWS MIN,487.5,243.75,34.77,543.2,108
CPT,72190,X-RAY EXAM OF PELVIS,,,,,0
CPT,72191,CT ANGIOGRAPH PELV W/O&W/DYE,,,,,0
CPT,72191,CTA PELVIS W 3D,3195.0,1597.5,170.45,3460.96,108
CPT,72192,CT PELVIS W/O DYE,,,,,0
CPT,72192,CT PELVIS WO CONTRAST,2128.5,1064.25,101.59,2305.69,108
CPT,72192,CT PELVIS WO CONTRAST LTD,2035.5,1017.75,101.59,2204.81,108
CPT,72193,CT PELVIS W CONTRAST,2573.0,1286.5,170.45,2787.78,162
CPT,72193,CT PELVIS W/DYE,,,,,0
CPT,72194,CT PELVIS W&WO CONTRAST,2852.5,1426.25,170.45,3090.42,108
CPT,72194,CT PELVIS W&WO CONTRAST LTD,2553.5,1276.75,170.45,2766.44,108
CPT,72194,CT PELVIS W/O & W/DYE,,,,,0
CPT,72195,MRI PELVIS W/O DYE,,,,,0
CPT,72195,MRI PELVIS WO CONTRAST,2928.5,1464.25,231.86,3172.87,108
CPT,72196,MRI PELVIS W CONTRAST,3530.0,1765.0,339.02,3424.1,54
CPT,72196,MRI PELVIS W/DYE,,,,,0
CPT,72197,MRI PELVIS W&WO CONTRAST,4426.5,2213.25,339.02,4795.68,108
CPT,72197,MRI PELVIS W/O & W/DYE,,,,,0
CPT,72198,MR ANGIO PELVIS W/O & W/DYE,,,,,0
CPT,72198,MRA PELVIS W CONTRAST,3229.0,1614.5,502.83,3132.13,47
CPT,72198,MRA PELVIS W&WO CONTRAST,4310.5,2155.25,502.83,4669.58,94
CPT,72198,MRA PELVIS WO CONTRAST,3123.0,1561.5,502.83,3029.31,47
CPT,721T,QUAN CT TISS CHARAC W/O CT,,,618.73,1237.46,8
CPT,72200,SACRO ILAC JTS < 3 VWS,487.5,243.75,25.2,543.2,108
CPT,72200,SACRO ILIAC < 3 VWS LTD,414.0,207.0,25.2,401.58,54
CPT,72200,X-RAY EXAM SI JOINTS,,,,,0
CPT,72202,SACRO ILIAC 3 VW MIN COMPL,487.5,243.75,29.52,543.2,108
CPT,72202,X-RAY EXAM SI JOINTS 3/> VWS,,,,,0
CPT,72220,SACRUM AND COCCYX 2 VW MIN,404.5,202.25,25.2,451.05,108
CPT,72220,X-RAY EXAM SACRUM TAILBONE,,,,,0
CPT,72240,MYELOGRAPHY NECK SPINE,,,,,0
CPT,72240,S&I LIMITED MYELOGRAM CERVICAL,1372.0,686.0,124.98,1528.72,108
CPT,72255,MYELOGRAPHY THORACIC SPINE,,,,,0
CPT,72255,S&I MYELOGRAM THORACIC,5168.0,2584.0,116.57,5041.09,108
CPT,72255,S&I MYELOGRAM THORACIC LTD,1478.0,739.0,116.57,1523.56,54
CPT,72265,MYELOGRAPHY L-S SPINE,,,,,0
CPT,72265,S&I MYELOGRAM LUMBOSACR LTD,2042.0,1021.0,118.28,1992.38,108
CPT,72265,S&I MYELOGRAM LUMBOSACRAL,1762.0,881.0,118.28,1900.23,108
CPT,72270,MYELOGPHY 2/> SPINE REGIONS,,,,,0
CPT,72270,S&I MYELOGRAM SPINE COMPL,1957.5,978.75,182.73,2180.56,108
CPT,72285,DISCOGRAPHY CERV/THOR SPINE,,,,,0
CPT,72285,S&I DISKO CERV/THORACIC,3623.5,1811.75,132.57,3795.16,108
CPT,72295,S&I DISKOGRAM LUMBAR,4836.0,2418.0,116.11,4886.86,108
CPT,72295,X-RAY OF LOWER SPINE DISK,,,,,0
CPT,722T,QUAN CT TISS CHARAC W/CT,,,618.73,1237.46,8
CPT,723T,QMRCP W/O DX MRI SM ANAT SES,,,904.08,1808.16,8
CPT,724T,QMRCP W/DX MRI SAME ANATOMY,,,904.08,1808.16,8
CPT,725T,VESTIBULAR DEV IMPLTJ UNI,,,,,0
CPT,726T,RMVL IMPLT VSTIBULAR DEV UNI,,,,,0
CPT,727T,RMVL&RPLCMT IMPLT VSTBLR DEV,,,,,0
CPT,728T,DX ALYS VSTBLR IMPLT UNI 1ST,,,,,0
CPT,729T,DX ALYS VSTBLR IMPLT UNI SBQ,,,,,0
CPT,72T,FCSD US ABLTJ LEIOMYOM>=200,,,3145.71,6291.42,8
CPT,72U,CYP2D6 GEN CYP2D6-2D7 HYBRID,,,450.91,901.82,8
CPT,730,ANESTH ABDOMINAL WALL SURG,,,,,0
CPT,73000,CLAVICLE,341.5,170.75,25.2,380.24,108
CPT,73000,X-RAY EXAM OF COLLAR BONE,,,,,0
CPT,73010,SCAPULA COMPLETE,487.5,243.75,25.81,543.2,108
CPT,73010,X-RAY EXAM OF SHOULDER BLADE,,,,,0
CPT,73020,SHOULDER 1 VIEW,341.5,170.75,20.56,380.24,108
CPT,73020,X-RAY EXAM OF SHOULDER,,,,,0
CPT,73030,SHOULDER 2 VIEWS MIN COMPLETE,404.5,202.25,26.41,451.05,108
CPT,73030,X-RAY EXAM OF SHOULDER,,,,,0
CPT,73040,CONTRAST X-RAY OF SHOULDER,,,,,0
CPT,73040,S&I ARTHROGRAM SHOULDER,1088.5,544.25,89.58,1212.5,108
CPT,73040,S&I ARTHROGRAM SHOULDERS BILAT,1052.0,526.0,89.58,1020.44,54
CPT,73050,ACROMIOCLAVICULAR JOINTS BIL,487.5,243.75,31.98,543.2,108
CPT,73050,X-RAY EXAM OF SHOULDERS,,,,,0
CPT,73060,HUMERUS 1 VIEW LIMITED,156.0,78.0,23.16,173.63,108
CPT,73060,HUMERUS 2 VIEWS MIN,404.5,202.25,25.81,451.05,108
CPT,73060,X-RAY EXAM OF HUMERUS,,,,,0
CPT,73070,ELBOW 1 VIEW LIMITED,156.0,78.0,23.16,173.63,108
CPT,73070,ELBOW 2 VIEWS,404.5,202.25,23.68,451.05,108
CPT,73070,X-RAY EXAM OF ELBOW,,,,,0
CPT,73080,ELBOW 3 VW MIN COMPLETE,487.5,243.75,29.56,543.2,108
CPT,73080,X-RAY EXAM OF ELBOW,,,,,0
CPT,73085,CONTRAST X-RAY OF ELBOW,,,,,0
CPT,73085,S&I ARTHROGRAM ELBOW,1088.5,544.25,80.85,1212.5,108
CPT,73090,FOREARM 1 VIEW LIMITED,156.0,78.0,23.16,173.63,108
CPT,73090,FOREARM 2 VIEWS,404.5,202.25,23.66,451.05,108
CPT,73090,X-RAY EXAM OF FOREARM,,,,,0
CPT,73092,UPPER EXTREMITY INFANT,404.5,202.25,24.6,451.05,108
CPT,73092,X-RAY EXAM OF ARM INFANT,,,,,0
CPT,730T,TRABECULOTOMY LSR W/OCT GDN,,,,,0
CPT,731,ANES UPR GI NDSC PX NOS,,,,,0
CPT,73100,WRIST 1 VIEW BILAT LTD,199.0,99.5,26.14,193.03,54
CPT,73100,WRIST 1 VIEW LIMITED,156.0,78.0,23.16,173.63,108
CPT,73100,WRIST 2 VIEWS,404.5,202.25,26.14,451.05,108
CPT,73100,X-RAY EXAM OF WRIST,,,,,0
CPT,73110,WRIST 3 VW MIN COMPLETE,487.5,243.75,29.87,543.2,108
CPT,73110,X-RAY EXAM OF WRIST,,,,,0
CPT,73115,CONTRAST X-RAY OF WRIST,,,,,0
CPT,73115,S&I ARTHROGRAM WRIST,1088.5,544.25,87.71,1212.5,108
CPT,73120,HAND 1 VIEW LIMITED,182.5,91.25,23.34,203.18,108
CPT,73120,HAND 2 VIEWS,404.5,202.25,23.34,451.05,108
CPT,73120,X-RAY EXAM OF HAND,,,,,0
CPT,73130,HAND 3 VIEWS MIN,487.5,243.75,27.07,543.2,108
CPT,73130,X-RAY EXAM OF HAND,,,,,0
CPT,73140,FINGER INDEX LT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER INDEX RT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER LONG LT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER LONG RT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER RING LT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER RING RT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER SMALL LT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER SMALL RT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER THUMB LT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGER THUMB RT,341.5,170.75,25.9,380.24,108
CPT,73140,FINGERS 2 VIEWS MIN,404.5,202.25,25.9,451.05,108
CPT,73140,X-RAY EXAM OF FINGER(S),,,,,0
CPT,731T,AUGMNT AI-BASED FCL PHNT A/R,,,57.33,114.66,8
CPT,732,ANES UPR GI NDSC PX ERCP,,,,,0
CPT,73200,CT UPPER EXT WO CONTRAST,2389.5,1194.75,101.59,2588.93,108
CPT,73200,CT UPPER EXTREMITY W/O DYE,,,,,0
CPT,73201,CT UPPER EXT W CONTRAST,2684.5,1342.25,251.65,2908.06,108
CPT,73201,CT UPPER EXTREMITY W/DYE,,,,,0
CPT,73202,CT UPPER EXT W&WO CONTRAST,2923.0,1461.5,170.45,3167.05,108
CPT,73202,CT UPPR EXTREMITY W/O&W/DYE,,,,,0
CPT,73206,CT ANGIO UPR EXTRM W/O&W/DYE,,,,,0
CPT,73206,CT UPPER EXT ANGIO W 3D,2749.0,1374.5,170.45,2908.06,108
CPT,73206,CTA UPPER EXTREMITY W 3D,2833.5,1416.75,170.45,2908.06,108
CPT,73218,MRI UPPER EXT WO CONTRAST,2665.0,1332.5,231.86,2886.72,108
CPT,73218,MRI UPPER EXTREMITY W/O DYE,,,,,0
CPT,73219,MRI UPPER EXT W CONTRAST,3730.0,1865.0,339.02,3618.1,54
CPT,73219,MRI UPPER EXTREMITY W/DYE,,,,,0
CPT,73220,MRI UPPER EXT W&WO CONTRST,3688.5,1844.25,339.02,3995.43,108
CPT,73220,MRI UPPR EXTREMITY W/O&W/DYE,,,,,0
CPT,73221,MRI JOINT UPR EXTREM W/O DYE,,,,,0
CPT,73221,MRI UPPER EXT JT WO CONT,3033.5,1516.75,231.86,3286.36,108
CPT,73222,MRI JOINT UPR EXTREM W/DYE,,,,,0
CPT,73222,MRI UPPER EXT JT W CONT,3478.0,1739.0,452.38,3767.48,108
CPT,73223,MRI JOINT UPR EXTR W/O&W/DYE,,,,,0
CPT,73223,MRI UPPER EXT JT W&WO CONT,4374.5,2187.25,339.02,4739.42,108
CPT,73225,MR ANGIO UPR EXTR W/O&W/DYE,,,,,0
CPT,73225,MRA UPPER EXT W&WO CONT,3727.0,1863.5,540.09,3615.19,47
CPT,732T,IMMNTX ADMN ELECTROPORATN IM,,,,,0
CPT,733T,REM R-T MTN NREHAB THER SPLY,,,333.38,666.76,8
CPT,734T,REM R-T MTN NREHAB TX MGMT,,,,,0
CPT,73501,"HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 1 VIEW",341.5,170.75,50.69,380.24,108
CPT,73501,X-RAY EXAM HIP UNI 1 VIEW,,,,,0
CPT,73502,"HIP, UNILATERAL, WITH PELVIS WHEN PERFORMED; 2-3 VIEWS",444.0,222.0,67.93,483.06,108
CPT,73502,X-RAY EXAM HIP UNI 2-3 VIEWS,,,,,0
CPT,73503,"HIP, UNILATERAL WITH PELVIS WHEN PERFORMED; MIN OF 4 VIEWS",518.0,259.0,76.82,577.15,108
CPT,73503,X-RAY EXAM HIP UNI 4/> VIEWS,,,,,0
CPT,73521,"HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED; 2 VIEWS",404.5,202.25,59.92,451.05,108
CPT,73521,X-RAY EXAM HIPS BI 2 VIEWS,,,,,0
CPT,73522,"HIPS, BILATERAL, WITH PELVIS WHEN PERFORMED; 3-4 VIEWS",518.0,259.0,76.82,577.15,108
CPT,73522,X-RAY EXAM HIPS BI 3-4 VIEWS,,,,,0
CPT,73523,"HIPS,BIL,WITH PELVIS WHEN PERF;MIN OF 5 VIEWS",560.0,280.0,83.09,623.71,108
CPT,73523,X-RAY EXAM HIPS BI 5/> VIEWS,,,,,0
CPT,73525,CONTRAST X-RAY OF HIP,,,,,0
CPT,73525,S&I ARTHROGRAM HIP,1088.5,544.25,81.78,1212.5,108
CPT,73551,FEMUR; 1 VIEW,341.5,170.75,50.69,380.24,108
CPT,73551,X-RAY EXAM OF FEMUR 1,,,,,0
CPT,73552,FEMUR; MINIMUM 2 VIEWS,404.5,202.25,59.92,451.05,108
CPT,73552,X-RAY EXAM OF FEMUR 2/>,,,,,0
CPT,73560,KNEE 1 OR 2 VIEWS,404.5,202.25,25.81,451.05,108
CPT,73560,KNEES 1 OR 2 VIEWS BILAT,297.0,148.5,25.81,330.77,108
CPT,73560,X-RAY EXAM OF KNEE 1 OR 2,,,,,0
CPT,73562,KNEE 3 VIEWS,487.5,243.75,30.46,543.2,108
CPT,73562,KNEE 3 VIEWS BILATERAL,481.5,240.75,30.46,543.2,108
CPT,73562,X-RAY EXAM OF KNEE 3,,,,,0
CPT,73564,KNEE 4 VIEWS MIN COMPLETE,518.0,259.0,35.06,577.15,108
CPT,73564,X-RAY EXAM KNEE 4 OR MORE,,,,,0
CPT,73565,KNEES STANDING AP BILATERAL,518.0,259.0,27.99,577.15,108
CPT,73565,X-RAY EXAM OF KNEES,,,,,0
CPT,73580,CONTRAST X-RAY OF KNEE JOINT,,,,,0
CPT,73580,S&I ARTHROGRAM KNEE,1088.5,544.25,104.84,1212.5,108
CPT,73590,TIBIA & FIBULA 1 VIEW LIMITED,156.0,78.0,23.16,173.63,108
CPT,73590,TIBIA & FIBULA 2 VIEWS,404.5,202.25,23.63,451.05,108
CPT,73590,X-RAY EXAM OF LOWER LEG,,,,,0
CPT,73592,LOWER EXTREMITY INFANT,404.5,202.25,24.91,451.05,108
CPT,73592,X-RAY EXAM OF LEG INFANT,,,,,0
CPT,735T,PREP TUM CAV IORT PRIM CRNOT,,,,,0
CPT,73600,ANKLE 1 VIEW LIMITED,249.0,124.5,23.66,277.42,108
CPT,73600,ANKLE 2 VIEWS,404.5,202.25,23.66,451.05,108
CPT,73600,X-RAY EXAM OF ANKLE,,,,,0
CPT,73610,ANKLE 3 VIEWS MIN,487.5,243.75,27.07,543.2,108
CPT,73610,X-RAY EXAM OF ANKLE,,,,,0
CPT,73615,CONTRAST X-RAY OF ANKLE,,,,,0
CPT,73615,S&I ARTHROGRAM ANKLE,936.5,468.25,84.59,1042.75,108
CPT,73620,FOOT 1 VIEW LIMITED,249.0,124.5,23.03,277.42,108
CPT,73620,FOOT 2 VIEWS,404.5,202.25,23.03,451.05,108
CPT,73620,X-RAY EXAM OF FOOT,,,,,0
CPT,73630,FOOT 3 VIEWS MIN,487.5,243.75,26.75,543.2,108
CPT,73630,X-RAY EXAM OF FOOT,,,,,0
CPT,73650,HEEL (OS CALSIS),404.5,202.25,23.34,451.05,108
CPT,73650,X-RAY EXAM OF HEEL,,,,,0
CPT,73660,TOE LT FOURTH,376.5,188.25,24.34,380.24,108
CPT,73660,TOE LT GREAT,376.5,188.25,24.34,380.24,108
CPT,73660,TOE LT LITTLE,376.5,188.25,24.34,380.24,108
CPT,73660,TOE LT SECOND,376.5,188.25,24.34,380.24,108
CPT,73660,TOE LT THIRD,376.5,188.25,24.34,380.24,108
CPT,73660,TOE RT FOURTH,376.5,188.25,24.34,380.24,108
CPT,73660,TOE RT GREAT,376.5,188.25,24.34,380.24,108
CPT,73660,TOE RT LITTLE,376.5,188.25,24.34,380.24,108
CPT,73660,TOE RT SECOND,376.5,188.25,24.34,380.24,108
CPT,73660,TOE RT THIRD,376.5,188.25,24.34,380.24,108
CPT,73660,TOES 2 VIEWS MIN,325.5,162.75,24.34,330.77,108
CPT,73660,X-RAY EXAM OF TOE(S),,,,,0
CPT,736T,NFCT AGT STI MULT AMP PRB TQ,,,125.04,250.08,8
CPT,73700,CT LOWER EXT WO CONTRAST,1862.0,931.0,101.59,2258.16,162
CPT,73700,CT LOWER EXTREMITY W/O DYE,,,,,0
CPT,73701,CT LOWER EXT W CONTRAST,2727.5,1363.75,170.45,2954.62,108
CPT,73701,CT LOWER EXTREMITY W/DYE,,,,,0
CPT,73702,CT LOWER EXT W&WO CONTRAST,3017.5,1508.75,170.45,3268.9,108
CPT,73702,CT LWR EXTREMITY W/O&W/DYE,,,,,0
CPT,73706,CT ANGIO LWR EXTR W/O&W/DYE,,,,,0
CPT,73706,CTA LOWER EXTREMITY W 3D,2862.0,1431.0,170.45,2937.16,108
CPT,73706,CTA LOWER EXTREMITY W 3D BIL,2831.0,1415.5,170.45,2746.07,54
CPT,73718,MRI LOWER EXT WO CONT,2526.5,1263.25,231.86,2737.34,108
CPT,73718,MRI LOWER EXTREMITY W/O DYE,,,,,0
CPT,73719,MRI LOWER EXT W CONT,3245.0,1622.5,339.02,3515.28,108
CPT,73719,MRI LOWER EXTREMITY W/DYE,,,,,0
CPT,73720,MRI LOWER EXT W&WO CONT,3720.0,1860.0,339.02,4030.35,108
CPT,73720,MRI LWR EXTREMITY W/O&W/DYE,,,,,0
CPT,73721,MRI JNT OF LWR EXTRE W/O DYE,,,,,0
CPT,73721,MRI LOWER EXT JT WO CONT,3004.0,1502.0,231.86,3254.35,108
CPT,73721,MRI LOWER EXT JT WO CONT BIL,3059.0,1529.5,231.86,2967.23,54
CPT,73722,MRI JOINT OF LWR EXTR W/DYE,,,,,0
CPT,73722,MRI LOWER EXT JT W CONT,2940.0,1470.0,452.39,3184.51,108
CPT,73723,MRI JOINT LWR EXTR W/O&W/DYE,,,,,0
CPT,73723,MRI LOWER EXT JT W&WO CONT,3694.5,1847.25,339.02,4002.22,108
CPT,73725,MR ANG LWR EXT W OR W/O DYE,,,,,0
CPT,73725,MRA LOWER EXT W CONT,2921.0,1460.5,503.72,2833.37,47
CPT,73725,MRA LOWER EXT W&WO CONT,4236.0,2118.0,503.72,4108.92,47
CPT,73725,MRA LOWER EXT WO CONT,2292.0,1146.0,399.26,2223.24,47
CPT,737T,XENOGRAFT IMPLTJ ARTCLR SURF,,,12476.14,24952.28,8
CPT,738T,TX PLN MAG FLD ABLTJ PRST8,,,,,0
CPT,739T,ABLTJ MAL PRST8 MAG FLD NDCT,,,,,0
CPT,73U,CYP2D6 GEN CYP2D7-2D6 HYBRID,,,450.91,901.82,8
CPT,74018,RADIOLOGIC EXAM ABDOMEN 1 VIEW,341.5,170.75,50.69,380.24,108
CPT,74018,X-RAY EXAM ABDOMEN 1 VIEW,,,,,0
CPT,74019,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,404.5,202.25,59.92,451.05,108
CPT,74019,X-RAY EXAM ABDOMEN 2 VIEWS,,,,,0
CPT,74021,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,487.5,243.75,72.29,543.2,108
CPT,74021,X-RAY EXAM ABDOMEN 3+ VIEWS,,,,,0
CPT,74022,ABDOMEN ACUTE SERIES,565.0,282.5,40.79,629.53,108
CPT,74022,X-RAY EXAM COMPLETE ABDOMEN,,,,,0
CPT,740T,REM AUTON ALG NSLN CAL SETUP,,,57.33,114.66,8
CPT,74150,CT ABDOMEN W/O DYE,,,,,0
CPT,74150,CT ABDOMEN WO CONTRAST,2228.0,1114.0,101.59,2413.36,162
CPT,74160,CT ABDOMEN W CONTRAST,2879.5,1439.75,170.45,3119.52,162
CPT,74160,CT ABDOMEN W/DYE,,,,,0
CPT,74170,CT ABD PELVIS W&WO CONT LTD,3316.0,1658.0,170.45,3591.91,108
CPT,74170,CT ABDOMEN W&WO CONTRAST,3304.5,1652.25,170.45,3580.27,108
CPT,74170,CT ABDOMEN W/O & W/DYE,,,,,0
CPT,74174,CT ANGIO ABD&PELV W/O&W/DYE,,,,,0
CPT,74174,CTA ABD/PEL W/WO CONTRAST POST,4772.5,2386.25,339.02,5170.1,108
CPT,74175,CT ANGIO ABDOM W/O & W/DYE,,,,,0
CPT,74175,CTA ABDOMEN W 3D,2465.5,1232.75,170.45,2671.38,108
CPT,74176,CT ABD & PELVIS W/O CONTRAST,,,,,0
CPT,74176,CT ABD PELVIS WO CONTRAST,4105.5,2052.75,185.4,4447.45,162
CPT,74177,CT ABD & PELV W/CONTRAST,,,,,0
CPT,74177,CT ABD PELVIS W CONTRAST,5049.5,2524.75,289.88,5470.8,162
CPT,74178,CT ABD & PELV 1/> REGNS,,,,,0
CPT,74178,CT ABD PELVIS W&WO CONTRAST,5817.5,2908.75,339.02,6302.09,108
CPT,74181,MRI ABDOMEN W/O DYE,,,,,0
CPT,74181,MRI ABDOMEN WO CONTRAST,3167.0,1583.5,231.86,3430.89,108
CPT,74182,MRI ABDOMEN W CONTRAST,3938.0,1969.0,339.02,3819.86,54
CPT,74182,MRI ABDOMEN W/DYE,,,,,0
CPT,74183,MRI ABDOMEN W&WO CONTRAST,4812.5,2406.25,339.02,5213.75,108
CPT,74183,MRI ABDOMEN W/O & W/DYE,,,,,0
CPT,74185,MRA ABDOMEN W CONT,4085.0,2042.5,501.26,3962.45,47
CPT,74185,MRA ABDOMEN W&WO CONT,4001.5,2000.75,501.26,4334.93,94
CPT,74185,MRA ABDOMEN WO CONT,2956.0,1478.0,501.26,2867.32,47
CPT,74185,MRI ANGIO ABDOM W ORW/O DYE,,,,,0
CPT,74190,S&I PERITONEOGRAM,605.0,302.5,68.1,1061.98,108
CPT,74190,X-RAY EXAM OF PERITONEUM,,,,,0
CPT,741T,REM AUTON ALG NSLN DATA COLL,,,36.27,72.54,8
CPT,74210,X-RAY XM PHRNX&/CRV ESOPH C+,,,64.7,340.9,24
CPT,74220,S&I ESOPHAGRAM,501.0,250.5,74.16,557.75,108
CPT,74220,X-RAY XM ESOPHAGUS 1CNTRST,,,,,0
CPT,74221,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,501.0,250.5,74.38,557.75,108
CPT,74221,X-RAY XM ESOPHAGUS 2CNTRST,,,,,0
CPT,74230,SWALLOW FUNCTN W CINE VIDEO,667.0,333.5,76.19,743.02,108
CPT,74230,X-RAY XM SWLNG FUNCJ C+,,,,,0
CPT,74235,REMOVE ESOPHAGUS OBSTRUCTION,,,146.92,170.62,16
CPT,74240,UPPER GI SERIES WO KUB,565.0,282.5,83.79,629.53,108
CPT,74240,UPPER GI SERIES WO KUB LTD,565.0,282.5,83.79,629.53,108
CPT,74240,X-RAY XM UPR GI TRC 1CNTRST,,,,,0
CPT,74246,UPPER GI WITH AIR WO KUB,609.5,304.75,90.4,679.0,108
CPT,74246,X-RAY XM UPR GI TRC 2CNTRST,,,,,0
CPT,74248,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,574.0,287.0,87.97,623.71,94
CPT,74248,X-RAY SM INT F-THRU STD,,,,,0
CPT,74250,SMALL BOWEL SERIES,609.5,304.75,86.3,679.0,108
CPT,74250,X-RAY XM SM INT 1CNTRST STD,,,,,0
CPT,74251,SMALL BOWEL SERIES VIA TUBE,868.0,434.0,112.01,1060.21,108
CPT,74251,X-RAY XM SM INT 2CNTRST STD,,,,,0
CPT,74261,CT COLONOGRAPHY DIAG WO CONT,2141.0,1070.5,101.59,2286.29,108
CPT,74261,CT COLONOGRAPHY DX,,,,,0
CPT,74262,CT COLONOGRAPHY DX W/DYE,,,170.45,463.87,24
CPT,74263,CT COLONOGRAPHY SCREENING,2133.5,1066.75,231.86,2311.51,108
CPT,74270,COLON WITH BARIUM,1070.5,535.25,123.57,1192.13,108
CPT,74270,COLON WITH BARIUM LTD,862.0,431.0,123.57,836.14,54
CPT,74270,COLON WITH GASTOGRAFIN,1050.5,525.25,123.57,1192.13,108
CPT,74270,X-RAY XM COLON 1CNTRST STD,,,,,0
CPT,74280,COLON BARIUM W AIR CONT,1070.5,535.25,158.87,1192.13,108
CPT,74280,X-RAY XM COLON 2CNTRST STD,,,,,0
CPT,74283,INTUSSUSCEPTION AIR REDUC,905.5,452.75,101.38,1192.13,108
CPT,74283,THER NMA RDCTJ INTUS/OBSTRCJ,,,,,0
CPT,74290,CHOLECYSTOGRAM,426.5,213.25,55.44,430.68,108
CPT,74290,CONTRAST X-RAY GALLBLADDER,,,,,0
CPT,742T,AQMBF SPECT XERS/STRS & REST,,,,,0
CPT,74300,CHOLANGIOGRAM OPERATIVE,1028.5,514.25,43.0,1038.87,94
CPT,74300,X-RAY BILE DUCTS/PANCREAS,,,,,0
CPT,74301,CHOLANGIOGRAM OPERATIVE ADDL,430.5,215.25,67.58,458.81,94
CPT,74301,X-RAYS AT SURGERY ADD-ON,,,,,0
CPT,74328,S&I ERCP BILIARY DUCT,1901.0,950.5,144.48,1920.6,94
CPT,74328,X-RAY BILE DUCT ENDOSCOPY,,,,,0
CPT,74329,S&I ERCP PANCREATIC DUCT,1011.5,505.75,144.17,1022.38,94
CPT,74329,X-RAY FOR PANCREAS ENDOSCOPY,,,,,0
CPT,74330,S&I ERCP BILIARY PANCREAS,962.0,481.0,153.1,955.45,94
CPT,74330,S&I ERCP BILIARY PANCREAS LTD,565.0,282.5,98.42,548.05,47
CPT,74330,X-RAY BILE/PANC ENDOSCOPY,,,,,0
CPT,74340,S&I GI TUBE PLACEMENT,781.5,390.75,102.95,942.84,94
CPT,74340,X-RAY GUIDE FOR GI TUBE,,,,,0
CPT,74355,S&I PLACE ENTEROCLYSIS TUBE,782.0,391.0,120.89,843.9,94
CPT,74355,X-RAY GUIDE INTESTINAL TUBE,,,,,0
CPT,74360,S&I INTRALUM DIL STRICT /OBST,1316.5,658.25,137.65,1329.87,94
CPT,74360,X-RAY GUIDE GI DILATION,,,,,0
CPT,74363,S&I DILATN TRANSHEP BILI DUCT,1295.0,647.5,219.49,1290.1,94
CPT,74363,X-RAY BILE DUCT DILATION,,,,,0
CPT,743T,B1 STR & FX RSK VRT FX ASSMT,,,231.86,463.72,8
CPT,74400,UROGRAM (IVP) W&WO KUB,634.0,317.0,91.25,706.16,108
CPT,74400,UROGRAPHY IV +-KUB TOMOG,,,,,0
CPT,74410,S&I INFUSION PYELOGRAM,760.5,380.25,95.3,768.24,108
CPT,74410,UROGRAPHY NFS DRIP&/BOLUS,,,,,0
CPT,74415,S&I INFUSION PYELOGRM W TOMOGR,775.0,387.5,110.89,863.3,108
CPT,74415,UROGRAPHY NFS DRIP&/BLS W/NF,,,,,0
CPT,74420,S&I PYELO UROGRAM RETROGR,773.5,386.75,110.94,861.36,108
CPT,74420,UROGRAPHY RTRGR +-KUB,,,,,0
CPT,74425,S&I URO/LOOPOGRAM ANTEGR,577.0,288.5,63.36,678.04,108
CPT,74425,S&I URO/LOOPOGRAM ANTEGR BIL,577.0,288.5,63.36,678.04,108
CPT,74425,UROGRAPHY ANTEGRADE RS&I,,,,,0
CPT,74430,CONTRAST X-RAY BLADDER,,,,,0
CPT,74430,S&I CYSTOGRAM 3 VIEWS MIN,487.5,243.75,66.04,678.04,108
CPT,74440,S&I VASOGRAM,434.0,217.0,71.52,463.72,54
CPT,74440,X-RAY MALE GENITAL TRACT,,,,,0
CPT,74445,S&I CORPORA CAVERNOSOGRAM,724.0,362.0,91.96,731.38,108
CPT,74445,X-RAY EXAM OF PENIS,,,,,0
CPT,74450,S&I URETHROCYSTOGRAM RETRO,646.0,323.0,67.77,719.74,108
CPT,74450,X-RAY URETHRA/BLADDER,,,,,0
CPT,74455,S&I URETHROCYSTO VOIDING,998.0,499.0,75.36,1111.62,108
CPT,74455,X-RAY URETHRA/BLADDER,,,,,0
CPT,74470,S&I RENAL CYST STUDY TRANSLUM,1075.5,537.75,68.6,1262.94,108
CPT,74470,X-RAY EXAM OF KIDNEY LESION,,,,,0
CPT,74485,DIL NEPHROSTOMY URETERS BILAT,3702.5,1851.25,93.95,4062.7,108
CPT,74485,DILATION URTR/URT RS&I,,,,,0
CPT,74485,S&I DIL NEPHROSTOMY URETHRA,2470.0,1235.0,93.95,4062.7,108
CPT,744T,INSJ BIOPROSTC VLV FEM VN,,,5407.35,10814.7,8
CPT,745T,CAR ABLT RAD ARR N-INVAS LOC,,,,,0
CPT,746T,CAR ABLT RAD ARR CNV LOC MAP,,,,,0
CPT,74712,MRI FETAL SNGL/1ST GESTATION,930.0,465.0,162.0,902.1,54
CPT,74713,MRI FETAL EA ADDL GESTATION,467.0,233.5,81.35,452.99,47
CPT,74740,S&I HYSTEROSALPINGOGRAM,1038.0,519.0,64.99,1156.24,108
CPT,74740,X-RAY FEMALE GENITAL TRACT,,,,,0
CPT,74742,S&I TRANSCERV CATH FALLOPIAN,1609.0,804.5,140.62,1625.72,94
CPT,74742,X-RAY FALLOPIAN TUBE,,,,,0
CPT,74775,S&I PERINEOGRAM,3518.0,1759.0,80.25,3412.46,54
CPT,74775,X-RAY EXAM OF PERINEUM,,,,,0
CPT,747T,CAR ABLT RAD ARRHYT DLVR RAD,,,,,0
CPT,748T,NJX STM CL PRDCT ANL SFT TIS,,,,,0
CPT,749T,B1 STR&FX RSK ASSMT DXR-BMD,,,,,0
CPT,74U,CYP2D6 NONDUPLICATED GENE,,,450.91,901.82,8
CPT,750,ANES HRNA RPR UPR ABD NOS,,,,,0
CPT,750T,B1 STR&FX RSK ASMT DXRBMD1VW,,,,,0
CPT,751T,DGTZ GLS MCRSCP SLD LEVEL II,,,,,0
CPT,752,ANES HRNA RPR LMBR&VNT&/DEHS,,,,,0
CPT,752T,DGTZ GLS MCRSCP SLD LVL III,,,,,0
CPT,753T,DGTZ GLS MCRSCP SLD LEVEL IV,,,,,0
CPT,754,ANES HRNA RPR OMPHALOCELE,,,,,0
CPT,754T,DGTZ GLS MCRSCP SLD LEVEL V,,,,,0
CPT,75557,CARDIAC MRI FOR MORPH,,,,,0
CPT,75557,MRI CARDIAC MORPH WO CONTRAST,1797.0,898.5,231.86,1743.09,54
CPT,75559,CARDIAC MRI W/STRESS IMG,,,,,0
CPT,75559,MRI CARDIAC WO CONT W STRESS,2378.0,1189.0,414.24,2306.66,54
CPT,75561,CARDIAC MRI FOR MORPH W/DYE,,,,,0
CPT,75561,MRI CARDIAC MORPH W&WO CONT,3034.0,1517.0,339.02,2942.98,54
CPT,75563,CARD MRI W/STRESS IMG & DYE,,,,,0
CPT,75563,MRI CARDIAC W&WO CONT W STRES,3706.0,1853.0,640.99,3594.82,54
CPT,75565,CARD MRI VELOC FLOW MAPPING,,,,,0
CPT,75565,MRI CARDIAC VELOCITY FLOW MAP,216.0,108.0,37.62,209.52,47
CPT,75571,CT CARDIAC SCORING EVAL,250.0,125.0,43.55,242.5,108
CPT,75571,CT HRT W/O DYE W/CA TEST,,,,,0
CPT,75572,CT HEART W 3D IMAGE,885.5,442.75,136.22,959.33,108
CPT,75572,CT HRT W/3D IMAGE,,,,,0
CPT,75573,CT HEART W 3D IMAGE CONGENITAL,958.0,479.0,147.37,1037.9,108
CPT,75573,CT HRT C+ STRUX CGEN HRT DS,,,,,0
CPT,75574,CT ANGIO HEART W 3D IMAGE,1875.5,937.75,310.07,1911.87,108
CPT,75574,CT ANGIO HRT W/3D IMAGE,,,,,0
CPT,75574,CTA CORONARY W CALC SCORE,1875.5,937.75,310.07,1911.87,108
CPT,75574,CTA CORONARY WO CALC SCORE,1764.5,882.25,271.4,1911.87,108
CPT,75580,N-INVAS EST C FFR SW ALY CTA,4929.0,2464.5,808.63,5059.52,108
CPT,755T,DGTZ GLS MCRSCP SLD LEVEL VI,,,,,0
CPT,756,ANES HRNA RPR DIPHRG HRNA,,,,,0
CPT,75600,CONTRAST EXAM THORACIC AORTA,,,240.25,6136.64,24
CPT,75605,CONTRAST EXAM THORACIC AORTA,,,,,0
CPT,75605,S&I AORTOGRAPHY THORACIC,14055.0,7027.5,200.25,13633.35,108
CPT,75605,S&I AORTOGRAPHY THORACIC SERIAL,5875.0,2937.5,200.25,10814.7,108
CPT,75625,CONTRAST EXAM ABDOMINL AORTA,,,,,0
CPT,75625,S&I AORTOGRAPHY ABD SELECT,3709.5,1854.75,200.22,6136.64,108
CPT,75630,S&I AORTOGRAPHY ABD W/RUNOFF,3926.5,1963.25,232.27,6136.64,108
CPT,75630,X-RAY AORTA LEG ARTERIES,,,,,0
CPT,75635,CT ANGIO ABDOMINAL ARTERIES,,,,,0
CPT,75635,CTA ABD AORTA & ILIOFEM W 3D,3238.0,1619.0,170.45,3507.52,108
CPT,756T,DGTZ GLS MCRSCP SLD SPC GRPI,,,,,0
CPT,75705,ARTERY X-RAYS SPINE,,,,,0
CPT,75705,S&I ANGIO SPINAL SELECTIVE,5622.0,2811.0,253.64,10814.7,108
CPT,75710,ARTERY X-RAYS ARM/LEG,,,,,0
CPT,75710,S&I ANGIO EXT UNI LT,5622.0,2811.0,210.87,6136.64,54
CPT,75710,S&I ANGIO EXT UNI RT,5622.0,2811.0,210.87,6136.64,54
CPT,75710,S&I ANGIO EXTREMITY UNIL,5397.5,2698.75,210.87,6136.64,108
CPT,75716,ARTERY X-RAYS ARMS/LEGS,,,,,0
CPT,75716,S&I ANGIO EXTREMITY BILAT,5939.5,2969.75,243.2,6136.64,108
CPT,75716,S&I ANGIOILIAC NON-SEL/CATH BI,5939.5,2969.75,243.2,6136.64,108
CPT,75726,ARTERY X-RAYS ABDOMEN,,,,,0
CPT,75726,S&I ANGIO VISCERAL SEL SUPRASEL,5939.5,2969.75,209.91,10814.7,108
CPT,75731,ARTERY X-RAYS ADRENAL GLAND,,,,,0
CPT,75731,S&I ANGIO ADRENAL SEL UNI,4179.0,2089.5,211.81,6136.64,108
CPT,75733,ARTERY X-RAYS ADRENALS,,,,,0
CPT,75733,S&I ANGIO ADRENAL SEL BIL,5152.5,2576.25,245.12,6136.64,108
CPT,75736,ARTERY X-RAYS PELVIS,,,,,0
CPT,75736,S&I ANGIO PELVIC SEL SUPRASEL,5622.0,2811.0,210.23,10814.7,108
CPT,75741,ARTERY X-RAYS LUNG,,,,,0
CPT,75741,S&I ANGIO PULM SEL UNIL,3681.0,1840.5,201.15,6136.64,108
CPT,75741,S&I ANGIO PULMON SELECT LT,3834.0,1917.0,201.15,6136.64,54
CPT,75741,S&I ANGIO PULMON SELECT RT,3834.0,1917.0,201.15,6136.64,54
CPT,75743,ARTERY X-RAYS LUNGS,,,,,0
CPT,75743,S&I ANGIO PULMON SELECT BIL,5064.5,2532.25,224.11,6136.64,108
CPT,75746,ARTERY X-RAYS LUNG,,,,,0
CPT,75746,S&I ANGIO PULM NONSELECT,3274.0,1637.0,203.68,6136.64,108
CPT,75756,ARTERY X-RAYS CHEST,,,,,0
CPT,75756,S&I ANGIO INT MAMMARY UNIL,3897.0,1948.5,225.39,6136.64,108
CPT,75756,S&I ANGIO INTERN MAMMARY LT,4059.0,2029.5,225.39,6136.64,54
CPT,75756,S&I ANGIO INTERNAL MAMMARY BIL,4482.0,2241.0,225.39,6136.64,108
CPT,75774,ARTERY X-RAY EACH VESSEL,,,,,0
CPT,75774,S&I ANGIO SEL EA ADDL VESSEL,2375.5,1187.75,149.49,2399.78,94
CPT,757T,DGTZ GLS MCRSCP SL SPC GRPII,,,,,0
CPT,75801,LYMPH VESSEL X-RAY ARM/LEG,,,,,0
CPT,75801,S&I LYMPHANGIOGRAM LOWER EXT,1158.0,579.0,193.36,1219.18,108
CPT,75801,S&I LYMPHANGIOGRAM UPPER EXT,1158.0,579.0,193.36,1219.18,108
CPT,75803,LYMPH VESSEL X-RAY ARMS/LEGS,,,,,0
CPT,75803,S&I LYMPHANGIOGRAM EXT BILAT,1616.0,808.0,246.51,3059.4,108
CPT,75805,LYMPH VESSEL X-RAY TRUNK,,,,,0
CPT,75805,S&I LYMPHANGIO PELVIC ABD UNI,3274.0,1637.0,257.78,6136.64,108
CPT,75807,LYMPH VESSEL X-RAY TRUNK,,,,,0
CPT,75807,S&I LYMPHANGIO PELVIC ABD BIL,3344.0,1672.0,271.07,6136.64,108
CPT,75809,NONVASCULAR SHUNT X-RAY,,,,,0
CPT,75809,S&I SHUNTOGRAM NON-VASC,328.0,164.0,48.77,364.72,108
CPT,75810,S&I SPLENOPORTOGRAPHY,5064.5,2532.25,503.19,6136.64,108
CPT,75810,VEIN X-RAY SPLEEN/LIVER,,,,,0
CPT,75820,S&I VENOGRAM EXTREMITY LT,1883.0,941.5,103.89,3059.4,54
CPT,75820,S&I VENOGRAM EXTREMITY RT,1883.0,941.5,103.89,3059.4,54
CPT,75820,S&I VENOGRAM EXTREMITY UNILAT,1872.5,936.25,103.89,3059.4,108
CPT,75820,VEIN X-RAY ARM/LEG,,,,,0
CPT,75822,S&I VENOGRAM EXTREMITY BILAT,1965.5,982.75,126.23,3059.4,108
CPT,75822,VEIN X-RAY ARMS/LEGS,,,,,0
CPT,75825,S&I VENOGRAM CAVAL INFERIOR,4063.5,2031.75,191.51,6136.64,108
CPT,75825,VEIN X-RAY TRUNK,,,,,0
CPT,75827,S&I VENOGRAM CAVAL SUPERIOR,2283.5,1141.75,190.59,3059.4,108
CPT,75827,VEIN X-RAY CHEST,,,,,0
CPT,75831,S&I RENAL VEIN LT,5377.0,2688.5,203.86,6136.64,54
CPT,75831,S&I RENAL VEIN RT,5377.0,2688.5,203.86,6136.64,54
CPT,75831,S&I VENOGRAP RENAL SEL UNILAT,5161.5,2580.75,203.86,6136.64,108
CPT,75831,VEIN X-RAY KIDNEY,,,,,0
CPT,75833,S&I VENOGRAM RENAL SEL BILAT,5910.5,2955.25,220.1,6136.64,108
CPT,75833,VEIN X-RAY KIDNEYS,,,,,0
CPT,75840,S&I VENOGRAM ADRENAL UNIL,4927.0,2463.5,200.74,6136.64,108
CPT,75840,VEIN X-RAY ADRENAL GLAND,,,,,0
CPT,75842,S&I VENOGRAM ADRENAL BILAT,6147.0,3073.5,220.73,6210.91,94
CPT,75842,VEIN X-RAY ADRENAL GLANDS,,,,,0
CPT,75860,S&I VENOGRAM SINUS JUGULAR,3344.0,1672.0,196.81,6136.64,108
CPT,75860,VEIN X-RAY NECK,,,,,0
CPT,75870,S&I VENOGRAM SUP SAGITTAL SINUS,4091.0,2045.5,195.9,6136.64,108
CPT,75870,VEIN X-RAY SKULL,,,,,0
CPT,75872,S&I VENOGRAM EPIDURAL,1855.5,927.75,233.61,1875.01,108
CPT,75872,VEIN X-RAY SKULL EPIDURAL,,,,,0
CPT,75880,S&I VENOGRAM ORBITS,1771.0,885.5,104.53,1717.87,54
CPT,75880,VEIN X-RAY EYE SOCKET,,,,,0
CPT,75885,S&I TRANSHEP PORTOGRM W HEMDY,4180.0,2090.0,206.5,6136.64,108
CPT,75885,VEIN X-RAY LIVER W/HEMODYNAM,,,,,0
CPT,75887,S&I TRANSHEP PORTOGRM WO HEMDYN,4091.0,2045.5,206.83,6136.64,108
CPT,75887,VEIN X-RAY LIVER W/O HEMODYN,,,,,0
CPT,75889,S&I HEPATIC VENOGRPHY W HEMDY,4594.5,2297.25,192.78,6136.64,108
CPT,75889,VEIN X-RAY LIVER W/HEMODYNAM,,,,,0
CPT,75891,S&I HEPATIC VENOGRPHY WO HEMD,5997.5,2998.75,192.78,6503.85,108
CPT,75891,VEIN X-RAY LIVER,,,,,0
CPT,75893,S&I VENOUS SAMPLING THRU CATH,6570.0,3285.0,163.79,10814.7,108
CPT,75893,VENOUS SAMPLING BY CATHETER,,,,,0
CPT,75894,S&I TRANSCATH THPY EMBOLI,4534.0,2267.0,756.89,4581.31,94
CPT,75894,X-RAYS TRANSCATH THERAPY,,,,,0
CPT,75898,FOLLOW-UP ANGIOGRAPHY,,,,,0
CPT,75898,S&I ANGIO F/U EMBO OR INFUS,4091.0,2045.5,109.94,6136.64,108
CPT,758T,DGTZ GLS MCRSCP SL SPC HCHEM,,,,,0
CPT,75901,REMOVE CVA DEVICE OBSTRUCT,,,,,0
CPT,75901,S&I MECH REMOV PERICATH OBST,665.5,332.75,111.13,672.21,94
CPT,75902,REMOVE CVA LUMEN OBSTRUCT,,,,,0
CPT,75902,S&I MECH REMOV INTRALUM OBST,660.5,330.25,110.79,664.45,94
CPT,75956,S&I ENDOVAS REPAIR THOR SUBCL,1760.5,880.25,293.87,1778.98,94
CPT,75956,XRAY ENDOVASC THOR AO REPR,,,,,0
CPT,75957,S&I ENDOVAS REPAIR THOR NO SUBCL,1938.0,969.0,323.48,1958.43,94
CPT,75957,XRAY ENDOVASC THOR AO REPR,,,,,0
CPT,75958,S&I ENDOVAS REPAIR THOR PROX EXT,1584.5,792.25,260.6,1622.81,94
CPT,75958,XRAY PLACE PROX EXT THOR AO,,,,,0
CPT,75959,S&I ENDOVAS REPAIR THOR DIST EXT,2478.5,1239.25,413.72,2504.54,94
CPT,75959,XRAY PLACE DIST EXT THOR AO,,,,,0
CPT,75970,S&I TRANSCATHETER BIOPSY,2331.0,1165.5,389.16,2355.16,94
CPT,75970,VASCULAR BIOPSY,,,,,0
CPT,75984,S&I REPLACE PERC DRN TUBE W CON,839.0,419.5,95.77,847.78,94
CPT,75984,XRAY CONTROL CATHETER CHANGE,,,,,0
CPT,75989,ABSCESS DRAINAGE UNDER X-RAY,,,,,0
CPT,75989,S&I CT GUIDANCE DRAINAGE ABSC,1307.0,653.5,117.55,1341.51,92
CPT,75989,S&I FL GUIDANCE FOR DRAINAGE,1434.5,717.25,117.55,1595.65,94
CPT,75989,S&I US GUIDANCE DRAINAGE ABSC,1611.0,805.5,117.55,1662.58,92
CPT,759T,DGTZ GLS MCRSCP SL SP GRPIII,,,,,0
CPT,75T,PERQ STENT/CHEST VERT ART,,,,,0
CPT,75U,CYP2D6 5' GENE DUP/MLT,,,450.91,901.82,8
CPT,76000,FLUORO UP TO 1HR PHYSCIAN/OTHER QUAL HEALTH CARE PROFESSIONAL,829.5,414.75,84.74,924.41,108
CPT,76000,FLUOROSCOPY <1 HR PHYS/QHP,,,,,0
CPT,76010,WHOLE BODY FB 1 VW CHILD,341.5,170.75,24.24,380.24,108
CPT,76010,X-RAY NOSE TO RECTUM,,,,,0
CPT,76014,MRI MR SAFETY IMPLT&/FB ASSMT STAFF 1ST 15 MIN,100.0,50.0,15.32,108.64,108
CPT,76015,MRI MR SAFETY IMPLT&/FB ASSMT STAFF EA ADD 30,481.0,240.5,74.03,520.89,94
CPT,76016,"MR safety determination by a physician or other qualified health care professional responsible for the safety of the MR procedure, including review of implant MR conditions for indicated MR examinatio",,,84.57,169.14,8
CPT,76017,MRI MR SAFETY MED PHYSICS XM CUSTOM PLNG&MNTR,985.0,492.5,151.55,1067.0,108
CPT,76018,MRI MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,373.5,186.75,57.48,404.49,108
CPT,76019,MRI MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,242.0,121.0,37.27,261.9,108
CPT,76080,S&I EXAM ABS FISTULA SINUS TR,703.0,351.5,53.12,1061.98,108
CPT,76080,X-RAY EXAM OF FISTULA,,,,,0
CPT,76098,SURG SPECIMEN RADIOGRAPH,786.0,393.0,17.42,1061.98,108
CPT,76098,X-RAY EXAM SURGICAL SPECIMEN,,,,,0
CPT,760T,DGTZ GLS MCRSCP SL IMM 1ST,,,,,0
CPT,76100,TOMOGRAM SINGLE PLANE BODY,382.5,191.25,56.78,425.83,108
CPT,76100,X-RAY EXAM OF BODY SECTION,,,,,0
CPT,76120,CINE/VIDEO X-RAYS,,,,,0
CPT,76120,S&I CINERADIOGRAPHY VIDEORADI,449.0,224.5,64.96,506.34,108
CPT,76125,CINE/VIDEO X-RAYS ADD-ON,,,,,0
CPT,76125,S&I CINE VIDEORADIOGRAPHY,235.5,117.75,39.36,237.65,94
CPT,76140,OUTSIDE X-RAY INTERPRETATION,97.0,48.5,16.89,94.09,47
CPT,76140,X-RAY CONSULTATION,,,,,0
CPT,76145,MED PHYSIC DOS EVAL RAD EXPS,,,362.62,725.24,8
CPT,761T,DGTZ GLS MCRSCP SL IMM EA 1,,,,,0
CPT,762T,DGTZ GLS MCRSCP SL IMM EA M,,,,,0
CPT,76376,3D RECON NON IND WKST,721.5,360.75,63.17,781.82,94
CPT,76376,3D RECON NON IND WORK STATION,806.0,403.0,63.17,781.82,46
CPT,76376,3D RENDER W/INTRP POSTPROCES,,,,,0
CPT,76377,3D RECON W IND WKST,849.0,424.5,83.15,919.56,94
CPT,76377,3D RECON W IND WORK STATION,948.0,474.0,83.15,919.56,46
CPT,76377,3D RENDER W/INTRP POSTPROCES,,,,,0
CPT,76380,CAT SCAN FOLLOW-UP STUDY,,,,,0
CPT,76380,CT LOCAL FOLLOW UP OR LTD,886.5,443.25,84.57,960.3,108
CPT,76390,MR SPECTROSCOPY,757.0,378.5,84.57,734.29,54
CPT,76391,MR ELASTOGRAPHY,,,,,0
CPT,76391,MRI MR ELASTOGRAPHY,511.0,255.5,89.01,495.67,54
CPT,763T,DGTZ GLS MCRSCP MPHMTRC ALYS,,,,,0
CPT,76496,UNLISTED FLUOROSCOPIC PX,,,84.57,169.14,8
CPT,76497,CT WHOLE BODY,726.0,363.0,84.57,786.67,76
CPT,76497,UNLISTED CT PROCEDURE,,,,,0
CPT,76498,"MAG RESONANCE PROCED ( DIAG, INTERL) MRI RAD PLAN UNLISTED",166.0,83.0,28.91,169.14,54
CPT,76498,MRI UNLISTED MAGNETIC RESONANCE PROCEDURE,1039.0,519.5,84.57,1007.83,54
CPT,76498,UNLISTED MR PROCEDURE,,,,,0
CPT,76499,MISC UNLISTED DIAGNOSTIC PROC,205.0,102.5,35.71,198.85,38
CPT,76499,S&I BRONCHOGRAM BILAT,1508.5,754.25,84.57,1523.87,76
CPT,76499,UNLISTED DX RADIOGRAPHIC PX,,,,,0
CPT,764T,ASSTV ALG ECG RSK ASMT CNCRT,,,129.29,258.58,8
CPT,76506,US ENCEPHALOGRAM FOLLOW UP,546.5,273.25,89.19,563.57,108
CPT,76506,US ENCEPHALOGRAM INITIAL,520.5,260.25,80.13,563.57,108
CPT,76510,OPH US DX B-SCAN&QUAN A-SCAN,,,129.29,258.58,24
CPT,76511,OPH US DX QUAN A-SCAN ONLY,,,80.69,203.18,24
CPT,76512,OPH US DX B-SCAN,,,77.24,203.18,24
CPT,76513,OPH US DX ANT SGM US UNI/BI,,,70.97,203.18,24
CPT,76514,ECHO EXAM OF EYE THICKNESS,,,12.41,56.22,24
CPT,76516,OPHTHALMIC A SCAN BILAT,533.0,266.5,57.81,549.99,108
CPT,76519,ECHO EXAM OF EYE,,,62.78,203.18,24
CPT,76529,ECHO EXAM OF EYE,,,59.9,169.14,24
CPT,76536,US NECK SOFT TISSUE THYROID,820.5,410.25,94.85,888.52,108
CPT,765T,ASSTV ALG ECG RSK ASMT PREV,,,129.29,258.58,8
CPT,76604,US CHEST LUNG MEDIASTINUM,458.5,229.25,70.55,496.64,108
CPT,76641,US BREAST COMPLETE BILAT,588.5,294.25,90.58,637.29,108
CPT,76641,US BREAST COMPLETE UNILAT,545.5,272.75,83.96,590.73,108
CPT,76642,US BREAST LIMITED BILAT,588.5,294.25,84.57,637.29,108
CPT,76642,US BREAST LIMITED UNILAT,545.5,272.75,83.96,590.73,108
CPT,766T,TC MAG STIMJ PN 1ST NERVE,,,209.83,419.66,8
CPT,76700,US ABDOMEN COMPL,1183.5,591.75,101.59,1282.34,108
CPT,76705,US ABDOMEN LMITED,859.0,429.5,87.62,930.23,108
CPT,76705,US ABDOMEN LTD,859.0,429.5,87.62,930.23,108
CPT,76705,US ABDOMEN LTD APPENDIX,901.0,450.5,87.62,930.23,108
CPT,76705,US ABDOMEN LTD RT UPPER QUAD,859.0,429.5,87.62,930.23,108
CPT,76705,US ABDOMEN LTD SNGL ORG/QUAD,859.0,429.5,87.62,930.23,108
CPT,76706,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,533.5,266.75,82.04,578.12,108
CPT,76770,US RETROPERITONEAL COMPL,1010.0,505.0,101.59,1094.16,108
CPT,76775,US RETROPERITONEAL LTD,620.5,310.25,93.86,672.21,108
CPT,76776,US TRANSPLANTD KIDNEY DOPPLER,746.0,373.0,101.59,808.01,108
CPT,767T,TC MAG STIMJ PN EA ADDL NRV,,,,,0
CPT,76800,US SPINAL CANAL,713.5,356.75,101.59,773.09,108
CPT,76801,US OB TRANSABD <14WKS,725.5,362.75,101.59,767.27,108
CPT,76802,US OB TRANSABD <14WKS EA ADDL,708.5,354.25,59.71,767.27,94
CPT,76805,US OB TRANSABD >=14WKS,708.5,354.25,101.59,767.27,108
CPT,76810,US OB TRANSABD >=14WKS EA ADD,708.5,354.25,80.91,767.27,94
CPT,76811,US OB DETAILED FETAL EXAM,1004.5,502.25,154.51,1088.34,108
CPT,76812,US OB DETAILED FETAL EXAM ADD,766.0,383.0,117.75,830.32,94
CPT,76813,US 1ST TRIMESTER SCREEN,580.0,290.0,101.03,562.6,54
CPT,76814,US 1ST TRIMESTER SCREEN EA ADD,330.0,165.0,57.48,320.1,47
CPT,76815,US OB LIMITED 1 OR MORE FETUS,557.5,278.75,75.04,604.31,108
CPT,76816,US OB TRANSABD F/UP,481.0,240.5,78.39,496.64,108
CPT,76816,US OB TRANSABD F/UP EA ADDL,458.5,229.25,70.55,496.64,108
CPT,76817,US OB TRANSVAGINAL,695.0,347.5,85.43,752.72,108
CPT,76818,FETAL BIO PROFILE W N-STRESS,935.0,467.5,100.72,906.95,54
CPT,76818,US FETAL BIO PROFILE W N-STRESS,879.0,439.5,100.72,906.95,108
CPT,76818,US FETAL BPP W NONSTRESS,694.0,347.0,100.72,751.75,108
CPT,76819,FETAL BIO PROFILE WO N-STRESS,720.0,360.0,77.28,698.4,54
CPT,76819,US FETAL BIO PROFILE WO N-STRESS,677.5,338.75,77.28,699.37,108
CPT,76819,US FETAL BPP WO NONSTRESS,634.0,317.0,77.28,686.76,108
CPT,76820,FETAL UMBILICAL ARTERY ECHO,412.0,206.0,41.68,399.64,54
CPT,76820,US FETAL UMBILICAL ARTERY ECHO,387.0,193.5,41.68,399.64,108
CPT,76821,US FETAL MIDDLE CEREBR ART ECHO,387.0,193.5,63.06,399.64,108
CPT,76825,ECHO FETAL CARDIOVASC W/IMAGE,2279.5,1139.75,177.07,2352.25,108
CPT,76826,ECHO FETAL CARDIOVASC W/IMAGE REPEAT STUDY,1106.0,553.0,100.23,1072.82,54
CPT,76827,DOP ECHO CARDIO W/SPECTRA COMP,766.0,383.0,57.1,743.02,54
CPT,76828,DOP ECHO CARDIO W/SPECTRA F/U,378.5,189.25,42.49,389.94,108
CPT,76830,US TRANSVAGINAL NON-PREG,920.0,460.0,101.44,997.16,108
CPT,76831,US HYSTEROSONOGRAPHY,718.0,359.0,101.7,777.94,108
CPT,76856,US PELVIC NON OB COMPLETE,1158.5,579.25,101.59,1255.18,108
CPT,76857,US PELVIS NON OB LTD,467.0,233.5,78.39,469.48,108
CPT,76870,US TESTICLE SCROTUM CONTENTS,926.5,463.25,101.53,1003.95,108
CPT,76872,US PROSTATE TRANSRECTAL,1028.0,514.0,101.59,1113.56,108
CPT,76873,US PROSTATE VOLUME STUDY,1874.0,937.0,101.59,1934.18,108
CPT,76881,US COMPLETE JOINT REAL-TIME W IMAGE DOCUMENTATION,677.0,338.5,96.7,733.32,108
CPT,76882,US ECHO EXTREM NOVAS LIMIT,295.0,147.5,26.25,348.23,108
CPT,76883,US NRV&ACC STRUX 1XTR COMPRE,,,101.59,203.18,8
CPT,76885,US INFANT HIPS DYNAMIC,496.0,248.0,76.29,537.38,108
CPT,76886,US INFANT HIPS STATIC,438.0,219.0,76.29,424.86,54
CPT,76932,ECHO GUIDE FOR HEART BIOPSY,,,85.75,99.58,16
CPT,76936,US PSEUDOANEURYSM THERAPY,677.5,338.75,110.44,699.37,108
CPT,76937,DX US GUIDE VASCULAR ACCESS,962.0,481.0,30.23,992.31,94
CPT,76937,US GUIDE VASCULAR ACCESS,962.0,481.0,30.23,992.31,94
CPT,76940,US GUIDE TISSUE ABLATION,652.0,326.0,113.57,632.44,47
CPT,76941,US GUIDE FOR FETAL TRANSFUSN,910.0,455.0,115.21,882.7,47
CPT,76942,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1363.0,681.5,158.21,1322.11,47
CPT,76942,US GUIDE NEEDLE PLACEMENT,882.0,441.0,153.29,857.48,94
CPT,76945,ECHO GUIDE VILLUS SAMPLING,,,84.2,97.78,16
CPT,76946,US GUIDANCE FOR AMNIOCENTESIS,719.5,359.75,34.43,742.05,94
CPT,76948,ECHO GUIDE OVA ASPIRATION,,,35.98,41.79,16
CPT,76965,US GUIDE INTERSTITIAL IMPLANT,1310.0,655.0,111.31,1352.18,94
CPT,76975,GI ENDOSCOPIC ULTRASOUND,,,92.61,463.72,24
CPT,76977,US BONE DENSITY MEASURE,,,11.1,203.18,24
CPT,76978,US TARGETED MICROBUBBLE CONTRAST FIRST LESION,1277.5,638.75,208.34,1318.23,108
CPT,76979,US TARGETED MICROBUBBLE CONTRAST OF ADDITIONAL LESION,1277.5,638.75,208.34,1318.23,94
CPT,76981,"US ELASTOGRAPHY PARENCHYMA (EG, ORGAN)",280.0,140.0,48.77,271.6,54
CPT,76982,US ELASTOGRAPH; FIRST TARGET LESION,280.0,140.0,48.77,271.6,54
CPT,76983,US ELASTOGRAPHY EA ADDL TAGET LESION,280.0,140.0,48.77,271.6,47
CPT,76984,DX INTRAOP THORACIC AORTA US,,,,,0
CPT,76987,DX INTRAOP EPICAR CAR US CHD,,,,,0
CPT,76988,DX NTROP EPCR US CHD IMG ACQ,,,,,0
CPT,76989,DX INTRAOP EPCAR US CHD I&R,,,,,0
CPT,76998,US GUIDE INTRAOPERATIVE,828.0,414.0,135.0,854.57,94
CPT,76999,US GUIDANCE UNLISTED MISC,269.0,134.5,41.28,291.97,76
CPT,76T,S&I STENT/CHEST VERT ART,,,,,0
CPT,76U,CYP2D6 3' GENE DUP/MLT,,,450.91,901.82,8
CPT,770,ANES PX MAJ ABD BLOOD VESSEL,,,,,0
CPT,77001,FLUOROGUIDE FOR VEIN DEVICE,,,,,0
CPT,77001,S&I FLUOR GUIDE CEN VEN ACC PLACE,1486.5,743.25,91.16,1748.91,94
CPT,77002,NEEDLE LOCALIZATION BY XRAY,,,,,0
CPT,77002,S&I FLUORO GUIDE NEEDLE PLACE,1041.0,520.5,60.91,1131.99,94
CPT,77003,FLUOROGUIDE FOR SPINE INJECT,1115.5,557.75,50.51,1242.57,94
CPT,77011,CT GUIDE STEREOTACTIC LOCALIZ,1354.0,677.0,208.34,1466.64,94
CPT,77011,CT SCAN FOR LOCALIZATION,,,,,0
CPT,77012,CT SCAN FOR NEEDLE BIOPSY,,,,,0
CPT,77012,S&I CT GUIDE NEEDLE PLACEMENT,1724.5,862.25,147.24,2447.31,186
CPT,77013,CT GUIDE FOR TISSUE ABLATION,,,,,0
CPT,77013,CT GUIDE PARENCHYM TISS ABLAT,1356.0,678.0,222.45,1391.95,94
CPT,77014,CT GUIDE PLACE RAD RX FIELDS,835.5,417.75,120.19,951.57,94
CPT,77014,CT SCAN FOR THERAPY GUIDE,,,,,0
CPT,77021,MRI GUIDANCE NDL PLMT RS&I,,,,,0
CPT,77021,S&I MR GUIDE NEEDLE PLACEMENT,1705.0,852.5,297.01,1653.85,47
CPT,77022,MRI GDN PARNCHYMA TISS ABLTJ,,,683.54,793.79,16
CPT,77046,MRI BREAST C- UNILATERAL,,,,,0
CPT,77046,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,3600.0,1800.0,231.86,3492.0,108
CPT,77047,MRI BREAST C- BILATERAL,,,,,0
CPT,77047,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,4600.0,2300.0,231.86,4462.0,108
CPT,77048,MRI BREAST C-+ W/CAD UNI,,,,,0
CPT,77048,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,3700.0,1850.0,644.54,3589.0,47
CPT,77049,MRI BREAST C-+ W/CAD BI,,,,,0
CPT,77049,MRI BREAST W&WO CONTRAST LIMIT BIL SCREENING,970.0,485.0,168.97,940.9,47
CPT,77049,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,4832.5,2416.25,827.45,4767.55,94
CPT,77053,S&I MAMMARY DUCTOGRM 1 DUCT,502.0,251.0,87.44,486.94,53
CPT,77053,X-RAY OF MAMMARY DUCT,,,,,0
CPT,77054,S&I MAMMARY DUCTOGRM MULT DUCTS,805.0,402.5,132.96,780.85,53
CPT,77054,X-RAY OF MAMMARY DUCTS,,,,,0
CPT,77058,MRI BREAST W CONTRAST UNIL,3605.0,1802.5,,,0
CPT,77061,BREAST TOMOSYNTHESIS UNI,,,,,0
CPT,77061,DIAG BREAST TOMOSYNTHESIS UNILAT,180.0,90.0,31.35,174.6,47
CPT,77062,BREAST TOMOSYNTHESIS BI,,,,,0
CPT,77062,DIAG BREAST TOMOSYNTHESIS BILAT,200.0,100.0,34.84,194.0,47
CPT,77063,BREAST TOMOSYNTHESIS BI,,,,,0
CPT,77063,SCRN BREAST TOMOSYNTHESIS,152.0,76.0,26.47,147.44,47
CPT,77065,DX MAMMO INCL CAD UNI,360.0,180.0,62.71,349.2,47
CPT,77066,DX MAMMO INCL CAD BI,457.0,228.5,79.6,443.29,47
CPT,77067,SCR MAMMO BI INCL CAD,365.0,182.5,63.58,354.05,47
CPT,77071,STRESS VIEW JOINT,249.0,124.5,38.08,251.23,108
CPT,77071,X-RAY STRESS VIEW,,,,,0
CPT,77072,BONE AGE STUDY,225.5,112.75,20.48,251.23,108
CPT,77072,X-RAYS FOR BONE AGE,,,,,0
CPT,77073,BONE LENGTH STUDY,328.0,164.0,33.7,364.72,108
CPT,77073,X-RAYS BONE LENGTH STUDIES,,,,,0
CPT,77074,BONE SURVEY LTD,315.0,157.5,46.68,351.14,108
CPT,77074,X-RAYS BONE SURVEY LIMITED,,,,,0
CPT,77075,BONE SURVEY COMPL,583.5,291.75,84.29,649.9,108
CPT,77075,X-RAYS BONE SURVEY COMPLETE,,,,,0
CPT,77076,BONE SURVEY INFANT,404.5,202.25,59.92,451.05,108
CPT,77076,X-RAYS BONE SURVEY INFANT,,,,,0
CPT,77077,JOINT EXAM SGL VIEW 2 OR MORE,307.0,153.5,37.05,297.79,54
CPT,77077,JOINT SURVEY 1 VIEW,341.5,170.75,37.05,380.24,108
CPT,77077,JOINT SURVEY SINGLE VIEW,,,,,0
CPT,77078,CT BONE DENSITY AXIAL,,,,,0
CPT,77078,CT BONE DENSITY STUDY,464.0,232.0,76.12,476.27,108
CPT,77080,BONE DENSITY STUDY AXIAL DEXA,389.0,194.5,54.13,397.7,108
CPT,77080,DXA BONE DENSITY AXIAL,,,,,0
CPT,77081,BONE DENSITY STUDY PERIP DEXA,394.5,197.25,25.1,408.37,108
CPT,77081,DXA BONE DENSITY/PERIPHERAL,,,,,0
CPT,77084,MAGNETIC IMAGE BONE MARROW,,,,,0
CPT,77084,MRI BONE MARROW BLOOD SUPPLY,551.0,275.5,95.98,534.47,54
CPT,77085,BONE DENSITY STUDY AXIAL DEXA W FX,257.0,128.5,38.14,286.15,108
CPT,77085,DXA BONE DENSITY STUDY,,,,,0
CPT,77086,FRACTURE ASSESSMENT VIA DXA,,,,,0
CPT,77086,VERTEB FX ASSESS BY DXA,292.0,146.0,43.37,324.95,108
CPT,77089,TBS DXA CAL W/I&R FX RISK,,,,,0
CPT,77090,TBS TECHL PREP&TRANSMIS DATA,,,84.57,169.14,8
CPT,77091,TBS TECHL CALCULATION ONLY,,,84.57,169.14,8
CPT,77092,TBS I&R FX RSK QHP,,,,,0
CPT,770T,VR TECHNOLOGY ASSIST THERAPY,,,,,0
CPT,771T,VR PX DISSOC SVC SM PHY 1ST,,,,,0
CPT,77261,RADIATION THERAPY PLANNING,,,,,0
CPT,77262,RADIATION THERAPY PLANNING,,,,,0
CPT,77263,RADIATION THERAPY PLANNING,,,,,0
CPT,77280,SET RADIATION THERAPY FIELD,,,,,0
CPT,77280,SIMULATION SIMPLE,2263.0,1131.5,130.61,2195.11,54
CPT,77280,SIMULATION SIMPLE ADDL,2263.0,1131.5,130.61,2195.11,54
CPT,77285,SET RADIATION THERAPY FIELD,,,363.86,727.72,8
CPT,77290,SET RADIATION THERAPY FIELD,,,,,0
CPT,77290,SIMULATION COMPLEX,3675.0,1837.5,363.86,3564.75,54
CPT,77293,RESPIRATOR MOTION MGMT SIMUL,1173.0,586.5,204.33,1137.81,47
CPT,77295,3-D RADIOTHERAPY PLAN,,,,,0
CPT,77295,3D RADIOTHERAPY PLAN,9055.0,4527.5,1345.04,8783.35,54
CPT,77299,UNLISTED PX THER RAD TX PLNG,,,130.61,261.22,8
CPT,772T,VR PX DISSOC SVC SM PHY EA,,,,,0
CPT,77300,DOSIMETRY CALCULATION,869.0,434.5,130.61,842.93,54
CPT,77300,DOSIMETRY CALCULATION EA ADDL,869.0,434.5,130.61,842.93,54
CPT,77300,RADIATION THERAPY DOSE PLAN,,,,,0
CPT,77301,IMRT PLAN,9454.0,4727.0,1345.04,9170.38,54
CPT,77306,TELETHX ISODOSE PLAN SIMPLE,2192.0,1096.0,363.86,2126.24,54
CPT,77307,TELETHX ISODOSE PLAN CPLX,4809.0,2404.5,363.86,4664.73,54
CPT,77316,BRACHYTX ISODOSE PLAN SIMPLE,2313.0,1156.5,363.86,2243.61,54
CPT,77317,BRACHYTX ISODOSE INTERMED,,,363.86,727.72,8
CPT,77318,BRACHYTX ISODOSE COMPLEX,2969.0,1484.5,363.86,2879.93,54
CPT,77321,SPEC THER PORT PLAN PARTICLES,1274.0,637.0,221.93,1235.78,54
CPT,77321,SPECIAL TELETX PORT PLAN,,,,,0
CPT,77331,SPECIAL DOSIMETRYMICR EA ADD,757.0,378.5,130.61,734.29,54
CPT,77331,SPECIAL DOSIMETRYMICRO,757.0,378.5,130.61,734.29,54
CPT,77331,SPECIAL RADIATION DOSIMETRY,,,,,0
CPT,77332,RADIATION TREATMENT AID(S),,,,,0
CPT,77332,TX DEVICE SIMPLE,1387.0,693.5,130.61,1345.39,54
CPT,77333,RADIATION TREATMENT AID(S),,,,,0
CPT,77333,TX DEVICE INTERMEDIATE,1406.0,703.0,130.61,1363.82,54
CPT,77334,RADIATION TREATMENT AID(S),,,,,0
CPT,77334,TX DEVICE COMPLEX,1840.0,920.0,320.52,1784.8,54
CPT,77334,TX DEVICE COMPLEX EA ADDL,1840.0,920.0,320.52,1784.8,54
CPT,77336,CONT MED PHYS PER WK,1110.0,555.0,130.61,1076.7,54
CPT,77336,RADIATION PHYSICS CONSULT,,,,,0
CPT,77338,DESIGN MLC DEVICE FOR IMRT,,,,,0
CPT,77338,MLC DEVICE IMRT,10107.0,5053.5,363.86,9803.79,54
CPT,77370,RADIATION PHYSICS CONSULT,,,,,0
CPT,77370,RADIATION PHYSICS CONSULTATN,1274.0,637.0,130.61,1235.78,54
CPT,77371,SRS MULTISOURCE,,,7157.31,14314.62,8
CPT,77372,SRS SINGLE FRACTION ONLY,24535.0,12267.5,4273.99,23798.95,54
CPT,77373,SBRT 1-5 MULTIPLE FRACTIONS,9851.0,4925.5,1716.04,9555.47,54
CPT,77385,IMRT DLVR SIMPLE,4384.0,2192.0,763.69,4252.48,47
CPT,77385,NTSTY MODUL RAD TX DLVR SMPL,,,,,0
CPT,77386,IMRT DLVR CPLX,4384.0,2192.0,763.69,4252.48,47
CPT,77386,NTSTY MODUL RAD TX DLVR CPLX,,,,,0
CPT,77387,GUIDANCE FOR LOCALIZATION,782.0,391.0,136.22,758.54,47
CPT,77387,GUIDANCE FOR RADJ TX DLVR,,,,,0
CPT,77399,UNLISTED PX MED RADJ PHYSICS,,,130.61,261.22,8
CPT,773T,VR PX DISSOC SVC OTH PHY 1ST,,,,,0
CPT,77401,RADIATION TREATMENT DELIVERY,,,,,0
CPT,77402,RADIATION TREATMENT DELIVERY,,,,,0
CPT,77402,RADIATION TX DELIVERY SIMPLE,970.0,485.0,99.15,940.9,54
CPT,77407,RADIATION TREATMENT DELIVERY,,,,,0
CPT,77407,RADIATION TX DELIVERY INTER,1286.0,643.0,224.02,1247.42,54
CPT,77412,RADIATION TREATMENT DELIVERY,,,,,0
CPT,77412,RADIATION TX DELIVERY COMPLEX,1555.0,777.5,270.88,1508.35,54
CPT,77417,PORT FILM(S) PER WEEK,707.0,353.5,123.15,685.79,47
CPT,77417,RADIOLOGY PORT IMAGES(S),,,,,0
CPT,77423,NEUTRON BEAM TX COMPLEX,,,536.94,1073.88,8
CPT,77424,IO RAD TX DELIVERY BY X-RAY,,,7157.31,14314.62,8
CPT,77425,IO RAD TX DELIVER BY ELCTRNS,,,7157.31,14314.62,8
CPT,77427,RADIATION TX MANAGEMENT X5,,,,,0
CPT,77431,RADIATION THERAPY MANAGEMENT,,,,,0
CPT,77432,STEREOTACTIC RADIATION TRMT,,,,,0
CPT,77435,SBRT MANAGEMENT,,,,,0
CPT,77469,IO RADIATION TX MANAGEMENT,,,,,0
CPT,77470,SPECIAL RADIATION TREATMENT,,,,,0
CPT,77470,SPECIAL TREATMENT PROCEDURE,3607.0,1803.5,536.94,3498.79,54
CPT,77499,UNLISTED PX THER RAD TX MGMT,,,,,0
CPT,774T,VR PX DISSOC SVC OTH PHY EA,,,,,0
CPT,77520,PROTON TRMT SIMPLE W/O COMP,,,536.94,1073.88,8
CPT,77522,PROTON TRMT SIMPLE W/COMP,,,1214.45,2428.9,8
CPT,77523,PROTON TRMT INTERMEDIATE,,,1214.45,2428.9,8
CPT,77525,PROTON TREATMENT COMPLEX,,,1214.45,2428.9,8
CPT,77600,HYPERTHERMIA TREATMENT,,,374.8,749.6,8
CPT,77605,HYPERTHERMIA TREATMENT,,,676.81,1353.62,8
CPT,77610,HYPERTHERMIA TREATMENT,,,536.94,1073.88,8
CPT,77615,HYPERTHERMIA TREATMENT,,,536.94,1073.88,8
CPT,77620,HYPERTHERMIA TREATMENT,,,536.94,1073.88,8
CPT,776T,THER INDCTJ NTRABRN HYPTHRM,,,,,0
CPT,77750,IN 111 INFUSION,532.6,266.3,92.77,749.6,53
CPT,77750,INFUSE RADIOACTIVE MATERIALS,,,,,0
CPT,77761,APPLY INTRCAV RADIAT SIMPLE,,,536.94,1073.88,8
CPT,77762,APPLY INTRCAV RADIAT INTERM,,,536.94,1073.88,8
CPT,77763,APPLY INTRCAV RADIAT COMPL,,,676.81,1353.62,8
CPT,77767,HDR RDNCL SKN SURF BRACHYTX,,,,,0
CPT,77767,HDR SKIN SURFACE <2.0 CM OR 1 CHANNEL,6245.0,3122.5,374.8,6057.65,54
CPT,77768,HDR RDNCL SKN SURF BRACHYTX,,,,,0
CPT,77768,HDR SKIN SURFACE >2.0 CM OR 2+ CHANNELS,6245.0,3122.5,374.8,6057.65,54
CPT,77770,HDR 1 CHANNEL,6185.0,3092.5,676.81,5999.45,54
CPT,77770,HDR RDNCL NTRSTL/ICAV BRCHTX,,,,,0
CPT,77771,HDR 2-12 CHANNELS,8872.0,4436.0,676.81,8605.84,54
CPT,77771,HDR 2-12 CHANNELS EACH ADDL,8722.0,4361.0,676.81,8460.34,54
CPT,77771,HDR RDNCL NTRSTL/ICAV BRCHTX,,,,,0
CPT,77772,HDR >12 CHANNELS,11560.0,5780.0,676.81,11213.2,54
CPT,77772,HDR >12 CHANNELS EACH ADDL,2963.0,1481.5,516.15,2874.11,54
CPT,77772,HDR RDNCL NTRSTL/ICAV BRCHTX,,,,,0
CPT,77778,APPLY INTERSTIT RADIAT COMPL,,,,,0
CPT,77778,LDR INTERSTITIAL IMPLANT: COMPLEX,11314.0,5657.0,676.81,10974.58,54
CPT,77789,APPLY SURF LDR RADIONUCLIDE,,,99.15,198.3,8
CPT,77790,RADIATION HANDLING,,,,,0
CPT,77799,UNLISTED PX CLIN BRACHYTX,,,99.15,198.3,8
CPT,777T,R-T PRS SENSING EDRL GDN SYS,,,,,0
CPT,778T,SMMG CNCRNT APPL IMU SNR,,,125.04,250.08,8
CPT,779T,GI MYOELECTRICAL ACTV STUDY,,,362.62,725.24,8
CPT,77U,IG PARAPROTEIN QUAL BLD/UR,,,43.43,86.86,8
CPT,78012,THYROID UPTAKE MEASUREMENT,,,,,0
CPT,78012,THYROID UPTAKE QUANTITATIVE,840.0,420.0,66.5,814.8,54
CPT,78013,THYROID IMAGING,1191.0,595.5,167.91,1155.27,54
CPT,78013,THYROID IMAGING W/BLOOD FLOW,,,,,0
CPT,78014,THYROID IMAGING W/BLOOD FLOW,,,,,0
CPT,78014,THYROID IMG/UPTAKE QUANT,1286.0,643.0,194.72,1247.42,54
CPT,78015,THYROID MET IMAGING,,,,,0
CPT,78015,THYROID METS LIMITED AREA,1575.0,787.5,172.22,1527.75,54
CPT,78016,THYROID MET IMAGING/STUDIES,,,253.28,776.96,24
CPT,78018,THYROID MET IMAGING BODY,,,,,0
CPT,78018,THYROID METS WHOLE BODY,2728.0,1364.0,257.88,2646.16,54
CPT,78020,THYROID MET UPTAKE,,,73.26,85.08,16
CPT,78070,PARATHYROID PLANAR IMAGING,,,,,0
CPT,78070,PARATHYROID SCAN,1609.0,804.5,140.44,1560.73,54
CPT,78071,PARATHROID SPECT,2024.0,1012.0,289.39,1963.28,54
CPT,78071,PARATHYRD PLANAR W/WO SUBTRJ,,,,,0
CPT,78072,PARATHYRD PLANAR W/SPECT&CT,5547.0,2773.5,527.64,5380.59,38
CPT,78075,ADRENAL CORTEX & MEDULLA IMG,,,341.02,2516.18,24
CPT,78099,UNLISTED ENDOCRINE PX DX NUC,,,388.48,776.96,8
CPT,780T,INSTLJ FECAL MICROBIOTA SSP,,,129.29,258.58,8
CPT,78102,BONE MARROW IMAGING LTD,1646.0,823.0,135.07,1596.62,54
CPT,78103,BONE MARROW IMAGING MULT,,,,,0
CPT,78103,BONE MARROW IMAGING MULTI,1646.0,823.0,179.86,1596.62,54
CPT,78104,BONE MARROW IMAGING BODY,,,,,0
CPT,78104,BONE MARROW IMAGING WB,870.0,435.0,151.55,843.9,54
CPT,78110,PLASMA VOLUME SINGLE,,,66.6,2516.18,24
CPT,78111,PLASMA VOLUME MULTIPLE,,,76.83,2516.18,24
CPT,78120,RED CELL MASS SINGLE,,,71.2,776.96,24
CPT,78121,RED CELL MASS MULTIPLE,,,81.31,1055.28,24
CPT,78122,BLOOD VOLUME,2204.0,1102.0,99.13,2137.88,54
CPT,78130,RED CELL SURVIVAL STUDY,,,128.38,776.96,24
CPT,78140,RED CELL SEQUESTRATION,,,118.41,776.96,24
CPT,78185,SPLEEN IMAGING,,,,,0
CPT,78185,SPLEEN RADIONUCLIDE SCAN,1492.0,746.0,157.83,1447.24,54
CPT,78191,PLATELET SURVIVAL,,,153.63,776.96,24
CPT,78195,LYMPH SYSTEM IMAGING,,,,,0
CPT,78195,LYMPHOSCINTIGRAPHY,2497.0,1248.5,283.64,2422.09,54
CPT,78199,UNLSTD HEMATOP RET/ENDO LYMP,,,388.48,776.96,8
CPT,781T,BRNCHSC RF DSTRJ PULM NRV BI,,,,,0
CPT,78201,LIVER IMAGING,,,148.68,1055.28,24
CPT,78202,LIVER IMAGING WITH FLOW,,,,,0
CPT,78202,LIVER SCAN PLANAR W FLOW,1566.0,783.0,164.78,1519.02,54
CPT,78215,LIVER & SPLEEN SCAN STATIC,1399.0,699.5,154.21,1357.03,54
CPT,78215,LIVER AND SPLEEN IMAGING,,,,,0
CPT,78216,LIVER & SPLEEN IMAGE/FLOW,,,111.34,776.96,24
CPT,78226,HEPATOBILIARY SCAN WO PHARMACOLOGY,3182.0,1591.0,264.45,3086.54,54
CPT,78226,HEPATOBILIARY SYSTEM IMAGING,,,,,0
CPT,78227,HEPATOBIL SYST IMAGE W/DRUG,,,,,0
CPT,78227,HEPATOBILIARY SCAN W PHARMACOLOGY,3240.0,1620.0,361.44,3142.8,54
CPT,78230,SALIVARY GLAND IMAGING,817.38,408.69,132.78,792.85,54
CPT,78231,SALIVARY GLAND W SERIAL IMAGE,847.0,423.5,107.09,821.59,54
CPT,78231,SERIAL SALIVARY IMAGING,,,,,0
CPT,78232,SALIVARY GLAND FUNCTION EXAM,,,104.68,776.96,24
CPT,78258,ESOPHAGEAL MOTILITY STUDY,,,185.5,776.96,24
CPT,78261,GASTRIC MUCOSA IMAGING,,,200.86,776.96,24
CPT,78262,GASTROESOPHAGEAL REFLUX,967.0,483.5,168.45,937.99,54
CPT,78262,GASTROESOPHAGEAL REFLUX EXAM,,,,,0
CPT,78264,GASTRIC EMPTYING IMAG STUDY,,,,,0
CPT,78264,GASTRIC EMPTYING SCAN,2643.0,1321.5,229.05,2563.71,54
CPT,78265,GASTRIC EMPTYING IMAG STUDY,1856.0,928.0,323.31,1800.32,54
CPT,78266,GASTRIC EMPTYING IMAG STUDY,,,,,0
CPT,78266,GASTRIC EMPTYING IMAG STUDY MULTIPLE DAYS,6033.0,3016.5,527.64,5852.01,54
CPT,78267,BREATH TST ATTAIN/ANAL C-14,,,,,0
CPT,78267,UREA BREATH TEST C 14,41.0,20.5,7.14,39.77,54
CPT,78268,BREATH TEST ANALYSIS C-14,,,77.96,188.82,24
CPT,78278,ACUTE GI BLOOD LOSS IMAGING,,,,,0
CPT,78278,GI BLEED SCAN,1820.0,910.0,277.23,1765.4,54
CPT,78282,GI PROTEIN LOSS EXAM,,,44.57,776.96,24
CPT,78290,MECKELS DIVERT EXAM,,,,,0
CPT,78290,MECKELS DIVERTICULUM SCAN,1399.0,699.5,243.7,1357.03,54
CPT,78291,LEVEEN/SHUNT PATENCY EXAM,,,,,0
CPT,78291,PERITONEAL VENOUS SHUNT FUNCT,1259.0,629.5,202.96,1221.23,54
CPT,78299,UNLISTED GI PX DX NUC MED,,,388.48,776.96,8
CPT,782T,BRNCHSC RF DSTRJ PLM NRV UNI,,,,,0
CPT,78300,BONE IMAGING LIMITED AREA,,,,,0
CPT,78300,BONE SCAN LIMITED AREA,862.0,431.0,142.4,836.14,54
CPT,78305,BONE IMAGING MULTIPLE AREAS,,,187.18,776.96,24
CPT,78306,BONE IMAGING WHOLE BODY,,,,,0
CPT,78306,BONE SCAN WHOLE BODY,2204.0,1102.0,205.51,2137.88,54
CPT,78315,BONE IMAGING 3 PHASE,,,,,0
CPT,78315,BONE SCAN 3 PHASE STUDY,2485.0,1242.5,277.17,2410.45,54
CPT,78350,BONE MINERAL SINGLE PHOTON,,,28.21,32.76,16
CPT,78351,BONE MINERAL DUAL PHOTON,,,14.02,16.29,16
CPT,78399,UNLISTED MUSCSKEL PX DX NUC,,,388.48,776.96,8
CPT,783T,TC AURICULR NEUROSTIMULATION,,,125.04,250.08,8
CPT,78414,NON-IMAGING HEART FUNCTION,,,52.57,1055.28,24
CPT,78428,CARDIAC SHUNT DETECTION,1633.0,816.5,162.04,1584.01,54
CPT,78428,CARDIAC SHUNT IMAGING,,,,,0
CPT,78429,MYOCRD IMG PET 1 STD W/CT,,,1389.57,2779.14,8
CPT,78430,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,3793.0,1896.5,660.74,3679.21,53
CPT,78430,MYOCRD IMG PET RST/STRS W/CT,,,,,0
CPT,78431,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,5851.0,2925.5,1019.24,5675.47,53
CPT,78431,MYOCRD IMG PET RST&STRS CT,,,,,0
CPT,78432,MYOCRD IMG PET 2RTRACER,,,1474.77,2949.54,8
CPT,78433,MYOCRD IMG PET 2RTRACER CT,,,2140.59,4281.18,8
CPT,78434,AQMBF PET REST & RX STRESS,,,,,0
CPT,78445,VASCULAR FLOW IMAGING,,,138.62,776.96,24
CPT,78451,HT MUSCLE IMAGE SPECT SING,,,,,0
CPT,78451,MYOCARDL PERF REST/STRS SNGLE,3812.0,1906.0,193.23,3697.64,53
CPT,78452,HT MUSCLE IMAGE SPECT MULT,,,,,0
CPT,78452,MYOCARDL PERFUS SPECT MULTI,6330.0,3165.0,329.27,6140.1,53
CPT,78453,HT MUSCLE IMAGE PLANAR SING,,,168.44,2516.18,24
CPT,78454,HT MUSC IMAGE PLANAR MULT,,,162.14,2516.18,24
CPT,78456,ACUTE VENOUS THROMB IMAGING,2603.04,1301.52,285.32,2524.94,54
CPT,78456,ACUTE VENOUS THROMBUS IMAGE,,,,,0
CPT,78457,VENOUS THROMBOSIS IMAGING,,,158.01,1055.28,24
CPT,78458,VEN THROMBOSIS IMAGES BILAT,,,,,0
CPT,78458,VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL,900.0,450.0,156.78,873.0,54
CPT,78459,PET CARDIAC IMAGING METABOLIC,5650.0,2825.0,984.23,5480.5,54
CPT,78466,HEART INFARCT IMAGE,,,,,0
CPT,78466,HEART INFARCT SCAN,1231.0,615.5,148.5,1194.07,54
CPT,78468,HEART INFARCT IMAGE (EF),,,183.82,1055.28,24
CPT,78469,HEART INFARCT IMAGE (3D),,,208.83,1055.28,24
CPT,78472,GATED HEART PLANAR SINGLE,,,,,0
CPT,78472,MUGA SINGLE STUDY REST/STRESS,2553.0,1276.5,210.56,2476.41,54
CPT,78473,GATED HEART MULTIPLE,,,,,0
CPT,78473,MUGA MULTI STUDY REST/STRESS,1540.0,770.0,268.26,1493.8,54
CPT,78481,HEART FIRST PASS SINGLE,,,180.65,1055.28,24
CPT,78483,HEART FIRST PASS MULTIPLE,,,253.21,1055.28,24
CPT,78491,PET MYOCARDIAL PERF SINGLE,4956.0,2478.0,805.28,4807.32,54
CPT,78492,PET MYOCARDIAL PERF MULTI,4956.0,2478.0,863.33,4807.32,54
CPT,78494,GATED BLOOD POOL SPECT,1540.0,770.0,227.29,1493.8,54
CPT,78494,HEART IMAGE SPECT,,,,,0
CPT,78496,CARDIAC FIRST PASS ADD ON,1167.0,583.5,80.33,1131.99,47
CPT,78496,HEART FIRST PASS ADD-ON,,,,,0
CPT,78499,UNLISTED CV PX DX NUC MED,,,388.48,776.96,8
CPT,784T,INS/RPLMT ELTRD RA SPI NSTIM,,,10828.04,21656.08,8
CPT,78579,LUNG VENTILATION IMAGING,,,,,0
CPT,78579,PULMONARY VENTILATION IMAGING,2225.0,1112.5,141.03,2158.25,54
CPT,78580,LUNG PERFUSION IMAGING,,,,,0
CPT,78580,PULMONARY PERFUSION IMAG PART,1259.0,629.5,172.09,1221.23,54
CPT,78582,LUNG VENTILAT&PERFUS IMAGING,,,,,0
CPT,78582,PULMONARY VENTILA/PERFUS IMAG,2553.0,1276.5,259.27,2476.41,54
CPT,78597,LUNG PERFUSION DIFFERENTIAL,,,,,0
CPT,78597,QUAN DIF PULM PERF INCLU IMAG,1974.0,987.0,157.88,1914.78,54
CPT,78598,LUNG PERF&VENTILAT DIFERENTL,,,,,0
CPT,78598,QUAN DIF PULM PERF/VENT W/IMA,2588.0,1294.0,242.91,2510.36,54
CPT,78599,UNLISTED RESP PX DX NUC MED,,,388.48,776.96,8
CPT,785T,REVJ/RMVL NEA SPI W/NSTIM,,,3397.38,6794.76,8
CPT,78600,BRAIN IMAGE < 4 VIEWS,,,,,0
CPT,78600,BRAIN IMAGING STATIC LESS THAN 4 VIEWS,900.0,450.0,144.03,873.0,54
CPT,78601,BRAIN IMAGE W/FLOW < 4 VIEWS,,,,,0
CPT,78601,BRAIN STATIC SCAN W FLOW LESS THAN 4 VIEWS,1893.0,946.5,171.31,1836.21,54
CPT,78605,BRAIN IMAGE 4+ VIEWS,,,,,0
CPT,78605,BRAIN SCAN STATIC,1456.0,728.0,159.43,1412.32,54
CPT,78606,BRAIN IMAGE W/FLOW 4 + VIEWS,,,,,0
CPT,78606,BRAIN PLANAR W FLOW,2029.0,1014.5,256.46,1968.13,54
CPT,78608,PET BRAIN IMAGING METABOLIC,7050.0,3525.0,1105.48,6838.5,54
CPT,78609,BRAIN IMAGING (PET),,,67.03,77.84,16
CPT,78610,BRAIN FLOW IMAGING ONLY,,,,,0
CPT,78610,BRAIN SCAN W FLOW,2183.0,1091.5,144.63,2117.51,54
CPT,78630,CEREBROSPINAL FLUID SCAN,,,,,0
CPT,78630,CISTERNOGRAPHY,2029.0,1014.5,267.9,1968.13,54
CPT,78635,CSF VENTRICULOGRAPHY,,,250.6,1055.28,24
CPT,78645,CSF SHUNT EVALUATION,2029.0,1014.5,251.59,1968.13,54
CPT,78650,CSF LEAKAGE DETECTION & LOC,2603.04,1301.52,262.11,2524.94,54
CPT,78650,CSF LEAKAGE IMAGING,,,,,0
CPT,78660,DACRYOCYSTOGRAPHY RADIOPHARM,756.07,378.04,131.7,776.96,54
CPT,78660,NUCLEAR EXAM OF TEAR FLOW,,,,,0
CPT,78699,UNLISTED NRVS SYS PX DX NUC,,,388.48,776.96,8
CPT,786T,INSJ/RPLCMT PRQ RA SAC NSTIM,,,10828.04,21656.08,8
CPT,78700,KIDNEY IMAGING MORPHOL,,,,,0
CPT,78700,RENAL SCAN STATIC,1224.0,612.0,142.13,1187.28,54
CPT,78701,KIDNEY IMAGING WITH FLOW,,,,,0
CPT,78701,RENAL SCAN W FLOW,2906.0,1453.0,171.35,2818.82,54
CPT,78707,K FLOW/FUNCT IMAGE W/O DRUG,,,,,0
CPT,78707,RENAL SCAN W FLOW & FUNCTION,2099.0,1049.5,196.25,2036.03,54
CPT,78708,K FLOW/FUNCT IMAGE W/DRUG,,,,,0
CPT,78708,RENAL SCAN W FLO &FUNC W DRUG,2344.0,1172.0,155.53,2273.68,54
CPT,78709,K FLOW/FUNCT IMAGE MULTIPLE,,,,,0
CPT,78709,RENAL SCN W FLO &FN W&WO DRUG,3394.0,1697.0,295.7,3292.18,54
CPT,78725,KIDNEY FUNCTION STUDY,,,83.37,776.96,24
CPT,78730,URINARY BLADDER RETENTION,,,62.02,72.02,16
CPT,78740,URETERAL REFLUX STUDY,,,,,0
CPT,78740,VOIDING CYSTOGRAM,1674.0,837.0,174.0,1623.78,54
CPT,78761,TESTICULAR IMAGING W/FLOW,,,,,0
CPT,78761,TESTICULAR SCAN W FLOW,1674.0,837.0,171.21,1623.78,54
CPT,78799,UNLISTED GU PX DX NUC MED,,,388.48,776.96,8
CPT,787T,REVJ/RMVL NEA SAC W/NSTIM,,,3397.38,6794.76,8
CPT,78800,RP LOCLZJ TUM 1 AREA 1 D IMG,,,,,0
CPT,78800,SCINTIMAMMOGRAPHY,1537.0,768.5,153.23,1490.89,54
CPT,78801,RP LOCLZJ TUM 2+AREA 1+D IMG,,,,,0
CPT,78801,TUMOR LOC SCAN MULT AREAS,1537.0,768.5,202.85,1490.89,54
CPT,78802,RP LOCLZJ TUM WHBDY 1 D IMG,,,,,0
CPT,78802,TUMOR LOC SCAN WB 1 DAY,2814.0,1407.0,264.72,2729.58,54
CPT,78803,RP LOCLZJ TUM SPECT 1 AREA,,,,,0
CPT,78803,TUMOR LOCALIZATION SPECT,2603.04,1301.52,288.88,2524.94,54
CPT,78804,RP LOCLZJ TUM WHBDY 2+D IMG,,,,,0
CPT,78804,TUMOR LOC SCAN WB MULTI DAY,3534.0,1767.0,470.64,3427.98,54
CPT,78808,IV INJ RA DRUG DX STUDY,,,37.96,776.96,24
CPT,78811,PET IMAGE LTD AREA,,,1110.97,2516.18,24
CPT,78812,PET IMAGE SKULL-THIGH,,,1125.78,2779.14,24
CPT,78813,PET IMAGE FULL BODY,,,1129.68,2779.14,24
CPT,78814,PET/CT LTD TUMOR IMAG INIT TX,7050.0,3525.0,1138.62,6838.5,54
CPT,78814,PET/CT LTD TUMOR IMAG SUB TX,7050.0,3525.0,1138.62,6838.5,54
CPT,78815,PET BREAST STGE MON SK TO TH INIT TX,10523.0,5261.5,1149.04,10207.31,54
CPT,78815,PET/CT ANAT LOC IMAGE SK TO INIT TX,10523.0,5261.5,1149.04,10207.31,54
CPT,78815,PET/CT ANAT LOC IMAGE SK TO TH SUB TX,10523.0,5261.5,1149.04,10207.31,54
CPT,78815,PET/CT SKULL BASE/THIG INIT TX,10523.0,5261.5,1149.04,10207.31,54
CPT,78815,PET/CT SKULL BASE/THIG SUB TX,10018.0,5009.0,1149.04,9717.46,54
CPT,78815,PET/CT TUM IMA SKU THI INIT TX,10018.0,5009.0,1149.04,9717.46,54
CPT,78815,PET/CT TUM IMA SKU-THI SUB TX,10018.0,5009.0,1149.04,9717.46,54
CPT,78816,PET/CT NM WB IMAG INIT TX,10523.0,5261.5,1151.41,10207.31,54
CPT,78816,PET/CT NM WB TUMO IMAG SUB TX,10018.0,5009.0,1151.41,9717.46,54
CPT,78830,RP LOCLZJ TUM SPECT W/CT 1,,,,,0
CPT,78830,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,2462.33,1231.17,428.93,2516.18,54
CPT,78831,RP LOCLZJ TUM SPECT 2 AREA 1D IMG/1 AREA IMG>2+D,2462.33,1231.17,428.93,2516.18,54
CPT,78831,RP LOCLZJ TUM SPECT 2 AREAS,,,,,0
CPT,78832,RP LOCLZJ TUM SPECT CT 2AREA 1D IMG/1 AR IMG>2+D,2712.89,1356.45,472.58,2779.14,54
CPT,78832,RP LOCLZJ TUM SPECT W/CT 2,,,,,0
CPT,78835,RP QUAN MEAS SINGLE AREA,,,,,0
CPT,788T,ELEC ALY SMP IINS SP/SAC NRV,,,92.39,184.78,8
CPT,78999,UNLISTED MISC PX DX NUC MED,,,388.48,776.96,8
CPT,789T,ELEC ALY CPX IINS SP/SAC NRV,,,92.39,184.78,8
CPT,790,ANES IPER UPR ABD NOS,,,,,0
CPT,79005,NUCLEAR RX ORAL ADMIN,,,,,0
CPT,79005,RADIONUCLIDE THERAPY THYROID,1529.0,764.5,124.12,1483.13,54
CPT,790T,REVJ RPLCMT/RMVL VRT TETHRG,,,17038.69,34077.38,8
CPT,79101,NUCLEAR RX IV ADMIN,,,,,0
CPT,79101,RADIONUC THERAPY IV ADMIN,1529.0,764.5,139.38,1483.13,54
CPT,791T,MOTR COG VR GAIT TRAIN EA 15,,,,,0
CPT,792,ANES IPER UPR ABD PRTL HPTC,,,,,0
CPT,79200,INTRACAVITARY THERAPY,1143.0,571.5,146.13,1108.71,54
CPT,79200,NUCLEAR RX INTRACAV ADMIN,,,,,0
CPT,792T,APPL SLVR DIAMN FLUORIDE 38%,,,,,0
CPT,79300,MET CARCINOMA TO BONE RNU,927.0,463.5,161.48,899.19,54
CPT,79300,NUCLR RX INTERSTIT COLLOID,,,,,0
CPT,793T,PRQ TCAT THRM ABLT NRV P-ART,,,17813.98,35627.96,8
CPT,794,ANES IPER UPR ABD PNCRTECT,,,,,0
CPT,79403,HEMATOPOIETIC NUCLEAR TX,,,,,0
CPT,79403,RADIOIMMUNOTHERAPY,1662.0,831.0,179.58,1612.14,54
CPT,79440,NUCLEAR RX INTRA-ARTICULAR,,,130.59,453.5,24
CPT,79445,NUCLEAR RX INTRA-ARTERIAL,,,,,0
CPT,79445,RADIONUC THERAPY INTRA ARTERY,1689.0,844.5,226.75,1638.33,54
CPT,794T,PT SPEC ALG RX-ONC TX OPTION,,,57.33,114.66,8
CPT,795T,TCAT INS 2CHMBR LDLS PM CMPL,,,18717.77,37435.54,8
CPT,796,ANES IPER UPR ABD LVR TRNSPL,,,,,0
CPT,796T,TCAT INS 2CHMBR LDLS PM RA,,,18717.77,37435.54,8
CPT,797,ANES IPER UPR ABD GSTR PX MO,,,,,0
CPT,797T,TCAT INS 2CHMBR LDLS PM RV,,,18717.77,37435.54,8
CPT,798T,TCAT RMV 2CHMBR LDLS PM CMPL,,,3068.32,6136.64,8
CPT,79999,RP THERAPY UNLISTED PX,,,226.75,453.5,8
CPT,799T,TCAT RMVL 2CHMBR LDLS PM RA,,,3068.32,6136.64,8
CPT,79U,CMPRTV DNA ALYS MLT SNPS,,,,,0
CPT,7M,ONC GASTRO 51 GENE NOMOGRAM,,,375.0,750.0,8
CPT,7U,RX TEST PRSMV UR W/DEF CONF,,,114.43,228.86,8
CPT,800,ANESTH ABDOMINAL WALL SURG,,,,,0
CPT,80047,METABOLIC PANEL IONIZED CA,,,,,0
CPT,80047,POC ISTAT BASIC METABOLIC PANEL,232.0,116.0,13.73,225.04,54
CPT,80048,BASIC METABOLIC PANEL,81.0,40.5,5.4,127.07,108
CPT,80048,METABOLIC PANEL TOTAL CA,,,,,0
CPT,80050,GENERAL HEALTH PANEL,294.0,147.0,51.21,285.18,94
CPT,80051,ELECTROLYTE PANEL,114.5,57.25,7.01,121.25,108
CPT,80053,COMPREHEN METABOLIC PANEL,,,,,0
CPT,80053,COMPREHENSIVE METABOLIC PANEL,97.5,48.75,6.61,152.29,108
CPT,80053,MUD COMPREHENSIVE METABOLIC PANEL NHCI,224.0,112.0,10.56,217.28,53
CPT,80055,OB PANEL,612.0,306.0,47.81,626.62,108
CPT,80055,OBSTETRIC PANEL,777.5,388.75,47.81,947.69,108
CPT,80061,LIPID PANEL,125.5,62.75,8.88,194.0,108
CPT,80069,RENAL FUNCTION PANEL,142.0,71.0,8.68,147.44,108
CPT,80074,ACUTE HEPATITIS PANEL,443.0,221.5,31.18,685.79,108
CPT,80076,HEPATIC FUNCTION PANEL,81.0,40.5,5.4,127.07,108
CPT,80081,OBSTETRIC PANEL,,,74.86,149.72,8
CPT,800T,TCAT RMVL 2CHMBR LDLS PM RV,,,3068.32,6136.64,8
CPT,80143,DRUG ASSAY ACETAMINOPHEN,277.0,138.5,18.64,268.69,54
CPT,80145,DRUG ASSAY ADALIMUMAB,535.0,267.5,38.57,584.91,108
CPT,80150,AMIKACIN LEVEL,224.0,112.0,15.08,217.28,54
CPT,80150,AMIKACIN LEVEL PEAK,253.0,126.5,15.08,245.41,54
CPT,80150,AMIKACIN LEVEL TROUGH,224.0,112.0,15.08,217.28,54
CPT,80150,ASSAY OF AMIKACIN,,,,,0
CPT,80151,DRUG ASSAY AMIODARONE,251.0,125.5,18.64,268.69,108
CPT,80155,CAFFEINE,276.5,138.25,21.42,417.1,108
CPT,80155,DRUG ASSAY CAFFEINE,,,,,0
CPT,80156,ASSAY CARBAMAZEPINE TOTAL,,,,,0
CPT,80156,CARBAMAZEPINE LEVEL,196.0,98.0,14.57,209.52,108
CPT,80157,ASSAY CARBAMAZEPINE FREE,,,,,0
CPT,80157,CARBAMEZEPINE FREE,251.0,125.5,13.25,295.85,108
CPT,80158,CYCLOSPORINE LEVEL,189.5,94.75,18.05,259.96,108
CPT,80158,DRUG ASSAY CYCLOSPORINE,,,,,0
CPT,80159,CLOZAPINE (CLOZARIL) SERUM,282.5,141.25,20.15,291.0,108
CPT,80159,DRUG ASSAY CLOZAPINE,,,,,0
CPT,80161,"ASY CARBAMAZEPIN 10,11-EPXID",,,,,0
CPT,80161,"DRUG ASSAY CARBAMAZEPINE -10,11-EPOXIDE",207.5,103.75,18.64,229.89,108
CPT,80162,ASSAY OF DIGOXIN TOTAL,,,,,0
CPT,80162,DIGOXIN TOTAL,124.0,62.0,8.88,191.09,108
CPT,80163,ASSAY OF DIGOXIN FREE,,,13.28,26.56,8
CPT,80164,ASSAY DIPROPYLACETIC ACD TOT,,,,,0
CPT,80164,VALPROIC ACID TOTAL,128.5,64.25,9.75,194.97,108
CPT,80165,DIPROPYLACETIC ACID FREE,,,,,0
CPT,80165,VALPROIC ACID FREE,268.5,134.25,13.54,260.93,108
CPT,80167,DRUG ASSAY FELBAMATE,398.0,199.0,18.64,386.06,54
CPT,80168,ASSAY OF ETHOSUXIMIDE,,,,,0
CPT,80168,ETHOSUXIMIDE/ZARONTIN,242.0,121.0,16.34,234.74,54
CPT,80169,DRUG ASSAY EVEROLIMUS,,,,,0
CPT,80169,EVEROLIMUS,338.0,169.0,13.73,369.57,108
CPT,80170,ASSAY OF GENTAMICIN,,,,,0
CPT,80170,GENTAMICIN LEVEL,257.0,128.5,16.38,249.29,54
CPT,80170,GENTAMICIN LEVEL PEAK,257.0,128.5,16.38,249.29,54
CPT,80170,GENTAMICIN LEVEL TROUGH,257.0,128.5,16.38,249.29,54
CPT,80171,DRUG SCREEN QUANT GABAPENTIN,,,,,0
CPT,80171,GABAPENTIN (NEURONTIN),279.5,139.75,21.67,288.09,108
CPT,80171,GABAPENTIN/NEURONTIN LEVEL BLD,345.0,172.5,21.67,334.65,54
CPT,80173,ASSAY OF HALOPERIDOL,,,,,0
CPT,80173,HALOPERIDOL (HALDOL) SERUM,249.0,124.5,15.78,297.79,108
CPT,80175,DRUG SCREEN QUAN LAMOTRIGINE,,,,,0
CPT,80175,LAMOTRIGINE (LAMICTAL) SERUM,228.5,114.25,13.25,288.09,108
CPT,80175,LAMOTRIGINE LEVEL,124.0,62.0,8.18,194.97,108
CPT,80176,ASSAY OF LIDOCAINE,,,,,0
CPT,80176,LIDOCAINE LEVEL,217.0,108.5,14.69,210.49,54
CPT,80177,DRUG SCRN QUAN LEVETIRACETAM,,,,,0
CPT,80177,LEVETIRACETAM (KEPPRA) SERUM,156.5,78.25,13.25,191.09,108
CPT,80178,ASSAY OF LITHIUM,,,,,0
CPT,80178,LITHIUM LEVEL,96.0,48.0,6.61,95.06,108
CPT,80179,DRUG ASSAY SALICYLATE,564.0,282.0,18.64,547.08,54
CPT,80180,DRUG SCRN QUAN MYCOPHENOLATE,,,,,0
CPT,80180,MYCOPHENOLIC ACID & METAB.,569.0,284.5,18.05,622.74,108
CPT,80181,DRUG ASSAY FLECAINIDE,277.0,138.5,18.64,268.69,54
CPT,80183,DRUG SCRN QUANT OXCARBAZEPIN,,,,,0
CPT,80183,OXCARBAZEPENIE (TRILEPTAL) SERUM,178.5,89.25,13.25,191.09,108
CPT,80184,ASSAY OF PHENOBARBITAL,,,,,0
CPT,80184,PHENOBARBITAL LEVEL,229.0,114.5,15.3,222.13,54
CPT,80185,ASSAY OF PHENYTOIN TOTAL,,,,,0
CPT,80185,PHENYTOIN DILANTIN LEVEL,178.5,89.25,13.25,191.09,108
CPT,80186,ASSAY OF PHENYTOIN FREE,,,,,0
CPT,80186,PHENYTOIN DILANTIN LEVEL FREE,170.5,85.25,13.76,169.75,108
CPT,80187,DRUG ASSAY POSACONAZOLE,,,,,0
CPT,80187,POSACONAZOLE LEVEL,259.0,129.5,27.11,251.23,108
CPT,80188,ASSAY OF PRIMIDONE,,,,,0
CPT,80188,PRIMIDONE LEVEL,201.0,100.5,16.59,194.97,54
CPT,80189,DRUG ASSAY ITRACONAZOLE,,,27.11,54.22,8
CPT,80190,ASSAY OF PROCAINAMIDE,,,60.0,120.0,8
CPT,80192,ASSAY OF PROCAINAMIDE,,,,,0
CPT,80192,PROCAINAMIDE/ NAPA LEVELS,374.0,187.0,16.75,362.78,54
CPT,80193,DRUG ASSAY LEFLUNOMIDE,467.0,233.5,38.57,452.99,54
CPT,80194,ASSAY OF QUINIDINE,,,,,0
CPT,80194,QUINIDINE LEVEL,328.0,164.0,14.6,318.16,54
CPT,80195,ASSAY OF SIROLIMUS,,,,,0
CPT,80195,SIROLIMUS RAPAMYCIN,185.0,92.5,13.73,197.88,108
CPT,80197,ASSAY OF TACROLIMUS,,,,,0
CPT,80197,TACROLIMUS/ PROGRAF LEVEL,147.0,73.5,9.75,230.86,108
CPT,80198,ASSAY OF THEOPHYLLINE,,,,,0
CPT,80198,THEOPHYLLINE LEVEL,211.0,105.5,14.14,204.67,54
CPT,80199,DRUG SCREEN QUANT TIAGABINE,,,27.11,54.22,8
CPT,801T,TCAT RMV&RPL 2CHMBR LDLS PM,,,18717.77,37435.54,8
CPT,802,ANESTH FAT LAYER REMOVAL,,,,,0
CPT,80200,ASSAY OF TOBRAMYCIN,,,,,0
CPT,80200,TOBRAMYCIN LEVEL,240.0,120.0,16.13,232.8,54
CPT,80200,TOBRAMYCIN LEVEL PEAK,267.0,133.5,16.13,258.99,54
CPT,80200,TOBRAMYCIN LEVEL TROUGH,267.0,133.5,16.13,258.99,54
CPT,80201,ASSAY OF TOPIRAMATE,,,,,0
CPT,80201,TOPIRAMATE LEVEL,178.0,89.0,11.92,172.66,54
CPT,80202,ASSAY OF VANCOMYCIN,,,,,0
CPT,80202,VANCOMYCIN LEVEL,201.0,100.5,13.54,194.97,54
CPT,80202,VANCOMYCIN LEVEL PEAK,188.5,94.25,13.54,194.97,108
CPT,80202,VANCOMYCIN LEVEL TROUGH,182.0,91.0,13.54,194.97,108
CPT,80203,DRUG SCREEN QUANT ZONISAMIDE,,,,,0
CPT,80203,ZONISAMIDE (ZONEGRAN) SERUM,253.0,126.5,13.25,270.63,108
CPT,80204,DRUG ASSAY METHOTREXATE,243.0,121.5,21.42,352.11,108
CPT,80210,DRUG ASSAY RUFINAMIDE,416.0,208.0,27.11,403.52,54
CPT,80220,DRUG ASY HYDROXYCHLOROQUINE,,,18.64,37.28,8
CPT,80230,DRUG ASSAY INFLIXIMAB,595.0,297.5,38.57,599.46,108
CPT,80235,DRUG ASSAY LACOSAMIDE,785.0,392.5,27.11,802.19,108
CPT,80280,DRUG ASSAY VEDOLIZUMAB,595.0,297.5,38.57,599.46,108
CPT,80285,DRUG ASSAY VORICONAZOLE,588.0,294.0,27.11,733.32,108
CPT,80299,ACETAMINOPHEN LEVEL QUANTITATIVE ASSAY,1160.0,580.0,18.64,1125.2,108
CPT,80299,AMIODARONE DEFINITIVE,396.0,198.0,16.37,677.06,108
CPT,80299,AMITRIPTYLINE (ELAVIL) QUANTITATIVE ASSAY DRUG,698.0,349.0,18.64,677.06,108
CPT,80299,CANRENONE SERUM/PLASMA QUANTITATIVE ASSAY DRUG,1248.0,624.0,18.64,1295.92,108
CPT,80299,CITALOPRAM (CELEXA)QUANTITATIVE ASSAY DRUG,1248.0,624.0,18.64,1295.92,108
CPT,80299,CLOBAZAM (ONFI)QUANTITATIVE ASSAY DRUG,1291.5,645.75,18.64,1380.31,108
CPT,80299,DESIPRAMINE QUANTITATIVE ASSAY DRUG,698.0,349.0,18.64,677.06,108
CPT,80299,DIGITOXIN LEVEL,393.0,196.5,15.32,677.06,108
CPT,80299,DISOPYRAMIDE LEVEL,698.0,349.0,18.64,677.06,54
CPT,80299,DOXEPINE (SINEQUAN) QUANTITATIVE ASSAY DRUG,698.0,349.0,18.64,677.06,108
CPT,80299,FELBAMATE (FELBATOL) QUANTITATIVE ASSAY,1160.0,580.0,18.64,1125.2,108
CPT,80299,FLECAINIDE LEVEL,698.0,349.0,18.64,677.06,54
CPT,80299,INFLIXIMAB (IFX) DEFINITIVE,396.0,198.0,16.37,677.06,108
CPT,80299,LEFLUNOMIDE METABOLITE (ARAVA),1160.0,580.0,18.64,1125.2,108
CPT,80299,MERCAPTOPURINE (6-MP PURIN.)QUANTITATIVE ASSAY DRUG,1248.0,624.0,18.64,1295.92,108
CPT,80299,METHADONE LEVEL QUANTITATIVE ASSAY DRUG,465.0,232.5,18.64,677.06,108
CPT,80299,METHOTREXATE LEVEL,393.0,196.5,15.32,677.06,108
CPT,80299,MEXILITINE LEVEL DEFINITIVE,396.0,198.0,16.37,677.06,108
CPT,80299,MITOTANE (LYSODREN) QUANTITATIVE ASSAY,620.5,310.25,18.64,677.06,108
CPT,80299,NORTRIPTYLINE (AVENTYL) QUANTITATIVE ASSAY DRUG,698.0,349.0,18.64,677.06,108
CPT,80299,PENTOBARBITAL LEVEL QUANTITATIVE ASSAY DRUG,1160.0,580.0,18.64,1125.2,54
CPT,80299,QUANTITATIVE ASSAY DRUG,878.5,439.25,18.64,1125.2,108
CPT,80299,QUETIAPINE (SEROQUEL) QUANTITATIVE ASSAY DRUG,1037.5,518.75,18.64,1125.2,108
CPT,80299,RIVAROXABAN QUANTITATIVE ASSAY,698.0,349.0,18.64,677.06,108
CPT,80299,RUFINAMIDE SERUM OR PLASMA QUANTITATIVE ASSAY,1160.0,580.0,18.64,1125.2,108
CPT,80299,SALICYLATE LEVEL QUANTITATIVE ASSAY,1160.0,580.0,18.64,1125.2,108
CPT,80299,THIOPURINE METAB DEFINITIVE,879.0,439.5,18.64,1125.2,108
CPT,80299,TRAZODONE QUANTITATIVE ASSAY DRUG,86.5,43.25,14.98,84.39,108
CPT,80299,VENLAFAXINE (EFFEXOR)QUANTITATIVE ASSAY DRUG,1248.0,624.0,18.64,1295.92,108
CPT,80299,VORICONAZOLE SERUM/PLASMA DEF,396.0,198.0,16.37,677.06,108
CPT,802T,TCAT RMV&RPL2CHMB LDLS PM RA,,,18717.77,37435.54,8
CPT,80305,DRUG TEST PRESUMP OPTICAL,365.0,182.5,12.6,354.05,54
CPT,80305,DRUG TEST PRSMV DIR OPT OBS,,,,,0
CPT,80305,POC DRUG TEST PRESUMP OPTICAL,219.0,109.5,12.6,212.43,54
CPT,80306,DRUG TEST PRESUMP OPT INST,365.0,182.5,17.14,354.05,54
CPT,80306,DRUG TEST PRSMV INSTRMNT,,,,,0
CPT,80307,ACETAMINOPHEN LVL BLD SCREEN,919.0,459.5,62.14,891.43,108
CPT,80307,ACETYLMORPHINE URINE,919.0,459.5,62.14,891.43,108
CPT,80307,ANABOLIC STERIOD DRG SCRN,919.0,459.5,62.14,891.43,108
CPT,80307,BUPRENORPHINE URINE SCREEN,1053.5,526.75,62.14,1152.36,108
CPT,80307,DRUG ABUSE SCREEN MECONIUM,1053.5,526.75,62.14,1152.36,108
CPT,80307,DRUG TEST PRESUMP NOT OPT,888.5,444.25,62.14,864.27,108
CPT,80307,DRUG TEST PRSMV CHEM ANLYZR,,,,,0
CPT,80307,ETHANOL LVL BLD SCREEN,552.0,276.0,62.14,535.44,108
CPT,80307,ETHYL GLUCURONIDE URINE,685.5,342.75,62.14,891.43,108
CPT,80307,FENTANYL URINE,735.5,367.75,62.14,891.43,108
CPT,80307,GHB PRESUMP DRG SCREEN,919.0,459.5,62.14,891.43,108
CPT,80307,KETAMINE PRESUMP SCRN,735.5,367.75,62.14,891.43,108
CPT,80307,LSD URINE,735.5,367.75,62.14,891.43,108
CPT,80307,MDMA URINE SCREEN,919.0,459.5,62.14,891.43,108
CPT,80307,MEPHEDRONE MDPV METHYLONE,919.0,459.5,62.14,891.43,108
CPT,80307,"NICOTINE METABOLITE, URINE",685.5,342.75,62.14,891.43,108
CPT,80307,OXYCODONE,735.5,367.75,62.14,891.43,108
CPT,80307,OXYCODONE / OXYMORPHONE URINE,735.5,367.75,62.14,891.43,108
CPT,80307,PCP URINE SCRN,919.0,459.5,62.14,891.43,108
CPT,80307,PRESUMPTIVE DRUG SCREEN CHEM ANLYZR,632.5,316.25,60.27,891.43,108
CPT,80307,SALICYLATE LVL BLD SCREEN,352.5,176.25,26.65,535.44,108
CPT,80307,SYNTHETIC CANNABINOIDS URINE,743.0,371.5,62.14,891.43,108
CPT,80307,TAPENTADOL UR PRESUMP SCRN,735.5,367.75,62.14,891.43,108
CPT,80307,TRAMADOL URINE SCREEN,919.0,459.5,62.14,891.43,108
CPT,80307,URINE DRUGS OF ABUSE SCREEN,888.5,444.25,62.14,864.27,108
CPT,80307,ZOLPIDEM DRG SCRN,919.0,459.5,62.14,891.43,108
CPT,80320,DRUG SCREEN QUANTALCOHOLS,,,,,0
CPT,80321,ALCOHOLS BIOMARKERS 1OR 2,,,,,0
CPT,80322,ALCOHOLS BIOMARKERS 3/MORE,,,,,0
CPT,80323,ALKALOIDS NOS,,,,,0
CPT,80324,DRUG SCREEN AMPHETAMINES 1/2,,,,,0
CPT,80325,AMPHETAMINES 3OR 4,,,,,0
CPT,80326,AMPHETAMINES 5 OR MORE,,,,,0
CPT,80327,ANABOLIC STEROID 1 OR 2,,,,,0
CPT,80328,ANABOLIC STEROID 3 OR MORE,,,,,0
CPT,80329,ANALGESICS NON-OPIOID 1 OR 2,,,,,0
CPT,80330,ANALGESICS NON-OPIOID 3-5,,,,,0
CPT,80331,ANALGESICS NON-OPIOID 6/MORE,,,,,0
CPT,80332,ANTIDEPRESSANTS CLASS 1 OR 2,,,,,0
CPT,80333,ANTIDEPRESSANTS CLASS 3-5,,,,,0
CPT,80334,ANTIDEPRESSANTS CLASS 6/MORE,,,,,0
CPT,80335,ANTIDEPRESSANT TRICYCLIC 1/2,,,,,0
CPT,80336,ANTIDEPRESSANT TRICYCLIC 3-5,,,,,0
CPT,80337,TRICYCLIC & CYCLICALS 6/MORE,,,,,0
CPT,80338,ANTIDEPRESSANT NOT SPECIFIED,,,,,0
CPT,80339,ANTIEPILEPTICS NOS 1-3,,,,,0
CPT,80340,ANTIEPILEPTICS NOS 4-6,,,,,0
CPT,80341,ANTIEPILEPTICS NOS 7/MORE,,,,,0
CPT,80342,ANTIPSYCHOTICS NOS 1-3,,,,,0
CPT,80343,ANTIPSYCHOTICS NOS 4-6,,,,,0
CPT,80344,ANTIPSYCHOTICS NOS 7/MORE,,,,,0
CPT,80345,DRUG SCREENING BARBITURATES,,,,,0
CPT,80346,BENZODIAZEPINES1-12,,,,,0
CPT,80347,BENZODIAZEPINES 13 OR MORE,,,,,0
CPT,80348,DRUG SCREENING BUPRENORPHINE,,,,,0
CPT,80349,CANNABINOIDS NATURAL,,,,,0
CPT,80350,CANNABINOIDS SYNTHETIC 1-3,,,,,0
CPT,80351,CANNABINOIDS SYNTHETIC 4-6,,,,,0
CPT,80352,CANNABINOID SYNTHETIC 7/MORE,,,,,0
CPT,80353,DRUG SCREENING COCAINE,,,,,0
CPT,80354,DRUG SCREENING FENTANYL,,,,,0
CPT,80355,GABAPENTIN NON-BLOOD,,,,,0
CPT,80356,HEROIN METABOLITE,,,,,0
CPT,80357,KETAMINE AND NORKETAMINE,,,,,0
CPT,80358,DRUG SCREENING METHADONE,,,,,0
CPT,80359,METHYLENEDIOXYAMPHETAMINES,,,,,0
CPT,80360,METHYLPHENIDATE,,,,,0
CPT,80361,OPIATES 1 OR MORE,,,,,0
CPT,80362,OPIOIDS & OPIATE ANALOGS 1/2,,,,,0
CPT,80363,OPIOIDS & OPIATE ANALOGS 3/4,,,,,0
CPT,80364,OPIOID &OPIATE ANALOG 5/MORE,,,,,0
CPT,80365,DRUG SCREENING OXYCODONE,,,,,0
CPT,80366,DRUG SCREENING PREGABALIN,,,,,0
CPT,80367,DRUG SCREENING PROPOXYPHENE,,,,,0
CPT,80368,SEDATIVE HYPNOTICS,,,,,0
CPT,80369,SKELETAL MUSCLE RELAXANT 1/2,,,,,0
CPT,80370,SKEL MUSC RELAXANT 3 OR MORE,,,,,0
CPT,80371,STIMULANTS SYNTHETIC,,,,,0
CPT,80372,DRUG SCREENING TAPENTADOL,,,,,0
CPT,80373,DRUG SCREENING TRAMADOL,,,,,0
CPT,80374,STEREOISOMER ANALYSIS,,,,,0
CPT,80375,DRUG/SUBSTANCE NOS 1-3,,,,,0
CPT,80376,DRUG/SUBSTANCE NOS 4-6,,,,,0
CPT,80377,DRUG/SUBSTANCE NOS 7/MORE,,,,,0
CPT,803T,TCAT RMV&RPL2CHMB LDLS PM RV,,,18717.77,37435.54,8
CPT,80400,ACTH STIMULATION PANEL,,,32.62,65.24,8
CPT,80402,ACTH STIMULATION PANEL,,,86.96,173.92,8
CPT,80406,ACTH STIMULATION PANEL,,,78.26,156.52,8
CPT,80408,ALDOSTERONE SUPPRESSION EVAL,,,125.5,251.0,8
CPT,80410,CALCITONIN STIMUL PANEL,,,80.37,160.74,8
CPT,80412,CRH STIMULATION PANEL,,,801.62,1603.24,8
CPT,80414,TESTOSTERONE RESPONSE PANEL,,,51.64,103.28,8
CPT,80415,TOT ESTRADIOL RESPONSE PANEL,,,55.89,111.78,8
CPT,80416,RENIN STIMULATION PANEL,,,209.32,418.64,8
CPT,80417,RENIN STIMULATION PANEL,,,43.99,87.98,8
CPT,80418,PITUITARY EVALUATION PANEL,,,579.48,1158.96,8
CPT,80420,DEXAMETHASONE PANEL,,,161.88,323.76,8
CPT,80422,GLUCAGON TOLERANCE PANEL,,,46.07,92.14,8
CPT,80424,GLUCAGON TOLERANCE PANEL,,,50.5,101.0,8
CPT,80426,GONADOTROPIN HORMONE PANEL,,,148.41,296.82,8
CPT,80428,GROWTH HORMONE PANEL,,,66.7,133.4,8
CPT,80430,GROWTH HORMONE PANEL,,,129.33,258.66,8
CPT,80432,INSULIN SUPPRESSION PANEL,,,165.61,331.22,8
CPT,80434,INSULIN TOLERANCE PANEL,,,285.03,570.06,8
CPT,80435,INSULIN TOLERANCE PANEL,,,103.0,206.0,8
CPT,80436,METYRAPONE PANEL,,,91.16,182.32,8
CPT,80438,TRH STIMULATION PANEL,,,50.41,100.82,8
CPT,80439,TRH STIMULATION PANEL,,,67.21,134.42,8
CPT,804T,PRGRMG EVL LDLS PM 2CHMBR IP,,,36.27,72.54,8
CPT,80503,PATH CLIN CONSLTJ SF 5-20,,,,,0
CPT,80503,PATHOLOGY CLIN CONSLTJ SF 5-20 MIN,535.5,267.75,45.98,782.79,108
CPT,80504,PATH CLIN CONSLTJ MOD 21-40,,,165.56,331.12,8
CPT,80505,PATH CLIN CONSLTJ HIGH 41-60,,,165.56,331.12,8
CPT,80506,PATH CLIN CONSLTJ PROLNG SVC,,,,,0
CPT,805T,TCAT S&IVC PRSTC VL IMPL PRQ,,,,,0
CPT,806T,TCAT S&IVC PRSTC VL IMPL OPN,,,,,0
CPT,807T,PULM TISS VNTJ ALYS PREV CT,,,209.83,419.66,8
CPT,808T,PULM TISS VNTJ ALYS W/CT,,,209.83,419.66,8
CPT,80U,ONC LNG 5 CLIN RSK FACTR ALG,,,3520.0,7040.0,8
CPT,81000,URINALYSIS NONAUTO W/SCOPE,28.0,14.0,4.02,27.16,54
CPT,81001,URINALYSIS AUTO W/ MICRO,32.5,16.25,2.43,49.47,108
CPT,81001,URINALYSIS AUTO W/SCOPE,,,,,0
CPT,81002,POC UR DIPSTK N-AUT W/O MIC,37.5,18.75,3.48,50.44,108
CPT,81002,REDUCING SUBSTANCE URINE,53.0,26.5,3.48,61.11,108
CPT,81002,URINALYSIS NONAUTO W/O SCOPE,,,,,0
CPT,81002,URINE SINGLE COMPONENT,37.5,18.75,3.48,50.44,108
CPT,81003,MUD URINALYSIS AUTO W/O SCOPE NHCI,73.0,36.5,2.25,70.81,53
CPT,81003,POC UR DIP STICK/TABLET RGNT AUTO W/O MIC,35.5,17.75,2.25,41.71,108
CPT,81003,URINALYSIS AUTO W/O MICROSCOP,32.0,16.0,2.25,41.71,108
CPT,81003,URINALYSIS AUTO W/O SCOPE,,,,,0
CPT,81005,URINALYSIS,,,,,0
CPT,81005,URINE REDUCING SUBSTANCES,50.0,25.0,2.17,60.14,108
CPT,81007,URINE SCREEN FOR BACTERIA,,,29.98,59.96,8
CPT,81015,MICROSCOPIC EXAM OF URINE,,,,,0
CPT,81015,URINALYSIS MICROSCOPIC ONLY,32.0,16.0,2.09,50.44,108
CPT,81020,URINALYSIS GLASS TEST,,,4.7,9.4,8
CPT,81025,POC HCG URINE QUALITATIVE,78.5,39.25,5.05,124.16,162
CPT,81025,UR HCG PREGNANCY QUAL,78.5,39.25,5.05,124.16,108
CPT,81025,URINE PREGNANCY TEST,,,,,0
CPT,81050,URINALYSIS VOLUME MEASURE,,,,,0
CPT,81050,VOL MEASURE TIMED COLLECT,49.0,24.5,3.64,52.38,108
CPT,81099,UNLISTED URINALYSIS PX,,,,,0
CPT,810T,SUBRTA NJX RX AGT W/VTRC,,,4042.91,8085.82,8
CPT,811,ANES LWR INTST NDSC NOS,,,,,0
CPT,81105,HPA-1 GENOTYPING,,,122.22,244.44,8
CPT,81106,HPA-2 GENOTYPING,,,122.22,244.44,8
CPT,81107,HPA-3 GENOTYPING,,,122.22,244.44,8
CPT,81108,HPA-4 GENOTYPING,,,122.22,244.44,8
CPT,81109,HPA-5 GENOTYPING,,,122.22,244.44,8
CPT,81110,HPA-6 GENOTYPING,,,122.22,244.44,8
CPT,81111,HPA-9 GENOTYPING,,,122.22,244.44,8
CPT,81112,HPA-15 GENOTYPING,,,122.22,244.44,8
CPT,81120,IDH1 COMMON VARIANTS,,,193.25,386.5,8
CPT,81121,IDH2 COMMON VARIANTS,,,295.79,591.58,8
CPT,81161,DMD DUP/DELET ANALYSIS,,,279.0,558.0,8
CPT,81162,BRCA1&2 GEN FULL SEQ DUP/DEL,1968.35,984.18,342.88,3649.76,108
CPT,81162,BRCA1/2 FULL SEQ GENE ANALYSIS,1968.35,984.18,342.88,3649.76,108
CPT,81163,BRCA1&2 GENE FULL SEQ ALYS,,,468.0,936.0,8
CPT,81164,BRCA1&2 GEN FUL DUP/DEL ALYS,,,584.23,1168.46,8
CPT,81165,BRCA1 GENE FULL SEQ ALYS,,,282.88,565.76,8
CPT,81166,BRCA1 GENE FULL DUP/DEL ALYS,,,301.35,602.7,8
CPT,81167,BRCA2 GENE FULL DUP/DEL ALYS,,,282.88,565.76,8
CPT,81168,CCND1/IGH TRANSLOCATION ALYS,,,207.31,414.62,8
CPT,81170,ABL1 GENE,,,,,0
CPT,81170,BCR-ABL1 KINASE DOMAIN GENE ANALYSIS,586.665,293.33500000000004,75.53,717.53,108
CPT,81171,AFF2 GEN ALY DETC ABNL ALLEL,,,137.0,274.0,8
CPT,81172,AFF2 GEN ALYS CHARAC ALLELES,,,274.83,549.66,8
CPT,81173,AR GENE FULL GENE SEQUENCE,,,301.35,602.7,8
CPT,81174,AR GENE KNOWN FAMIL VARIANT,,,185.2,370.4,8
CPT,81175,ASXL1 FULL GENE SEQUENCE,,,676.5,1353.0,8
CPT,81176,ASXL1 GENE TARGET SEQ ALYS,,,241.9,483.8,8
CPT,81177,ATN1 GENE DETC ABNOR ALLELES,88.0,44.0,15.32,274.0,108
CPT,81178,ATXN1 GENE DETC ABNOR ALLELE,88.0,44.0,15.32,274.0,108
CPT,81179,ATXN2 GENE DETC ABNOR ALLELE,88.0,44.0,15.32,274.0,108
CPT,81180,ATXN3 GENE DETC ABNOR ALLELE,88.0,44.0,15.32,274.0,108
CPT,81181,ATXN7 GENE DETC ABNOR ALLELE,88.0,44.0,15.32,274.0,108
CPT,81182,ATXN8OS GEN DETC ABNOR ALLEL,88.0,44.0,15.32,274.0,108
CPT,81183,ATXN10 GENE DETC ABNOR ALLEL,88.0,44.0,15.32,274.0,108
CPT,81184,CACNA1A GEN DETC ABNOR ALLEL,88.0,44.0,15.32,274.0,108
CPT,81185,CACNA1A GENE FULL GENE SEQ,,,846.27,1692.54,8
CPT,81186,CACNA1A GEN KNOWN FAMIL VRNT,,,185.2,370.4,8
CPT,81187,CNBP GENE DETC ABNOR ALLELE,,,137.0,274.0,8
CPT,81188,CSTB GENE DETC ABNOR ALLELE,,,137.0,274.0,8
CPT,81189,CSTB GENE FULL GENE SEQUENCE,,,274.83,549.66,8
CPT,81190,CSTB GENE KNOWN FAMIL VRNT,,,185.2,370.4,8
CPT,81191,NTRK1 TRANSLOCATION ANALYSIS,,,207.31,414.62,8
CPT,81192,NTRK2 TRANSLOCATION ANALYSIS,,,207.31,414.62,8
CPT,81193,NTRK3 TRANSLOCATION ANALYSIS,,,207.31,414.62,8
CPT,81194,NTRK TRANSLOCATION ANALYSIS,,,518.28,1036.56,8
CPT,81195,"Cytogenomic (genome-wide) analysis, hematologic malignancy, structural variants and copy number variants, optical genome mapping (OGM)",,,1863.22,3726.44,8
CPT,811T,REM MLT DAY UROFLOW SETUP,,,129.38,258.76,8
CPT,812,ANES LWR INTST SCR COLSC,,,,,0
CPT,81200,ASPA GENE,,,,,0
CPT,81200,ASPA GENE ANALYSIS,1304.5,652.25,47.25,1271.67,108
CPT,81201,APC GENE FULL SEQUENCE,,,780.0,1560.0,8
CPT,81202,APC GENE KNOWN FAM VARIANTS,,,280.0,560.0,8
CPT,81203,APC GENE DUP/DELET VARIANTS,,,200.0,400.0,8
CPT,81204,AR GENE CHARAC ALLELES,,,137.0,274.0,8
CPT,81205,BCKDHB GENE,,,,,0
CPT,81205,BCKDHB GENE ANALYSIS,1304.5,652.25,94.99,1271.67,108
CPT,81206,BCR/ABL1 GENE MAJOR BP,91.5,45.75,15.93,327.92,108
CPT,81207,BCR/ABL1 GENE MINOR BP,91.5,45.75,15.93,289.68,108
CPT,81208,BCR/ABL1 GENE OTHER BP,,,214.62,429.24,8
CPT,81209,BLM GENE,,,,,0
CPT,81209,BLM GENE ANALYSIS,1304.5,652.25,39.31,1271.67,108
CPT,81210,BRAF GENE,,,,,0
CPT,81210,BRAF GENE ANALYSIS,385.0,192.5,67.06,373.45,108
CPT,81212,BRCA1&2 185&5385&6174 VRNT,,,440.0,880.0,8
CPT,81215,BRCA1 GENE KNOWN FAMIL VRNT,,,375.25,750.5,8
CPT,81216,BRCA2 GENE FULL SEQ ALYS,,,185.12,370.24,8
CPT,81217,BRCA2 GENE KNOWN FAMIL VRNT,,,375.25,750.5,8
CPT,81218,CEBPA GENE FULL SEQUENCE,,,241.9,483.8,8
CPT,81219,CALR (CALRETICULIN) GENE ANALYSIS,361.5,180.75,57.13,383.15,540
CPT,81219,CALR GENE COM VARIANTS,395.0,197.5,68.8,383.15,216
CPT,81220,CFTR GENE COM VARIANTS,158.54500000000002,79.275,11.84,1113.2,540
CPT,81221,CFTR GENE KNOWN FAM VARIANTS,,,97.22,194.44,8
CPT,81222,CFTR GENE DUP/DELET VARIANTS,,,435.07,870.14,8
CPT,81223,CFTR GENE FULL SEQUENCE,4017.0,2008.5,499.0,3912.98,108
CPT,81224,CFTR GENE INTRON POLY T,,,168.75,337.5,8
CPT,81225,CYP2C19 GENE ANALYSIS,213.15,106.575,35.36,582.72,108
CPT,81225,CYP2C19 GENE COM VARIANTS,,,,,0
CPT,81226,CYP2D6 GENE COM VARIANTS,,,,,0
CPT,81226,CYP2D6 GENOTYPING ANALYSIS,640.0,320.0,111.48,901.82,54
CPT,81227,CYP2C9 GENE COM VARIANTS,,,,,0
CPT,81227,CYTOCHROME P450 2C9 GENOTYPING RT-PCR,288.0,144.0,50.16,349.62,54
CPT,81228,CYTOG ALYS CHRML ABNR CGH,,,900.0,1800.0,8
CPT,81229,CYTOG ALYS CHRML ABNR SNPCGH,1117.0,558.5,175.94,2320.0,216
CPT,81229,CYTOGEN M ARRAY COPY NO&SNP,1080.0,540.0,188.13,2320.0,108
CPT,81230,CYP3A4 GENE COMMON VARIANTS,,,174.81,349.62,8
CPT,81231,CYP3A5 GENE COMMON VARIANTS,,,174.81,349.62,8
CPT,81232,DPD 5-FU TOXICITY DPYD GENE ANALYSIS,320.46500000000003,160.235,44.42,374.3,108
CPT,81232,DPYD GENE COMMON VARIANTS,320.46500000000003,160.235,44.42,374.3,108
CPT,81233,BTK GENE COMMON VARIANTS,,,175.4,350.8,8
CPT,81234,DMPK GENE DETC ABNOR ALLELE,,,137.0,274.0,8
CPT,81235,EGFR,400.0,200.0,69.68,649.16,54
CPT,81235,EGFR GENE COM VARIANTS,,,,,0
CPT,81236,EZH2 GENE FULL GENE SEQUENCE,,,282.88,565.76,8
CPT,81237,EZH2 GENE COMMON VARIANTS,,,175.4,350.8,8
CPT,81238,F9 FULL GENE SEQUENCE,,,600.0,1200.0,8
CPT,81239,DMPK GENE CHARAC ALLELES,,,274.83,549.66,8
CPT,81240,F2 GENE,,,,,0
CPT,81240,F2 GENE ANALYSIS,44.0,22.0,7.66,131.38,108
CPT,81240,F2/ PROTHROMBIN II,44.0,22.0,7.66,131.38,108
CPT,81241,F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT,36.0,18.0,6.27,146.74,108
CPT,81241,F5 GENE,,,,,0
CPT,81241,FACTOR V LEIDEN 511154,36.0,18.0,6.27,146.74,108
CPT,81241,FACTOR V LEIDEN MUTATION,288.75,144.38,50.3,280.08,108
CPT,81242,FANCC GENE,,,,,0
CPT,81242,FANCONI ANEMIA GENE ANALYSIS,360.0,180.0,36.62,352.11,108
CPT,81243,FMR1 (FRAGILE X) GENE ANALYSIS,105.0,52.5,18.29,114.08,108
CPT,81243,FMR1 GEN ALY DETC ABNL ALLEL,,,,,0
CPT,81243,FMR1 GENE DETECTION,105.0,52.5,12.01,291.97,216
CPT,81244,FMR1 FRAGILE X GENE ANALYSIS ALLELES CHARACTERIZATION,121.0,60.5,21.07,117.37,108
CPT,81244,FMR1 GEN ALYS CHARAC ALLELES,,,,,0
CPT,81244,FRAGILE X SOUTHERN BLOT,121.0,60.5,21.07,117.37,108
CPT,81245,FLT3 GENE,,,165.51,331.02,8
CPT,81246,FLT3 GENE ANALYSIS,,,83.0,166.0,8
CPT,81247,G6PD GENE ALYS CMN VARIANT,,,174.81,349.62,8
CPT,81248,G6PD KNOWN FAMILIAL VARIANT,,,375.25,750.5,8
CPT,81249,G6PD FULL GENE SEQUENCE,,,600.0,1200.0,8
CPT,81250,G6PC GENE,,,,,0
CPT,81250,G6PC GENE ANALYSIS,1304.5,652.25,58.49,1271.67,108
CPT,81251,GBA GENE,,,,,0
CPT,81251,GBA GENE ANALYSIS,1304.5,652.25,47.25,1271.67,108
CPT,81252,GJB2 GENE FULL SEQUENCE,,,101.12,202.24,8
CPT,81253,GJB2 GENE KNOWN FAM VARIANTS,,,61.52,123.04,8
CPT,81254,GJB6 GENE COM VARIANTS,,,35.0,70.0,8
CPT,81255,HEXA GENE,,,,,0
CPT,81255,HEXA GENE ANALYSIS,1304.5,652.25,51.45,1271.67,108
CPT,81256,HEREDITARY HEMOCHROMATOSIS DNA,60.75,30.38,10.58,130.72,108
CPT,81256,HFE GENE,,,,,0
CPT,81257,HBA1/HBA2 GENE,287.0,143.5,39.02,339.5,216
CPT,81258,HBA1/HBA2 GENE FAM VRNT,,,375.25,750.5,8
CPT,81259,HBA1/HBA2 FULL GENE SEQUENCE,,,600.0,1200.0,8
CPT,81260,IKBKAP GENE,,,,,0
CPT,81260,IKBKAP GENE ANALYSIS,1304.5,652.25,39.31,1271.67,108
CPT,81261,IGH GENE REARRANGE AMP METH,339.76,169.88,59.18,395.98,108
CPT,81262,IGH GENE REARRANG DIR PROBE,,,68.55,137.1,8
CPT,81263,IGH VARI MUTATION ANALYSIS,566.2,283.1,98.63,589.04,108
CPT,81263,IGH VARI REGIONAL MUTATION,,,,,0
CPT,81264,IGK GENE REARRANGE DETECT ABN CLONAL POP,339.76,169.88,59.18,345.46,108
CPT,81264,IGK REARRANGEABN CLONAL POP,,,,,0
CPT,81265,PRE TP ENGRAFT,341.6,170.8,30.48,492.95,108
CPT,81265,STR MARKERS SPECIMEN ANAL,,,,,0
CPT,81266,STR MARKERS SPEC ANAL ADDL,,,304.81,609.62,8
CPT,81267,CHIMERISM ANAL NO CELL SELEC,,,,,0
CPT,81267,POST TP ENGRAFT,205.43,102.715,21.77,414.92,108
CPT,81268,CHIMERISM ANAL CD33/CD66B CELL,155.0,77.5,17.42,521.58,108
CPT,81268,CHIMERISM ANAL W/CELL SELECT,,,,,0
CPT,81268,CHIMERISM ANALYSIS CD3 CELLS,310.0,155.0,34.84,521.58,108
CPT,81268,CHIMERISM ANALYSIS CD56 CELLS,361.25,180.625,43.55,521.58,108
CPT,81269,HBA1/HBA2 GENE DUP/DEL VRNTS,,,202.4,404.8,8
CPT,81270,JAK2 GENE,,,,,0
CPT,81270,JAK2 GENE ANALYSIS P.VAL617PHE VARIANT,223.26,111.63,19.07,326.89,540
CPT,81270,JAK2 MUTATION ANALYSIS QNT,109.52,54.76,19.07,183.32,108
CPT,81270,JAK2 MUTATION V617F,109.52,54.76,19.07,183.32,108
CPT,81270,KIT MUTATION GENE ANALYSIS,109.52,54.76,19.07,183.32,54
CPT,81271,HTT GENE DETC ABNOR ALLELES,,,137.0,274.0,8
CPT,81272,KIT GENE TARGETED SEQ ANALYS,,,,,0
CPT,81272,KIT GENE TARGETED SEQ ANALYSIS,504.0,252.0,87.79,659.02,54
CPT,81273,KIT GENE ANALYS D816 VARIANT,,,124.87,249.74,8
CPT,81274,HTT GENE CHARAC ALLELES,,,274.83,549.66,8
CPT,81275,KRAS GENE VARIANTS EXON 2,,,193.25,386.5,8
CPT,81276,KRAS GENE ADDL VARIANTS,755.0,377.5,130.82,736.23,108
CPT,81277,CYTOGENOMIC NEO MICRORA ALYS,,,,,0
CPT,81277,CYTOGENOMIC NEOPLASIA MICROARRAY ANALYSIS,1847.48,923.74,321.83,2320.0,108
CPT,81278,IGH@/BCL2 TRANSLOCATION ALYS,,,207.31,414.62,8
CPT,81279,JAK2 GENE TRGT SEQUENCE ALYS,109.52,54.76,19.07,370.4,324
CPT,81279,JAK2 TARGETED SEQUENCE ANALYSIS,109.52,54.76,19.07,370.4,324
CPT,81283,IFNL3 GENE,363.5,181.75,63.06,354.05,108
CPT,81284,FXN GENE DETC ABNOR ALLELES,,,137.0,274.0,8
CPT,81285,FXN GENE CHARAC ALLELES,,,274.83,549.66,8
CPT,81286,FXN GENE FULL GENE SEQUENCE,,,274.83,549.66,8
CPT,81287,MGMT GENE PRMTR MTHYLTN ALYS,,,,,0
CPT,81287,MGMT METHYL GENE ANALYSIS,892.0,446.0,124.64,869.12,108
CPT,81288,MLH1 GENE,,,192.32,384.64,8
CPT,81289,FXN GENE KNOWN FAMIL VARIANT,,,185.2,370.4,8
CPT,81290,MCOLN1 GENE,,,,,0
CPT,81290,MCOLN1 GENE ANALYSIS,1304.5,652.25,39.31,1271.67,108
CPT,81291,MTHFR GENE,65.0,32.5,11.32,130.68,108
CPT,81292,MLH1 GENE FULL SEQ,,,675.4,1350.8,8
CPT,81293,MLH1 GENE KNOWN VARIANTS,,,331.0,662.0,8
CPT,81294,MLH1 GENE DUP/DELETE VARIANT,,,202.4,404.8,8
CPT,81295,MSH2 GENE FULL SEQ,,,381.7,763.4,8
CPT,81296,MSH2 GENE KNOWN VARIANTS,,,337.73,675.46,8
CPT,81297,MSH2 GENE DUP/DELETE VARIANT,,,213.3,426.6,8
CPT,81298,MSH6 GENE FULL SEQ,,,641.85,1283.7,8
CPT,81299,MSH6 GENE KNOWN VARIANTS,,,308.0,616.0,8
CPT,812T,REM MLT DAY UROFLOW DEV SPLY,,,125.04,250.08,8
CPT,813,ANES UPR LWR GI NDSC PX,,,,,0
CPT,81300,MSH6 GENE DUP/DELETE VARIANT,,,238.0,476.0,8
CPT,81301,MICROSATELLITE INSTABILITY,,,348.56,697.12,8
CPT,81302,MECP2 GENE FULL SEQ,,,527.87,1055.74,8
CPT,81303,MECP2 GENE KNOWN VARIANT,,,120.0,240.0,8
CPT,81304,MECP2 GENE DUP/DELET VARIANT,,,150.0,300.0,8
CPT,81305,MYD88 GENE P.LEU265PRO VRNT,,,,,0
CPT,81305,MYD88 MUTATION DETECTION PCR,367.5,183.75,64.01,356.47,108
CPT,81306,NUDT15 GENE COMMON VARIANTS,,,291.36,582.72,8
CPT,81307,PALB2 GENE FULL GENE SEQ,,,676.5,1353.0,8
CPT,81308,PALB2 GENE KNOWN FAMIL VRNT,,,301.35,602.7,8
CPT,81309,PIK3CA GENE TRGT SEQ ALYS,,,274.83,549.66,8
CPT,81310,NPM1 GENE,,,,,0
CPT,81310,NPM1 GENE ANALYSIS EXON 12,126.0,63.0,21.94,493.04,54
CPT,81311,NRAS GENE ANALYSIS,711.0,355.5,123.33,692.58,108
CPT,81311,NRAS GENE VARIANTS EXON 2&3,,,,,0
CPT,81312,PABPN1 GENE DETC ABNOR ALLEL,,,137.0,274.0,8
CPT,81313,PCA3/KLK3 ANTIGEN,,,255.05,510.1,8
CPT,81314,PDGFRA GENE,,,329.51,659.02,8
CPT,81315,APL(PML-RARA) QUANT,330.0,165.0,57.48,414.62,108
CPT,81315,PML/RARALPHA COM BREAKPOINTS,,,,,0
CPT,81316,PML/RARALPHA 1 BREAKPOINT,,,207.31,414.62,8
CPT,81317,PMS2 GENE FULL SEQ ANALYSIS,,,676.5,1353.0,8
CPT,81318,PMS2 KNOWN FAMILIAL VARIANTS,,,331.0,662.0,8
CPT,81319,PMS2 GENE DUP/DELET VARIANTS,,,203.5,407.0,8
CPT,81320,PLCG2 GENE COMMON VARIANTS,,,291.36,582.72,8
CPT,81321,PTEN GENE FULL SEQUENCE,,,600.0,1200.0,8
CPT,81322,PTEN GENE KNOWN FAM VARIANT,,,46.6,93.2,8
CPT,81323,PTEN GENE DUP/DELET VARIANT,,,300.0,600.0,8
CPT,81324,PMP22 GENE DUP/DELET,,,758.36,1516.72,8
CPT,81325,PMP22 GENE FULL SEQUENCE,,,769.58,1539.16,8
CPT,81326,PMP22 GENE KNOWN FAM VARIANT,,,46.6,93.2,8
CPT,81327,SEPT9 GEN PRMTR MTHYLTN ALYS,,,192.0,384.0,8
CPT,81328,SLCO1B1 GENE COM VARIANTS,,,174.81,349.62,8
CPT,81329,SMN1 GENE DOS/DELETION ALYS,182.4,91.2,11.84,891.18,540
CPT,81330,SMPD1 GENE ANALYSIS,1304.5,652.25,47.0,1271.67,108
CPT,81330,SMPD1 GENE COMMON VARIANTS,,,,,0
CPT,81331,SNRPN/UBE3A GENE,,,,,0
CPT,81331,SNRPN/UBE3A GENE ANALYSIS,225.0,112.5,39.19,218.25,108
CPT,81331,SNRPN/UBE3A METHYLATION ANALYSIS,225.0,112.5,39.19,218.25,108
CPT,81332,ALPHA-1-ANTITRYPSIN DEFICIENCY GENE ANALYSIS,180.0,90.0,31.35,174.6,108
CPT,81332,SERPINA1 GENE,,,,,0
CPT,81333,TGFBI GENE COMMON VARIANTS,,,137.0,274.0,8
CPT,81334,RUNX1 GENE TARGETED SEQ ALYS,,,329.51,659.02,8
CPT,81335,TPMT GENE COM VARIANTS,,,174.81,349.62,8
CPT,81336,SMN1 GENE FULL GENE SEQUENCE,,,301.35,602.7,8
CPT,81337,SMN1 GEN NOWN FAMIL SEQ VRNT,,,185.2,370.4,8
CPT,81338,MPL GENE ANALYSIS COMMON VARIANTS,401.5,200.75,57.13,460.75,756
CPT,81338,MPL GENE COMMON VARIANTS,,,,,0
CPT,81339,MPL GENE SEQ ALYS EXON 10,,,185.2,370.4,8
CPT,81340,TRB / GENE REARRANGE AMPLIFY,189.2,94.6,32.95,417.84,216
CPT,81340,TRB@ GENE REARRANGE AMPLIFY,,,,,0
CPT,81341,TRB@ GENE REARRANGE DIRPROBE,,,49.59,99.18,8
CPT,81342,T CELL GENE ARRANGEMENT PCR,189.2,94.6,32.95,403.0,108
CPT,81342,TRG GENE REARRANGEMENT ANAL,,,,,0
CPT,81342,TRG GENE REARRANGEMENT ANALYSI,189.2,94.6,32.95,403.0,108
CPT,81343,PPP2R2B GEN DETC ABNOR ALLEL,88.0,44.0,15.32,274.0,108
CPT,81344,TBP GENE DETC ABNOR ALLELES,88.0,44.0,15.32,274.0,108
CPT,81345,TERT GENE TARGETED SEQ ALYS,,,185.2,370.4,8
CPT,81346,TYMS GENE COM VARIANTS,,,174.81,349.62,8
CPT,81347,SF3B1 GENE COMMON VARIANTS,,,193.25,386.5,8
CPT,81348,SRSF2 GENE COMMON VARIANTS,,,175.4,350.8,8
CPT,81349,CYTOG ALYS CHRML ABNR LW-PS,,,1197.94,2395.88,8
CPT,81350,UGT1A1 GENE COMMON VARIANTS,,,,,0
CPT,81350,UGT1A1 RINOTECAN TOX GENE ANALYSIS,250.0,125.0,43.55,468.0,108
CPT,81351,TP53 GENE FULL GENE SEQUENCE,,,641.85,1283.7,8
CPT,81352,TP53 GENE TRGT SEQUENCE ALYS,700.075,350.03999999999996,118.97,695.63,108
CPT,81353,TP53 GENE KNOWN FAMIL VRNT,,,308.0,616.0,8
CPT,81355,VKORC1 GENE,,,88.2,176.4,8
CPT,81357,U2AF1 GENE COMMON VARIANTS,,,193.25,386.5,8
CPT,81360,ZRSR2 GENE COMMON VARIANTS,,,193.25,386.5,8
CPT,81361,HBB GENE COM VARIANTS,,,174.81,349.62,8
CPT,81362,HBB GENE KNOWN FAM VARIANT,,,375.25,750.5,8
CPT,81363,HBB GENE DUP/DEL VARIANTS,,,202.4,404.8,8
CPT,81364,HBB FULL GENE SEQ BETA THALASSEMIA,735.0,367.5,128.03,712.95,108
CPT,81364,HBB FULL GENE SEQUENCE,,,,,0
CPT,81370,HLA I & II TYPING LR,,,,,0
CPT,81370,"MUD HLA-A/B/C, DRB1/3/4/5, DQB1 INTERMEDIATE RESOLUTION NHCI",6048.0,3024.0,402.12,5866.56,53
CPT,81370,"MUD HLA-A/B/C, DRB1/3/4/5, DQB1 LOW RESOLUTION NHCI",3219.0,1609.5,402.12,3122.43,53
CPT,81371,HLA I & II TYPE VERIFY LR,,,404.52,809.04,8
CPT,81372,HLA CLASS I TYPING LOW COMPLETE,132.5,66.25,22.99,807.18,108
CPT,81372,HLA I TYPING COMPLETE LR,,,,,0
CPT,81372,MUD HLA CLASS I TYPING LOW RESOLUTION COMPLETE NHCI,1375.0,687.5,239.52,1333.75,53
CPT,81373,ARC HLA MOLECULAR AB TYPING,1247.5,623.75,127.43,1212.5,108
CPT,81373,HLA A PACBIO-TP IR,125.0,62.5,6.96,254.86,108
CPT,81373,HLA B PACBIO-TP IR,62.5,31.25,3.48,254.86,108
CPT,81373,HLA C PACBIO-TP IR,125.0,62.5,6.96,254.86,108
CPT,81373,HLA I TYPING 1 LOCUS LR,,,,,0
CPT,81373,HLA-B (IR),31.965,15.985000000000001,5.33,254.86,108
CPT,81374,HLA B 27 DISEASE ASSOCIATION,18.0,9.0,3.13,148.66,108
CPT,81374,HLA I TYPING 1 ANTIGEN LR,18.0,9.0,3.13,148.66,54
CPT,81375,"HLA DRB1,3,4,5,DQB1 (IR)",180.0,90.0,31.35,441.48,108
CPT,81375,HLA II TYPING AG EQUIV LR,,,,,0
CPT,81376,DPB1 PACBIO-TP IR,142.5,71.25,13.06,244.44,108
CPT,81376,DQB1 PACBIO-TP IR,142.5,71.25,13.06,244.44,108
CPT,81376,DRB1 PACBIO-TP IR,142.5,71.25,13.06,244.44,108
CPT,81376,DRB1345 PACBIO-TP IR,77.5,38.75,8.71,244.44,108
CPT,81376,HLA DPA1 TP (IR),247.5,123.75,13.06,407.4,108
CPT,81376,HLA DQA1 TP (IR),247.5,123.75,13.06,407.4,108
CPT,81376,HLA DRB1 (IR),100.0,50.0,17.42,244.44,108
CPT,81376,HLA II TYPING 1 LOCUS LR,,,,,0
CPT,81377,CELIAC DISEASE HLA AG GENE ANALYSIS,87.5,43.75,15.24,189.48,108
CPT,81377,CELIAC DISEASE HLA DQ ASSOC,92.37,46.19,16.09,189.48,108
CPT,81377,HLA II TYPE 1 AG EQUIV LR,,,,,0
CPT,81378,HLA I & II TYPING HR,,,345.57,691.14,8
CPT,81379,HLA I TYPING COMPLETE HR,,,335.38,670.76,8
CPT,81380,ARC HLA HIGH RES: HLA-A ONLY,313.0,156.5,54.52,354.5,108
CPT,81380,ARC HLA HIGH RES: HLA-B ONLY,313.0,156.5,54.52,354.5,108
CPT,81380,HLA A PACBIO-TP HR,142.5,71.25,13.06,354.5,108
CPT,81380,HLA B PACBIO-TP HR,142.5,71.25,13.06,354.5,108
CPT,81380,HLA C PACBIO-TP HR,142.5,71.25,13.06,354.5,108
CPT,81380,HLA CLASS I TYPING HI RES COMPL,367.5,183.75,64.01,356.47,108
CPT,81380,HLA I TYPING 1 LOCUS HR,,,,,0
CPT,81381,HLA B5701 I TYPING 1 ALLELE HR,40.25,20.13,7.01,339.8,108
CPT,81381,HLA I TYPING 1 ALLELE HR,246.25,123.125,21.77,356.47,108
CPT,81382,DPB1 PACBIO-TP HR,155.0,77.5,17.42,247.36,108
CPT,81382,DQB1 PACBIO-TP HR,404.375,202.19,17.42,687.48,108
CPT,81382,DRB1 PACBIO-TP HR,260.0,130.0,17.42,407.4,108
CPT,81382,DRB1345 PACBIO-TP HR,90.0,45.0,13.06,247.36,108
CPT,81382,HLA DPA1 TP (HR),416.25,208.125,26.13,662.02,108
CPT,81382,HLA DQA1 TP (HR),285.0,142.5,26.13,407.4,108
CPT,81382,HLA II TYPING 1 LOC HR,,,,,0
CPT,81382,"MUD HLA-A/B/C,DRB1, DRB3/4/5, DQB1, DPB1, DQA1, DPA1 HIGH RESOLUTION NHCI",16445.0,8222.5,123.68,15951.65,53
CPT,81383,HLA CLASS II ONE ALLELE OR GRP,75.0,37.5,13.06,218.26,108
CPT,81383,HLA II TYPING 1 ALLELE HR,,,,,0
CPT,813T,EGD VOL ADJMT BARIATRIC BALO,,,881.37,1762.74,8
CPT,81400,MOLECULAR PATH LEVEL 1,286.875,143.44,35.92,356.47,216
CPT,81400,MOPATH PROCEDURE LEVEL 1,,,,,0
CPT,81401,MOLECULAR PATH LEVEL 2,1156.5,578.25,137.0,1126.17,108
CPT,81401,MOPATH PROCEDURE LEVEL 2,,,,,0
CPT,81402,MOLECULAR PATH LEVEL 3,716.0,358.0,118.97,695.49,324
CPT,81402,MOPATH PROCEDURE LEVEL 3,,,,,0
CPT,81403,ARC RHCE VARIANTS BY SNP ARRAY,397.0,198.5,69.15,385.09,108
CPT,81403,ARC RHD GENOTYPING,511.0,255.5,89.01,495.67,108
CPT,81403,CEBPA MOLECULAR DNA SEQ,175.67,87.84,30.6,370.4,54
CPT,81403,JAK2 EXON 12 MUTATION,168.91,84.46,29.42,370.4,108
CPT,81403,MOLECULAR PATH LEVEL 4,168.91,84.46,29.42,370.4,216
CPT,81403,MOPATH PROCEDURE LEVEL 4,,,,,0
CPT,81403,MUD KIR TESTING NHCI,2964.0,1482.0,185.2,2875.08,53
CPT,81404,MOLECULAR PATH LEVEL 5,1705.0,852.5,219.49,1667.43,216
CPT,81404,MOPATH PROCEDURE LEVEL 5,,,,,0
CPT,81405,MOLECULAR PATH LEVEL 6,357.0,178.5,60.97,602.7,270
CPT,81405,MOPATH PROCEDURE LEVEL 6,,,,,0
CPT,81406,MOLECULAR PATH LEVEL 7,288.75,144.38,50.3,565.76,108
CPT,81406,MOPATH L 7 ARRAY ANALY SNP CMA,300.3,150.15,52.31,565.76,54
CPT,81406,MOPATH PROCEDURE LEVEL 7,,,,,0
CPT,81406,MUTATION ANALYS 11-25 EXONS,300.3,150.15,52.31,565.76,54
CPT,81407,MOPATH PROCEDURE LEVEL 8,,,846.27,1692.54,8
CPT,81408,MOPATH PROCEDURE LEVEL 9,,,2000.0,4000.0,8
CPT,81410,AORTIC DYSFUNCTION/DILATION,,,504.0,1008.0,8
CPT,81411,AORTIC DYSFUNCTION/DILATION,,,1350.19,2700.38,8
CPT,81412,ASHKENAZI JEWISH ASSOC DIS,,,2448.56,4897.12,8
CPT,81413,CAR ION CHNNLPATH INC 10 GNS,,,584.9,1169.8,8
CPT,81414,CAR ION CHNNLPATH INC 2 GNS,,,584.9,1169.8,8
CPT,81415,EXOME SEQUENCE ANALYSIS,,,4780.0,9560.0,8
CPT,81416,EXOME SEQUENCE ANALYSIS,,,12000.0,24000.0,8
CPT,81417,EXOME RE-EVALUATION,,,320.0,640.0,8
CPT,81418,RX METAB GEN SEQ ALYS PNL 6,,,917.08,1834.16,8
CPT,81419,EPILEPSY GEN SEQ ALYS PANEL,,,2448.56,4897.12,8
CPT,81420,FETAL CHRMOML ANEUPLOIDY,,,,,0
CPT,81420,FETAL CHROMOSOMAL GENE SEQ ANALYSIS,402.95,201.475,33.87,1518.1,648
CPT,81422,FETAL CHRMOML MICRODELTJ,,,,,0
CPT,81422,FETAL CHROMOSOMAL MICRODELTJ,242.0,121.0,33.87,1518.1,324
CPT,81425,GENOME SEQUENCE ANALYSIS,,,5031.2,10062.4,8
CPT,81426,GENOME SEQUENCE ANALYSIS,,,2709.95,5419.9,8
CPT,81427,GENOME RE-EVALUATION,,,2337.65,4675.3,8
CPT,81430,HEARING LOSS SEQUENCE ANALYS,,,1625.0,3250.0,8
CPT,81431,HEARING LOSS DUP/DEL ANALYS,,,679.57,1359.14,8
CPT,81432,HRDTRY BRST CA-RLATD DSORDRS,,,1303.95,2607.9,8
CPT,81434,HEREDITARY RETINAL DISORDERS,,,597.91,1195.82,8
CPT,81435,HEREDITARY COLON CA DSORDRS,,,1303.95,2607.9,8
CPT,81437,HEREDTRY NURONDCRN TUM DSRDR,,,1303.95,2607.9,8
CPT,81439,HRDTRY CARDMYPY GENE PANEL,,,584.9,1169.8,8
CPT,81440,MITOCHONDRIAL GENE,,,3324.0,6648.0,8
CPT,81441,IBMFS SEQ ALYS PNL 30 GENES,,,2448.56,4897.12,8
CPT,81442,CARDIO-NOONAN SYNDROME/RASOPATHIES PROFILE,1161.0,580.5,202.24,4287.2,54
CPT,81442,NOONAN SPECTRUM DISORDERS,,,,,0
CPT,81443,GENETIC TSTG SEVERE INH COND,,,2448.56,4897.12,8
CPT,81445,SO NEO GSAP 5-50DNA/DNA&RNA,,,597.91,1195.82,8
CPT,81448,HRDTRY PERPH NEURPHY PANEL,,,584.9,1169.8,8
CPT,81449,SO NEO GSAP 5-50 RNA ALYS,,,597.91,1195.82,8
CPT,81450,GEN SEQ ANALYS HEMATOLYMPHOID NEO 5-50 GENE,2625.0,1312.5,435.5,2667.5,108
CPT,81450,HL NEO GSAP 5-50DNA/DNA&RNA,,,,,0
CPT,81451,HL NEO GSAP 5-50 RNA ALYS,,,759.53,1519.06,8
CPT,81455,SO/HL 51/>GSAP DNA/DNA&RNA,,,2919.6,5839.2,8
CPT,81456,SO/HL 51/>GSAP RNA ALYS,,,2919.6,5839.2,8
CPT,81457,SO NEO GSAP DNA MCRSTL INS,,,896.87,1793.74,8
CPT,81458,SO GSAP DNA CPY NMBR&MCRSTL,,,1046.35,2092.7,8
CPT,81459,SO NEO GSAP DNA/DNA&RNA,,,2989.55,5979.1,8
CPT,81460,WHOLE MITOCHONDRIAL GENOME,,,1287.0,2574.0,8
CPT,81462,SO GSAP CLL FR DNA/DNA&RNA,,,1195.83,2391.66,8
CPT,81463,SO GSAP CL FR CPY NMBR&MCRST,,,1345.31,2690.62,8
CPT,81464,SO GSAP CLL FR MCRSTL INS,,,3288.51,6577.02,8
CPT,81465,WHOLE MITOCHONDRIAL GENOME,,,936.0,1872.0,8
CPT,81470,X-LINKED INTELLECTUAL DBLT,,,914.0,1828.0,8
CPT,81471,X-LINKED INTELLECTUAL DBLT,,,914.0,1828.0,8
CPT,81479,"BCR-ABL1, CML/ALL, PCR, QUANT",289.0,144.5,50.34,280.33,94
CPT,81479,COMP SPINOC ATAXIA RPT EXP PNL,288.75,144.38,50.3,280.08,94
CPT,81479,FIBRINOGEN GENETIC ANALYSIS,2268.0,1134.0,395.08,2199.96,94
CPT,81479,UNLISTED MOLECULAR PATH,241.0,120.5,41.98,233.77,94
CPT,81479,UNLISTED MOLECULAR PATH 354,300.3,150.15,52.31,291.29,47
CPT,81479,UNLISTED MOLECULAR PATH 434,288.75,144.38,50.3,280.08,47
CPT,81479,UNLISTED MOLECULAR PATHOLOGY,,,,,0
CPT,81490,AUTOIMMUNE RA ALYS 12 BMRK,773.625,386.815,97.24,1681.3,108
CPT,81493,COR ARTERY DISEASE MRNA,,,1050.0,2100.0,8
CPT,814T,PRQ NJX BIOD OSTEO MATRL FEM,,,,,0
CPT,81500,ONCO (OVAR) TWO PROTEINS,,,,,0
CPT,81500,OVARIAN BIOCHEMICAL ASSAYS,851.0,425.5,148.24,825.47,216
CPT,81503,ONCO (OVAR) FIVE PROTEINS,,,897.0,1794.0,8
CPT,81504,ONCOLOGY TISSUE OF ORIGIN,,,520.0,1040.0,8
CPT,81506,ENDO ASSAY SEVEN ANAL,,,68.92,137.84,8
CPT,81507,FETAL ANEUPLOIDY TRISOM RISK,,,795.0,1590.0,8
CPT,81508,FTL CGEN ABNOR TWO PROTEINS,,,54.3,108.6,8
CPT,81509,FTL CGEN ABNOR 3 PROTEINS,,,1487.37,2974.74,8
CPT,81510,FTL CGEN ABNOR THREE ANAL,,,55.54,111.08,8
CPT,81511,FTL CGEN ABNOR FOUR ANAL,,,153.5,307.0,8
CPT,81512,FTL CGEN ABNOR FIVE ANAL,,,69.52,139.04,8
CPT,81513,NFCT DS BV RNA VAG FLU ALG,,,142.63,285.26,8
CPT,81514,NFCT DS BV&VAGINITIS DNA ALG,,,262.99,525.98,8
CPT,81515,"Infectious disease, bacterial vaginosis and vaginitis, real-time PCR amplification of DNA markers for Atopobium vaginae, Atopobium species, Megasphaera type 1, and Bacterial Vaginosis Associated Bacte",,,262.99,525.98,8
CPT,81517,LIVER DS ALYS 3 BMRK SRM ALG,400.58,200.29,69.78,388.56,108
CPT,81518,ONC BRST MRNA 11 GENES,,,3873.0,7746.0,8
CPT,81519,ONCOLOGY BREAST MRNA,,,3873.0,7746.0,8
CPT,81520,ONC BREAST MRNA 58 GENES,,,2510.21,5020.42,8
CPT,81521,ONC BREAST MRNA 70 GENES,,,3873.0,7746.0,8
CPT,81522,ONC BREAST MRNA 12 GENES,,,3873.0,7746.0,8
CPT,81523,ONC BRST MRNA 70 CNT 31 GENE,,,3873.0,7746.0,8
CPT,81525,ONCOLOGY COLON MRNA,,,3116.0,6232.0,8
CPT,81528,ONCOLOGY COLORECTAL SCR,,,508.87,1017.74,8
CPT,81529,ONC CUTAN MLNMA MRNA 31 GENE,,,7193.0,14386.0,8
CPT,81535,ONCOLOGY GYNECOLOGIC,,,579.46,1158.92,8
CPT,81536,ONCOLOGY GYNECOLOGIC,,,177.56,355.12,8
CPT,81538,ONCOLOGY LUNG,,,2871.0,5742.0,8
CPT,81539,ONCOLOGY PROSTATE PROB SCORE,,,760.0,1520.0,8
CPT,81540,ONCOLOGY TUM UNKNOWN ORIGIN,,,3750.0,7500.0,8
CPT,81541,ONC PROSTATE MRNA 46 GENES,,,3873.0,7746.0,8
CPT,81542,ONC PROSTATE MRNA 22 CNT GEN,,,3873.0,7746.0,8
CPT,81546,"ONC THYR MRNA 10,196 GEN ALG",,,3600.0,7200.0,8
CPT,81551,ONC PROSTATE 3 GENES,,,2030.0,4060.0,8
CPT,81552,ONC UVEAL MLNMA MRNA 15 GENE,,,7776.0,15552.0,8
CPT,81554,PULM DS IPF MRNA 190 GEN ALG,,,5409.6,10819.2,8
CPT,81558,"Transplantation medicine (allograft rejection, kidney), mRNA, gene expression profiling by quantitative polymerase chain reaction (qPCR) of 139 genes, utilizing whole blood, algorithm reported as a bi",,,3240.0,6480.0,8
CPT,81560,TRNSPLJ PD LVR&BWL CD154+CLL,,,640.73,1281.46,8
CPT,81595,CARDIOLOGY HRT TRNSPL MRNA,,,3240.0,6480.0,8
CPT,81596,NFCT DS CHRNC HCV 6 ASSAYS,404.5,202.25,51.73,496.64,108
CPT,81599,UNLISTED MAAA,,,,,0
CPT,815T,US REMS B1 DNS HIPS PLVS/SPI,,,,,0
CPT,816T,OPN INSJ/RPLCMT INS PTN SUBQ,,,18852.29,37704.58,8
CPT,817T,OPN INSJ/RPLCMT INS PTN SUBF,,,18852.29,37704.58,8
CPT,818T,REVJ/RMVL INS PTN SUBQ,,,3397.38,6794.76,8
CPT,819T,REVJ/RMVL INS PTN SUBF,,,3397.38,6794.76,8
CPT,820,ANESTH ABDOMINAL WALL SURG,,,,,0
CPT,82009,ACETONE/ OTHER KETONES QUAL,70.5,35.25,4.52,83.42,108
CPT,82009,TEST FOR ACETONE/KETONES,,,,,0
CPT,82010,ACETONE ASSAY,,,,,0
CPT,82010,BETA HYDROXYBUTYRIC ACID,250.5,125.25,8.17,252.2,108
CPT,82013,ACETYCHOLINESTERASE,365.0,182.5,12.29,354.05,54
CPT,82013,ACETYLCHOLINESTERASE ASSAY,,,,,0
CPT,82016,ACYLCARNITINES QUAL,,,16.49,32.98,8
CPT,82017,ACYLCARNITINE,442.0,221.0,16.87,428.74,54
CPT,82017,ACYLCARNITINES QUANT,,,,,0
CPT,82024,ADENOCORTICOTROPIC HORMONE,360.0,180.0,25.78,554.84,108
CPT,82024,ASSAY OF ACTH,,,,,0
CPT,82030,ASSAY OF ADP & AMP,,,25.8,51.6,8
CPT,82040,ALBUMIN LEVEL,47.0,23.5,3.65,70.81,108
CPT,82040,ASSAY OF SERUM ALBUMIN,,,,,0
CPT,82042,ALBUMIN LEVEL BODY FLUID,114.0,57.0,7.78,110.58,54
CPT,82042,ALBUMIN LEVEL CSF,114.0,57.0,7.78,110.58,54
CPT,82042,OTHER SOURCE ALBUMIN QUAN EA,,,,,0
CPT,82043,MICROALBUMIN LEVEL URINE,70.0,35.0,5.78,83.42,108
CPT,82043,MICROALBUMIN LEVEL URINE 24HR,60.5,30.25,4.87,90.21,108
CPT,82043,UR ALBUMIN QUANTITATIVE,,,,,0
CPT,82044,MICROALBUMIN URINE SEMIQUANT,75.0,37.5,6.23,72.75,54
CPT,82044,UR ALBUMIN SEMIQUANTITATIVE,,,,,0
CPT,82045,ALBUMIN ISCHEMIA MODIFIED,,,33.94,67.88,8
CPT,82075,ASSAY OF BREATH ETHANOL,,,,,0
CPT,82075,BREATH ALCOHOL,96.0,48.0,16.72,93.12,54
CPT,82077,ASSAY SPEC XCP UR&BREATH IA,,,,,0
CPT,82077,ETHANOL LEVEL QUANTITATIVE ASSAY,879.0,439.5,17.27,1125.2,108
CPT,82085,ALDOLASE,118.5,59.25,9.71,140.65,108
CPT,82085,ASSAY OF ALDOLASE,,,,,0
CPT,82088,ALDOSTERONE SERUM,488.5,244.25,40.75,618.86,108
CPT,82088,ALDOSTERONE URINE,502.0,251.0,40.75,495.67,108
CPT,82088,ASSAY OF ALDOSTERONE,,,,,0
CPT,820T,MNTR PSYCHDLC MED 1STPHY/QHP,,,,,0
CPT,82103,ALPHA 1 ANTITRYPSIN,153.5,76.75,13.44,194.0,108
CPT,82103,ALPHA-1-ANTITRYPSIN TOTAL,,,,,0
CPT,82104,ALPHA 1 ANTITRYPSIN PHENOTYPE,113.0,56.5,8.18,173.63,108
CPT,82104,ALPHA-1-ANTITRYPSIN PHENO,,,,,0
CPT,82105,ALPHA FETOPROTEIN MATERNAL,278.5,139.25,16.77,343.38,108
CPT,82105,ALPHA FETOPROTEIN TUMOR MARK,168.0,84.0,15.15,241.53,108
CPT,82105,ALPHA-FETOPROTEIN SERUM,,,,,0
CPT,82106,ALPHA FETOPROTEIN AMNIONTIC,354.0,177.0,17.0,343.38,54
CPT,82106,ALPHA-FETOPROTEIN AMNIOTIC,,,,,0
CPT,82107,ALPHA FETOPROTEIN L3 PERCENT,670.5,335.25,64.41,927.32,108
CPT,82107,ALPHA-FETOPROTEIN L3,,,,,0
CPT,82108,ALUMINUM SERUM,398.0,199.0,25.48,386.06,54
CPT,82108,ALUMINUM URINE,308.0,154.0,25.48,298.76,54
CPT,82108,ASSAY OF ALUMINUM,,,,,0
CPT,82120,AMINES VAGINAL FLUID QUAL,,,5.99,11.98,8
CPT,82127,AMINO ACID SINGLE QUAL,,,14.18,28.36,8
CPT,82128,AMINO ACIDS MULT QUAL,,,,,0
CPT,82128,AMINO ACIDS QUAL BLOOD,309.0,154.5,13.87,299.73,54
CPT,82128,AMINO ACIDS QUAL URINE,309.0,154.5,13.87,299.73,54
CPT,82131,AMINO ACIDS SINGLE QUANT,,,,,0
CPT,82131,CYSTINE QUANT BLOOD,428.0,214.0,22.98,415.16,54
CPT,82135,ASSAY AMINOLEVULINIC ACID,,,,,0
CPT,82135,DELTA AMINOLEVULINIC ACID,215.5,107.75,16.45,261.9,108
CPT,82136,AMINO ACIDS 2-5 QUANT,829.5,414.75,19.61,823.53,108
CPT,82136,AMINO ACIDS QNT 2-5 BLOOD,766.0,383.0,19.61,743.02,54
CPT,82136,AMINO ACIDS QNT 2-5 URINE,766.0,383.0,19.61,743.02,54
CPT,82136,AMINO ACIDS QUANT 2-5,,,,,0
CPT,82139,AMINO ACIDS QNT 6+ BLOOD,860.0,430.0,16.87,834.2,54
CPT,82139,AMINO ACIDS QNT 6+ URINE,860.0,430.0,16.87,834.2,54
CPT,82139,AMINO ACIDS QUAN 6 OR MORE,,,,,0
CPT,82140,AMMONIA LEVEL,135.0,67.5,9.4,209.52,108
CPT,82140,ASSAY OF AMMONIA,,,,,0
CPT,82143,AMNIOTIC FLUID SCAN,,,9.35,18.7,8
CPT,82150,AMYLASE LEVEL,89.5,44.75,6.48,101.85,108
CPT,82150,AMYLASE LEVEL BODY FLUID,89.5,44.75,6.48,101.85,108
CPT,82150,AMYLASE LEVEL URINE,145.5,72.75,6.48,165.87,108
CPT,82150,AMYLASE LEVEL URINE 24 HR,145.5,72.75,6.48,165.87,108
CPT,82150,ASSAY OF AMYLASE,,,,,0
CPT,82154,ANDROSTANEDIOL GLUCURONIDE,,,28.83,57.66,8
CPT,82157,ANDROSTENEDIONE,314.5,157.25,29.28,344.35,108
CPT,82157,ASSAY OF ANDROSTENEDIONE,,,,,0
CPT,82160,ASSAY OF ANDROSTERONE,,,25.55,51.1,8
CPT,82163,ASSAY OF ANGIOTENSIN II,,,20.52,41.04,8
CPT,82164,ANGIOTENSIN CONVERTING ENZYME,191.0,95.5,14.6,240.56,108
CPT,82164,ANGIOTENSIN I ENZYME TEST,,,,,0
CPT,82166,ASSAY ANTI-MULLERIAN HORM,,,,,0
CPT,82166,ASSAY OF ANTI-MULLERIAN HORMONE,363.0,181.5,21.42,584.91,108
CPT,82172,APOLIPOPROTEIN EACH,217.0,108.5,21.09,211.46,108
CPT,82172,ASSAY OF APOLIPOPROTEIN,,,,,0
CPT,82175,ARSENIC LEVEL,256.0,128.0,18.97,274.51,108
CPT,82175,ARSENIC LEVEL URINE,273.5,136.75,18.97,308.46,108
CPT,82175,ARSENIC LEVEL URINE 24 HR,284.0,142.0,18.97,276.45,108
CPT,82175,ASSAY OF ARSENIC,,,,,0
CPT,82180,ASSAY OF ASCORBIC ACID,,,,,0
CPT,82180,VITAMIN C ASCORBIC ACID LEVEL,118.0,59.0,9.89,143.56,108
CPT,82190,ATOMIC ABSORPTION,,,15.9,31.8,8
CPT,821T,MNTR PSYCHDLC MED 2NDPHY/QHP,,,,,0
CPT,82232,ASSAY OF BETA-2 PROTEIN,,,,,0
CPT,82232,BETA 2 MICROGLOBULIN,295.5,147.75,16.18,385.09,108
CPT,82233,Beta-amyloid; 1-40 (Abeta 40),,,128.92,257.84,8
CPT,82234,Beta-amyloid; 1-42 (Abeta 42),,,128.92,257.84,8
CPT,82239,BILE ACIDS TOTAL,254.0,127.0,17.12,246.38,54
CPT,82240,BILE ACIDS CHOLYLGLYCINE,,,26.58,53.16,8
CPT,82247,BILIRUBIN TOTAL,124.5,62.25,5.02,184.3,108
CPT,82247,BILIRUBIN TOTAL FLUID,183.0,91.5,5.02,184.3,108
CPT,82248,BILIRUBIN DIRECT,51.0,25.5,3.3,80.51,108
CPT,82248,BILIRUBIN DIRECT NEONATAL,101.0,50.5,5.02,131.92,108
CPT,82252,FECAL BILIRUBIN TEST,,,4.56,9.12,8
CPT,82261,ASSAY OF BIOTINIDASE,,,,,0
CPT,82261,BIOTINIDASE EA SPECIMEN,368.0,184.0,16.87,356.96,108
CPT,82270,OCCULT BLOOD FECES,,,,,0
CPT,82270,OCCULT BLOOD QL FECES X3SCRN,47.5,23.75,2.61,77.6,108
CPT,82271,OCCULT BLOOD OTHER SOURCES,,,,,0
CPT,82271,OCCULT BLOOD QL GASTRIC FLD,98.0,49.0,5.32,95.06,54
CPT,82271,POC OCCULT BLOOD GASTRIC,98.0,49.0,5.32,95.06,54
CPT,82272,OCCULT BLD FECES 1-3 TESTS,,,,,0
CPT,82272,OCCULT BLOOD QL FECES SINGLE,55.0,27.5,4.23,64.99,108
CPT,82272,POC OCCULT BLD PEROXIDASE,62.0,31.0,4.23,60.14,54
CPT,82274,ASSAY TEST FOR BLOOD FECAL,,,,,0
CPT,82274,OCCULT BLOOD QL FECES ASSAY,152.5,76.25,15.92,196.91,108
CPT,82286,ASSAY OF BRADYKININ,,,5.16,10.32,8
CPT,822T,MNTR PSYCHDLC MED CLN STAFF,,,,,0
CPT,82300,ASSAY OF CADMIUM,,,,,0
CPT,82300,CADMIUM LEVEL,260.0,130.0,23.64,276.45,108
CPT,82306,25-HYDROXYVITAMIN D LEVEL,297.0,148.5,27.0,425.83,108
CPT,82306,VITAMIN D 25 HYDROXY,,,,,0
CPT,82308,ASSAY OF CALCITONIN,,,,,0
CPT,82308,CALCITONIN LEVEL,266.5,133.25,18.81,412.25,108
CPT,82310,ASSAY OF CALCIUM,,,,,0
CPT,82310,CALCIUM LEVEL BODY FLUID,96.0,48.0,5.16,126.1,108
CPT,82310,CALCIUM LEVEL TOTAL,50.0,25.0,3.3,78.57,108
CPT,82310,CALCIUM LEVEL TOTAL PTH,114.5,57.25,5.16,126.1,108
CPT,82310,CALCIUM LEVEL URINE,96.0,48.0,5.16,126.1,108
CPT,82330,ASSAY OF CALCIUM,,,,,0
CPT,82330,CALCIUM LEVEL IONIZED,168.0,84.0,13.68,196.91,108
CPT,82330,IONIZED CALCIUM,269.0,134.5,13.68,260.93,54
CPT,82330,POC ISTAT ASSAY CALCIUM IONIZED,165.0,82.5,13.68,160.05,54
CPT,82331,CALCIUM INFUSION TEST,,,13.34,26.68,8
CPT,82340,ASSAY OF CALCIUM IN URINE,,,,,0
CPT,82340,CALCIUM LEVEL URINE 24 HR,93.0,46.5,6.03,95.06,108
CPT,82355,CALCULUS ANALYSIS QUAL,,,11.58,23.16,8
CPT,82360,CALCULUS ASSAY QUANT,,,,,0
CPT,82360,CALCULUS QNT CHEMICAL,223.5,111.75,12.87,280.33,108
CPT,82365,CALCULUS QNT INFRARED SPECT,116.5,58.25,7.31,185.27,108
CPT,82365,CALCULUS SPECTROSCOPY,,,,,0
CPT,82370,X-RAY ASSAY CALCULUS,,,12.52,25.04,8
CPT,82373,ASSAY C-D TRANSFER MEASURE,,,,,0
CPT,82373,CARBOHYDRATE DEFICIENT TRANSFERRIN,300.0,150.0,18.06,303.61,108
CPT,82374,ASSAY BLOOD CARBON DIOXIDE,,,,,0
CPT,82374,CARBON DIOXIDE LEVEL,70.0,35.0,4.88,104.76,108
CPT,82375,ASSAY CARBOXYHB QUANT,,,,,0
CPT,82375,CARBOXYHEMOGLOBIN,153.0,76.5,12.32,148.41,54
CPT,82375,CARBOXYHEMOGLOBIN QNT,117.5,58.75,7.49,186.24,108
CPT,82376,ASSAY CARBOXYHB QUAL,,,14.07,28.14,8
CPT,82378,CARCINOEMBRYONIC ANTIGEN,181.5,90.75,13.93,274.51,108
CPT,82379,ASSAY OF CARNITINE,,,,,0
CPT,82379,CARNITINE FREE/TOTAL,250.0,125.0,16.87,242.5,54
CPT,82380,ASSAY OF CAROTENE,,,,,0
CPT,82380,CAROTENE,147.0,73.5,9.22,142.59,54
CPT,82382,ASSAY URINE CATECHOLAMINES,,,27.3,54.6,8
CPT,82383,ASSAY BLOOD CATECHOLAMINES,,,29.08,58.16,8
CPT,82384,ASSAY THREE CATECHOLAMINES,,,,,0
CPT,82384,CATECHOLAMINES FRAC 24 URINE,259.5,129.75,21.77,382.18,108
CPT,82384,CATECHOLAMINES FRACTIONATED,306.0,153.0,25.25,296.82,54
CPT,82384,CATECHOLAMINES PLASMA,350.0,175.0,25.25,382.18,108
CPT,82387,ASSAY OF CATHEPSIN-D,,,18.06,36.12,8
CPT,82390,ASSAY OF CERULOPLASMIN,,,,,0
CPT,82390,CERULOPLASMIN,102.5,51.25,7.83,155.2,108
CPT,82397,ANTI-MULLERIAN HORMONE (AMH),323.5,161.75,14.12,391.88,108
CPT,82397,CHEMILUMINESCENT ASSAY,593.5,296.75,14.12,671.24,108
CPT,82397,INFLIXIMAB (IFX) ANTIBODY,381.5,190.75,14.12,504.4,108
CPT,82397,PTH RELATED PEPTIDE,343.5,171.75,14.12,504.4,108
CPT,82397,VEDOLIZUMAB ANTIBODY,381.5,190.75,14.12,504.4,108
CPT,823T,TCAT INS 1CHMBR LDLS PM RA,,,18717.77,37435.54,8
CPT,82415,ASSAY OF CHLORAMPHENICOL,,,12.67,25.34,8
CPT,82435,ASSAY OF BLOOD CHLORIDE,,,,,0
CPT,82435,CHLORIDE LEVEL,62.0,31.0,4.6,66.93,162
CPT,82436,ASSAY OF URINE CHLORIDE,,,,,0
CPT,82436,CHLORIDE LEVEL URINE,86.0,43.0,5.75,83.42,54
CPT,82436,CHLORIDE LEVEL URINE 24 HR,102.0,51.0,5.75,98.94,54
CPT,82438,ASSAY OTHER FLUID CHLORIDES,,,,,0
CPT,82438,CHLORIDE LEVEL BODY FLUID,149.0,74.5,5.0,144.53,54
CPT,82438,CHLORIDE LEVEL CSF,230.0,115.0,5.0,223.1,54
CPT,82441,CHLORINATED HYDROCARBONS SCREEN,104.5,52.25,6.01,131.92,108
CPT,82441,TEST FOR CHLOROHYDROCARBONS,,,,,0
CPT,82465,ASSAY BLD/SERUM CHOLESTEROL,,,,,0
CPT,82465,CHOLESTEROL TOTAL,40.0,20.0,2.96,61.11,108
CPT,82480,ASSAY SERUM CHOLINESTERASE,,,,,0
CPT,82480,CHOLINESTERASE PLASMA,124.0,62.0,7.87,120.28,54
CPT,82480,PSEUDOCHOLINESTERASE,126.0,63.0,7.87,122.22,54
CPT,82482,ACETYLCHOLINESTERASE RBC,119.0,59.5,9.81,115.43,54
CPT,82482,ASSAY RBC CHOLINESTERASE,,,,,0
CPT,82482,CHOLINESTERASE RBC,119.0,59.5,9.81,115.43,54
CPT,82485,ASSAY CHONDROITIN SULFATE,,,20.65,41.3,8
CPT,82495,ASSAY OF CHROMIUM,,,,,0
CPT,82495,CHROMIUM LEVEL,301.0,150.5,20.28,291.97,54
CPT,824T,TCAT RMV 1CHMBR LDLS PM RA,,,3068.32,6136.64,8
CPT,82507,ASSAY OF CITRATE,,,,,0
CPT,82507,CITRATE LEVEL,428.0,214.0,27.8,415.16,54
CPT,82507,CITRATE LEVEL URINE 24 HR,428.0,214.0,27.8,415.16,54
CPT,82523,COLLAGEN CROSSLINKS,,,,,0
CPT,82523,COLLAGEN N-TELOPEPTIDE CROSSL,247.0,123.5,18.68,339.5,108
CPT,82525,ASSAY OF COPPER,,,,,0
CPT,82525,COPPER LEVEL,164.0,82.0,12.41,188.18,108
CPT,82525,COPPER LEVEL LIVER,153.0,76.5,12.41,151.32,108
CPT,82525,COPPER LEVEL URINE,172.0,86.0,12.41,188.18,108
CPT,82525,COPPER LEVEL URINE 24 HR,153.0,76.5,12.41,151.32,108
CPT,82528,ASSAY OF CORTICOSTERONE,,,22.52,45.04,8
CPT,82530,CORTISOL FREE,,,,,0
CPT,82530,CORTISOL LEVEL FREE UR 24 HR,180.5,90.25,16.54,258.02,108
CPT,82533,CORTISOL LEVEL,269.5,134.75,16.3,276.45,108
CPT,82533,CORTISOL LEVEL 1 HR,309.0,154.5,16.3,318.16,108
CPT,82533,CORTISOL LEVEL 2 HR,309.0,154.5,16.3,318.16,108
CPT,82533,CORTISOL LEVEL AM,282.0,141.0,16.3,281.3,108
CPT,82533,CORTISOL LEVEL BASE,309.0,154.5,16.3,318.16,108
CPT,82533,CORTISOL LEVEL HALF HR,309.0,154.5,16.3,318.16,108
CPT,82533,CORTISOL LEVEL PM,309.0,154.5,16.3,318.16,108
CPT,82533,TOTAL CORTISOL,,,,,0
CPT,82540,ASSAY OF CREATINE,,,,,0
CPT,82540,CREATINE LEVEL,60.5,30.25,3.3,98.94,108
CPT,82542,AMIODARONE QUANT GC/MS,203.5,101.75,24.09,218.25,108
CPT,82542,BILE ACIDS FRACTIONATED,356.0,178.0,21.42,571.33,108
CPT,82542,COENZYME Q10 TOTAL,366.5,183.25,24.09,571.33,108
CPT,82542,COL CHROMOTOGRAPHY QUAL/QUAN,711.0,355.5,24.09,689.67,108
CPT,82542,MEVALONATE ACID QNT,427.5,213.75,24.09,689.67,108
CPT,82542,N-METHYLHISTAMINE,427.5,213.75,24.09,689.67,108
CPT,82542,OXCARBAZEPINE,203.5,101.75,24.09,218.25,108
CPT,82542,SERATONIN RELEASE ASSAY,366.5,183.25,24.09,571.33,108
CPT,82542,THIOPURINE METHYLTRANS DEFINITIVIT,417.0,208.5,21.42,689.67,108
CPT,82542,TRAZODONE QUANT NES,200.0,100.0,24.09,218.25,108
CPT,82550,ASSAY OF CK (CPK),,,,,0
CPT,82550,CREATINE KINASE TOTAL,65.5,32.75,4.18,103.79,108
CPT,82552,ASSAY OF CPK IN BLOOD,,,,,0
CPT,82552,CPK ISOENZYMES,131.5,65.75,8.01,210.49,108
CPT,82553,CK-MB ISOENZYMES,110.0,55.0,8.01,168.78,108
CPT,82553,CREATINE MB FRACTION,,,,,0
CPT,82554,CREATINE ISOFORMS,,,11.87,23.74,8
CPT,82565,ASSAY OF CREATININE,,,,,0
CPT,82565,CREATININE BLOOD,75.0,37.5,3.3,111.55,162
CPT,82565,POC CREATININE BLD,77.5,38.75,5.12,77.6,108
CPT,82570,ASSAY OF URINE CREATININE,,,,,0
CPT,82570,CREATININE BODY FLUID,102.0,51.0,5.18,115.43,108
CPT,82570,CREATININE URINE,79.0,39.5,5.18,82.45,108
CPT,82570,CREATININE URINE 24 HOUR,81.5,40.75,5.18,82.45,108
CPT,82575,CREATININE CLEARANCE 12 HR,178.0,89.0,9.46,172.66,54
CPT,82575,CREATININE CLEARANCE 24HR,91.0,45.5,7.31,135.8,108
CPT,82575,CREATININE CLEARANCE TEST,,,,,0
CPT,82585,ASSAY OF CRYOFIBRINOGEN,,,,,0
CPT,82585,CRYOFIBRINOGEN ASSAY,108.0,54.0,7.83,165.87,108
CPT,82595,ASSAY OF CRYOGLOBULIN,,,,,0
CPT,82595,CRYOGLOBULIN,68.0,34.0,5.4,101.85,108
CPT,825T,TCAT RMV&RPL1CHMB LDLS PM RA,,,18717.77,37435.54,8
CPT,82600,ASSAY OF CYANIDE,,,,,0
CPT,82600,CYANIDE LEVEL,408.0,204.0,19.4,395.76,54
CPT,82607,VITAMIN B-12,,,,,0
CPT,82607,VITAMIN B12 LEVEL,141.0,70.5,10.1,217.28,108
CPT,82608,B-12 BINDING CAPACITY,,,,,0
CPT,82608,VITAMIN B12 LEVEL UNSAT,226.0,113.0,14.32,219.22,54
CPT,82610,CYSTATIN C,244.5,122.25,18.52,266.75,108
CPT,82615,TEST FOR URINE CYSTINES,,,9.55,19.1,8
CPT,82626,DEHYDROEPIANDROSTERONE,296.0,148.0,25.27,362.78,108
CPT,82627,DEHYDROEPIANDROSTERONE,,,,,0
CPT,82627,DEHYDROEPIANDROSTERONE SULFAT,209.0,104.5,12.36,336.59,108
CPT,82633,11-DESOXYCORTICOSTERONE,533.0,266.5,30.98,671.24,108
CPT,82633,DESOXYCORTICOSTERONE,,,,,0
CPT,82634,11-DEOXYCORTISOL,652.0,326.0,29.28,632.44,54
CPT,82634,DEOXYCORTISOL,,,,,0
CPT,82638,ASSAY OF DIBUCAINE NUMBER,,,,,0
CPT,82638,DIBUCAINE NUMBER,196.0,98.0,12.25,190.12,54
CPT,82642,DIHYDROTESTOSTERONE,414.5,207.25,29.28,459.78,108
CPT,82652,"1,25-DIHYDROXYVITAMIN D LEVEL",359.5,179.75,25.78,553.87,108
CPT,82652,VIT D 1 25-DIHYDROXY,,,,,0
CPT,82653,EL-1 FECAL QUANTITATIVE,408.0,204.0,22.97,415.16,108
CPT,82656,EL-1 FECAL QUAL/SEMIQ,,,,,0
CPT,82656,PANCREATIC ELASTASE FECAL,377.5,188.75,11.53,384.12,108
CPT,82657,ENZYME ACTIVITY NON RADIO EA SPECIMEN,785.5,392.75,22.17,828.38,108
CPT,82657,ENZYME CELL ACTIVITY,,,,,0
CPT,82658,ENZYME CELL ACTIVITY RA,,,44.03,88.06,8
CPT,82664,ELECTROPHORETIC TECHNIQUE NES,516.5,258.25,40.58,776.0,108
CPT,82664,ELECTROPHORETIC TEST,,,,,0
CPT,82668,ASSAY OF ERYTHROPOIETIN,,,,,0
CPT,82668,ERYTHROPOIETIN LEVEL,175.0,87.5,12.36,270.63,108
CPT,82670,ASSAY OF TOTAL ESTRADIOL,,,,,0
CPT,82670,ESTRADIOL TOTAL,274.0,137.0,19.33,423.89,108
CPT,82671,ASSAY OF ESTROGENS,,,,,0
CPT,82671,ESTROGEN FRACTIONATED,458.0,229.0,32.3,510.22,108
CPT,82672,ASSAY OF ESTROGEN,,,,,0
CPT,82672,ESTROGEN LEVEL TOTAL,203.0,101.5,14.8,311.37,108
CPT,82677,ASSAY OF ESTRIOL,,,,,0
CPT,82677,ESTRIOL LEVEL,189.0,94.5,14.8,284.21,108
CPT,82679,ASSAY OF ESTRONE,,,,,0
CPT,82679,ESTRONE LEVEL,359.5,179.75,24.95,404.49,108
CPT,82681,ASSAY DIR MEAS FR ESTRADIOL,,,27.94,55.88,8
CPT,82693,ASSAY OF ETHYLENE GLYCOL,,,,,0
CPT,82693,ETHYLENE GLYCOL LEVEL,220.0,110.0,14.9,213.4,54
CPT,82696,ASSAY OF ETIOCHOLANOLONE,,,26.24,52.48,8
CPT,826T,PRGRMG EVL LDLS PM 1CHMBR IP,,,36.27,72.54,8
CPT,82705,FATS/LIPIDS FECES QUAL,,,,,0
CPT,82705,FECAL FAT QUALITATIVE,84.0,42.0,5.1,90.21,108
CPT,82710,FATS/LIPIDS FECES QUANT,,,,,0
CPT,82710,FECAL FAT QUANTITATIVE,267.0,133.5,16.8,258.99,54
CPT,82715,ASSAY OF FECAL FAT,,,22.97,45.94,8
CPT,82725,ASSAY OF BLOOD FATTY ACIDS,,,,,0
CPT,82725,FATTY ACIDS,279.0,139.5,18.77,270.63,54
CPT,82726,FATTY ACIDS LONG CHAIN,520.5,260.25,19.75,507.31,108
CPT,82726,LONG CHAIN FATTY ACIDS,,,,,0
CPT,82728,ASSAY OF FERRITIN,,,,,0
CPT,82728,FERRITIN LEVEL,130.0,65.0,9.92,196.91,108
CPT,82731,ASSAY OF FETAL FIBRONECTIN,,,,,0
CPT,82731,FETAL FIBRONECTIN,956.0,478.0,64.41,927.32,54
CPT,82735,ASSAY OF FLUORIDE,,,18.54,37.08,8
CPT,82746,ASSAY OF FOLIC ACID SERUM,,,,,0
CPT,82746,FOLATE LEVEL,137.5,68.75,10.1,210.49,108
CPT,82747,ASSAY OF FOLIC ACID RBC,,,,,0
CPT,82747,FOLATE LEVEL RBC,163.5,81.75,11.49,253.17,108
CPT,82757,ASSAY OF SEMEN FRUCTOSE,,,17.34,34.68,8
CPT,82759,ASSAY OF RBC GALACTOKINASE,,,21.48,42.96,8
CPT,82760,ASSAY OF GALACTOSE,,,11.2,22.4,8
CPT,82775,ASSAY GALACTOSE TRANSFERASE,,,,,0
CPT,82775,GALACTOSE-1-PHOS URIDYL TRANSF,880.5,440.25,21.07,858.45,108
CPT,82776,GALACTOSE TRANSFERASE TEST,,,11.74,23.48,8
CPT,82777,GALECTIN-3,,,44.25,88.5,8
CPT,82784,ASSAY IGA/IGD/IGG/IGM EACH,,,,,0
CPT,82784,IMMUNOGLOBULIN EACH,141.5,70.75,9.3,146.47,108
CPT,82784,IMMUNOGLOBULIN IGA,141.5,70.75,9.3,146.47,108
CPT,82784,IMMUNOGLOBULIN IGD,141.5,70.75,9.3,146.47,108
CPT,82784,IMMUNOGLOBULIN IGG,141.5,70.75,9.3,146.47,108
CPT,82784,IMMUNOGLOBULIN IGM,141.5,70.75,9.3,146.47,108
CPT,82785,ASSAY OF IGE,,,,,0
CPT,82785,IMMUNOGLOBULIN IGE,162.0,81.0,13.93,236.68,108
CPT,82787,IGG 1 2 3 OR 4 EACH,,,,,0
CPT,82787,IMMUNOGLOBULIN IGG CSF,160.0,80.0,8.02,155.2,54
CPT,82787,IMMUNOGLOBULIN IGG SUB EA,106.5,53.25,8.02,115.43,108
CPT,827T,DGTZ GLS MCRSCP CYTP SMEARS,,,,,0
CPT,82800,BLOOD GAS PH ONLY,155.0,77.5,11.0,150.35,54
CPT,82800,BLOOD PH,,,,,0
CPT,82803,BLOOD GAS NEONATAL,322.0,161.0,26.07,312.34,54
CPT,82803,BLOOD GAS W CALC O2,322.0,161.0,26.07,312.34,54
CPT,82803,BLOOD GASES ANY COMBINATION,,,,,0
CPT,82803,POC BLOOD GASES ANY COMBINATION,184.0,92.0,26.07,178.48,54
CPT,82803,POC ISTAT BLOOD GASES ANY COMB PH PCO2 PO2 CO2 HCO3,315.0,157.5,26.07,305.55,54
CPT,82805,BLOOD GAS W DIR MEAS O2,294.0,147.0,51.21,285.18,54
CPT,82805,BLOOD GASES W/O2 SATURATION,,,,,0
CPT,82810,BLOOD GAS O2 SAT ONLY,95.0,47.5,9.77,92.15,54
CPT,82810,BLOOD GASES O2 SAT ONLY,,,,,0
CPT,82820,BLOOD GAS PO2 SAT,70.0,35.0,12.19,67.9,54
CPT,82820,HEMOGLOBIN-OXYGEN AFFINITY,,,,,0
CPT,828T,DGTZ GLS MCRSCP CYTP SMPL FL,,,,,0
CPT,82930,GASTRIC ANALY W/PH EA SPEC,,,6.71,13.42,8
CPT,82938,GASTRIN TEST,,,17.69,35.38,8
CPT,82941,ASSAY OF GASTRIN,,,,,0
CPT,82941,GASTRIN LEVEL,188.0,94.0,17.63,253.17,108
CPT,82943,ASSAY OF GLUCAGON,,,,,0
CPT,82943,GLUCAGON PLASMA,177.0,88.5,9.23,291.97,108
CPT,82945,GLUCOSE BODY FLUID,103.0,51.5,3.93,99.91,54
CPT,82945,GLUCOSE CSF,93.5,46.75,3.93,99.91,108
CPT,82945,GLUCOSE OTHER FLUID,,,,,0
CPT,82945,GLUCOSE URINE 24 HR,94.0,47.0,3.93,91.18,54
CPT,82946,GLUCAGON TOLERANCE TEST,,,17.77,35.54,8
CPT,82947,ASSAY GLUCOSE BLOOD QUANT,,,,,0
CPT,82947,GLUCOSE FASTING,40.5,20.25,3.93,56.26,108
CPT,82947,GLUCOSE RANDOM,58.0,29.0,2.78,91.18,162
CPT,82947,GLUCOSE SERUM,51.5,25.75,3.93,56.26,108
CPT,82947,GLUCOSE TOLERANCE 1HR,82.5,41.25,3.93,91.18,108
CPT,82947,GLUCOSE TOLERANCE NG,82.5,41.25,3.93,91.18,108
CPT,82947,OSULLIVAN GLUCOSE FASTING,82.5,41.25,3.93,91.18,108
CPT,82947,POC ASSAY GLUCOSE BLOOD QUANT,37.0,18.5,3.93,35.89,54
CPT,82947,POC ISTAT ASSAY GLUCOSE BLOOD QUANT,71.0,35.5,3.93,68.87,54
CPT,82948,GLUCOSE BLOOD REAGENT STRIP,21.0,10.5,3.65,20.37,54
CPT,82948,REAGENT STRIP/BLOOD GLUCOSE,,,,,0
CPT,82950,GLUCOSE 1 HOUR,102.0,51.0,4.75,98.94,54
CPT,82950,GLUCOSE 1 HOUR POST,102.0,51.0,4.75,98.94,54
CPT,82950,GLUCOSE 2 HOUR,102.0,51.0,4.75,98.94,54
CPT,82950,GLUCOSE 2 HOUR PC,102.0,51.0,4.75,98.94,54
CPT,82950,GLUCOSE POST DOSE,75.0,37.5,4.75,72.75,54
CPT,82950,GLUCOSE TEST,,,,,0
CPT,82950,OSULLIVAN GLUCOSE,70.0,35.0,4.75,67.9,54
CPT,82951,GLUCOSE TOL 2HRS 1ST 3 SPEC,232.0,116.0,12.87,225.04,54
CPT,82951,GLUCOSE TOL 3HRS 1ST 3 SPEC,232.0,116.0,12.87,225.04,54
CPT,82951,GLUCOSE TOL 4HRS 1ST 3 SPEC,232.0,116.0,12.87,225.04,54
CPT,82951,GLUCOSE TOL 5HRS 1ST 3 SPEC,232.0,116.0,12.87,225.04,54
CPT,82951,GLUCOSE TOL 6HRS 1ST 3 SPEC,232.0,116.0,12.87,225.04,54
CPT,82951,GLUCOSE TOLERANCE 1ST 3 SPEC,232.0,116.0,12.87,225.04,54
CPT,82951,GLUCOSE TOLERANCE TEST (GTT),,,,,0
CPT,82951,LACTOSE FASTING,232.0,116.0,12.87,225.04,54
CPT,82952,GLUCOSE TOL EA ADDL SPEC >3,94.0,47.0,3.92,91.18,54
CPT,82952,GTT-ADDED SAMPLES,,,,,0
CPT,82955,ASSAY OF G6PD ENZYME,,,,,0
CPT,82955,GLUCOSE-6-PD QUANT,92.0,46.0,5.74,146.47,108
CPT,82960,GLUCOSE-6-PD QUAL SCREEN,161.0,80.5,6.05,156.17,54
CPT,82960,TEST FOR G6PD ENZYME,,,,,0
CPT,82962,GLUCOSE BLOOD TEST,,,,,0
CPT,82962,POC GLUCOSE,44.0,22.0,3.28,46.56,108
CPT,82963,ASSAY OF GLUCOSIDASE,,,21.48,42.96,8
CPT,82965,ASSAY OF GDH ENZYME,,,13.15,26.3,8
CPT,82977,ASSAY OF GGT,,,,,0
CPT,82977,GAMMA GLUTAMYL TRANSFERASE,67.5,33.75,4.87,103.79,108
CPT,82978,ASSAY OF GLUTATHIONE,,,,,0
CPT,82978,GLUTATHIONE BLOOD,558.0,279.0,15.45,555.81,108
CPT,82979,ASSAY RBC GLUTATHIONE,,,9.44,18.88,8
CPT,82985,ASSAY OF GLYCATED PROTEIN,,,,,0
CPT,82985,FRUCTOSAMINE GLYCATED PROTEIN,125.5,62.75,10.1,187.21,108
CPT,829T,DGTZ GLS MCRSCP CYTP CONCTRJ,,,,,0
CPT,82U,RX TEST DEF 90+ RX/SBSTS UR,,,246.92,493.84,8
CPT,830,ANESTH REPAIR OF HERNIA,,,,,0
CPT,83001,ASSAY OF GONADOTROPIN (FSH),,,,,0
CPT,83001,FOLLICLE STIMULATING HORMONE,220.0,110.0,18.58,281.3,108
CPT,83002,ASSAY OF GONADOTROPIN (LH),,,,,0
CPT,83002,LUTEINIZING HORMONE,218.5,109.25,18.52,266.75,108
CPT,83003,ASSAY GROWTH HORMONE (HGH),,,,,0
CPT,83003,HUMAN GROWTH HORMONE,231.0,115.5,16.67,252.2,108
CPT,83006,GROWTH STIMULATION GENE 2,,,75.6,151.2,8
CPT,83009,H PYLORI (C-13) BLOOD,,,,,0
CPT,83009,H-PYLORI BLOOD UREASE TEST,1354.0,677.0,67.36,1313.38,54
CPT,83010,ASSAY OF HAPTOGLOBIN QUANT,,,,,0
CPT,83010,HAPTOGLOBIN,116.5,58.25,8.18,180.42,108
CPT,83012,ASSAY OF HAPTOGLOBINS,,,26.89,53.78,8
CPT,83013,H PYLORI (C-13) BREATH,,,,,0
CPT,83013,H PYLORI SCRN BREATH TEST,738.5,369.25,60.97,1093.19,108
CPT,83014,H PYLORI DRUG ADMIN,,,7.86,15.72,8
CPT,83015,HEAVY METAL QUAL ANY ANAL,,,,,0
CPT,83015,HEAVY METAL SCREEN,422.0,211.0,20.94,409.34,54
CPT,83018,HEAVY METAL QNT BARIUM,776.0,388.0,21.96,752.72,54
CPT,83018,HEAVY METAL QNT COBALT,500.5,250.25,21.96,825.47,108
CPT,83018,HEAVY METAL QUANT EACH NES,,,,,0
CPT,83018,MOLYBDENUM SERUM,463.0,231.5,21.96,752.72,108
CPT,83020,HEMOGLOBIN ELECTROPHORESIS,130.5,65.25,12.36,184.3,108
CPT,83021,HEMOGLOBIN CHROMATOGRAPHY A2,274.5,137.25,18.06,321.07,108
CPT,83021,HEMOGLOBIN CHROMOTOGRAPHY,176.5,88.25,14.8,259.96,108
CPT,83021,HEMOGLOGIN FRAC W/O SOLUBILITY,291.5,145.75,18.06,354.05,108
CPT,83026,HEMOGLOBIN COPPER SULFATE,,,4.01,8.02,8
CPT,83030,HEMOGLOBIN F FETAL CHEMICAL,,,,,0
CPT,83030,HEMOGLOBIN FETAL CHEMICAL,156.5,78.25,10.74,178.48,108
CPT,83033,HEMOGLOBIN FETAL QUALITATIVE,133.0,66.5,8.0,129.01,54
CPT,83033,HEMOGLOBIN FTL F ASSAY QUAL,,,,,0
CPT,83036,HEMOGLOBIN A1C,91.5,45.75,6.61,140.65,108
CPT,83036,HEMOGLOBIN GLYCOSYLATED A1C,,,,,0
CPT,83037,HB GLYCOSYLATED A1C HOME DEV,,,9.71,19.42,8
CPT,83045,HGB METHEMOGLOBIN QUAL,,,6.49,12.98,8
CPT,83050,HGB METHEMOGLOBIN QUAN,,,,,0
CPT,83050,METHEMOGLOBIN,99.0,49.5,8.2,96.03,54
CPT,83050,METHEMOGLOBIN QUANT,99.0,49.5,8.2,96.03,108
CPT,83051,HEMOGLOBIN PLASMA,109.0,54.5,7.31,105.73,54
CPT,83060,HGB SULFHEMOGLOBIN QUAN,,,8.8,17.6,8
CPT,83065,HEMOGLOBIN THERMOLABILE,,,9.0,18.0,8
CPT,83068,HEMOGLOBIN UNSTABLE SCREEN,,,9.47,18.94,8
CPT,83069,HEMOGLOBIN URINE,,,3.95,7.9,8
CPT,83070,ASSAY OF HEMOSIDERIN QUAL,,,,,0
CPT,83070,HEMOSIDERIN QUAL URINE,115.0,57.5,4.75,142.59,108
CPT,83080,ASSAY OF B HEXOSAMINIDASE EA,,,,,0
CPT,83080,B HEXOSAMINIDASE EA ASSAY,839.0,419.5,16.87,813.83,54
CPT,83088,ASSAY OF HISTAMINE,,,,,0
CPT,83088,HISTAMINE,318.5,159.25,18.46,515.07,108
CPT,83090,ASSAY OF HOMOCYSTEINE,,,,,0
CPT,83090,HOMOCYSTEINE TOTAL,184.5,92.25,17.92,247.35,108
CPT,830T,DGTZ GLS MCRSCP CYTP SLCTV,,,,,0
CPT,83150,ASSAY OF HOMOVANILLIC ACID,,,,,0
CPT,83150,HOMOVANILLIC ACID,536.5,268.25,22.41,586.85,108
CPT,831T,DGTZ GLS MCRSCP CYTP C/V,,,,,0
CPT,832,ANESTH REPAIR OF HERNIA,,,,,0
CPT,832T,DGTZ GLS MCRSCP CYTP OTH SCR,,,,,0
CPT,833T,DGTZ GLS MCRSCP CYTP OTH PRP,,,,,0
CPT,834,ANESTH HERNIA REPAIR < 1 YR,,,,,0
CPT,83491,17-OH CORTICOSTEROID UR 24 HR,1089.0,544.5,17.9,1056.33,54
CPT,83491,ASY HYDROXYCORTICOSTEROIDS17,,,,,0
CPT,83497,5-OH INDOLEACETIC ACID UR24HR,133.5,66.75,10.8,198.85,108
CPT,83497,ASSAY OF 5-HIAA,,,,,0
CPT,83497,HYDROXYINDOLACETIC ACID 5-HIAA,126.5,63.25,10.8,185.27,108
CPT,83498,17 HYDROXYPROGESTERONE URINE,329.0,164.5,27.17,319.13,54
CPT,83498,17-HYDROXYPROGESTERONE,169.0,84.5,15.15,243.47,108
CPT,83498,ASY HYDROXYPROGESTERONE 17-D,,,,,0
CPT,834T,DGTZ GLS MCRSCP CYTP OTH XTN,,,,,0
CPT,83500,ASSAY FREE HYDROXYPROLINE,,,,,0
CPT,83500,HYDROXYPROLINE FREE,512.0,256.0,22.65,496.64,54
CPT,83505,ASSAY TOTAL HYDROXYPROLINE,,,24.3,48.6,8
CPT,83516,ACTIN SMOOTH MUSCLE AB,269.5,134.75,11.53,440.38,108
CPT,83516,ANTI GBM PROFILE 082719,439.0,219.5,11.53,440.38,108
CPT,83516,ANTI-PLA2R AUTOANTIBODIES,360.0,180.0,11.53,569.39,108
CPT,83516,ANTIBODY IGE,276.0,138.0,11.53,440.38,108
CPT,83516,ANTIGLOMERULAR BM AB,454.0,227.0,11.53,440.38,108
CPT,83516,ANTIPARIETAL CELL ANTIBODY,276.0,138.0,11.53,411.28,108
CPT,83516,ANTIRIBOSOMAL ABS,267.5,133.75,11.53,411.28,108
CPT,83516,ENDOMYSIAL ANTIBODY,454.0,227.0,11.53,440.38,108
CPT,83516,GLIADIN ANTIBODIES IGA,454.0,227.0,11.53,440.38,108
CPT,83516,GLIADIN ANTIBODIES IGG,454.0,227.0,11.53,440.38,108
CPT,83516,GM1 AB IGG,363.0,181.5,11.53,440.38,108
CPT,83516,GM1 AB IGM,363.0,181.5,11.53,440.38,108
CPT,83516,IMMUNOASSAY NON INF AGENT MULTI,277.0,138.5,11.53,424.86,108
CPT,83516,IMMUNOASSAY NONANTIBODY,,,,,0
CPT,83516,MITOCHONDRIAL M2 AB,454.0,227.0,11.53,440.38,108
CPT,83516,MUSK ANTIBODY TEST,276.0,138.0,11.53,440.38,108
CPT,83516,TISSUE TRANSGLUTAMINASE IGA,454.0,227.0,11.53,440.38,108
CPT,83516,TISSUE TRANSGLUTAMINASE IGG,265.5,132.75,11.53,440.38,108
CPT,83518,IMMUNOASSAY DIPSTICK,,,9.64,19.28,8
CPT,83519,ACETYLCHOLINE RECEPT BIND AB,618.0,309.0,18.4,619.83,108
CPT,83519,ACETYLCHOLINE RECEPT BLOCK AB,529.5,264.75,18.4,579.09,108
CPT,83519,ACETYLCHOLINE RECEPT MODUL AB,462.0,231.0,18.4,448.14,108
CPT,83519,ACH RECEPTOR (MUSCLE) MODULATING,458.5,229.25,18.4,620.8,108
CPT,83519,AMYLOID BETA-PROTEIN,458.5,229.25,18.4,620.8,108
CPT,83519,GAD65 AB (GLUTAMIC ACID DECARB),458.5,229.25,18.4,620.8,108
CPT,83519,GLUTAMIC ACID DECARBOXY-65 AB,550.5,275.25,18.4,619.83,108
CPT,83519,IGF-2,353.0,176.5,18.4,549.02,108
CPT,83519,IMMUNOASSAY NON INF QNT RIA,373.0,186.5,18.4,579.09,108
CPT,83519,MELANOCYTE STIMULATING HORMONE,394.5,197.25,18.4,496.64,108
CPT,83519,MUSCLE SPECIFIC KINASE (MUSK) AB,1336.5,668.25,18.4,1666.46,108
CPT,83519,PANCREATIC POLYPEPTIDE,394.5,197.25,18.4,496.64,108
CPT,83519,RIA NONANTIBODY,,,,,0
CPT,83519,SOLUBLE TRANSFERRIN RECEP,394.5,197.25,18.4,496.64,108
CPT,83519,TRYPSIN LIKE IMMUNOREACTIVITY,462.0,231.0,18.4,448.14,54
CPT,83520,11-DEHYDRO THROMBOXANE B2,601.0,300.5,17.27,903.07,108
CPT,83520,ADAMTS13 AB,490.5,245.25,17.27,709.07,108
CPT,83520,ANTIMYELOPEROXIDASE ABS,510.0,255.0,15.5,903.07,108
CPT,83520,ANTINEURONAL CELL ABS,510.0,255.0,15.5,903.07,108
CPT,83520,ANTIPROTEINASE 3 (PR-3) ABS,510.0,255.0,15.5,903.07,108
CPT,83520,BETA-AMYLOID 40,601.0,300.5,17.27,903.07,108
CPT,83520,BETA-AMYLOID 42,601.0,300.5,17.27,903.07,108
CPT,83520,GLOMERULAR BASEMENT MEMBR AB,931.0,465.5,17.27,903.07,108
CPT,83520,HUMAN TRANS GROWTH FACT BETA 1,510.0,255.0,15.5,903.07,108
CPT,83520,IGF-BP1,410.0,205.0,15.5,709.07,108
CPT,83520,IGF-BP3,410.0,205.0,15.5,709.07,108
CPT,83520,IMMUNOASSAY QUANT NOS NONAB,569.5,284.75,17.27,709.07,108
CPT,83520,INHIBIN B,569.5,284.75,17.27,709.07,108
CPT,83520,INTERLEUKIN-2 SERUM,422.5,211.25,17.27,438.44,108
CPT,83520,INTERLEUKIN-2 SOLUBLE RECEPTOR A,490.5,245.25,17.27,709.07,108
CPT,83520,INTERLEUKIN-6 PLASMA,515.0,257.5,17.24,903.07,108
CPT,83520,INTERLEUKIN-6 SERUM,515.0,257.5,17.24,903.07,108
CPT,83520,NEUROMYELITIS OPTICA IGG AUTOABS,510.0,255.0,15.5,903.07,108
CPT,83520,PLATELET FACTOR 4,510.0,255.0,15.5,903.07,108
CPT,83520,RNA POLYMERASE III IGG ABS,510.0,255.0,15.5,903.07,108
CPT,83520,THYROTROPIN RECEPTOR ABS,415.0,207.5,17.24,709.07,108
CPT,83520,TRYPTASE,490.5,245.25,17.27,709.07,108
CPT,83520,VEGF PLASMA,490.5,245.25,17.27,709.07,108
CPT,83520,VEGF SERUM,490.5,245.25,17.27,709.07,108
CPT,83521,IG LIGHT CHAINS FREE EACH,240.0,120.0,17.27,249.29,108
CPT,83525,ASSAY OF INSULIN,,,,,0
CPT,83525,INSULIN LEVEL TOTAL,130.5,65.25,11.43,162.96,108
CPT,83527,ASSAY OF INSULIN,,,,,0
CPT,83527,INSULIN LEVEL FREE,174.0,87.0,12.95,185.27,108
CPT,83528,ASSAY OF INTRINSIC FACTOR,,,19.82,39.64,8
CPT,83529,ASAY OF INTERLEUKIN-6 (IL-6),188.5,94.25,17.27,260.93,108
CPT,83540,ASSAY OF IRON,,,,,0
CPT,83540,IRON LEVEL,63.0,31.5,5.05,94.09,108
CPT,83540,IRON QUANT LIVER,130.0,65.0,6.47,165.87,108
CPT,83550,IRON BINDING CAPACITY TOTAL,83.0,41.5,6.09,127.07,108
CPT,83550,IRON BINDING TEST,,,,,0
CPT,83570,ASSAY OF IDH ENZYME,,,8.85,17.7,8
CPT,83582,ASSAY OF KETOGENIC STEROIDS,,,15.47,30.94,8
CPT,83586,17-KETOSTEROIDS TOTAL,524.0,262.0,12.8,508.28,54
CPT,83586,ASSAY 17- KETOSTEROIDS,,,,,0
CPT,83593,FRACTIONATION KETOSTEROIDS,,,28.5,57.0,8
CPT,835T,DGTZ GLS MCRSCP FNA 1ST EA,,,,,0
CPT,836,ANESTH HERNIA REPAIR PREEMIE,,,,,0
CPT,83605,ASSAY OF LACTIC ACID,,,,,0
CPT,83605,LACTIC ACID LEVEL,444.0,222.0,11.57,448.14,108
CPT,83605,RC LACTATE ACID LEVEL,283.0,141.5,11.57,274.51,54
CPT,83605,RC LACTATE ARTERIAL,283.0,141.5,11.57,274.51,54
CPT,83605,RC LACTATE VENOUS,283.0,141.5,11.57,274.51,54
CPT,83615,LACTATE (LD) (LDH) ENZYME,,,,,0
CPT,83615,LACTATE DEHYDROGENASE,56.0,28.0,4.18,85.36,108
CPT,83615,LACTATE DEHYDROGENASE FLUID,93.0,46.5,6.04,95.06,108
CPT,83615,MUD LACTATE DEHYDROGENASE LDH NHCI,86.0,43.0,6.04,83.42,53
CPT,83625,ASSAY OF LDH ENZYMES,,,,,0
CPT,83625,LACTATE DEHYDROGENASE ISOENZ,174.5,87.25,12.79,188.18,108
CPT,83630,LACTOFERRIN FECAL (QUAL),,,,,0
CPT,83630,LACTOFERRIN STOOL QUAL,292.0,146.0,19.7,283.24,54
CPT,83631,LACTOFERRIN FECAL (QUANT),,,,,0
CPT,83631,LACTOFERRIN QNT,264.5,132.25,19.63,283.24,108
CPT,83632,PLACENTAL LACTOGEN,,,20.22,40.44,8
CPT,83633,TEST URINE FOR LACTOSE,,,11.25,22.5,8
CPT,83655,ASSAY OF LEAD,,,,,0
CPT,83655,LEAD LEVEL,163.5,81.75,12.11,174.6,108
CPT,83655,LEAD LEVEL PEDIATRIC,180.0,90.0,12.11,174.6,54
CPT,83655,LEAD LEVEL URINE,216.0,108.0,12.11,209.52,54
CPT,83655,LEAD LEVEL URINE 24 HR,180.0,90.0,12.11,174.6,54
CPT,83661,L/S RATIO FETAL LUNG,,,,,0
CPT,83661,LECITHIN SPHINGOMYELIN RATIO,490.0,245.0,21.99,475.3,54
CPT,83662,FOAM STABILITY FETAL LUNG,,,18.91,37.82,8
CPT,83663,FETAL LUNG MATURITY FL POLAR,410.0,205.0,18.91,397.7,54
CPT,83663,FLUORO POLARIZE FETAL LUNG,,,,,0
CPT,83664,LAMELLAR BDY FETAL LUNG,,,,,0
CPT,83664,LAMELLAR BODY DENSITY,478.0,239.0,19.32,463.66,54
CPT,83670,ASSAY OF LAP ENZYME,,,9.81,19.62,8
CPT,83690,ASSAY OF LIPASE,,,,,0
CPT,83690,LIPASE LEVEL,156.5,78.25,6.89,228.92,108
CPT,83690,LIPASE LEVEL BODY FLUID,209.0,104.5,6.89,228.92,108
CPT,83695,ASSAY OF LIPOPROTEIN(A),,,,,0
CPT,83695,LIPOPROTEIN A,182.0,91.0,14.32,176.54,54
CPT,83698,ASSAY LIPOPROTEIN PLA2,,,,,0
CPT,83698,LIPOPROTEIN PLA 2,724.0,362.0,46.31,702.28,54
CPT,836T,DGTZ GLS MCRSCP FNA EA ADDL,,,,,0
CPT,83700,LIPOPRO BLD ELECTROPHORETIC,,,,,0
CPT,83700,LIPOPROTEIN ELECTROPHORESIS,136.0,68.0,11.26,131.92,54
CPT,83701,LIPOPROTEIN BLD HR FRACTION,,,33.86,67.72,8
CPT,83704,LIPOPROTEIN BLD QUAN PART,,,,,0
CPT,83704,LIPOPROTEIN NMR,199.0,99.5,18.98,280.33,108
CPT,83718,ASSAY OF LIPOPROTEIN,,,,,0
CPT,83718,CHOLESTEROL HDL,144.0,72.0,8.19,180.42,108
CPT,83719,ASSAY OF BLOOD LIPOPROTEIN,,,12.75,25.5,8
CPT,83721,ASSAY OF BLOOD LIPOPROTEIN,,,,,0
CPT,83721,CHOLESTEROL LDL,156.0,78.0,10.5,151.32,54
CPT,83722,LIPOPRTN DIR MEAS SD LDL CHL,,,34.19,68.38,8
CPT,83727,ASSAY OF LRH HORMONE,,,17.19,34.38,8
CPT,83735,ASSAY OF MAGNESIUM,,,,,0
CPT,83735,MAGNESIUM LEVEL,81.0,40.5,6.7,96.03,108
CPT,83735,MAGNESIUM LEVEL OB LABOR,93.5,46.75,6.7,102.82,108
CPT,83735,MAGNESIUM LEVEL URINE,113.5,56.75,6.7,141.62,108
CPT,83735,MAGNESIUM LEVEL WHOLE BLOOD,113.5,56.75,6.7,141.62,108
CPT,83775,ASSAY MALATE DEHYDROGENASE,,,7.37,14.74,8
CPT,83785,ASSAY OF MANGANESE,,,,,0
CPT,83785,MANGANESE LEVEL,416.0,208.0,26.65,403.52,54
CPT,83789,IODINE SERUM/PLASMA,355.0,177.5,24.11,372.48,108
CPT,83789,MASS SPECTROMETRY QUAL/QUAN,,,,,0
CPT,837T,DGTZ GLS MCRSCP FNA I&R,,,,,0
CPT,83825,ASSAY OF MERCURY,,,,,0
CPT,83825,MERCURY LEVEL,219.0,109.5,16.26,233.77,108
CPT,83825,MERCURY LEVEL URINE,219.0,109.5,16.26,233.77,108
CPT,83825,MERCURY LEVEL URINE 24 HR,241.0,120.5,16.26,233.77,54
CPT,83835,ASSAY OF METANEPHRINES,,,,,0
CPT,83835,METANEPHRINES LEVEL PLASMA,226.5,113.25,16.94,244.44,108
CPT,83835,METANEPHRINES LEVEL UR 24 HR,219.0,109.5,16.94,244.44,108
CPT,83857,ASSAY OF METHEMALBUMIN,,,10.74,21.48,8
CPT,83861,MICROFLUID ANALY TEARS,,,22.48,44.96,8
CPT,83864,MUCOPOLYSACCHARIDES,,,28.5,57.0,8
CPT,83872,ASSAY SYNOVIAL FLUID MUCIN,,,,,0
CPT,83872,MUCIN CLOT SYNOVIAL FLUID,138.0,69.0,5.86,133.86,54
CPT,83873,ASSAY OF CSF PROTEIN,,,,,0
CPT,83873,MYELIN BASIC PROTEIN CSF,257.0,128.5,17.2,249.29,54
CPT,83874,ASSAY OF MYOGLOBIN,,,,,0
CPT,83874,MYOGLOBIN LEVEL,173.5,86.75,12.92,185.27,108
CPT,83874,MYOGLOBIN URINE QUAL,246.0,123.0,12.92,238.62,54
CPT,83874,MYOGLOBIN URINE QUANT,191.0,95.5,12.92,185.27,54
CPT,83876,ASSAY MYELOPEROXIDASE,,,50.86,101.72,8
CPT,83880,ASSAY OF NATRIURETIC PEPTIDE,,,,,0
CPT,83880,B-TYPE NATRIURETIC PEPTIDE,464.0,232.0,39.26,594.61,108
CPT,83880,PRO BNP,464.0,232.0,39.26,594.61,108
CPT,83883,ASSAY NEPHELOMETRY NOT SPEC,,,,,0
CPT,83883,HCV FIBROSURE NEPHELOMETRY,213.5,106.75,13.6,218.25,108
CPT,83883,KAPPA LIGHT CHAINS QUANT,256.5,128.25,13.6,269.66,108
CPT,83883,LAMBDA LIGHT CHAINS QUANT,256.5,128.25,13.6,269.66,108
CPT,83883,NASH FIBROSURE NEPHELOMETRY,174.0,87.0,13.6,195.94,108
CPT,83883,NEPHELOMETRY EACH ANALYTE,220.5,110.25,13.6,218.25,108
CPT,83884,Neurofilament light chain (NfL),,,116.23,232.46,8
CPT,83885,ASSAY OF NICKEL,,,,,0
CPT,83885,NICKEL PLASMA,427.0,213.5,24.51,525.74,108
CPT,838T,DGTZ GLS MCRSCP CSLT SLD ELS,,,,,0
CPT,83915,5' NUCLEOTIDASE,203.0,101.5,11.15,233.77,108
CPT,83915,ASSAY OF NUCLEOTIDASE,,,,,0
CPT,83916,OLIGOCLONAL BANDS,408.0,204.0,27.39,395.76,54
CPT,83918,ORGANIC ACIDS TOTAL QNT EA,782.5,391.25,23.6,1002.01,108
CPT,83918,ORGANIC ACIDS TOTAL QUANT,,,,,0
CPT,83919,ORGANIC ACIDS QUAL EA,370.0,185.0,16.45,358.9,54
CPT,83919,ORGANIC ACIDS QUAL EACH,,,,,0
CPT,83921,METHYLMALONIC ACID QNT,323.5,161.75,21.21,409.34,108
CPT,83921,ORGANIC ACID SINGLE QUANT,,,,,0
CPT,83921,OROTIC ACID URINE,348.0,174.0,21.21,356.96,108
CPT,83930,ASSAY OF BLOOD OSMOLALITY,,,,,0
CPT,83930,OSMOLALITY,63.5,31.75,5.05,95.06,108
CPT,83935,ASSAY OF URINE OSMOLALITY,,,,,0
CPT,83935,OSMOLALITY URINE,65.0,32.5,4.87,98.94,108
CPT,83937,ASSAY OF OSTEOCALCIN,,,,,0
CPT,83937,OSTEOCALCIN SERUM,361.0,180.5,29.85,350.17,108
CPT,83945,ASSAY OF OXALATE,,,,,0
CPT,83945,OXALATE URINE 24HR,289.0,144.5,14.45,280.33,54
CPT,83950,ONCOPROTEIN HER-2/NEU,,,64.41,128.82,8
CPT,83951,ONCOPROTEIN DCP,,,,,0
CPT,83951,"ONCOPROTEIN, HER-2/NEU",1107.5,553.75,64.41,1392.92,108
CPT,83970,ASSAY OF PARATHORMONE,,,,,0
CPT,83970,PARATHYROID HORMONE LEVEL,401.0,200.5,27.34,625.65,108
CPT,83986,ASSAY PH BODY FLUID NOS,,,,,0
CPT,83986,PH BODY FLUID,59.0,29.5,3.58,57.23,54
CPT,83986,PH BODY FLUID EXCEPT BLOOD,96.0,48.0,3.58,93.12,54
CPT,83986,POC PH BODY FLD EXCEPT BLD,59.0,29.5,3.58,57.23,54
CPT,83987,EXHALED BREATH CONDENSATE,,,3.58,7.16,8
CPT,83992,ASSAY FOR PHENCYCLIDINE,,,,,0
CPT,83993,ASSAY FOR CALPROTECTIN FECAL,,,,,0
CPT,83993,CALPECTIN FECAL,511.5,255.75,19.63,559.69,108
CPT,839T,DGTZ GLS MCRSCP CSLT MAT PRP,,,,,0
CPT,83U,ONC RSPSE CHEMO CNTRST TOMOG,,,167.35,334.7,8
CPT,840,ANESTH SURG LOWER ABDOMEN,,,,,0
CPT,84030,ASSAY OF BLOOD PKU,,,,,0
CPT,84030,PHENYLALANINE PKU NEWBORN,122.0,61.0,5.5,118.34,54
CPT,84035,ASSAY OF PHENYLKETONES,,,3.98,7.96,8
CPT,84060,ACID PHOSPHATASE TOTAL,267.0,133.5,7.64,258.99,54
CPT,84060,ASSAY ACID PHOSPHATASE,,,,,0
CPT,84066,ACID PHOSPHATASE PROSTATIC,163.5,81.75,9.66,195.94,108
CPT,84066,ASSAY PROSTATE PHOSPHATASE,,,,,0
CPT,84075,ALKALINE PHOS FLUID,102.0,51.0,5.18,101.85,108
CPT,84075,ALKALINE PHOS TOTAL,48.0,24.0,3.3,74.69,108
CPT,84075,ASSAY ALKALINE PHOSPHATASE,,,,,0
CPT,84078,ALKALINE PHOS HEAT STABLE,101.0,50.5,8.26,98.94,108
CPT,84078,ASSAY ALKALINE PHOSPHATASE,,,,,0
CPT,84080,ALKALINE PHOS ISOENZYMES,204.5,102.25,14.78,224.07,108
CPT,84080,ALKALINE PHOS LIVER %,169.5,84.75,14.78,224.07,108
CPT,84080,ASSAY ALKALINE PHOSPHATASES,,,,,0
CPT,84081,ASSAY PHOSPHATIDYLGLYCEROL,,,,,0
CPT,84081,PHOSPHATIDYLGLYCEROL LEVEL,368.0,184.0,16.52,356.96,54
CPT,84085,ASSAY OF RBC PG6D ENZYME,,,9.44,18.88,8
CPT,84087,ASSAY PHOSPHOHEXOSE ENZYMES,,,,,0
CPT,84087,PHOSPHOHEXOSE ISOMERACE,207.5,103.75,10.73,277.42,108
CPT,840T,DGTZ GLS MCRSCP CSLT COMPRE,,,,,0
CPT,84100,ASSAY OF PHOSPHORUS,,,,,0
CPT,84100,PHOSPHORUS LEVEL,44.0,22.0,3.13,67.9,108
CPT,84100,PHOSPHORUS LEVEL FLUID,81.5,40.75,4.74,102.82,108
CPT,84105,ASSAY OF URINE PHOSPHORUS,,,,,0
CPT,84105,PHOSPHORUS LEVEL URINE,93.0,46.5,5.78,90.21,54
CPT,84105,PHOSPHORUS LEVEL URINE 24 HR,104.0,52.0,5.78,100.88,54
CPT,84106,TEST FOR PORPHOBILINOGEN,,,5.82,11.64,8
CPT,84110,ASSAY OF PORPHOBILINOGEN,,,,,0
CPT,84110,PORPHOBILINOGEN URINE 24 HR,134.0,67.0,8.44,161.02,108
CPT,84110,PORPHOBILINOGEN URINE QUAL,113.5,56.75,8.44,121.25,108
CPT,84112,EVAL AMNIOTIC FLUID PROTEIN,,,,,0
CPT,84112,PLACENTA ALPHA MICROGLOBULIN1,812.0,406.0,98.11,787.64,54
CPT,84119,PORPHYRINS URINE QUAL,192.0,96.0,13.36,186.24,54
CPT,84119,TEST URINE FOR PORPHYRINS,,,,,0
CPT,84120,ASSAY OF URINE PORPHYRINS,,,,,0
CPT,84120,PORPHYRINS QN & FRACTION URINE,154.0,77.0,14.71,211.46,108
CPT,84120,PORPHYRINS URINE QNT 24 HR,198.0,99.0,14.71,211.46,108
CPT,84126,ASSAY OF FECES PORPHYRINS,,,,,0
CPT,84126,PROPHYRINS FECAL QNT,1001.0,500.5,39.11,975.82,108
CPT,84132,ASSAY OF SERUM POTASSIUM,,,,,0
CPT,84132,POC ISTAT ASSAY POTASSIUM SERUM PLASMA/WHOLE BLOOD,73.0,36.5,4.76,70.81,54
CPT,84132,POC POTASSIUM,73.0,36.5,4.76,70.81,54
CPT,84132,POTASSIUM ANALYSIS,94.0,47.0,4.76,91.18,54
CPT,84132,POTASSIUM LEVEL,44.0,22.0,3.13,67.9,108
CPT,84132,POTASSIUM LEVEL WHOLE BLOOD,63.5,31.75,4.76,67.9,108
CPT,84133,ASSAY OF URINE POTASSIUM,,,,,0
CPT,84133,POTASSIUM LEVEL BODY FLUID,85.0,42.5,4.73,82.45,54
CPT,84133,POTASSIUM LEVEL URINE,70.0,35.0,4.73,67.9,54
CPT,84133,POTASSIUM LEVEL URINE 24 HR,75.0,37.5,4.73,72.75,54
CPT,84134,ASSAY OF PREALBUMIN,,,,,0
CPT,84134,PREALBUMIN LEVEL,135.0,67.5,9.4,209.52,108
CPT,84135,ASSAY OF PREGNANEDIOL,,,21.27,42.54,8
CPT,84138,ASSAY OF PREGNANETRIOL,,,21.05,42.1,8
CPT,84140,ASSAY OF PREGNENOLONE,,,,,0
CPT,84140,PREGNENOLONE LEVEL,329.0,164.5,20.67,319.13,54
CPT,84143,17-HYDROPREGNENOLONE,319.5,159.75,22.81,352.11,108
CPT,84143,ASSAY OF 17-HYDROXYPREGNENO,,,,,0
CPT,84144,ASSAY OF PROGESTERONE,,,,,0
CPT,84144,PROGESTERONE LEVEL,259.0,129.5,20.86,257.05,108
CPT,84145,PROCALCITONIN (PCT),,,,,0
CPT,84145,PROCALCITONIN LEVEL,728.0,364.0,27.22,962.24,108
CPT,84146,ASSAY OF PROLACTIN,,,,,0
CPT,84146,PROLACTIN LEVEL,181.0,90.5,12.89,279.36,108
CPT,84150,ASSAY OF PROSTAGLANDIN,,,,,0
CPT,84150,ASSAY OF PROSTAGLNDIN EACH,319.0,159.5,23.16,489.85,108
CPT,84152,ASSAY OF PSA COMPLEXED,,,,,0
CPT,84152,PSA COMPLEXED,620.0,310.0,18.39,601.4,108
CPT,84153,ASSAY OF PSA TOTAL,,,,,0
CPT,84153,PROSTATE SPEC AG TOTAL,171.0,85.5,12.19,263.84,108
CPT,84153,PSA ULTRASENSITIVE,184.5,92.25,16.89,263.84,108
CPT,84154,ASSAY OF PSA FREE,,,,,0
CPT,84154,PROSTATE SPEC AG FREE,171.0,85.5,12.19,263.84,108
CPT,84155,ASSAY OF PROTEIN SERUM,,,,,0
CPT,84155,PROTEIN TOTAL,38.5,19.25,3.13,57.23,108
CPT,84156,ASSAY OF PROTEIN URINE,,,,,0
CPT,84156,PROTEIN TOTAL URINE,43.0,21.5,3.67,57.23,108
CPT,84156,PROTEIN TOTAL URINE 24 HR,43.0,21.5,3.67,57.23,108
CPT,84157,ASSAY OF PROTEIN OTHER,,,,,0
CPT,84157,PROTEIN TOTAL BODY FLUID,61.0,30.5,4.0,59.17,54
CPT,84157,PROTEIN TOTAL CSF,59.0,29.5,4.0,59.17,108
CPT,84160,ASSAY OF PROTEIN ANY SOURCE,,,5.61,11.22,8
CPT,84163,PAPPA SERUM,,,,,0
CPT,84163,PREG ASSOC PLASMA PROTEIN A,250.0,125.0,15.05,242.5,54
CPT,84165,MUD PROTEIN ELECTROPHORETIC FRACT&QUANT SERUM NHCI,152.0,76.0,10.74,147.44,53
CPT,84165,PROTEIN E-PHORESIS SERUM,,,,,0
CPT,84165,PROTEIN ELECTROPHORESIS,103.5,51.75,8.18,155.2,108
CPT,84166,PROTEIN E-PHORESIS/URINE/CSF,,,,,0
CPT,84166,PROTEIN ELECTROPH BENCE JONE,307.5,153.75,17.83,328.83,108
CPT,84166,PROTEIN ELECTROPH CSF,258.0,129.0,17.83,256.08,108
CPT,84166,PROTEIN ELECTROPH URINE,236.0,118.0,17.83,256.08,108
CPT,84166,PROTEIN ELECTROPH URINE 24 HR,236.0,118.0,17.83,256.08,108
CPT,84181,WESTERN BLOT ANTI 68KD(HSP 70) ABS,366.5,183.25,17.03,398.67,108
CPT,84181,WESTERN BLOT HSV TYPE SPECIFIC,414.5,207.25,17.03,405.46,108
CPT,84181,WESTERN BLOT TEST,,,,,0
CPT,84182,CRMP-5 IGG WESTERN BLOT,1629.5,814.75,29.21,1973.95,108
CPT,84182,PARANEOPLASTIC AUTOAB WB,1629.5,814.75,29.21,1973.95,108
CPT,84182,PROTEIN WESTERN BLOT IM FOR BANDS,1224.0,612.0,29.21,1187.28,108
CPT,84182,PROTEIN WESTERN BLOT TEST,,,,,0
CPT,84182,WESTERN BLOT CREUTZFELDT-JAKOB,1546.5,773.25,29.21,1973.95,108
CPT,84182,WESTERN BLOT RECOX MATA,2035.0,1017.5,29.21,1973.95,108
CPT,841T,DGTZ GLS MCRSCP PTH CSLT 1ST,,,,,0
CPT,842,ANESTH AMNIOCENTESIS,,,,,0
CPT,84202,ASSAY RBC PROTOPORPHYRIN,,,,,0
CPT,84202,PROTOPORPHYRIN RBC QNT,240.0,120.0,14.35,232.8,54
CPT,84203,TEST RBC PROTOPORPHYRIN,,,9.74,19.48,8
CPT,84206,ASSAY OF PROINSULIN,,,,,0
CPT,84206,PROINSULIN,359.0,179.5,26.69,384.12,108
CPT,84207,ASSAY OF VITAMIN B-6,,,,,0
CPT,84207,VITAMIN B6 PYRIDOXAL PHOS,263.5,131.75,19.33,403.52,108
CPT,84210,ASSAY OF PYRUVATE,,,,,0
CPT,84210,PYRUVIC ACID LEVEL,92.0,46.0,14.48,89.24,54
CPT,84220,ASSAY OF PYRUVATE KINASE,,,,,0
CPT,84220,PYRUVATE KINASE LEVEL,221.0,110.5,9.44,238.62,108
CPT,84228,ASSAY OF QUININE,,,11.63,23.26,8
CPT,84233,ASSAY OF ESTROGEN,,,,,0
CPT,84233,RECEPTOR ASSAY ESTROGEN,1435.0,717.5,87.88,1391.95,54
CPT,84234,ASSAY OF PROGESTERONE,,,,,0
CPT,84234,RECEPTOR ASSAY PROGESTERONE,1450.0,725.0,64.88,1406.5,54
CPT,84235,ASSAY OF ENDOCRINE HORMONE,,,,,0
CPT,84235,RECEPTOR ASSAY ESTRADIOL,1169.0,584.5,71.23,1133.93,54
CPT,84238,ACETYLCHOLINE RECEPT BIND AB,449.5,224.75,36.57,443.29,108
CPT,84238,ACETYLCHOLINE RECEPT BLOCK AB,449.5,224.75,36.57,443.29,108
CPT,84238,ASSAY NONENDOCRINE RECEPTOR,363.0,181.5,27.0,553.87,108
CPT,84244,ASSAY OF RENIN,,,,,0
CPT,84244,RENIN ACTIVITY,246.5,123.25,21.99,317.19,108
CPT,84252,ASSAY OF VITAMIN B-2,,,,,0
CPT,84252,VITAMIN B2 RIBOFLAVIN LEVEL,186.0,93.0,12.36,291.97,108
CPT,84255,ASSAY OF SELENIUM,,,,,0
CPT,84255,SELENIUM LEVEL,266.0,133.0,23.34,386.06,108
CPT,84260,ASSAY OF SEROTONIN,,,,,0
CPT,84260,SEROTONIN LEVEL,299.5,149.75,19.85,470.45,108
CPT,84270,ASSAY OF SEX HORMONE GLOBUL,,,,,0
CPT,84270,SEX HORMONE BINDING GLOBULIN,216.5,108.25,15.15,335.62,108
CPT,84275,ASSAY OF SIALIC ACID,,,,,0
CPT,84275,SIALIC ACID,301.0,150.5,13.44,291.97,54
CPT,84285,ASSAY OF SILICA,,,25.21,50.42,8
CPT,84295,ASSAY OF SERUM SODIUM,,,,,0
CPT,84295,POC ISTAT ASSAY SODIUM SERUM PLASMA OR WHOLE BLOOD,58.0,29.0,4.81,56.26,54
CPT,84295,POC SODIUM LEVEL,58.0,29.0,4.81,56.26,54
CPT,84295,SODIUM ANALYSIS,109.0,54.5,4.81,105.73,54
CPT,84295,SODIUM LEVEL,43.5,21.75,2.78,68.87,108
CPT,84295,SODIUM LEVEL WHOLE BLD,83.5,41.75,4.81,105.73,108
CPT,842T,DGTZ GLS MCRSCP PTH CSLT EA,,,,,0
CPT,84300,ASSAY OF URINE SODIUM,,,,,0
CPT,84300,SODIUM LEVEL BODY FLUID,96.0,48.0,5.06,96.03,108
CPT,84300,SODIUM LEVEL URINE,45.5,22.75,2.78,72.75,108
CPT,84300,SODIUM LEVEL URINE 24 HR,72.0,36.0,5.06,78.57,108
CPT,84302,ASSAY OF SWEAT SODIUM,,,,,0
CPT,84302,SODIUM FECAL,141.5,70.75,4.86,147.44,108
CPT,84305,ASSAY OF SOMATOMEDIN,,,,,0
CPT,84305,SOMATOMEDIN,286.0,143.0,21.26,305.55,108
CPT,84307,ASSAY OF SOMATOSTATIN,,,18.28,36.56,8
CPT,84311,ADENOSINE DEAMINASE PLEURAL FLUID,594.5,297.25,8.1,715.86,108
CPT,84311,BROMIDE SPECTROPHOTOMETRY,96.5,48.25,8.1,114.46,108
CPT,84311,CHOLESTEROL FLUID,363.0,181.5,8.1,658.63,108
CPT,84311,HEMOGLOBIN-OXYGEN AFFINITY,103.0,51.5,8.1,99.91,108
CPT,84311,PHOSPHOLIPIDS SERUM,158.5,79.25,8.1,157.14,108
CPT,84311,PORPHYRINS TOTAL SERUM,363.0,181.5,8.1,658.63,108
CPT,84311,SPECTROPHOTOMETRY,,,,,0
CPT,84315,BODY FLUID SPECIFIC GRAVITY,,,,,0
CPT,84315,SPECIFIC GRAVITY BODY FLUID,57.0,28.5,3.28,55.29,54
CPT,84375,CHROMATOGRAM ASSAY SUGARS,,,39.0,78.0,8
CPT,84376,SUGARS QUAL SINGLE,185.0,92.5,5.5,179.45,54
CPT,84376,SUGARS SINGLE QUAL,,,,,0
CPT,84377,FECAL REDUCING SUBSTANCES,80.5,40.25,5.5,91.18,108
CPT,84377,SUGARS MULTIPLE QUAL,,,,,0
CPT,84378,SUGARS SINGLE QUANT,,,11.53,23.06,8
CPT,84379,SUGARS MULTIPLE QUANT,,,11.53,23.06,8
CPT,84392,ASSAY OF URINE SULFATE,,,,,0
CPT,84392,SULFATE URINE,185.0,92.5,5.49,327.86,108
CPT,84393,TAU PHOSPHORYLATED EACH,688.0,344.0,119.84,667.36,108
CPT,84393,"Tau, phosphorylated (eg, pTau 181, pTau 217), each",,,,,0
CPT,84394,TOTAL TAU (TTAU),688.0,344.0,119.84,667.36,108
CPT,84394,"Tau, total (tTau)",,,,,0
CPT,843T,DGTZ GLS MCRSCP CSLT CYT 1ST,,,,,0
CPT,844,ANESTH PELVIS SURGERY,,,,,0
CPT,84402,ASSAY OF FREE TESTOSTERONE,,,,,0
CPT,84402,TESTOSTERONE FREE,258.0,129.0,23.86,367.63,108
CPT,84403,ASSAY OF TOTAL TESTOSTERONE,,,,,0
CPT,84403,TESTOTSTERONE TOTAL,245.0,122.5,18.29,373.45,108
CPT,84410,TESTOSTERONE BIOAVAILABLE,713.0,356.5,51.28,977.76,108
CPT,84425,ASSAY OF VITAMIN B-1,,,,,0
CPT,84425,VITAMIN B1 THIAMINE LEVEL,223.0,111.5,19.68,323.01,108
CPT,84430,ASSAY OF THIOCYANATE,,,,,0
CPT,84430,THIOCYANATE LEVEL,342.0,171.0,11.63,331.74,54
CPT,84431,THROMBOXANE METAB URINE,269.5,134.75,20.03,411.28,108
CPT,84431,THROMBOXANE URINE,,,,,0
CPT,84432,ASSAY OF THYROGLOBULIN,,,,,0
CPT,84432,THYROGLOBULIN LEVEL,229.5,114.75,16.06,300.7,108
CPT,84433,ASY THIOPURIN S-MTHYLTRNSFRS,542.0,271.0,22.17,525.74,108
CPT,84436,ASSAY OF TOTAL THYROXINE,,,,,0
CPT,84436,THYROXINE TOTAL T4,62.5,31.25,4.0,98.94,108
CPT,84437,ASSAY OF NEONATAL THYROXINE,,,6.47,12.94,8
CPT,84439,ASSAY OF FREE THYROXINE,,,,,0
CPT,84439,THYROXINE FREE T4,161.5,80.75,9.02,218.25,108
CPT,84442,ASSAY OF THYROID ACTIVITY,,,,,0
CPT,84442,THYROXINE BINDING GLOBULIN,218.0,109.0,14.78,211.46,54
CPT,84443,ASSAY THYROID STIM HORMONE,,,,,0
CPT,84443,THYROID STIMULATING HORMONE,159.5,79.75,13.76,232.8,108
CPT,84445,ASSAY OF TSI GLOBULIN,,,,,0
CPT,84445,THYROID STIM IMMUNOGLOBULIN,458.5,229.25,28.22,732.35,108
CPT,84446,ASSAY OF VITAMIN E,,,,,0
CPT,84446,VITAMIN E TOCOPHERAL LEVEL,142.5,71.25,12.89,204.67,108
CPT,84449,ASSAY OF TRANSCORTIN,,,,,0
CPT,84449,TRANSCORTIN (CORTISOL BINDING GLOBULIN),276.0,138.0,18.0,303.61,108
CPT,84450,AST/ SGOT LEVEL,49.0,24.5,3.65,74.69,108
CPT,84450,TRANSFERASE (AST) (SGOT),,,,,0
CPT,84460,ALANINE AMINO (ALT) (SGPT),,,,,0
CPT,84460,ALT/ SGPT LEVEL,50.5,25.25,3.65,77.6,108
CPT,84466,ASSAY OF TRANSFERRIN,,,,,0
CPT,84466,TRANSFERIN,119.5,59.75,8.71,183.33,108
CPT,84478,ASSAY OF TRIGLYCERIDES,,,,,0
CPT,84478,TRIGLYCERIDE LEVEL,54.5,27.25,4.0,83.42,108
CPT,84478,TRIGLYCERIDE LEVEL BODY FLUID,93.0,46.5,5.74,97.0,108
CPT,84479,ASSAY OF THYROID (T3 OR T4),,,,,0
CPT,84479,THYROID T3 UPTAKE,60.0,30.0,4.0,94.09,108
CPT,84480,ASSAY TRIIODOTHYRONINE (T3),,,,,0
CPT,84480,THYROID T3 TOTAL,132.0,66.0,9.23,204.67,108
CPT,84481,FREE ASSAY (FT-3),,,,,0
CPT,84481,THYROID T3 FREE,442.5,221.25,16.94,586.85,108
CPT,84482,T3 REVERSE,,,,,0
CPT,84482,THYROID T3 REVERSE SERUM,213.0,106.5,15.76,227.95,108
CPT,84484,ASSAY OF TROPONIN QUANT,,,,,0
CPT,84484,TROPONIN I,244.5,122.25,12.47,327.86,108
CPT,84484,TROPONIN T,178.0,89.0,12.47,201.76,108
CPT,84485,ASSAY DUODENAL FLUID TRYPSIN,,,7.2,14.4,8
CPT,84488,TEST FECES FOR TRYPSIN,,,,,0
CPT,84488,TRYPSIN QUAL FECES,152.0,76.0,7.3,147.44,54
CPT,84490,ASSAY OF FECES FOR TRYPSIN,,,9.93,19.86,8
CPT,844T,DGTZ GLS MCRSCP CSLT CYT EA,,,,,0
CPT,84510,ASSAY OF TYROSINE,,,10.63,21.26,8
CPT,84512,ASSAY OF TROPONIN QUAL,,,10.09,20.18,8
CPT,84520,ASSAY OF UREA NITROGEN,,,,,0
CPT,84520,UREA NITROGEN BLOOD,40.5,20.25,2.96,62.08,108
CPT,84520,UREA NITROGEN BODY FLUID,106.0,53.0,3.95,102.82,54
CPT,84525,UREA NITROGEN SEMI-QUANT,,,5.13,10.26,8
CPT,84540,ASSAY OF URINE/UREA-N,,,,,0
CPT,84540,UREA NITROGEN URINE,83.0,41.5,5.56,80.51,54
CPT,84540,UREA NITROGEN URINE 24 HR,83.0,41.5,5.56,80.51,54
CPT,84545,UREA NITROGEN CLEARANCE,126.0,63.0,7.2,122.22,54
CPT,84545,UREA-N CLEARANCE TEST,,,,,0
CPT,84550,ASSAY OF BLOOD/URIC ACID,,,,,0
CPT,84550,URIC ACID LEVEL,46.0,23.0,3.3,70.81,108
CPT,84560,ASSAY OF URINE/URIC ACID,,,,,0
CPT,84560,URIC ACID LEVEL BODY FLUID,75.0,37.5,5.08,72.75,54
CPT,84560,URIC ACID LEVEL URINE,80.0,40.0,5.08,82.45,108
CPT,84560,URIC ACID LEVEL URINE 24 HR,75.0,37.5,5.08,72.75,54
CPT,84577,ASSAY OF FECES/UROBILINOGEN,,,16.8,33.6,8
CPT,84578,TEST URINE UROBILINOGEN,,,4.47,8.94,8
CPT,84580,ASSAY OF URINE UROBILINOGEN,,,9.55,19.1,8
CPT,84583,ASSAY OF URINE UROBILINOGEN,,,6.05,12.1,8
CPT,84585,ASSAY OF URINE VMA,,,,,0
CPT,84585,VANILMANDELIC ACID URINE 24HR,219.5,109.75,15.5,224.07,108
CPT,84586,ASSAY OF VIP,,,,,0
CPT,84586,VASOACTIVE INTESTINAL PEPTIDE,369.0,184.5,32.4,535.44,108
CPT,84588,ANTIDIURETIC HORMONE LEVEL,423.0,211.5,33.94,523.8,108
CPT,84588,ASSAY OF VASOPRESSIN,,,,,0
CPT,84590,ASSAY OF VITAMIN A,,,,,0
CPT,84590,VITAMIN A LEVEL,117.5,58.75,10.97,166.84,108
CPT,84591,ASSAY OF NOS VITAMIN,,,,,0
CPT,84591,VITAMIN B3 (NIACIN & METAB),476.0,238.0,17.06,474.33,108
CPT,84591,VITAMIN B7,431.0,215.5,17.06,456.87,108
CPT,84597,ASSAY OF VITAMIN K,,,,,0
CPT,84597,VITAMIN K LEVEL,140.0,70.0,10.45,213.4,108
CPT,845T,DGTZ GLS MCRSCP IMFLUOR 1ST,,,,,0
CPT,846,ANESTH HYSTERECTOMY,,,,,0
CPT,84600,ASSAY OF VOLATILES,,,,,0
CPT,84600,VOLATILES ASSAY,297.0,148.5,17.11,375.39,108
CPT,84600,VOLATILES METHANOL,387.0,193.5,17.11,375.39,54
CPT,84620,D-XYLOSE ABSORPTION TEST,717.0,358.5,12.91,695.49,54
CPT,84620,XYLOSE TOLERANCE TEST,,,,,0
CPT,84630,ASSAY OF ZINC,,,,,0
CPT,84630,ZINC LEVEL,185.0,92.5,11.39,252.2,108
CPT,84681,ASSAY OF C-PEPTIDE,,,,,0
CPT,84681,C-PEPTIDE,281.0,140.5,20.81,300.7,108
CPT,846T,DGTZ GLS MCRSCP IMFLUOR EA,,,,,0
CPT,84702,CHORIONIC GONADOTROPIN TEST,,,,,0
CPT,84702,HCG QUANT 1ST TRIMESTER,202.0,101.0,15.05,195.94,108
CPT,84702,HCG QUANT TUMOR MARKER,202.0,101.0,15.05,195.94,108
CPT,84702,HCG QUANTITATIVE,260.0,130.0,15.05,252.2,108
CPT,84702,HCG SUBUNIT QN (SERIAL),228.5,114.25,15.05,240.56,108
CPT,84703,CHORIONIC GONADOTROPIN ASSAY,,,,,0
CPT,84703,HCG QUAL SERUM PREG,70.5,35.25,5.22,107.67,108
CPT,84703,MUD GONADOTROPIN CHORIONIC QUALITATIVE NHCI,112.0,56.0,7.52,108.64,53
CPT,84704,HCG FREE BETACHAIN TEST,,,15.29,30.58,8
CPT,847T,DGTZ GLS MCRSCP XM ARCH TISS,,,,,0
CPT,848,ANESTH PELVIC ORGAN SURG,,,,,0
CPT,84830,OVULATION TESTS,,,12.7,25.4,8
CPT,848T,DGTZ GLS MCRSCP ISH 1ST,,,,,0
CPT,84999,CLINICAL CHEMISTRY TEST UNLISTED,274.0,137.0,47.73,265.78,47
CPT,84999,POTASSIUM FECAL,115.0,57.5,18.11,122.22,94
CPT,84999,UNLISTED CHEMISTRY PROCEDURE,,,,,0
CPT,849T,DGTZ GLS MCRSCP ISH EA ADL 1,,,,,0
CPT,84U,RBC DNA GNOTYP 10 BLD GROUPS,,,720.0,1440.0,8
CPT,85002,BLEEDING TIME,105.0,52.5,4.82,101.85,54
CPT,85002,BLEEDING TIME TEST,,,,,0
CPT,85004,AUTOMATED DIFF WBC COUNT,49.0,24.5,3.48,75.66,108
CPT,85007,BL SMEAR W/DIFF WBC COUNT,,,,,0
CPT,85007,MANUAL DIFFERENTIAL,64.0,32.0,3.8,79.54,108
CPT,85008,BL SMEAR W/O DIFF WBC COUNT,,,,,0
CPT,85008,MANUAL BLOOD SMEAR W/O DIFF,82.0,41.0,3.43,79.54,54
CPT,85009,MANUAL DIFF WBC COUNT B-COAT,48.5,24.25,2.78,78.57,108
CPT,85013,POC SPUN HEMATOCRIT,85.0,42.5,7.0,82.45,54
CPT,85013,SPUN MICROHEMATOCRIT,,,,,0
CPT,85014,HEMATOCRIT,40.0,20.0,1.91,61.11,162
CPT,85014,POC ISTAT BLOOD COUNT HEMATOCRIT HCT,29.0,14.5,2.37,28.13,54
CPT,85014,POC STAT HCT,57.0,28.5,2.37,55.29,54
CPT,85018,HEMOGLOBIN,40.0,20.0,2.37,61.11,162
CPT,85018,POC HEMOGLOBIN,57.0,28.5,2.37,55.29,54
CPT,85018,POC ISTAT BLOOD COUNT HEMOGLOBIN HGB,43.0,21.5,2.37,41.71,54
CPT,85025,CBC W/ AUTO DIFFERENTIAL,78.5,39.25,6.44,116.4,108
CPT,85025,CBC W/ CONFIRMATORY DIFF,78.5,39.25,6.44,116.4,108
CPT,85025,COMPLETE CBC W/AUTO DIFF WBC,1668.5,834.25,7.77,3014.76,108
CPT,85025,MUD COMPLETE CBC W/AUTO DIFF WBC NHCI,3230.0,1615.0,7.77,3133.1,53
CPT,85027,CBC W/O DIFFERENTIAL,60.5,30.25,4.18,94.09,108
CPT,85027,COMPLETE CBC AUTOMATED,,,,,0
CPT,85032,MANUAL CELL COUNT EACH,,,,,0
CPT,85032,MANUAL PLATELET COUNT,52.0,26.0,4.31,50.44,54
CPT,85041,AUTOMATED RBC COUNT,,,,,0
CPT,85041,G-6-PD BLOOD,46.5,23.25,3.02,49.47,108
CPT,85041,RBC AUTOMATED,57.5,28.75,3.02,70.81,108
CPT,85044,MANUAL RETICULOCYTE COUNT,,,,,0
CPT,85044,RETICULOCYTE COUNT MANUAL,103.0,51.5,4.31,99.91,54
CPT,85045,AUTOMATED RETICULOCYTE COUNT,,,,,0
CPT,85045,RETIC COUNT AUTO W CELL PARAMETER(S),40.0,20.0,2.78,62.08,108
CPT,85045,RETICULOCYTE COUNT AUTO,40.0,20.0,2.78,62.08,108
CPT,85046,RETICYTE/HGB CONCENTRATE,,,5.57,11.14,8
CPT,85048,AUTOMATED LEUKOCYTE COUNT,,,,,0
CPT,85048,EOSINOPHIL BLD CELL COUNT,55.5,27.75,2.54,58.2,108
CPT,85048,WHITE BLD CELL COUNT,55.5,27.75,2.54,58.2,108
CPT,85048,WHITE BLD CELL COUNT W DIFF,55.5,27.75,2.54,58.2,108
CPT,85049,AUTOMATED PLATELET COUNT,,,,,0
CPT,85049,PLATELET COUNT AUTOMATED,42.5,21.25,3.13,64.99,108
CPT,85055,RETICULATED PLATELET ASSAY,140.0,70.0,24.38,135.8,54
CPT,85060,BLOOD SMEAR INTERPRETATION,,,,,0
CPT,85097,BONE MARROW INTERPRETATION,,,,,0
CPT,85097,MARROW SMEAR INTERPRETATION,1022.0,511.0,178.03,1565.86,108
CPT,850T,DGTZ GLS MCRSCP ISH EA MULT,,,,,0
CPT,851,ANESTH TUBAL LIGATION,,,,,0
CPT,85130,APIXABAN ANTI-XA ASSAY,525.0,262.5,11.89,539.32,108
CPT,85130,CHROMOGENIC SUBSTRATE ASSAY,,,,,0
CPT,85130,HEPARIN COFACTOR II,806.0,403.0,11.89,781.82,108
CPT,85170,BLOOD CLOT RETRACTION,,,16.3,32.6,8
CPT,85175,BLOOD CLOT LYSIS TIME,,,20.37,40.74,8
CPT,851T,DGTZ GLS MCRSCP MPHMTRC 1ST,,,,,0
CPT,85210,CLOT FACTOR II PROTHROM SPEC,,,,,0
CPT,85210,FACTOR II ACTIVITY,297.0,148.5,12.98,363.75,108
CPT,85220,BLOOC CLOT FACTOR V TEST,,,,,0
CPT,85220,FACTOR V LABILE,182.5,91.25,13.06,281.3,108
CPT,85230,CLOT FACTOR VII PROCONVERTIN,,,,,0
CPT,85230,FACTOR VII STABLE,391.0,195.5,17.9,530.59,108
CPT,85240,CLOT FACTOR VIII AHG 1 STAGE,,,,,0
CPT,85240,FACTOR VIII AHG 1-STAGE,281.0,140.5,17.9,347.26,108
CPT,85244,CLOT FACTOR VIII RELTD ANTGN,,,,,0
CPT,85244,CLOTTING FACTOR VIII RELATED ANTIGEN,248.0,124.0,20.42,240.56,54
CPT,85245,CLOT FACTOR VIII VW RISTOCTN,,,,,0
CPT,85245,FACTOR VIII VW RISTOCETIN,278.0,139.0,22.94,347.26,108
CPT,85246,CLOT FACTOR VIII VW ANTIGEN,,,,,0
CPT,85246,FACTOR VIII VW ANTIGEN,235.5,117.75,19.68,347.26,108
CPT,85247,CLOT FACTOR VIII MULTIMETRIC,,,,,0
CPT,85247,VON WILLEBRANDS MULTIMERS,331.0,165.5,22.94,373.45,108
CPT,85250,CLOT FACTOR IX PTC/CHRSTMAS,,,,,0
CPT,85250,FACTOR IX PTC CHRISTMAS,531.0,265.5,19.04,757.57,108
CPT,85250,FACTOR IX XMAS ANTIGEN,531.0,265.5,19.04,757.57,108
CPT,85260,CLOT FACTOR X STUART-POWER,,,,,0
CPT,85260,FACTOR X ANTIGEN RESEARCH,606.0,303.0,17.9,733.32,108
CPT,85260,FACTOR X STUART-PROWER,615.5,307.75,17.9,921.5,108
CPT,85270,CLOT FACTOR XI PTA,,,,,0
CPT,85270,FACTOR XI PTA,210.0,105.0,17.9,257.05,108
CPT,85280,CLOT FACTOR XII HAGEMAN,,,,,0
CPT,85280,FACTOR XII HAGEMAN,232.0,116.0,19.35,303.61,108
CPT,85290,CLOT FACTOR XIII FIBRIN STAB,,,,,0
CPT,85290,FACTOR XIII ACTIVITY,456.5,228.25,16.34,453.96,108
CPT,85291,CLOT FACTOR XIII FIBRIN SCRN,,,,,0
CPT,85291,FACTOR XIII SCRN SOLUBILITY,155.0,77.5,9.11,150.35,108
CPT,85292,CLOT FACTOR FLETCHER FACT,,,18.93,37.86,8
CPT,85293,CLOT FACTOR WGHT KININOGEN,,,18.93,37.86,8
CPT,852T,DGTZ GLS MCRSCP MPHMTRC EA 1,,,,,0
CPT,85300,ANTITHROMBIN III,115.0,57.5,7.83,179.45,108
CPT,85300,ANTITHROMBIN III ACTIVITY,,,,,0
CPT,85301,ANTITHROMBIN III ANTIGEN,113.5,56.75,10.1,163.93,108
CPT,85302,CLOT INHIBIT PROT C ANTIGEN,,,,,0
CPT,85302,PROTEIN C ANTIGEN,113.0,56.5,9.4,166.84,108
CPT,85303,CLOT INHIBIT PROT C ACTIVITY,,,,,0
CPT,85303,PROTEIN C ACTIVITY,134.5,67.25,12.36,192.06,108
CPT,85305,CLOT INHIBIT PROT S TOTAL,,,,,0
CPT,85305,PROTEIN S TOTAL,112.0,56.0,7.49,175.57,108
CPT,85306,CLOT INHIBIT PROT S FREE,,,,,0
CPT,85306,PROTEIN S FREE,147.0,73.5,12.89,213.4,108
CPT,85307,APC RESISTANCE ASSAY,268.5,134.25,15.32,280.33,108
CPT,85307,ASSAY ACTIVATED PROTEIN C,,,,,0
CPT,85335,FACTOR INHIBITOR TEST,424.0,212.0,12.87,474.33,108
CPT,85337,THROMBOMODULIN,,,17.27,34.54,8
CPT,85345,COAGULATION TIME LEE & WHITE,,,4.69,9.38,8
CPT,85347,ACTIVATED CLOTTING TIME,77.0,38.5,4.28,74.69,54
CPT,85347,COAGULATION TIME ACTIVATED,,,,,0
CPT,85347,POC ACTIVATED CLOTTING TIME,104.0,52.0,4.28,100.88,54
CPT,85348,COAGULATION TIME OTR METHOD,,,4.49,8.98,8
CPT,85360,EUGLOBULIN LYSIS,127.0,63.5,8.41,148.41,108
CPT,85362,FIBRIN DEGRADATION PRODUCTS,108.0,54.0,6.89,104.76,54
CPT,85366,FIBRINOGEN TEST,,,80.46,160.92,8
CPT,85370,FIBRINOGEN TEST,,,12.43,24.86,8
CPT,85378,FIBRIN DEGRADE SEMIQUANT,,,9.72,19.44,8
CPT,85379,FDP D-DIMER QUANT,106.0,53.0,10.18,146.47,108
CPT,85379,FIBRIN DEGRADATION QUANT,,,,,0
CPT,85380,FIBRIN DEGRADJ D-DIMER,,,10.18,20.36,8
CPT,85384,FIBRINOGEN ACTIVITY,89.0,44.5,5.74,140.65,108
CPT,85385,FIBRINOGEN ANTIGEN,153.0,76.5,14.46,207.58,108
CPT,85390,FIBRINOLYSINS SCREEN I&R,61.0,30.5,8.53,70.81,108
CPT,85396,CLOTTING ASSAY WHOLE BLOOD,69.5,34.75,10.8,74.69,94
CPT,85397,ADAMTS13 FUNC ACTIVITY,583.0,291.5,30.86,580.06,108
CPT,85397,CLOTTING FUNCT ACTIVITY,530.5,265.25,30.86,580.06,108
CPT,853T,DGTZ GLS MCRSCP MPHMTRC EA M,,,,,0
CPT,85400,FIBRINOLYTIC PLASMIN,,,7.71,15.42,8
CPT,85410,ALPHA-2-ANTIPLASMINOGEN,207.0,103.5,7.71,200.79,108
CPT,85410,FIBRINOLYTIC ANTIPLASMIN,,,,,0
CPT,85415,FIBRINOLYTIC PLASMINOGEN,,,,,0
CPT,85415,PLASMINOGEN ACTIVATOR,413.5,206.75,17.19,607.22,108
CPT,85420,FIBRINOLYTIC PLASMINOGEN,,,,,0
CPT,85420,PLASMINOGEN ACTIVITY,110.0,55.0,6.53,125.13,108
CPT,85421,FIBRINOLYTIC PLASMINOGEN,,,10.18,20.36,8
CPT,85441,HEINZ BODIES DIRECT,,,4.2,8.4,8
CPT,85445,HEINZ BODIES INDUCED,,,6.82,13.64,8
CPT,85460,FETAL STAIN KLEIHAUR BETKE,153.0,76.5,7.73,148.41,54
CPT,85460,HEMOGLOBIN FETAL,,,,,0
CPT,85461,FETAL SCREEN ROSETTE,131.0,65.5,9.36,127.07,54
CPT,85461,HEMOGLOBIN FETAL,,,,,0
CPT,85475,HEMOLYSIN ACID,,,8.87,17.74,8
CPT,854T,DGTZ GLS MCRSCP BLD SMR PRPH,,,,,0
CPT,85520,HEPARIN ASSAY,333.0,166.5,13.09,323.01,108
CPT,85520,HEPARIN ASSAY ANTI XA,333.0,166.5,13.09,323.01,108
CPT,85520,HEPARIN ASSAY LOW MOLEC WT,301.5,150.75,13.09,418.07,108
CPT,85520,HEPARIN ASSAY UNFRACTIONATED,333.0,166.5,13.09,323.01,108
CPT,85525,HEPARIN NEUTRALIZATION,,,,,0
CPT,85525,HEPARIN NEUTRALIZATION TE,284.0,142.0,11.84,275.48,54
CPT,85530,HEPARIN-PROTAMINE TOLERANCE,,,13.09,26.18,8
CPT,85536,IRON STAIN PERIPHERAL BLOOD,,,6.88,13.76,8
CPT,85540,LEUKOCYTE ALK PHOS STAIN,155.0,77.5,8.6,199.82,108
CPT,85540,WBC ALKALINE PHOSPHATASE,,,,,0
CPT,85547,RBC MECHANICAL FRAGILITY,,,8.6,17.2,8
CPT,85549,LYSOZYME/MURAMIDASE,134.5,67.25,10.27,203.7,108
CPT,85549,MURAMIDASE,,,,,0
CPT,85555,OSMOTIC FRAGILITY ERYTHROCYTE,477.5,238.75,7.47,476.27,108
CPT,85555,RBC OSMOTIC FRAGILITY,,,,,0
CPT,85557,RBC OSMOTIC FRAGILITY,38.0,19.0,6.61,36.86,54
CPT,85576,BLOOD PLATELET AGGREGATION,,,,,0
CPT,85576,BLOOD PLATELET AGGREGATION EA AGENT,219.0,109.5,21.07,307.49,108
CPT,85576,PLATELET AGGREG CADP,250.0,125.0,19.16,378.3,108
CPT,85576,PLATELET AGGREG EFFIENT PRU,308.0,154.0,24.91,304.58,108
CPT,85576,PLATELET AGGREG PFA-100,238.0,119.0,14.98,378.3,108
CPT,85576,PLATELET AGGREG PLAVIX BASE,346.0,173.0,24.91,378.3,108
CPT,85576,PLATELET AGGREG PLVX PRU,346.0,173.0,24.91,378.3,108
CPT,85576,PLATELET AGGREG SPONTANEOUS,308.0,154.0,24.91,304.58,108
CPT,85597,PHOSPHOLIPID PLTLT NEUTRALIZ,,,,,0
CPT,85597,PLATELET NEUTRALIZATION,273.5,136.75,17.98,283.24,108
CPT,85598,HEXAGNAL PHOSPH PLTLT NEUTRL,,,,,0
CPT,85598,LUPUS HEX PHASE PHOSPHOLIPID,182.0,91.0,14.8,270.63,108
CPT,855T,DGTZ GLS MCRSCP B1 MAROW SMR,,,,,0
CPT,85610,POC PROTHROMBIN TIME,56.0,28.0,4.29,54.32,54
CPT,85610,PROTHROMBIN TIME,60.0,30.0,4.29,62.08,108
CPT,85610,PROTIME FINGERSTICK,80.5,40.25,4.29,78.57,108
CPT,85610,PROTIME INR,80.5,40.25,4.29,78.57,108
CPT,85611,PROTHROMBIN TEST,,,,,0
CPT,85611,PT MIXING STUDY EACH,41.0,20.5,3.94,56.26,108
CPT,85612,LUPUS INHIBITOR SCREEN,216.0,108.0,17.49,209.52,54
CPT,85612,VIPER VENOM PROTHROMBIN TIME,,,,,0
CPT,85613,LUPUS DILUTED RVVT,132.0,66.0,9.58,132.89,108
CPT,85613,LUPUS DILUTED RVVT CONFIRM,132.0,66.0,9.58,132.89,108
CPT,85613,LUPUS DILUTED RVVT MIX,132.0,66.0,9.58,132.89,108
CPT,85613,LUPUS DILUTED RVVT SCRN,132.0,66.0,9.58,132.89,108
CPT,85613,RUSSELL VIPER VENOM DILUTED,,,,,0
CPT,85635,REPTILASE TEST,308.5,154.25,9.85,311.37,108
CPT,85651,RBC SED RATE NONAUTOMATED,,,,,0
CPT,85651,SEDIMENTATION RATE NONAUTO,94.0,47.0,4.27,91.18,54
CPT,85652,RBC SED RATE AUTOMATED,,,,,0
CPT,85652,SEDIMENTATION RATE AUTOMATED,30.5,15.25,2.7,41.71,108
CPT,85660,ARC HBG S NEG UNIT,135.0,67.5,5.51,142.59,108
CPT,85660,HGB S SICKLING RBC PATIENT,135.0,67.5,5.51,142.59,108
CPT,85660,HGB S SICKLING RBC PRODUCT,135.0,67.5,5.51,142.59,108
CPT,85660,MUD RBC SICKLE CELL TEST NHCI,125.0,62.5,5.51,121.25,53
CPT,85660,RBC SICKLE CELL TEST,,,,,0
CPT,85660,SICKLE CELL PREP,72.0,36.0,5.51,87.3,108
CPT,85670,THROMBIN NEUTRALIZATION,175.0,87.5,5.77,191.09,108
CPT,85670,THROMBIN TIME,197.0,98.5,5.77,191.09,108
CPT,85670,THROMBIN TIME MIX,197.0,98.5,5.77,191.09,108
CPT,85670,THROMBIN TIME PLASMA,,,,,0
CPT,85675,THROMBIN TIME TITER,,,6.85,13.7,8
CPT,856T,DGTZ GLS MCRSCP ELECTRON MIC,,,,,0
CPT,85705,DILUTE PROTHROMBIN TIME,83.5,41.75,9.58,108.64,108
CPT,85705,LUPUS COMP THROMBOPLAS INHIB,112.0,56.0,9.63,108.64,108
CPT,85705,THROMBOPLASTIN INHIBITION,,,,,0
CPT,85705,THROMBOPLASTIN INHIBITION TISSUE,87.5,43.75,6.44,133.86,108
CPT,85730,PARTIAL THOMBOPLASTIN TIME,60.5,30.25,4.7,91.18,108
CPT,85730,PTT INCUBATED 1:1 1HR,138.5,69.25,6.01,147.44,108
CPT,85730,PTT INCUBATED 1:1NP IMMED,138.5,69.25,6.01,147.44,108
CPT,85730,PTT LUPUS ANTICOAGULANT SCRN,60.5,30.25,4.7,91.18,108
CPT,85730,THROMBOPLASTIN TIME PARTIAL,,,,,0
CPT,85732,APTT 1:1 NORMAL PLASMA,111.0,55.5,6.47,145.5,108
CPT,85732,PTT INCUBATED LA MIX,111.0,55.5,6.47,145.5,108
CPT,85732,PTT MIXING STUDY,111.0,55.5,6.47,145.5,108
CPT,85732,THROMBOPLASTIN TIME LA MIX,111.0,55.5,6.47,145.5,108
CPT,85732,THROMBOPLASTIN TIME NEUTRAL,150.0,75.0,6.47,145.5,108
CPT,85732,THROMBOPLASTIN TIME PARTIAL,,,,,0
CPT,85732,THROMBOPLASTIN TIME REF,150.0,75.0,6.47,145.5,108
CPT,857T,OPTO-ACOUSTIC IMG BREAST UNI,,,101.59,203.18,8
CPT,85810,BLOOD VISCOSITY EXAMINATION,,,,,0
CPT,85810,VISCOSITY,117.5,58.75,10.8,167.81,108
CPT,858T,EXT TRNSCRANL MAG STIMJ MEAS,,,,,0
CPT,85999,EOSINOPHIL URINE,91.5,45.75,13.93,99.91,94
CPT,85999,UNLISTED HEMATOLOGY&COAGJ PX,,,,,0
CPT,859T,NCNTC IFR SPCTRSC O/T PAD EA,,,,,0
CPT,860,ANESTH SURGERY OF ABDOMEN,,,,,0
CPT,86000,AGGLUTININS FEBRILE ANTIGEN,,,6.98,13.96,8
CPT,86001,ALLERGEN SPECIFIC IGG,,,,,0
CPT,86001,ALLERGEN SPECIFIC IGG QNT EA,186.0,93.0,7.82,225.04,108
CPT,86003,ALLERGEN IGE QUANT/SEMIQNT,61.0,30.5,2.61,103.79,108
CPT,86003,ALLERGEN LATEX,197.0,98.5,5.22,191.09,54
CPT,86003,ALLERGEN RAST,197.0,98.5,5.22,191.09,54
CPT,86003,ALLERGENS (94) FOODS,33.0,16.5,2.78,48.5,108
CPT,86003,ALLG SPEC IGE CRUDE XTRC EA,,,,,0
CPT,86005,ALLERGEN SPECIFIC IGE QUAL,115.5,57.75,7.97,129.98,108
CPT,86005,ALLG SPEC IGE MULTIALLG SCR,,,,,0
CPT,86008,ALLG SPEC IGE RECOMB EA,240.5,120.25,17.93,257.05,108
CPT,86015,ACTIN ANTIBODY EACH,125.0,62.5,10.62,183.33,108
CPT,86021,ANCA,336.0,168.0,15.05,325.92,54
CPT,86021,WBC ANTIBODY IDENTIFICATION,,,,,0
CPT,86022,ARC NAIT EVAL/PLT TEST,369.0,184.5,18.37,357.93,54
CPT,86022,ARC PLA-1 NEG PLT FEE,369.0,184.5,18.37,357.93,54
CPT,86022,ARC PLA-1 PLT ABY SCR,369.0,184.5,18.37,357.93,54
CPT,86022,ARC XM PLT FEE,369.0,184.5,18.37,357.93,54
CPT,86022,HEPARIN INDUCED PLT AB,304.5,152.25,18.37,358.9,108
CPT,86022,PLATELET A1 AB,369.0,184.5,18.37,357.93,54
CPT,86022,PLATELET ANTIBODIES,,,,,0
CPT,86022,PLATELET ANTIBODY,380.5,190.25,18.37,379.27,108
CPT,86023,IMMUNOGLOBULIN ASSAY,,,12.46,24.92,8
CPT,86036,ANCA SCREEN EACH ANTIBODY,142.0,71.0,12.05,174.6,108
CPT,86037,ANCA TITER EACH ANTIBODY,115.5,57.75,7.31,183.33,108
CPT,86038,ANTI NUCLEAR AB FLUID SCRN,500.0,250.0,12.09,544.17,108
CPT,86038,ANTI NUCLEAR AB SCREEN,493.0,246.5,12.09,544.17,108
CPT,86038,ANTINUCLEAR ANTIBODIES,,,,,0
CPT,86039,ANTINUCLEAR ANTIBODIES (ANA),,,,,0
CPT,86039,ANTINUCLEAR ANTIBODY TITER,210.0,105.0,11.16,203.7,54
CPT,86041,ACETYLCHOLN RCPTR BNDNG ANTB,189.0,94.5,15.67,279.36,108
CPT,86042,ACETYLCHOLN RCPTR BLCKG ANTB,189.0,94.5,15.67,279.36,108
CPT,86043,ACETYLCHOLN RCPTR MODLG ANTB,202.0,101.0,12.05,252.2,108
CPT,86051,AQUAPORIN-4 ANTB ELISA,1305.0,652.5,11.53,1515.14,108
CPT,86052,AQUAPORIN-4 ANTB CBA EACH,2704.5,1352.25,12.05,3177.72,108
CPT,86053,AQAPRN-4 ANTB FLO CYTMTRY EA,2736.0,1368.0,37.73,3177.72,108
CPT,86060,ANTISTREPTOLYSIN O TITER,167.0,83.5,7.3,188.18,108
CPT,86063,ANTISTREPTOLYSIN O SCREEN,126.0,63.0,5.77,122.22,54
CPT,86077,ARC PT PROBLEM CASE BASIC,432.0,216.0,28.11,419.04,54
CPT,86077,ARC PT PROBLEM CASE COMPLEX,432.0,216.0,28.11,419.04,54
CPT,86077,ARC PT PROBLEM CASE EXTENDED,432.0,216.0,28.11,419.04,54
CPT,86077,PHYS BLOOD BANK SERV XMATCH,,,,,0
CPT,86078,PHYS BLOOD BANK SERV REACTJ,,,,,0
CPT,86078,SUSPECTED TRANSFUSION RXN,3022.0,1511.0,165.56,2931.34,54
CPT,86079,PHYS BLOOD BANK SERV AUTHRJ,,,50.64,101.28,8
CPT,860T,NCNTC IFR SPCTRSC SCR PAD,,,,,0
CPT,86140,C REACTIVE PROTEIN,54.0,27.0,4.0,82.45,108
CPT,86140,C-REACTIVE PROTEIN,,,,,0
CPT,86141,C REACTIVE PROTEIN CARDIAC,188.5,94.25,12.95,185.27,108
CPT,86141,C REACTIVE PROTEIN HIGHSENS,260.0,130.0,12.95,252.2,54
CPT,86141,C-REACTIVE PROTEIN HS,,,,,0
CPT,86146,BETA-2 GLYCOPROTEIN 1 AB EA,170.0,85.0,13.93,252.2,108
CPT,86146,BETA-2 GLYCOPROTEIN ANTIBODY,,,,,0
CPT,86146,BETA2 GLYCOPROTEIN 1 AB IGA,170.0,85.0,13.93,252.2,108
CPT,86146,BETA2 GLYCOPROTEIN 1 AB IGG,170.0,85.0,13.93,252.2,108
CPT,86146,BETA2 GLYCOPROTEIN 1 AB IGM,170.0,85.0,13.93,252.2,108
CPT,86147,CARDIOLIPIN ANTIBODY EA IG,,,,,0
CPT,86147,CARDIOLIPIN ANTIBODY EA IG CLASS,231.0,115.5,13.93,370.54,108
CPT,86147,CARDIOLIPIN ANTIBODY IGA,231.0,115.5,13.93,370.54,108
CPT,86147,CARDIOLIPIN ANTIBODY IGG,231.0,115.5,13.93,370.54,108
CPT,86147,CARDIOLIPIN ANTIBODY IGM,231.0,115.5,13.93,370.54,108
CPT,86147,LUPUS ANTICOAGULANT EVAL,202.0,101.0,16.54,299.73,108
CPT,86148,ANTI-PHOSPHOLIPID ANTIBODY,,,,,0
CPT,86148,PHOSPHOLIPID ANTIBODY,160.0,80.0,11.84,244.44,108
CPT,86148,PHOSPHOLIPID ANTIBODY IGA,196.0,98.0,16.07,192.06,108
CPT,86148,PHOSPHOLIPID ANTIBODY IGG,196.0,98.0,16.07,192.06,108
CPT,86148,PHOSPHOLIPID ANTIBODY IGM,196.0,98.0,16.07,192.06,108
CPT,86152,CELL ENUMERATION & ID,,,,,0
CPT,86152,CIRCULATING TUMOR CELLS,4271.0,2135.5,250.78,5343.73,108
CPT,86152,CTC BREAST,3033.0,1516.5,250.78,2942.01,54
CPT,86153,CELL ENUMERATION PHYS INTERP,,,,,0
CPT,86155,CHEMOTAXIS ASSAY,,,15.99,31.98,8
CPT,86156,COLD AGGLUTININ SCREEN,168.0,84.0,8.07,162.96,54
CPT,86157,COLD AGGLUTININ TITER,114.5,57.25,8.06,164.9,108
CPT,86160,COMPLEMENT ANTIGEN,,,,,0
CPT,86160,COMPLEMENT C1Q,261.5,130.75,12.0,313.31,108
CPT,86160,COMPLEMENT C2,173.0,86.5,12.0,194.0,108
CPT,86160,COMPLEMENT C3,200.0,100.0,12.0,194.0,108
CPT,86160,COMPLEMENT C4,200.0,100.0,12.0,194.0,108
CPT,86161,C1 ESTERASE INHIBITOR,162.5,81.25,12.0,173.63,108
CPT,86161,COMPLEMENT/FUNCTION ACTIVITY,,,,,0
CPT,86162,COMPLEMENT TOTAL (CH50),,,,,0
CPT,86162,COMPLEMENT TOTAL CH50,208.5,104.25,20.03,292.94,108
CPT,86171,COMPLEMENT FIXATION EACH,,,10.01,20.02,8
CPT,861T,RMVL PG WCS LV BOTH COMPNT,,,3631.43,7262.86,8
CPT,862,ANESTH KIDNEY/URETER SURG,,,,,0
CPT,86200,CCP ANTIBODY,,,,,0
CPT,86200,CYCLIC CITRULL PEPTIDE AB,171.5,85.75,12.95,185.27,108
CPT,86215,DEOXYRIBONUCLEASE AB,197.0,98.5,13.25,191.09,54
CPT,86215,DEOXYRIBONUCLEASE ANTIBODY,,,,,0
CPT,86225,DNA AB DOUBLE STRANDED,269.0,134.5,13.74,260.93,108
CPT,86225,DNA ANTIBODY NATIVE,,,,,0
CPT,86226,ANTI-DNA(SS)IGG ANTIBODY QN,229.0,114.5,12.11,301.67,108
CPT,86226,DNA ANTIBODY SINGLE STRAND,,,,,0
CPT,86231,EMA EACH IG CLASS,116.0,58.0,7.49,183.33,108
CPT,86231,EMA EACH IGA CLASS,116.0,58.0,7.49,183.33,108
CPT,86235,ANTI-PM/SCL-75 AB (RDL),437.5,218.75,17.93,529.62,108
CPT,86235,ANTI-RO (SS-A) AB (RDL),367.5,183.75,17.93,515.07,108
CPT,86235,ANTIHISTONE ANTIBODIES,336.0,168.0,17.93,332.71,108
CPT,86235,CENTROMERE ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,CHROMATIN ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,JO 1 ENA ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,NUCLEAR ANTIGEN ANTIBODY,,,,,0
CPT,86235,"NUCLEAR ANTIGEN ANTIBODY, ANY METHOD",363.0,181.5,17.93,506.34,108
CPT,86235,RNP ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,SCL70 ENA ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,SMITH ENA ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,SSA ENA ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86235,SSB ENA ANTIBODY,363.0,181.5,17.93,506.34,108
CPT,86255,AMPA-R AB CBA,249.5,124.75,12.05,403.52,108
CPT,86255,"CASPR2-IGG CBA, S",336.5,168.25,12.05,572.3,108
CPT,86255,ENDOMYSIAL ANTIBODY EACH,572.0,286.0,12.05,825.47,108
CPT,86255,ENDOMYSIAL ANTIBODY IGA,223.0,111.5,12.05,345.32,108
CPT,86255,FLUORESCENT ANTIBODY SCREEN,,,,,0
CPT,86255,FLUORESCENT ANTIBODY SCREEN EA AB,851.0,425.5,12.05,825.47,108
CPT,86255,GABA-B-R AB CBA,249.5,124.75,12.05,403.52,108
CPT,86255,"LGI1-IGG CBA, S",336.5,168.25,12.05,572.3,108
CPT,86255,N-METHYL-D-ASPARTATE RECPT IGG,249.5,124.75,12.05,403.52,108
CPT,86255,NMDA-R AB CBA,249.5,124.75,12.05,403.52,108
CPT,86255,NMO/AQP4-IGG CBA,249.5,124.75,12.05,403.52,108
CPT,86255,PARIETAL CELL ANTIBODY,220.0,110.0,12.05,345.32,108
CPT,86255,RETICULIN ANTIBODY IGG,324.5,162.25,12.05,345.32,108
CPT,86255,RETICULIN IGA ANTIBODY,243.0,121.5,12.05,259.96,108
CPT,86255,STRIATED MUSCLE ANTIBODY,851.0,425.5,12.05,825.47,108
CPT,86256,AMPA-R AB IF TITER ASSAY,197.0,98.5,12.05,301.67,108
CPT,86256,ANTI-AQP4 ANTIBODY TITER,389.5,194.75,12.05,530.59,108
CPT,86256,ANTI-HU ANTIBODIES,197.0,98.5,12.05,301.67,108
CPT,86256,ANTINEUTOPHIL CYTOPLAS AB,201.0,100.5,12.05,302.64,108
CPT,86256,DNA ANTIBODY TITER,312.0,156.0,12.05,302.64,54
CPT,86256,ENDOMYSIAL ANTIBODY TITER,312.0,156.0,12.05,302.64,54
CPT,86256,FLUORESCENT ANTIBODY TITER,,,,,0
CPT,86256,GABA-B-R AB IF TITER ASSAY,197.0,98.5,12.05,301.67,108
CPT,86256,NMDA,197.0,98.5,12.05,301.67,108
CPT,86256,NMDA-R AB IF TITER ASSAY,197.0,98.5,12.05,301.67,108
CPT,86256,NON-INFECT AGENT AB TITER EA,547.0,273.5,12.05,530.59,108
CPT,86258,DGP ANTIBODY EACH IG CLASS,114.5,57.25,6.96,183.33,108
CPT,86277,GROWTH HORMONE ANTIBODY,,,15.74,31.48,8
CPT,86280,HEMAGGLUTINATION INHIBITION,,,8.19,16.38,8
CPT,86294,IMMUNOASSAY TUMOR QUAL,,,25.57,51.14,8
CPT,862T,RLCJ PG WCS LV BATTERY ONLY,,,2005.02,4010.04,8
CPT,86300,CA 15-3,197.5,98.75,14.8,300.7,108
CPT,86300,CA 27 29,197.5,98.75,14.8,300.7,108
CPT,86300,IMMUNOASSAY TUMOR CA 15-3,,,,,0
CPT,86301,CA 19-9,195.5,97.75,14.11,300.7,108
CPT,86301,IMMUNOASSAY TUMOR CA 19-9,,,,,0
CPT,86304,CA 125,199.0,99.5,15.32,300.7,108
CPT,86304,IMMUNOASSAY TUMOR CA 125,,,,,0
CPT,86305,HUMAN EPIDIDYMIS PROTEIN 4,721.5,360.75,20.81,836.14,108
CPT,86308,HETEROPHILE ANTIBODY SCREEN,,,,,0
CPT,86308,MONONUCLEOSIS SCREEN,57.0,28.5,5.05,82.45,108
CPT,86309,HETEROPHILE ANTIBODY TITER,,,,,0
CPT,86309,MONONUCLEOSIS TEST QNT,112.0,56.0,6.47,141.62,108
CPT,86310,HETEROPHILE ANTIBODY ABSRBJ,,,7.37,14.74,8
CPT,86316,AFP CSF TUMOR MARKER,281.0,140.5,20.81,300.7,108
CPT,86316,CHROMOGRANIN A,280.0,140.0,20.81,300.7,108
CPT,86316,IMMUNOASSAY TUMOR OTHER,,,,,0
CPT,86316,NEURON-SPECIFIC ENOLASE,281.0,140.5,20.81,300.7,108
CPT,86317,DIPHTHERIA ANTIBODY QUANT NOS,212.5,106.25,12.54,342.41,108
CPT,86317,HEP B SURFACE ANTIBODY QNT NOS,335.5,167.75,14.99,546.11,108
CPT,86317,IMMUNOASSAY INF AGENT QNT NES,317.5,158.75,12.54,546.11,108
CPT,86317,IMMUNOASSAY INFECTIOUS AGENT,,,,,0
CPT,86317,PNEUMO ANTIBODY SERO 1,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 12F,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 14,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 18C,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 19F,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 23F,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 3,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 4,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 5,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 6B,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 7F,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 8,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 9N,381.0,190.5,14.99,461.72,108
CPT,86317,PNEUMO ANTIBODY SERO 9V,381.0,190.5,14.99,461.72,108
CPT,86317,TETANUS ANTIBODY QUANT NOS,317.5,158.75,12.54,546.11,108
CPT,86317,WESTERN BLOT CRMP-5 IGG,274.0,137.0,12.54,461.72,108
CPT,86317,WESTERN BLOT PARANEOPLSTIC AUTOAB,274.0,137.0,12.54,461.72,108
CPT,86318,IA INFECTIOUS AGENT ANTIBODY,,,18.09,36.18,8
CPT,86320,SERUM IMMUNOELECTROPHORESIS,,,29.92,59.84,8
CPT,86325,OTHER IMMUNOELECTROPHORESIS,,,23.13,46.26,8
CPT,86328,IA NFCT AB SARSCOV2 COVID19,,,45.28,90.56,8
CPT,86329,IMMUNODIFFUSION NES,,,,,0
CPT,86329,TEICHOIC ACID ANTIBODY,170.0,85.0,14.05,164.9,54
CPT,86331,FUNGAL SEROLOGY GEL DIFFUS,195.0,97.5,11.98,204.67,108
CPT,86331,IMMUNODIFFUSION OUCHTERLONY,,,,,0
CPT,86332,IMMUNE COMPLEX ASSAY,,,,,0
CPT,86332,IMMUNE COMPLEX ASSAY C1Q BINDING,385.0,192.5,24.37,403.52,108
CPT,86334,IMMUNOFIX E-PHORESIS SERUM,,,,,0
CPT,86334,IMMUNOFIXATION ELECT SERUM,296.5,148.25,22.34,323.01,108
CPT,86335,IMMUNFIX E-PHORSIS/URINE/CSF,,,,,0
CPT,86335,IMMUNOFIXATION ELECT URINE,385.5,192.75,29.35,425.83,108
CPT,86335,MATSCR4 INHIBIN,693.0,346.5,29.35,672.21,108
CPT,86336,INHIBIN A,229.5,114.75,15.59,235.71,108
CPT,86337,INSULIN ANTIBODIES,,,,,0
CPT,86337,INSULIN ANTIBODY,272.0,136.0,21.41,263.84,54
CPT,86340,INTRINSIC FACTOR ANTIBODY,207.0,103.5,15.08,228.92,108
CPT,86341,ISLET CELL ANTIBODY,815.5,407.75,23.57,1171.76,108
CPT,86343,LEUKOCYTE HISTAMINE RELEASE,,,12.46,24.92,8
CPT,86344,LEUKOCYTE PHAGOCYTOSIS,,,10.39,20.78,8
CPT,86352,CELL FUNCTION ASSAY W/STIM,,,,,0
CPT,86352,CHRONIC URTICARIA CELL FUNC ASSAY,1038.0,519.0,75.42,1593.71,108
CPT,86353,LYMPHCYTE TRANSFORMATION,593.0,296.5,49.03,575.21,108
CPT,86353,LYMPHOCYTE TRANSFORMATION,,,,,0
CPT,86355,B CELL TOTAL COUNT,371.0,185.5,26.47,572.3,108
CPT,86355,B CELLS TOTAL COUNT,,,,,0
CPT,86356,MONONUCLEAR CELL AG QNT EACH,360.0,180.0,26.78,385.09,108
CPT,86356,MONONUCLEAR CELL ANTIGEN,,,,,0
CPT,86357,NATURAL KILLER CELLS TOTAL COUNT,712.0,356.0,37.73,708.1,108
CPT,86357,NK CELLS TOTAL COUNT,,,,,0
CPT,86359,T CELLS TOTAL COUNT,331.5,165.75,31.53,467.54,108
CPT,86360,T CELL ABSOLUTE COUNT/RATIO,,,,,0
CPT,86360,T CELLS ABS CD4/CD8 & RATIO,461.0,230.5,32.74,711.98,108
CPT,86361,CD4 HELPER ABSOLUTE COUNT,221.5,110.75,17.76,330.77,108
CPT,86361,T CELL ABSOLUTE COUNT,,,,,0
CPT,86362,MOG-IGG1 ANTB CBA EACH,2772.0,1386.0,12.05,2688.84,108
CPT,86363,MOG-IGG1 ANTB FLO CYTMTRY EA,,,37.73,75.46,8
CPT,86364,TISS TRNSGLTMNASE EA IG CLAS,,,,,0
CPT,86364,TISS TRNSGLTMNASE EA IG CLASS,110.0,55.0,6.96,174.6,108
CPT,86364,TISS TRNSGLTMNASE EA IGA CLASS,110.0,55.0,6.96,174.6,108
CPT,86364,TISS TRNSGLTMNASE EA IGG CLASS,110.0,55.0,6.96,174.6,108
CPT,86366,MUSCLE-SPECIFIC KINASE ANTB,,,,,0
CPT,86366,MUSCLE-SPECIFIC KINASE ANTIBODY,1814.5,907.25,18.4,2130.12,108
CPT,86367,MUD STEM CELLS TOTAL COUNT NHCI,695.0,347.5,77.78,674.15,53
CPT,86367,STEM CELL TOTAL COUNT CD34,579.0,289.5,44.42,875.91,108
CPT,86367,STEM CELLS TOTAL COUNT,,,,,0
CPT,86376,ANTI THYROID PEROXIDASE,216.0,108.0,14.55,209.52,54
CPT,86376,MICROSOMAL ANTIBODY EACH,,,,,0
CPT,86376,THYROID MICROSOMAL ANTIBODY,143.5,71.75,12.36,209.52,108
CPT,86381,MITOCHONDRIAL ANTIBODY EACH,265.0,132.5,23.16,385.09,108
CPT,86382,NEUTRALIZATION TEST VIRAL,,,16.91,33.82,8
CPT,86384,NITROBLUE TETRAZOLIUM DYE,,,13.61,27.22,8
CPT,86386,NUCLEAR MATRIX PROTEIN 22,,,21.78,43.56,8
CPT,863T,RLCJ PG WCS LV TRNSMTR ONLY,,,2005.02,4010.04,8
CPT,864,ANESTH REMOVAL OF BLADDER,,,,,0
CPT,86403,ANTIGEN DETECTION BACTERIAL,229.0,114.5,11.54,222.13,54
CPT,86403,CRYPTOCOCCUS AB SCREEN,229.0,114.5,11.54,222.13,54
CPT,86403,PARTICLE AGGLUT ANTBDY SCRN,,,,,0
CPT,86403,STREPTOZYME,229.0,114.5,11.54,222.13,54
CPT,86406,CRYPTOCOCCUS AB TITER,159.0,79.5,10.64,154.23,54
CPT,86406,PARTICLE AGGLUT ANTBDY TITR,,,,,0
CPT,86408,NEUTRLZG ANTB SARSCOV2 SCR,,,42.13,84.26,8
CPT,86409,NEUTRLZG ANTB SARSCOV2 TITER,,,79.61,159.22,8
CPT,86413,SARS-COV-2 ANTB QUANTITATIVE,,,51.43,102.86,8
CPT,86430,RHEUMATOID FACTOR QUAL,93.5,46.75,6.14,109.61,108
CPT,86430,RHEUMATOID FACTOR TEST QUAL,,,,,0
CPT,86431,RHEUMATOID FACTOR QUANT,54.5,27.25,4.18,82.45,108
CPT,86431,RHEUMATOID FACTOR QUANT FLD,110.5,55.25,5.67,109.61,108
CPT,86480,QUANTIFERON TB GOLD,449.0,224.5,41.8,638.26,108
CPT,86480,TB TEST CELL IMMUN MEASURE,,,,,0
CPT,86481,TB AG RESPONSE T-CELL SUSP,,,100.0,200.0,8
CPT,86485,SKIN TEST CANDIDA,,,28.11,56.22,8
CPT,86486,SKIN TEST UNLISTED ANTIGN EA,,,28.11,56.22,8
CPT,864T,LOW NTSTY ESWT CORPUS CVRNSM,,,242.79,485.58,8
CPT,865,ANESTH REMOVAL OF PROSTATE,,,,,0
CPT,86510,HISTOPLASMOSIS SKIN TEST,,,36.3,72.6,8
CPT,86580,POC TB SKIN TEST,77.0,38.5,13.41,74.69,54
CPT,86580,TB INTRADERMAL TEST,,,,,0
CPT,86581,STRPTCS PNEUM ANTB SEROT IA,187.0,93.5,32.57,184.06,108
CPT,86581,"Streptococcus pneumoniae antibody (IgG), serotypes, multiplex immunoassay, quantitative",,,,,0
CPT,86590,STREPTOKINASE ANTIBODY,,,12.66,25.32,8
CPT,86592,MUD SYPHILIS TEST NON-TREPONEMAL ANTIBODY QUAL NHCI,3230.0,1615.0,4.27,3133.1,53
CPT,86592,RPR SCREEN,46.5,23.25,4.27,64.02,108
CPT,86592,SYPHILIS TEST NON-TREP QUAL,143.0,71.5,4.27,3014.76,216
CPT,86592,VDRL SCREEN CSF,79.5,39.75,4.27,90.21,108
CPT,86593,RPR TITER,58.5,29.25,4.4,62.08,108
CPT,86593,SYPHILIS TEST NON-TREP QUANT,161.0,80.5,4.4,156.17,108
CPT,86593,VDRL TITER CSF,87.0,43.5,4.4,84.39,54
CPT,86596,VOLTAGE-GTD CA CHNL ANTB EA,1816.0,908.0,12.05,2183.47,108
CPT,865T,QUAN MRI ALYS BRN W/O DX MRI,,,231.86,463.72,8
CPT,866,ANESTH REMOVAL OF ADRENAL,,,,,0
CPT,86602,ACTINOMYCES ANTIBODY,369.0,184.5,10.18,370.54,108
CPT,86602,ANTINOMYCES ANTIBODY,,,,,0
CPT,86603,ADENOVIRUS AB QUANT,149.0,74.5,7.31,248.32,108
CPT,86603,ADENOVIRUS ANTIBODY,,,,,0
CPT,86603,ADENOVIRUS ANTIBODY IGG,286.0,143.0,12.87,277.42,54
CPT,86603,ADENOVIRUS ANTIBODY IGM,286.0,143.0,12.87,277.42,54
CPT,86606,ASPERGILLUS ANTIBODY,348.5,174.25,15.05,447.17,108
CPT,86609,BACTERIUM ANTIBODY,,,,,0
CPT,86609,BACTERIUM ANTIBODY NES,280.5,140.25,12.88,370.54,108
CPT,86611,BARTONELLA ANTIBODY,,,,,0
CPT,86611,BARTONELLA HENSELAE AB IGG,107.5,53.75,10.18,146.47,108
CPT,86611,BARTONELLA HENSELAE AB IGM,164.0,82.0,10.18,198.85,108
CPT,86612,BLASTOMYCES ANTIBODY,202.0,101.0,12.9,195.94,54
CPT,86615,BORDETELLA ANTIBODY,182.5,91.25,13.19,199.82,108
CPT,86617,LYME DISEASE ANTIBODY,,,,,0
CPT,86617,LYME DISEASE WEST BLOT AB,389.0,194.5,15.49,377.33,54
CPT,86617,LYME DISEASE WEST BLOT CSF,389.0,194.5,15.49,377.33,54
CPT,86617,LYME DISEASE WEST BLOT IGG,332.0,166.0,15.49,486.94,108
CPT,86617,LYME DISEASE WEST BLOT IGM,332.0,166.0,15.49,486.94,108
CPT,86618,LYME DISEASE ANTIBODY,,,,,0
CPT,86618,LYME DISEASE TOTAL ANTIBODY,394.5,197.25,17.03,609.16,108
CPT,86619,BORRELIA ANTIBODY,,,13.38,26.76,8
CPT,86622,BRUCELLA ANTIBODY,133.5,66.75,8.93,129.98,108
CPT,86625,CAMPYLOBACTER ANTIBODY,,,13.12,26.24,8
CPT,86628,CANDIDA ANTIBODY,211.0,105.5,12.01,261.9,108
CPT,86631,CHLAMYDIA ANTIBODY,133.0,66.5,11.82,129.01,54
CPT,86631,CHLAMYDIA PNEUMONIAE AB IGG,205.0,102.5,11.82,198.85,54
CPT,86631,CHLAMYDIA PSITTACI AB IGG,133.0,66.5,11.82,129.01,54
CPT,86631,CHLAMYDIA TRACHOMAT AB IGG,205.0,102.5,11.82,198.85,54
CPT,86632,CHLAMYDIA IGM ANTIBODY,,,,,0
CPT,86632,CHLAMYDIA PNEUMONIAE AB IGM,198.0,99.0,12.68,192.06,54
CPT,86632,CHLAMYDIA PSITTACI AB IGM,198.0,99.0,12.68,192.06,54
CPT,86632,CHLAMYDIA TRACHOMAT AB IGM,198.0,99.0,12.68,192.06,54
CPT,86635,COCCIDIOIDES ANTIBODY,192.0,96.0,11.47,186.24,54
CPT,86638,Q FEVER AB,151.0,75.5,7.31,252.2,108
CPT,86638,Q FEVER ANTIBODY,,,,,0
CPT,86641,CRYPTOCOCCAL ANTIBODY,213.0,106.5,14.41,206.61,54
CPT,86641,CRYPTOCOCCUS ANTIBODY,,,,,0
CPT,86644,ARC CMV TESTING,273.5,136.75,14.39,313.31,108
CPT,86644,CMV ANTIBODY,,,,,0
CPT,86644,CYTOMEGALOVIRUS AB IGG,334.5,167.25,14.39,515.07,108
CPT,86644,MUD ANTIBODY CYTOMEGALOVIRUS CMV NHCI,197.0,98.5,14.39,191.09,53
CPT,86645,CMV ANTIBODY IGM,,,,,0
CPT,86645,CYTOMEGALOVIRUS AB IGM,153.0,76.5,9.75,242.5,108
CPT,86648,DIPHTHERIA ANTIBODY,,,,,0
CPT,86648,DIPTHERIA ANTIBODY,236.5,118.25,15.21,281.3,108
CPT,86651,CALIFORNIA ANTIBODY,169.5,84.75,7.49,287.12,108
CPT,86651,ENCEPHALITIS CALIFORN ANTBDY,,,,,0
CPT,86652,EASTERN EQUINE ANTIBODY,169.5,84.75,7.49,287.12,108
CPT,86652,ENCEPHALTIS EAST EQNE ANBDY,,,,,0
CPT,86653,ENCEPHALTIS ST LOUIS ANTBODY,,,,,0
CPT,86653,SAINT LOUIS ANTIBODY,169.5,84.75,7.49,287.12,108
CPT,86654,ENCEPHALTIS WEST EQNE ANTBDY,,,,,0
CPT,86654,WESTERN EQUINE ANTIBODY,169.5,84.75,7.49,287.12,108
CPT,86658,COXSACKIE A9 ANTIBODY,212.0,106.0,13.03,205.64,54
CPT,86658,COXSACKIE B ANTIBODY EA ADD,335.0,167.5,13.03,324.95,54
CPT,86658,COXSACKIE B ANTIBODY T1,335.0,167.5,13.03,324.95,54
CPT,86658,ECHOVIRUS ANTIBODY,335.0,167.5,13.03,324.95,54
CPT,86658,ENTEROVIRUS ANTIBODY,,,,,0
CPT,86658,POLIOVIRUS ANTIBODY,335.0,167.5,13.03,324.95,54
CPT,86663,EPSTEIN BARR EARLY AG AB,122.5,61.25,8.88,188.18,108
CPT,86663,EPSTEIN-BARR ANTIBODY,,,,,0
CPT,86664,ANTIBODY EBV NUCLEAR AG,140.0,70.0,9.4,219.22,108
CPT,86664,EPSTEIN-BARR NUCLEAR ANTIGEN,,,,,0
CPT,86665,EPSTEIN BARR VCA IGG,165.0,82.5,10.62,260.93,108
CPT,86665,EPSTEIN BARR VCA IGM,165.0,82.5,10.62,260.93,108
CPT,86665,EPSTEIN-BARR CAPSID VCA,,,,,0
CPT,86666,EHRLICHIA ANTIBODY,,,,,0
CPT,86666,EHRLICHIA ANTIBODY IGG,125.5,62.75,10.18,146.47,108
CPT,86666,EHRLICHIA ANTIBODY IGM,123.0,61.5,10.18,146.47,108
CPT,86668,FRANCISELLA TULARENSIS,,,,,0
CPT,86668,FRANCISELLA TULARENSIS AB,240.0,120.0,14.16,291.0,108
CPT,86671,AUREOBASIDIUM PULLULANS AB,386.5,193.25,12.25,379.27,108
CPT,86671,FUNGUS ANTIBODY NES,310.5,155.25,12.25,379.27,108
CPT,86671,FUNGUS NES ANTIBODY,,,,,0
CPT,86674,GIARDIA LAMBLIA ANTIBODY,270.0,135.0,7.14,484.03,108
CPT,86677,HELICOBACTER PYLORI ANTIBODY,,,,,0
CPT,86677,HELICOBACTOR PYLOR ANTIBODY,281.0,140.5,16.85,347.26,108
CPT,86682,ECHINOCOCCUS ANTIBODY,846.5,423.25,13.01,963.21,108
CPT,86682,HELMINTH ANTIBODY,652.0,326.0,13.01,632.44,54
CPT,86684,HAEMOPHILUS INFLUENZA AB,392.0,196.0,15.84,380.24,54
CPT,86684,HEMOPHILUS INFLUENZA ANTIBDY,,,,,0
CPT,86687,HTLV-I,93.5,46.75,7.83,137.74,108
CPT,86687,HTLV-I ANTIBODY,406.0,203.0,9.09,393.82,108
CPT,86688,HTLV-II,134.5,67.25,10.62,201.76,108
CPT,86688,HTLV-II ANTIBODY,406.0,203.0,14.0,393.82,108
CPT,86689,HIV 1 WESTERN BLOT RELEX,334.5,167.25,19.35,421.95,108
CPT,86689,HIV-1 WESTERN BLOT,435.0,217.5,19.35,421.95,54
CPT,86689,HTLV/HIV CONFIRMJ ANTIBODY,,,,,0
CPT,86692,HEPATITIS DELTA AGENT ANTBDY,,,,,0
CPT,86692,HEPATITIS DELTA ANTIBODY,231.5,115.75,17.16,247.35,108
CPT,86694,HERPES SIMPLEX AB IGG,193.5,96.75,14.39,206.61,108
CPT,86694,HERPES SIMPLEX AB IGM,225.0,112.5,14.39,229.89,108
CPT,86694,HERPES SIMPLEX NES ANTBDY,,,,,0
CPT,86695,HERPES SIMPLEX TYPE 1 TEST,,,,,0
CPT,86695,HERPES SIMPLEX TYPE1 AB IGG,270.0,135.0,13.19,261.9,108
CPT,86696,HERPES SIMPLEX TYPE 1,511.0,255.5,19.35,495.67,108
CPT,86696,HERPES SIMPLEX TYPE 2 TEST,,,,,0
CPT,86696,HERPES SIMPLEX TYPE2 AB IGG,464.5,232.25,19.35,551.93,108
CPT,86696,HERPES SIMPLEX VIRUS BY PCR,511.0,255.5,19.35,495.67,108
CPT,86698,HISTOPLASMA ANTIBODY,522.0,261.0,13.79,506.34,54
CPT,866T,QUAN MRI ALYS BRN W/DX MRI,,,231.86,463.72,8
CPT,86701,HIV 1 ANTIBODY,157.5,78.75,8.89,193.03,108
CPT,86701,HIV RAPID SCREEN TEST,115.5,57.75,8.89,129.01,108
CPT,86701,HIV-1 ANTIBODY,374.0,187.0,8.89,362.78,108
CPT,86701,HIV-1ANTIBODY,,,,,0
CPT,86702,HIV 2,124.5,62.25,8.36,194.97,108
CPT,86702,HIV-2 ANTIBODY,374.0,187.0,13.52,362.78,108
CPT,86703,HIV 1/ HIV 2 SINGLE RESULT ANTIBODY,204.0,102.0,13.71,197.88,54
CPT,86703,HIV-1/HIV-2 1 RESULT ANTBDY,,,,,0
CPT,86703,MUD ANTIBODY HIV-1&HIV-2 SINGLE RESULT NHCI,188.0,94.0,13.71,182.36,53
CPT,86704,HEP B CORE ANTIBODY TOTAL,,,,,0
CPT,86704,HEPITITIS B CORE AB TOTAL,112.5,56.25,7.83,174.6,108
CPT,86704,MUD HEPATITIS B CORE ANTIBODY HBCAB TOTAL NHCI,165.0,82.5,12.05,160.05,53
CPT,86705,HEP B CORE ANTIBODY IGM,,,,,0
CPT,86705,HEPATITIS B CORE AB IGM,110.5,55.25,8.18,168.78,108
CPT,86706,HEP B SURFACE ANTIBODY,101.0,50.5,7.31,155.2,108
CPT,86707,HEPATITIS BE ANTIBODY,165.0,82.5,11.57,175.57,108
CPT,86708,HEPATITIS A ANTIBODY,,,,,0
CPT,86708,HEPATITIS A ANTIBODY TOTAL,165.5,82.75,12.39,179.45,108
CPT,86709,HEPATITIS A ANTIBODY IGM,106.5,53.25,8.18,161.02,108
CPT,86709,HEPATITIS A IGM ANTIBODY,,,,,0
CPT,86710,INFLUENZA A ANTIBODY,216.0,108.0,13.55,209.52,54
CPT,86710,INFLUENZA A ANTIBODY IGG,189.5,94.75,13.55,209.52,108
CPT,86710,INFLUENZA A ANTIBODY IGM,216.0,108.0,13.55,209.52,54
CPT,86710,INFLUENZA B ANTIBODY,216.0,108.0,13.55,209.52,54
CPT,86710,INFLUENZA B ANTIBODY IGG,216.0,108.0,13.55,209.52,54
CPT,86710,INFLUENZA B ANTIBODY IGM,216.0,108.0,13.55,209.52,54
CPT,86710,INFLUENZA VIRUS ANTIBODY,,,,,0
CPT,86710,PARAINFLUENZA ANTIBODY,216.0,108.0,13.55,209.52,54
CPT,86711,JOHN CUNNINGHAM ANTIBODY,,,16.89,33.78,8
CPT,86713,LEGIONELLA ANTIBODY,229.0,114.5,15.3,222.13,54
CPT,86717,LEISHMANIA ANTIBODY,,,12.25,24.5,8
CPT,86720,LEPTOSPIRA ANTIBODY,367.0,183.5,16.2,355.99,54
CPT,86723,LISTERIA MONCYTOGENES,653.5,326.75,13.19,727.5,108
CPT,86723,LISTERIA MONOCYTOGENES,,,,,0
CPT,86727,LYMPH CHORIOMENINGITIS AB,,,12.87,25.74,8
CPT,86732,MUCORMYCOSIS ANTIBODY,,,15.0,30.0,8
CPT,86735,MUMPS ANTIBODY,144.0,72.0,13.05,188.18,108
CPT,86738,MYCOPLASMA ANTIBODY,,,,,0
CPT,86738,MYCOPLASMA ANTIBODY IGG,178.5,89.25,13.24,191.09,108
CPT,86738,MYCOPLASMA IG M,178.5,89.25,13.24,191.09,108
CPT,86741,NEISSERIA MENINGITIDIS,,,13.19,26.38,8
CPT,86744,NOCARDIA ANTIBODY,,,15.99,31.98,8
CPT,86747,PARVOVIRUS ANTIBODY,,,,,0
CPT,86747,PARVOVIRUS B19 IGG,151.5,75.75,15.03,207.58,108
CPT,86747,PARVOVIRUS B19 IGM,185.0,92.5,15.03,207.58,108
CPT,86750,MALARIA ANTIBODY,,,13.19,26.38,8
CPT,86753,AMEBIASIS SEROLOGY,186.0,93.0,12.39,180.42,54
CPT,86753,MUD ANTIBODY PROTOZOA NES NHCI,224.0,112.0,12.39,217.28,53
CPT,86753,PROTOZOA AB NES,206.5,103.25,12.39,253.17,108
CPT,86753,PROTOZOA ANTIBODY NOS,,,,,0
CPT,86756,RESPIRATORY VIRUS ANTIBODY,,,,,0
CPT,86756,RSV ANTIBODY,289.0,144.5,15.89,280.33,54
CPT,86757,MURINE TYPHUS ANTIBODIES IGG,254.5,127.25,19.35,266.75,108
CPT,86757,RICKETTSIA ANTIBODY,,,,,0
CPT,86757,ROCKY MTN SP FEVER ANTIBODY,315.0,157.5,19.35,344.35,108
CPT,86757,ROCKY MTN SP FEVER IGG,212.5,106.25,19.35,278.39,108
CPT,86757,ROCKY MTN SP FEVER IGM,212.5,106.25,19.35,278.39,108
CPT,86757,ROCKY MTN SP FEVER TITER,275.0,137.5,19.35,266.75,54
CPT,86759,ROTAVIRUS ANTIBODY,,,18.23,36.46,8
CPT,86762,RUBELLA ANTIBODY,199.5,99.75,14.39,218.25,108
CPT,86762,RUBELLA ANTIBODY IGG,157.5,78.75,14.39,206.61,108
CPT,86762,RUBELLA ANTIBODY IGM,213.0,106.5,14.39,206.61,54
CPT,86762,RUBELLA ANTIBODY QUAL,198.0,99.0,14.39,192.06,54
CPT,86765,RUBEOLA ANTIBODY,156.0,78.0,12.88,151.32,54
CPT,86765,RUBEOLA ANTIBODY IGG,179.0,89.5,12.88,195.94,108
CPT,86765,RUBEOLA ANTIBODY IGM,179.0,89.5,12.88,195.94,108
CPT,86768,SALMONELLA ANTIBODY,512.0,256.0,13.19,546.11,108
CPT,86769,SARS-COV-2 COVID-19 ANTIBODY,144.5,72.25,21.6,160.05,108
CPT,86769,SARS-COV-2 COVID-19 ANTIBODY IGA,134.0,67.0,23.34,129.98,108
CPT,86769,SARS-COV-2 COVID-19 ANTIBODY IGG,149.5,74.75,23.34,160.05,108
CPT,86769,SARS-COV-2 COVID-19 ANTIBODY IGM,134.0,67.0,23.34,129.98,108
CPT,86771,SHIGELLA ANTIBODY,,,24.48,48.96,8
CPT,86774,TETANUS ANTIBODY,253.0,126.5,14.8,317.19,108
CPT,86777,TOXOPLASMA ANTIBODY,,,,,0
CPT,86777,TOXOPLASMA ANTIBODY IGG,133.0,66.5,9.23,206.61,108
CPT,86778,TOXOPLASMA ANTIBODY IGM,135.0,67.5,9.92,206.61,108
CPT,86780,TREPONEMA PALLIDUM,,,,,0
CPT,86780,TREPONEMA PALLIDUM ANTIBODY,179.0,89.5,13.24,245.41,216
CPT,86784,TRICHINELLA ANTIBODY,,,,,0
CPT,86784,TRICHINOSIS ANTIBODY,282.0,141.0,12.56,273.54,54
CPT,86787,VARICELLA ZOSTER AB IGG,265.0,132.5,12.88,257.05,108
CPT,86787,VARICELLA ZOSTER AB IGM,265.0,132.5,12.88,257.05,108
CPT,86787,VARICELLA-ZOSTER ANTIBODY,,,,,0
CPT,86788,WEST NILE VIRUS AB IGM,349.5,174.75,16.85,435.53,108
CPT,86789,WEST NILE VIRUS AB IGG,331.0,165.5,14.39,435.53,108
CPT,86789,WEST NILE VIRUS ANTIBODY,,,,,0
CPT,86790,ARBOVIRUS ANTIBODY,754.0,377.0,12.88,731.38,108
CPT,86790,CHIKUNGUNYA AB IGG,646.5,323.25,12.88,731.38,108
CPT,86790,CHIKUNGUNYA AB IGM,646.5,323.25,12.88,731.38,108
CPT,86790,DENGUE FEVER AB,646.5,323.25,12.88,731.38,108
CPT,86790,HTLV I/II ANTIBODY,477.5,238.75,12.88,524.77,108
CPT,86790,HUMAN HERPES VIRUS 6 AB IGG,500.0,250.0,12.88,524.77,108
CPT,86790,HUMAN HERPES VIRUS 6 AB IGM,646.5,323.25,12.88,731.38,108
CPT,86790,MUD ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED NHCI,282.0,141.0,12.88,273.54,53
CPT,86790,VIRUS ANTIBODY NOS,,,,,0
CPT,86793,YERSINIA ANTIBODY,,,13.19,26.38,8
CPT,86794,ZIKA VIRUS IGM ANTIBODY,489.0,244.5,16.85,474.33,54
CPT,86794,ZIKA VIRUS MAC-ELISA IGM EUA,378.0,189.0,16.85,366.66,54
CPT,867T,"Transperineal laser ablation of benign prostatic hyperplasia, including imaging guidance; prostate volume greater or equal to 50 mL",,,5210.39,10420.78,8
CPT,868,ANESTH KIDNEY TRANSPLANT,,,,,0
CPT,86800,THYROGLOBULIN ANTIBODY,148.5,74.25,10.62,228.92,108
CPT,86803,HEPATITIS C AB CONFIRMATION,230.5,115.25,14.27,279.36,108
CPT,86803,HEPATITIS C AB TEST,,,,,0
CPT,86803,HEPATITIS C ANTIBODY,132.0,66.0,9.23,204.67,108
CPT,86803,MUD HEPATITIS C ANTIBODY NHCI,196.0,98.0,14.27,190.12,53
CPT,86804,HEP C AB TEST CONFIRM,,,,,0
CPT,86804,HEPATITIS C AB RIBA,453.0,226.5,15.49,439.41,108
CPT,86805,LYMPHOCYTOTOXICITY ASSAY,,,189.51,379.02,8
CPT,86806,LYMPHOCYTOTOXICITY ASSAY,,,47.59,95.18,8
CPT,86807,ARC HLA ANTIBODY SCREEN,971.0,485.5,78.65,941.87,54
CPT,86807,CYTOTOXIC ANTIBODY SCREENING,,,,,0
CPT,86807,HLA ANTIBODY SCREEN,971.0,485.5,78.65,941.87,54
CPT,86808,CYTOTOXIC ANTIBODY SCREENING,,,29.68,59.36,8
CPT,86812,HLA B27 SINGLE AG,466.0,233.0,25.81,452.02,54
CPT,86812,HLA TYPING A B OR C,,,,,0
CPT,86813,ARC HLA MATCH PLT FEE,1158.0,579.0,58.0,1123.26,54
CPT,86813,ARC PATIENT HLA TYPINGS,1158.0,579.0,58.0,1123.26,54
CPT,86813,HLA ABC TYPE MULT AG DONOR,1158.0,579.0,58.0,1123.26,54
CPT,86813,HLA ABC TYPE MULT AGS,1158.0,579.0,58.0,1123.26,54
CPT,86813,HLA TYPING A B OR C,,,,,0
CPT,86816,HLA TYPING DR/DQ,,,30.17,60.34,8
CPT,86817,ARC ANTIGEN TYPING FEE/UNIT,568.0,284.0,98.94,550.96,54
CPT,86817,ARC HLA DR TYPING,568.0,284.0,98.94,550.96,54
CPT,86817,HLA DR TYPE MULT AGS,568.0,284.0,98.94,550.96,54
CPT,86817,HLA TYPING DR/DQ,,,,,0
CPT,86821,LYMPHOCYTE CULTURE MIXED,,,36.56,73.12,8
CPT,86825,ALLO-CROSSMATCH BY FLOW,1890.0,945.0,109.49,1833.3,108
CPT,86825,AUTO-CROSSMATCH BY FLOW,1890.0,945.0,109.49,1833.3,108
CPT,86825,HLA X-MATH NON-CYTOTOXIC,,,,,0
CPT,86826,HLA X-MATCH NONCYTOTOXC ADDL,,,36.53,73.06,8
CPT,86828,"HLA CLASS 1,2 ANTIBODY SCREEN",665.5,332.75,57.13,972.91,108
CPT,86828,HLA CLASS I&II ANTIBODY QUAL,,,,,0
CPT,86829,HLA CLASS I/II ANTIBODY QUAL,,,64.19,128.38,8
CPT,86830,HLA CLASS I ANTIBODY ID,1155.0,577.5,95.52,1120.35,108
CPT,86830,HLA CLASS I PHENOTYPE QUAL,,,,,0
CPT,86831,HLA CLASS II ANTIBODY ID,990.0,495.0,81.88,960.3,108
CPT,86831,HLA CLASS II PHENOTYPE QUAL,,,,,0
CPT,86832,"ARC HLA: ANTIBODY IDENTIFICATION, CLASS 1, IGG",1438.0,719.0,234.82,1482.16,108
CPT,86832,HLA CLASS I ANTIBODY HD,3193.0,1596.5,231.33,4906.26,108
CPT,86832,HLA CLASS I C1Q BINDING ASSAY,2791.0,1395.5,290.21,3798.52,108
CPT,86832,HLA CLASS I HIGH DEFIN QUAL,,,,,0
CPT,86833,HLA CLASS II ANTIBODY HD,3213.5,1606.75,232.73,4938.27,108
CPT,86833,HLA CLASS II C1Q BINDING ASSAY,2803.0,1401.5,290.21,3821.8,108
CPT,86833,HLA CLASS II HIGH DEFIN QUAL,,,,,0
CPT,86834,HLA CLASS I SEMIQUANT PANEL,,,357.56,715.12,8
CPT,86835,HLA CLASS II SEMIQUANT PANEL,,,322.96,645.92,8
CPT,86849,ANTI-PHOSPHOLIPID ANALYSIS,557.0,278.5,92.5,565.51,94
CPT,86849,CHRONIC URTICARIA PD-BAT,1013.0,506.5,176.46,982.61,94
CPT,86849,IMMUNOLOGY PROCEDURE,,,,,0
CPT,86850,ANTIBODY SCREEN RBC,295.5,147.75,49.29,298.76,108
CPT,86850,ANTIBODY SCREEN TANGO,215.0,107.5,25.6,274.51,108
CPT,86850,HDN SCREEN,215.0,107.5,25.6,274.51,108
CPT,86850,RBC ANTIBODY SCREEN,209.0,104.5,28.56,246.38,108
CPT,86860,ANTIBODY ELUTION,241.0,120.5,41.98,331.12,54
CPT,86860,ARC ANTIBODY ELUTION,241.0,120.5,41.98,331.12,54
CPT,86860,RBC ANTIBODY ELUTION,,,,,0
CPT,86870,ANTIBODY ID RBC AB EA PANEL,430.0,215.0,74.9,696.64,108
CPT,86870,RBC ANTIBODY IDENTIFICATION,,,,,0
CPT,86880,AHG COOMBS DIRECT,109.0,54.5,18.98,114.66,108
CPT,86880,AHG COOMBS DIRECT NB,109.0,54.5,18.98,114.66,108
CPT,86880,AHG COOMBS DIRECT TANGO NB,186.0,93.0,32.4,180.42,108
CPT,86880,ARC AHG COOMBS DIRECT,91.5,45.75,12.89,114.66,108
CPT,86880,COOMBS TEST DIRECT,,,,,0
CPT,86880,MONOSPECIFIC COOMBS DIR POS,91.5,45.75,12.89,114.66,108
CPT,86880,MONOSPECIFIC COOMBS DIR PRE,91.5,45.75,12.89,114.66,108
CPT,86880,MONOSPECIFIC COOMBS DIRECT,91.5,45.75,12.89,114.66,108
CPT,86885,BLOOD TYPE RH DU,357.0,178.5,62.18,346.29,54
CPT,86885,COOMBS TEST INDIRECT QUAL,,,,,0
CPT,86886,ANTIBODY TITER,180.0,90.0,31.35,331.12,54
CPT,86886,ARC COOMBS TEST INDIR TITER,180.0,90.0,31.35,331.12,54
CPT,86886,COOMBS TEST INDIRECT TITER,,,,,0
CPT,86890,AUTOLOGOUS BLOOD PROCESS,,,,,0
CPT,86890,AUTOLOGOUS UNIT PROCES STORE,635.5,317.75,74.55,817.71,108
CPT,86890,MUD AUTOLOGOUS BLOOD PROCESS NHCI,10596.0,5298.0,165.56,10278.12,53
CPT,86891,AUTOLOGOUS BLOOD OP SALVAGE,,,782.93,1565.86,8
CPT,868T,"High-resolution gastric electrophysiology mapping with simultaneous patient-symptom profiling, with interpretation and report",,,362.62,725.24,8
CPT,86900,BLOOD TYPE ABO,154.0,77.0,26.82,258.58,108
CPT,86900,BLOOD TYPE ABO TANGO,335.0,167.5,58.35,324.95,108
CPT,86900,BLOOD TYPE ABO TANGO NB,335.0,167.5,58.35,324.95,108
CPT,86900,BLOOD TYPE RXN ABO,335.0,167.5,58.35,324.95,108
CPT,86900,BLOOD TYPING SEROLOGIC ABO,168.0,84.0,29.26,258.58,108
CPT,86900,MUD BLOOD TYPING SEROLOGIC ABO NHCI,395.0,197.5,68.8,383.15,53
CPT,86901,BLOOD TYPE RH,68.5,34.25,9.92,77.6,108
CPT,86901,BLOOD TYPE RH TANGO,65.5,32.75,8.88,77.6,108
CPT,86901,BLOOD TYPING SEROLOGIC RH(D),88.0,44.0,15.32,85.36,108
CPT,86901,MUD BLOOD TYPING SEROLOGIC RH(D) NHCI,115.0,57.5,20.03,111.55,53
CPT,86902,ANTIGEN TYPE DONOR BLD,468.0,234.0,81.52,696.64,54
CPT,86902,ARC AG SCREEN REAGENT SER1,468.0,234.0,81.52,696.64,54
CPT,86902,ARC AG SCREEN REAGENT SER2,468.0,234.0,81.52,696.64,54
CPT,86902,ARC AG SCREEN REAGENT SER3,468.0,234.0,81.52,696.64,54
CPT,86902,ARC AG SCREEN REAGENT SER4,468.0,234.0,81.52,696.64,54
CPT,86902,ARC AG SCREEN REAGENT SER5,468.0,234.0,81.52,696.64,54
CPT,86902,ARC C TYPING,935.0,467.5,162.87,906.95,54
CPT,86902,ARC E TYPING,468.0,234.0,81.52,696.64,54
CPT,86902,ARC HIGH INC AG NEG UNIT,935.0,467.5,162.87,906.95,54
CPT,86902,BLOOD TYPE ANTIGEN DONOR EA,,,,,0
CPT,86904,BLOOD TYPING PATIENT SERUM,,,57.33,114.66,8
CPT,86905,BLOOD TYPING RBC ANTIGENS,,,,,0
CPT,86905,BLOOD TYPING RBC ANTIGENS EACH,468.0,234.0,81.52,696.64,108
CPT,86906,ARC RH PHENOTYPE,108.5,54.25,8.88,161.02,108
CPT,86906,BLD TYPING SEROLOGIC RH PHNT,,,,,0
CPT,86910,BLOOD TYPING PATERNITY TEST,,,,,0
CPT,86911,BLOOD TYPING ANTIGEN SYSTEM,,,,,0
CPT,86920,COMPATIBILITY TEST SPIN,,,,,0
CPT,86920,CROSSMATCH IMMED SPIN,249.0,124.5,43.37,331.12,54
CPT,86921,COMPATIBILITY TEST INCUBATE,,,,,0
CPT,86921,CROSSMATCH INCUBATION,182.0,91.0,31.7,331.12,54
CPT,86922,ARC PLATELET XM FEE,269.0,134.5,46.85,331.12,54
CPT,86922,COMPATIBILITY TEST ANTIGLOB,,,,,0
CPT,86922,CROSSMATCH AHG,269.0,134.5,46.85,331.12,54
CPT,86922,CROSSMATCH GEL,269.0,134.5,46.85,331.12,54
CPT,86922,CROSSMATCH PEG,269.0,134.5,46.85,331.12,54
CPT,86923,COMPATIBILITY TEST ELECTRIC,,,,,0
CPT,86923,CROSSMATCH ELECTRONIC,319.0,159.5,55.56,331.12,54
CPT,86927,CRYOPRECIPITATE THAWING,217.0,108.5,37.8,331.12,54
CPT,86927,FROZEN PRODUCT THAWING,217.0,108.5,37.8,331.12,54
CPT,86927,PLASMA FRESH FROZEN,,,,,0
CPT,86930,ARC AUTOLOG PRESURG FROZEN,1277.0,638.5,165.56,1238.69,53
CPT,86930,ARC FREEZING FEE,1277.0,638.5,165.56,1238.69,53
CPT,86930,FROZEN BLOOD PREP,,,,,0
CPT,86931,DEGLYC THAWING FEE,354.0,177.0,61.66,343.38,53
CPT,86931,FROZEN BLOOD THAW,,,,,0
CPT,86932,FROZEN BLOOD FREEZE/THAW,,,36.3,72.6,8
CPT,86940,HEMOLYSINS/AGGLUTININS AUTO,,,,,0
CPT,86940,HEMOLYSINS/AGGLUTININS AUTO SCREEN,286.0,143.0,8.77,277.42,54
CPT,86941,HEMOLYSINS/AGGLUTININS,,,,,0
CPT,86941,HEMOLYSINS/AGGLUTININS INCUBATED,311.0,155.5,12.11,301.67,54
CPT,86945,BLOOD PRODUCT/IRRADIATION,,,,,0
CPT,86945,IRRADIATION OF BLD PRODUCT,441.0,220.5,36.3,427.77,53
CPT,86950,LEUKACYTE TRANSFUSION,,,165.56,331.12,8
CPT,86960,VOL REDUCTION OF BLD PRODUCT,2089.0,1044.5,165.56,2026.33,53
CPT,86960,VOL REDUCTION OF BLOOD/PROD,,,,,0
CPT,86965,POOLING BLOOD PLATELETS,,,,,0
CPT,86965,POOLING OF BLD PRODUCTS,186.0,93.0,32.4,331.12,53
CPT,86965,POOLING OF CRYOPRECIPITATE,186.0,93.0,32.4,331.12,53
CPT,86965,POOLING OF PLATELETS,186.0,93.0,32.4,331.12,53
CPT,86970,ARC PRETRE RBC INCUB CHEM,241.0,120.5,41.98,233.77,53
CPT,86970,PRETREAT RBCS CHLOROQUINE,249.0,124.5,43.37,241.53,53
CPT,86970,PRETX RBC ANTIBODY INCUBAT W/CHEM AGNTS/DRUGS EA,293.0,146.5,51.04,284.21,53
CPT,86970,RBC PRETX INCUBATJ W/CHEMICL,,,,,0
CPT,86971,ARC PRETREAT RBCS ENZYME,350.0,175.0,60.97,339.5,53
CPT,86971,PRETREAT RBCS ENZYME,340.0,170.0,59.22,331.12,53
CPT,86971,RBC PRETX INCUBATJ W/ENZYMES,,,,,0
CPT,86972,ARC RETIC SEPARATION,314.0,157.0,54.69,331.12,53
CPT,86972,RBC PRETX INCUBATJ W/DENSITY,,,,,0
CPT,86975,RBC SERUM PRETX INCUBJ DRUGS,511.0,255.5,89.01,868.22,54
CPT,86976,RBC SERUM PRETX ID DILUTION,151.0,75.5,26.3,146.47,54
CPT,86977,PRETREAT W/ SERUM INHIBITOR,1270.0,635.0,165.56,1231.9,53
CPT,86977,RBC SERUM PRETX INCUBJ/INHIB,,,,,0
CPT,86978,ARC RBC PRETREATMENT SERUM,305.0,152.5,53.13,295.85,53
CPT,86978,PRETREAT W/ COLD ABSORPTION,314.0,157.0,54.69,304.58,53
CPT,86978,PRETREAT W/ WARM ABSORPTION,314.0,157.0,54.69,304.58,53
CPT,86978,RBC PRETREATMENT SERUM,,,,,0
CPT,86985,SPLIT BLOOD OR PRODUCTS,,,,,0
CPT,86985,SPLITTING OF BLOOD PRODUCTS,1867.0,933.5,165.56,1810.99,53
CPT,86999,MUD INFECTIOUS DISEASE MARKERS RESULTS NHCI,16712.0,8356.0,28.11,16210.64,53
CPT,86999,UNLISTED TRANSFUSION MED PX,,,,,0
CPT,869T,"Injection(s), bone-substitute material for bone and/or soft tissue hardware fixation augmentation, including intraoperative imaging guidance, when performed",,,3179.6,6359.2,8
CPT,86U,NFCT DS BACT&FNG ORG ID 6+,,,200.0,400.0,8
CPT,870,ANESTH BLADDER STONE SURG,,,,,0
CPT,87003,SMALL ANIMAL INOCULATION,,,16.84,33.68,8
CPT,87015,CONCENTRATION INF AGENTS,90.0,45.0,6.68,96.03,108
CPT,87015,SPECIMEN INFECT AGNT CONCNTJ,,,,,0
CPT,87040,BLOOD CULTURE FOR BACTERIA,,,,,0
CPT,87040,CULTURE BLOOD,110.0,55.0,9.4,161.02,108
CPT,87045,CULTURE STOOL,102.5,51.25,7.83,155.2,108
CPT,87045,FECES CULTURE AEROBIC BACT,,,,,0
CPT,87046,CULTURE STOOL ADDL PATHOGENS EA,129.5,64.75,9.44,143.56,108
CPT,87046,CULTURE STOOL CAMPYLOBACTER,115.0,57.5,9.44,112.52,108
CPT,87046,CULTURE STOOL VIBRIO,115.0,57.5,9.44,112.52,108
CPT,87046,CULTURE STOOL YERSINIA,131.0,65.5,9.44,143.56,108
CPT,87046,STOOL CULTR AEROBIC BACT EA,,,,,0
CPT,87070,CULTURE AEROBIC,135.5,67.75,8.62,134.83,108
CPT,87070,CULTURE BODY FLUID,132.0,66.0,8.62,134.83,108
CPT,87070,CULTURE BORDETELLA PERTUSIS,219.0,109.5,8.62,212.43,54
CPT,87070,CULTURE CATHRETER TIP,139.0,69.5,8.62,134.83,54
CPT,87070,CULTURE CSF,121.5,60.75,8.62,134.83,108
CPT,87070,CULTURE DIALYSIS,226.0,113.0,8.62,219.22,54
CPT,87070,CULTURE ENVIRONMENTAL,226.0,113.0,8.62,219.22,54
CPT,87070,CULTURE HA FLUID,226.0,113.0,8.62,219.22,54
CPT,87070,CULTURE MAKI TECHNIQUE,172.0,86.0,8.62,166.84,54
CPT,87070,CULTURE NASOPHARYNX,139.0,69.5,8.62,134.83,54
CPT,87070,CULTURE OTHR SPECIMN AEROBIC,,,,,0
CPT,87070,CULTURE RESPIRATORY,132.0,66.0,8.62,134.83,108
CPT,87070,CULTURE SPUTUM,165.0,82.5,8.62,219.22,108
CPT,87070,CULTURE THROAT,132.0,66.0,8.62,134.83,108
CPT,87070,CULTURE UROGENITAL,165.0,82.5,8.62,219.22,108
CPT,87070,CULTURE VENTRICULAR,226.0,113.0,8.62,219.22,54
CPT,87070,CULTURE WOUND,165.0,82.5,8.62,219.22,108
CPT,87071,CULTURE AEROBIC QUANT OTHER,,,,,0
CPT,87071,CULTURE QUANT RESPIRATORY,134.0,67.0,9.89,143.56,108
CPT,87073,CULTURE BACTERIA ANAEROBIC,,,9.66,19.32,8
CPT,87075,CULTR BACTERIA EXCEPT BLOOD,,,,,0
CPT,87075,CULTURE ANAEROBIC,121.0,60.5,9.47,144.53,108
CPT,87075,CULTURE CLOSTRIDUM DIFFICIL,149.0,74.5,9.47,144.53,54
CPT,87076,CULTURE ANAEROBE IDENT EACH,,,,,0
CPT,87076,CULTURE ID ANAEROBIC EA,294.5,147.25,8.08,310.4,108
CPT,87077,CULTURE AEROBIC IDENTIFY,,,,,0
CPT,87077,CULTURE ID AEROBIC EA,236.5,118.25,8.08,302.64,108
CPT,87077,UREASE TEST H PYLORI,312.0,156.0,8.08,302.64,54
CPT,87081,CULTURE ACANTHAMOEBA,222.0,111.0,6.63,215.34,54
CPT,87081,CULTURE BRUCELLA,222.0,111.0,6.63,215.34,54
CPT,87081,CULTURE FLUOROQUINOLONE RESIST GNR,282.0,141.0,6.63,273.54,108
CPT,87081,CULTURE GC,255.0,127.5,6.63,279.36,108
CPT,87081,CULTURE GROUP B STREP,288.0,144.0,6.63,279.36,54
CPT,87081,CULTURE GRP A STREP SCRN,288.0,144.0,6.63,279.36,54
CPT,87081,CULTURE HELICOBACTER PYLORI,288.0,144.0,6.63,279.36,54
CPT,87081,CULTURE LEGIONELLA,222.0,111.0,6.63,215.34,54
CPT,87081,CULTURE LEPTOSPIRA,222.0,111.0,6.63,215.34,54
CPT,87081,CULTURE SCREEN ONLY,,,,,0
CPT,87081,CULTURE VRE,205.0,102.5,6.63,198.85,54
CPT,87084,CULTURE OF SPECIMEN BY KIT,,,27.07,54.14,8
CPT,87086,CULTURE URINE W COLONY CT,82.5,41.25,7.83,116.4,108
CPT,87086,URINE CULTURE/COLONY COUNT,,,,,0
CPT,87088,CULTURE URINE PRESUMP ID EA,109.0,54.5,8.09,116.4,108
CPT,87088,URINE BACTERIA CULTURE,,,,,0
CPT,870T,"Implantation of subcutaneous peritoneal ascites pump system, percutaneous, including pump-pocket creation, insertion of tunneled indwelling bladder and peritoneal catheters with pump connections, incl",,,,,0
CPT,87101,CULTURE FUNGUS SK HAIR NAIL,114.5,57.25,7.71,154.23,108
CPT,87101,SKIN FUNGI CULTURE,,,,,0
CPT,87102,CULTURE FUNGUS OTHER SOURCE,219.0,109.5,8.41,212.43,54
CPT,87102,FUNGUS ISOLATION CULTURE,,,,,0
CPT,87103,BLOOD FUNGUS CULTURE,,,,,0
CPT,87103,CULTURE FUNGUS BLOOD,320.0,160.0,20.46,310.4,54
CPT,87106,CULTURE FUNGI ID YEAST,312.0,156.0,10.32,302.64,54
CPT,87106,FUNGI IDENTIFICATION YEAST,,,,,0
CPT,87106,MUD CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST NHCI,437.0,218.5,10.32,423.89,53
CPT,87107,CULTURE FUNGI ID MOLD,802.5,401.25,10.32,1283.31,108
CPT,87107,FUNGI IDENTIFICATION MOLD,,,,,0
CPT,87109,CULTURE MYCOPLASMA PNEUMO,230.0,115.0,15.39,223.1,54
CPT,87109,CULTURE MYCOPLASMA UROGEN,308.0,154.0,15.39,298.76,54
CPT,87109,MYCOPLASMA,,,,,0
CPT,87110,CHLAMYDIA CULTURE,,,,,0
CPT,87110,CULTURE CHLAMYDIA,290.0,145.0,19.6,281.3,54
CPT,87116,CULTURE AFB W/ SMEAR,102.5,51.25,7.49,157.14,108
CPT,87116,MYCOBACTERIA CULTURE,145.0,72.5,10.8,155.2,108
CPT,87118,MYCOBACTERIC IDENTIFICATION,,,,,0
CPT,87118,ORGANISM ID MYCOBACTERIA,454.0,227.0,14.61,440.38,54
CPT,87140,C TRACHOMATIS CULT TYPING,75.0,37.5,5.57,80.51,108
CPT,87140,CULTURE TYPE IMMUNOFLUORESC,,,,,0
CPT,87143,CULTURE TYPING GLC/HPLC,96.5,48.25,7.14,147.44,108
CPT,87147,CULTURE TYPE IMMUNOLOGIC,,,,,0
CPT,87147,HAEMOPHILUS SEROGROUPING,103.0,51.5,5.18,99.91,54
CPT,87147,SEROLOGICAL TYPING,103.0,51.5,5.18,99.91,54
CPT,87147,STAPH SEROLOGIC SPECIATION,77.0,38.5,5.18,74.69,54
CPT,87147,STREP SEROLOGIC SPECIATION,77.0,38.5,5.18,74.69,54
CPT,87149,CULTURE ID AFB,298.0,149.0,20.05,289.06,54
CPT,87149,DNA/RNA DIRECT PROBE,,,,,0
CPT,87150,DNA/RNA AMPLIFIED PROBE,,,,,0
CPT,87150,DNA/RNA AMPLIFIED PROBE CULTURE,474.0,237.0,17.42,822.56,108
CPT,87152,CULTURE TYPE PULSE FIELD GEL,,,7.74,15.48,8
CPT,87153,DNA/RNA SEQUENC CULTURE T E ISOLAT,1598.5,799.25,115.36,1747.94,108
CPT,87153,DNA/RNA SEQUENCING,,,,,0
CPT,87154,CUL TYP ID BLD PTHGN 6+ TRGT,2252.0,1126.0,191.27,3303.82,108
CPT,87158,CULTURE TYPING ADDED METHOD,85.5,42.75,7.74,115.43,108
CPT,87164,DARK FIELD EXAMINATION,,,10.74,21.48,8
CPT,87166,DARK FIELD EXAMINATION,,,11.3,22.6,8
CPT,87168,MACRO PARASITE EXAM ARTHROPOD,102.0,51.0,4.27,104.76,108
CPT,87168,MACROSCOPIC EXAM ARTHROPOD,,,,,0
CPT,87169,MACRO PARASITE EXAM WORM,83.0,41.5,4.31,99.91,108
CPT,87169,MACROSCOPIC EXAM PARASITE,,,,,0
CPT,87172,PINWORM EXAM,,,,,0
CPT,87172,PINWORM PREP,67.0,33.5,4.27,64.99,54
CPT,87176,TISSUE HOMOGENIZATION CULTR,,,,,0
CPT,87176,TISSUE HOMOGENIZE FOR CULT,175.0,87.5,5.88,169.75,54
CPT,87177,OVA & PARASITES SMEAR,108.5,54.25,8.9,131.92,108
CPT,87177,OVA AND PARASITES SMEARS,,,,,0
CPT,87181,MICROBE SUSCEPTIBLE DIFFUSE,,,,,0
CPT,87181,SUSCEPT BY AGAR DILUTION,70.0,35.0,4.75,67.9,54
CPT,87184,MICROBE SUSCEPTIBLE DISK,,,,,0
CPT,87184,SUSCEPT BY KB DISK METHOD,111.0,55.5,7.48,107.67,54
CPT,87184,SUSCEPT KB FOR ESBL,81.0,40.5,7.48,107.67,108
CPT,87184,SUSCEPT MIC ANAEROBE,139.0,69.5,7.48,134.83,54
CPT,87185,MICROBE SUSCEPTIBLE ENZYME,,,,,0
CPT,87185,SUSCEPT ENZYME BETA LAC,70.0,35.0,4.75,67.9,54
CPT,87186,MICROBE SUSCEPTIBLE MIC,,,,,0
CPT,87186,SUSCEPT MIC ETEST,450.0,225.0,8.65,648.93,108
CPT,87186,SUSCEPT MIC METHOD,669.0,334.5,8.65,648.93,108
CPT,87187,MICROBE SUSCEPTIBLE MLC,,,40.17,80.34,8
CPT,87188,MICROBE SUSCEPT MACROBROTH,454.0,227.0,6.64,440.38,108
CPT,87188,SUSCEPTIBILITY BROTH METHOD EA,388.5,194.25,6.64,440.38,108
CPT,87190,MICROBE SUSCEPT MYCOBACTERI,284.0,142.0,7.31,275.48,108
CPT,87190,SUSCEPT MYCOBACT PROP METHOD EA,138.0,69.0,7.31,166.84,108
CPT,87197,BACTERICIDAL LEVEL SERUM,,,15.02,30.04,8
CPT,871T,"Replacement of a subcutaneous peritoneal ascites pump, including reconnection between pump and indwelling bladder and peritoneal catheters, including initial programming and imaging, when performed",,,,,0
CPT,872,ANESTH KIDNEY STONE DESTRUCT,,,,,0
CPT,87205,SMEAR EOSINOPHILS IN URINE,81.0,40.5,4.27,90.21,108
CPT,87205,SMEAR GRAM STAIN,51.5,25.75,4.27,66.93,108
CPT,87206,SMEAR ACID FAST BACILLI,58.0,29.0,5.39,80.51,108
CPT,87206,SMEAR CRYPTOSPORIDIUM,100.0,50.0,5.39,131.92,108
CPT,87206,SMEAR FLUORESCENT/ACID STAI,,,,,0
CPT,87206,SMEAR FUNGUS,76.5,38.25,5.39,80.51,108
CPT,87207,SMEAR BLOOD MALARIA,86.0,43.0,5.99,92.15,108
CPT,87207,SMEAR SPECIAL STAIN,,,,,0
CPT,87209,SMEAR COMPLEX STAIN,,,,,0
CPT,87209,SMEAR TRICHROME OVA PARASIT,195.0,97.5,17.98,273.54,108
CPT,87210,POC FERN TEST AMNIOTIC FLD,87.0,43.5,5.82,84.39,54
CPT,87210,SMEAR FERN TEST,123.0,61.5,5.82,119.31,54
CPT,87210,SMEAR INDIA INK,123.0,61.5,5.82,119.31,54
CPT,87210,SMEAR KOH PREP,123.0,61.5,5.82,119.31,54
CPT,87210,SMEAR WET MOUNT SALINE/INK,,,,,0
CPT,87210,SMEAR WET PREP SCREEN,63.5,31.75,5.82,84.39,108
CPT,87220,SLIDE KOH SKIN HAIR NAILS,109.0,54.5,4.27,105.73,54
CPT,87220,TISSUE EXAM FOR FUNGI,,,,,0
CPT,87230,ASSAY TOXIN OR ANTITOXIN,,,,,0
CPT,87230,CLOSTRIDIUM DIFFICILE TOXIN,189.0,94.5,14.8,284.21,108
CPT,87250,VIRUS INOCULATE EGGS/ANIMAL,,,19.56,39.12,8
CPT,87252,CULTURE CYTOMEGALOVIRUS,387.0,193.5,26.07,375.39,54
CPT,87252,CULTURE VARICELLA ZOSTER,254.5,127.25,21.25,375.39,108
CPT,87252,CULTURE VIRUS COMPREHENSIVE,402.0,201.0,26.07,404.49,108
CPT,87252,VIRUS INOCULATION TISSUE,,,,,0
CPT,87253,VIRUS INOCULATE TISSUE ADDL,,,,,0
CPT,87253,VIRUS ISOLATION TISSUE ADDL,378.0,189.0,20.2,366.66,54
CPT,87254,VIRUS INOCULATION SHELL VIA,,,,,0
CPT,87254,VIRUS ISOLATION SHELL VIAL1,288.0,144.0,19.56,307.49,108
CPT,87254,VIRUS ISOLATION SHELL VIAL2,395.0,197.5,19.56,383.15,54
CPT,87254,VIRUS ISOLATION SHELL VIAL3,395.0,197.5,19.56,383.15,54
CPT,87255,CULTURE HERPES,456.0,228.0,33.86,486.94,108
CPT,87255,GENET VIRUS ISOLATE HSV,,,,,0
CPT,87255,VIRUS ISOLATION BY ENZ ACTIVITY,487.0,243.5,33.86,547.08,108
CPT,87260,ADENOVIRUS AG DFA,223.0,111.5,14.43,216.31,54
CPT,87260,ADENOVIRUS AG IF,,,,,0
CPT,87265,BORDETELLA PERTUSSIS AG DFA,241.0,120.5,11.98,233.77,54
CPT,87265,PERTUSSIS AG IF,,,,,0
CPT,87267,ENTEROVIRUS ANTIBODY DFA,,,13.42,26.84,8
CPT,87269,GIARDIA AG IF,,,13.61,27.22,8
CPT,87270,& CHLAMYDIA AG DFA,241.0,120.5,11.98,233.77,54
CPT,87270,CHLAMYDIA TRACHOMATIS AG IF,,,,,0
CPT,87271,CYTOMEGALOVIRUS AG DFA,241.0,120.5,13.42,233.77,54
CPT,87271,CYTOMEGALOVIRUS DFA,,,,,0
CPT,87272,CRYPTOSPORIDIUM AG IF,,,11.98,23.96,8
CPT,87273,HERPES SIMPLEX 2 AG IF,,,11.98,23.96,8
CPT,87274,HERPES SIMPLEX 1 AG IF,,,11.98,23.96,8
CPT,87275,INFLUENZA B AG DFA,183.0,91.5,12.25,177.51,54
CPT,87275,INFLUENZA B AG IF,,,,,0
CPT,87276,INFLUENZA A AG DFA,238.0,119.0,16.07,230.86,54
CPT,87276,INFLUENZA A AG IF,,,,,0
CPT,87278,LEGION PNEUMOPHILIA AG IF,,,,,0
CPT,87278,LEGIONELLA AG DFA,232.0,116.0,15.6,225.04,54
CPT,87279,PARAINFLUENZA 1 AG DFA,228.0,114.0,16.43,221.16,54
CPT,87279,PARAINFLUENZA 123 AG DFA,243.0,121.5,16.43,235.71,54
CPT,87279,PARAINFLUENZA 2 AG DFA,228.0,114.0,16.43,221.16,54
CPT,87279,PARAINFLUENZA 3 AG DFA,228.0,114.0,16.43,221.16,54
CPT,87279,PARAINFLUENZA AG IF,,,,,0
CPT,87280,RESP SYNCYTIAL VIRUS AG DFA,200.0,100.0,13.42,194.0,54
CPT,87280,RESPIRATORY SYNCYTIAL AG IF,,,,,0
CPT,87281,PNEUMOCYSTIS CARINII AG DETECTION,162.5,81.25,11.98,173.63,108
CPT,87281,PNEUMOCYSTIS CARINII AG IF,,,,,0
CPT,87283,RUBEOLA AG IF,,,60.8,121.6,8
CPT,87285,TREPONEMA PALLIDUM AG IF,,,12.18,24.36,8
CPT,87290,VARICELLA ZOSTER AG IF,,,13.42,26.84,8
CPT,87299,ANTIBODY DETECTION NOS IF,,,,,0
CPT,87299,INFECT AGENT AG DFA NOS,241.0,120.5,16.1,233.77,54
CPT,872T,"Replacement of indwelling bladder and peritoneal catheters, including tunneling of catheter(s) and connection with previously implanted peritoneal ascites pump, including imaging and programming, when",,,,,0
CPT,873,ANESTH KIDNEY STONE DESTRUCT,,,,,0
CPT,87300,AG DETECTION POLYVAL IF,,,,,0
CPT,87300,HERPES SIMPLEX VIRUS DFA,260.0,130.0,11.98,252.2,54
CPT,87301,ADENOVIRUS AG IA,,,11.98,23.96,8
CPT,87305,ASPERGILLUS AG EIA,348.5,174.25,11.98,440.38,108
CPT,87305,ASPERGILLUS AG IA,,,,,0
CPT,87320,CHLMYD TRACH AG IA,,,15.0,30.0,8
CPT,87324,CLOSTRIDIUM AG IA,,,,,0
CPT,87324,CLOSTRIDIUM DIFFICILE TOXIN,115.0,57.5,8.88,173.63,108
CPT,87327,CRYPTOCOCCUS NEOFORM AG IA,,,13.42,26.84,8
CPT,87328,CRYPTOSPORIDIUM AG EIA,333.0,166.5,13.82,323.01,54
CPT,87328,CRYPTOSPORIDIUM AG IA,,,,,0
CPT,87329,GIARDIA AG BY EIA,168.0,84.0,11.98,173.63,108
CPT,87329,GIARDIA AG IA,,,,,0
CPT,87332,CYOMEGALOVIRUS AG EIA,241.0,120.5,11.98,233.77,54
CPT,87332,CYTOMEGALOVIRUS AG IA,,,,,0
CPT,87335,E COLI 0157 AG IA,,,12.66,25.32,8
CPT,87336,ENTAMOEB HIST DISPR AG IA,,,16.0,32.0,8
CPT,87337,ENTAMOEB HIST GROUP AG IA,,,,,0
CPT,87337,ENTAMOEBA HISTOLYTICA GROUP,248.5,124.25,11.98,328.83,108
CPT,87338,HELICOBACTOR PYLORI AG EIA,210.5,105.25,14.38,206.61,108
CPT,87338,HPYLORI STOOL AG IA,,,,,0
CPT,87339,H PYLORI AG IA,,,16.0,32.0,8
CPT,87340,HEP B SURFACE AG PRENATAL,166.5,83.25,10.33,173.63,108
CPT,87340,HEP B SURFACE ANTIGEN,132.0,66.0,10.33,149.38,108
CPT,87340,HEPATITIS B SURFACE AG IA,101.0,50.5,7.14,156.17,108
CPT,87340,MUD HEPATITIS B SURFACE AG IA NHCI,140.0,70.0,10.33,135.8,53
CPT,87341,HEP B SURFACE AG NEUTR,157.5,78.75,10.33,184.3,108
CPT,87341,HEP B SURFACE AG NEUTRLZJ IA,,,,,0
CPT,87350,HEP BE ANTIGEN,163.5,81.75,11.53,174.6,108
CPT,87350,HEPATITIS BE AG IA,,,,,0
CPT,87380,HEP DELTA AGENT AG EIA,294.0,147.0,18.36,334.65,108
CPT,87380,HEPATITIS DELTA AGENT AG IA,,,,,0
CPT,87385,HISTOPLASMA AG URINE,343.0,171.5,13.25,332.71,54
CPT,87385,HISTOPLASMA CAPSUL AG IA,,,,,0
CPT,87389,HIV-1 AG W/HIV-1 & HIV-2 AB,225.0,112.5,16.02,347.26,108
CPT,87389,HIV-1 AG W/HIV-1&-2 AB AG IA,,,,,0
CPT,87390,HIV ANTIGEN,331.0,165.5,24.06,321.07,54
CPT,87390,HIV-1 AG IA,,,,,0
CPT,87391,HIV-2 AG IA,,,21.9,43.8,8
CPT,873T,"Revision of a subcutaneously implanted peritoneal ascites pump system, any component (ascites pump, associated peritoneal catheter, associated bladder catheter), including imaging and programming, whe",,,,,0
CPT,87400,INFLUENZA A/B EACH AG IA,,,,,0
CPT,87400,INFLUENZA SCREEN A (COMBO),250.0,125.0,14.13,242.5,54
CPT,87400,INFLUENZA SCREEN B (COMBO),250.0,125.0,14.13,242.5,54
CPT,87420,RESP SYNCYTIAL VIRUS AG IA,,,,,0
CPT,87420,RSV DIRECT ANTIGEN EIA,260.0,130.0,13.91,252.2,54
CPT,87425,ROTAVIRUS AG BY EIA,259.0,129.5,11.98,251.23,54
CPT,87425,ROTAVIRUS AG IA,,,,,0
CPT,87426,SARSCOV CORONAVIRUS AG IA,427.0,213.5,35.33,414.19,54
CPT,87427,E COLI TOXIN BY EIA,116.5,58.25,7.83,182.36,108
CPT,87427,SHIGA-LIKE TOXIN AG IA,,,,,0
CPT,87428,IAAD IA SARSCOV & INFLUENZA VIRUS TYPES A&B,152.05,76.03,26.48,147.48,54
CPT,87428,POC SARSCOV & INFLUENZA VIRUS A&B,77.5,38.75,13.06,140.58,108
CPT,87428,SARSCOV & INF VIR A&B AG IA,,,,,0
CPT,87430,DIR STREP GRP A RAPID TEST,151.5,75.75,9.23,242.5,108
CPT,87430,STREP A AG IA,,,,,0
CPT,87449,ASPERGILLUS GALACTOMAN AG,504.0,252.0,11.98,488.88,54
CPT,87449,CLOSTRIDIUM DIFFICILE GDH ANTIGEN,484.5,242.25,11.98,631.47,108
CPT,87449,FUNGITELL INFECT AGENT AG,595.5,297.75,11.98,631.47,108
CPT,87449,LEGIONELLA AG URINE EIA NOS,651.0,325.5,11.98,631.47,54
CPT,87449,NOS EACH ORGANISM AG IA,,,,,0
CPT,87449,STREP PNEUMO UR AG EIA NOS,398.0,199.0,11.98,386.06,54
CPT,87451,POLYVALENT MULT ORG EA AG IA,,,10.51,21.02,8
CPT,87467,HEPATITIS B SURFACE AG QUAN,,,25.32,50.64,8
CPT,87468,ANAPLSMA PHGCYTOPHLM AMP PRB,489.0,244.5,35.09,541.26,108
CPT,87469,BABESIA MICROTI AMP PRB,921.0,460.5,35.09,893.37,54
CPT,87471,B HENSELAE & QUINTANA AMP DNA,1020.0,510.0,35.09,989.4,108
CPT,87471,BARTONELLA DNA AMP PROBE,,,,,0
CPT,87472,BARTONELLA DNA QUANT,,,42.84,85.68,8
CPT,87475,LYME DIS DNA DIR PROBE,,,20.05,40.1,8
CPT,87476,LYME DIS DNA AMP PROBE,,,,,0
CPT,87476,LYME DISEASE PCR FLUID,472.0,236.0,35.09,504.4,108
CPT,87478,BORRELIA MIYAMOTOI AMP PRB,,,35.09,70.18,8
CPT,87480,CANDIDA DNA DIR PROBE,243.0,121.5,20.05,235.71,54
CPT,87481,CANDIDA DNA AMP PROBE,,,,,0
CPT,87481,CANDIDA SPECIES AMP DNA,610.5,305.25,35.09,773.09,108
CPT,87482,CANDIDA DNA QUANT,,,55.74,111.48,8
CPT,87483,CNS DNA AMP PROBE TYPE 12-25,,,,,0
CPT,87483,CNS DNA/RNA AMP PROBE MULTIPLE SUBTYPES 12-25,3918.0,1959.0,230.98,6314.7,108
CPT,87484,EHRLICHA CHAFFEENSIS AMP PRB,129.0,64.5,22.47,125.13,54
CPT,87485,CHLMYD PNEUM DNA DIR PROBE,,,20.05,40.1,8
CPT,87486,CHLAMYDIA PNEUMONIAE PCR,475.5,237.75,35.09,629.53,108
CPT,87486,CHLMYD PNEUM DNA AMP PROBE,,,,,0
CPT,87487,CHLMYD PNEUM DNA QUANT,,,42.84,85.68,8
CPT,87490,CHLMYD TRACH DNA DIR PROBE,,,22.75,45.5,8
CPT,87491,C TRACHOMATIS DIRECT PROBE,270.0,135.0,19.16,417.1,108
CPT,87491,CHLAMYDIA TRACHOMAT AMP DNA,419.0,209.5,35.09,417.1,108
CPT,87491,CHLMYD TRACH DNA AMP PROBE,,,,,0
CPT,87492,CHLMYD TRACH DNA QUANT,,,53.47,106.94,8
CPT,87493,C DIFF AMPLIFIED PROBE,,,,,0
CPT,87493,CLOSTRIDIUM DIFFICI AMP DNA,471.5,235.75,37.27,536.41,108
CPT,87493,CLOSTRIDIUM DIFFICILE PCR,1691.0,845.5,37.27,2204.81,108
CPT,87495,CYTOMEG DNA DIR PROBE,,,30.03,60.06,8
CPT,87496,CYTOMEG DNA AMP PROBE,,,,,0
CPT,87496,CYTOMEGALOVIRUS AMP DNA,792.5,396.25,35.09,866.21,108
CPT,87497,CYTOMEG DNA QUANT,,,,,0
CPT,87497,CYTOMEGALOVIRUS QUANT PCR,843.0,421.5,42.84,1165.94,108
CPT,87498,ENTEROVIRUS BY PCR,783.0,391.5,35.09,759.51,54
CPT,87498,ENTEROVIRUS PROBE&REVRS TRNS,,,,,0
CPT,874T,"Removal of a peritoneal ascites pump system, including implanted peritoneal ascites pump and indwelling bladder and peritoneal catheters",,,,,0
CPT,87500,VANOMYCIN DNA AMP PROBE,,,35.09,70.18,8
CPT,87501,INFLUENZA A H1N1 RT PCR,894.0,447.0,51.31,1131.99,108
CPT,87501,INFLUENZA DNA AMP PROB 1+,,,,,0
CPT,87502,INFLUENZA A/B PCR,728.0,364.0,77.34,981.64,108
CPT,87502,INFLUENZA DNA AMP PROBE,,,,,0
CPT,87503,INFLUENZA DNA AMP PROB ADDL,,,,,0
CPT,87503,INFLUENZA DNA AMP PROB EA ADDL,271.0,135.5,29.22,271.6,108
CPT,87505,NFCT AGENT DETECTION GI,980.5,490.25,71.24,1505.44,108
CPT,87506,GASTRO PATHOGEN 6-7 TARGETS,4015.0,2007.5,262.99,4704.5,108
CPT,87506,IADNA-DNA/RNA PROBE TQ 6-11,,,,,0
CPT,87507,GI PANEL STOOL PCR 12-25 TARGETS,3445.0,1722.5,275.23,5150.7,108
CPT,87507,IADNA-DNA/RNA PROBE TQ 12-25,,,,,0
CPT,87510,GARDNER VAG DNA DIR PROBE,243.0,121.5,20.05,235.71,54
CPT,87511,GARDNER VAG DNA AMP PROBE,,,35.09,70.18,8
CPT,87512,GARDNER VAG DNA QUANT,,,41.76,83.52,8
CPT,87513,"Infectious agent detection by nucleic acid (DNA or RNA); Helicobacter pylori (H. pylori), clarithromycin resistance, amplified probe technique",,,35.09,70.18,8
CPT,87516,HEP B VIRUS DNA,1048.0,524.0,35.09,1016.56,54
CPT,87516,HEPATITIS B DNA AMP PROBE,,,,,0
CPT,87517,HEP B VIRUS DNA QNT,773.0,386.5,42.84,749.81,108
CPT,87517,HEPATITIS B DNA QUANT,,,,,0
CPT,87520,HEPATITIS C RNA DIR PROBE,,,31.22,62.44,8
CPT,87521,HEP C VIRUS AMP PROBE,433.5,216.75,35.09,429.71,108
CPT,87521,HEPATITIS C PROBE&RVRS TRNSC,,,,,0
CPT,87521,MUD HEPATITIS C PROBE&RVRS TRNSC NHCI,479.0,239.5,35.09,464.63,53
CPT,87522,HEP C VIRUS QUANTASURE,1167.5,583.75,42.84,1163.03,108
CPT,87522,HEP C VIRUS RNA BDNA,1005.0,502.5,42.84,1163.03,108
CPT,87522,HEPATITIS C QUANT & REVERSE TRANSCR,1005.5,502.75,42.84,1163.03,108
CPT,87522,HEPATITIS C REVRS TRNSCRPJ,,,,,0
CPT,87523,HEPATITIS D QUANTIFICATION,,,42.84,85.68,8
CPT,87525,HEPATITIS G DNA DIR PROBE,,,29.8,59.6,8
CPT,87526,HEPATITIS G DNA AMP PROBE,,,39.26,78.52,8
CPT,87527,HEPATITIS G DNA QUANT,,,41.76,83.52,8
CPT,87528,HSV DNA DIR PROBE,,,20.05,40.1,8
CPT,87529,HSV AMP PROBE PCR TYPE 1,978.5,489.25,35.09,1144.6,108
CPT,87529,HSV AMP PROBE PCR TYPE 2,978.5,489.25,35.09,1144.6,108
CPT,87529,HSV DNA AMP PROBE,,,,,0
CPT,87529,HSV PCR,777.0,388.5,35.09,753.69,54
CPT,87530,HSV B QUANT TYPE 2,660.0,330.0,42.84,640.2,54
CPT,87530,HSV DNA QUANT,,,,,0
CPT,87530,HSV QUANT TYPE 1,660.0,330.0,42.84,640.2,54
CPT,87530,HSV QUANT TYPE 2,854.0,427.0,42.84,828.38,54
CPT,87531,HHV-6 DNA DIR PROBE,,,58.0,116.0,8
CPT,87532,HHV 6 AB IGG LC138479,781.0,390.5,35.09,757.57,54
CPT,87532,HHV-6 DNA AMP PROBE,,,,,0
CPT,87533,HERPES VIRUS-6 QUANT,1234.0,617.0,41.76,1278.46,108
CPT,87533,HHV-6 DNA QUANT,,,,,0
CPT,87534,HIV-1 DNA DIR PROBE,,,21.92,43.84,8
CPT,87535,HIV 1 PROBE&REVERSE TRNSCRP,235.0,117.5,21.94,333.68,108
CPT,87535,HIV DNA PCR /NEWBORN,424.0,212.0,35.09,411.28,108
CPT,87535,HIV-1 PROBE&REVERSE TRNSCRPJ,,,,,0
CPT,87535,MUD HIV-1 PROBE&REVERSE TRNSCRP NHCI,2408.0,1204.0,35.09,2335.76,53
CPT,87536,HIV 1 RNA QUANT PCR,1307.0,653.5,85.1,1881.8,108
CPT,87536,HIV-1 QUANT&REVRSE TRNSCRPJ,,,,,0
CPT,87537,HIV-2 DNA DIR PROBE,,,21.92,43.84,8
CPT,87538,HIV-2 PROBE&REVRSE TRNSCRIPJ,341.0,170.5,23.34,531.56,108
CPT,87539,HIV-2 QUANT&REVRSE TRNSCRIPJ,,,,,0
CPT,87539,HIV-2 QUANTIFICATION,840.0,420.0,58.62,942.84,108
CPT,87540,LEGION PNEUMO DNA DIR PROB,,,20.05,40.1,8
CPT,87541,IADNA LEGIONELLA PNEUMOPHILA AMPLIFIED PROBE TQ,811.5,405.75,35.09,975.82,108
CPT,87541,LEGION PNEUMO DNA AMP PROB,,,,,0
CPT,87542,LEGION PNEUMO DNA QUANT,,,41.76,83.52,8
CPT,87550,MYCOBACTERIA DNA DIR PROBE,,,,,0
CPT,87550,MYCOBACTERIUM DIRECT PROBE,457.0,228.5,20.05,443.29,54
CPT,87551,MYCOBACTERIA DNA AMP PROBE,,,48.24,96.48,8
CPT,87552,MYCOBACTERIA DNA QUANT,,,42.84,85.68,8
CPT,87555,M.TUBERCULO DNA DIR PROBE,,,,,0
CPT,87555,MYCOBACTERIA TB DIR PROBE,361.0,180.5,26.88,350.17,54
CPT,87556,M.TUBERCULO DNA AMP PROBE,630.5,315.25,41.68,623.71,108
CPT,87556,MYCOBACTERIUM TB PCR,504.0,252.0,41.68,488.88,54
CPT,87556,MYCOBACTERIUM TB PCR CSF,504.0,252.0,41.68,488.88,54
CPT,87557,M.TUBERCULO DNA QUANT,,,42.84,85.68,8
CPT,87560,M.AVIUM-INTRA DNA DIR PROB,,,,,0
CPT,87560,MYCOBACTERIUM AVIUM PROBE,457.0,228.5,27.29,443.29,54
CPT,87561,M.AVIUM-INTRA DNA AMP PROB,,,35.09,70.18,8
CPT,87562,M.AVIUM-INTRA DNA QUANT,,,42.84,85.68,8
CPT,87563,M. GENITALIUM AMP PROBE,,,35.09,70.18,8
CPT,87564,"Infectious agent detection by nucleic acid (DNA or RNA); Mycobacterium tuberculosis, rifampin resistance, amplified probe technique",,,,,0
CPT,87564,MTB RIFAMPIN RST AMP PRB TQ,496.5,248.25,45.29,711.01,108
CPT,87580,M.PNEUMON DNA DIR PROBE,,,20.05,40.1,8
CPT,87581,M PNEUMONIAE AMP PCR,867.5,433.75,35.09,915.68,108
CPT,87581,M.PNEUMON DNA AMP PROBE,,,,,0
CPT,87582,M.PNEUMON DNA QUANT,,,302.62,605.24,8
CPT,87590,N.GONORRHOEAE DNA DIR PROB,,,26.88,53.76,8
CPT,87591,N GONORRHOEAE AMP PROBE,270.0,135.0,19.16,417.1,108
CPT,87591,N.GONORRHOEAE DNA AMP PROB,,,,,0
CPT,87592,N.GONORRHOEAE DNA QUANT,,,42.84,85.68,8
CPT,87593,IAD NUCLEIC ACID ORTHOPOXVIRUS AMP PRB EACH,334.5,167.25,45.46,395.76,108
CPT,87593,ORTHOPOXVIRUS AMP PRB EACH,,,,,0
CPT,87594,"Infectious agent detection by nucleic acid (DNA or RNA); Pneumocystis jirovecii, amplified probe technique",,,35.09,70.18,8
CPT,875T,Programming of subcutaneously implanted peritoneal ascites pump system by physician or other qualified health care professional,,,,,0
CPT,87623,HPV LOW RISK TYPES,267.5,133.75,19.33,411.28,108
CPT,87623,HPV LOW-RISK TYPES,,,,,0
CPT,87624,HPV HIGH-RISK TYPES,374.5,187.25,35.09,504.4,108
CPT,87625,HPV TYPES 16 & 18 ONLY,291.5,145.75,16.72,472.39,108
CPT,87626,HPV SEP HI-RSK TYP&POOL RSLT,504.5,252.25,58.87,650.87,108
CPT,87626,"Infectious agent detection by nucleic acid (DNA or RNA); Human Papillomavirus (HPV), separately reported high-risk types (eg, 16, 18, 31, 45, 51, 52) and high-risk pooled result(s)",,,,,0
CPT,87631,RESP VIRUS 3-5 TARGETS,1725.0,862.5,142.63,1673.25,108
CPT,87632,RESP VIRUS 6-11 TARGETS,2637.0,1318.5,218.06,2557.89,54
CPT,87633,RESP VIRUS 12-25 TARGETS,,,,,0
CPT,87633,RESP VIRUS PCR,3258.5,1629.25,257.29,4888.8,108
CPT,87634,RSV DNA/RNA AMP PROBE,982.5,491.25,70.2,1082.52,108
CPT,87635,SARS-COV-2 COVID-19 AMP PRB,,,,,0
CPT,87635,SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,153.5,76.75,24.38,161.99,108
CPT,87636,IADNA SARSCOV2& INF A&B MULT AMP PRB TQ,1170.0,585.0,107.13,1673.25,108
CPT,87636,SARSCOV2 & INF A&B AMP PRB,,,,,0
CPT,87637,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,653.5,326.75,107.13,671.24,108
CPT,87637,SARSCOV2&INF A&B&RSV AMP PRB,,,,,0
CPT,87640,STAPH A DNA AMP PROBE,,,35.09,70.18,8
CPT,87641,MR-STAPH DNA AMP PROBE,,,35.09,70.18,8
CPT,87650,STREP A DIRECT DNA PROBE,350.5,175.25,20.05,444.26,108
CPT,87650,STREP A DNA DIR PROBE,,,,,0
CPT,87651,STREP A DNA AMP PROBE,438.0,219.0,35.09,424.86,54
CPT,87652,STREP A DNA QUANT,,,41.76,83.52,8
CPT,87653,STREP B DNA AMP PROBE,,,,,0
CPT,87653,STREPTOCOCCUS AGALACTIAE AMP PRB PCR,558.0,279.0,35.09,541.26,54
CPT,87660,TRICHOMONAS VAGIN DIR PROBE,243.0,121.5,20.05,235.71,54
CPT,87661,TRICHOMONAS VAGINALIS AMPLIF,,,,,0
CPT,87661,TRICHOMONAS VAGINALIS NAA,324.5,162.25,25.95,485.0,108
CPT,87662,ZIKA VIRUS DNA/RNA AMP PROBE,,,,,0
CPT,87662,ZIKA VIRUS NAA SERUM,679.5,339.75,51.31,715.86,108
CPT,87662,ZIKA VIRUS NAA URINE,679.5,339.75,51.31,715.86,108
CPT,876T,"Duplex scan of hemodialysis fistula, computer-aided, limited (volume flow, diameter, and depth, including only body of fistula)",,,,,0
CPT,87797,DETECT AGENT NOS DNA DIR,,,30.03,60.06,8
CPT,87798,A PHAGOCYTOPHILUM PCR,787.5,393.75,35.09,1298.83,108
CPT,87798,ADENOVIRUS AMP PRB PCR,986.5,493.25,35.09,1298.83,108
CPT,87798,BABESIA MICROTI PCR,787.5,393.75,35.09,1298.83,108
CPT,87798,BORDETELLA PARAPERTUSIS DNA,1782.5,891.25,35.09,2159.22,108
CPT,87798,BORDETELLA PERTUSSIS DNA,1782.5,891.25,35.09,2159.22,108
CPT,87798,CHIKUNGUNYA VIRUS RNA QI PCR,706.0,353.0,35.09,1145.57,108
CPT,87798,CRYPTOCOCCUS NEOFORMANS/GATTII AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,DETECT AGENT NOS DNA AMP,821.0,410.5,35.09,796.37,108
CPT,87798,EHRLICHIA DETECTION PCR,787.5,393.75,35.09,1298.83,108
CPT,87798,EPSTEIN BARR QUAL PCR,1066.0,533.0,35.09,1034.02,54
CPT,87798,ESCHERICHIA COLI K1 AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,HAEMOPHILUS INFLUENZAE AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,HUMAN PARECHOVIRUS AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,HUMAN PARVOVIRUS DNA PCR,1339.0,669.5,35.09,1298.83,54
CPT,87798,INFECTIOUS AGENT NOS DETECT NUC ACID AMP PROBE E ORGANISM,767.5,383.75,35.09,1034.02,108
CPT,87798,JC VIRUS DNA PCR,1066.0,533.0,35.09,1034.02,54
CPT,87798,LISTERIA MONOCYTOGENES AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,MUD DETECT AGENT NOS DNA AMP NHCI,568.0,284.0,35.09,550.96,53
CPT,87798,NEISSERIA MENINGITIDIS AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,NOROVIRUS AMPLIFIED PROBE,1339.0,669.5,35.09,1298.83,54
CPT,87798,PARVOVIRUS B19 PCR,767.5,383.75,35.09,1034.02,108
CPT,87798,STREPTOCOCCUS PNEUMONIAE AMP PRB PCR,566.0,283.0,35.09,549.02,54
CPT,87798,TOXOPLASMA GONDII PCR,651.0,325.5,35.09,1034.02,108
CPT,87798,TROPHERYMA WHIPPLEI PCR,703.0,351.5,35.09,681.91,54
CPT,87798,VZV REAL TIME PCR,1066.0,533.0,35.09,1034.02,54
CPT,87798,WEST NILE VIRUS RNA PCR,1066.0,533.0,35.09,1034.02,54
CPT,87799,ADENOVIRUS QPCR (BAL),1718.5,859.25,42.84,2136.91,108
CPT,87799,ADENOVIRUS QUANT PCR,1535.5,767.75,42.84,2136.91,108
CPT,87799,BK VIRUS QUANT PCR,811.5,405.75,42.84,1325.02,108
CPT,87799,DETECT AGENT NOS DNA QUANT,,,,,0
CPT,87799,EBV DNA QNT PCR,915.0,457.5,42.84,1325.02,108
CPT,87799,HHV8 QPCR (WHOLE BLOOD),1123.0,561.5,42.84,1089.31,108
CPT,87799,PARVOVIRUS B19 QNT PCR,915.0,457.5,42.84,1325.02,108
CPT,87799,PARVOVIRUS B19 QUANT PCR,2203.0,1101.5,42.84,2136.91,108
CPT,87799,PNEUMOCYSTIS JIROVECI QPCR BAL,1102.0,551.0,42.84,1285.25,108
CPT,87799,VZV QPCR (BAL),1392.0,696.0,42.84,1350.24,108
CPT,87799,VZV QPCR (PLASMA),1718.5,859.25,42.84,2136.91,108
CPT,877T,Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained without concurrent CT examination o,,,618.73,1237.46,8
CPT,87800,DETECT AGNT MULT DNA DIREC,,,43.67,87.34,8
CPT,87801,DETECT AGNT MULT DNA AMPLI,,,,,0
CPT,87801,IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,495.5,247.75,10.62,1022.38,216
CPT,87802,BETA STREP SCREEN,356.0,178.0,12.73,345.32,54
CPT,87802,STREP B ASSAY W/OPTIC,,,,,0
CPT,87803,CLOSTRIDIUM TOXIN A W/OPTIC,,,16.0,32.0,8
CPT,87804,INFLUENZA A & B SCREEN,235.0,117.5,16.55,256.08,216
CPT,87804,INFLUENZA A/B RAPID NASAL TEST,232.5,116.25,16.55,256.08,108
CPT,87804,INFLUENZA ASSAY W/OPTIC,,,,,0
CPT,87806,HIV AG W/HIV1&2 ANTB W/OPTIC,,,32.77,65.54,8
CPT,87807,RSV AG BY DIA,260.0,130.0,13.1,252.2,54
CPT,87807,RSV ASSAY W/OPTIC,,,,,0
CPT,87808,TRICHOMONAS ASSAY W/OPTIC,,,15.29,30.58,8
CPT,87809,ADENOVIRUS ASSAY W/OPTIC,,,21.76,43.52,8
CPT,87810,CHLMYD TRACH ASSAY W/OPTIC,,,35.29,70.58,8
CPT,87811,SARS-COV-2 COVID19 W/OPTIC,,,41.38,82.76,8
CPT,87850,N. GONORRHOEAE ASSAY W/OPTIC,,,24.56,49.12,8
CPT,87880,POC STREP A ASSAY W/OPTIC,127.0,63.5,8.01,201.76,162
CPT,87880,STREP A ASSAY W/OPTIC,,,,,0
CPT,87899,AGENT NOS ASSAY W/OPTIC,,,,,0
CPT,87899,CAMPYLOBACTOR RAPIDTEST DIA,216.0,108.0,16.07,209.52,54
CPT,87899,CRYPTOCOCCUS AG BY DIA,205.5,102.75,16.07,272.57,108
CPT,87899,CRYPTOCOCCUS AG CSF,216.0,108.0,16.07,209.52,54
CPT,87899,EHEC TOXIN IMMUNOCARD DIA,216.0,108.0,16.07,209.52,54
CPT,87899,H INFLUENZA B BY DIA,216.0,108.0,16.07,209.52,54
CPT,87899,INFECTIOUS AGENT NOS,281.0,140.5,16.07,272.57,54
CPT,87899,NEISSERIA MENINGITIS BY DIA,216.0,108.0,16.07,209.52,54
CPT,87899,STEP PNEUMO BY DIA,281.0,140.5,16.07,272.57,54
CPT,878T,Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; obtained with concurrent CT examination of t,,,618.73,1237.46,8
CPT,87900,PHENOTYPE INFECT AGENT DRUG,,,,,0
CPT,87900,VIRTUAL PHENOTYPE,1577.0,788.5,130.35,1529.69,54
CPT,87901,HIV 1 GENOTYPE PCR,3114.0,1557.0,257.45,3020.58,54
CPT,87901,NFCT AGT GNTYP ALYS HIV1 REV,,,,,0
CPT,87902,HEP C GENOTYPING,1467.5,733.75,142.49,2053.49,108
CPT,87902,NFCT AGT GNTYP ALYS HEP C,,,,,0
CPT,87903,PHENOTYPE 1ST THRU 10 DRUGS,8507.0,4253.5,488.66,10771.85,108
CPT,87903,PHENOTYPE DNA HIV W/CULTURE,,,,,0
CPT,87904,PHENOTYPE DNA HIV W/CLT ADD,,,,,0
CPT,87904,PHENOTYPE EA ADDL DRUG >10,454.0,227.0,26.07,575.21,108
CPT,87905,SIALIDASE ENZYME ASSAY,,,12.22,24.44,8
CPT,87906,HIV-1 OTHER REGION,2242.0,1121.0,128.73,2839.19,108
CPT,87906,NFCT AGT GNTYP ALYS HIV1,,,,,0
CPT,87910,NFCT AGT GNTYP ALYS CMV,,,257.45,514.9,8
CPT,87912,HBV GENOTYPE,4483.0,2241.5,257.45,5676.44,108
CPT,87912,NFCT AGT GNTYP ALYS HEP B,,,,,0
CPT,87913,NFCT AGT GNTYP ALYS SARSCOV2,,,257.45,514.9,8
CPT,87999,UNLISTED MICROBIOLOGY PX,,,,,0
CPT,879T,Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; radiological data preparation and transmissi,,,,,0
CPT,87U,CRD HRT TRNSPL MRNA 1283 GEN,,,3159.42,6318.84,8
CPT,880,ANESTH ABDOMEN VESSEL SURG,,,,,0
CPT,88000,AUTOPSY (NECROPSY) GROSS,,,,,0
CPT,88005,AUTOPSY (NECROPSY) GROSS,,,,,0
CPT,88007,AUTOPSY (NECROPSY) GROSS,,,,,0
CPT,88012,AUTOPSY (NECROPSY) GROSS,,,,,0
CPT,88014,AUTOPSY (NECROPSY) GROSS,,,,,0
CPT,88016,AUTOPSY (NECROPSY) GROSS,,,,,0
CPT,88020,AUTOPSY (NECROPSY) COMPLETE,,,,,0
CPT,88020,AUTOPSY ADULT/ADOLESCENT WO BRAIN,3570.0,1785.0,621.89,3462.9,47
CPT,88020,AUTOPSY FULL WO BRAIN,3512.0,1756.0,611.79,3406.64,47
CPT,88020,AUTOPSY INFANT/NEWBORN/STILLBORN WO BRAIN,2550.0,1275.0,444.21,2473.5,47
CPT,88025,AUTOPSY (NECROPSY) COMPLETE,,,,,0
CPT,88025,AUTOPSY ADULT/ADOLESCENT W BRAIN,4000.0,2000.0,696.8,3880.0,47
CPT,88025,AUTOPSY FULL,5238.0,2619.0,912.45,5080.86,47
CPT,88027,AUTOPSY (NECROPSY) COMPLETE,,,,,0
CPT,88028,AUTOPSY (NECROPSY) COMPLETE,,,,,0
CPT,88028,AUTOPSY INFANT W BRAIN,3060.0,1530.0,533.05,2968.2,47
CPT,88029,AUTOPSY (NECROPSY) COMPLETE,,,,,0
CPT,88029,AUTOPSY FETAL/BABY,3156.0,1578.0,549.77,3061.32,47
CPT,88029,AUTOPSY STILLBORN/NEWBORN W BRAIN,3000.0,1500.0,522.6,2910.0,47
CPT,88036,AUTOPSY PARTIAL,3553.0,1776.5,618.93,3446.41,47
CPT,88036,LIMITED AUTOPSY,,,,,0
CPT,88037,LIMITED AUTOPSY,,,,,0
CPT,88040,FORENSIC AUTOPSY (NECROPSY),,,,,0
CPT,88045,CORONERS AUTOPSY (NECROPSY),,,,,0
CPT,88099,UNLISTED NECROPSY (AUTOPSY),,,,,0
CPT,880T,Augmentative analysis of chest computed tomography (CT) imaging data to provide categorical diagnostic subtype classification of interstitial lung disease; physician or other qualified health care pro,,,,,0
CPT,88104,CYTO NGYN FLUIDS/WASH/BRUSH,488.0,244.0,36.3,473.36,54
CPT,88104,CYTOPATH FL NONGYN SMEARS,,,,,0
CPT,88106,CYTOPATH FL NONGYN FILTER,,,28.11,56.22,8
CPT,88108,CYTO CONCENTRATN SMR/INTERP,530.5,265.25,36.3,580.06,108
CPT,88108,CYTOPATH CONCENTRATE TECH,,,,,0
CPT,88112,CYTO CELL ENHANCEMT EA ADDL,625.0,312.5,50.64,606.25,54
CPT,88112,CYTO CELL ENHANCEMT W INTRP,641.5,320.75,50.64,638.26,108
CPT,88112,CYTOPATH CELL ENHANCE TECH,,,,,0
CPT,88120,CYTO FISH URINARY SPECIMEN,1968.0,984.0,165.56,1908.96,108
CPT,88120,CYTP URNE 3-5 PROBES EA SPEC,,,,,0
CPT,88121,CYTP URINE 3-5 PROBES CMPTR,2463.5,1231.75,165.56,2870.23,108
CPT,88125,FORENSIC CYTOPATHOLOGY,,,50.64,101.28,8
CPT,88130,CYTO BUCCAL SMEAR (X-CHROM),273.5,136.75,17.98,320.1,108
CPT,88130,SEX CHROMATIN IDENTIFICATION,,,,,0
CPT,88140,SEX CHROMATIN IDENTIFICATION,,,7.99,15.98,8
CPT,88141,CYTO GYN W/ PATH INTERP,40.0,20.0,5.74,45.59,94
CPT,88141,CYTOPATH C/V INTERPRET,,,,,0
CPT,88142,CYTO GYN THIN PREP,246.5,123.25,20.26,240.56,108
CPT,88142,CYTOPATH C/V THIN LAYER,,,,,0
CPT,88143,CYTOPATH C/V THIN LAYER REDO,,,23.04,46.08,8
CPT,88147,CYTOPATH C/V AUTOMATED,,,50.56,101.12,8
CPT,88148,CYTOPATH C/V AUTO RESCREEN,,,18.54,37.08,8
CPT,88150,CYTOPATH C/V MANUAL,,,18.54,37.08,8
CPT,88152,CYTOPATH C/V AUTO REDO,,,27.64,55.28,8
CPT,88153,CYTOPATH C/V REDO,,,24.03,48.06,8
CPT,88155,CYTOPATH C/V INDEX ADD-ON,47.0,23.5,8.18,45.59,54
CPT,88160,CYTO NGYN SMEARS SCREEN,342.0,171.0,28.11,331.74,54
CPT,88160,CYTO SMEAR TZANCK PREP,342.0,171.0,28.11,331.74,54
CPT,88160,CYTOPATH SMEAR OTHER SOURCE,,,,,0
CPT,88161,CYTO NGYN SMEAR EA ADDL,342.0,171.0,28.11,331.74,54
CPT,88161,CYTO NGYN SMEAR PREP/INTERP,342.0,171.0,28.11,331.74,54
CPT,88161,CYTOPATH SMEAR OTHER SOURCE,,,,,0
CPT,88162,CYTO NGYN EXT STUDY >5 SMRS,876.0,438.0,50.64,849.72,54
CPT,88162,CYTOPATH SMEAR OTHER SOURCE,,,,,0
CPT,88164,CYTO GYN PAP SMEAR BETHESDA,214.0,107.0,18.54,207.58,108
CPT,88164,CYTOPATH TBS C/V MANUAL,,,,,0
CPT,88165,CYTO GYN PAP BETH W/RESCRN,511.0,255.5,42.22,495.67,54
CPT,88165,CYTOPATH TBS C/V REDO,,,,,0
CPT,88166,CYTOPATH TBS C/V AUTO REDO,,,18.54,37.08,8
CPT,88167,CYTOPATH TBS C/V SELECT,,,18.54,37.08,8
CPT,88172,CYTO FNA IMMED READ /ADEQ,633.5,316.75,90.23,726.53,108
CPT,88172,CYTP DX EVAL FNA 1ST EA SITE,,,,,0
CPT,88173,CYTO FNA INTERP & RPT,561.0,280.5,50.64,606.25,108
CPT,88173,CYTOPATH EVAL FNA REPORT,,,,,0
CPT,88174,CYTOPATH C/V AUTO IN FLUID,,,25.37,50.74,8
CPT,88175,CYTO PAP AUTO W MAN RESCRN,368.0,184.0,26.61,402.55,108
CPT,88175,CYTOPATH C/V AUTO FLUID REDO,,,,,0
CPT,88177,CYTP FNA EVAL EA ADDL,332.5,166.25,48.42,375.39,94
CPT,88182,CELL MARKER STUDY,,,,,0
CPT,88182,FLOW CYTOMETRY EA CELL SURF,1333.0,666.5,50.64,1293.01,54
CPT,88184,FLOW CYTOMETRY 1ST MARKER,668.5,334.25,103.12,722.65,108
CPT,88184,FLOWCYTOMETRY/ TC 1 MARKER,,,,,0
CPT,88184,MUD FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST NHCI,1104.0,552.0,192.31,1070.88,53
CPT,88185,FLOW CYTOMETRY ADDL MRKR AD,362.5,181.25,51.91,414.19,94
CPT,88185,FLOW CYTOMETRY EA ADDL MARK,287.5,143.75,48.25,289.06,94
CPT,88185,FLOWCYTOMETRY/TC ADD-ON,,,,,0
CPT,88187,FLOWCYTOMETRY/READ 2-8,,,,,0
CPT,88188,FLOWCYTOMETRY/READ 9-15,,,,,0
CPT,88189,FLOWCYTOMETRY/READ 16 & >,,,,,0
CPT,88199,UNLISTED CYTOPATHOLOGY PX,,,50.64,101.28,8
CPT,881T,"Cryotherapy of the oral cavity using temperature regulated fluid cooling system, including placement of an oral device, monitoring of patient tolerance to treatment, and removal of the oral device",,,434.11,868.22,8
CPT,882,ANESTH MAJOR VEIN LIGATION,,,,,0
CPT,88230,TISSUE CULT NON-NEO BLOOD,1049.0,524.5,64.45,1676.16,108
CPT,88230,TISSUE CULTURE LYMPHOCYTE,,,,,0
CPT,88233,TISSUE CULT NON-NEO SKN/TIS,2089.0,1044.5,140.73,2026.33,54
CPT,88233,TISSUE CULTURE SKIN/BIOPSY,,,,,0
CPT,88235,SICKLE CELL AMNIOTIC FLUID,2395.0,1197.5,150.3,2323.15,54
CPT,88235,TISSUE CULT NON-NEO AMN/CV,1436.5,718.25,83.26,2323.15,108
CPT,88235,TISSUE CULTURE PLACENTA,,,,,0
CPT,88237,TISSUE CULT NEO BM EA ADDL,1227.5,613.75,124.72,1686.83,108
CPT,88237,TISSUE CULT NEO BONE MARROW,1480.5,740.25,124.72,2177.65,108
CPT,88237,TISSUE CULTURE BONE MARROW,,,,,0
CPT,88239,TISSUE CULT NEO SOLID TUMOR,3233.0,1616.5,147.52,3136.01,54
CPT,88239,TISSUE CULTURE TUMOR,,,,,0
CPT,88240,CELL CRYOPRESERVE/STORAGE,,,13.07,26.14,8
CPT,88241,FROZEN CELL PREPARATION,,,12.09,24.18,8
CPT,88245,CHROMOSOME ANALYSIS 20-25,,,173.17,346.34,8
CPT,88248,CHROM ANALY SCORE 50-100 CNT 2,2946.5,1473.25,173.17,3685.03,108
CPT,88248,CHROMOSOME ANALYSIS 50-100,,,,,0
CPT,88249,CHROM ANALY SCORE 100,2946.5,1473.25,173.17,3685.03,108
CPT,88249,CHROMOSOME ANALYSIS 100,,,,,0
CPT,88261,CHROM ANALY 5 CELLS 1 KARY,2210.0,1105.0,146.5,3471.63,108
CPT,88261,CHROMOSOME ANALYSIS 5,,,,,0
CPT,88262,CHROM ANALY 15-20CELLS 2KAR,1690.5,845.25,125.49,1807.11,108
CPT,88262,CHROM ANALY BM 15-20 CELLS,1954.0,977.0,125.49,1895.38,54
CPT,88262,CHROMOSOME ANALYSIS 15-20,,,,,0
CPT,88263,CHROMOSOME ANALYSIS 45,,,150.29,300.58,8
CPT,88264,CHROM ANALY 20-25CELLS 2KAR,1124.5,562.25,70.89,1786.74,108
CPT,88264,CHROMOSOME ANALYSIS 20-25,,,,,0
CPT,88267,CHROM AMN/CV 15 CELLS 1KARY,1551.0,775.5,104.52,2426.94,108
CPT,88267,CHROMOSOME ANALYS PLACENTA,,,,,0
CPT,88269,CHROM AMN 6-12 COL IKAR,2355.0,1177.5,173.66,2284.35,54
CPT,88269,CHROMOSOME ANALYS AMNIOTIC,,,,,0
CPT,88271,CYTOGENETICS DNA PROBE,,,,,0
CPT,88271,MOL CG DNA PROBE EA,193.5,96.75,12.19,307.49,108
CPT,88272,CYTOGENETICS 3-5,,,40.7,81.4,8
CPT,88273,CYTOGENETICS 10-30,,,,,0
CPT,88273,MOL CG INSITU 10-30 CELLS,563.0,281.5,34.81,683.85,108
CPT,88274,CYTOGENETICS 25-99,,,,,0
CPT,88274,MOL CG INSITU 25-99 CELLS,513.0,256.5,42.38,497.61,108
CPT,88275,CYTOGENETICS 100-300,,,,,0
CPT,88275,MOL CG INSITU 100-300 CELLS,463.0,231.5,29.09,736.23,108
CPT,88280,CHROM ANALY ADD KARYOTYP EA,354.5,177.25,19.16,581.03,108
CPT,88280,CHROM ANALY BONE MARROW,354.5,177.25,19.16,581.03,108
CPT,88280,CHROMOSOME KARYOTYPE STUDY,,,,,0
CPT,88283,CHROMOSOME BANDING STUDY,,,68.6,137.2,8
CPT,88285,CHROM ANALY ADDL CELLS EACH,371.0,185.5,26.91,403.52,108
CPT,88285,CHROM ANALY BM ADDL CELLS,416.0,208.0,26.91,403.52,54
CPT,88285,CHROMOSOME COUNT ADDITIONAL,,,,,0
CPT,88289,CHROM ANALY HIGH RES STDY,678.0,339.0,34.43,657.66,54
CPT,88289,CHROMOSOME STUDY ADDITIONAL,,,,,0
CPT,88291,CYTO/MOLECULAR REPORT,,,,,0
CPT,88291,CYTOGEN &MOL CG INTERP/RPT,120.0,60.0,6.27,197.88,94
CPT,88299,UNLISTED CYTOGENETIC STUDY,,,50.64,101.28,8
CPT,882T,"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; initial nerve (List s",,,,,0
CPT,88300,SURG PATH LEVEL I,331.0,165.5,15.67,331.74,162
CPT,88300,SURG PATH LEVEL I ADD,250.5,125.25,15.67,398.67,108
CPT,88300,SURGICAL PATH GROSS,,,,,0
CPT,88302,SURG PATH LEVEL II,342.0,171.0,15.67,429.71,162
CPT,88302,SURG PATH LEVEL II ADD,250.5,125.25,15.67,398.67,108
CPT,88302,TISSUE EXAM BY PATHOLOGIST,,,,,0
CPT,88304,SURG PATH LEVEL III,617.0,308.5,28.56,606.25,162
CPT,88304,SURG PATH LEVEL III ADD,394.5,197.25,28.56,606.25,108
CPT,88304,TISSUE EXAM BY PATHOLOGIST,,,,,0
CPT,88305,CELL BLOCK BONE MARROW,408.5,204.25,33.44,606.25,162
CPT,88305,SURG PATH LEVEL IV,625.0,312.5,33.44,638.26,162
CPT,88305,SURG PATH LEVEL IV ADD,408.5,204.25,33.44,606.25,162
CPT,88305,TISSUE EXAM BY PATHOLOGIST,,,,,0
CPT,88307,SURG PATH LEVEL V,1192.0,596.0,189.87,1255.18,162
CPT,88307,SURG PATH LEVEL V ADD,1090.0,545.0,189.87,1057.3,108
CPT,88307,TISSUE EXAM BY PATHOLOGIST,,,,,0
CPT,88309,SURG PATH LEVEL VI,2187.0,1093.5,225.76,2528.79,162
CPT,88309,SURG PATH LEVEL VI ADD,2725.5,1362.75,454.13,2758.68,108
CPT,88309,TISSUE EXAM BY PATHOLOGIST,,,,,0
CPT,88311,DECALCIFY TISSUE,,,,,0
CPT,88311,SURG PATH DECALCIFICATION,102.0,51.0,1.21,129.98,141
CPT,88312,SPECIAL STAINS GROUP 1,,,,,0
CPT,88312,SPECIAL STAINS GROUP I,382.0,191.0,29.09,606.25,162
CPT,88312,SPEICAL STAINS GROUP I ADD,396.0,198.0,29.09,606.25,108
CPT,88313,SPECIAL STAINS GROUP 2,,,,,0
CPT,88313,SPECIAL STAINS GROUP II,350.0,175.0,32.4,682.88,162
CPT,88313,SPECIAL STAINS GROUP II ADD,212.0,106.0,32.4,258.58,162
CPT,88314,HISTOCHEMICAL STAINS ADD-ON,,,,,0
CPT,88314,STAIN FROZEN W/HISTOCHEM,290.0,145.0,50.51,281.3,47
CPT,88319,ENZYME CONSTITUENTS ID,1062.0,531.0,185.0,1565.86,54
CPT,88319,ENZYME HISTOCHEMISTRY,,,,,0
CPT,88321,CONSLTJ&REPRT SLD PREP ELSWR,,,,,0
CPT,88321,CONSULT REF SLIDES LEVEL 1,530.5,265.25,36.3,580.06,108
CPT,88323,CONSLTJ&REPRT MATRL PREP SLD,,,,,0
CPT,88323,CONSULT REF W SLIDE PREP,807.0,403.5,50.64,782.79,54
CPT,88325,CONSLTJ COMPRE RVW REC REPRT,,,,,0
CPT,88325,CONSULT COMP W RECORD REV,1968.0,984.0,165.56,1908.96,54
CPT,88329,PATH CONSLTJ DRG SURG,,,,,0
CPT,88329,PATH CONSULT DURING OR,83.0,41.5,14.45,114.66,54
CPT,88331,FROZEN SECTION 1ST BLOCK,970.0,485.0,165.56,940.9,54
CPT,88331,OR/CONS FS SINGLE SPEC ADD,646.0,323.0,112.53,626.62,54
CPT,88331,PATH CONSLTJ SURG 1 BLK 1SPC,,,,,0
CPT,88332,FROZEN SECTION EA ADD BLOCK,306.0,153.0,53.3,296.82,47
CPT,88332,OR/CONS FS ADD X1 ADD,250.0,125.0,43.55,242.5,47
CPT,88332,PATH CONSLTJ SURG EA ADD BLK,,,,,0
CPT,88333,CYTO EXAM TOUCHPREP INITIAL,943.0,471.5,164.27,1565.86,54
CPT,88333,PATH CONSLTJ SURG CYTO XM 1,,,,,0
CPT,88334,INTRAOP TOUCH PREP ADD SITE,72.0,36.0,12.54,69.84,47
CPT,88334,PATH CONSLTJ SURG CYTO XM EA,,,,,0
CPT,88341,IHC PER SPECIMEN ADDL STAIN,545.0,272.5,9.58,942.84,141
CPT,88341,IMHCHEM/IMCYTCHM EA ADD ANTB,,,,,0
CPT,88342,IHC PER SPECIMEN 1ST STAIN,576.0,288.0,94.93,1127.14,162
CPT,88342,IMHCHEM/IMCYTCHM 1ST ANTB,,,,,0
CPT,88344,IHC PER SPECIMEN E MULTI STAIN,2727.0,1363.5,189.87,4233.08,108
CPT,88344,IMHCHEM/IMCYTCHM EA MLT ANTB,,,,,0
CPT,88346,IMFLUOR 1ST 1ANTB STAIN PX,,,,,0
CPT,88346,IMMUNOFLUOR ANTB 1ST STAIN,1555.0,777.5,165.56,1508.35,54
CPT,88346,RENAL BX IMMUNOFLUORESCENCE,878.0,439.0,152.94,851.66,54
CPT,88348,ELECTRON MICROSCOPY DIAGNOS,2926.0,1463.0,454.13,3147.65,108
CPT,88348,ELECTRON MICROSCOPY DX,,,,,0
CPT,88350,IMFLUOR EA ADDL 1ANTB STN PX,,,,,0
CPT,88350,IMMUNOFLUOR ANTB ADDL STAIN,490.0,245.0,85.35,475.3,47
CPT,88355,M/PHMTRC ALYS SKELETAL MUSC,,,165.56,331.12,8
CPT,88356,ANALYSIS NERVE,,,,,0
CPT,88356,MORPHOMET ANALYSIS NERVE,786.0,393.0,50.64,762.42,54
CPT,88358,ANALYSIS TUMOR,,,,,0
CPT,88358,MORPHOMET ANALYSIS TUMOR,4257.0,2128.5,165.56,4129.29,54
CPT,88360,MORPHOMET ANALY EA AB MAN,1595.5,797.75,165.56,1908.96,108
CPT,88360,TUMOR IMMUNOHISTOCHEM/MANUAL,,,,,0
CPT,88361,MORPHOMET ANALY EA AB ADDL,1185.0,592.5,206.42,1149.45,54
CPT,88361,MORPHOMET ANALY EA AB CMPTR,1779.0,889.5,309.9,1725.63,108
CPT,88361,TUMOR IMMUNOHISTOCHEM/COMPUT,,,,,0
CPT,88362,NERVE TEASING PREPARATIONS,6257.5,3128.75,454.13,9610.76,108
CPT,88363,XM ARCHIVE TISSUE MOLEC ANAL,291.5,145.75,28.11,331.74,108
CPT,88364,INSITU HYBRIDIZ E ADDL PROBE STAIN,589.5,294.75,34.66,950.6,94
CPT,88364,INSITU HYBRIDIZATION (FISH),,,,,0
CPT,88365,INSITU HYBRIDIZ FISH PROBE,987.0,493.5,90.23,1412.32,108
CPT,88365,INSITU HYBRIDIZATION (FISH),,,,,0
CPT,88366,INSITU HYBRIDIZATION (FISH),,,,,0
CPT,88366,ISH E SPECIMEN E MULTIPLEX PROBE,594.0,297.0,103.47,576.18,54
CPT,88367,INSITU HYBRIDIZATION AUTO,,,,,0
CPT,88367,MORPHOMET ANALY INSITU CMPT,1090.0,545.0,189.87,1057.3,54
CPT,88368,INSITU HYBRIDIZATION MANUAL,,,,,0
CPT,88368,MORPHOMET ANALY INSITU MAN,1090.0,545.0,189.87,1057.3,108
CPT,88368,MORPHOMET ANALY INSITU MANB,1090.0,545.0,189.87,1057.3,54
CPT,88369,M/PHMTRC ALYSISHQUANT/SEMIQ,,,,,0
CPT,88369,MORPHOMET ANALY INSITU MAN ADD,362.5,181.25,61.66,359.87,94
CPT,88371,PROTEIN WESTERN BLOT TISSUE,,,22.23,44.46,8
CPT,88372,PROTEIN ANALYSIS W/PROBE,,,26.22,52.44,8
CPT,88373,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,,,0
CPT,88373,MORPHOMET ANALY INSITU CMP ADD,384.0,192.0,66.89,372.48,47
CPT,88374,ISH ALYS COMP ASSIST MULTIPLEX,1602.0,801.0,137.44,2342.55,108
CPT,88374,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,,,0
CPT,88375,OPTICAL ENDOMICROSCPY INTERP,,,,,0
CPT,88377,ISH ALYS QUANT/SEMIQ MANUAL MU,1200.0,600.0,165.56,1283.31,108
CPT,88377,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,,,0
CPT,88380,MICRODISSECTION LASER,,,,,0
CPT,88381,MICRODISSECTION MANUAL,231.5,115.75,11.32,386.06,94
CPT,88387,TISS EXAM MOLECULAR STUDY,,,,,0
CPT,88399,UNLISTED SURGICAL PATH PX,,,50.64,101.28,8
CPT,883T,"Intraoperative therapeutic electrical stimulation of peripheral nerve to promote nerve regeneration, including lead placement and removal, upper extremity, minimum of 10 minutes; each additional nerve",,,,,0
CPT,884T,"Esophagoscopy, flexible, transoral, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for esophageal s",,,5899.47,11798.94,8
CPT,885T,"Colonoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, includ",,,5899.47,11798.94,8
CPT,886T,"Sigmoidoscopy, flexible, with initial transendoscopic mechanical dilation (eg, nondrug-coated balloon) followed by therapeutic drug delivery by drug-coated balloon catheter for colonic stricture, incl",,,5899.47,11798.94,8
CPT,88720,BILIRUBIN TOTAL TRANSCUT,,,5.02,10.04,8
CPT,88738,HGB QUANT TRANSCUTANEOUS,134.0,67.0,5.02,129.98,54
CPT,88740,HGB QUANT TRANSCUT CARBOXYHEM,134.0,67.0,9.37,129.98,54
CPT,88740,TRANSCUTANEOUS CARBOXYHB,,,,,0
CPT,88741,TRANSCUTANEOUS METHB,,,9.37,18.74,8
CPT,88749,UNLISTED IN VIVO LAB SERVICE,,,,,0
CPT,887T,End-tidal control of inhaled anesthetic agents and oxygen to assist anesthesia care delivery (List separately in addition to code for primary procedure),,,,,0
CPT,888T,"Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant renal tissue, including imaging guidance",,,16645.78,33291.56,8
CPT,889T,"Personalized target development for accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation derived from a structural and resting-state functional MRI, including d",,,904.08,1808.16,8
CPT,88U,TRNSPLJ KDN ALGRFT REJ 1494,,,3159.42,6318.84,8
CPT,89049,CHCT FOR MAL HYPERTHERMIA,,,165.56,331.12,8
CPT,89050,BODY FLUID CELL COUNT,,,,,0
CPT,89050,CELL COUNT W/O BDY FLD,94.0,47.0,4.72,91.18,54
CPT,89051,BODY FLUID CELL COUNT,,,,,0
CPT,89051,CELL COUNT W DIFF BDY FLD,336.5,168.25,5.6,367.63,108
CPT,89055,LEUKOCYTE ASSESSMENT FECAL,,,,,0
CPT,89055,LEUKOCYTES FECAL,56.0,28.0,4.27,60.14,108
CPT,89060,CRYSTAL ID BODY FLUID,109.0,54.5,7.33,105.73,54
CPT,89060,EXAM SYNOVIAL FLUID CRYSTALS,,,,,0
CPT,890T,"Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including target assessment, initial motor threshold determination, neuronavigation, delivery and manageme",,,3567.33,7134.66,8
CPT,89125,SPECIMEN FAT STAIN,,,5.88,11.76,8
CPT,89160,EXAM FECES FOR MEAT FIBERS,,,,,0
CPT,89160,MEAT FIBERS STOOL,72.0,36.0,4.85,69.84,54
CPT,89190,NASAL SMEAR FOR EOSINOPHILS,,,,,0
CPT,89190,SMEAR EOSINOPHILL,68.0,34.0,2.78,116.4,108
CPT,891T,"Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent treatment day",,,3567.33,7134.66,8
CPT,89220,SPUTUM SPECIMEN COLLECTION,,,165.56,331.12,8
CPT,89230,COLLECT SWEAT FOR TEST,,,,,0
CPT,89230,SWEAT CHLORIDE ANALYSIS,625.0,312.5,50.64,606.25,54
CPT,89240,MISCELLANEOUS ID,164.0,82.0,28.56,159.08,54
CPT,89240,UNLISTED MISC PATH TEST,,,,,0
CPT,89250,CULTR OOCYTE/EMBRYO <4 DAYS,,,165.56,331.12,8
CPT,89251,CULTR OOCYTE/EMBRYO <4 DAYS,,,165.56,331.12,8
CPT,89253,EMBRYO HATCHING,,,165.56,331.12,8
CPT,89254,OOCYTE IDENTIFICATION,,,165.56,331.12,8
CPT,89255,PREPARE EMBRYO FOR TRANSFER,,,50.64,101.28,8
CPT,89257,SPERM IDENTIFICATION,,,50.64,101.28,8
CPT,89258,CRYOPRESERVATION EMBRYO(S),,,782.93,1565.86,8
CPT,89259,CRYOPRESERVATION SPERM,,,165.56,331.12,8
CPT,89260,SPERM ISOLATION SIMPLE,,,50.64,101.28,8
CPT,89261,SPERM ISOLATION COMPLEX,,,50.64,101.28,8
CPT,89264,IDENTIFY SPERM TISSUE,,,50.64,101.28,8
CPT,89268,INSEMINATION OF OOCYTES,,,165.56,331.12,8
CPT,89272,EXTENDED CULTURE OF OOCYTES,,,782.93,1565.86,8
CPT,89280,ASSIST OOCYTE FERTILIZATION,,,782.93,1565.86,8
CPT,89281,ASSIST OOCYTE FERTILIZATION,,,165.56,331.12,8
CPT,89290,BIOPSY OOCYTE POLAR BODY <=5,,,165.56,331.12,8
CPT,89291,BIOPSY OOCYTE POLAR BODY,,,165.56,331.12,8
CPT,892T,"Accelerated, repetitive high-dose functional connectivity MRI-guided theta-burst stimulation, including neuronavigation, delivery and management, subsequent motor threshold redetermination with delive",,,3567.33,7134.66,8
CPT,89300,SEMEN ANALYSIS W/HUHNER,,,,,0
CPT,89300,SEMEN POST VASECTOMY,203.0,101.5,9.84,196.91,54
CPT,89310,SEMEN ANALYSIS W/COUNT,,,,,0
CPT,89310,SEMEN MOTILITY AND COUNT,164.0,82.0,8.61,159.08,54
CPT,89320,SEMEN ANAL VOL/COUNT/MOT,,,,,0
CPT,89320,SEMEN ANALYSIS COMPLETE,332.0,166.0,12.31,322.04,54
CPT,89321,SEMEN ANAL SPERM DETECTION,,,,,0
CPT,89321,SEMEN ANALYSIS PRESENCE /MOTILITY,191.5,95.75,12.05,229.89,108
CPT,89322,SEMEN ANAL STRICT CRITERIA,,,,,0
CPT,89322,SPERM MORPHOLOGY,306.0,153.0,15.5,296.82,54
CPT,89325,SPERM ANTIBODY TEST,,,10.67,21.34,8
CPT,89329,SPERM EVALUATION TEST,,,19.59,39.18,8
CPT,89330,EVALUATION CERVICAL MUCUS,,,10.38,20.76,8
CPT,89331,RETROGRADE EJACULATION ANAL,,,19.59,39.18,8
CPT,89335,CRYOPRESERVE TESTICULAR TISS,,,50.64,101.28,8
CPT,89337,CRYOPRESERVATION OOCYTE(S),,,165.56,331.12,8
CPT,89342,STORAGE/YEAR EMBRYO(S),,,165.56,331.12,8
CPT,89343,STORAGE/YEAR SPERM/SEMEN,,,165.56,331.12,8
CPT,89344,STORAGE/YEAR REPROD TISSUE,,,165.56,331.12,8
CPT,89346,STORAGE/YEAR OOCYTE(S),,,165.56,331.12,8
CPT,89352,THAWING CRYOPRESRVED EMBRYO,,,165.56,331.12,8
CPT,89353,THAWING CRYOPRESRVED SPERM,,,50.64,101.28,8
CPT,89354,THAW CRYOPRSVRD REPROD TISS,,,165.56,331.12,8
CPT,89356,THAWING CRYOPRESRVED OOCYTE,,,165.56,331.12,8
CPT,89398,UNLISTED REPROD MED LAB PROC,,,50.64,101.28,8
CPT,893T,"Noninvasive assessment of blood oxygenation, gas exchange efficiency, and cardiorespiratory status, with physician or other qualified health care professional interpretation and report",,,129.29,258.58,8
CPT,894T,Cannulation of the liver allograft in preparation for connection to the normothermic perfusion device and decannulation of the liver allograft following normothermic perfusion,,,,,0
CPT,895T,"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; initial 4 hours of monitoring time, including hourly physiological and laboratory assessments (eg, perfusate",,,,,0
CPT,896T,"Connection of liver allograft to normothermic machine perfusion device, hemostasis control; each additional hour, including physiological and laboratory assessments (eg, perfusate temperature, perfusa",,,,,0
CPT,897T,"Noninvasive augmentative arrhythmia analysis derived from quantitative computational cardiac arrhythmia simulations, based on selected intervals of interest from 12-lead electrocardiogram and uploaded",,,834.49,1668.98,8
CPT,898T,"Noninvasive prostate cancer estimation map, derived from augmentative analysis of image-guided fusion biopsy and pathology, including visualization of margin volume and location, with margin determina",,,834.49,1668.98,8
CPT,899T,"Noninvasive determination of absolute quantitation of myocardial blood flow (AQMBF), derived from augmentative algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (CMR",,,,,0
CPT,89U,ONC MLNMA PRAME & LINC00518,,,760.0,1520.0,8
CPT,8U,HPYLORI DETCJ ABX RSTNC DNA,,,597.91,1195.82,8
CPT,9001F,AORTIC ANEURYSM<5CM DIAM CT,,,,,0
CPT,9002F,AORTIC ANEURYSM 5-5.4CM DIAM,,,,,0
CPT,9003F,AORTIC ANRYSM5.5-5.9CM DIAM,,,,,0
CPT,9004F,AORTIC ANRYSM 6/> CM DIAM,,,,,0
CPT,9005F,ASYMPT CAROT/VRTBRBAS STEN,,,,,0
CPT,9006F,SYMPT STEN-TIA/STRK<120DAYS,,,,,0
CPT,9007F,OTHER CAROT STEN 120 DAYS/>,,,,,0
CPT,900T,"Noninvasive estimate of absolute quantitation of myocardial blood flow (AQMBF), derived from assistive algorithmic analysis of the dataset acquired via contrast cardiac magnetic resonance (CMR), pharm",,,,,0
CPT,901T,"Placement of bone marrow sampling port, including imaging guidance when performed",,,,,0
CPT,902,ANESTH ANORECTAL SURGERY,,,,,0
CPT,90281,HUMAN IG IM,,,145.75,199.46,2
CPT,90283,HUMAN IG IV,,,113.31,156.0,2
CPT,90284,HUMAN IG SC,,,27.59,31.19,5
CPT,90287,BOTULINUM ANTITOXIN,,,,,0
CPT,90288,BOTULISM IG IV,,,91224.47,91224.47,1
CPT,90291,CMV IG IV,,,2572.03,3685.45,2
CPT,90296,DIPHTHERIA ANTITOXIN,,,,,0
CPT,902T,"QTc interval derived by augmentative algorithmic analysis of input from an external, patient-activated mobile ECG device",,,129.29,258.58,8
CPT,90371,HEP B IG IM,,,127.64,331.6,10
CPT,90375,RABIES IG IM/SC,,,266.18,703.22,10
CPT,90376,RABIES IG HEAT TREATED,,,335.23,949.39,10
CPT,90377,RABIES IG HT&SOL HUMAN IM/SC,,,211.4,748.0,10
CPT,90378,RSV MAB IM 50MG,,,415.42,3819.31,14
CPT,90380,RSV MONOC ANTB SEASN .5ML IM,,,814.18,1166.64,5
CPT,90381,RSV MONOC ANTB SEASN 1 ML IM,,,814.18,1166.64,5
CPT,90382,"Respiratory syncytial virus, monoclonal antibody, seasonal dose, 0.7 mL, for intramuscular use",,,1166.35,1166.35,1
CPT,90384,RH IG FULL-DOSE IM,,,159.25,173.76,2
CPT,90385,RH IG MINIDOSE IM,,,57.55,152.18,11
CPT,90386,RH IG IV,,,21.63,808.53,2
CPT,90389,TETANUS IG IM,,,950.38,1361.8,2
CPT,90393,VACCINA IG IM,,,,,0
CPT,90396,VARICELLA-ZOSTER IG IM,,,2246.47,4784.48,10
CPT,90399,UNLISTED IMMUNE GLOBULIN,,,522.03,522.03,1
CPT,903T,"Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; with interpretation and report",,,,,0
CPT,904,ANESTH PERINEAL SURGERY,,,,,0
CPT,90460,IM ADMIN 1ST/ONLY COMPONENT,,,,,0
CPT,90461,IM ADMIN EACH ADDL COMPONENT,,,,,0
CPT,90471,HEPATITIS VACCINE ADMIN,95.0,47.5,16.54,139.94,54
CPT,90471,IMMUNIZATION ADMIN,95.0,47.5,16.54,139.94,162
CPT,90471,INFLUENZA VACCINE ADMIN,95.0,47.5,16.54,139.94,162
CPT,90471,PNEUMOCOCCAL VAC ADMIN,95.0,47.5,16.54,139.94,108
CPT,90472,IMMUNIZATION ADM EA ADDL VAC,63.0,31.5,10.97,61.11,141
CPT,90473,IMMUNE ADMIN ORAL/NASAL,,,69.97,139.94,8
CPT,90474,IMMUNE ADMIN ORAL/NASAL ADDL,,,,,0
CPT,90476,ADENOVIRUS VACCINE TYPE 4,,,,,0
CPT,90477,ADENOVIRUS VACCINE TYPE 7,,,,,0
CPT,90480,IMM ADMN SARSCOV2 VACCINE SINGLE DOSE,94.0,47.0,16.37,91.18,54
CPT,904T,"Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; tracing only",,,57.33,114.66,8
CPT,90581,ANTHRAX VACCINE SC OR IM,,,141.59,207.68,2
CPT,90584,DENGUE VACC QUAD 2 DOSE SUBQ,,,,,0
CPT,90585,BCG VACCINE PERCUT,,,258.64,370.61,2
CPT,90586,BCG VACCINE INTRAVESICAL,,,190.52,370.61,5
CPT,90587,DENGUE VACC QUAD 3 DOSE SUBQ,,,96.62,138.45,2
CPT,90589,CHIKUNGUNYA VACCINE LIVE IM,,,576.88,576.88,1
CPT,90593,"Chikungunya virus vaccine, recombinant, for intramuscular use",,,503.25,576.88,2
CPT,905T,"Electrocardiogram, algorithmically generated 12-lead ECG from a reduced-lead ECG; interpretation and report only",,,,,0
CPT,906,ANESTH REMOVAL OF VULVA,,,,,0
CPT,90611,SMALLPOX&MONKEYPOX VAC 0.5ML,,,0.01,566.4,10
CPT,90612,"Influenza virus vaccine, trivalent, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 31.7 mcg/0.32 mL dosage, for intramuscular use",,,,,0
CPT,90613,"Influenza virus vaccine, quadrivalent, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 40 mcg/0.4 mL dosage, for intramuscular use",,,,,0
CPT,90619,MENACWY-TT VACCINE IM,,,251.58,360.76,2
CPT,90620,MENB-4C VACC 2 DOSE IM,,,346.97,497.45,2
CPT,90621,MENB-FHBP VACC 2/3 DOSE IM,,,303.33,434.91,2
CPT,90622,VACCINIA VRS VAC 0.3 ML PERQ,,,0.01,0.02,10
CPT,90623,MENACWY-TT MENB-FHBP VACC IM,,,346.82,496.96,2
CPT,90624,"Meningococcal pentavalent vaccine, Men B-4C recombinant proteins and outer membrane vesicle and conjugated Men A, C, W, Y-diphtheria toxoid carrier, for intramuscular use",,,366.92,366.92,1
CPT,90625,CHOLERA VACCINE LIVE ORAL,,,611.5,611.5,1
CPT,90626,TIC-BRN ENCEPH VAC 0.25ML IM,,,637.51,637.51,1
CPT,90627,TIC-BRN ENCEPH VAC 0.5ML IM,,,637.51,637.51,1
CPT,90631,"Influenza virus vaccine (IIV), H5, pandemic formulation, split virus, adjuvanted, for intramuscular use",,,,,0
CPT,90632,HEPA VACCINE ADULT IM,,,88.67,170.59,2
CPT,90633,HEPA VACC PED/ADOL 2 DOSE IM,,,51.63,81.49,2
CPT,90634,HEPA VACC PED/ADOL 3 DOSE,,,35.51,35.51,1
CPT,90635,"Influenza virus vaccine, H5N1, derived from cell cultures, adjuvanted, for intramuscular use",,,,,0
CPT,90636,HEP A/HEP B VACC ADULT IM,,,193.52,277.8,2
CPT,90637,"Influenza virus vaccine, quadrivalent (qIRV), mRNA; 30 mcg/0.5 mL dosage, for intramuscular use",,,,,0
CPT,90638,"Influenza virus vaccine, quadrivalent (qIRV), mRNA; 60 mcg/0.5 mL dosage, for intramuscular use",,,,,0
CPT,90644,HIB-MENCY VACC 6WK-18M0 IM,,,26.84,51.84,2
CPT,90647,HIB PRP-OMP VACC 3 DOSE IM,,,44.58,64.15,2
CPT,90648,HIB PRP-T VACCINE 4 DOSE IM,,,19.26,27.63,2
CPT,90649,4VHPV VACCINE 3 DOSE IM,,,128.26,336.0,2
CPT,90650,2VHPV VACCINE 3 DOSE IM,,,278.14,278.14,1
CPT,90651,9VHPV VACCINE 2/3 DOSE IM,,,450.16,645.29,2
CPT,90653,IIV ADJUVANT VACCINE IM,,,101.86,153.89,2
CPT,90655,IIV3 VACC NO PRSV 0.25 ML IM,,,16.32,26.2,2
CPT,90656,IIV3 VACC NO PRSV 0.5 ML IM,,,27.27,41.39,2
CPT,90657,IIV3 VACCINE SPLT 0.25 ML IM,,,13.33,20.25,2
CPT,90658,IIV3 VACCINE SPLT 0.5 ML IM,,,26.67,40.49,2
CPT,90660,LAIV3 VACCINE INTRANASAL,,,35.22,53.38,2
CPT,90661,CCIIV3 VAC NO PRSV 0.5 ML IM,,,44.96,68.06,2
CPT,90662,IIV NO PRSV INCREASED AG IM,,,101.86,153.89,2
CPT,90664,LAIV VACC PANDEMIC INTRANASL,,,,,0
CPT,90666,FLU VAC PANDEM PRSRV FREE IM,,,,,0
CPT,90667,IIV VACC PANDEMIC ADJUVT IM,,,,,0
CPT,90668,IIV VACCINE PANDEMIC IM,,,,,0
CPT,90670,PCV13 VACCINE IM,,,314.75,474.99,2
CPT,90671,PCV15 VACCINE IM,,,318.6,480.8,2
CPT,90672,LAIV4 VACCINE INTRANASAL,,,51.4,51.4,1
CPT,90673,RIV3 VACCINE NO PRESERV IM,,,101.86,153.89,2
CPT,90674,CCIIV4 VAC NO PRSV 0.5 ML IM,,,63.14,63.14,1
CPT,90675,RABIES VACCINE IM,,,298.36,911.7,10
CPT,90676,RABIES VACCINE ID,,,225.29,450.58,9
CPT,90677,PCV20 VACCINE IM,,,381.74,576.04,2
CPT,90678,RSV VACC PREF BIVALENT IM,,,449.16,643.6,2
CPT,90679,RSV VACC PREF RECOMB ADJT IM,,,448.5,642.65,2
CPT,90680,RV5 VACC 3 DOSE LIVE ORAL,,,144.48,207.3,2
CPT,90681,RV1 VACC 2 DOSE LIVE ORAL,,,215.05,308.41,2
CPT,90682,RIV4 VACC RECOMBINANT DNA IM,,,135.32,135.32,1
CPT,90683,RSV VACC MRNA LIPID NANO IM,,,424.56,608.35,2
CPT,90684,"Pneumococcal conjugate vaccine, 21 valent (PCV21), for intramuscular use",,,400.03,603.63,2
CPT,90685,IIV4 VACC NO PRSV 0.25 ML IM,,,40.08,40.08,1
CPT,90686,IIV4 VACC NO PRSV 0.5 ML IM,,,41.39,41.39,1
CPT,90687,IIV4 VACCINE SPLT 0.25 ML IM,,,19.35,19.35,1
CPT,90688,IIV4 VACCINE SPLT 0.5 ML IM,,,38.68,38.68,1
CPT,90689,VACC IIV4 NO PRSRV 0.25ML IM,,,,,0
CPT,90690,TYPHOID VACCINE ORAL,,,171.7,246.02,2
CPT,90691,TYPHOID VACCINE IM,,,182.55,322.85,2
CPT,90694,VACC AIIV4 NO PRSRV 0.5ML IM,,,142.61,142.61,1
CPT,90695,"Influenza virus vaccine, H5N8, derived from cell cultures, adjuvanted, for intramuscular use",,,,,0
CPT,90696,DTAP-IPV VACCINE 4-6 YRS IM,,,93.43,131.78,2
CPT,90697,DTAP-IPV-HIB-HEPB VACCINE IM,,,228.25,328.54,2
CPT,90698,DTAP-IPV/HIB VACCINE IM,,,164.69,251.86,2
CPT,906T,"Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; first application, total wound(s) surface area less than or equal to 50 sq cm",,,194.97,389.94,8
CPT,90700,DTAP VACCINE < 7 YRS IM,,,43.55,62.07,2
CPT,90702,DT VACCINE UNDER 7 YRS IM,,,20.52,138.64,2
CPT,90707,MMR VACCINE SC,,,138.82,199.7,2
CPT,90710,MMRV VACCINE SC,,,406.49,583.51,2
CPT,90713,POLIOVIRUS IPV SC/IM,,,65.31,93.84,2
CPT,90714,TD VACC NO PRESV 7 YRS+ IM,,,44.37,88.63,2
CPT,90715,TDAP VACCINE 7 YRS/> IM,,,48.45,102.27,2
CPT,90716,VAR VACCINE LIVE SUBQ,,,267.73,383.89,2
CPT,90717,YELLOW FEVER VACCINE SUBQ,,,344.27,493.31,2
CPT,90723,DTAP-HEP B-IPV VACCINE IM,,,150.78,217.36,2
CPT,90732,PPSV23 VACC 2 YRS+ SUBQ/IM,,,162.83,245.61,2
CPT,90733,MPSV4 VACCINE SUBQ,,,101.42,258.38,2
CPT,90734,MENACWYD/MENACWYCRM VACC IM,,,243.94,349.8,2
CPT,90736,HZV VACCINE LIVE SUBQ,,,162.19,446.13,2
CPT,90738,INACTIVATED JE VACC IM,,,372.97,619.01,2
CPT,90739,HEPB VACC 2/4 DOSE ADULT IM,,,216.62,326.73,2
CPT,90740,HEPB VACC 3 DOSE IMMUNSUP IM,,,200.59,391.83,2
CPT,90743,HEPB VACC 2 DOSE ADOLESC IM,,,91.68,144.35,2
CPT,90744,HEPB VACC 3 DOSE PED/ADOL IM,,,38.64,58.55,2
CPT,90746,HEPB VACCINE 3 DOSE ADULT IM,,,85.86,144.35,2
CPT,90747,HEPB VACC 4 DOSE IMMUNSUP IM,,,171.72,303.09,2
CPT,90748,HIB-HEPB VACCINE IM,,,56.44,88.24,2
CPT,90749,UNLISTED VACCINE/TOXOID,,,,,0
CPT,90750,HZV VACC RECOMBINANT IM,,,452.09,452.09,1
CPT,90756,CCIIV4 VACC ABX FREE IM,,,59.82,59.82,1
CPT,90758,ZAIRE EBOLAVIRUS VAC LIVE IM,,,,,0
CPT,90759,HEP B VAC 3AG 10MCG 3 DOS IM,,,90.06,135.83,2
CPT,90785,PSYTX COMPLEX INTERACTIVE,,,,,0
CPT,90791,PSY DIAG EVALUATION,393.0,196.5,68.46,381.21,54
CPT,90792,PSYCH DIAG EVAL W/MED SRVCS,,,172.48,344.96,8
CPT,907T,"Concurrent optical and magnetic stimulation (COMS) therapy, wound assessment and dressing care; each additional application, total wound(s) surface area less than or equal to 50 sq cm (List separately",,,,,0
CPT,908,ANESTH REMOVAL OF PROSTATE,,,,,0
CPT,90832,MH-IOP PSYTX W PT 30 MIN,269.0,134.5,46.68,344.96,108
CPT,90832,PHP PSYTX W PT 30 MIN,268.0,134.0,46.68,344.96,54
CPT,90833,PSYTX W PT W E/M 30 MIN,,,,,0
CPT,90834,MH-IOP PSYTX W PT 45 MIN,345.5,172.75,59.92,344.96,108
CPT,90834,PHP PSYTX W PT 45 MIN,344.0,172.0,59.92,344.96,54
CPT,90836,PSYTX W PT W E/M 45 MIN,,,,,0
CPT,90837,MH-IOP PSYTX W PT 60 MIN,366.0,183.0,63.4,356.96,108
CPT,90837,PHP PSYTX W PT 60 MIN,364.0,182.0,63.4,353.08,54
CPT,90838,PSYTX W PT W E/M 60 MIN,,,,,0
CPT,90839,PSYTX CRISIS 1ST 60 MIN,332.0,166.0,57.83,344.96,54
CPT,90840,PSYTX CRISIS ADD 30 MIN,150.0,75.0,26.13,145.5,47
CPT,90845,PSYCHOANALYSIS,,,172.48,344.96,8
CPT,90846,MH-IOP PSYTX FAMILY WO PT 50 MIN,371.0,185.5,64.62,359.87,54
CPT,90846,PHP PSYTX FAMILY WO PT 50 MIN,367.0,183.5,63.93,355.99,54
CPT,90847,MH-IOP PSYTX FAMILY W PT 50 MIN,612.0,306.0,106.61,593.64,54
CPT,90847,PHP PSYTX FAMILY W PT 50 MIN,605.0,302.5,105.39,586.85,54
CPT,90849,PSYCHOTHERAPY MULTIFAMILY GRP,174.0,87.0,30.31,344.96,54
CPT,90853,MH-IOP PSYTX GROUP,367.0,183.5,63.93,355.99,54
CPT,90853,OP PSYTX GROUP THERAPY,371.0,185.5,64.62,359.87,54
CPT,90853,PHP PSYTX GROUP,367.0,183.5,63.93,355.99,54
CPT,90863,PHARMACOLOGIC MGMT W/PSYTX,,,,,0
CPT,90865,NARCOSYNTHESIS,,,172.48,344.96,8
CPT,90867,TCRANIAL MAGN STIM TX PLAN,,,209.83,419.66,8
CPT,90868,TCRANIAL MAGN STIM TX DELI,,,209.83,419.66,8
CPT,90869,TCRAN MAGN STIM REDETEMINE,,,209.83,419.66,8
CPT,90870,ELECTROCONVULSIVE THERAPY,1326.0,663.0,230.98,1668.98,54
CPT,90875,PSYCHOPHYSIOLOGICAL THERAPY,,,,,0
CPT,90876,PSYCHOPHYSIOLOGICAL THERAPY,,,,,0
CPT,90880,HYPNOTHERAPY,,,98.72,197.44,8
CPT,90882,ENVIRONMENTAL MANIPULATION,,,,,0
CPT,90885,PSY EVALUATION OF RECORDS,,,,,0
CPT,90887,CONSULTATION WITH FAMILY,,,,,0
CPT,90889,PREPARATION OF REPORT,,,,,0
CPT,90899,UNLISTED PSYC SVC/THERAPY,,,36.41,72.82,8
CPT,908T,"Open implantation of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed",,,29986.33,59972.66,8
CPT,90901,BIOFEEDBACK ANY MODALITY,173.0,86.5,30.13,167.81,47
CPT,90912,BFB TRAINING 1ST 15 MIN,,,,,0
CPT,90913,BFB TRAINING EA ADDL 15 MIN,,,,,0
CPT,90935,ACUTE HEMODIALYSIS IP,830.0,415.0,144.58,1333.86,53
CPT,90935,ACUTE HEMODIALYSIS OP,904.0,452.0,157.47,1333.86,54
CPT,90935,CHRONIC HEMODIALYSIS IP,830.0,415.0,144.58,1333.86,53
CPT,90935,CHRONIC HEMODIALYSIS OP,904.0,452.0,157.47,1333.86,54
CPT,90935,HEMODIALYSIS ONE EVALUATION,,,,,0
CPT,90937,HEMODIALYSIS REPEATED EVAL,,,,,0
CPT,90940,HEMODIALYSIS ACCESS STUDY,,,,,0
CPT,90945,CRRT EACH SUBSEQUENT DAY,3262.0,1631.0,405.48,3164.14,53
CPT,90945,DIALYSIS ONE EVALUATION,,,,,0
CPT,90945,O/P PERITONEAL DIALYSIS,816.0,408.0,142.14,810.96,54
CPT,90947,DIALYSIS REPEATED EVAL,,,,,0
CPT,90951,ESRD SERV 4 VISITS P MO <2YR,,,,,0
CPT,90952,ESRD SERV 2-3 VSTS P MO <2YR,,,,,0
CPT,90953,ESRD SERV 1 VISIT P MO <2YRS,,,,,0
CPT,90954,ESRD SERV 4 VSTS P MO 2-11,,,,,0
CPT,90955,ESRD SRV 2-3 VSTS P MO 2-11,,,,,0
CPT,90956,ESRD SRV 1 VISIT P MO 2-11,,,,,0
CPT,90957,ESRD SRV 4 VSTS P MO 12-19,,,,,0
CPT,90958,ESRD SRV 2-3 VSTS P MO 12-19,,,,,0
CPT,90959,ESRD SERV 1 VST P MO 12-19,,,,,0
CPT,90960,ESRD SRV 4 VISITS P MO 20+,,,,,0
CPT,90961,ESRD SRV 2-3 VSTS P MO 20+,,,,,0
CPT,90962,ESRD SERV 1 VISIT P MO 20+,,,,,0
CPT,90963,ESRD HOME PT SERV P MO <2YRS,,,,,0
CPT,90964,ESRD HOME PT SERV P MO 2-11,,,,,0
CPT,90965,ESRD HOME PT SERV P MO 12-19,,,,,0
CPT,90966,ESRD HOME PT SERV P MO 20+,,,,,0
CPT,90967,ESRD SVC PR DAY PT <2,,,,,0
CPT,90968,ESRD SVC PR DAY PT 2-11,,,,,0
CPT,90969,ESRD SVC PR DAY PT 12-19,,,,,0
CPT,90970,ESRD SVC PR DAY PT 20+,,,,,0
CPT,90989,DIALYSIS TRAINING COMPLETE,,,,,0
CPT,90993,DIALYSIS TRAINING INCOMPL,,,,,0
CPT,90997,HEMOPERFUSION,,,,,0
CPT,90999,UNLISTED DIALYSIS PROCEDURE,,,,,0
CPT,909T,"Replacement of integrated neurostimulation system, vagus nerve, including analysis and programming, when performed",,,29986.33,59972.66,8
CPT,90U,ONC CUTAN MLNMA MRNA 23 GENE,,,1950.0,3900.0,8
CPT,910,ANESTH BLADDER SURGERY,,,,,0
CPT,91010,ESOPHAGUS MOTILITY STUDY,,,362.62,725.24,8
CPT,91013,ESOPHGL MOTIL W/STIM/PERFUS,,,,,0
CPT,91020,GASTRIC MOTILITY STUDIES,,,362.62,725.24,8
CPT,91022,DUODENAL MOTILITY STUDY,,,362.62,725.24,8
CPT,91030,ACID PERFUSION OF ESOPHAGUS,,,362.62,725.24,8
CPT,91034,GASTROESOPHAGEAL REFLUX TEST,,,362.62,725.24,8
CPT,91035,G-ESOPH REFLX TST W/ELECTROD,,,834.49,1668.98,8
CPT,91037,ESOPH IMPED FUNCTION TEST,,,209.83,419.66,8
CPT,91038,ESOPH IMPED FUNCT TEST > 1HR,,,362.62,725.24,8
CPT,91040,ESOPH BALLOON DISTENSION TST,,,362.62,725.24,8
CPT,91065,BREATH HYDROGEN/METHANE TEST,,,209.83,419.66,8
CPT,910T,"Removal of integrated neurostimulation system, vagus nerve",,,3397.38,6794.76,8
CPT,91110,GI TRC IMG INTRAL ESOPH-ILE,,,745.66,1762.74,24
CPT,91111,GI TRC IMG INTRAL ESOPHAGUS,,,881.37,1762.74,8
CPT,91112,GI WIRELESS CAPSULE MEASURE,,,881.37,1762.74,8
CPT,91113,GI TRC IMG INTRAL COLON I&R,,,903.7,1807.4,8
CPT,91117,COLON MOTILITY 6 HR STUDY,,,209.83,419.66,8
CPT,91120,RECTAL SENSATION TEST,,,,,0
CPT,91122,ANAL PRESSURE RECORD,,,,,0
CPT,91132,ELECTROGASTROGRAPHY,,,209.83,419.66,8
CPT,91133,ELECTROGASTROGRAPHY W/TEST,,,129.29,258.58,8
CPT,911T,"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; without programming by physician or other qualified health care professional",,,57.33,114.66,8
CPT,912,ANESTH BLADDER TUMOR SURG,,,,,0
CPT,91200,US LIVER ELASTOGRAPHY W/O IMAG,385.0,192.5,67.06,373.45,54
CPT,91299,UNLISTED DX GI PROCEDURE,,,125.04,250.08,8
CPT,912T,"Electronic analysis of implanted integrated neurostimulation system, vagus nerve; with simple programming by physician or other qualified health care professional",,,92.39,184.78,8
CPT,91304,SARSCOV2 VAC 5MCG/0.5ML IM,,,197.08,297.25,2
CPT,91318,SARSCOV2 VAC 3MCG TRS-SUC IM,,,79.97,120.62,2
CPT,91319,SARSCV2 VAC 10MCG TRS-SUC IM,,,107.09,161.53,2
CPT,91320,SARSCV2 VAC 30MCG TRS-SUC IM,,,190.2,286.87,2
CPT,91321,SARSCOV2 VAC 25 MCG/.25ML IM,,,179.41,270.61,2
CPT,91322,SARSCOV2 VAC 50 MCG/0.5ML IM,,,197.21,297.47,2
CPT,91323,"Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 10 mcg/0.2 mL dosage, for intramuscular use",,,,,0
CPT,913T,"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting), including mechanical dilation by nondrug-delivery balloon angioplasty, endo",,,11218.2,22436.4,8
CPT,914,ANESTH REMOVAL OF PROSTATE,,,,,0
CPT,914T,"Percutaneous transcatheter therapeutic drug delivery by intracoronary drug-delivery balloon (eg, drug-coated, drug-eluting) performed on a separate target lesion from the target lesion treated with ba",,,,,0
CPT,915T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse",,,30502.49,61004.98,8
CPT,916,ANESTH BLEEDING CONTROL,,,,,0
CPT,916T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; pulse",,,21615.45,43230.9,8
CPT,917T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; singl",,,8041.71,16083.42,8
CPT,918,ANESTH STONE REMOVAL,,,,,0
CPT,918T,"Insertion of permanent cardiac contractility modulation-defibrillation system component(s), including fluoroscopic guidance, and evaluation and programming of sensing and therapeutic parameters; dual ",,,8041.71,16083.42,8
CPT,919T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); pulse generator only,,,3631.43,7262.86,8
CPT,91U,ONC CLRCT SCR WHL BLD ALG,,,,,0
CPT,920,ANESTH GENITALIA SURGERY,,,,,0
CPT,92002,INTRM OPH EXAM NEW PATIENT,,,129.38,258.76,8
CPT,92004,COMPRE OPH EXAM NEW PT 1/>,,,129.38,258.76,8
CPT,92012,INTRM OPH EXAM EST PATIENT,,,129.38,258.76,8
CPT,92014,COMPRE OPH EXAM EST PT 1/>,,,129.38,258.76,8
CPT,92015,DETERMINE REFRACTIVE STATE,,,,,0
CPT,92018,COMPL OPH EXAM GENERAL ANES,,,2310.35,4620.7,8
CPT,92019,LMTD OPH EXAM GENERAL ANES,,,2310.35,4620.7,8
CPT,92020,GONIOSCOPY,,,129.29,258.58,8
CPT,92025,CPTRIZED CORNEAL TOPOGRAPHY,,,57.33,114.66,8
CPT,92060,SENSORIMOTOR EXAMINATION,,,57.33,114.66,8
CPT,92065,ORTHOP TRAING PFRMD PHYS/QHP,,,,,0
CPT,92066,ORTHOP TRAING SUPVJ PHYS/QHP,,,57.33,114.66,8
CPT,92071,CONTACT LENS FITTING FOR TX,,,,,0
CPT,92072,FITG C-LENS KERATOCONUS 1ST,,,,,0
CPT,92081,LIMITED VISUAL FIELD XM,,,44.44,114.66,24
CPT,92082,INTERMEDIATE VISUAL FIELD XM,,,57.33,114.66,8
CPT,92083,EXTENDED VISUAL FIELD XM,,,129.29,258.58,8
CPT,920T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous pacing lead only,,,3631.43,7262.86,8
CPT,921,ANESTH VASECTOMY,,,,,0
CPT,92100,SERIAL TONOMETRY,,,,,0
CPT,92132,CMPTR OPHTH DX IMG ANT SEGMT,,,57.33,114.66,8
CPT,92133,CMPTR OPHTH IMG OPTIC NERVE,,,57.33,114.66,8
CPT,92134,CPTR OPHTH DX IMG POST SEGMT,,,57.33,114.66,8
CPT,92136,OPHTHALMIC BIOMETRY,,,129.29,258.58,8
CPT,92137,"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [OCT]), posterior segment, with interpretation and report, unilateral or bilateral; retina, including OCT angiography",,,209.83,419.66,8
CPT,92145,CORNEAL HYSTERESIS DETER,,,57.33,114.66,8
CPT,921T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); single transvenous defibrillation lead only,,,3631.43,7262.86,8
CPT,922,ANESTH SPERM DUCT SURGERY,,,,,0
CPT,92201,OPSCPY EXTND RTA DRAW UNI/BI,,,57.33,114.66,8
CPT,92202,OPSCPY EXTND ON/MAC DRAW,,,57.33,114.66,8
CPT,92227,IMG RTA DETCJ/MNTR DS STAFF,,,57.33,114.66,8
CPT,92228,IMG RTA DETC/MNTR DS PHY/QHP,,,36.3,72.6,8
CPT,92229,IMG RTA DETC/MNTR DS POC ALY,,,57.33,114.66,8
CPT,92230,FLUORESCEIN ANGIOSCOPY I&R,,,362.62,725.24,8
CPT,92235,FLUORESCEIN ANGRPH MLTIFRAME,,,209.83,419.66,8
CPT,92240,ICG ANGIOGRAPHY I&R UNI/BI,,,209.83,419.66,8
CPT,92242,FLUORESCEIN&ICG ANGIOGRAPHY,,,209.83,419.66,8
CPT,92250,FUNDUS PHOTOGRAPHY W/I&R,,,129.29,258.58,8
CPT,92260,OPHTHALMODYNAMOMETRY,,,36.3,72.6,8
CPT,92265,NDL OCULOELECTROMYOGRAPHY 1+,,,57.33,114.66,8
CPT,92270,ELECTRO-OCULOGRAPHY W/I&R,,,129.29,258.58,8
CPT,92273,FULL FIELD ERG W/I&R,,,209.83,419.66,8
CPT,92274,MULTIFOCAL ERG W/I&R,,,125.04,250.08,8
CPT,92283,EXTND COLOR VISION XM,,,57.33,114.66,8
CPT,92284,DX DARK ADAPTATION EXAM I&R,,,434.11,868.22,8
CPT,92285,EXTERNAL OCULAR PHOTOGRAPHY,,,36.3,72.6,8
CPT,92286,ANT SGM IMG I&R SPECLR MIC,,,129.29,258.58,8
CPT,92287,ANT SGM IMG IR FLRSCN ANGRPH,,,129.29,258.58,8
CPT,922T,Removal of a permanent cardiac contractility modulation-defibrillation system component(s); dual (pacing and defibrillation) transvenous leads only,,,3631.43,7262.86,8
CPT,92310,CONTACT LENS FITTING OU,,,,,0
CPT,92311,CONTACT LENS FITG APHAKIA 1,,,434.11,868.22,8
CPT,92312,CONTACT LENS FITG APHAKIA OU,,,129.29,258.58,8
CPT,92313,C-LENS FITG CORNEOSCLRL LENS,,,129.29,258.58,8
CPT,92314,C-LENS FITG TECH OU,,,,,0
CPT,92315,C-LENS FITG TECH APHAKIA 1,,,129.29,258.58,8
CPT,92316,C-LENS FITG TECH APHAKIA OU,,,129.29,258.58,8
CPT,92317,C-LENS FITG TECH CORNEOSCLRL,,,36.3,72.6,8
CPT,92325,MODIFICATION OF CONTACT LENS,,,129.29,258.58,8
CPT,92326,REPLACEMENT OF CONTACT LENS,,,57.33,114.66,8
CPT,92340,FIT SPECTACLES MONOFOCAL,,,,,0
CPT,92341,FIT SPECTACLES BIFOCAL,,,,,0
CPT,92342,FIT SPECTACLES MULTIFOCAL,,,,,0
CPT,92352,FIT APHAKIA SPECTCL MONOFOCL,,,57.33,114.66,8
CPT,92353,FIT APHAKIA SPECTCL MULTIFOC,,,57.33,114.66,8
CPT,92354,FITG SPECT LOW VIS 1SYSTEM,,,36.3,72.6,8
CPT,92355,FITG SPECT LW VIS CMPND LENS,,,36.3,72.6,8
CPT,92358,APHAKIA PROSTH SERVICE TEMP,,,57.33,114.66,8
CPT,92370,RPR&REFITG SPECT XCP APHAKIA,,,,,0
CPT,92371,RPR&REFIT SPCT PRSTH APHAKIA,,,57.33,114.66,8
CPT,923T,Removal and replacement of permanent cardiac contractility modulation-defibrillation pulse generator only,,,21615.45,43230.9,8
CPT,924,ANESTH TESTIS EXPLORATION,,,,,0
CPT,92499,UNLISTED OPH SVC/PROCEDURE,,,28.11,56.22,8
CPT,924T,"Repositioning of previously implanted cardiac contractility modulation-defibrillation transvenous electrode(s)/lead(s), including fluoroscopic guidance and programming of sensing and therapeutic param",,,609.59,1219.18,8
CPT,92502,EAR AND THROAT EXAMINATION,,,524.1,1048.2,8
CPT,92504,EAR MICROSCOPY EXAMINATION,,,,,0
CPT,92507,SP SPEECH VOICE LANG TRMT,262.0,131.0,45.64,254.14,47
CPT,92507,SPEECH/HEARING THERAPY,,,,,0
CPT,92508,SPEECH/HEARING THERAPY,,,,,0
CPT,92511,NASOPHARYNGOSCOPY,396.0,198.0,68.98,387.94,54
CPT,92512,NASAL FUNCTION STUDIES,,,209.83,419.66,8
CPT,92516,FACIAL NERVE FUNCTION TEST,,,209.83,419.66,8
CPT,92517,VEMP TEST I&R CERVICAL,,,125.04,250.08,8
CPT,92518,VEMP TEST I&R OCULAR,,,125.04,250.08,8
CPT,92519,VEMP TST I&R CERVICAL&OCULAR,,,209.83,419.66,8
CPT,92520,LARYNGEAL FUNCTION STUDIES,,,129.29,258.58,8
CPT,92521,EVALUATION OF SPEECH FLUENCY,,,,,0
CPT,92521,SP EVAL SPEECH FLUENCY,380.0,190.0,66.19,368.6,47
CPT,92522,EVALUATE SPEECH PRODUCTION,,,,,0
CPT,92522,SP EVAL SPEECH PRODUCTION,380.0,190.0,66.19,368.6,47
CPT,92523,SP SPEECH SOUND LANG COMPREHEN,380.0,190.0,66.19,368.6,47
CPT,92523,SPEECH SOUND LANG COMPREHEN,,,,,0
CPT,92524,BEHAVRAL QUALIT ANALYS VOICE,,,,,0
CPT,92524,SP BEHAVRL QUALIT ANALYS VOICE,380.0,190.0,66.19,368.6,47
CPT,92526,SP SWALLOWING/ORAL FUNCT TRMT,262.0,131.0,45.64,254.14,47
CPT,92531,SPONTANEOUS NYSTAGMUS STUDY,,,,,0
CPT,92532,POSITIONAL NYSTAGMUS TEST,,,,,0
CPT,92533,CALORIC VESTIBULAR TEST,,,,,0
CPT,92534,OPTOKINETIC NYSTAGMUS TEST,,,,,0
CPT,92537,CALORIC VSTBLR TEST W/REC,,,125.04,250.08,8
CPT,92538,CALORIC VSTBLR TEST W/REC,,,209.83,419.66,8
CPT,92540,BASIC VESTIBULAR EVALUATION,,,209.83,419.66,8
CPT,92541,SPONTANEOUS NYSTAGMUS TEST,,,129.29,258.58,8
CPT,92542,POSITIONAL NYSTAGMUS TEST,,,129.29,258.58,8
CPT,92544,OPTOKINETIC NYSTAGMUS TEST,,,125.04,250.08,8
CPT,92545,OSCILLATING TRACKING TEST,,,209.83,419.66,8
CPT,92546,SINUSOIDAL ROTATIONAL TEST,,,125.04,250.08,8
CPT,92547,SUPPLEMENTAL ELECTRICAL TEST,,,,,0
CPT,92548,CDP-SOT 6 COND W/I&R,,,129.29,258.58,8
CPT,92549,CDP-SOT 6 COND W/I&R MCT&ADT,,,129.29,258.58,8
CPT,92550,TYMPANOMETRY & REFLEX THRESH,238.0,119.0,41.45,419.66,54
CPT,92551,PURE TONE HEARING TEST AIR,,,,,0
CPT,92552,PURE TONE AUDIOMETRY AIR ONLY,155.0,77.5,27.0,258.58,54
CPT,92553,PURE TONE AUDIOMETRY AIR&BONE,276.0,138.0,48.07,267.72,54
CPT,92555,SPEECH AUDIOMETRY THRESHOLD,159.0,79.5,27.69,154.23,54
CPT,92556,SP AUDIOMETRY W SP RECOGN,165.0,82.5,28.74,160.05,54
CPT,92557,COMP AUDIOM EVAL& SP RECOG,286.0,143.0,49.82,277.42,54
CPT,92557,COMP AUDIOMETRY RE-EVAL,280.0,140.0,48.77,271.6,54
CPT,92558,EVOKED AUDITORY TEST QUAL,,,,,0
CPT,92562,LOUDNESS BALANCE TEST,,,209.83,419.66,8
CPT,92563,TONE DECAY TEST,119.0,59.5,20.72,115.43,54
CPT,92565,STENGER TEST PURE TONE,,,57.33,114.66,8
CPT,92567,TYMPANOMETRY,155.0,77.5,27.0,150.35,54
CPT,92568,ACOUSTIC REFLEX TESTING,147.0,73.5,25.6,142.59,54
CPT,92570,ACOUSTIC REFLEX DECAY,293.0,146.5,51.04,284.21,54
CPT,92571,FILTERED SPEECH HEARING TEST,,,36.3,72.6,8
CPT,92572,STAGGERED SPONDAIC WORD TEST,,,125.04,250.08,8
CPT,92575,SENSORINEURAL ACUITY TEST,,,36.3,72.6,8
CPT,92576,SYNTHETIC SENTENCE TEST,,,36.3,72.6,8
CPT,92577,STENGER TEST SPEECH,577.0,288.5,100.51,725.24,54
CPT,92579,VISUAL AUDIOMETRY (VRA),,,209.83,419.66,8
CPT,92582,CONDITIONING PLAY AUDIOMETRY,,,125.04,250.08,8
CPT,92583,SELECT PICTURE AUDIOMETRY,,,57.33,114.66,8
CPT,92584,ELECTROCOCHLEOGRAPHY,,,125.04,250.08,8
CPT,92587,EVOK OTOACOUSTIC EMISSION LTD,343.0,171.5,59.75,419.66,54
CPT,92588,COMP EVOKED OTOACOUST EMISSN,421.0,210.5,73.33,725.24,54
CPT,92590,HEARING AID EXAM ONE EAR,,,,,0
CPT,92591,HEARING AID EXAM BOTH EARS,,,,,0
CPT,92592,HEARING AID CHECK MONAURAL COMPLEX 30+ MIN,254.0,127.0,44.24,246.38,47
CPT,92592,HEARING AID CHECK MONAURAL MODERATE 15-30 MIN,212.0,106.0,36.93,205.64,47
CPT,92592,HEARING AID RE-CHECK,219.0,109.5,38.14,212.43,47
CPT,92593,HEARING AID CHECK BINAURAL SIMPLE 0-15 MIN,171.0,85.5,29.78,165.87,47
CPT,92594,ELECTROACOUSTC EVAL H AID MON,286.0,143.0,49.82,277.42,47
CPT,92595,ELECTROACOUSTC EVAL H AID BI,350.0,175.0,60.97,339.5,47
CPT,92596,EAR PROTECTOR EVALUATION,,,36.3,72.6,8
CPT,92597,SP EVAL VOICE PROSTHESIS,154.0,77.0,26.82,149.38,47
CPT,925T,Relocation of skin pocket for implanted cardiac contractility modulation-defibrillation pulse generator,,,2005.02,4010.04,8
CPT,926,ANESTH REMOVAL OF TESTIS,,,,,0
CPT,92601,COCHLEAR IMPLT F/UP EXAM <7,,,125.04,250.08,8
CPT,92602,REPROGRAM COCHLEAR IMPLT <7,,,125.04,250.08,8
CPT,92603,COCHLEAR IMPLT F/UP EXAM 7/>,,,125.04,250.08,8
CPT,92604,REPROGRAM COCHLEAR IMPLT 7/>,,,125.04,250.08,8
CPT,92605,SP EVAL NONSP GEN DEV 1ST HR,276.0,138.0,48.07,267.72,47
CPT,92606,SP MODIF NON SP GEN DEVICE,538.0,269.0,93.71,521.86,47
CPT,92607,SP EVAL SP GEN DEV RX 1ST HR,656.0,328.0,114.27,636.32,47
CPT,92608,SP EVAL SP GEN RX ADDL 30MIN,174.0,87.0,30.31,168.78,47
CPT,92609,SP TX SERV SP GENERATING DEV,340.0,170.0,59.22,329.8,47
CPT,92610,SP SWALLOW FUNCTION EVAL,380.0,190.0,66.19,368.6,47
CPT,92611,SP MOTN FLUORO SWAL EVAL MBSS,380.0,190.0,66.19,368.6,47
CPT,92612,SP FLEX FIBEROP ENDOSCOP EVAL,660.0,330.0,114.97,640.2,47
CPT,92613,ENDOSCOPY SWALLOW (FEES) I&R,,,,,0
CPT,92614,LARYNGOSCOPIC SENSORY VID,,,,,0
CPT,92615,LARYNGOSCOPIC SENSORY I&R,,,,,0
CPT,92616,FEES W/LARYNGEAL SENSE TEST,,,,,0
CPT,92617,FEES W/LARYNGEAL SENSE I&R,,,,,0
CPT,92618,SP EVAL NONSP GEN DEV +30 MIN,144.0,72.0,25.08,139.68,47
CPT,92620,CENTRAL AUD FUNC W/RPT 60MIN,393.0,196.5,68.46,381.21,54
CPT,92621,CENT AUDITORY FUNC ADDL 15MIN,180.0,90.0,31.35,174.6,47
CPT,92622,DX ALY AUD OI SND PRCSR 1ST,,,125.04,250.08,8
CPT,92623,DX ALY AUD OI SND PRCSR EACH,,,,,0
CPT,92625,TINNITUS ASSESSMENT,,,125.04,250.08,8
CPT,92626,EVAL AUD REHAB STATUS 1ST HR,393.0,196.5,68.46,381.21,54
CPT,92627,EVAL AUD REHAB STATUS ADD15MI,100.0,50.0,17.42,97.0,47
CPT,92630,AUD REHAB PRE-LING HEAR LOSS,,,,,0
CPT,92633,AUD REHAB POSTLING HEAR LOSS,,,,,0
CPT,92640,AUD BRAINSTEM IMPLT PROGRAMG,,,125.04,250.08,8
CPT,92650,AEP SCR AUDITORY POTENTIAL,323.0,161.5,56.26,313.31,47
CPT,92651,AEP HEARING STATUS DETER I&R,613.0,306.5,106.78,594.61,54
CPT,92652,AEP THRSHLD EST MLT FREQ I&R,1003.0,501.5,174.72,972.91,54
CPT,92652,AUD EVOK POTENT THRSHLD EST MLT FREQ I&R,2023.0,1011.5,209.83,1962.31,54
CPT,92653,AEP NEURODIAGNOSTIC I&R,627.0,313.5,109.22,608.19,54
CPT,92653,AUD EVOK POTENT NEURODIAGNOSTIC I&R,1974.0,987.0,209.83,1914.78,54
CPT,926T,"Programming device evaluation (in person) with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, including",,,36.27,72.54,8
CPT,92700,UNLISTED ORL SERVICE/PX,,,28.11,56.22,8
CPT,927T,"Interrogation device evaluation (in person) with analysis, review, and report, including connection, recording, and disconnection, per patient encounter, implantable cardiac contractility modulation-d",,,36.27,72.54,8
CPT,928,ANESTH REMOVAL OF TESTIS,,,,,0
CPT,928T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system with interim analysis and report(s) by a physician or other qualified health care profes",,,,,0
CPT,92920,PRQ CARDIAC ANGIOPLAST 1 ART,,,5530.84,11061.68,8
CPT,92921,PRQ CARDIAC ANGIO ADDL ART,,,,,0
CPT,92924,PRQ CARD ANGIO/ATHRECT 1 ART,,,11218.2,22436.4,8
CPT,92925,PRQ CARD ANGIO/ATHRECT ADDL,,,,,0
CPT,92928,PRQ CARD STENT W/ANGIO 1 VSL,,,11218.2,22436.4,8
CPT,92929,PRQ CARD STENT W/ANGIO ADDL,,,,,0
CPT,92933,PRQ CARD STENT/ATH/ANGIO,,,17813.98,35627.96,8
CPT,92934,PRQ CARD STENT/ATH/ANGIO,,,,,0
CPT,92937,PRQ REVASC BYP GRAFT 1 VSL,,,11218.2,22436.4,8
CPT,92938,PRQ REVASC BYP GRAFT ADDL,,,,,0
CPT,92941,PRQ CARD REVASC MI 1 VSL,,,,,0
CPT,92943,PRQ CARD REVASC CHRONIC 1VSL,,,11218.2,22436.4,8
CPT,92944,PRQ CARD REVASC CHRONIC ADDL,,,,,0
CPT,92950,CPR,1227.0,613.5,209.83,1190.19,54
CPT,92950,CPR HEARTLUNG RESUSCITATION,1289.0,644.5,209.83,1250.33,54
CPT,92953,TEMPORARY PACING,792.0,396.0,137.96,1284.56,54
CPT,92960,CARDIOVERSION ELECT EXTERNAL,1994.0,997.0,210.78,2029.24,162
CPT,92961,CARDIOVERSION ELECTRIC INT,,,642.28,1284.56,8
CPT,92970,CARDIOASSIST INTERNAL,,,,,0
CPT,92971,CARDIOASSIST EXTERNAL,,,,,0
CPT,92972,PERQ TRLUML CORONRY LITHOTRP,,,,,0
CPT,92973,PRQ CORONARY MECH THROMBECT,,,,,0
CPT,92974,CATH PLACE CARDIO BRACHYTX,,,,,0
CPT,92975,DISSOLVE CLOT HEART VESSEL,,,,,0
CPT,92977,IV CORONARY THROMBOLYSIS,758.0,379.0,132.04,735.26,47
CPT,92978,ENDOLUMINL IVUS OCT C 1ST,,,,,0
CPT,92979,ENDOLUMINL IVUS OCT C EA,,,,,0
CPT,92986,REVISION OF AORTIC VALVE,,,5530.84,11061.68,8
CPT,92987,REVISION OF MITRAL VALVE,,,11218.2,22436.4,8
CPT,92990,REVISION OF PULMONARY VALVE,,,11218.2,22436.4,8
CPT,92997,PUL ART BALLOON REPR PERCUT,,,11218.2,22436.4,8
CPT,92998,PUL ART BALLOON REPR PERCUT,,,,,0
CPT,929T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation-defibrillation system, remote data acquisition(s), receipt of transmissions, technician review, technical supp",,,36.27,72.54,8
CPT,92U,ONC LNG 3 PRTN BMRK PLSM ALG,,,2488.0,4976.0,8
CPT,930,ANESTH TESTIS SUSPENSION,,,,,0
CPT,93000,ELECTROCARDIOGRAM COMPLETE,,,18.02,20.93,16
CPT,93005,ECG 12 LEAD TRACING,361.0,180.5,9.96,442.32,108
CPT,93005,MUD ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R NHCI,196.0,98.0,9.96,190.12,54
CPT,93010,ECG INTERPRETATION,46.0,23.0,8.01,44.62,47
CPT,93015,CARDIOVASCULAR STRESS TEST,,,80.44,93.41,16
CPT,93016,CARDIOVASCULAR STRESS TEST,,,20.28,23.55,16
CPT,93017,CARDIAC STRESS TEST TRACE ONL,1433.0,716.5,46.44,1390.01,54
CPT,93018,CARDIOVASCULAR STRESS TEST,,,13.73,15.94,16
CPT,93024,CARDIAC DRUG STRESS TEST,,,100.78,868.22,24
CPT,93025,MICROVOLT T-WAVE ASSESS,,,125.04,250.08,8
CPT,93040,RHYTHM ECG WITH REPORT,,,12.44,14.44,16
CPT,93041,RHYTHM STRIP,212.0,106.0,5.29,205.64,54
CPT,93042,RHYTHM ECG REPORT,,,,,0
CPT,93050,ART PRESSURE WAVEFORM ANALYS,,,28.11,56.22,8
CPT,930T,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arr",,,1183.16,2366.32,8
CPT,93150,THERAPY ACTIVATION IPNSS,,,92.39,184.78,8
CPT,93151,INTERROG&PRGRMG IPNSS,,,92.39,184.78,8
CPT,93152,INTERROG&PRGRMG IPNSS POLYSM,,,298.46,596.92,8
CPT,93153,INTERROG W/O PRGRMG IPNSS,,,92.39,184.78,8
CPT,931T,"Electrophysiologic evaluation of cardiac contractility modulation-defibrillator leads, including defibrillation-threshold evaluation (induction of arrhythmia, evaluation of sensing and therapy for arr",,,1183.16,2366.32,8
CPT,932,ANESTH AMPUTATION OF PENIS,,,,,0
CPT,93224,ECG MONIT/REPRT UP TO 48 HRS,,,91.81,106.62,16
CPT,93225,HOLTER MONITOR,387.0,193.5,27.42,375.39,54
CPT,93226,ECG MONIT/REPRT UP TO 48 HRS,,,40.83,114.66,24
CPT,93227,ECG MONIT/REPRT UP TO 48 HRS,,,,,0
CPT,93228,REMOTE 30 DAY ECG REV/REPORT,,,23.55,27.35,16
CPT,93229,CV REMOTE 30 DAY TELEMETRY ECG TECH SUPP,926.0,463.0,161.3,898.22,54
CPT,93241,EXT ECG>48HR<7D REC SCAN A/R,,,,,0
CPT,93242,EXT ECG>48HR<7D RECORDING,,,36.3,72.6,8
CPT,93243,EXT ECG>48HR<7D SCAN A/R,,,129.29,258.58,8
CPT,93244,EXT ECG>48HR<7D REV&INTERPJ,,,,,0
CPT,93245,EXT ECG>7D<15D REC SCAN A/R,,,,,0
CPT,93246,EXT ECG>7D<15D RECORDING,,,36.3,72.6,8
CPT,93247,EXT ECG>7D<15D SCAN A/R,,,129.29,258.58,8
CPT,93248,EXT ECG>7D<15D REV&INTERPJ,,,,,0
CPT,93260,PRGRMG DEV EVAL IMPLTBL SYS,,,36.27,72.54,8
CPT,93261,INTERROGATE SUBQ DEFIB,,,36.27,72.54,8
CPT,93264,REM MNTR WRLS P-ART PRS SNR,,,36.27,72.54,8
CPT,93268,ECG RECORD/REVIEW,,,209.18,242.92,16
CPT,93270,MULT EVENT MONITR RECORD/HOOK,461.0,230.5,14.95,447.17,54
CPT,93271,ECG/MONITORING AND ANALYSIS,,,92.39,193.23,24
CPT,93272,ECG/REVIEW INTERPRET ONLY,,,19.7,22.87,16
CPT,93278,ECG SIGNAL AVERAGED,264.0,132.0,31.27,256.08,54
CPT,93278,ECG SIGNAL AVERAGED INTERP,125.0,62.5,21.77,121.25,54
CPT,93279,PRGRMG DEV EVAL PM/LDLS PM,,,36.27,72.54,24
CPT,93280,PM DEVICE PROGR EVAL DUAL,,,36.27,72.54,24
CPT,93281,PM DEVICE PROGR EVAL MULTI,,,36.27,74.58,24
CPT,93282,PRGRMG EVAL IMPLANTABLE DFB,,,36.27,72.54,24
CPT,93283,PRGRMG EVAL IMPLANTABLE DFB,,,36.27,87.03,24
CPT,93284,PRGRMG EVAL IMPLANTABLE DFB,,,36.27,98.37,24
CPT,93285,PRGRMG DEV EVAL SCRMS IP,,,36.27,72.54,24
CPT,93286,PERI-PX EVAL PM/LDLS PM IP,,,23.69,27.51,16
CPT,93287,PERI-PX DEVICE EVAL & PRGR,,,30.87,35.85,16
CPT,93288,PM DEVICE EVAL IN PERSON,109.0,54.5,18.98,105.73,54
CPT,93289,INTERROG DEVICE EVAL HEART,,,36.27,72.54,24
CPT,93290,ICM DEVICE EVAL,163.0,81.5,27.17,158.11,54
CPT,93291,INTERROG DEV EVAL SCRMS IP,,,28.11,56.22,24
CPT,93292,WCD DEVICE INTERROGATE,,,30.6,72.54,24
CPT,93293,PM PHONE R-STRIP DEVICE EVAL,,,36.27,72.54,24
CPT,93294,REM INTERROG EVL PM/LDLS PM,,,31.39,36.45,16
CPT,93295,DEV INTERROG REMOTE 1/2/MLT,,,61.55,71.47,16
CPT,93296,REM INTERROG EVL PM/IDS,,,30.23,72.54,24
CPT,93297,REM INTERROG DEV EVAL ICPMS,,,23.55,72.54,24
CPT,93298,REM INTERROG DEV EVAL SCRMS,,,26.04,72.54,24
CPT,932T,"Noninvasive detection of heart failure derived from augmentative analysis of an echocardiogram that demonstrated preserved ejection fraction, with interpretation and report by a physician or other qua",,,298.46,596.92,8
CPT,93303,ECHO COMPLETE CONGENITAL ANOM W/CONTRAST OR W & W/O CONTRAST,2720.0,1360.0,176.27,2838.22,108
CPT,93303,ECHO COMPLETE CONGENITAL ANOM W/O CONTRAST,3077.5,1538.75,176.27,3132.13,108
CPT,93304,ECHO LIMITED CONGENITAL ANOMA W/CONTRAST OR W & W/O CONTRAST,1650.5,825.25,111.61,1985.59,108
CPT,93304,ECHO LIMITED CONGENITAL ANOMA W/O CONTRAST,1563.0,781.5,111.61,1562.67,108
CPT,93306,ECHO COMPLETE WITH DOPPLER W/CONTRAST OR W & W/O CONTRAST,2538.0,1269.0,206.8,2838.22,108
CPT,93306,ECHO COMPLETE WITH DOPPLER W/O CONTRAST,2461.5,1230.75,206.8,2628.7,108
CPT,93307,ECHO COMPLETE WO DOPPLER W/CONTRAST OR W & W/O CONTRAST,1922.5,961.25,133.09,2198.02,108
CPT,93307,ECHO COMPLETE WO DOPPLER W/O CONTRAST,1626.0,813.0,133.09,1577.22,54
CPT,93308,ECHO LIMITED OR FOLLOW UP W/CONTRAST OR W & W/O CONTRAST,830.0,415.0,89.62,943.81,108
CPT,93308,ECHO LIMITED OR FOLLOW UP W/O CONTRAST,839.5,419.75,89.62,943.81,108
CPT,93312,TRANSESOPHAGEAL ECHO W/CONTRAST OR W & W/O CONTRAST,2402.5,1201.25,269.48,2628.7,108
CPT,93312,TRANSESOPHAGEAL ECHO W/O CONTRAST,2402.5,1201.25,269.48,2628.7,108
CPT,93313,ECHO TRANSESOPHAGEAL,,,37.0,1061.98,24
CPT,93314,ECHO TRANSESOPHAGEAL,,,233.4,271.04,16
CPT,93315,ECHO TRANSESOPHAGEAL,,,323.48,1061.98,24
CPT,93316,ECHO TRANSESOPHAGEAL,,,40.11,1061.98,24
CPT,93317,ECHO TRANSESOPHAGEAL,,,212.77,247.08,16
CPT,93318,TRA ESOPHOG ECHO-OR/CATH/EP W/CONTRAST OR W & W/O CONTRAST,3454.5,1727.25,257.54,3429.92,108
CPT,93318,TRA ESOPHOG ECHO-OR/CATH/EP W/O CONTRAST,3444.0,1722.0,257.54,3409.55,108
CPT,93319,3D ECHO IMG TEE/TTE CGEN CAR ANOMAL,43.0,21.5,7.49,41.71,94
CPT,93320,DOPPLER ECHO,528.0,264.0,58.44,601.4,94
CPT,93321,DOPPLER ECHO LIMITED,528.0,264.0,27.11,523.8,94
CPT,93325,DOPPLER COLOR FLOW VELOCITY,411.0,205.5,36.0,492.76,188
CPT,93350,STRESS TTE ONLY W/CONTRAST OR W & W/O CONTRAST,2766.0,1383.0,176.25,2838.22,108
CPT,93350,STRESS TTE ONLY W/O CONTRAST,2631.0,1315.5,176.25,2628.7,108
CPT,93351,STRESS ECHO W CONTINUOUS ECG W/CONTRAST OR W & W/O CONTRAST,2766.0,1383.0,210.55,2838.22,108
CPT,93351,STRESS ECHO W CONTINUOUS ECG W/O CONTRAST,2631.0,1315.5,210.55,2628.7,108
CPT,93352,ADMIN ECG CONTRAST AGENT,,,31.4,36.47,16
CPT,93355,ECHO TEE GUIDANCE/STRUCTURAL INTVN,470.0,235.0,81.35,458.81,94
CPT,93356,MYOCARDIAL STRAIN IMG SPECKLE TRCK,152.0,76.0,21.6,174.6,94
CPT,933T,"Transcatheter implantation of wireless left atrial pressure sensor for long-term left atrial pressure monitoring, including sensor calibration and deployment, right heart catheterization, transseptal ",,,3150.38,6300.76,8
CPT,934,ANESTH PENIS NODES REMOVAL,,,,,0
CPT,93451,RIGHT HEART CATH,,,3150.38,6300.76,8
CPT,93452,LEFT HRT CATH W/VENTRCLGRPHY,,,3150.38,6300.76,8
CPT,93453,R&L HRT CATH W/VENTRICLGRPHY,,,3150.38,6300.76,8
CPT,93454,CORONARY ARTERY ANGIO S&I,,,3150.38,6300.76,8
CPT,93455,CORONARY ART/GRFT ANGIO S&I,,,3150.38,6300.76,8
CPT,93456,R HRT CORONARY ARTERY ANGIO,,,3150.38,6300.76,8
CPT,93457,R HRT ART/GRFT ANGIO,,,3150.38,6300.76,8
CPT,93458,L HRT ARTERY/VENTRICLE ANGIO,,,3150.38,6300.76,8
CPT,93459,L HRT ART/GRFT ANGIO,,,3150.38,6300.76,8
CPT,93460,R&L HRT ART/VENTRICLE ANGIO,,,3150.38,6300.76,8
CPT,93461,R&L HRT ART/VENTRICLE ANGIO,,,3150.38,6300.76,8
CPT,93462,L HRT CATH TRNSPTL PUNCTURE,,,,,0
CPT,93463,DRUG ADMIN & HEMODYNMIC MEAS,,,,,0
CPT,93464,EXERCISE W/HEMODYNAMIC MEAS,,,,,0
CPT,934T,"Remote monitoring of a wireless left atrial pressure sensor for up to 30 days, including data from daily uploads of left atrial pressure recordings, interpretation(s) and trend analysis, with adjustme",,,,,0
CPT,93503,INSERT/PLACE HEART CATHETER,,,1529.7,3059.4,8
CPT,93505,BIOPSY OF HEART LINING,,,3068.32,6136.64,8
CPT,93563,NJX CGEN CAR CTH SLCTV C ANG,,,,,0
CPT,93564,NJX CGEN CAR CATH SLCTV OPAC,,,,,0
CPT,93565,NJX CAR CTH SLCTV LV/LA ANG,,,,,0
CPT,93566,NJX CAR CTH SLCTV RV/RA ANG,,,,,0
CPT,93567,NJX CAR CTH SPRVLV AORTGRPHY,,,,,0
CPT,93568,NJX CAR CTH NSLC P-ART ANGRP,,,,,0
CPT,93569,NJX CTH SLCT P-ART ANGRP UNI,,,,,0
CPT,93571,HEART FLOW RESERVE MEASURE,,,,,0
CPT,93572,HEART FLOW RESERVE MEASURE,,,,,0
CPT,93573,NJX CATH SLCT P-ART ANGRP BI,,,,,0
CPT,93574,NJX CATH SLCT PULM VN ANGRPH,,,,,0
CPT,93575,NJX CATH SLCT P ANGRPH MAPCA,,,,,0
CPT,93580,TRANSCATH CLOSURE OF ASD,,,17813.98,35627.96,8
CPT,93581,TRANSCATH CLOSURE OF VSD,,,17813.98,35627.96,8
CPT,93582,PERQ TRANSCATH CLOSURE PDA,,,17813.98,35627.96,8
CPT,93583,PERQ TRANSCATH SEPTAL REDUXN,,,,,0
CPT,93584,VNGRPH CHD ANOM/PERSIST SVC,,,,,0
CPT,93585,VNGRPH CHD AZYGS/HEMIAZYGS,,,,,0
CPT,93586,VNGRPH CHD CORONARY SINUS,,,,,0
CPT,93587,VNGRPH CHD VNVN CLTRL AT/ABV,,,,,0
CPT,93588,VNGRPH CHD VNVN CLTRL BELOW,,,,,0
CPT,93590,PERQ TRANSCATH CLS MITRAL,,,17813.98,35627.96,8
CPT,93591,PERQ TRANSCATH CLS AORTIC,,,17813.98,35627.96,8
CPT,93592,PERQ TRANSCATH CLOSURE EACH,,,,,0
CPT,93593,R HRT CATH CHD NML NT CNJ,,,3150.38,6300.76,8
CPT,93594,R HRT CATH CHD ABNL NT CNJ,,,3150.38,6300.76,8
CPT,93595,L HRT CATH CHD NM/ABN NT CNJ,,,3150.38,6300.76,8
CPT,93596,R&L HRT CATH CHD NML NT CNJ,,,3150.38,6300.76,8
CPT,93597,R&L HRT CATH CHD ABNL NT CNJ,,,3150.38,6300.76,8
CPT,93598,CAR OUTP MEAS DRG CATH CHD,,,,,0
CPT,935T,"Cystourethroscopy with renal pelvic sympathetic denervation, radiofrequency ablation, retrograde ureteral approach, including insertion of guide wire, selective placement of ureteral sheath(s) and mul",,,,,0
CPT,936,ANESTH PENIS NODES REMOVAL,,,,,0
CPT,93600,BUNDLE OF HIS RECORDING,,,7579.41,15158.82,8
CPT,93602,INTRA-ATRIAL RECORDING,,,7579.41,15158.82,8
CPT,93603,RIGHT VENTRICULAR RECORDING,,,1183.16,2366.32,8
CPT,93609,MAP TACHYCARDIA ADD-ON,,,,,0
CPT,93610,INTRA-ATRIAL PACING,,,7579.41,15158.82,8
CPT,93612,INTRAVENTRICULAR PACING,,,7579.41,15158.82,8
CPT,93613,ELECTROPHYS MAP 3D ADD-ON,,,,,0
CPT,93615,ESOPHAGEAL RECORDING,,,1183.16,2366.32,8
CPT,93616,ESOPHAGEAL RECORDING,,,1183.16,2366.32,8
CPT,93618,HEART RHYTHM PACING,,,1183.16,2366.32,8
CPT,93619,ELECTROPHYSIOLOGY EVALUATION,,,7579.41,15158.82,8
CPT,93620,ELECTROPHYSIOLOGY EVALUATION,,,7579.41,15158.82,8
CPT,93621,ELECTROPHYSIOLOGY EVALUATION,,,,,0
CPT,93622,ELECTROPHYSIOLOGY EVALUATION,,,,,0
CPT,93623,STIMULATION PACING HEART,,,,,0
CPT,93624,ELECTROPHYSIOLOGIC STUDY,,,7579.41,15158.82,8
CPT,93631,HEART PACING MAPPING,,,,,0
CPT,93640,EVALUATION HEART DEVICE,,,,,0
CPT,93641,ELECTROPHYSIOLOGY EVALUATION,,,,,0
CPT,93642,ELECTROPHYSIOLOGY EVALUATION,,,1183.16,2366.32,8
CPT,93644,ELECTROPHYSIOLOGY EVALUATION,,,,,0
CPT,93650,ABLATE HEART DYSRHYTHM FOCUS,,,7579.41,15158.82,8
CPT,93653,COMPRE EP EVAL TX SVT,,,25399.77,50799.54,8
CPT,93654,COMPRE EP EVAL TX VT,,,25399.77,50799.54,8
CPT,93655,ICAR CATH ABLTJ DSCRT ARRHYT,,,,,0
CPT,93656,COMPRE EP EVAL ABLTJ ATR FIB,,,25399.77,50799.54,8
CPT,93657,TX L/R ATRIAL FIB ADDL,,,,,0
CPT,93660,TILT TABLE,2047.5,1023.75,260.08,2523.94,108
CPT,93662,INTRACARDIAC ECG (ICE),,,,,0
CPT,93668,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,124.0,62.0,21.6,120.28,54
CPT,936T,"Photobiomodulation therapy of retina, single session",,,,,0
CPT,93701,BIOIMPEDANCE CV ANALYSIS,,,129.29,258.58,8
CPT,93702,BIS XTRACELL FLUID ANALYSIS,321.0,160.5,55.91,311.37,54
CPT,93724,CARDIOVERSION/PACER REPROGRAM,358.0,179.0,62.36,596.92,54
CPT,93740,TEMPERATURE GRADIENT STUDIES,,,125.04,250.08,8
CPT,93745,SET-UP CARDIOVERT-DEFIBRILL,,,298.46,596.92,8
CPT,93750,INTERROGATION VAD IN PERSON,,,92.39,184.78,8
CPT,93770,MEASURE VENOUS PRESSURE,,,,,0
CPT,93784,AMBL BP MNTR W/SOFTWARE,,,56.87,66.04,16
CPT,93786,AMBL BP MNTR W/SW REC ONLY,,,129.29,258.58,8
CPT,93788,AMBL BP MNTR W/SW A/R,,,129.29,258.58,8
CPT,93790,AMBL BP MNTR W/SW I&R,,,,,0
CPT,93792,PT/CAREGIVER TRAING HOME INR,,,,,0
CPT,93793,ANTICOAG MGMT PT WARFARIN,,,,,0
CPT,93797,OP CARDIAC REHAB W/O MONITOR,167.0,83.5,29.09,250.54,54
CPT,93798,OP CARDIAC REHAB W MONITORING,350.0,175.0,60.97,339.5,54
CPT,93799,ACOUS ELEC CARDGRPHY AV & VV,179.0,89.5,31.18,250.08,54
CPT,93799,ACOUS ELEC CARDGRPHY AV OR W,179.0,89.5,31.18,250.08,54
CPT,93799,ACOUS ELEC CARDIOGRPHY,179.0,89.5,31.18,250.08,54
CPT,937T,"External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; including recording, scanning analysis with report, review and interpretation",,,,,0
CPT,938,ANESTH INSERT PENIS DEVICE,,,,,0
CPT,93880,DUP EXTRACRANIAL CMPLT BIL,1153.5,576.75,161.13,1340.54,108
CPT,93882,DUP EXTRACRANIAL LTD UNI,784.0,392.0,101.59,771.15,108
CPT,93886,TRANSCRANIAL DOPPLER CMPLT,964.5,482.25,155.73,1003.95,108
CPT,93888,TRANSCRANIAL DOPPLER LMTD,721.0,360.5,101.59,699.37,54
CPT,93892,US TRANSCRAN DOPPLR EMB WO BUB,745.0,372.5,101.59,722.65,54
CPT,93893,US TRANSCRAN DOPPLR EMB W BUB,745.0,372.5,101.59,722.65,54
CPT,93895,CAROTID INTIMA ATHEROMA EVAL,,,,,0
CPT,93896,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,4456.5,2228.25,771.88,4347.54,94
CPT,93897,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,5606.5,2803.25,970.99,5469.83,94
CPT,93898,"Venous-arterial shunt detection with intravenous microbubble injection performed with transcranial Doppler study of intracranial arteries, complete (List separately in addition to code for primary pro",,,,,0
CPT,938T,External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; recording (including connection and initial recording),,,,,0
CPT,93922,DOPPLER EXTREM ART 1 LVL LTD,475.0,237.5,71.94,520.89,108
CPT,93922,NONINVASV STDY UPR/L EXT ART BILAT 1-2 LVLS,297.0,148.5,51.73,288.09,54
CPT,93922,NONINVASV STDY UPR/L EXT ART UNILAT 1-2 LVLS,332.0,166.0,57.83,322.04,54
CPT,93922,NONINVASV STDY-UPLO EX,499.0,249.5,86.92,484.03,54
CPT,93922,PROF NONINVASV STDY UPR/L EXT ART BILAT 1-2 LVLS,544.0,272.0,94.76,527.68,54
CPT,93922,PROF NONINVASV STDY UPR/L EXT ART UNILAT 1-2 LVLS,537.0,268.5,93.54,520.89,54
CPT,93923,DOPPLER EXTREM 3+ LVL BILAT,945.0,472.5,146.15,1019.47,108
CPT,93923,NONINVASV STDY UPR/L EXT ART BILAT STDY 3+ LVLS,372.0,186.0,64.8,419.66,54
CPT,93923,PROF NONINVASV STDY UPR/L EXT ART BILAT STDY 3+ LVLS,1082.0,541.0,156.47,1049.54,54
CPT,93923,PROF NONINVASV STDY UPR/L EXT ART UNILAT 3+ LVLS,811.0,405.5,141.27,786.67,54
CPT,93924,DOPPLER LOWR EXT RST/STRS BIL,1125.5,562.75,172.28,1224.14,108
CPT,93925,DUPLEX SCAN LE ART BIL CMPLT,1104.5,552.25,185.52,1109.68,108
CPT,93926,DUPLEX SCAN LE ART UNI/ LMTD,659.5,329.75,101.59,673.18,108
CPT,93930,DUPLEX SCAN UE ART BIL CMPLT,890.5,445.25,137.09,964.18,108
CPT,93931,DUPLEX SCAN UE ART UNI/LMTD,565.5,282.75,86.57,614.98,108
CPT,93970,DUPLEX SCAN EXT VEINS BIL CMP,1267.5,633.75,177.5,1470.52,108
CPT,93971,DUPLEX SCAN EXT VEINS UNI/LTD,690.5,345.25,96.15,804.13,108
CPT,93975,DUPLEX ABD PEL VESSELS COMPL,1069.5,534.75,180.99,1067.0,108
CPT,93976,DUPLEX ABD PEL VESSELS LTD,729.5,364.75,101.59,847.78,108
CPT,93978,DUPLEX AORT IVC ILIAC GR COMP,883.5,441.75,133.95,968.06,108
CPT,93979,DUPLEX AORT IVC ILIAC GRF LTD,753.0,376.5,101.59,881.73,108
CPT,93980,DUPLEX PENILE VESSELS COMPL,931.0,465.5,101.59,903.07,54
CPT,93981,DUPLEX PENILE VESSELS LTD,662.5,331.25,100.51,725.56,108
CPT,93985,DUP-SCAN HEMO COMPL BI STD,760.0,380.0,107.3,876.88,108
CPT,93986,DUP-SCAN HEMO COMPL UNI STD,760.0,380.0,101.59,876.88,108
CPT,93990,DUPLEX HEMODIALYSIS ACCESS,910.0,455.0,101.59,994.25,108
CPT,93998,US CAROTID IMT,250.0,125.0,28.11,242.5,76
CPT,939T,External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; scanning analysis with report,,,,,0
CPT,93U,RX MNTR 65 COM DRUGS URINE,,,62.14,124.28,8
CPT,940,ANESTH VAGINAL PROCEDURES,,,,,0
CPT,94002,OSCILLATORY VENT MGMT INITIAL,7414.0,3707.0,600.34,7191.58,54
CPT,94002,VENT MGMT INITIAL,1326.0,663.0,230.98,1286.22,54
CPT,94002,VENT MGMT INPAT INIT DAY,,,,,0
CPT,94002,VENT MGMT W NITRIC OXIDE INITIAL,26379.0,13189.5,600.34,25587.63,54
CPT,94002,VENT MGMT WJET INITIAL,1364.0,682.0,237.6,1323.08,54
CPT,94003,OSCILLATORY VENT SUBSEQ,3485.0,1742.5,600.34,3380.45,54
CPT,94003,VENT MGMT INPAT SUBQ DAY,,,,,0
CPT,94003,VENT MGMT SUBSEQUENT,927.0,463.5,161.48,1200.68,54
CPT,94003,VENT MGMT W NITRIC OXIDE SUBSEQ,20050.0,10025.0,600.34,19448.5,54
CPT,94003,VENT MGMT WJET SUBSEQUENT,954.0,477.0,166.18,1200.68,54
CPT,94004,VENT MGMT NF PER DAY,,,,,0
CPT,94005,HOME VENT MGMT SUPERVISION,,,,,0
CPT,94010,INCENT SPIROMETER INITIAL,248.0,124.0,29.25,419.66,54
CPT,94010,INCENT SPIROMETER SUBSEQUENT,248.0,124.0,29.25,419.66,54
CPT,94010,SPIROMETRY,291.0,145.5,29.25,419.66,54
CPT,94011,SPIROMETRY UP TO 2 YRS OLD,,,125.04,250.08,8
CPT,94012,SPIRMTRY W/BRNCHDIL INF-2 YR,,,209.83,419.66,8
CPT,94013,MEAS LUNG VOL THRU 2 YRS,,,362.62,725.24,8
CPT,94014,PATIENT RECORDED SPIROMETRY,,,41.64,868.22,24
CPT,94015,PATIENT RECORDED SPIROMETRY,,,20.56,419.66,24
CPT,94016,REVIEW PATIENT SPIROMETRY,,,,,0
CPT,94060,SPIROMETRY PREPOST BRON STDY,503.0,251.5,49.54,725.24,54
CPT,94070,PFS CHALLENGE TEST,1291.0,645.5,49.88,1252.27,54
CPT,940T,External electrocardiographic recording for greater than 15 days up to 30 days by continuous rhythm recording and storage; review and interpretation by a physician or other qualified health care profe,,,,,0
CPT,94150,VITAL CAPACITY,209.0,104.5,20.72,250.08,54
CPT,941T,"Cystourethroscopy, flexible; with insertion and expansion of prostatic urethral scaffold using integrated cystoscopic visualization",,,,,0
CPT,942,ANESTH SURG ON VAG/URETHRAL,,,,,0
CPT,94200,LUNG FUNCTION TEST (MBC/MVV),,,20.33,114.66,24
CPT,942T,"Cystourethroscopy, flexible; with removal and replacement of prostatic urethral scaffold",,,,,0
CPT,94375,FLOW VOLUME LOOP,372.0,186.0,32.4,419.66,54
CPT,943T,"Cystourethroscopy, flexible; with removal of prostatic urethral scaffold",,,,,0
CPT,944,ANESTH VAGINAL HYSTERECTOMY,,,,,0
CPT,94450,HYPOXIA RESPONSE CURVE,,,46.56,250.08,24
CPT,94452,HAST W/REPORT,269.0,134.5,46.85,260.93,54
CPT,94453,HAST W/OXYGEN TITRATE,271.0,135.5,47.2,262.87,54
CPT,944T,3D contour simulation of target liver lesion(s) and margin(s) for image-guided percutaneous microwave ablation,,,231.86,463.72,8
CPT,945T,"Intraoperative assessment for abnormal (tumor) tissue, in-vivo, following partial mastectomy (eg, lumpectomy) using computer-aided fluorescence imaging (List separately in addition to code for primary",,,,,0
CPT,94610,SURFACTANT DOSING,241.0,120.5,41.98,425.58,54
CPT,94617,EXERCISE TEST FOR BRONCHOSPASM,321.0,160.5,55.91,311.37,54
CPT,94618,PULMONARY STRESS TESTING,318.0,159.0,55.39,308.46,54
CPT,94619,EXERCISE TST BRNCSPSM WO ECG,,,57.33,114.66,8
CPT,94621,PULMONARY STRESS TEST COMPLEX,2329.0,1164.5,135.49,2259.13,54
CPT,94625,PHY/QHP OP PULM RHB W/O MNTR,338.0,169.0,57.33,327.86,54
CPT,94626,PHY/QHP OP PULM RHB W/MNTR,342.0,171.0,57.33,331.74,54
CPT,94640,AIRWAY INHALATION TREATMENT,,,,,0
CPT,94640,EZ PAP TX INITIAL,275.0,137.5,12.46,425.58,54
CPT,94640,MDI TX INITIAL,275.0,137.5,12.46,425.58,54
CPT,94640,NEBULIZER TX INITIAL,275.0,137.5,12.46,425.58,54
CPT,94640,PAP-MDI-NEBULIZER TX INITIAL,267.0,133.5,12.46,425.58,54
CPT,94640,SPUTUM INDUCTION DX WTX,267.0,133.5,12.46,425.58,54
CPT,94642,AEROSOL INHALATION TREATMENT,,,,,0
CPT,94642,PENTAMIDINE TREATMENT,330.0,165.0,25.8,425.58,54
CPT,94644,CBT 1ST HOUR,,,,,0
CPT,94644,CONTINUOUS INHALAT TX 1ST HR,385.0,192.5,67.06,373.45,54
CPT,94645,CBT EACH ADDL HOUR,,,,,0
CPT,94645,CONTIN INHALAT TX EA ADDL HR,267.0,133.5,46.51,258.99,47
CPT,94660,CONT NON INVAS VENT,977.0,488.5,49.86,947.69,54
CPT,94660,POS AIRWAY PRESSURE CPAP,,,,,0
CPT,94662,NEG PRESS VENTILATION CNP,,,32.09,37.27,16
CPT,94664,AEROSOL SELF TRTMT EVAL/DEMO,236.0,118.0,12.77,425.58,54
CPT,94664,EVALUATE PT USE OF INHALER,,,,,0
CPT,94667,CHEST WALL MANIPULATION,,,,,0
CPT,94667,MUCOUS CLEAR WDEVICE INITIAL,498.0,249.0,17.45,483.06,54
CPT,94667,PERCUSSION THERAPY INITIAL,213.0,106.5,17.45,258.58,54
CPT,94668,CHEST WALL MANIPULATION,,,,,0
CPT,94668,MUCOUS CLEAR WDEVICE SUBSEQ,168.0,84.0,17.13,258.58,54
CPT,94668,PERCUSSION THERAPY SUBSEQUENT,168.0,84.0,17.13,258.58,54
CPT,94669,MECHANICAL CHEST WALL OSCILL,,,212.79,425.58,8
CPT,94680,EXHALED AIR ANALYSIS O2,,,48.39,250.08,24
CPT,94681,EXHALED AIR ANALYSIS O2/CO2,,,49.76,725.24,24
CPT,94690,INDIRECT CALORIMETRY REST,238.0,119.0,41.45,230.86,54
CPT,946T,"Orthopedic implant movement analysis using paired computed tomography (CT) examination of the target structure, including data acquisition, data preparation and transmission, interpretation and report",,,101.59,203.18,8
CPT,94726,LUNG VOLS -BODY PLETHYSMOGRY,372.0,186.0,43.64,725.24,54
CPT,94727,LUNG VOLS -GAS WASHOUT/DILUTN,254.0,127.0,34.33,419.66,54
CPT,94728,AIRWAY RESIST -IMPULSE OSCILL,320.0,160.0,32.9,310.4,54
CPT,94729,DIFFUSION TEST,254.0,127.0,44.14,246.38,47
CPT,94760,PULSE OXIMETRY SINGLE,29.0,14.5,2.8,28.13,47
CPT,94761,PULSE OXIMETRY MULTIPLE EXER,172.0,86.0,4.04,166.84,47
CPT,94762,PULSE OXIMETRY OVERNIGHT,479.0,239.5,19.94,464.63,54
CPT,94772,BREATH RECORDING INFANT,,,179.47,725.24,24
CPT,94774,PED HOME APNEA REC COMPL,,,,,0
CPT,94775,PED HOME APNEA REC HK-UP,,,125.04,250.08,8
CPT,94776,PED HOME APNEA REC DOWNLD,,,125.04,250.08,8
CPT,94777,PED HOME APNEA REC REPORT,,,,,0
CPT,94780,CARS/BD TST INFT-12MO 60 MIN,,,36.3,72.6,8
CPT,94781,CARS/BD TST INFT-12MO +30MIN,,,,,0
CPT,94799,MIP -OR MEP,200.0,100.0,34.84,250.08,54
CPT,94799,SUPRAGLOTTIC AIRWAY INSERTION/REMOVAL,922.0,461.0,125.04,894.34,54
CPT,947T,"Magnetic resonance image guided low intensity focused ultrasound (MRgFUS), stereotactic blood-brain barrier disruption using microbubble resonators to increase the concentration of blood-based biomark",,,,,0
CPT,948,ANESTH REPAIR OF CERVIX,,,,,0
CPT,948T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system with interim analysis, review and report(s) by a physician or other qualified health care professional",,,,,0
CPT,949T,"Interrogation device evaluation (remote), up to 90 days, cardiac contractility modulation system, remote data acquisition(s), receipt of transmissions, technician review, technical support, and distri",,,36.27,72.54,8
CPT,94U,GENOME RAPID SEQUENCE ALYS,,,7582.2,15164.4,8
CPT,950,ANESTH VAGINAL ENDOSCOPY,,,,,0
CPT,95004,PERCUT ALLERGY SKIN TESTS,,,834.49,1668.98,8
CPT,95012,EXHALED NITRIC OXIDE MEAS,,,36.3,72.6,8
CPT,95017,PERQ & ICUT ALLG TEST VENOMS,,,28.11,56.22,8
CPT,95018,PERQ&IC ALLG TEST DRUGS/BIOL,,,36.3,72.6,8
CPT,95024,ICUT ALLERGY TEST DRUG/BUG,,,57.33,114.66,8
CPT,95027,ICUT ALLERGY TITRATE-AIRBORN,,,28.11,56.22,8
CPT,95028,ICUT ALLERGY TEST-DELAYED,,,36.3,72.6,8
CPT,95044,ALLERGY PATCH TESTS,,,834.49,1668.98,8
CPT,95052,PHOTO PATCH TEST,,,57.33,114.66,8
CPT,95056,PHOTOSENSITIVITY TESTS,,,129.29,258.58,8
CPT,95060,EYE ALLERGY TESTS,,,129.29,258.58,8
CPT,95065,NOSE ALLERGY TEST,,,36.3,72.6,8
CPT,95070,BRONCHIAL CHALLENGE TESTING,791.0,395.5,137.79,767.27,54
CPT,95076,INGEST CHALLENGE INI 120 MIN,,,362.62,725.24,8
CPT,95079,INGEST CHALLENGE ADDL 60 MIN,,,,,0
CPT,950T,"Ablation of benign prostate tissue, transrectal, with high intensity-focused ultrasound (HIFU), including ultrasound guidance",,,9199.14,18398.28,8
CPT,95115,IMMUNOTHERAPY ONE INJECTION,,,45.5,91.0,8
CPT,95117,IMMUNOTHERAPY INJECTIONS,,,45.5,91.0,8
CPT,95120,IMMUNOTHERAPY ONE INJECTION,,,,,0
CPT,95125,IMMUNOTHERAPY 2/> INJECTIONS,,,,,0
CPT,95130,IMMNTX 1 STING INSECT,,,,,0
CPT,95131,IMMNTX 2 STING INSECTS,,,,,0
CPT,95132,IMMNTX 3 STING INSECTS,,,,,0
CPT,95133,IMMNTX 4 STING INSECTS,,,,,0
CPT,95134,IMMNTX 5 STING INSECTS,,,,,0
CPT,95144,ANTIGEN THERAPY SERVICES,,,45.5,91.0,8
CPT,95145,ANTIGEN THERAPY SERVICES,,,45.5,91.0,8
CPT,95146,ANTIGEN THERAPY SERVICES,,,45.5,91.0,8
CPT,95147,ANTIGEN THERAPY SERVICES,,,69.97,139.94,8
CPT,95148,ANTIGEN THERAPY SERVICES,,,69.97,139.94,8
CPT,95149,ANTIGEN THERAPY SERVICES,,,69.97,139.94,8
CPT,95165,ANTIGEN THERAPY SERVICES,,,45.5,91.0,8
CPT,95170,ANTIGEN THERAPY SERVICES,,,45.5,91.0,8
CPT,95180,RAPID DESENSITIZATION,,,434.11,868.22,8
CPT,95199,UNLISTED ALL/IMMLG SVC/PX,,,28.11,56.22,8
CPT,951T,"Totally implantable active middle ear hearing implant; initial placement, including mastoidectomy, placement of and attachment to sound processor",,,,,0
CPT,952,ANESTH HYSTEROSCOPE/GRAPH,,,,,0
CPT,95249,CONT GLUC MNTR PT PROV EQP,,,57.33,114.66,8
CPT,95250,CONT GLUC MNTR PHYS/QHP EQP,,,129.38,258.76,8
CPT,95251,CONT GLUC MNTR ANALYSIS I&R,,,36.59,42.49,16
CPT,952T,"Totally implantable active middle ear hearing implant; revision or replacement, with mastoidectomy and replacement of sound processor",,,,,0
CPT,953T,"Totally implantable active middle ear hearing implant; revision or replacement, without mastoidectomy and replacement of sound processor",,,,,0
CPT,954T,"Totally implantable active middle ear hearing implant; replacement of sound processor only, with attachment to existing transducers",,,,,0
CPT,955T,"Totally implantable active middle ear hearing implant; removal, including removal of sound processor and all implant components",,,,,0
CPT,956T,"Partial craniectomy, channel creation, and tunneling of electrode for sub-scalp implantation of an electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitor",,,26367.8,52735.6,8
CPT,95700,EEG CONT REC W/VID EEG TECH,2097.0,1048.5,209.83,2034.09,54
CPT,95705,EEG W/O VID 2-12 HR UNMONITORED,3529.0,1764.5,209.83,3423.13,54
CPT,95706,EEG W/O VID 2-12 HR INTERMITTENT MNTR,3633.0,1816.5,209.83,3524.01,54
CPT,95707,EEG W/O VID 2-12 HR CONTINUOUS MNTR,3633.0,1816.5,209.83,3524.01,54
CPT,95708,EEG W/O VID EA 12-26 HR UNMONITORED,7058.0,3529.0,362.62,6846.26,54
CPT,95709,EEG W/O VID EA 12-26 HR INTERMITTENT MNTR,7058.0,3529.0,362.62,6846.26,54
CPT,95710,EEG W/O VID EA 12-26 HR CONTINUOUS MNTR,7269.0,3634.5,362.62,7050.93,54
CPT,95711,VEEG 2-12 HR UNMONITORED,3633.0,1816.5,209.83,3524.01,54
CPT,95712,VEEG 2-12 HR INTERMITTENT MNTR,3529.0,1764.5,362.62,3423.13,54
CPT,95713,VEEG 2-12 HR CONTINUOUS MNTR,3529.0,1764.5,362.62,3423.13,54
CPT,95714,VEEG EA 12-26 HR UNMONITORED,7269.0,3634.5,362.62,7050.93,54
CPT,95715,VEEG EA 12-26 HR INTERMITTENT MNTR,7058.0,3529.0,362.62,6846.26,54
CPT,95716,VEEG EA 12-26 HR CONTINUOUS MNTR,7058.0,3529.0,834.49,6846.26,54
CPT,95717,EEG PHYS/QHP 2-12 HR W/O VID,,,,,0
CPT,95718,EEG PHYS/QHP 2-12 HR W/VEEG,,,,,0
CPT,95719,EEG PHYS/QHP EA INCR W/O VID,,,,,0
CPT,95720,EEG PHY/QHP EA INCR W/VEEG,,,,,0
CPT,95721,EEG PHY/QHP>36<60 HR W/O VID,,,,,0
CPT,95722,EEG PHY/QHP>36<60 HR W/VEEG,,,,,0
CPT,95723,EEG PHY/QHP>60<84 HR W/O VID,,,,,0
CPT,95724,EEG PHY/QHP>60<84 HR W/VEEG,,,,,0
CPT,95725,EEG PHY/QHP>84 HR W/O VID,,,,,0
CPT,95726,EEG PHY/QHP>84 HR W/VEEG,,,,,0
CPT,95782,POLYSOM <6 YR OLD,4506.0,2253.0,784.94,4370.82,54
CPT,95783,POLYSOM <6 YR OLD W/CIPAPBIPAP,4946.0,2473.0,834.49,4797.62,54
CPT,957T,"Revision of sub-scalp implanted electrode array, receiver, and telemetry unit for electrode, when required, including imaging guidance",,,1562.58,3125.16,8
CPT,95800,SLP STDY UNATTENDED,,,209.83,419.66,8
CPT,95801,SLP STDY UNATND W/ANAL,,,57.33,114.66,8
CPT,95803,ACTIGRAPHY TESTING,,,57.33,119.59,24
CPT,95805,MSLT OR MT WAKEFULNESS TEST,3077.0,1538.5,536.01,2984.69,54
CPT,95806,HOME/UNATTENDED SLEEP STUDY TYPE 3,707.0,353.5,123.15,685.79,54
CPT,95806,SLEEP STUDY SIMULT APNEA LINK,728.0,364.0,125.59,712.95,108
CPT,95807,SLEEP STUDY ATTENDED,,,362.62,725.24,8
CPT,95808,POLYSOM ANY AGE 1-3> PARAM,,,834.49,1668.98,8
CPT,95810,POLYSOM 6+ YR OLD,4506.0,2253.0,784.94,4370.82,54
CPT,95811,POLYSOM 6+ YR OLD W/CIPAPBIPAP,4946.0,2473.0,834.49,4797.62,54
CPT,95812,EEG EXTENDED 41-60 MINUTES,1348.0,674.0,209.83,1307.56,54
CPT,95813,EEG EXTENDED 61-119 MINUTES,1483.0,741.5,209.83,1438.51,54
CPT,95816,EEG AWAKE AND DROWSY,1435.0,717.5,209.11,1391.95,54
CPT,95819,EEG AWAKE AND ASLEEP,1435.0,717.5,209.83,1391.95,54
CPT,95822,EEG COMA OR SLEEP ONLY,1085.0,542.5,189.0,1052.45,54
CPT,95822,EEG COMA/SLEEP ONLY > 3TO6HRS,1951.0,975.5,209.83,1892.47,54
CPT,95822,EEG COMA/SLEEP ONLY > 6HRS,3510.0,1755.0,209.83,3404.7,54
CPT,95822,EEG COMA/SLEEP ONLY UP TO3HRS,1084.0,542.0,188.83,1051.48,54
CPT,95824,EEG CEREBRAL DEATH EVAL,868.0,434.0,151.2,841.96,54
CPT,95829,ELECTROCORTICOGRAM,5315.0,2657.5,925.87,5155.55,47
CPT,95830,SPHENOIDAL ELECTRODES,903.0,451.5,157.3,875.91,47
CPT,95836,ECOG IMPLTD BRN NPGT <30 D,,,36.27,72.54,8
CPT,95851,PT RANGE MOTION MEAS EA EXTRE,133.0,66.5,14.63,129.01,47
CPT,95852,RANGE OF MOTION MEASUREMENTS,,,11.92,13.85,16
CPT,95857,CHOLINESTERASE CHALLENGE,,,38.17,419.66,24
CPT,95860,EMG NEEDLE 1 EXTREMITY,644.0,322.0,72.21,624.68,54
CPT,95860,MUSCLE TEST ONE LIMB >3TO6HRS,2575.0,1287.5,72.21,2497.75,54
CPT,95860,MUSCLE TEST ONE LIMB >6 HRS,3865.0,1932.5,72.21,3749.05,54
CPT,95860,MUSCLE TEST ONE LIMB UP TO3HRS,644.0,322.0,72.21,624.68,54
CPT,95861,EMG NEEDLE 2 EXTREMITIES,972.0,486.0,104.07,942.84,54
CPT,95861,EMG TWO EXTREM PORT >3TO6HRS,2705.0,1352.5,104.07,2623.85,54
CPT,95861,EMG TWO EXTREM PORT >6HRS,4133.0,2066.5,104.07,4009.01,54
CPT,95861,EMG TWO EXTREM PORT UP TO3HRS,1378.0,689.0,104.07,1336.66,54
CPT,95863,EMG NEEDLE 3 EXTREMITIES,1289.0,644.5,125.04,1250.33,54
CPT,95863,MUSCLE TEST 3 LIMBS >3TO6HRS,2573.0,1286.5,125.04,2495.81,54
CPT,95863,MUSCLE TEST 3 LIMBS >6HRS,3862.0,1931.0,125.04,3746.14,54
CPT,95863,MUSCLE TEST 3 LIMBS UP TO 3HRS,1289.0,644.5,125.04,1250.33,54
CPT,95864,EMG NEEDLE 4 EXTREMITIES,1762.0,881.0,125.04,1709.14,54
CPT,95864,MUSCLE TEST 4 LIMBS >3TO6HRS,2573.0,1286.5,125.04,2495.81,54
CPT,95864,MUSCLE TEST 4 LIMBS >6HRS,3862.0,1931.0,125.04,3746.14,54
CPT,95864,MUSCLE TEST 4 LIMBS UP TO3HRS,1745.0,872.5,125.04,1692.65,54
CPT,95865,EMG LARYNX,378.0,189.0,65.84,366.66,54
CPT,95866,MUSCLE TEST HEMIDIAPHRAGM,,,125.04,250.08,8
CPT,95867,MUSCLE TEST CRAN NERV UNILAT,513.0,256.5,63.22,497.61,54
CPT,95868,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,369.0,184.5,64.27,419.66,54
CPT,95869,MUSCLE TEST THOR PARASPINAL,,,43.5,419.66,24
CPT,95870,EMG LIMITED STUDY,182.0,91.0,31.7,258.58,54
CPT,95870,EMG NONEX W/NERVE LT >3TO6HRS,2728.0,1364.0,42.25,2646.16,54
CPT,95870,EMG NONEX W/NERVE LT >6 HRS,4093.0,2046.5,42.25,3970.21,54
CPT,95870,EMG NONEX W/NERVE LT UP TO3HRS,1364.0,682.0,42.25,1323.08,54
CPT,95872,MUSCLE TEST ONE FIBER,,,146.83,419.66,24
CPT,95873,GUIDE NERV DESTR ELEC STIM,,,,,0
CPT,95874,GUIDE NERV DESTR NEEDLE EMG,,,,,0
CPT,95875,LIMB EXERCISE TEST,,,83.14,250.08,24
CPT,95885,EMG WNERVE COND TEST LIMITED,673.0,336.5,49.72,652.81,47
CPT,95886,EMG WNERVE COND TEST COMPLET,1138.0,569.0,68.59,1103.86,47
CPT,95887,EMG WNERVE TST NON-EXTREMITY,1165.0,582.5,57.78,1130.05,47
CPT,958T,"Removal of sub-scalp implanted electrode array, receiver, and telemetry unit for continuous bilateral electroencephalography monitoring system, including imaging guidance",,,3179.6,6359.2,8
CPT,95905,MOTOR /SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,1038.0,519.0,180.81,1006.86,54
CPT,95907,NERVE CONDUCTION STUDIES 1-2,630.0,315.0,76.06,611.1,54
CPT,95908,NERVE CONDUCTION STUDIES 3-4,1266.0,633.0,93.73,1228.02,54
CPT,95909,NERVE CONDUCTION STUDIES 5-6,2004.0,1002.0,112.44,1943.88,54
CPT,95910,NERVE CONDUCTION STUDIES 7-8,2534.0,1267.0,148.02,2457.98,54
CPT,95911,NERVE CONDUCTION STUDIES 9-10,3170.0,1585.0,179.22,3074.9,54
CPT,95912,NERVE CONDUCTION STUDIES11-12,3802.0,1901.0,209.87,3687.94,54
CPT,95913,NERVE CONDUCT STUDY13OR MORE,4120.0,2060.0,243.18,3996.4,54
CPT,95919,QUAN PUPLMTRY PHY/QHP UNI/BI,,,129.29,258.58,8
CPT,95921,AUTONOMIC NRV PARASYM INERVJ,,,64.24,250.08,24
CPT,95922,AFT VASOMOTOR,469.0,234.5,77.52,454.93,54
CPT,95923,AUTONOMIC NRV SYST FUNJ TEST,,,107.56,258.58,24
CPT,95924,ANS PARASYMP & SYMP W/TILT,,,118.43,419.66,24
CPT,95925,EVOKED POTENTIAL UPPER LIMBS,1709.0,854.5,112.96,1657.73,54
CPT,95926,EVOKED POTENTIAL LOWER LIMBS,1760.0,880.0,110.47,1707.2,54
CPT,95927,SOMATOSENSORY TESTING,,,107.97,419.66,24
CPT,95928,C MOTOR EVOKED UPPR LIMBS,2585.0,1292.5,450.3,2507.45,54
CPT,95929,CENT MOT EVOKED LWR LIMBS UP TO3HRS,1289.0,644.5,224.54,1250.33,54
CPT,95929,CENT MOT EVOKED LWR LIMBS>3TO6HRS,2548.0,1274.0,362.62,2471.56,54
CPT,95929,CENT MOT EVOKED LWR LIMBS>6 HRS,3860.0,1930.0,362.62,3744.2,54
CPT,95930,VISUAL EP TEST CNS W/I&R,,,97.46,419.66,24
CPT,95933,BLINK REFLEX TEST,,,57.33,114.66,24
CPT,95937,NEUROMUSC JUNC PORT UP TO 3HRS,1364.0,682.0,51.94,1323.08,54
CPT,95937,NEUROMUSC JUNC PORT>3TO6HRS,2728.0,1364.0,51.94,2646.16,54
CPT,95937,NEUROMUSC JUNC PORT>6 HRS,4131.0,2065.5,51.94,4007.07,54
CPT,95938,SOMATOSENSORY STUDY >3TO6HRS,2763.0,1381.5,481.31,2680.11,54
CPT,95938,SOMATOSENSORY STUDY >6HRS,4140.0,2070.0,721.18,4015.8,54
CPT,95938,SOMATOSENSORY STUDY UP TO 3HRS,1382.0,691.0,240.74,1668.98,54
CPT,95939,CEN MOT EVOK STU LIMB >3TO6HRS,2770.0,1385.0,482.53,2686.9,54
CPT,95939,CEN MOT EVOK STU LIMB >6HRS,4149.0,2074.5,722.75,4024.53,54
CPT,95939,CEN MOT EVOK STU LIMB UP TO3HRS,1378.0,689.0,240.04,1668.98,54
CPT,95940,IONM IN OPERATNG ROOM 15 MIN,342.0,171.0,59.57,331.74,47
CPT,95941,IONM REMOTE/>1 PT OR PER HR,1350.0,675.0,235.17,1309.5,47
CPT,95954,EEG MONITORING/GIVING DRUGS,,,227.8,725.24,24
CPT,95955,EEG NONINTRACRANIAL SURGERY,3069.0,1534.5,124.47,2976.93,47
CPT,95957,EEG DIGITAL ANALYSIS,,,246.85,286.66,16
CPT,95958,WADA ACTIVATION TEST,2664.0,1332.0,350.05,2584.08,54
CPT,95961,BRAIN MAP ELECTRODE STIM 1 HR,1155.0,577.5,198.39,1668.98,54
CPT,95962,ELECTRODE STIM BRAIN ADD HOUR,764.0,382.0,133.08,741.08,47
CPT,95965,MEG SPONTANEOUS,,,834.49,1668.98,8
CPT,95966,MEG EVOKED SINGLE,,,834.49,1668.98,8
CPT,95967,MEG EVOKED EACH ADDL,,,,,0
CPT,95970,ALYS NPGT W/O PRGRMG,,,46.13,258.58,24
CPT,95971,ANALYZE NEUROSTIM SIMPLE,321.0,160.5,55.91,311.37,54
CPT,95972,ANALYZE NEUROSTIM COMPLEX,313.0,156.5,54.52,303.61,54
CPT,95976,ALYS SMPL CN NPGT PRGRMG,,,36.27,72.54,8
CPT,95977,ALYS CPLX CN NPGT PRGRMG,,,92.39,184.78,8
CPT,95980,IO ANAL GAST N-STIM INIT,,,,,0
CPT,95981,IO ANAL GAST N-STIM SUBSQ,265.0,132.5,46.16,257.05,54
CPT,95982,IO GA N-STIM SUBSQ W/REPROG,89.0,44.5,15.5,86.33,54
CPT,95983,ALYS BRN NPGT PRGRMG 15 MIN,,,92.39,184.78,8
CPT,95984,ALYS BRN NPGT PRGRMG ADDL 15,,,,,0
CPT,95990,SPIN/BRAIN PUMP REFIL & MAIN,1656.0,828.0,288.47,1606.32,54
CPT,95991,SPIN/BRAIN PUMP REFIL & MAIN,,,298.28,596.56,8
CPT,95992,PT CANALITH REPOSITIONING,136.0,68.0,23.69,131.92,47
CPT,95999,UNLISTED NEUROLOGICAL DX PX,,,125.04,250.08,8
CPT,959T,"Removal or replacement of magnet from coil assembly that is connected to continuous bilateral electroencephalography monitoring system, including imaging guidance",,,1604.96,3209.92,8
CPT,95T,RMVL ARTIFIC DISC ADDL CRVCL,,,,,0
CPT,95U,EE&MJ BSC PRTN ELISA EST DEV,,,771.98,1543.96,8
CPT,96000,MOTION ANALYSIS VIDEO/3D,,,362.62,725.24,8
CPT,96001,MOTION TEST W/FT PRESS MEAS,,,834.49,1668.98,8
CPT,96002,DYNAMIC SURFACE EMG,,,209.83,419.66,8
CPT,96004,PHYS REVIEW OF MOTION TESTS,,,,,0
CPT,96020,FUNCTIONAL BRAIN MAPPING,,,,,0
CPT,96041,"Medical genetics and genetic counseling services, each 30 minutes of total time provided by the genetic counselor on the date of the encounter",,,,,0
CPT,960T,"Replacement of sub-scalp implanted electrode array, receiver, and telemetry unit with tunneling of electrode for continuous bilateral electroencephalography monitoring system, including imaging guidan",,,26367.8,52735.6,8
CPT,96105,SP APHASIA ASSESS PER HR,318.0,159.0,55.39,308.46,47
CPT,96110,PT DEVELOP SCREEN W/SCORE,357.0,178.5,62.18,346.29,47
CPT,96110,SP DEVELOP SCREEN W/SCORE,382.0,191.0,66.54,370.54,47
CPT,96112,DEVEL TST PHYS/QHP 1ST HR,,,125.04,250.08,8
CPT,96113,DEVEL TST PHYS/QHP EA ADDL,,,,,0
CPT,96116,PSY NEUROBEHAVIORAL STAT EXAM,954.0,477.0,166.18,925.38,54
CPT,96121,NUBHVL XM PHY/QHP EA ADDL HR,,,,,0
CPT,96125,SP STANDARD COGNITIVE TEST/HR,510.0,255.0,88.84,494.7,47
CPT,96127,BRIEF EMOTIONAL/BEHAV ASSMT,,,36.3,72.6,8
CPT,96130,PSYCL TST EVAL PHYS/QHP 1ST,,,209.83,419.66,8
CPT,96131,PSYCL TST EVAL PHYS/QHP EA,,,,,0
CPT,96132,NRPSYC TST EVAL PHYS/QHP 1ST,,,362.62,725.24,8
CPT,96133,NRPSYC TST EVAL PHYS/QHP EA,,,,,0
CPT,96136,PSYCL/NRPSYC TST PHY/QHP 1ST,,,129.29,258.58,8
CPT,96137,PSYCL/NRPSYC TST PHY/QHP EA,,,,,0
CPT,96138,PSYCL/NRPSYC TECH 1ST,,,434.11,868.22,8
CPT,96139,PSYCL/NRPSYC TST TECH EA,,,,,0
CPT,96146,PSYCL/NRPSYC TST AUTO RESULT,,,28.11,56.22,8
CPT,96156,HLTH BHV ASSMT/REASSESSMENT,,,98.72,197.44,8
CPT,96158,HLTH BHV IVNTJ INDIV 1ST 30,,,172.48,344.96,8
CPT,96159,HLTH BHV IVNTJ INDIV EA ADDL,,,,,0
CPT,96160,PT-FOCUSED HLTH RISK ASSMT,,,36.41,72.82,8
CPT,96161,CAREGIVER HEALTH RISK ASSMT,,,36.41,72.82,8
CPT,96164,HLTH BHV IVNTJ GRP 1ST 30,,,36.41,72.82,8
CPT,96165,HLTH BHV IVNTJ GRP EA ADDL,,,,,0
CPT,96167,HLTH BHV IVNTJ FAM 1ST 30,,,36.41,72.82,8
CPT,96168,HLTH BHV IVNTJ FAM EA ADDL,,,,,0
CPT,96170,HLTH BHV IVNTJ FAM WO PT 1ST,,,,,0
CPT,96171,HLTH BHV IVNTJ FAM W/O PT EA,,,,,0
CPT,961T,"Shortwave infrared radiation imaging, surgical pathology specimen, to assist gross examination for lymph node localization in fibroadipose tissue, per specimen (List separately in addition to code for",,,,,0
CPT,96202,MLT FAM GRP BHV TRAIN 1ST 60,,,,,0
CPT,96203,MLT FAM GRP BHV TRAIN EA ADD,,,,,0
CPT,962T,"Assistive algorithmic analysis of acoustic and electrocardiogram recording for detection of cardiac dysfunction (eg, reduced ejection fraction, cardiac murmurs, atrial fibrillation), with review and i",,,129.29,258.58,8
CPT,96360,IV INF HYDRAT INIT 31MIN -1HR,673.0,336.5,68.28,694.52,162
CPT,96361,IV INF HYDRAT EA ADDL HR,436.0,218.0,28.56,450.08,162
CPT,96365,IV INF INITIAL UP TO 1HR,543.5,271.75,72.11,652.81,162
CPT,96365,MUD IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR NHCI,704.0,352.0,122.63,682.88,54
CPT,96366,IV INF EA ADDL HR,300.0,150.0,28.56,422.92,162
CPT,96367,IV INF SEQ NEW DRUG UP TO 1HR,317.5,158.75,35.71,417.1,162
CPT,96368,IV INF CONCURRENT,118.5,59.25,17.59,131.92,141
CPT,96369,SC THER INFUSION UP TO 1 HR,,,206.7,413.4,8
CPT,96370,SC THER INFUSION ADDL HR,,,45.5,91.0,8
CPT,96371,SC THER INFUSION RESET PUMP,,,69.97,139.94,8
CPT,96372,INJECTION SUBQ OR IM,202.0,101.0,18.66,207.58,162
CPT,96372,MUD THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM NHCI,65704.0,32852.0,18.66,63732.88,54
CPT,96373,THER/PROPH/DIAG INJ IA,,,15.85,413.4,24
CPT,96374,INJECTION IV PUSH INITIAL,349.0,174.5,46.38,413.4,162
CPT,96375,INJECTION IV PUSH SEQ NEW DRG,349.0,174.5,19.42,359.87,162
CPT,96376,INJECTION IV PUSH SQ SAME DRG,306.0,153.0,20.72,314.28,141
CPT,96377,APPL ON BODY INJ/TIMED SUBQ INJ,178.5,89.25,27.0,195.94,108
CPT,96379,UNL THER/PROP/DIAG INJ/INF,,,45.5,91.0,8
CPT,96380,ADMN RSV MONOC ANTB IM CNSL,,,,,0
CPT,96381,1 ADMN RSV MONOC ANTB IM NJX,,,,,0
CPT,963T,Anoscopy with directed submucosal injection of bulking agent into anal canal,,,1162.85,2325.7,8
CPT,96401,CHEMO ADMIN SQ OR IM NON HORM,366.5,183.25,57.66,389.94,108
CPT,96402,CHEMO ADMIN SQ OR IM HORM,266.0,133.0,35.01,321.07,108
CPT,96405,CHEMO INJ INTRALESION 1-7 LESIONS,163.0,81.5,28.39,158.11,108
CPT,96406,CHEMO INJ INTRALESION > 7 LESIONS,730.0,365.0,127.16,708.1,108
CPT,96409,CHEMO ADMIN IV PUSH INITIAL,618.0,309.0,73.86,787.64,108
CPT,96411,CHEMO ADMIN IV PUSH EA ADDL,266.0,133.0,35.01,321.07,108
CPT,96413,CHEMO ADMIN IV INITIAL TO 1HR,618.0,309.0,73.86,787.64,108
CPT,96415,CHEMO ADMIN IV EA ADDL HR,266.0,133.0,35.01,321.07,108
CPT,96416,CHEMO ADMIN IV >8HRS W/PUMP,675.5,337.75,73.86,899.19,108
CPT,96417,CHEMO ADMIN IV SEQ INF TO 1HR,266.0,133.0,35.01,321.07,108
CPT,96420,CHEMO IA PUSH TECNIQUE,,,320.98,641.96,8
CPT,96422,CHEMO IA INFUSION UP TO 1 HR,,,320.98,641.96,8
CPT,96423,CHEMO IA INFUSE EACH ADDL HR,,,45.5,91.0,8
CPT,96425,CHEMOTHERAPY INFUSION METHOD,,,320.98,641.96,8
CPT,96440,CHMOTX ADMN PLRL CAV THRCNTS,,,320.98,641.96,8
CPT,96446,INTRAPERITONEAL CHEMOTHERAPY PORT/CATH,1332.5,666.25,217.75,1372.55,108
CPT,96450,CHEMO ADMIN INTRATHECAL,1244.5,622.25,215.83,1212.5,108
CPT,964T,"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; single arch, without mandibular advancement mechanism",,,3221.84,6443.68,8
CPT,96521,REFILL /MAINT PORTABLE PUMP,550.0,275.0,84.13,598.49,108
CPT,96522,REFILL/MAINT PUMP/RESVR SYST,,,206.7,413.4,8
CPT,96523,IRRIG IMPLANT VEN ACC DEVICE,238.5,119.25,38.32,249.29,108
CPT,96542,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,682.0,341.0,118.8,661.54,54
CPT,96547,INTRAOP HIPEC PX 1ST 60 MIN,,,,,0
CPT,96548,NTRAOP HIPEC PX EA ADD 30MIN,,,,,0
CPT,96549,CHEMO ADMIN CONCURRENT,109.0,54.5,17.07,116.4,108
CPT,96567,PDT DSTR PRMLG LES SKN,,,194.97,389.94,8
CPT,96570,PHOTODYNMC TX 30 MIN ADD-ON,,,,,0
CPT,96571,PHOTODYNAMIC TX ADDL 15 MIN,,,,,0
CPT,96573,PDT DSTR PRMLG LES PHYS/QHP,,,194.97,389.94,8
CPT,96574,DBRDMT PRMLG LES W/PDT,,,194.97,389.94,8
CPT,965T,"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, non-fixed hinge mechani",,,3221.84,6443.68,8
CPT,966T,"Impression and custom preparation of jaw expansion oral prosthesis for obstructive sleep apnea, including initial adjustment; dual arch, with additional mandibular advancement, fixed hinge mechanism",,,3221.84,6443.68,8
CPT,967T,"Transanal insertion of endoluminal temporary colorectal anastomosis protection device, including vacuum anchoring component and flexible sheath connected to external vacuum source and monitoring syste",,,1162.85,2325.7,8
CPT,968T,"Insertion or replacement of epicranial neurostimulator system, including electrode array and pulse generator, with connection to electrode array",,,,,0
CPT,96900,ULTRAVIOLET LIGHT THERAPY,,,36.3,72.6,8
CPT,96902,TRICHOGRAM,,,,,0
CPT,96904,WHOLE BODY PHOTOGRAPHY,,,,,0
CPT,96910,PHOTOCHEMOTHERAPY WITH UV-B,,,57.33,114.66,8
CPT,96912,PHOTOCHEMOTHERAPY WITH UV-A,,,57.33,114.66,8
CPT,96913,PHOTOCHEMOTHERAPY UV-A OR B,,,395.04,790.08,8
CPT,96920,EXCIMER LSR PSRIASIS<250SQCM,,,194.97,389.94,8
CPT,96921,EXCIMER LSR PSRIASIS 250-500,,,194.97,389.94,8
CPT,96922,EXCIMER LSR PSRIASIS>500SQCM,,,395.04,790.08,8
CPT,96931,RCM CELULR SUBCELULR IMG SKN,,,,,0
CPT,96932,RCM CELULR SUBCELULR IMG SKN,,,,,0
CPT,96933,RCM CELULR SUBCELULR IMG SKN,,,,,0
CPT,96934,RCM CELULR SUBCELULR IMG SKN,,,,,0
CPT,96935,RCM CELULR SUBCELULR IMG SKN,,,,,0
CPT,96936,RCM CELULR SUBCELULR IMG SKN,,,,,0
CPT,96999,UNLISTED SPEC DERM SVC/PX,,,194.97,389.94,8
CPT,969T,Removal of epicranial neurostimulator system,,,,,0
CPT,96U,HPV HI RISK TYPES MALE URINE,,,35.09,70.18,8
CPT,97010,HOT OR COLD PACKS THERAPY,,,,,0
CPT,97012,MECHANICAL TRACTION THERAPY,,,,,0
CPT,97012,PT TRACTIONAL MECHANICAL,133.0,66.5,23.16,129.01,47
CPT,97014,ELECTRIC STIMULATION THERAPY,,,,,0
CPT,97014,PT ESTIM UNATTENDED,133.0,66.5,23.16,129.01,47
CPT,97016,PT VASOPNEUMATIC DEV APPL,133.0,66.5,23.16,129.01,47
CPT,97016,VASOPNEUMATIC DEVICE THERAPY,,,,,0
CPT,97018,PARAFFIN BATH THERAPY,,,,,0
CPT,97022,PT FLUIDOTHERAPY,197.0,98.5,34.31,191.09,47
CPT,97022,WHIRLPOOL THERAPY,,,,,0
CPT,97024,DIATHERMY EG MICROWAVE,,,,,0
CPT,97026,INFRARED THERAPY,,,,,0
CPT,97028,ULTRAVIOLET THERAPY,,,,,0
CPT,97032,APPL MODALITY 1+ESTIM EA 15,,,,,0
CPT,97032,PT ESTIM ATTENDED/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97033,APP MDLTY 1+IONTPHRSIS EA 15,,,,,0
CPT,97033,PT IONTOPHORESIS/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97034,APP MDLTY 1+CNTRST BTH EA 15,,,,,0
CPT,97035,APP MDLTY 1+ULTRASOUND EA 15,,,,,0
CPT,97035,PT ULTRASOUND/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97036,APP MDLTY 1+HUBBRD TNK EA 15,,,,,0
CPT,97037,APPL MODALITY 1+LLLT PO PAIN,,,36.3,72.6,8
CPT,97039,UNLISTED MODALITY,,,,,0
CPT,970T,"Ablation, benign breast tumor (eg, fibroadenoma), percutaneous, laser, including imaging guidance when performed, each tumor",,,3804.87,7609.74,8
CPT,97110,OT THERAPEUTIC EXERCISE/15MIN,133.0,66.5,23.16,129.01,46
CPT,97110,PT THERAPEUTIC EXERCISE/15MIN,133.0,66.5,23.16,129.01,47
CPT,97110,THERAPEUTIC EXERCISES,,,,,0
CPT,97112,NEUROMUSCULAR REEDUCATION,,,,,0
CPT,97112,OT NEUROMUSCULAR RE-ED/15MIN,133.0,66.5,23.16,129.01,46
CPT,97112,PT NEUROMUSCULAR RE-ED/15MIN,133.0,66.5,23.16,129.01,47
CPT,97113,AQUATIC THERAPY/EXERCISES,,,,,0
CPT,97113,PT AQUATIC THERAPY/15MIN,133.0,66.5,23.16,129.01,47
CPT,97116,GAIT TRAINING THERAPY,,,,,0
CPT,97116,PT GAIT TRAINING/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97124,MASSAGE THERAPY,,,,,0
CPT,97129,OT THERAPEUTIC IVNTJ 1ST 15 MIN,414.0,207.0,72.11,401.58,46
CPT,97129,PT THERAPEUTIC IVNTJ 1ST 15 MIN,133.0,66.5,23.16,129.01,47
CPT,97129,SP THERAPEUTIC IVNTJ 1ST 15 MIN,428.0,214.0,74.55,415.16,46
CPT,97129,THER IVNTJ 1ST 15 MIN,,,,,0
CPT,97130,OT THERAPEUTIC IVNTJ EA ADDL 15 MIN,414.0,207.0,72.11,401.58,46
CPT,97130,PT THERAPEUTIC IVNTJ EA ADDL 15 MIN,133.0,66.5,23.16,129.01,47
CPT,97130,SP THERAPEUTIC IVNTJ EA ADDL 15 MIN,428.0,214.0,74.55,415.16,46
CPT,97130,THER IVNTJ EA ADDL 15 MIN,,,,,0
CPT,97139,UNLISTED THERAPEUTIC PX,,,,,0
CPT,97140,MANUAL THERAPY 1/> REGIONS,,,,,0
CPT,97140,OT MANUAL THERAPY/15 MIN,133.0,66.5,23.16,129.01,46
CPT,97140,PT MANUAL THERAPY/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97150,GROUP THERAPEUTIC PROCEDURES,,,,,0
CPT,97150,OT GROUP THERAPY,85.0,42.5,14.8,82.45,46
CPT,97150,PT GROUP THERAPY,85.0,42.5,14.8,82.45,47
CPT,97151,BHV ID ASSMT BY PHYS/QHP,,,98.72,197.44,8
CPT,97152,BHV ID SUPRT ASSMT BY 1 TECH,,,98.72,197.44,8
CPT,97153,ADAPTIVE BEHAVIOR TX BY TECH,,,98.72,197.44,8
CPT,97154,GRP ADAPT BHV TX BY TECH,,,36.41,72.82,8
CPT,97155,ADAPT BEHAVIOR TX PHYS/QHP,,,172.48,344.96,8
CPT,97156,FAM ADAPT BHV TX GDN PHY/QHP,,,36.41,72.82,8
CPT,97157,MULT FAM ADAPT BHV TX GDN,,,36.41,72.82,8
CPT,97158,GRP ADAPT BHV TX BY PHY/QHP,,,36.41,72.82,8
CPT,97161,PT EVAL LOW COMPLEX 20 MIN,300.0,150.0,52.26,291.0,47
CPT,97162,PT EVAL MOD COMPLEX 30 MIN,300.0,150.0,52.26,291.0,47
CPT,97163,PT EVAL HIGH COMPLEX 45 MIN,300.0,150.0,52.26,291.0,47
CPT,97164,PT RE-EVAL EST PLAN CARE,164.0,82.0,28.56,159.08,47
CPT,97165,OT EVAL LOW COMPLEX 30 MIN,310.0,155.0,54.0,300.7,47
CPT,97166,OT EVAL MOD COMPLEX 45 MIN,310.0,155.0,54.0,300.7,47
CPT,97167,OT EVAL HIGH COMPLEX 60 MIN,310.0,155.0,54.0,300.7,47
CPT,97168,OT RE-EVAL EST PLAN CARE,164.0,82.0,28.56,159.08,47
CPT,97169,ATHLETIC TRN EVAL LOW CMPLX,,,,,0
CPT,97170,ATHLETIC TRN EVAL MOD CMPLX,,,,,0
CPT,97171,ATHLETIC TRN EVAL HIGH CMPLX,,,,,0
CPT,97172,ATHLETIC TRN RE-EVAL PLAN CR,,,,,0
CPT,971T,"Ablation, malignant breast tumor(s), percutaneous, laser, including imaging guidance when performed, unilateral",,,3804.87,7609.74,8
CPT,972T,"Assistive algorithmic classification of burn healing (ie, healing or nonhealing) by noninvasive multispectral imaging, including system set-up and acquisition, selection, and transmission of images, w",,,,,0
CPT,973T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs;",,,395.04,790.08,8
CPT,974T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, trunk, arms, legs;",,,,,0
CPT,97530,OT THERAPEUT ACTIVITIES/15MIN,133.0,66.5,23.16,129.01,46
CPT,97530,PT THERAPEUT ACTIVITIES/15MIN,133.0,66.5,23.16,129.01,47
CPT,97530,THERAPEUTIC ACTIVITIES,,,,,0
CPT,97533,OT SENSORY INTEGRATION/15MIN,133.0,66.5,23.16,129.01,46
CPT,97533,PT SENSORY INTEGRATION/15MIN,133.0,66.5,23.16,129.01,47
CPT,97533,SENSORY INTEGRATION,,,,,0
CPT,97535,OT SLFCARE/HME MGT TRNG/15MIN,133.0,66.5,23.16,129.01,46
CPT,97535,PT SLFCARE/HME MGT TRNG/15MIN,133.0,66.5,23.16,129.01,47
CPT,97535,SELF CARE MNGMENT TRAINING,,,,,0
CPT,97537,COMMUNITY/WORK REINTEGRATION,,,,,0
CPT,97537,OT COMM WORK REINT/15 MIN,133.0,66.5,23.16,129.01,46
CPT,97537,PT COMM WORK REINT/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97542,OT WHEELCHR MGT TRAIN/15 MIN,133.0,66.5,23.16,129.01,46
CPT,97542,PT WHEELCHR MGT TRAIN/15MIN,133.0,66.5,23.16,129.01,47
CPT,97542,WHEELCHAIR MNGMENT TRAINING,,,,,0
CPT,97545,WORK HARDENING,,,,,0
CPT,97546,WORK HARDENING ADD-ON,,,,,0
CPT,97550,PT CAREGIVER TRAING 1ST 30 MIN,208.0,104.0,36.23,201.76,47
CPT,97550,SP CAREGIVER TRAING 1ST 30 MIN,208.0,104.0,36.23,201.76,47
CPT,97551,PT CAREGIVER TRAING EA ADDL 15,104.0,52.0,18.11,100.88,47
CPT,97551,SP CAREGIVER TRAING EA ADDL 15,104.0,52.0,18.11,100.88,47
CPT,97552,PT GROUP CAREGIVER TRAINING,94.0,47.0,16.37,91.18,47
CPT,97552,SP GROUP CAREGIVER TRAINING,94.0,47.0,16.37,91.18,47
CPT,97597,DBRDMT OPN WND 1ST 20 CM/<,,,,,0
CPT,97597,PROF DEBRID SELLAVAGE<=20SQ CM,397.0,198.5,69.15,389.94,53
CPT,97597,PT DEBRID SELECTIVE<=20SQ CM,374.0,187.0,65.15,389.94,54
CPT,97598,DBRDMT OPN WND ADDL 20CM/<,,,,,0
CPT,97598,PT DEBRID SELECTIVE EA ADDL 20SQ CM,433.0,216.5,75.42,420.01,47
CPT,975T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands",,,395.04,790.08,8
CPT,97602,PT DEBRID NON-SELECTIVE,586.0,293.0,102.08,568.42,54
CPT,97602,WOUND(S) CARE NON-SELECTIVE,,,,,0
CPT,97605,NEG PRS WND THER DME<=50SQCM,,,,,0
CPT,97605,PT NEG PRESS WND W/DME <= 50 CM,626.0,313.0,109.04,607.22,54
CPT,97606,NEG PRS WND THER DME>50 SQCM,,,,,0
CPT,97606,PT NEG PRESS WND W/DME >50 CM,1039.0,519.5,180.99,1007.83,54
CPT,97607,NEG PRS WND THR NDME<=50SQCM,,,,,0
CPT,97607,PROF WOUND VAC <= 50SQ CM,779.0,389.5,135.7,790.08,53
CPT,97608,NEG PRESS WOUND TX >50 CM,1385.0,692.5,241.26,1343.45,53
CPT,97608,NEG PRS WND THER NDME>50SQCM,,,,,0
CPT,97608,PROF WOUND VAC > 50SQ CM,1385.0,692.5,241.26,1343.45,53
CPT,97610,LOW FREQUENCY NON-THERMAL US,,,194.97,389.94,8
CPT,976T,"Selective enzymatic debridement, partial-thickness and/or full-thickness burn eschar, requiring anesthesia (ie, general anesthesia, moderate sedation), including patient monitoring, scalp, neck, hands",,,,,0
CPT,97750,PHYSICAL PERFORMANCE TEST,,,,,0
CPT,97750,PT PHY PERFORM TEST/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97755,ASSISTIVE TECHNOLOGY ASSESS,,,,,0
CPT,97760,ORTHOTIC MGMT&TRAING 1ST ENC,,,,,0
CPT,97760,OT ORTHOTIC MGMT TRAIN/15 MIN,133.0,66.5,23.16,129.01,46
CPT,97760,PT ORTHOTIC MGMT TRAIN/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97761,PROSTHETIC TRAING 1ST ENC,,,,,0
CPT,97761,PT PROSTHETIC TRAINING/15 MIN,133.0,66.5,23.16,129.01,47
CPT,97763,ORTHC/PROSTC MGMT SBSQ ENC,,,,,0
CPT,97763,PT ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,133.0,66.5,23.16,129.01,47
CPT,97799,UNLISTED PHYSCL MED/REHAB PX,,,,,0
CPT,977T,"Upper gastrointestinal blood detection, sensor capsule, with interpretation and report",,,881.37,1762.74,8
CPT,97802,MEDICAL NUTRITION INDIV IN,,,,,0
CPT,97803,MED NUTRITION INDIV SUBSEQ,,,,,0
CPT,97804,MEDICAL NUTRITION GROUP,,,,,0
CPT,97810,ACUPUNCT W/O STIMUL 15 MIN,,,28.11,56.22,8
CPT,97811,ACUPUNCT W/O STIMUL ADDL 15M,,,,,0
CPT,97813,ACUPUNCT W/STIMUL 15 MIN,,,28.11,56.22,8
CPT,97814,ACUPUNCT W/STIMUL ADDL 15M,,,,,0
CPT,978T,"Submucosal cryolysis therapy; soft palate, base of tongue, and lingual tonsil",,,,,0
CPT,979T,Submucosal cryolysis therapy; soft palate only,,,,,0
CPT,98000,PROF SYNCH AUDIO-VIDEO NEW SF 15,133.0,66.5,23.16,129.01,47
CPT,98001,PROF SYNCH AUDIO-VIDEO NEW LOW 30,200.0,100.0,34.84,194.0,47
CPT,98002,PROF SYNCH AUDIO-VIDEO NEW MOD 45,269.0,134.5,46.85,260.93,47
CPT,98003,PROF SYNCH AUDIO-VIDEO NEW HI 60,337.0,168.5,58.7,326.89,47
CPT,98004,PROF SYNCH AUDIO-VIDEO EST SF 10,103.0,51.5,17.94,99.91,47
CPT,98005,PROF SYNCH AUDIO-VIDEO EST LOW 20,155.0,77.5,27.0,150.35,47
CPT,98006,PROF SYNCH AUDIO-VIDEO EST MOD 30,209.0,104.5,36.4,202.73,47
CPT,98007,PROF SYNCH AUDIO-VIDEO EST HI 40,261.0,130.5,45.46,253.17,47
CPT,98008,PROF SYNCH AUDIO-ONLY NEW SF 15,127.0,63.5,22.12,123.19,47
CPT,98009,PROF SYNCH AUDIO-ONLY NEW LOW 30,190.0,95.0,33.09,184.3,47
CPT,98010,PROF SYNCH AUDIO-ONLY NEW MOD 45,257.0,128.5,44.76,249.29,47
CPT,98011,PROF SYNCH AUDIO-ONLY NEW HIGH 60,321.0,160.5,55.91,311.37,47
CPT,98012,PROF SYNCH AUDIO-ONLY EST SF 10,94.0,47.0,16.37,91.18,47
CPT,98013,PROF SYNCH AUDIO-ONLY EST LOW 20,140.0,70.0,24.38,135.8,47
CPT,98014,PROF SYNCH AUDIO-ONLY EST MOD 30,189.0,94.5,32.92,183.33,47
CPT,98015,PROF SYNCH AUDIO-ONLY EST HIGH 40,237.0,118.5,41.28,229.89,47
CPT,98016,PROF BRIEF COMUNICAJ TECH-BSD SVC,103.0,51.5,17.94,99.91,47
CPT,980T,Submucosal cryolysis therapy; base of tongue and lingual tonsil only,,,,,0
CPT,981T,"Transcatheter implantation of wireless inferior vena cava sensor for long-term hemodynamic monitoring, including deployment of the sensor, radiological supervision and interpretation, right heart cath",,,17813.98,35627.96,8
CPT,982T,"Remote monitoring of implantable inferior vena cava pressure sensor, physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial set-up and patient education ",,,129.38,258.76,8
CPT,983T,"Remote monitoring of an implanted inferior vena cava sensor for up to 30 days, including at least weekly downloads of inferior vena cava area recordings, interpretation(s), trend analysis, and report(",,,36.27,72.54,8
CPT,984T,"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,,,0
CPT,985T,"Intravascular imaging of extracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,,,0
CPT,986T,"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,,,0
CPT,987T,"Intravascular imaging of intracranial cerebral vessels using optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention, including all associated radiological supe",,,,,0
CPT,98925,OSTEOPATH MANJ 1-2 REGIONS,,,20.98,41.96,8
CPT,98926,OSTEOPATH MANJ 3-4 REGIONS,,,20.98,41.96,8
CPT,98927,OSTEOPATH MANJ 5-6 REGIONS,,,20.98,41.96,8
CPT,98928,OSTEOPATH MANJ 7-8 REGIONS,,,20.98,41.96,8
CPT,98929,OSTEOPATH MANJ 9-10 REGIONS,,,20.98,41.96,8
CPT,98940,CHIROPRACT MANJ 1-2 REGIONS,,,20.98,41.96,8
CPT,98941,CHIROPRACT MANJ 3-4 REGIONS,,,20.98,41.96,8
CPT,98942,CHIROPRACTIC MANJ 5 REGIONS,,,20.98,41.96,8
CPT,98943,CHIROPRACT MANJ XTRSPINL 1/>,,,,,0
CPT,98960,SELF-MGMNT EDUC&TRAIN 30MIN,85.0,42.5,14.8,82.45,47
CPT,98961,SELF-MGMT EDUC/TRAIN 2-4 PT,,,,,0
CPT,98962,SELF-MGMT EDUC/TRAIN 5-8 PT,,,,,0
CPT,98966,PT NONPHYSICIAN TELEPHONE ASSESSM 5-10 MIN,41.0,20.5,7.14,39.77,47
CPT,98966,SP NONPHYSICIAN TELEPHONE ASSESSM 5-10 MIN,41.0,20.5,7.14,39.77,47
CPT,98967,PT NONPHYSICIAN TELEPHONE ASSESSM 11-20 MIN,65.5,32.75,9.05,76.63,94
CPT,98967,SP NONPHYSICIAN TELEPHONE ASSESSM 11-20 MIN,52.0,26.0,9.05,50.44,47
CPT,98968,PT NONPHYSICIAN TELEPHONE ASSESSM 21-30 MIN,94.5,47.25,12.89,111.55,94
CPT,98968,SP NONPHYSICIAN TELEPHONE ASSESSM 21-30 MIN,74.0,37.0,12.89,71.78,47
CPT,98970,QNHP OL DIG ASSMT&MGMT 5-10,,,,,0
CPT,98971,QNHP OL DIG ASSMT&MGMT 11-20,,,,,0
CPT,98972,QNHP OL DIG ASSMT&MGMT 21+,,,,,0
CPT,98975,PT REM THER MNTR 1ST SETUP&EDU,193.0,96.5,33.62,258.76,54
CPT,98975,SP REM THER MNTR 1ST SETUP&EDU,193.0,96.5,33.62,258.76,54
CPT,98976,PT REM THER MNTR DEV SPLY RESP,193.0,96.5,33.62,187.21,54
CPT,98976,SP REM THER MNTR DEV SPLY RESP,193.0,96.5,33.62,187.21,54
CPT,98977,PT REM THER MNTR DV SPLY MSCSKL,129.0,64.5,22.47,125.13,54
CPT,98977,SP REM THER MNTR DV SPLY MSCSKL,129.0,64.5,22.47,125.13,54
CPT,98978,REM THER MNTR DEV SPLY CBT,,,36.27,72.54,8
CPT,98980,REM THER MNTR 1ST 20 MIN,,,,,0
CPT,98981,REM THER MNTR EA ADDL 20 MIN,,,,,0
CPT,98T,REV ARTIFIC DISC ADDL,,,,,0
CPT,99000,LEGAL CASE SETUP FEE,29.0,14.5,5.05,28.13,94
CPT,99000,SPECIMEN HANDLING OFFICE-LAB,,,,,0
CPT,99001,SPECIMEN HANDLING PT-LAB,,,,,0
CPT,99002,DEVICE HANDLING PHYS/QHP,,,,,0
CPT,99024,POSTOP FOLLOW-UP VISIT,,,,,0
CPT,99026,IN-HOSPITAL ON CALL SERVICE,,,,,0
CPT,99027,OUT-OF-HOSP ON CALL SERVICE,,,,,0
CPT,99050,MEDICAL SERVICES AFTER HRS,,,,,0
CPT,99051,MED SERV EVE/WKEND/HOLIDAY,,,,,0
CPT,99053,MED SERV 10PM-8AM 24 HR FAC,,,,,0
CPT,99056,MED SERVICE OUT OF OFFICE,,,,,0
CPT,99058,OFFICE EMERGENCY CARE,,,,,0
CPT,99060,OUT OF OFFICE EMERG MED SERV,,,,,0
CPT,99070,SPECIAL SUPPLIES PHYS/QHP,,,,,0
CPT,99071,PATIENT EDUCATION MATERIALS,,,,,0
CPT,99072,ADDL SUPL MATRL&STAF TM PHE,,,,,0
CPT,99075,MEDICAL TESTIMONY,,,,,0
CPT,99078,GROUP HEALTH EDUCATION,,,,,0
CPT,99080,SPECIAL REPORTS OR FORMS,,,,,0
CPT,99082,UNUSUAL PHYSICIAN TRAVEL,,,,,0
CPT,99091,COLLJ & INTERPJ DATA EA 30 D,,,,,0
CPT,99100,ANES PT EXTEME AGE<1 YR&>70,,,,,0
CPT,99116,ANES COMP TOT BDY HYPTHRM,,,,,0
CPT,99135,ANES COMP CTRLD HYPOTENSION,,,,,0
CPT,99140,ANES COMP EMERGENCY COND,,,,,0
CPT,99151,MOD SED SAME PHYS/QHP <5 YRS INITIAL 15 MINUTES,332.0,166.0,57.83,322.04,47
CPT,99152,MOD SED SAME PHYS/QHP 5/>YRS INITIAL 15 MINUTES,333.78499999999997,166.89499999999998,58.1,323.98,94
CPT,99153,MOD SED SAME PHYS/QHP EA 15 MIN ADDITIONAL,133.005,66.505,23.16,129.01,94
CPT,99155,MOD SED OTHER PHYS/QHP <5 YRS INITIAL 15 MINUTES,303.0,151.5,52.78,293.91,47
CPT,99156,MOD SED OTHER PHYS/QHP 5/>YRS INITIAL 15 MINUTES,305.0,152.5,53.13,295.85,47
CPT,99157,MOD SED OTHER PHYS/QHP EA 15 MIN ADDITIONAL,104.0,52.0,18.11,100.88,47
CPT,99170,ANOGENITAL EXAM CHILD W IMAG,,,196.46,392.92,8
CPT,99172,OCULAR FUNCTION SCREEN,,,,,0
CPT,99173,VISUAL ACUITY SCREEN,,,,,0
CPT,99174,OCULAR INSTRUMNT SCREEN BIL,,,,,0
CPT,99175,INDUCTION OF VOMITING,,,,,0
CPT,99177,OCULAR INSTRUMNT SCREEN BIL,,,,,0
CPT,99183,PROF ATTENDSUPERVS HYPER,420.0,210.0,73.16,407.4,47
CPT,99184,HYPOTHERMIA ILL NEONATE,,,,,0
CPT,99188,APP TOPICAL FLUORIDE VARNISH,,,,,0
CPT,99190,SPECIAL PUMP SERVICES,,,,,0
CPT,99191,SPECIAL PUMP SERVICES,,,,,0
CPT,99192,SPECIAL PUMP SERVICES,,,,,0
CPT,99195,THERAPEUTIC PHLEBOTOMY,381.5,190.75,55.74,429.71,108
CPT,99199,UNLISTED SPECIAL SVC PX/RPRT,,,,,0
CPT,99202,CL VISIT NEW PT LEVEL 2,318.0,159.0,55.39,308.46,47
CPT,99202,CL VISIT NEW PT LEVEL 2 WPROC,318.0,159.0,55.39,308.46,47
CPT,99202,PROF CL VISIT NEW LVL 2 WPROC,187.0,93.5,32.57,181.39,47
CPT,99202,PROF CL VISIT NEW PT LEVEL 2,185.0,92.5,32.22,179.45,47
CPT,99203,CL VISIT NEW PT LEVEL 3,421.0,210.5,73.33,408.37,47
CPT,99203,CL VISIT NEW PT LEVEL 3 WPROC,425.0,212.5,74.03,412.25,47
CPT,99203,PROF CL VISIT NEW LVL 3 WPROC,298.0,149.0,51.91,289.06,47
CPT,99203,PROF CL VISIT NEW PT LEVEL 3,298.0,149.0,51.91,289.06,47
CPT,99204,CL VISIT NEW PT LEVEL 4,584.0,292.0,101.73,566.48,47
CPT,99204,CL VISIT NEW PT LEVEL 4 WPROC,584.0,292.0,101.73,566.48,47
CPT,99204,PROF CL VISIT NEW LVL 4 WPROC,466.0,233.0,81.17,452.02,47
CPT,99204,PROF CL VISIT NEW PT LEVEL 4,466.0,233.0,81.17,452.02,47
CPT,99205,CL VISIT NEW PT LEVEL 5,690.0,345.0,120.19,669.3,47
CPT,99205,CL VISIT NEW PT LEVEL 5 WPROC,697.0,348.5,121.41,676.09,47
CPT,99205,PROF CL VISIT NEW LVL 5 WPROC,605.0,302.5,105.39,586.85,47
CPT,99205,PROF CL VISIT NEW PT LEVEL 5,606.0,303.0,105.56,587.82,47
CPT,99211,CL VISIT ESTAB LEVEL 1,166.0,83.0,28.91,161.02,47
CPT,99211,CL VISIT ESTAB LEVEL 1 WPROC,166.0,83.0,28.91,161.02,47
CPT,99211,PR HOSPITAL OUTPT CLINIC VISIT,294.0,147.0,51.21,285.18,47
CPT,99211,PROF CL VISIT EST LVL 1 WPROC,48.0,24.0,8.36,46.56,47
CPT,99211,PROF CL VISIT ESTAB PT LVL 1,47.0,23.5,8.18,45.59,47
CPT,99212,CL VISIT ESTAB LEVEL 2,307.0,153.5,53.47,297.79,47
CPT,99212,CL VISIT ESTAB LEVEL 2 WPROC,262.0,131.0,45.64,254.14,47
CPT,99212,ORAL ADMIN & PACU VISIT,522.0,261.0,90.93,506.34,47
CPT,99212,PROF CL VISIT EST LVL 2 WPROC,98.0,49.0,17.07,95.06,47
CPT,99212,PROF CL VISIT ESTAB PT LVL 2,97.0,48.5,16.89,94.09,47
CPT,99213,CL VISIT ESTAB LEVEL 3,458.0,229.0,79.78,444.26,47
CPT,99213,CL VISIT ESTAB LEVEL 3 WPROC,306.0,153.0,53.3,296.82,47
CPT,99213,PROF CL VISIT EST LVL 3 WPROC,187.0,93.5,32.57,181.39,47
CPT,99213,PROF CL VISIT ESTAB PT LVL 3,187.0,93.5,32.57,181.39,47
CPT,99214,CL VISIT ESTAB LEVEL 4,474.0,237.0,82.57,459.78,47
CPT,99214,CL VISIT ESTAB LEVEL 4 WPROC,375.0,187.5,65.32,363.75,47
CPT,99214,PROF CL VISIT EST LVL 4 WPROC,288.0,144.0,50.16,279.36,47
CPT,99214,PROF CL VISIT ESTAB PT LVL 4,287.0,143.5,49.99,278.39,47
CPT,99215,CL VISIT ESTAB LEVEL 5,763.0,381.5,132.91,740.11,47
CPT,99215,CL VISIT ESTAB LEVEL 5 WPROC,450.0,225.0,78.39,436.5,47
CPT,99215,PROF CL VISIT EST LVL 5 WPROC,412.0,206.0,71.77,399.64,47
CPT,99215,PROF CL VISIT ESTAB PT LVL 5,411.0,205.5,71.59,398.67,47
CPT,99221,1ST HOSP IP/OBS SF/LOW 40,,,,,0
CPT,99222,1ST HOSP IP/OBS MODERATE 55,,,,,0
CPT,99223,1ST HOSP IP/OBS HIGH 75,,,,,0
CPT,99231,SBSQ HOSP IP/OBS SF/LOW 25,,,,,0
CPT,99232,SBSQ HOSP IP/OBS MODERATE 35,,,,,0
CPT,99233,SBSQ HOSP IP/OBS HIGH 50,,,,,0
CPT,99234,HOSP IP/OBS SM DT SF/LOW 45,,,,,0
CPT,99235,HOSP IP/OBS SAME DATE MOD 70,,,,,0
CPT,99236,HOSP IP/OBS SAME DATE HI 85,,,,,0
CPT,99238,HOSP IP/OBS DSCHRG MGMT 30/<,,,,,0
CPT,99239,HOSP IP/OBS DSCHRG MGMT >30,,,,,0
CPT,99242,OFF/OP CONSLTJ NEW/EST SF 20,,,,,0
CPT,99243,OFF/OP CNSLTJ NEW/EST LOW 30,,,,,0
CPT,99244,OFF/OP CNSLTJ NEW/EST MOD 40,,,,,0
CPT,99245,OFF/OP CONSLTJ NEW/EST HI 55,,,,,0
CPT,99252,IP/OBS CONSLTJ NEW/EST SF 35,,,,,0
CPT,99253,IP/OBS CNSLTJ NEW/EST LOW 45,,,,,0
CPT,99254,IP/OBS CNSLTJ NEW/EST MOD 60,,,,,0
CPT,99255,IP/OBS CONSLTJ NEW/EST HI 80,,,,,0
CPT,99281,ED VISIT LEVEL 1,282.0,141.0,49.12,273.54,54
CPT,99281,ED VISIT LEVEL 1 W/PROC,282.0,141.0,49.12,273.54,54
CPT,99281,EMR DPT VST MAYX REQ PHY/QHP,,,,,0
CPT,99282,ED VISIT LEVEL 2,573.0,286.5,99.81,555.81,54
CPT,99282,ED VISIT LEVEL 2 W/PROC,573.0,286.5,99.81,555.81,54
CPT,99282,EMERGENCY DEPT VISIT SF MDM,,,,,0
CPT,99283,ED VISIT LEVEL 3,1726.0,863.0,265.27,1674.22,54
CPT,99283,ED VISIT LEVEL 3 W/PROC,1726.0,863.0,265.27,1674.22,54
CPT,99283,EMERGENCY DEPT VISIT LOW MDM,,,,,0
CPT,99284,ED VISIT LEVEL 4,2455.0,1227.5,405.48,2381.35,54
CPT,99284,ED VISIT LEVEL 4 W/PROC,2455.0,1227.5,405.48,2381.35,54
CPT,99284,EMERGENCY DEPT VISIT MOD MDM,,,,,0
CPT,99285,ED VISIT LEVEL 5,3453.0,1726.5,578.71,3349.41,54
CPT,99285,ED VISIT LEVEL 5 W/PROC,3453.0,1726.5,578.71,3349.41,54
CPT,99285,EMERGENCY DEPT VISIT HI MDM,,,,,0
CPT,99288,DIRECT ADVANCED LIFE SUPPORT,,,,,0
CPT,99291,CRITICAL CARE FIRST HOUR,,,,,0
CPT,99291,ED VISIT LEVEL 6 CC,4643.0,2321.5,802.7,4503.71,54
CPT,99291,ED VISIT LEVEL 6 CC W/PROC,4644.0,2322.0,802.7,4504.68,54
CPT,99292,CC E/M CRIT ILL/INJ EA ADD 30,305.0,152.5,53.13,295.85,47
CPT,99292,CRITICAL CARE ADDL 30 MIN,,,,,0
CPT,99304,1ST NF CARE SF/LOW MDM 25,,,,,0
CPT,99305,1ST NF CARE MODERATE MDM 35,,,,,0
CPT,99306,1ST NF CARE HIGH MDM 50,,,,,0
CPT,99307,SBSQ NF CARE SF MDM 10,,,,,0
CPT,99308,SBSQ NF CARE LOW MDM 20,,,,,0
CPT,99309,SBSQ NF CARE MODERATE MDM 30,,,,,0
CPT,99310,SBSQ NF CARE HIGH MDM 45,,,,,0
CPT,99315,NF DSCHRG MGMT 30 MIN/LESS,,,,,0
CPT,99316,NF DSCHRG MGMT 30 MIN+,,,,,0
CPT,99341,HOME/RES VST NEW SF MDM 15,,,,,0
CPT,99342,HOME/RES VST NEW LOW MDM 30,,,,,0
CPT,99344,HOME/RES VST NEW MOD MDM 60,,,,,0
CPT,99345,HOME/RES VST NEW HIGH MDM 75,,,,,0
CPT,99347,HOME/RES VST EST SF MDM 20,,,,,0
CPT,99348,HOME/RES VST EST LOW MDM 30,,,,,0
CPT,99349,HOME/RES VST EST MOD MDM 40,,,,,0
CPT,99350,HOME/RES VST EST HIGH MDM 60,,,,,0
CPT,99358,PROLONG SERVICE W/O CONTACT,,,,,0
CPT,99359,PROLONG SERV W/O CONTACT ADD,,,,,0
CPT,99360,PHYSICIAN STANDBY SERVICES,,,,,0
CPT,99366,OT MEDICAL TEAM CONF W/PAT,173.0,86.5,30.13,167.81,47
CPT,99366,PT MEDICAL TEAM CONF W/PAT,167.0,83.5,29.09,161.99,47
CPT,99366,SP MEDICAL TEAM CONF W/PAT,184.0,92.0,32.05,178.48,47
CPT,99367,TEAM CONF W/O PAT BY PHYS,,,,,0
CPT,99368,OT TEAM CONF W/O PAT BY HC PRO,250.0,125.0,43.55,242.5,47
CPT,99368,PT TEAM CONF W/O PAT BY HC PRO,250.0,125.0,43.55,242.5,47
CPT,99368,SP TEAM CONF W/O PAT BY HC PRO,250.0,125.0,43.55,242.5,47
CPT,99374,HOME HEALTH CARE SUPERVISION,,,,,0
CPT,99375,HOME HEALTH CARE SUPERVISION,,,,,0
CPT,99377,HOSPICE CARE SUPERVISION,,,,,0
CPT,99378,HOSPICE CARE SUPERVISION,,,,,0
CPT,99379,NURSING FAC CARE SUPERVISION,,,,,0
CPT,99380,NURSING FAC CARE SUPERVISION,,,,,0
CPT,99381,INIT PM E/M NEW PAT INFANT,,,,,0
CPT,99382,INIT PM E/M NEW PAT 1-4 YRS,,,,,0
CPT,99383,PREV VISIT NEW AGE 5-11,,,,,0
CPT,99384,PREV VISIT NEW AGE 12-17,,,,,0
CPT,99385,PREV VISIT NEW AGE 18-39,,,,,0
CPT,99386,PREV VISIT NEW AGE 40-64,,,,,0
CPT,99387,INIT PM E/M NEW PAT 65+ YRS,,,,,0
CPT,99391,PER PM REEVAL EST PAT INFANT,,,,,0
CPT,99392,PREV VISIT EST AGE 1-4,,,,,0
CPT,99393,PREV VISIT EST AGE 5-11,,,,,0
CPT,99394,PREV VISIT EST AGE 12-17,,,,,0
CPT,99395,PREV VISIT EST AGE 18-39,,,,,0
CPT,99396,PREV VISIT EST AGE 40-64,,,,,0
CPT,99397,PER PM REEVAL EST PAT 65+ YR,,,,,0
CPT,99401,PREV MED CNSL INDIV APPRX 15,,,,,0
CPT,99402,PREV MED CNSL INDIV APPRX 30,,,,,0
CPT,99403,PREV MED CNSL INDIV APPRX 45,,,,,0
CPT,99404,PREV MED CNSL INDIV APPRX 60,,,,,0
CPT,99406,SMOKE/TOBACCO COUNSEL 3-10MIN,50.0,25.0,5.74,72.82,108
CPT,99407,SMOKE/TOBACCO COUNSEL > 10 MIN,77.5,38.75,12.71,79.54,108
CPT,99408,AUDIT/DAST 15-30 MIN,,,,,0
CPT,99409,AUDIT/DAST OVER 30 MIN,,,,,0
CPT,99411,PREVENTIVE COUNSELING GROUP,,,,,0
CPT,99412,PREVENTIVE COUNSELING GROUP,,,,,0
CPT,99415,PROLNG CLIN STAFF SVC 1ST HR,,,,,0
CPT,99416,PROLNG CLIN STAFF SVC EA ADD,,,,,0
CPT,99417,PROLNG OP E/M EACH 15 MIN,,,,,0
CPT,99418,PROLNG IP/OBS E/M EA 15 MIN,,,,,0
CPT,99421,OL DIG E/M SVC 5-10 MIN,,,,,0
CPT,99422,OL DIG E/M SVC 11-20 MIN,,,,,0
CPT,99423,OL DIG E/M SVC 21+ MIN,,,,,0
CPT,99424,PRIN CARE MGMT PHYS 1ST 30,,,,,0
CPT,99425,PRIN CARE MGMT PHYS EA ADDL,,,,,0
CPT,99426,PRIN CARE MGMT STAFF 1ST 30,,,98.72,197.44,8
CPT,99427,PRIN CARE MGMT STAFF EA ADDL,,,,,0
CPT,99429,UNLISTED PREVENTIVE SERVICE,,,,,0
CPT,99437,CHRNC CARE MGMT PHYS EA ADDL,,,,,0
CPT,99439,CHRNC CARE MGMT STAF EA ADDL,,,,,0
CPT,99446,NTRPROF PH1/NTRNET/EHR 5-10,,,,,0
CPT,99447,NTRPROF PH1/NTRNET/EHR 11-20,,,,,0
CPT,99448,NTRPROF PH1/NTRNET/EHR 21-30,,,,,0
CPT,99449,NTRPROF PH1/NTRNET/EHR 31/>,,,,,0
CPT,99450,BASIC LIFE DISABILITY EXAM,,,,,0
CPT,99451,NTRPROF PH1/NTRNET/EHR 5/>,,,,,0
CPT,99452,NTRPROF PH1/NTRNET/EHR RFRL,,,,,0
CPT,99453,REM MNTR PHYSIOL PARAM SETUP,,,129.38,258.76,8
CPT,99454,REM MNTR PHYSIOL PARAM DEV,,,36.27,72.54,8
CPT,99455,WORK RELATED DISABILITY EXAM,,,,,0
CPT,99456,DISABILITY EXAMINATION,,,,,0
CPT,99457,REM PHYSIOL MNTR 1ST 20 MIN,,,,,0
CPT,99458,REM PHYSIOL MNTR EA ADDL 20,,,,,0
CPT,99459,PELVIC EXAMINATION,,,,,0
CPT,99460,INIT NB EM PER DAY HOSP,,,129.38,258.76,8
CPT,99461,INIT NB EM PER DAY NON-FAC,,,,,0
CPT,99462,SBSQ NB EM PER DAY HOSP,,,,,0
CPT,99463,SAME DAY NB DISCHARGE,,,129.38,258.76,8
CPT,99464,ATT DEL&INIT STABILIZ NEWBORN,373.0,186.5,64.97,361.81,47
CPT,99465,DELIVERYBIRTHING ROOM RESUSC,783.0,391.5,136.39,1284.56,54
CPT,99466,PED CRIT CARE TRANSPORT,,,,,0
CPT,99467,PED CRIT CARE TRANSPORT ADDL,,,,,0
CPT,99468,NEONATE CRIT CARE INITIAL,,,,,0
CPT,99469,NEONATE CRIT CARE SUBSQ,,,,,0
CPT,99471,PED CRITICAL CARE INITIAL,,,,,0
CPT,99472,PED CRITICAL CARE SUBSQ,,,,,0
CPT,99473,SELF-MEAS BP PT EDUCAJ/TRAIN,,,28.11,56.22,8
CPT,99474,SELF-MEAS BP 2 READG BID 30D,,,,,0
CPT,99475,PED CRIT CARE AGE 2-5 INIT,,,,,0
CPT,99476,PED CRIT CARE AGE 2-5 SUBSQ,,,,,0
CPT,99477,INIT DAY HOSP NEONATE CARE,,,,,0
CPT,99478,IC LBW INF < 1500 GM SUBSQ,,,,,0
CPT,99479,IC LBW INF 1500-2500 G SUBSQ,,,,,0
CPT,99480,IC INF PBW 2501-5000 G SUBSQ,,,,,0
CPT,99483,ASSMT & CARE PLN PT COG IMP,,,98.72,197.44,8
CPT,99484,CARE MGMT SVC BHVL HLTH COND,,,36.41,72.82,8
CPT,99485,SUPRV INTERFACILTY TRANSPORT,,,,,0
CPT,99486,SUPRV INTERFAC TRNSPORT ADDL,,,,,0
CPT,99487,CPLX CHRNC CARE 1ST 60 MIN,,,172.48,344.96,8
CPT,99489,CPLX CHRNC CARE EA ADDL 30,,,,,0
CPT,99490,CHRNC CARE MGMT STAFF 1ST 20,,,98.72,197.44,8
CPT,99491,CHRNC CARE MGMT PHYS 1ST 30,,,,,0
CPT,99492,1ST PSYC COLLAB CARE MGMT,,,98.72,197.44,8
CPT,99493,SBSQ PSYC COLLAB CARE MGMT,,,98.72,197.44,8
CPT,99494,1ST/SBSQ PSYC COLLAB CARE,,,,,0
CPT,99495,TRANS CARE MGMT 14 DAY DISCH,263.0,131.5,45.81,258.76,54
CPT,99496,TRANS CARE MGMT 7 DAY DISCH,263.0,131.5,45.81,258.76,54
CPT,99497,PR ADVANCE CARE PLANNING FIRST 30 MINS,200.0,100.0,34.84,197.44,54
CPT,99498,ADVNCD CARE PLAN ADDL 30 MIN,,,,,0
CPT,99499,UNLISTED E&M SERVICE,,,,,0
CPT,99500,HOME VISIT PRENATAL,,,,,0
CPT,99501,HOME VISIT POSTNATAL,,,,,0
CPT,99502,HOME VISIT NB CARE,,,,,0
CPT,99503,HOME VISIT RESP THERAPY,,,,,0
CPT,99504,HOME VISIT MECH VENTILATOR,,,,,0
CPT,99505,HOME VISIT STOMA CARE,,,,,0
CPT,99506,HOME VISIT IM INJECTION,,,,,0
CPT,99507,HOME VISIT CATH MAINTAIN,,,,,0
CPT,99509,HOME VISIT DAY LIFE ACTIVITY,,,,,0
CPT,99510,HOME VISIT SING/M/FAM COUNS,,,,,0
CPT,99511,HOME VISIT FECAL/ENEMA MGMT,,,,,0
CPT,99512,HOME VISIT FOR HEMODIALYSIS,,,,,0
CPT,99600,UNLISTED HOME VISIT SVC/PX,,,,,0
CPT,99601,HOME NFS VISIT <2 HRS,,,,,0
CPT,99602,HOME NFS VISIT EACH ADDL HR,,,,,0
CPT,99605,MTMS BY PHARM NP 15 MIN,,,,,0
CPT,99606,MTMS BY PHARM EST 15 MIN,,,,,0
CPT,99607,MTMS BY PHARM ADDL 15 MIN,,,,,0
CPT,9U,ONC BRST CA ERBB2 AMP/NONAMP,,,107.0,214.0,8
HCPCS,A0021,OUTSIDE STATE AMBULANCE SERV,,,,,0
HCPCS,A0080,NONINTEREST ESCORT IN NON ER,,,,,0
HCPCS,A0090,INTEREST ESCORT IN NON ER,,,,,0
HCPCS,A0100,NONEMERGENCY TRANSPORT TAXI,,,,,0
HCPCS,A0110,NONEMERGENCY TRANSPORT BUS,,,,,0
HCPCS,A0120,NONER TRANSPORT MINI-BUS,,,,,0
HCPCS,A0130,NONER TRANSPORT WHEELCH VAN,,,,,0
HCPCS,A0140,NONEMERGENCY TRANSPORT AIR,,,,,0
HCPCS,A0160,NONER TRANSPORT CASE WORKER,,,,,0
HCPCS,A0170,TRANSPORT PARKING FEES/TOLLS,,,,,0
HCPCS,A0180,NONER TRANSPORT LODGNG RECIP,,,,,0
HCPCS,A0190,NONER TRANSPORT MEALS RECIP,,,,,0
HCPCS,A0200,NONER TRANSPORT LODGNG ESCRT,,,,,0
HCPCS,A0210,NONER TRANSPORT MEALS ESCORT,,,,,0
HCPCS,A0225,NEONATAL EMERGENCY TRANSPORT,,,,,0
HCPCS,A0380,BASIC LIFE SUPPORT MILEAGE,,,,,0
HCPCS,A0382,BASIC SUPPORT ROUTINE SUPPLS,,,,,0
HCPCS,A0384,BLS DEFIBRILLATION SUPPLIES,,,,,0
HCPCS,A0390,ADVANCED LIFE SUPPORT MILEAG,,,,,0
HCPCS,A0392,ALS DEFIBRILLATION SUPPLIES,,,,,0
HCPCS,A0394,ALS IV DRUG THERAPY SUPPLIES,,,,,0
HCPCS,A0396,ALS ESOPHAGEAL INTUB SUPPLS,,,,,0
HCPCS,A0398,ALS ROUTINE DISPOSBLE SUPPLS,,,,,0
HCPCS,A0420,AMBULANCE WAITING 1/2 HR,,,,,0
HCPCS,A0422,AMBULANCE 02 LIFE SUSTAINING,,,,,0
HCPCS,A0424,EXTRA AMBULANCE ATTENDANT,,,,,0
HCPCS,A0425,GROUND MILEAGE/LOADED,31.0,15.5,5.4,30.07,47
HCPCS,A0425,GROUND MILEAGE/LOADED NEONATE,31.0,15.5,5.4,30.07,47
HCPCS,A0426,ALS 1,,,,,0
HCPCS,A0427,ALS 1 EMERGENCY TRANSPORT,2945.0,1472.5,513.01,2856.65,47
HCPCS,A0428,BLS,,,,,0
HCPCS,A0429,BLS 1 COMMUNITY CALL TRANSPORT,131.0,65.5,22.82,127.07,47
HCPCS,A0429,BLS EMERGENCY TRANSPORT,1719.0,859.5,299.44,1667.43,47
HCPCS,A0430,FIXED WING AIR TRANSPORT,,,,,0
HCPCS,A0431,ROTARY WING AIR TRANSPORT,,,,,0
HCPCS,A0432,PI VOLUNTEER AMBULANCE CO,,,,,0
HCPCS,A0433,ALS 2 EMERGENCY TRANSPORT,4841.0,2420.5,843.3,4695.77,47
HCPCS,A0434,SPECIALTY CARE TRANSPORT,5522.0,2761.0,961.93,5356.34,47
HCPCS,A0434,SPECIALTY CARE TRANSPORT NEON,5522.0,2761.0,961.93,5356.34,47
HCPCS,A0435,FIXED WING AIR MILEAGE,,,,,0
HCPCS,A0436,ROTARY WING AIR MILEAGE,,,,,0
HCPCS,A0888,NONCOVERED AMBULANCE MILEAGE,,,,,0
HCPCS,A0998,AMBULANCE RESPONSE/TREATMENT,,,,,0
HCPCS,A0999,UNLISTED AMBULANCE SERVICE,,,,,0
HCPCS,A2001,"INNOVAMATRIX AC, PER SQ CM",,,120.93,2388.08,10
HCPCS,A2002,MIRRAGEN ADV WND MAT PER SQ,,,120.93,418.3,9
HCPCS,A2004,"XCELLISTEM, 1 MG",,,19.03,24.84,2
HCPCS,A2005,"MICROLYTE MATRIX, PER SQ CM",,,120.93,310.58,9
HCPCS,A2006,NOVOSORB SYNPATH PER SQ CM,,,120.93,241.86,8
HCPCS,A2007,"RESTRATA, PER SQ CM",,,98.26,385.28,10
HCPCS,A2008,"THERAGENESIS, PER SQ CM",,,109.7,283.33,10
HCPCS,A2009,"SYMPHONY, PER SQ CM",,,120.93,241.86,10
HCPCS,A2010,"APIS, PER SQUARE CENTIMETER",,,120.93,241.86,8
HCPCS,A2011,"SUPRA SDRM, PER SQ CM",,,120.93,241.86,8
HCPCS,A2012,"SUPRATHEL, PER SQ CM",,,120.93,241.86,8
HCPCS,A2013,"INNOVAMATRIX FS, PER SQ CM",,,120.93,2579.12,10
HCPCS,A2014,OMEZA COLLAG PER 100 MG,,,187.58,244.78,2
HCPCS,A2015,"PHOENIX WND MTRX, PER SQ CM",,,120.93,1755.17,9
HCPCS,A2016,"PERMEADERM B, PER SQ CM",,,120.93,241.86,8
HCPCS,A2017,"PERMEADERM GLOVE, EACH",,,,,0
HCPCS,A2018,"PERMEADERM C, PER SQ CM",,,120.93,241.86,8
HCPCS,A2019,KERECIS MARIGEN SHLD SQ CM,,,120.93,1137.49,10
HCPCS,A2020,AC5 WOUND SYSTEM,,,,,0
HCPCS,A2021,NEOMATRIX PER SQ CM,,,120.93,3294.06,10
HCPCS,A2022,INNOVABRN/INNOVAMATX XL SQCM,,,120.93,2722.41,10
HCPCS,A2023,"INNOVAMATRIX PD, 1 MG",,,20.13,31.05,2
HCPCS,A2024,RESOLVE MATRIX PER SQ CM,,,120.93,2367.76,9
HCPCS,A2025,MIRO3D PER CUBIC CM,,,120.93,398.01,10
HCPCS,A2026,"Restrata minimatrix, 5 mg",,,,,0
HCPCS,A2027,"MatriDerm, per square centimeter",,,120.93,241.86,8
HCPCS,A2028,"MicroMatrix Flex, per mg",,,1494.75,1494.75,1
HCPCS,A2029,"MiroTract Wound Matrix Sheet, per cubic centimeter",,,120.93,796.03,10
HCPCS,A2030,"Miro3D Fibers, per milligram",,,6.67,8.77,2
HCPCS,A2031,"MiroDry Wound Matrix, per square centimeter",,,120.93,955.23,10
HCPCS,A2032,"Myriad Matrix, per square centimeter",,,28.71,32.96,2
HCPCS,A2033,"Myriad Morcells, 4 milligrams",,,16.1,21.02,2
HCPCS,A2034,"Foundation DRS Solo, per square centimeter",,,1876.87,1876.87,1
HCPCS,A2035,"Corplex P or Theracor P or Allacor P, per milligram",,,139.68,139.68,1
HCPCS,A2038,"MARIGEN PACTO, PER SQ CM",45.0,22.5,7.83,241.86,54
HCPCS,A4100,SKIN SUB FDA CLRD AS DEV NOS,,,,,0
HCPCS,A4206,1 CC STERILE SYRINGE&NEEDLE,,,,,0
HCPCS,A4207,2 CC STERILE SYRINGE&NEEDLE,,,,,0
HCPCS,A4208,3 CC STERILE SYRINGE&NEEDLE,,,,,0
HCPCS,A4209,5+ CC STERILE SYRINGE&NEEDLE,,,,,0
HCPCS,A4210,NONNEEDLE INJECTION DEVICE,,,,,0
HCPCS,A4211,SUPP FOR SELF-ADM INJECTIONS,,,,,0
HCPCS,A4212,NON CORING NEEDLE OR STYLET,,,,,0
HCPCS,A4213,20+ CC SYRINGE ONLY,,,,,0
HCPCS,A4215,STERILE NEEDLE,,,,,0
HCPCS,A4216,DME POS,,,0.54,1.08,8
HCPCS,A4217,DME POS,,,3.8,7.6,8
HCPCS,A4218,STERILE SALINE OR WATER,,,,,0
HCPCS,A4220,INFUSION PUMP REFILL KIT,,,,,0
HCPCS,A4221,DME POS,,,25.87,51.74,8
HCPCS,A4222,DME POS,,,49.07,98.14,8
HCPCS,A4223,INFUSION SUPPLIES W/O PUMP,,,,,0
HCPCS,A4224,DME POS,,,25.87,51.74,8
HCPCS,A4225,DME POS,,,3.47,6.94,8
HCPCS,A4226,WEEKLY SUPPLY MAINT CGS PUMP,,,,,0
HCPCS,A4230,INFUS INSULIN PUMP NON NEEDL,,,,,0
HCPCS,A4231,INFUSION INSULIN PUMP NEEDLE,,,,,0
HCPCS,A4232,SYRINGE W/NEEDLE INSULIN 3CC,,,,,0
HCPCS,A4233,DME POS,,,0.51,1.02,8
HCPCS,A4234,DME POS,,,2.36,4.72,8
HCPCS,A4235,DME POS,,,1.0,2.0,8
HCPCS,A4236,DME POS,,,1.16,2.32,8
HCPCS,A4238,DME POS,,,280.71,561.42,8
HCPCS,A4239,DME POS,,,273.28,546.56,8
HCPCS,A4244,ALCOHOL OR PEROXIDE PER PINT,,,,,0
HCPCS,A4245,ALCOHOL WIPES PER BOX,,,,,0
HCPCS,A4246,BETADINE/PHISOHEX SOLUTION,,,,,0
HCPCS,A4247,BETADINE/IODINE SWABS/WIPES,,,,,0
HCPCS,A4248,CHLORHEXIDINE ANTISEPT,,,0.06,0.06,1
HCPCS,A4250,URINE REAGENT STRIPS/TABLETS,,,,,0
HCPCS,A4252,BLOOD KETONE TEST OR STRIP,,,,,0
HCPCS,A4253,DME POS,,,8.32,16.64,8
HCPCS,A4255,DME POS,,,5.7,11.4,8
HCPCS,A4256,DME POS,,,3.38,6.76,8
HCPCS,A4257,DME POS,,,18.19,36.38,8
HCPCS,A4258,DME POS,,,2.12,4.24,8
HCPCS,A4259,DME POS,,,1.42,2.84,8
HCPCS,A4261,CERVICAL CAP CONTRACEPTIVE,,,,,0
HCPCS,A4262,TEMPORARY TEAR DUCT PLUG,,,,,0
HCPCS,A4263,PERMANENT TEAR DUCT PLUG,,,,,0
HCPCS,A4264,INTRATUBAL OCCLUSION DEVICE,,,,,0
HCPCS,A4265,DME POS,,,4.86,9.72,8
HCPCS,A4266,DIAPHRAGM,,,,,0
HCPCS,A4267,MALE CONDOM,,,,,0
HCPCS,A4268,FEMALE CONDOM,,,,,0
HCPCS,A4269,SPERMICIDE,,,,,0
HCPCS,A4270,DISPOSABLE ENDOSCOPE SHEATH,,,,,0
HCPCS,A4271,Home lancing/test cartridges,,,34.1,68.2,8
HCPCS,A4280,DME POS,,,7.61,15.22,8
HCPCS,A4281,REPLACEMENT BREASTPUMP TUBE,,,,,0
HCPCS,A4282,REPLACEMENT BREASTPUMP ADPT,,,,,0
HCPCS,A4283,REPLACEMENT BREASTPUMP CAP,,,,,0
HCPCS,A4284,REPLCMNT BREAST PUMP SHIELD,,,,,0
HCPCS,A4285,REPLCMNT BREAST PUMP BOTTLE,,,,,0
HCPCS,A4286,REPLCMNT BREASTPUMP LOK RING,,,,,0
HCPCS,A4287,DISP COL STO BAG BREAST MILK,,,,,0
HCPCS,A4290,SACRAL NERVE STIM TEST LEAD,,,,,0
HCPCS,A4300,CATH IMPL VASC ACCESS PORTAL,,,,,0
HCPCS,A4301,IMPLANTABLE ACCESS SYST PERC,,,,,0
HCPCS,A4305,DRUG DELIVERY SYSTEM >=50 ML,,,,,0
HCPCS,A4306,DRUG DELIVERY SYSTEM <=50 ML,,,,,0
HCPCS,A4310,DME POS,,,9.36,18.72,8
HCPCS,A4311,DME POS,,,21.11,42.22,8
HCPCS,A4312,DME POS,,,25.7,51.4,8
HCPCS,A4313,DME POS,,,26.4,52.8,8
HCPCS,A4314,DME POS,,,36.03,72.06,8
HCPCS,A4315,DME POS,,,37.59,75.18,8
HCPCS,A4316,DME POS,,,40.47,80.94,8
HCPCS,A4320,DME POS,,,6.47,12.94,8
HCPCS,A4321,DME POS,,,,,0
HCPCS,A4322,DME POS,,,4.19,8.38,8
HCPCS,A4326,DME POS,,,15.37,30.74,8
HCPCS,A4327,DME POS,,,63.57,127.14,8
HCPCS,A4328,DME POS,,,14.62,29.24,8
HCPCS,A4330,DME POS,,,10.17,20.34,8
HCPCS,A4331,DME POS,,,4.53,9.06,8
HCPCS,A4332,DME POS,,,0.15,0.3,8
HCPCS,A4333,DME POS,,,3.16,6.32,8
HCPCS,A4334,DME POS,,,7.01,14.02,8
HCPCS,A4335,INCONTINENCE SUPPLY,,,,,0
HCPCS,A4336,DME POS,,,2.05,4.1,8
HCPCS,A4337,INCONTINENT RECTAL INSERT,,,,,0
HCPCS,A4338,DME POS,,,15.48,30.96,8
HCPCS,A4340,DME POS,,,38.46,76.92,8
HCPCS,A4341,DIABETES PREV STANDARD CURR,,,347.75,695.5,8
HCPCS,A4342,DME POS,,,878.06,1756.12,8
HCPCS,A4344,DME POS,,,20.46,40.92,8
HCPCS,A4346,DME POS,,,23.72,47.44,8
HCPCS,A4349,DME POS,,,2.87,5.74,8
HCPCS,A4351,DME POS,,,2.19,4.38,8
HCPCS,A4352,DME POS,,,8.44,16.88,8
HCPCS,A4353,DME POS,,,9.99,19.98,8
HCPCS,A4354,DME POS,,,16.83,33.66,8
HCPCS,A4355,DME POS,,,12.71,25.42,8
HCPCS,A4356,DME POS,,,64.65,129.3,8
HCPCS,A4357,DME POS,,,13.84,27.68,8
HCPCS,A4358,DME POS,,,9.46,18.92,8
HCPCS,A4360,DME POS,,,0.7,1.4,8
HCPCS,A4361,DME POS,,,26.16,52.32,8
HCPCS,A4362,DME POS,,,4.95,9.9,8
HCPCS,A4363,DME POS,,,3.38,6.76,8
HCPCS,A4364,DME POS,,,3.56,7.12,8
HCPCS,A4366,DME POS,,,1.84,3.68,8
HCPCS,A4367,DME POS,,,8.92,17.84,8
HCPCS,A4368,DME POS,,,0.36,0.72,8
HCPCS,A4369,DME POS,,,3.46,6.92,8
HCPCS,A4371,DME POS,,,5.2,10.4,8
HCPCS,A4372,DME POS,,,5.99,11.98,8
HCPCS,A4373,DME POS,,,8.94,17.88,8
HCPCS,A4375,DME POS,,,24.47,48.94,8
HCPCS,A4376,DME POS,,,67.81,135.62,8
HCPCS,A4377,DME POS,,,6.11,12.22,8
HCPCS,A4378,DME POS,,,43.82,87.64,8
HCPCS,A4379,DME POS,,,21.4,42.8,8
HCPCS,A4380,DME POS,,,53.2,106.4,8
HCPCS,A4381,DME POS,,,6.59,13.18,8
HCPCS,A4382,DME POS,,,35.09,70.18,8
HCPCS,A4383,DME POS,,,40.17,80.34,8
HCPCS,A4384,DME POS,,,13.69,27.38,8
HCPCS,A4385,DME POS,,,7.26,14.52,8
HCPCS,A4387,DME POS,,,3.2,6.4,8
HCPCS,A4388,DME POS,,,6.21,12.42,8
HCPCS,A4389,DME POS,,,8.84,17.68,8
HCPCS,A4390,DME POS,,,13.68,27.36,8
HCPCS,A4391,DME POS,,,10.07,20.14,8
HCPCS,A4392,DME POS,,,11.65,23.3,8
HCPCS,A4393,DME POS,,,12.88,25.76,8
HCPCS,A4394,DME POS,,,3.69,7.38,8
HCPCS,A4395,DME POS,,,0.05,0.1,8
HCPCS,A4396,DME POS,,,57.69,115.38,8
HCPCS,A4398,DME POS,,,19.7,39.4,8
HCPCS,A4399,DME POS,,,17.32,34.64,8
HCPCS,A4400,DME POS,,,59.2,118.4,8
HCPCS,A4402,DME POS,,,1.93,3.86,8
HCPCS,A4404,DME POS,,,2.03,4.06,8
HCPCS,A4405,DME POS,,,4.87,9.74,8
HCPCS,A4406,DME POS,,,8.16,16.32,8
HCPCS,A4407,DME POS,,,12.48,24.96,8
HCPCS,A4408,DME POS,,,14.07,28.14,8
HCPCS,A4409,DME POS,,,8.84,17.68,8
HCPCS,A4410,DME POS,,,12.88,25.76,8
HCPCS,A4411,DME POS,,,7.26,14.52,8
HCPCS,A4412,DME POS,,,3.86,7.72,8
HCPCS,A4413,DME POS,,,7.85,15.7,8
HCPCS,A4414,DME POS,,,7.01,14.02,8
HCPCS,A4415,DME POS,,,8.55,17.1,8
HCPCS,A4416,DME POS,,,3.93,7.86,8
HCPCS,A4417,DME POS,,,5.31,10.62,8
HCPCS,A4418,DME POS,,,2.58,5.16,8
HCPCS,A4419,DME POS,,,2.46,4.92,8
HCPCS,A4420,DME POS,,,,,0
HCPCS,A4421,OSTOMY SUPPLY MISC,,,,,0
HCPCS,A4422,DME POS,,,0.15,0.3,8
HCPCS,A4423,DME POS,,,2.64,5.28,8
HCPCS,A4424,DME POS,,,6.78,13.56,8
HCPCS,A4425,DME POS,,,5.1,10.2,8
HCPCS,A4426,DME POS,,,3.89,7.78,8
HCPCS,A4427,DME POS,,,3.98,7.96,8
HCPCS,A4428,DME POS,,,9.29,18.58,8
HCPCS,A4429,DME POS,,,11.76,23.52,8
HCPCS,A4430,DME POS,,,12.14,24.28,8
HCPCS,A4431,DME POS,,,8.84,17.68,8
HCPCS,A4432,DME POS,,,5.11,10.22,8
HCPCS,A4433,DME POS,,,4.78,9.56,8
HCPCS,A4434,DME POS,,,5.36,10.72,8
HCPCS,A4435,DME POS,,,8.21,16.42,8
HCPCS,A4436,DME POS,,,23.23,46.46,8
HCPCS,A4437,DME POS,,,23.23,46.46,8
HCPCS,A4438,Adhesive clip ext ens contr,,,1.96,3.92,8
HCPCS,A4450,DME POS,,,0.1,0.2,8
HCPCS,A4452,DME POS,,,0.5,1.0,8
HCPCS,A4453,REC CATH MAN PUMP ENEMA REPL,,,14.04,28.08,8
HCPCS,A4455,DME POS,,,1.73,3.46,8
HCPCS,A4456,DME POS,,,0.35,0.7,8
HCPCS,A4457,ENEMA TUBE ANY TYPE REPL,,,,,0
HCPCS,A4458,REUSABLE ENEMA BAG,,,,,0
HCPCS,A4459,"MANUAL PUMP ENEMA, REUSABLE",,,160.42,320.84,8
HCPCS,A4461,DME POS,,,4.7,9.4,8
HCPCS,A4463,DME POS,,,18.97,37.94,8
HCPCS,A4465,NON-ELASTIC EXTREMITY BINDER,,,,,0
HCPCS,A4467,BELT STRAP SLEEV GRMNT COVER,,,,,0
HCPCS,A4468,EXSUFF BELT INCL ALL SUP ACC,,,,,0
HCPCS,A4470,GRAVLEE JET WASHER,,,,,0
HCPCS,A4480,VABRA ASPIRATOR,,,,,0
HCPCS,A4481,DME POS,,,0.52,1.04,8
HCPCS,A4483,DME POS,,,,,0
HCPCS,A4490,ABOVE KNEE SURGICAL STOCKING,,,,,0
HCPCS,A4495,THIGH LENGTH SURG STOCKING,,,,,0
HCPCS,A4500,BELOW KNEE SURGICAL STOCKING,,,,,0
HCPCS,A4510,FULL LENGTH SURG STOCKING,,,,,0
HCPCS,A4520,INCONTINENCE GARMENT ANYTYPE,,,,,0
HCPCS,A4540,TRANS ELEC NERV PERIPH NERV,,,,,0
HCPCS,A4541,DME POS,,,41.07,82.14,8
HCPCS,A4542,DME POS,,,526.85,1053.7,8
HCPCS,A4543,"Supplies for transcutaneous electrical nerve stimulator, for nerves in the auricular region, per month",,,,,0
HCPCS,A4544,Electrode for external lower extremity nerve stimulator for restless legs syndrome,,,6.34,12.68,8
HCPCS,A4545,"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month",,,41.72,83.44,8
HCPCS,A4550,SURGICAL TRAYS,,,,,0
HCPCS,A4553,"NONDISP UNDERPADS, ALL SIZES",,,,,0
HCPCS,A4554,DISPOSABLE UNDERPADS,,,,,0
HCPCS,A4555,CA TX E-STIM ELECTR/TRANSDUC,,,,,0
HCPCS,A4556,DME POS,,,14.71,29.42,8
HCPCS,A4557,DME POS,,,13.48,26.96,8
HCPCS,A4558,DME POS,,,7.77,15.54,8
HCPCS,A4559,DME POS,,,0.13,0.26,8
HCPCS,A4560,NMES DISPOSABLE,,,,,0
HCPCS,A4561,DME POS,,,29.34,58.68,8
HCPCS,A4562,DME POS,,,72.96,145.92,8
HCPCS,A4563,DME POS,,,1689.73,3379.46,8
HCPCS,A4564,"Pessary, disposable any type",,,,,0
HCPCS,A4565,DME POS,,,10.98,21.96,8
HCPCS,A4566,SHOULD SLING/VEST/ABRESTRAIN,,,,,0
HCPCS,A4570,SPLINT,,,,,0
HCPCS,A4575,HYPERBARIC O2 CHAMBER DISPS,,,,,0
HCPCS,A4580,CAST SUPPLIES (PLASTER),,,,,0
HCPCS,A4590,SPECIAL CASTING MATERIAL,,,,,0
HCPCS,A4593,Neuromod sti sys adj rehab,,,52.81,105.62,8
HCPCS,A4594,Neuromod adj rehab mouthpie,,,3095.12,6190.24,8
HCPCS,A4595,DME POS,,,13.24,26.48,8
HCPCS,A4596,DME POS,,,41.07,82.14,9
HCPCS,A4600,"SLEEVE, INTER LIMB COMP DEV",,,,,0
HCPCS,A4601,LITH ION NON PROSTH RECHARGE,,,,,0
HCPCS,A4602,DME POS,,,5.31,10.62,8
HCPCS,A4604,DME POS,,,49.36,98.72,8
HCPCS,A4605,DME POS,,,23.38,46.76,8
HCPCS,A4606,OXYGEN PROBE USED W OXIMETER,,,,,0
HCPCS,A4608,DME POS,,,71.44,142.88,8
HCPCS,A4611,HEAVY DUTY BATTERY,,,,,0
HCPCS,A4612,BATTERY CABLES,,,,,0
HCPCS,A4613,BATTERY CHARGER,,,,,0
HCPCS,A4614,DME POS,,,33.89,67.78,8
HCPCS,A4615,DME POS,,,1.04,2.08,8
HCPCS,A4616,DME POS,,,0.08,0.16,8
HCPCS,A4617,DME POS,,,4.42,8.84,8
HCPCS,A4618,DME POS,,,10.78,21.56,8
HCPCS,A4619,DME POS,,,2.57,5.14,8
HCPCS,A4620,DME POS,,,0.91,1.82,8
HCPCS,A4623,DME POS,,,7.94,15.88,8
HCPCS,A4624,DME POS,,,3.2,6.4,8
HCPCS,A4625,DME POS,,,8.39,16.78,8
HCPCS,A4626,DME POS,,,3.86,7.72,8
HCPCS,A4627,SPACER BAG/RESERVOIR,,,,,0
HCPCS,A4628,DME POS,,,5.33,10.66,8
HCPCS,A4629,DME POS,,,6.63,13.26,8
HCPCS,A4630,DME POS,,,8.88,17.76,8
HCPCS,A4633,DME POS,,,58.49,116.98,8
HCPCS,A4634,REPLACEMENT BULB TH LIGHTBOX,,,,,0
HCPCS,A4635,DME POS,,,6.19,12.38,8
HCPCS,A4636,DME POS,,,3.97,7.94,8
HCPCS,A4637,DME POS,,,2.2,4.4,8
HCPCS,A4638,DME POS,,,,,0
HCPCS,A4639,DME POS,,,40.94,81.88,8
HCPCS,A4640,DME POS,,,63.32,126.64,8
HCPCS,A4641,I-123 CAPSULE,105.5,52.75,12.01,137.74,92
HCPCS,A4641,I-131 THERAPY SOLUTION 150MCI,10716.0,5358.0,1866.72,10394.52,46
HCPCS,A4641,I-131 THERAPY SOLUTION 200MCI,14052.0,7026.0,2447.85,13630.44,46
HCPCS,A4641,I-131 THERAPY SOLUTION 250MCI,17052.0,8526.0,2970.45,16540.44,46
HCPCS,A4642,IN-111 SATUMOMB/DOS <= 6 MCI,4825.0,2412.5,814.55,4824.78,94
HCPCS,A4642,INDIUM IN-111 SATUM PEND DX PER STUDY DOSE UP TO 6 MILLI,2058.0,1029.0,32.74,3810.16,94
HCPCS,A4648,SEEDS ACCULOC PER PACKAGE,2078.0,1039.0,361.98,2015.66,47
HCPCS,A4649,SURGICAL SUPPLIES,,,,,0
HCPCS,A4650,IMPLANT RADIATION DOSIMETER,,,,,0
HCPCS,A4651,CALIBRATED MICROCAP TUBE,,,,,0
HCPCS,A4652,MICROCAPILLARY TUBE SEALANT,,,,,0
HCPCS,A4653,PD CATHETER ANCHOR BELT,,,,,0
HCPCS,A4657,SYRINGE W/WO NEEDLE,,,,,0
HCPCS,A4660,SPHYG/BP APP W CUFF AND STET,,,,,0
HCPCS,A4663,DIALYSIS BLOOD PRESSURE CUFF,,,,,0
HCPCS,A4670,"AUTOMATIC BP MONITOR, DIAL",,,,,0
HCPCS,A4671,DISPOSABLE CYCLER SET,,,,,0
HCPCS,A4672,"DRAINAGE EXT LINE, DIALYSIS",,,,,0
HCPCS,A4673,EXT LINE W EASY LOCK CONNECT,,,,,0
HCPCS,A4674,"CHEM/ANTISEPT SOLUTION, 8OZ",,,,,0
HCPCS,A4680,"ACTIVATED CARBON FILTER, EA",,,,,0
HCPCS,A4690,"DIALYZER, EACH",,,,,0
HCPCS,A4706,BICARBONATE CONC SOL PER GAL,,,,,0
HCPCS,A4707,BICARBONATE CONC POW PER PAC,,,,,0
HCPCS,A4708,ACETATE CONC SOL PER GALLON,,,,,0
HCPCS,A4709,ACID CONC SOL PER GALLON,,,,,0
HCPCS,A4714,TREATED WATER PER GALLON,,,,,0
HCPCS,A4719,"""""Y SET"""" TUBING",,,,,0
HCPCS,A4720,DIALYSAT SOL FLD VOL > 249CC,,,,,0
HCPCS,A4721,DIALYSAT SOL FLD VOL > 999CC,,,,,0
HCPCS,A4722,DIALYS SOL FLD VOL > 1999CC,,,,,0
HCPCS,A4723,DIALYS SOL FLD VOL > 2999CC,,,,,0
HCPCS,A4724,DIALYS SOL FLD VOL > 3999CC,,,,,0
HCPCS,A4725,DIALYS SOL FLD VOL > 4999CC,,,,,0
HCPCS,A4726,DIALYS SOL FLD VOL > 5999CC,,,,,0
HCPCS,A4728,"DIALYSATE SOLUTION, NON-DEX",,,,,0
HCPCS,A4730,"FISTULA CANNULATION SET, EA",,,,,0
HCPCS,A4736,"TOPICAL ANESTHETIC, PER GRAM",,,,,0
HCPCS,A4737,INJ ANESTHETIC PER 10 ML,,,,,0
HCPCS,A4740,SHUNT ACCESSORY,,,,,0
HCPCS,A4750,ART OR VENOUS BLOOD TUBING,,,,,0
HCPCS,A4755,COMB ART/VENOUS BLOOD TUBING,,,,,0
HCPCS,A4760,"DIALYSATE SOL TEST KIT, EACH",,,,,0
HCPCS,A4765,DIALYSATE CONC POW PER PACK,,,,,0
HCPCS,A4766,DIALYSATE CONC SOL ADD 10 ML,,,,,0
HCPCS,A4770,BLOOD COLLECTION TUBE/VACUUM,,,,,0
HCPCS,A4771,SERUM CLOTTING TIME TUBE,,,,,0
HCPCS,A4772,BLOOD GLUCOSE TEST STRIPS,,,,,0
HCPCS,A4773,OCCULT BLOOD TEST STRIPS,,,,,0
HCPCS,A4774,AMMONIA TEST STRIPS,,,,,0
HCPCS,A4802,PROTAMINE SULFATE PER 50 MG,,,25.44,25.44,1
HCPCS,A4860,DISPOSABLE CATHETER TIPS,,,,,0
HCPCS,A4870,PLUMB/ELEC WK HM HEMO EQUIP,,,,,0
HCPCS,A4890,REPAIR/MAINT CONT HEMO EQUIP,,,,,0
HCPCS,A4911,DRAIN BAG/BOTTLE,,,,,0
HCPCS,A4913,MISC DIALYSIS SUPPLIES NOC,,,,,0
HCPCS,A4918,VENOUS PRESSURE CLAMP,,,,,0
HCPCS,A4927,NON-STERILE GLOVES,,,,,0
HCPCS,A4928,SURGICAL MASK,,,,,0
HCPCS,A4929,"TOURNIQUET FOR DIALYSIS, EA",,,,,0
HCPCS,A4930,"STERILE, GLOVES PER PAIR",,,,,0
HCPCS,A4931,REUSABLE ORAL THERMOMETER,,,,,0
HCPCS,A4932,REUSABLE RECTAL THERMOMETER,,,,,0
HCPCS,A5051,DME POS,,,2.94,5.88,8
HCPCS,A5052,DME POS,,,2.12,4.24,8
HCPCS,A5053,DME POS,,,2.09,4.18,8
HCPCS,A5054,DME POS,,,2.56,5.12,8
HCPCS,A5055,DME POS,,,1.76,3.52,8
HCPCS,A5056,DME POS,,,6.66,13.32,8
HCPCS,A5057,DME POS,,,13.68,27.36,8
HCPCS,A5061,DME POS,,,5.04,10.08,8
HCPCS,A5062,DME POS,,,3.18,6.36,8
HCPCS,A5063,DME POS,,,3.86,7.72,8
HCPCS,A5071,DME POS,,,8.57,17.14,8
HCPCS,A5072,DME POS,,,4.87,9.74,8
HCPCS,A5073,DME POS,,,4.53,9.06,8
HCPCS,A5081,DME POS,,,4.15,8.3,8
HCPCS,A5082,DME POS,,,16.02,32.04,8
HCPCS,A5083,DME POS,,,0.92,1.84,8
HCPCS,A5093,DME POS,,,2.36,4.72,8
HCPCS,A5102,DME POS,,,32.16,64.32,8
HCPCS,A5105,DME POS,,,58.11,116.22,8
HCPCS,A5112,DME POS,,,49.35,98.7,8
HCPCS,A5113,DME POS,,,5.7,11.4,8
HCPCS,A5114,DME POS,,,10.84,21.68,8
HCPCS,A5120,DME POS,,,0.33,0.66,8
HCPCS,A5121,DME POS,,,10.62,21.24,8
HCPCS,A5122,DME POS,,,17.89,35.78,8
HCPCS,A5126,DME POS,,,1.59,3.18,8
HCPCS,A5131,DME POS,,,20.6,41.2,8
HCPCS,A5200,DME POS,,,16.12,32.24,8
HCPCS,A5500,DME POS,,,90.63,181.26,8
HCPCS,A5501,DME POS,,,271.8,543.6,8
HCPCS,A5503,DME POS,,,45.79,91.58,8
HCPCS,A5504,DME POS,,,45.79,91.58,8
HCPCS,A5505,DME POS,,,45.79,91.58,8
HCPCS,A5506,DME POS,,,45.79,91.58,8
HCPCS,A5507,DME POS,,,45.79,91.58,8
HCPCS,A5508,DIABETIC DELUXE SHOE,,,,,0
HCPCS,A5510,COMPRESSION FORM SHOE INSERT,,,,,0
HCPCS,A5512,DME POS,,,36.96,73.92,8
HCPCS,A5513,DME POS,,,55.16,110.32,8
HCPCS,A5514,DME POS,,,55.16,110.32,8
HCPCS,A6000,WOUND WARMING WOUND COVER,,,,,0
HCPCS,A6010,DME POS,,,44.14,88.28,8
HCPCS,A6011,DME POS,,,3.25,6.5,8
HCPCS,A6021,DME POS,,,29.97,59.94,8
HCPCS,A6022,DME POS,,,29.97,59.94,8
HCPCS,A6023,DME POS,,,271.22,542.44,8
HCPCS,A6024,DME POS,,,8.81,17.62,8
HCPCS,A6025,"SILICONE GEL SHEET, EACH",,,,,0
HCPCS,A6154,DME POS,,,20.47,40.94,8
HCPCS,A6196,DME POS,,,10.49,20.98,8
HCPCS,A6197,DME POS,,,23.44,46.88,8
HCPCS,A6198,ALGINATE DRESSING > 48 SQ IN,,,,,0
HCPCS,A6199,DME POS,,,7.52,15.04,8
HCPCS,A6203,DME POS,,,4.8,9.6,8
HCPCS,A6204,DME POS,,,8.86,17.72,8
HCPCS,A6205,COMPOSITE DRSG > 48 SQ IN,,,,,0
HCPCS,A6206,CONTACT LAYER <= 16 SQ IN,,,,,0
HCPCS,A6207,DME POS,,,10.47,20.94,8
HCPCS,A6208,CONTACT LAYER > 48 SQ IN,,,,,0
HCPCS,A6209,DME POS,,,10.65,21.3,8
HCPCS,A6210,DME POS,,,28.4,56.8,8
HCPCS,A6211,DME POS,,,41.86,83.72,8
HCPCS,A6212,DME POS,,,13.84,27.68,8
HCPCS,A6213,FOAM DRG >16<=48 SQ IN W/BDR,,,,,0
HCPCS,A6214,DME POS,,,14.68,29.36,8
HCPCS,A6215,FOAM DRESSING WOUND FILLER,,,,,0
HCPCS,A6216,DME POS,,,0.05,0.1,8
HCPCS,A6217,DME POS,,,,,0
HCPCS,A6218,NON-STERILE GAUZE > 48 SQ IN,,,,,0
HCPCS,A6219,DME POS,,,1.36,2.72,8
HCPCS,A6220,DME POS,,,3.69,7.38,8
HCPCS,A6221,GAUZE > 48 SQ IN W/BORDER,,,,,0
HCPCS,A6222,DME POS,,,3.04,6.08,8
HCPCS,A6223,DME POS,,,3.46,6.92,8
HCPCS,A6224,DME POS,,,5.13,10.26,8
HCPCS,A6228,GAUZE <= 16 SQ IN WATER/SAL,,,,,0
HCPCS,A6229,DME POS,,,5.13,10.26,8
HCPCS,A6230,GAUZE > 48 SQ IN WATER/SALNE,,,,,0
HCPCS,A6231,DME POS,,,6.68,13.36,8
HCPCS,A6232,DME POS,,,9.78,19.56,8
HCPCS,A6233,DME POS,,,27.33,54.66,8
HCPCS,A6234,DME POS,,,9.33,18.66,8
HCPCS,A6235,DME POS,,,23.97,47.94,8
HCPCS,A6236,DME POS,,,38.83,77.66,8
HCPCS,A6237,DME POS,,,11.27,22.54,8
HCPCS,A6238,DME POS,,,32.5,65.0,8
HCPCS,A6239,HYDROCOLLD DRG > 48 IN W/BDR,,,,,0
HCPCS,A6240,DME POS,,,17.45,34.9,8
HCPCS,A6241,DME POS,,,3.66,7.32,8
HCPCS,A6242,DME POS,,,8.63,17.26,8
HCPCS,A6243,DME POS,,,17.56,35.12,8
HCPCS,A6244,DME POS,,,55.99,111.98,8
HCPCS,A6245,DME POS,,,10.36,20.72,8
HCPCS,A6246,DME POS,,,14.16,28.32,8
HCPCS,A6247,DME POS,,,33.89,67.78,8
HCPCS,A6248,DME POS,,,23.15,46.3,8
HCPCS,A6250,SKIN SEAL PROTECT MOISTURIZR,,,,,0
HCPCS,A6251,DME POS,,,2.84,5.68,8
HCPCS,A6252,DME POS,,,4.64,9.28,8
HCPCS,A6253,DME POS,,,9.03,18.06,8
HCPCS,A6254,DME POS,,,1.7,3.4,8
HCPCS,A6255,DME POS,,,4.34,8.68,8
HCPCS,A6256,ABSORPT DRG > 48 SQ IN W/BDR,,,,,0
HCPCS,A6257,DME POS,,,2.18,4.36,8
HCPCS,A6258,DME POS,,,6.14,12.28,8
HCPCS,A6259,DME POS,,,15.59,31.18,8
HCPCS,A6260,WOUND CLEANSER ANY TYPE/SIZE,,,,,0
HCPCS,A6261,WOUND FILLER GEL/PASTE /OZ,,,,,0
HCPCS,A6262,WOUND FILLER DRY FORM / GRAM,,,,,0
HCPCS,A6266,DME POS,,,2.72,5.44,8
HCPCS,A6402,DME POS,,,0.15,0.3,8
HCPCS,A6403,DME POS,,,0.58,1.16,8
HCPCS,A6404,STERILE GAUZE > 48 SQ IN,,,,,0
HCPCS,A6407,DME POS,,,2.66,5.32,8
HCPCS,A6410,DME POS,,,0.53,1.06,8
HCPCS,A6411,DME POS,,,,,0
HCPCS,A6412,OCCLUSIVE EYE PATCH,,,,,0
HCPCS,A6413,"ADHESIVE BANDAGE, FIRST-AID",,,,,0
HCPCS,A6441,DME POS,,,0.97,1.94,8
HCPCS,A6442,DME POS,,,0.23,0.46,8
HCPCS,A6443,DME POS,,,0.4,0.8,8
HCPCS,A6444,DME POS,,,0.8,1.6,8
HCPCS,A6445,DME POS,,,0.45,0.9,8
HCPCS,A6446,DME POS,,,0.55,1.1,8
HCPCS,A6447,DME POS,,,0.97,1.94,8
HCPCS,A6448,DME POS,,,1.64,3.28,8
HCPCS,A6449,DME POS,,,2.5,5.0,8
HCPCS,A6450,DME POS,,,2.5,5.0,8
HCPCS,A6451,DME POS,,,2.5,5.0,8
HCPCS,A6452,DME POS,,,8.4,16.8,8
HCPCS,A6453,DME POS,,,0.9,1.8,8
HCPCS,A6454,DME POS,,,1.12,2.24,8
HCPCS,A6455,DME POS,,,1.99,3.98,8
HCPCS,A6456,DME POS,,,1.79,3.58,8
HCPCS,A6457,DME POS,,,1.62,3.24,8
HCPCS,A6460,SYNTHETIC DRSG <= 16 SQ IN,,,,,0
HCPCS,A6461,SYNTHETIC DRSG >16<=48 SQ IN,,,,,0
HCPCS,A6501,DME POS,,,,,0
HCPCS,A6502,DME POS,,,,,0
HCPCS,A6503,DME POS,,,,,0
HCPCS,A6504,DME POS,,,,,0
HCPCS,A6505,DME POS,,,,,0
HCPCS,A6506,DME POS,,,,,0
HCPCS,A6507,DME POS,,,,,0
HCPCS,A6508,DME POS,,,,,0
HCPCS,A6509,DME POS,,,,,0
HCPCS,A6510,DME POS,,,,,0
HCPCS,A6511,DME POS,,,,,0
HCPCS,A6512,"COMPRES BURN GARMENT, NOC",,,,,0
HCPCS,A6513,DME POS,,,,,0
HCPCS,A6515,"Gradient compression wrap with adjustable straps, full leg, each, custom",,,,,0
HCPCS,A6516,"Gradient compression wrap with adjustable straps, foot, each, custom",,,,,0
HCPCS,A6517,"Gradient compression wrap with adjustable straps, below knee, each, custom",,,,,0
HCPCS,A6518,"Gradient compression wrap with adjustable straps, arm, each, custom",,,,,0
HCPCS,A6519,"Gradient compression garment, not otherwise specified, for nighttime use, each",,,,,0
HCPCS,A6520,DME POS,,,126.45,252.9,8
HCPCS,A6521,DME POS,,,501.75,1003.5,8
HCPCS,A6522,DME POS,,,307.26,614.52,8
HCPCS,A6523,DME POS,,,729.02,1458.04,8
HCPCS,A6524,DME POS,,,383.34,766.68,8
HCPCS,A6525,DME POS,,,773.9,1547.8,8
HCPCS,A6526,DME POS,,,693.06,1386.12,8
HCPCS,A6527,DME POS,,,1274.45,2548.9,8
HCPCS,A6528,DME POS,,,666.42,1332.84,8
HCPCS,A6529,DME POS,,,1053.04,2106.08,8
HCPCS,A6530,DME POS,,,39.07,78.14,8
HCPCS,A6531,DME POS,,,61.66,123.32,8
HCPCS,A6532,DME POS,,,86.88,173.76,8
HCPCS,A6533,DME POS,,,54.86,109.72,8
HCPCS,A6534,DME POS,,,62.65,125.3,8
HCPCS,A6535,DME POS,,,72.13,144.26,8
HCPCS,A6536,DME POS,,,73.95,147.9,8
HCPCS,A6537,DME POS,,,87.67,175.34,8
HCPCS,A6538,DME POS,,,102.65,205.3,8
HCPCS,A6539,DME POS,,,97.86,195.72,8
HCPCS,A6540,DME POS,,,116.68,233.36,8
HCPCS,A6541,DME POS,,,138.21,276.42,8
HCPCS,A6544,GC STOCKING GARTER BELT,,,,,0
HCPCS,A6545,DME POS,,,121.41,242.82,8
HCPCS,A6549,G COMPRESSION GARMENT,,,,,0
HCPCS,A6550,DME POS,,,31.35,62.7,8
HCPCS,A6552,DME POS,,,57.97,115.94,8
HCPCS,A6553,DME POS,,,226.38,452.76,8
HCPCS,A6554,DME POS,,,79.72,159.44,8
HCPCS,A6555,DME POS,,,226.38,452.76,8
HCPCS,A6556,DME POS,,,310.25,620.5,8
HCPCS,A6557,DME POS,,,310.25,620.5,8
HCPCS,A6558,DME POS,,,320.17,640.34,8
HCPCS,A6559,G STCKNG FULL/CHAP18-30 CUST,,,,,0
HCPCS,A6560,G STCKNG FULL/CHAP30-40 CUST,,,,,0
HCPCS,A6561,G STOCKNG FULL/CHAP 40+ CUST,,,,,0
HCPCS,A6562,DME POS,,,1015.37,2030.74,8
HCPCS,A6563,DME POS,,,1015.37,2030.74,8
HCPCS,A6564,DME POS,,,1093.78,2187.56,8
HCPCS,A6565,DME POS,,,175.45,350.9,8
HCPCS,A6566,DME POS,,,254.75,509.5,8
HCPCS,A6567,DME POS,,,800.42,1600.84,8
HCPCS,A6568,DME POS,,,166.26,332.52,8
HCPCS,A6569,DME POS,,,946.74,1893.48,8
HCPCS,A6570,DME POS,,,113.28,226.56,8
HCPCS,A6571,DME POS,,,680.84,1361.68,8
HCPCS,A6572,DME POS,,,105.11,210.22,8
HCPCS,A6573,DME POS,,,249.43,498.86,8
HCPCS,A6574,DME POS,,,317.99,635.98,8
HCPCS,A6575,DME POS,,,103.05,206.1,8
HCPCS,A6576,DME POS,,,195.16,390.32,8
HCPCS,A6577,DME POS,,,161.53,323.06,8
HCPCS,A6578,DME POS,,,79.55,159.1,8
HCPCS,A6579,DME POS,,,313.26,626.52,8
HCPCS,A6580,DME POS,,,310.96,621.92,8
HCPCS,A6581,DME POS,,,72.99,145.98,8
HCPCS,A6582,DME POS,,,48.68,97.36,8
HCPCS,A6583,DME POS,,,160.13,320.26,8
HCPCS,A6584,GRAD COM WRAP W STRAPS,,,,,0
HCPCS,A6585,DME POS,,,189.6,379.2,8
HCPCS,A6586,DME POS,,,558.59,1117.18,8
HCPCS,A6587,DME POS,,,73.17,146.34,8
HCPCS,A6588,DME POS,,,243.87,487.74,8
HCPCS,A6589,DME POS,,,96.27,192.54,8
HCPCS,A6590,DME POS,,,438.6,877.2,8
HCPCS,A6591,DME POS,,,90.64,181.28,8
HCPCS,A6593,GRAD COM ACCESSORY GMT_WRAP,,,,,0
HCPCS,A6594,DME POS,,,35.05,70.1,8
HCPCS,A6595,DME POS,,,34.48,68.96,8
HCPCS,A6596,DME POS,,,0.18,0.36,8
HCPCS,A6597,DME POS,,,1.55,3.1,8
HCPCS,A6598,DME POS,,,0.75,1.5,8
HCPCS,A6599,DME POS,,,1.7,3.4,8
HCPCS,A6600,DME POS,,,3.07,6.14,8
HCPCS,A6601,DME POS,,,3.45,6.9,8
HCPCS,A6602,DME POS,,,5.03,10.06,8
HCPCS,A6603,DME POS,,,2.36,4.72,8
HCPCS,A6604,DME POS,,,1.38,2.76,8
HCPCS,A6605,DME POS,,,1.57,3.14,8
HCPCS,A6606,DME POS,,,4.67,9.34,8
HCPCS,A6607,DME POS,,,1.25,2.5,8
HCPCS,A6608,DME POS,,,5.21,10.42,8
HCPCS,A6609,G COMPRESSION BANDAGING,,,,,0
HCPCS,A6610,DME POS,,,226.38,452.76,8
HCPCS,A6611,"Gradient compression wrap with adjustable straps, above knee, each, custom",,,,,0
HCPCS,A7000,DME POS,,,10.5,21.0,8
HCPCS,A7001,DME POS,,,40.87,81.74,8
HCPCS,A7002,DME POS,,,4.65,9.3,8
HCPCS,A7003,DME POS,,,1.89,3.78,8
HCPCS,A7004,DME POS,,,1.59,3.18,8
HCPCS,A7005,DME POS,,,15.02,30.04,8
HCPCS,A7006,DME POS,,,9.57,19.14,8
HCPCS,A7007,DME POS,,,4.17,8.34,8
HCPCS,A7008,DME POS,,,13.32,26.64,8
HCPCS,A7009,DME POS,,,57.32,114.64,8
HCPCS,A7010,DME POS,,,20.18,40.36,8
HCPCS,A7012,DME POS,,,3.7,7.4,8
HCPCS,A7013,DME POS,,,0.73,1.46,8
HCPCS,A7014,DME POS,,,4.09,8.18,8
HCPCS,A7015,DME POS,,,1.64,3.28,8
HCPCS,A7016,DME POS,,,9.55,19.1,8
HCPCS,A7017,DME POS,,,156.31,312.62,8
HCPCS,A7018,DME POS,,,0.41,0.82,8
HCPCS,A7020,DME POS,,,20.47,40.94,8
HCPCS,A7021,"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)",,,136.37,272.74,8
HCPCS,A7023,MECH ALLERGEN PARTI BARRIER,,,,,0
HCPCS,A7025,DME POS,,,61.99,123.98,8
HCPCS,A7026,DME POS,,,40.96,81.92,8
HCPCS,A7027,DME POS,,,153.68,307.36,8
HCPCS,A7028,DME POS,,,42.97,85.94,8
HCPCS,A7029,DME POS,,,19.2,38.4,8
HCPCS,A7030,DME POS,,,110.55,221.1,8
HCPCS,A7031,DME POS,,,42.87,85.74,8
HCPCS,A7032,DME POS,,,24.05,48.1,8
HCPCS,A7033,DME POS,,,19.36,38.72,8
HCPCS,A7034,DME POS,,,69.75,139.5,8
HCPCS,A7035,DME POS,,,22.89,45.78,8
HCPCS,A7036,DME POS,,,13.32,26.64,8
HCPCS,A7037,DME POS,,,14.77,29.54,8
HCPCS,A7038,DME POS,,,2.58,5.16,8
HCPCS,A7039,DME POS,,,7.57,15.14,8
HCPCS,A7040,DME POS,,,57.96,115.92,8
HCPCS,A7041,DME POS,,,108.93,217.86,8
HCPCS,A7044,DME POS,,,106.22,212.44,8
HCPCS,A7045,DME POS,,,14.62,29.24,8
HCPCS,A7046,DME POS,,,17.01,34.02,8
HCPCS,A7047,DME POS,,,172.31,344.62,8
HCPCS,A7048,DME POS,,,60.63,121.26,8
HCPCS,A7049,EPAP NASAL VALVE,,,,,0
HCPCS,A7501,DME POS,,,149.66,299.32,8
HCPCS,A7502,DME POS,,,71.15,142.3,8
HCPCS,A7503,DME POS,,,16.17,32.34,8
HCPCS,A7504,DME POS,,,0.97,1.94,8
HCPCS,A7505,DME POS,,,6.68,13.36,8
HCPCS,A7506,DME POS,,,0.46,0.92,8
HCPCS,A7507,DME POS,,,3.56,7.12,8
HCPCS,A7508,DME POS,,,4.09,8.18,8
HCPCS,A7509,DME POS,,,2.01,4.02,8
HCPCS,A7520,DME POS,,,67.66,135.32,8
HCPCS,A7521,DME POS,,,67.04,134.08,8
HCPCS,A7522,DME POS,,,64.36,128.72,8
HCPCS,A7523,TRACHEOSTOMY SHOWER PROTECT,,,,,0
HCPCS,A7524,DME POS,,,110.33,220.66,8
HCPCS,A7525,DME POS,,,2.94,5.88,8
HCPCS,A7526,DME POS,,,4.83,9.66,8
HCPCS,A7527,DME POS,,,5.1,10.2,8
HCPCS,A8000,DME POS,,,218.57,437.14,8
HCPCS,A8001,DME POS,,,218.57,437.14,8
HCPCS,A8002,DME POS,,,,,0
HCPCS,A8003,DME POS,,,,,0
HCPCS,A8004,DME POS,,,,,0
HCPCS,A9150,MISC/EXPER NON-PRESCRIPT DRU,,,,,0
HCPCS,A9152,SINGLE VITAMIN NOS,,,,,0
HCPCS,A9153,MULTI-VITAMIN NOS,,,,,0
HCPCS,A9154,"Artificial saliva, 1 ml",,,0.69,0.69,1
HCPCS,A9156,ORAL MUCOADHESIVE PER 1 ML,,,4.63,4.63,1
HCPCS,A9180,"LICE TREATMENT, TOPICAL",,,1.7,1.7,1
HCPCS,A9268,PROGRAMMER ORALLY INGEST CAP,,,,,0
HCPCS,A9269,PROGRAMABLE INGEST CAPSULE,,,,,0
HCPCS,A9270,NON-COVERED ITEM OR SERVICE,,,,,0
HCPCS,A9272,"DISP WOUND SUCT, DRSG/ACCESS",,,,,0
HCPCS,A9273,HOT/COLD BOTLE/CAP/COL/WRAP,,,,,0
HCPCS,A9274,EXT AMB INSULIN DELIVERY SYS,,,,,0
HCPCS,A9275,DISP HOME GLUCOSE MONITOR,,,,,0
HCPCS,A9276,"DISPOSABLE SENSOR, CGM SYS",,,,,0
HCPCS,A9277,"EXTERNAL TRANSMITTER, CGM",,,,,0
HCPCS,A9278,"EXTERNAL RECEIVER, CGM SYS",,,,,0
HCPCS,A9279,MONITORING FEATURE/DEVICENOC,,,,,0
HCPCS,A9280,"ALERT DEVICE, NOC",,,,,0
HCPCS,A9281,REACHING/GRABBING DEVICE,,,,,0
HCPCS,A9282,WIG ANY TYPE,,,,,0
HCPCS,A9283,FOOT PRESS OFF LOAD SUPP DEV,,,,,0
HCPCS,A9284,NON-ELECTRONIC SPIROMETER,,,,,0
HCPCS,A9285,INVERSION EVERSION COR DEVIC,,,,,0
HCPCS,A9286,"ANY HYGIENIC ITEM, DEVICE",,,,,0
HCPCS,A9291,PRES DIG COG BEHAV THERA FDA,,,,,0
HCPCS,A9292,PRES DIG VISUAL THERAPY FDA,,,,,0
HCPCS,A9293,Fertility cycl tracking soft,,,,,0
HCPCS,A9300,EXERCISE EQUIPMENT,,,,,0
HCPCS,A9500,TC99M SESTAMIBI DOSE,293.0,146.5,45.64,549.71,94
HCPCS,A9501,TECHNETIUM TC-99M TEBOROXIME,,,,,0
HCPCS,A9502,TC99M TETROFSMN/DOS DX PER STUDY DOSE,385.5,192.75,66.19,379.27,94
HCPCS,A9503,TC99M MEDRONAT/DOSE <= 30MCI,95.0,47.5,14.8,101.85,94
HCPCS,A9504,TC99M APCITDE/DOSE <= 20MCI,1348.5,674.25,227.67,1348.3,94
HCPCS,A9505,TL-201 PER MCI,162.0,81.0,27.34,161.99,94
HCPCS,A9506,"Graphite crucible for preparation of technetium TC 99m-labeled carbon aerosol, one crucible",,,312.55,625.1,9
HCPCS,A9507,IN-111 CHLORIDE PER MCI,2558.0,1279.0,445.6,8398.4,54
HCPCS,A9507,PROSTACINT/DOSE <= 10MCI,7531.0,3765.5,1311.9,8398.4,54
HCPCS,A9508,I-131 MIBG PER .5 MCI,11146.0,5573.0,906.47,10831.02,162
HCPCS,A9509,IODINE I-123 SOD IODIDE MIL,,,205.61,268.85,2
HCPCS,A9510,TC99M DISOFENIN PER VIAL,240.0,120.0,39.36,237.65,141
HCPCS,A9512,TC99M PERTECHNATE PER 10 MCI,42.0,21.0,3.24,40.74,47
HCPCS,A9512,TC99M PERTECHNATE PER 30 MCI,124.5,62.25,3.24,122.22,94
HCPCS,A9512,TC99M PERTECHNATE PER MCI,3.0,1.5,0.52,13.02,94
HCPCS,A9513,LUTETIUM LU 177 DOTATATE THERAPEUTIC 1 MCI,1981.0,990.5,301.51,1921.57,54
HCPCS,A9515,CHOLINE C-11,,,2393.53,9552.3,10
HCPCS,A9516,I-123 CAP/100 MCI <= 999 MCI,340.0,170.0,58.18,345.32,141
HCPCS,A9516,I-123 CAP/100 UCI <= 100 UCI,527.0,263.5,90.06,520.89,94
HCPCS,A9516,I-123 CAP/100 UCI <= 30 0UCI,561.0,280.5,97.72,544.17,47
HCPCS,A9516,I-123 CAP/100MCI <= 200 MCI,876.0,438.0,142.85,874.94,141
HCPCS,A9517,I-131 SOD IODIDE CAPRX EA MCI,72.0,36.0,10.8,152.44,162
HCPCS,A9520,TC99 TILMANOCEPT DIAG 0.5MCI,4394.0,2197.0,634.08,4993.56,92
HCPCS,A9521,TC99M EXAMETAZINE <= 25 MCI,6754.0,3377.0,882.4,6754.11,108
HCPCS,A9524,I-131 SERUM ALBUMN PER5UCI(25,289.0,144.5,48.77,1565.58,141
HCPCS,A9526,NITROGEN N-13 AMMONIA,,,897.38,1258.99,2
HCPCS,A9527,I-125 SOD IODIDE SOL RX/MCI,23616.5,11808.25,254.47,25037.64,108
HCPCS,A9528,IODINE I-131 SODIUM IODIDE CAPSULE DIAG PER MILLICURIE,401.0,200.5,69.85,388.97,47
HCPCS,A9529,I-131 SOD IODIDE SOL DIAG/MCI,451.0,225.5,76.12,451.05,92
HCPCS,A9530,"I131 IODIDE SOL, RX",,,17.51,39.52,10
HCPCS,A9531,SODIUM IODIDE1-131DIAG EA UCI,186.0,93.0,5.14,180.42,47
HCPCS,A9532,"I125 SERUM ALBUMIN, DX",,,250.2,892.3,10
HCPCS,A9536,TC99M DEPREOTID/DOS <= 35MCI,3299.0,1649.5,574.68,3200.03,47
HCPCS,A9537,TC99M MEBROFNIN/DOS <= 15MCI,199.5,99.75,31.7,210.49,94
HCPCS,A9538,TC99M PYPROPHOS/DOS <= 25MCI,104.0,52.0,17.59,122.36,94
HCPCS,A9539,TC99M DTPA/DOSE <= 25MCI,789.0,394.5,33.94,765.33,47
HCPCS,A9540,TC99M ALBUM MAA/DOS <= 10MCI,1026.0,513.0,35.92,1084.46,94
HCPCS,A9541,LASIX 40MG INJ,52.0,26.0,9.05,916.71,47
HCPCS,A9541,TC99M COLLOID DX/DOS FILTERED,1013.0,506.5,160.61,1070.88,94
HCPCS,A9541,TC99M COLLOID DX/DOS TO 20MCI,257.0,128.5,44.76,916.71,47
HCPCS,A9541,TC99M COLLOID DX/DOS UNFILTRD,68.0,34.0,11.84,916.71,47
HCPCS,A9542,"IN111 IBRITUMOMAB, DX",,,973.58,6338.46,2
HCPCS,A9543,"Y90 IBRITUMOMAB, RX",,,54049.24,127627.61,10
HCPCS,A9546,ATROPINE 1MG INJ,43.0,21.5,1.57,41.71,47
HCPCS,A9546,COBALT 57/58 /DOS <= 1 MCI,1167.5,583.75,1.57,1166.91,94
HCPCS,A9547,IN-111 WBC OXINE PER .5 MCI,9588.5,4794.25,790.85,9588.45,108
HCPCS,A9548,IN-111 DTPA PER .5 MCI,9968.0,4984.0,709.2,10000.7,108
HCPCS,A9550,TC99M GLUCEPTAT/DOS <= 25MCI,102.0,51.0,17.24,101.85,92
HCPCS,A9551,TC99M DMSA/DOSE <= 10 MCI,1600.0,800.0,270.18,1599.53,108
HCPCS,A9552,FDG PER DOSE UPTO 45 MCI,1016.5,508.25,173.15,1007.83,94
HCPCS,A9553,CR51 CHROMATE,,,514.19,3648.58,10
HCPCS,A9554,"I125 IOTHALAMATE, DX",,,47.36,1235.82,10
HCPCS,A9555,RB82 RUBIDIUM,,,632.19,720.02,2
HCPCS,A9556,GA 67 CITRATE PER MCI,448.0,224.0,26.84,462.69,141
HCPCS,A9557,NEUROLITE PER DOSE <= 25MCI,6754.0,3377.0,737.64,7004.36,108
HCPCS,A9558,XE 133 PER 10 MCI,127.0,63.5,21.42,487.35,94
HCPCS,A9559,COBALT 57 CAP/DOS <= 1 MCI,1071.0,535.5,180.81,1070.88,94
HCPCS,A9560,TC99M RBC/DOSE <= 30MCI,823.5,411.75,128.65,873.97,94
HCPCS,A9561,TC99M OXIDRONAT/DOS <= 30MCI,153.0,76.5,26.65,148.41,47
HCPCS,A9562,TC99M MERTIATDE/DOS <= 15MCI,1510.5,755.25,238.47,1602.44,94
HCPCS,A9563,P32 NA PHOSPHATE,,,218.53,582.45,10
HCPCS,A9564,P-32 CHROM PHOSPHATE PER MCI,2726.0,1363.0,184.68,2725.7,94
HCPCS,A9566,TC99M FANOLESOMAB,,,,,0
HCPCS,A9567,TC99M AEROSOL <= 75MCI,1922.0,961.0,24.86,1864.34,47
HCPCS,A9568,TECHNETIUM TC99M ARCITUMOMAB,,,987.6,1851.01,2
HCPCS,A9569,TECHNETIUM TC-99M AUTO WBC,,,888.51,3274.47,10
HCPCS,A9570,INDIUM IN-111 AUTO WBC,3522.0,1761.0,613.53,8042.96,54
HCPCS,A9571,INDIUM IN-111 AUTO PLATELET,,,5668.03,8042.96,2
HCPCS,A9572,IN-111 PENTETREO/DOS <= 6MCI,11796.0,5898.0,1903.21,11796.17,108
HCPCS,A9573,"INJ, GADOPICLENOL, 1 ML",,,4.16,6.39,2
HCPCS,A9575,INJ GADOTERATE MEGLUMI 0.1ML,,,0.15,0.22,2
HCPCS,A9576,INJ PROHANCE MULTIPACK,,,1.73,2.66,2
HCPCS,A9577,INJ MULTIHANCE,,,2.12,3.26,2
HCPCS,A9578,INJ MULTIHANCE MULTIPACK,,,2.09,3.2,2
HCPCS,A9579,"GAD-BASE MR CONTRAST NOS,1ML",,,1.79,2.75,2
HCPCS,A9580,SOD FLUORIDE F18 DX UP TO30MCI,544.0,272.0,94.76,527.68,47
HCPCS,A9581,GADOXETATE DISODIUM INJ,,,17.93,27.53,2
HCPCS,A9582,I123-MIBG PER DOSE,8538.5,4269.25,1395.86,9759.42,108
HCPCS,A9583,GADOFOSVESET TRISODIUM INJ,,,,,0
HCPCS,A9584,I-123 IOFLUPANE PER DOSE 5MCI,13519.0,6759.5,1319.96,13518.89,108
HCPCS,A9585,GADOBUTROL INJECTION,,,0.32,0.49,2
HCPCS,A9586,FLORBETAPIR F18 PER DOSE 10MCI,15592.0,7796.0,1736.48,15591.78,108
HCPCS,A9587,"GALLIUM GA-68, DOTATATE DIAGNOSTIC 0.1 MILLICURIE",221.0,110.5,37.27,221.16,108
HCPCS,A9588,"FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURIE",1653.0,826.5,279.06,1652.88,108
HCPCS,A9589,INSTI HEXAMINOLEVULINATE HCL,,,1737.68,2667.77,2
HCPCS,A9590,IODINE I-131 IOBENGUANE 1MCI,,,612.1,612.1,1
HCPCS,A9591,"FLUOROESTRADIOL F18, DIAG, PER MILLICURE",4987.5,2493.75,437.93,4987.74,108
HCPCS,A9592,COPPER CU-64 DOTATATE DIAG PER MILLICURE,6462.5,3231.25,565.26,6462.14,108
HCPCS,A9593,GALLIUM GA-68 PSMA-11 UCSF,,,523.26,1486.08,10
HCPCS,A9594,"GALLIUM GA-68 PSMA-11, UCLA",,,345.75,1455.02,10
HCPCS,A9595,"PIFLU F-18, DIA PER MILLICURIE",3298.0,1649.0,329.57,3298.0,108
HCPCS,A9596,GALLIUM ILLUCCIX 1 MILLICURE,5436.0,2718.0,455.15,5435.88,108
HCPCS,A9597,"PET, DX, FOR TUMOR ID, NOC",2915.0,1457.5,492.11,2914.85,90
HCPCS,A9598,"PET DX FOR NON-TUMOR ID, NOC",,,,,0
HCPCS,A9600,SR89 STRONTIUM,,,3943.83,7887.66,10
HCPCS,A9601,FLORTAUCIPIR INJ 1 MILLICURI,,,668.66,7057.6,10
HCPCS,A9602,FLUORODOPA F-18 DIAG PER MCI,,,608.32,1627.52,10
HCPCS,A9603,"INJ, PAFOLACIANINE, 0.1 MG",,,253.74,253.74,1
HCPCS,A9604,SM 153 LEXIDRONAM,,,3005.48,31107.8,10
HCPCS,A9606,RADIUM 223 PER UCI,1008.0,504.0,163.81,988.43,108
HCPCS,A9607,"LUTETIUM LU 177 VIPIVOTIDE, THERAPEUTIC, 1 MILLICURIE",1754.5,877.25,243.34,1754.73,108
HCPCS,A9608,FLOTUFOLASTAT F18 DIAG 1 MCI,4383.0,2191.5,638.44,4617.2,108
HCPCS,A9609,"F18 FDG, 15 MILLICURIES",,,,,0
HCPCS,A9610,"Xenon Xe-129 hyperpolarized gas, diagnostic, per study dose",,,,,0
HCPCS,A9611,"FLURPIRIDAZ F18, DIAG, 1 MCI",1576.0,788.0,100.56,1528.72,54
HCPCS,A9615,"Injection, pegulicianine, 1 mg",,,35.68,71.36,10
HCPCS,A9697,"INJ, MAGTRACE PER STUDY DOSE",,,1192.75,2385.5,9
HCPCS,A9698,NON-RAD CONTRAST MATERIALNOC,,,,,0
HCPCS,A9699,RADIOPHARM RX AGENT NOC,,,55169.68,55169.68,1
HCPCS,A9700,ECHOCARDIOGRAPHY CONTRAST,,,,,0
HCPCS,A9800,GALLIUM LOCAMETZ 1 MILLICURI,,,344.8,1169.43,10
HCPCS,A9900,SUPPLY/ACCESSORY/SERVICE,,,,,0
HCPCS,A9901,DELIVERY/SET UP/DISPENSING,,,,,0
HCPCS,A9999,"DME SUPPLY OR ACCESSORY, NOS",,,,,0
HCPCS,B4034,DME PEN,,,,,0
HCPCS,B4035,DME PEN,,,,,0
HCPCS,B4036,DME PEN,,,,,0
HCPCS,B4081,DME PEN,,,,,0
HCPCS,B4082,DME PEN,,,,,0
HCPCS,B4083,DME PEN,,,,,0
HCPCS,B4087,DME PEN,,,,,0
HCPCS,B4088,DME PEN,,,,,0
HCPCS,B4100,FOOD THICKENER ORAL,,,,,0
HCPCS,B4102,EF ADULT FLUIDS AND ELECTRO,,,,,0
HCPCS,B4103,EF PED FLUID AND ELECTROLYTE,,,,,0
HCPCS,B4104,ADDITIVE FOR ENTERAL FORMULA,,,,,0
HCPCS,B4105,ENZYME CARTRIDGE ENTERAL NUT,,,,,0
HCPCS,B4148,ENTERAL FEED ELASTOMER DAILY,,,,,0
HCPCS,B4149,DME PEN,,,,,0
HCPCS,B4150,DME PEN,,,,,0
HCPCS,B4152,DME PEN,,,,,0
HCPCS,B4153,DME PEN,,,,,0
HCPCS,B4154,DME PEN,,,,,0
HCPCS,B4155,DME PEN,,,,,0
HCPCS,B4157,EF SPECIAL METABOLIC INHERIT,,,,,0
HCPCS,B4158,EF PED COMPLETE INTACT NUT,,,,,0
HCPCS,B4159,EF PED COMPLETE SOY BASED,,,,,0
HCPCS,B4160,EF PED CALORIC DENSE>/=0.7KC,,,,,0
HCPCS,B4161,EF PED HYDROLYZED/AMINO ACID,,,,,0
HCPCS,B4162,EF PED SPECMETABOLIC INHERIT,,,,,0
HCPCS,B4164,DME PEN,,,,,0
HCPCS,B4168,DME PEN,,,,,0
HCPCS,B4172,PARENTERAL SOL AMINO ACID 5.,,,,,0
HCPCS,B4176,DME PEN,,,,,0
HCPCS,B4178,DME PEN,,,,,0
HCPCS,B4180,DME PEN,,,,,0
HCPCS,B4185,DME PEN,,,,,0
HCPCS,B4187,DME PEN,,,,,0
HCPCS,B4189,DME PEN,,,,,0
HCPCS,B4193,DME PEN,,,,,0
HCPCS,B4197,DME PEN,,,,,0
HCPCS,B4199,DME PEN,,,,,0
HCPCS,B4216,DME PEN,,,,,0
HCPCS,B4220,DME PEN,,,,,0
HCPCS,B4222,DME PEN,,,,,0
HCPCS,B4224,DME PEN,,,,,0
HCPCS,B5000,DME PEN,,,,,0
HCPCS,B5100,DME PEN,,,,,0
HCPCS,B5200,PARENTERAL SOL HEPATIC FREAM,,,,,0
HCPCS,B9002,DME PEN,,,,,0
HCPCS,B9004,DME PEN,,,,,0
HCPCS,B9006,DME PEN,,,,,0
HCPCS,B9998,ENTERAL SUPP NOT OTHERWISE C,,,,,0
HCPCS,B9999,PARENTERAL SUPP NOT OTHRWS C,,,,,0
HCPCS,C1052,"HEMOSTATIC AGENT, GI, TOPIC",,,,,0
HCPCS,C1062,INTRAVERTEBRAL FX AUG IMPL,,,,,0
HCPCS,C1600,"CATH, BLADED, VASC PREP",,,,,0
HCPCS,C1601,"ENDO, SINGLE, PULMONARY",,,,,0
HCPCS,C1602,ORTH/MATRX/BN FILL DRUG-ELUT,,,,,0
HCPCS,C1603,"RET DEV, LASER, IVC FILTER",,,,,0
HCPCS,C1604,"GRFT, TRNSMURL/TRNSVENS BYPS",,,,,0
HCPCS,C1605,"Pacemaker, leadless, dual chamber (right atrial and right ventricular implantable components), rate-responsive, including all necessary components for implantation",,,,,0
HCPCS,C1606,"Adapter, single-use (i.e. disposable), for attaching ultrasound system to upper gastrointestinal endoscope",,,,,0
HCPCS,C1713,"ANCHOR/SCREW BN/BN,TIS/BN",,,,,0
HCPCS,C1714,"CATH, TRANS ATHERECTOMY, DIR",,,,,0
HCPCS,C1715,BRACHYTHERAPY NEEDLE,453.0,226.5,78.91,439.41,47
HCPCS,C1716,"BRACHYTX, NON-STR, GOLD-198",,,488.49,976.98,8
HCPCS,C1717,HDR IR-192 SOURCE NS,2354.0,1177.0,340.03,2283.38,54
HCPCS,C1719,"BRACHYTX, NS, NON-HDRIR-192",,,864.32,1728.64,8
HCPCS,C1721,"AICD, DUAL CHAMBER",,,,,0
HCPCS,C1722,"AICD, SINGLE CHAMBER",,,,,0
HCPCS,C1724,"CATH, TRANS ATHEREC,ROTATION",,,,,0
HCPCS,C1725,"CATH, TRANSLUMIN NON-LASER",,,,,0
HCPCS,C1726,BALLOON CERVICAL RIPEN 184000,355.0,177.5,61.84,344.35,47
HCPCS,C1727,"CATH, BAL TIS DIS, NON-VAS",,,,,0
HCPCS,C1728,"CATH, BRACHYTX SEED ADM",,,,,0
HCPCS,C1729,"CATH, DRAINAGE",,,,,0
HCPCS,C1730,"CATH, EP, 19 OR FEW ELECT",,,,,0
HCPCS,C1731,"CATH, EP, 20 OR MORE ELEC",,,,,0
HCPCS,C1732,"CATH, EP, DIAG/ABL, 3D/VECT",,,,,0
HCPCS,C1733,"CATH, EP, OTHR THAN COOL-TIP",,,,,0
HCPCS,C1734,"ORTH/DEVIC/DRUG BN/BN,TIS/BN",,,,,0
HCPCS,C1735,"Catheter(s), intravascular for renal denervation, radiofrequency, including all single use system components",,,,,0
HCPCS,C1736,"Catheter(s), intravascular for renal denervation, ultrasound, including all single use system components",,,,,0
HCPCS,C1737,"Joint fusion and fixation device(s), sacroiliac and pelvis, including all system components (implantable)",,,,,0
HCPCS,C1738,"Powered, single-use (i.e. disposable) endoscopic ultrasound-guided biopsy device",,,,,0
HCPCS,C1739,"Tissue marker, probe detectable any method (implantable), with delivery system",,,,,0
HCPCS,C1747,"ENDO, SINGLE, URINARY TRACT",,,,,0
HCPCS,C1748,"ENDOSCOPE, SINGLE, UGI",,,,,0
HCPCS,C1749,"ENDO, COLON, RETRO IMAGING",,,,,0
HCPCS,C1750,"CATH, HEMODIALYSIS,LONG-TERM",,,,,0
HCPCS,C1751,"CATH, INF, PER/CENT/MIDLINE",,,,,0
HCPCS,C1752,"CATH,HEMODIALYSIS,SHORT-TERM",,,,,0
HCPCS,C1753,"CATH, INTRAVAS ULTRASOUND",,,,,0
HCPCS,C1754,"CATHETER, INTRADISCAL",,,,,0
HCPCS,C1755,"CATHETER, INTRASPINAL",,,,,0
HCPCS,C1756,"CATH, PACING, TRANSESOPH",,,,,0
HCPCS,C1757,"CATH, THROMBECTOMY/EMBOLECT",,,,,0
HCPCS,C1758,"CATHETER, URETERAL",,,,,0
HCPCS,C1759,"CATH, INTRA ECHOCARDIOGRAPHY",,,,,0
HCPCS,C1760,"CLOSURE DEV, VASC",,,,,0
HCPCS,C1761,"CATH, TRANS INTRA LITHO/CORO",,,,,0
HCPCS,C1762,"CONN TISS, HUMAN(INC FASCIA)",,,,,0
HCPCS,C1763,"CONN TISS, NON-HUMAN",,,,,0
HCPCS,C1764,"EVENT RECORDER, CARDIAC",,,,,0
HCPCS,C1765,ADHESIVE BARRIER -INTERCEED,2860.0,1430.0,498.21,2774.2,47
HCPCS,C1766,"INTRO/SHEATH,STRBLE,NON-PEEL",,,,,0
HCPCS,C1767,"GENERATOR, NEURO NON-RECHARG",,,,,0
HCPCS,C1768,"GRAFT, VASCULAR",,,,,0
HCPCS,C1769,GUIDE WIRE,,,,,0
HCPCS,C1770,"IMAGING COIL, MR, INSERTABLE",,,,,0
HCPCS,C1771,"REP DEV, URINARY, W/SLING",,,,,0
HCPCS,C1772,"INFUSION PUMP, PROGRAMMABLE",,,,,0
HCPCS,C1773,"RET DEV, INSERTABLE",,,,,0
HCPCS,C1776,JOINT DEVICE (IMPLANTABLE),,,,,0
HCPCS,C1777,"LEAD, AICD, ENDO SINGLE COIL",,,,,0
HCPCS,C1778,"LEAD, NEUROSTIMULATOR",,,,,0
HCPCS,C1779,"LEAD, PMKR, TRANSVENOUS VDD",,,,,0
HCPCS,C1780,"LENS, INTRAOCULAR (NEW TECH)",,,,,0
HCPCS,C1781,MESH (IMPLANTABLE),,,,,0
HCPCS,C1782,MORCELLATOR,,,,,0
HCPCS,C1783,"OCULAR IMP, AQUEOUS DRAIN DE",,,,,0
HCPCS,C1784,"OCULAR DEV, INTRAOP, DET RET",,,,,0
HCPCS,C1785,"PMKR, DUAL, RATE-RESP",,,,,0
HCPCS,C1786,"PMKR, SINGLE, RATE-RESP",,,,,0
HCPCS,C1787,"PATIENT PROGR, NEUROSTIM",,,,,0
HCPCS,C1788,"PORT, INDWELLING, IMP",,,,,0
HCPCS,C1789,"PROSTHESIS, BREAST, IMP",,,,,0
HCPCS,C1813,"PROSTHESIS, PENILE, INFLATAB",,,,,0
HCPCS,C1814,"RETINAL TAMP, SILICONE OIL",,,,,0
HCPCS,C1815,"PROS, URINARY SPH, IMP",,,,,0
HCPCS,C1816,"RECEIVER/TRANSMITTER, NEURO",,,,,0
HCPCS,C1817,SEPTAL DEFECT IMP SYS,,,,,0
HCPCS,C1818,INTEGRATED KERATOPROSTHESIS,,,,,0
HCPCS,C1819,TISSUE LOCALIZATION-EXCISION,,,,,0
HCPCS,C1820,GENERATOR NEURO RECHG BAT SY,,,,,0
HCPCS,C1821,INTERSPINOUS IMPLANT,,,,,0
HCPCS,C1822,"GEN, NEURO, HF, RECHG BAT",,,,,0
HCPCS,C1823,"GEN, NEURO, TRANS SEN/STIM",,,,,0
HCPCS,C1824,"GENERATOR, CCM, IMPLANT",,,,,0
HCPCS,C1825,"GEN, NEURO, CAROT SINUS BARO",,,,,0
HCPCS,C1826,"GEN, NEURO, CLO LOOP, RECHG",,,,,0
HCPCS,C1827,"GEN, NEURO, IMP LED, EX CNTR",,,,,0
HCPCS,C1830,POWER BONE MARROW BX NEEDLE,,,,,0
HCPCS,C1831,PERSONALIZED INTERBODY CAGE,,,,,0
HCPCS,C1832,AUTO CELL PROCESS SYS,,,,,0
HCPCS,C1833,CARDIAC MONITOR SYS,,,,,0
HCPCS,C1839,IRIS PROSTHESIS,,,,,0
HCPCS,C1840,TELESCOPIC INTRAOCULAR LENS,,,,,0
HCPCS,C1874,"STENT, COATED/COV W/DEL SYS",,,,,0
HCPCS,C1875,"STENT, COATED/COV W/O DEL SY",,,,,0
HCPCS,C1876,"STENT, NON-COA/NON-COV W/DEL",,,,,0
HCPCS,C1877,"STENT, NON-COAT/COV W/O DEL",,,,,0
HCPCS,C1878,MATRL FOR VOCAL CORD,,,,,0
HCPCS,C1880,VENA CAVA FILTER,,,,,0
HCPCS,C1881,DIALYSIS ACCESS SYSTEM,,,,,0
HCPCS,C1882,"AICD, OTHER THAN SING/DUAL",,,,,0
HCPCS,C1883,"ADAPT/EXT, PACING/NEURO LEAD",,,,,0
HCPCS,C1884,EMBOLIZATION PROTECT SYST,,,,,0
HCPCS,C1885,"CATH, TRANSLUMIN ANGIO LASER",,,,,0
HCPCS,C1886,"CATHETER, ABLATION",,,,,0
HCPCS,C1887,"CATHETER, GUIDING",,,,,0
HCPCS,C1888,ENDOVAS NON-CARDIAC ABL CATH,,,,,0
HCPCS,C1889,JADA HEMO CONTROL SUPPLIES,7918.0,3959.0,1379.31,7680.46,47
HCPCS,C1889,SPACEOAR SUPPLY,22316.0,11158.0,3887.44,21646.52,47
HCPCS,C1890,NO DEVICE W/DEV-INTENSIVE PX,,,,,0
HCPCS,C1891,"INFUSION PUMP,NON-PROG, PERM",,,,,0
HCPCS,C1892,"INTRO/SHEATH,FIXED,PEEL-AWAY",,,,,0
HCPCS,C1893,"INTRO/SHEATH, FIXED,NON-PEEL",,,,,0
HCPCS,C1894,"INTRO/SHEATH, NON-LASER",,,,,0
HCPCS,C1895,"LEAD, AICD, ENDO DUAL COIL",,,,,0
HCPCS,C1896,"LEAD, AICD, NON SING/DUAL",,,,,0
HCPCS,C1897,"LEAD, NEUROSTIM TEST KIT",,,,,0
HCPCS,C1898,"LEAD, PMKR, OTHER THAN TRANS",,,,,0
HCPCS,C1899,"LEAD, PMKR/AICD COMBINATION",,,,,0
HCPCS,C1900,"LEAD, CORONARY VENOUS",,,,,0
HCPCS,C1982,"CATH, PRESSURE,VALVE-OCCLU",,,,,0
HCPCS,C2596,"PROBE, ROBOTIC, WATER-JET",,,,,0
HCPCS,C2613,LUNG BX PLUG W/DEL SYS,,,,,0
HCPCS,C2614,"PROBE, PERC LUMB DISC",,,,,0
HCPCS,C2615,"SEALANT, PULMONARY, LIQUID",,,,,0
HCPCS,C2616,YTTRIUM 90 BRACHYTHPY SEEDS,71811.0,35905.5,12153.93,71636.44,108
HCPCS,C2617,"STENT, NON-COR, TEM W/O DEL",,,,,0
HCPCS,C2618,"PROBE/NEEDLE, CRYO",,,,,0
HCPCS,C2619,"PMKR, DUAL, NON RATE-RESP",,,,,0
HCPCS,C2620,"PMKR, SINGLE, NON RATE-RESP",,,,,0
HCPCS,C2621,"PMKR, OTHER THAN SING/DUAL",,,,,0
HCPCS,C2622,"PROSTHESIS, PENILE, NON-INF",,,,,0
HCPCS,C2623,"CATH, TRANSLUMIN, DRUG-COAT",,,,,0
HCPCS,C2624,WIRELESS PRESSURE SENSOR,,,,,0
HCPCS,C2625,"STENT, NON-COR, TEM W/DEL SY",,,,,0
HCPCS,C2626,"INFUSION PUMP, NON-PROG,TEMP",,,,,0
HCPCS,C2627,"CATH, SUPRAPUBIC/CYSTOSCOPIC",,,,,0
HCPCS,C2628,"CATHETER, OCCLUSION",,,,,0
HCPCS,C2629,"INTRO/SHEATH, LASER",,,,,0
HCPCS,C2630,"CATH, EP, COOL-TIP",,,,,0
HCPCS,C2631,"REP DEV, URINARY, W/O SLING",,,,,0
HCPCS,C2634,"BRACHYTX, NON-STR, HA, I-125",,,165.56,331.12,8
HCPCS,C2635,"BRACHYTX, NON-STR, HA, P-103",,,101.54,203.08,8
HCPCS,C2636,"BRACHY LINEAR, NON-STR,P-103",,,85.03,170.06,8
HCPCS,C2637,"BRACHY,NON-STR,YTTERBIUM-169",,,,,0
HCPCS,C2638,"BRACHYTX, STRANDED, I-125",,,33.54,67.08,8
HCPCS,C2639,"BRACHYTX, NON-STRANDED,I-125",,,34.85,69.7,8
HCPCS,C2640,"BRACHYTX, STRANDED, P-103",,,83.95,167.9,8
HCPCS,C2641,SEEDS PALLADIUM-103 NS,762.0,381.0,61.33,739.14,54
HCPCS,C2642,"BRACHYTX, STRANDED, C-131",,,113.29,226.58,8
HCPCS,C2643,"BRACHYTX, NON-STRANDED,C-131",,,94.93,189.86,8
HCPCS,C2644,BRACHYTX CESIUM-131 CHLORIDE,,,,,0
HCPCS,C2645,"BRACHYTX PLANAR, P-103",,,4.46,8.92,8
HCPCS,C2698,"BRACHYTX, STRANDED, NOS",,,33.54,67.08,8
HCPCS,C2699,"BRACHYTX, NON-STRANDED, NOS",,,34.85,69.7,8
HCPCS,C5271,APPL SKINSUB1ST 25 (LEG),4434.0,2217.0,772.4,4300.98,47
HCPCS,C5272,APPL SKINSUB ADD 25 (LEG),2916.0,1458.0,507.96,2828.52,47
HCPCS,C5273,APPL SKINSUB >100(LEG),4897.0,2448.5,853.05,4750.09,47
HCPCS,C5274,LOW COST SKIN SUBSTITUTE APP,,,,,0
HCPCS,C5275,LOW COST SKIN SUBSTITUTE APP,,,,,0
HCPCS,C5276,LOW COST SKIN SUBSTITUTE APP,,,,,0
HCPCS,C5277,LOW COST SKIN SUBSTITUTE APP,,,,,0
HCPCS,C5278,LOW COST SKIN SUBSTITUTE APP,,,,,0
HCPCS,C7500,DEB BONE 20 CM2 W/DRUG DEV,,,,,0
HCPCS,C7501,PERC BX BREAST LESIONS STERO,,,,,0
HCPCS,C7502,PERC BX BREAST LESIONS MR,,,,,0
HCPCS,C7503,OPEN EXC CERV NODE(S) W/ ID,,,,,0
HCPCS,C7504,PERQ CVT&LS INJ VERT BODIES,,,,,0
HCPCS,C7505,PERQ LS&CVT INJ VERT BODIES,,,,,0
HCPCS,C7506,FUSION OF FINGER JOINTS,,,,,0
HCPCS,C7507,PERQ THOR&LUMB VERT AUG,,,,,0
HCPCS,C7508,PERQ LUMB&THOR VERT AUG,,,,,0
HCPCS,C7509,DX BRONCH W/ NAVIGATION,,,,,0
HCPCS,C7510,BRONCH/LAVAG W/ NAVIGATION,,,,,0
HCPCS,C7511,BRONCH/BPSY(S) W/ NAVIGATION,,,,,0
HCPCS,C7512,BRONCH/BPSY(S) W/ EBUS,,,,,0
HCPCS,C7513,CATH/ANGIO DIALCIR W/APLASTY,,,,,0
HCPCS,C7514,CATH/ANGIO DIAL CIR W/STENTS,,,,,0
HCPCS,C7515,CATH/ANGIO DIAL CIR W/EMBOL,,,,,0
HCPCS,C7516,COR ANGIO W/ IVUS OR OCT,,,,,0
HCPCS,C7517,COR ANGIO W/ILIC/FEM ANGIO,,,,,0
HCPCS,C7518,COR/GFT ANGIO W/ IVUS OR OCT,,,,,0
HCPCS,C7519,COR/GFT ANGIO W/ FLOW RESRV,,,,,0
HCPCS,C7520,COR/GFT ANGIO W/ILIC/FEM ANG,,,,,0
HCPCS,C7521,R HRT ANGIO W/ IVUS OR OCT,,,,,0
HCPCS,C7522,R HRT ANGIO W/FLOW RESRV,,,,,0
HCPCS,C7523,L HRT ANGIO W/ IVUS OR OCT,,,,,0
HCPCS,C7524,L HRT ANGIO W/FLOW RESRV,,,,,0
HCPCS,C7525,L HRT GFT ANG W/ IVUS OR OCT,,,,,0
HCPCS,C7526,L HRT GFT ANG W/FLOW RESRV,,,,,0
HCPCS,C7527,R&L HRT ANGIO W/ IVUS OR OCT,,,,,0
HCPCS,C7528,R&L HRT ANGIO W/FLOW RESRV,,,,,0
HCPCS,C7529,R&L HRT GFT ANG W/FLOW RESRV,,,,,0
HCPCS,C7530,CATH/APLASTY DIAL CIR W/STNT,,,,,0
HCPCS,C7531,ANGIO FEM/POP W/ US,,,,,0
HCPCS,C7532,ANGIO W/ US NON-CORONARY,,,,,0
HCPCS,C7533,PTCA W/ PLCMT BRACHYTX DEV,,,,,0
HCPCS,C7534,FEM/POP REVASC W/ARTHR & US,,,,,0
HCPCS,C7535,FEM/POP REVASC W/STENT & US,,,,,0
HCPCS,C7537,INSRT ATRIL PM W/L VENT LEAD,,,,,0
HCPCS,C7538,INSRT VENT PM W/L VENT LEAD,,,,,0
HCPCS,C7539,INSRT A & V PM W/L VENT LEAD,,,,,0
HCPCS,C7540,RMV&RPLC PM DUL W/L VNT LEAD,,,,,0
HCPCS,C7541,ERCP W/ PANCREATOSCOPY,,,,,0
HCPCS,C7542,ERCP W/BX & PANCREATOSCOPY,,,,,0
HCPCS,C7543,"ERCP W/OTOMY, PANCREATOSCOPY",,,,,0
HCPCS,C7544,ERCP RMV CALC PANCREATOSCOPY,,,,,0
HCPCS,C7545,EXCH BIL CATH W/ RMV CALCULI,,,,,0
HCPCS,C7546,REP NPH/URT CATH W/DIL STRIC,,,,,0
HCPCS,C7547,CNVRT NEPH CATH W/ DIL STRIC,,,,,0
HCPCS,C7548,EXCH NEPH CATH W/ DIL STRIC,,,,,0
HCPCS,C7549,CHGE URTR STENT W/ DIL STRIC,,,,,0
HCPCS,C7550,CYSTO W/ BX(S) W/ BLUE LIGHT,,,,,0
HCPCS,C7551,EXC NEUROMA W/ IMPLNT NV END,,,,,0
HCPCS,C7552,R HRT ART/GRFT ANG HRT FLOW,,,,,0
HCPCS,C7553,R&I HRT ART/VENT ANG DRG AD,,,,,0
HCPCS,C7554,CYSTURETH BLU LI CYST FL IMG,,,,,0
HCPCS,C7555,RMVL THYRD W/AUTOTRAN PARATH,,,,,0
HCPCS,C7556,BRONCH LAVAGE W/EBUS,,,,,0
HCPCS,C7557,COR ANGIO/VENT W/FFR,,,,,0
HCPCS,C7560,ERCP REMOVE FORGN BODY&ENDO,,,,,0
HCPCS,C7562,"Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart ca",,,,,0
HCPCS,C7563,"Transluminal balloon angioplasty (except lower extremity artery(ies) for occlusive disease, intracranial, coronary, pulmonary, or dialysis circuit), open or percutaneous, including all imaging and rad",,,,,0
HCPCS,C7564,"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance with intravascular ultrasound (noncoronary vesse",,,,,0
HCPCS,C7565,"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",,,,,0
HCPCS,C7900,"HOPD MNTL HLT, 15-29 MIN",,,36.41,72.82,8
HCPCS,C7901,"HOPD MNTL HLT, 30-60 MIN",,,98.72,197.44,8
HCPCS,C7902,"HOPD MNTL HLT, EA ADDL",,,,,0
HCPCS,C7903,"HOPD MNTL HLT, GRP",,,36.41,72.82,8
HCPCS,C8000,"Support device, extravascular, for arteriovenous fistula (implantable)",,,,,0
HCPCS,C8001,"3d anatomical segmentation imaging for preoperative planning, data preparation and transmission, obtained from previous diagnostic computed tomographic or magnetic resonance examination of the same an",,,125.04,250.08,8
HCPCS,C8002,"Preparation of skin cell suspension autograft, automated, including all enzymatic processing and device components (Do not report with manual suspension preparation)",,,6896.39,13792.78,8
HCPCS,C8003,"Implantation of medial knee extraarticular implantable shock absorber spanning the knee joint from distal femur to proximal tibia, open, includes measurements, positioning and adjustments, with imagin",,,17038.69,34077.38,8
HCPCS,C8004,"Simulation angiogram with use of a pressure-generating catheter (e.g., one-way valve, intermittently occluding), inclusive of all radiological supervision and interpretation, intraprocedural roadmappi",,,11218.2,22436.4,8
HCPCS,C8005,"Bronchoscopy, rigid or flexible, non-thermal transbronchial ablation of lesion(s) by pulsed electric field (PEF) energy, including fluoroscopic and/or ultrasound guidance, when performed, with compute",,,16645.78,33291.56,8
HCPCS,C8900,"MRA W/CONT, ABD",,,339.02,678.04,8
HCPCS,C8901,"MRA W/O CONT, ABD",,,231.86,463.72,8
HCPCS,C8902,"MRA W/O FOL W/CONT, ABD",,,339.02,678.04,8
HCPCS,C8903,"MRI W/CONT, BREAST,  UNI",,,170.45,340.9,8
HCPCS,C8905,"MRI W/O FOL W/CONT, BRST, UN",,,339.02,678.04,8
HCPCS,C8906,"MRI W/CONT, BREAST,  BI",,,339.02,678.04,8
HCPCS,C8908,"MRI W/O FOL W/CONT, BREAST,",,,339.02,678.04,8
HCPCS,C8909,"MRA W/CONT, CHEST",,,339.02,678.04,8
HCPCS,C8910,"MRA W/O CONT, CHEST",,,231.86,463.72,8
HCPCS,C8911,"MRA W/O FOL W/CONT, CHEST",,,339.02,678.04,8
HCPCS,C8912,"MRA W/CONT, LWR EXT",,,339.02,678.04,8
HCPCS,C8913,"MRA W/O CONT, LWR EXT",,,231.86,463.72,8
HCPCS,C8914,"MRA W/O FOL W/CONT, LWR EXT",,,339.02,678.04,8
HCPCS,C8918,"MRA W/CONT, PELVIS",,,339.02,678.04,8
HCPCS,C8919,"MRA W/O CONT, PELVIS",,,231.86,463.72,8
HCPCS,C8920,"MRA W/O FOL W/CONT, PELVIS",,,339.02,678.04,8
HCPCS,C8921,"TTE W OR W/O FOL W/CONT, COM",,,761.78,1523.56,8
HCPCS,C8922,"TTE W OR W/O FOL W/CONT, F/U",,,761.78,1523.56,8
HCPCS,C8923,"2D TTE W OR W/O FOL W/CON,CO",,,761.78,1523.56,8
HCPCS,C8924,"2D TTE W OR W/O FOL W/CON,FU",,,339.02,678.04,8
HCPCS,C8925,"2D TEE W OR W/O FOL W/CON,IN",,,761.78,1523.56,8
HCPCS,C8926,"TEE W OR W/O FOL W/CONT,CONG",,,761.78,1523.56,8
HCPCS,C8927,"TEE W OR W/O FOL W/CONT, MON",,,761.78,1523.56,8
HCPCS,C8928,"TTE W OR W/O FOL W/CON,STRES",,,761.78,1523.56,8
HCPCS,C8929,"TTE W OR WO FOL WCON,DOPPLER",,,761.78,1523.56,8
HCPCS,C8930,"TTE W OR W/O CONTR, CONT ECG",,,761.78,1523.56,8
HCPCS,C8931,"MRA, W/DYE, SPINAL CANAL",,,339.02,678.04,8
HCPCS,C8932,"MRA, W/O DYE, SPINAL CANAL",,,231.86,463.72,8
HCPCS,C8933,"MRA, W/O&W/DYE, SPINAL CANAL",,,339.02,678.04,8
HCPCS,C8934,"MRA, W/DYE, UPPER EXTREMITY",,,339.02,678.04,8
HCPCS,C8935,"MRA, W/O DYE, UPPER EXTR",,,231.86,463.72,8
HCPCS,C8936,"MRA, W/O&W/DYE, UPPER EXTR",,,339.02,678.04,8
HCPCS,C8937,MRI CAD BREAST,119.0,59.5,20.72,115.43,47
HCPCS,C8957,"PROLONGED IV INF, REQ PUMP",,,206.7,413.4,8
HCPCS,C9046,COCAINE HCL NASAL (GOPRELTO),,,3.22,3.22,1
HCPCS,C9047,"INJECTION, CAPLACIZUMAB-YHDP",,,763.3,1526.6,9
HCPCS,C9067,GALLIUM GA-68 DOTATOC,,,3.43,14.48,10
HCPCS,C9088,"INSTILL, BUPIVAC AND MELOXIC",,,0.99,1.44,2
HCPCS,C9089,"BUPIVACAINE IMPLANT, 1 MG",,,1.59,1.59,1
HCPCS,C9101,"INJ, OLICERIDINE 0.1 MG",,,1.59,2.47,2
HCPCS,C9143,COCAINE HCL NASAL (NUMBRINO),,,4.29,4.29,1
HCPCS,C9144,"INJ, BUPIVACAINE (POSIMIR)",,,0.62,0.92,2
HCPCS,C9145,"INJ, APONVIE, 1 MG",,,1.82,3.64,10
HCPCS,C9248,"INJ, CLEVIDIPINE BUTYRATE",,,3.51,6.74,2
HCPCS,C9250,ARTISS FIBRIN SEALANT,,,134.96,351.32,10
HCPCS,C9254,"INJECTION, LACOSAMIDE",,,0.37,0.37,1
HCPCS,C9257,BEVACIZUMAB INJECTION,,,1.74,3.8,10
HCPCS,C9285,"PATCH, LIDOCAINE/TETRACAINE",,,32.38,32.38,1
HCPCS,C9293,"INJECTION, GLUCARPIDASE",,,406.83,813.66,9
HCPCS,C9352,"NEURAGEN NERVE GUIDE, PER CM",,,1983.06,1983.06,1
HCPCS,C9353,"NEURAWRAP NERVE PROTECTOR,CM",,,2115.12,2115.12,1
HCPCS,C9354,"VERITAS COLLAGEN MATRIX, CM2",,,36.3,36.3,1
HCPCS,C9355,"NEUROMATRIX NERVE CUFF, CM",,,341.34,341.34,1
HCPCS,C9356,"TENOGLIDE TENDON PROT, CM2",,,209.87,209.87,1
HCPCS,C9358,"SURGIMEND, FETAL",,,,,0
HCPCS,C9359,"IMPLNT,BON VOID FILLER-PUTTY",,,,,0
HCPCS,C9360,"SURGIMEND, NEONATAL",,,,,0
HCPCS,C9361,NEUROMEND NERVE WRAP,,,332.01,332.01,1
HCPCS,C9362,"IMPLNT,BON VOID FILLER-STRIP",,,,,0
HCPCS,C9363,INTEGRA MESHED BIL WOUND MAT,,,120.93,241.86,9
HCPCS,C9364,"PORCINE IMPLANT, PERMACOL",,,34.44,34.44,1
HCPCS,C9399,UNCLASSIFIED DRUGS OR BIOLOG,,,,,0
HCPCS,C9460,"INJECTION, CANGRELOR",,,19.0,38.27,10
HCPCS,C9462,"INJECTION, DELAFLOXACIN",,,0.9,0.9,1
HCPCS,C9482,SOTALOL HYDROCHLORIDE IV,,,23.83,47.66,10
HCPCS,C9488,CONIVAPTAN HCL,,,85.15,85.15,1
HCPCS,C9507,COVID-19 CONVALESCENT PLASMA,4581.0,2290.5,646.82,4443.57,54
HCPCS,C9600,PERC DRUG-EL COR STENT SING,,,11218.2,22436.4,8
HCPCS,C9601,PERC DRUG-EL COR STENT BRAN,,,,,0
HCPCS,C9602,PERC D-E COR STENT ATHER S,,,17813.98,35627.96,8
HCPCS,C9603,PERC D-E COR STENT ATHER BR,,,,,0
HCPCS,C9604,PERC D-E COR REVASC T CABG S,,,11218.2,22436.4,8
HCPCS,C9605,PERC D-E COR REVASC T CABG B,,,,,0
HCPCS,C9606,PERC D-E COR REVASC W AMI S,,,,,0
HCPCS,C9607,PERC D-E COR REVASC CHRO SIN,,,17813.98,35627.96,8
HCPCS,C9608,PERC D-E COR REVASC CHRO ADD,,,,,0
HCPCS,C9610,"Catheter, transluminal drug delivery with or without angioplasty, coronary, non-laser (insertable)",,,,,0
HCPCS,C9725,PLACE ENDORECTAL APP,,,903.7,1807.4,8
HCPCS,C9726,RXT BREAST APPL PLACE/REMOV,,,,,0
HCPCS,C9727,INSERT PALATE IMPLANTS,,,1507.77,3015.54,8
HCPCS,C9728,"PLACE DEVICE/MARKER, NON PRO",,,1345.04,2690.08,8
HCPCS,C9733,NON-OPHTHALMIC FVA,,,339.02,678.04,8
HCPCS,C9734,"U/S TRTMT, NOT LEIOMYOMATA",,,12476.14,24952.28,8
HCPCS,C9738,BLUE LIGHT CYSTO IMAG AGENT,,,,,0
HCPCS,C9739,CYSTOSCOPY PROSTATIC IMP 1-3,,,5210.39,10420.78,8
HCPCS,C9740,CYSTO IMPL 4 OR MORE,,,9199.14,18398.28,8
HCPCS,C9751,"MICROWAVE BRONCH, 3D, EBUS",,,,,0
HCPCS,C9756,FLUORESCENCE LYMPH MAP W/ICG,,,,,0
HCPCS,C9757,SPINE DEVICE IMPLANT SURGERY,,,12476.14,24952.28,8
HCPCS,C9758,BLIND INTERATRIAL SHUNT IDE,,,16645.78,33291.56,8
HCPCS,C9759,TRANSCATH INTRAOP MICROINF,,,,,0
HCPCS,C9760,NON-BLIND INTERATRIAL SHUNT,,,26157.38,52314.76,8
HCPCS,C9761,"CYSTO, LITHO, VACUUM KIDNEY",,,9199.14,18398.28,8
HCPCS,C9762,CARDIAC MRI SEG DYS STRAIN,,,530.99,1061.98,8
HCPCS,C9763,CARDIAC MRI SEG DYS STRESS,,,530.99,1061.98,8
HCPCS,C9764,REVASC INTRAVASC LITHOTRIPSY,,,11218.2,22436.4,8
HCPCS,C9765,REVASC INTRA LITHOTRIP-STENT,,,17813.98,35627.96,8
HCPCS,C9766,REVASC INTRA LITHOTRIP-ATHER,,,17813.98,35627.96,8
HCPCS,C9767,REVASC LITHOTRIP-STENT-ATHER,,,17813.98,35627.96,8
HCPCS,C9768,ENDO US-GUIDE HEP PORTO GRAD,,,,,0
HCPCS,C9772,REVASC LITHOTRIP TIBI/PERONE,,,11218.2,22436.4,8
HCPCS,C9773,REVASC LITHOTR-STENT TIB/PER,,,17813.98,35627.96,8
HCPCS,C9774,REVASC LITHOTR-ATHER TIB/PER,,,17813.98,35627.96,8
HCPCS,C9775,REVASC LITH-STEN-ATH TIB/PER,,,17813.98,35627.96,8
HCPCS,C9776,FLUO BILE DUCT IMAGING W/ICG,,,,,0
HCPCS,C9777,ESOPHAG MUC INTEG W/ESO EGD,,,3746.6,7493.2,8
HCPCS,C9778,"COLPOPEXY, MIN/INV, EX-PERIT",,,4861.19,9722.38,8
HCPCS,C9779,ESD ENDOSCOPY OR COLONOSCOPY,,,3746.6,7493.2,8
HCPCS,C9780,INSERT CV CATH INF & SUP APP,,,7847.55,15695.1,8
HCPCS,C9781,ARTHRO/SHOUL SURG; W/SPACER,,,12476.14,24952.28,8
HCPCS,C9782,BLIND MYOCAR TRPL BON MARROW,,,16645.78,33291.56,8
HCPCS,C9783,BLIND COR SINUS REDUCER IMPL,,,11218.2,22436.4,8
HCPCS,C9784,ENDO SLEEVE GASTRO W/TUBE,,,,,0
HCPCS,C9785,ENDO OUTLET RESTRICT W/TUBE,,,10329.66,20659.32,8
HCPCS,C9789,INSTILL PHARM RENAL PELVIS,,,1189.43,2378.86,8
HCPCS,C9791,MRI HYPERPOLARIZED XENON129,,,1189.43,2378.86,8
HCPCS,C9792,BLIND/NONBLIND TRANS ATRIAL,,,9274.29,18548.58,8
HCPCS,C9793,PRE-PLAN 3D MODEL W/CCTA,,,834.49,1668.98,8
HCPCS,C9796,Rpr intst excl anrect fist,,,2697.28,5394.56,8
HCPCS,C9797,Vasc emb/occ w/prs cath,,,17813.98,35627.96,8
HCPCS,C9804,"Elastomeric infusion pump (e.g., On-Q* pump with bolus), including catheter and all disposable system components, non-opioid medical device (must be a qualifying Medicare non-opioid Medical device for",,,,,0
HCPCS,C9806,"Rotary peristaltic infusion pump (e.g., ambIT pump), including catheter and all disposable system components, non-opioid medical device (must be a qualifying Medicare non-opioid medical device for pos",,,,,0
HCPCS,C9807,"Nerve stimulator, percutaneous, peripheral (e.g., SPRINT peripheral nerve stimulation system), including electrode and all disposable system components, non-opioid medical device (must be a qualifying",,,,,0
HCPCS,C9808,"Nerve cryoablation probe (e.g., cryoICE, cryoSPHERE, cryoSPHERE MAX, cryoICE cryoSPHERE, cryoICE cryO2), including probe and all disposable system components, non-opioid medical device (must be a qual",,,,,0
HCPCS,C9809,"Cryoablation needle (e.g., iovera system), including needle/tip and all disposable system components, non-opioid medical device (must be a qualifying Medicare non-opioid medical device for post-surgic",,,,,0
HCPCS,C9898,INPNT STAY RADIOLABELED ITEM,1.0,0.5,0.17,0.97,94
HCPCS,C9899,"INPT IMPLANT PROS DEV,NO COV",,,,,0
HCPCS,C9901,"Endoscopic defect closure within the entire gastrointestinal tract, including upper endoscopy (including diagnostic, if performed) or colonoscopy (including diagnostic, if performed), with all system ",,,10329.66,20659.32,8
HCPCS,D0120,PERIODIC ORAL EVALUATION,,,129.38,258.76,8
HCPCS,D0140,LIMIT ORAL EVAL PROBLM FOCUS,,,129.38,258.76,8
HCPCS,D0145,"ORAL EVALUATION, PT < 3YRS",,,,,0
HCPCS,D0150,COMPREHENSVE ORAL EVALUATION,,,129.38,258.76,8
HCPCS,D0160,EXTENSV ORAL EVAL PROB FOCUS,,,129.38,258.76,8
HCPCS,D0170,"RE-EVAL,EST PT,PROBLEM FOCUS",,,129.38,258.76,8
HCPCS,D0171,RE-EVAL POST-OP VISIT,,,129.38,258.76,8
HCPCS,D0180,COMP PERIODONTAL EVALUATION,,,129.38,258.76,8
HCPCS,D0190,SCREENING OF A PATIENT,,,,,0
HCPCS,D0191,ASSESSMENT OF A PATIENT,,,129.38,258.76,8
HCPCS,D0210,INTRAOR COMPREHENSIVE SERIES,,,231.86,463.72,8
HCPCS,D0220,INTRAORAL PERIAPICAL FIRST,,,84.57,169.14,8
HCPCS,D0230,INTRAORAL PERIAPICAL EA ADD,,,,,0
HCPCS,D0240,INTRAORAL OCCLUSAL FILM,,,84.57,169.14,8
HCPCS,D0250,EXTRAORAL 2D PROJECT IMAGE,,,84.57,169.14,8
HCPCS,D0251,EXTRAORAL POSTERIOR IMAGE,,,84.57,169.14,8
HCPCS,D0270,DENTAL BITEWING SINGLE IMAGE,,,84.57,169.14,8
HCPCS,D0272,DENTAL BITEWINGS TWO IMAGES,,,84.57,169.14,8
HCPCS,D0273,BITEWINGS - THREE IMAGES,,,231.86,463.72,8
HCPCS,D0274,BITEWINGS FOUR IMAGES,,,231.86,463.72,8
HCPCS,D0277,VERT BITEWINGS 7 TO 8 IMAGES,,,231.86,463.72,8
HCPCS,D0310,DENTAL SALIOGRAPHY,,,231.86,463.72,8
HCPCS,D0320,DENTAL TMJ ARTHROGRAM INCL I,,,231.86,463.72,8
HCPCS,D0321,OTHER TMJ IMAGES BY REPORT,,,84.57,169.14,8
HCPCS,D0322,DENTAL TOMOGRAPHIC SURVEY,,,101.59,203.18,8
HCPCS,D0330,PANORAMIC IMAGE,,,231.86,463.72,8
HCPCS,D0340,2D CEPHALOMETRIC IMAGE,,,84.57,169.14,8
HCPCS,D0350,ORAL/FACIAL PHOTO IMAGES,,,84.57,169.14,8
HCPCS,D0364,CONE BEAM CT CAPT & INTERP,,,101.59,203.18,8
HCPCS,D0365,CONE BEAM CT INTERPRETE MAN,,,101.59,203.18,8
HCPCS,D0366,CONE BEAM CT INTERPRETE MAX,,,101.59,203.18,8
HCPCS,D0367,CONE BEAM CT INTERP BOTH JAW,,,101.59,203.18,8
HCPCS,D0368,CONE BEAM CT INTERPRETE TMJ,,,101.59,203.18,8
HCPCS,D0369,MAX MRI CAPTURE & INTERPRETE,,,101.59,203.18,8
HCPCS,D0370,MAX ULTRASOUND CAPT & INTERP,,,101.59,203.18,8
HCPCS,D0371,SIALOENDOSCOPY CAPT & INTERP,,,84.57,169.14,8
HCPCS,D0372,TOMO COMP SERIES IMAGES,,,,,0
HCPCS,D0373,TOMO BITEWING IMAGE,,,,,0
HCPCS,D0374,TOMO PERIAPICAL IMAGE,,,,,0
HCPCS,D0380,CONE BEAM CT CAPTURE LIMITED,,,101.59,203.18,8
HCPCS,D0381,CONE BEAM CT CAPT MANDIBLE,,,101.59,203.18,8
HCPCS,D0382,CONE BEAM CT CAPT MAXILLA,,,101.59,203.18,8
HCPCS,D0383,CONE BEAM CT BOTH JAWS,,,101.59,203.18,8
HCPCS,D0384,CONE BEAM CT CAPTURE TMJ,,,101.59,203.18,8
HCPCS,D0385,MAX MRI IMAGE CAPTURE,,,101.59,203.18,8
HCPCS,D0386,MAX ULTRASOUND IMAGE CAPTURE,,,101.59,203.18,8
HCPCS,D0387,COMP IMAGE CAPTURE ONLY,,,,,0
HCPCS,D0388,BITEWING IMAGE CAPTURE ONLY,,,,,0
HCPCS,D0389,PERIOPIC IMAGE CAPTURE ONLY,,,,,0
HCPCS,D0391,IMTERPRETE DIAGNOSTIC IMAGE,,,,,0
HCPCS,D0393,TRTMNT SIMULATION 3D IMAGE,,,84.57,169.14,8
HCPCS,D0394,DIGITAL SUB 2 OR MORE IMAGES,,,84.57,169.14,8
HCPCS,D0395,FUSION 2 OR MORE 3D IMAGES,,,84.57,169.14,8
HCPCS,D0396,3D PRINT OF 3D SURFACE SCAN,,,,,0
HCPCS,D0411,HBA1C IN OFFICE TESTING,,,,,0
HCPCS,D0412,BLOOD GLUCOSE LEVEL TEST,,,,,0
HCPCS,D0414,LAB PROCESS MICROBIAL SPEC,,,,,0
HCPCS,D0415,COLLECTION OF MICROORGANISMS,,,,,0
HCPCS,D0416,VIRAL CULTURE,,,,,0
HCPCS,D0417,COLLECT & PREP SALIVA SAMPLE,,,,,0
HCPCS,D0418,ANALYSIS OF SALIVA SAMPLE,,,,,0
HCPCS,D0419,ASSESS OF SALIVARY FLOW,,,,,0
HCPCS,D0422,COLLECT & PREP GENETIC SAMP,,,,,0
HCPCS,D0423,GENETIC TEST SPEC ANALYSIS,,,,,0
HCPCS,D0425,CARIES SUSCEPTIBILITY TEST,,,,,0
HCPCS,D0431,DIAG TST DETECT MUCOS ABNORM,,,,,0
HCPCS,D0460,PULP VITALITY TEST,,,628.23,1256.46,8
HCPCS,D0470,DIAGNOSTIC CASTS,,,,,0
HCPCS,D0472,"GROSS EXAM, PREP & REPORT",,,,,0
HCPCS,D0473,"MICRO EXAM, PREP & REPORT",,,,,0
HCPCS,D0474,MICRO W EXAM OF SURG MARGINS,,,,,0
HCPCS,D0475,DECALCIFICATION PROCEDURE,,,,,0
HCPCS,D0476,SPEC STAINS FOR MICROORGANIS,,,,,0
HCPCS,D0477,SPEC STAINS NOT FOR MICROORG,,,,,0
HCPCS,D0478,IMMUNOHISTOCHEMICAL STAINS,,,,,0
HCPCS,D0479,TISSUE IN-SITU HYBRIDIZATION,,,,,0
HCPCS,D0480,CYTOPATH SMEAR PREP & REPORT,,,,,0
HCPCS,D0481,ELECTRON MICROSCOPY,,,,,0
HCPCS,D0482,DIRECT IMMUNOFLUORESCENCE,,,,,0
HCPCS,D0483,INDIRECT IMMUNOFLUORESCENCE,,,,,0
HCPCS,D0484,CONSULT SLIDES PREP ELSEWHER,,,,,0
HCPCS,D0485,CONSULT INC PREP OF SLIDES,,,,,0
HCPCS,D0486,ACCESS OF TRANSEP CYTOL SAMP,,,,,0
HCPCS,D0502,OTHER ORAL PATHOLOGY PROCEDU,,,,,0
HCPCS,D0600,NON-IONIZING DIAG PROC,,,628.23,1256.46,8
HCPCS,D0601,CARIES RISK ASSESS LOW RISK,,,,,0
HCPCS,D0602,CARIES RISK ASSESS MOD RISK,,,,,0
HCPCS,D0603,CARIES RISK ASSESS HIGH RISK,,,,,0
HCPCS,D0604,ANTIGEN TEST PUB HLTH PATHOG,,,,,0
HCPCS,D0605,ANTIBODY TEST PUB HLTH PATH,,,,,0
HCPCS,D0606,MOLECULAR TEST PUB HLTH PATH,,,,,0
HCPCS,D0701,PANO RADIO IMAGE,,,84.57,169.14,8
HCPCS,D0702,2D CEPHAL RADIO IMAGE,,,84.57,169.14,8
HCPCS,D0703,2D ORAL/FACIAL PHOTO IMAGE,,,84.57,169.14,8
HCPCS,D0705,EXTRA ORAL POST RADIO IMAGE,,,84.57,169.14,8
HCPCS,D0706,INTRAORAL OCCLUS RADIO IMAGE,,,84.57,169.14,8
HCPCS,D0707,INTRAORAL PERIAP RADIO IMAGE,,,84.57,169.14,8
HCPCS,D0708,INTRAORAL BITE RADIO IMAGE,,,84.57,169.14,8
HCPCS,D0709,INTRAORAL COMP IMAGE CAPTURE,,,84.57,169.14,8
HCPCS,D0801,3D DENTAL SCAN DIRECT,,,,,0
HCPCS,D0802,3D DENTAL SCAN INDIRECT,,,,,0
HCPCS,D0803,3D FACIAL SCAN DIRECT,,,,,0
HCPCS,D0804,3D FACIAL SCAN INDIRECT,,,,,0
HCPCS,D0999,UNSPECIFIED DIAGNOSTIC PROCE,,,,,0
HCPCS,D1110,DENTAL PROPHYLAXIS ADULT,,,129.38,258.76,8
HCPCS,D1120,DENTAL PROPHYLAXIS CHILD,,,,,0
HCPCS,D1206,TOPICAL FLUORIDE VARNISH,,,,,0
HCPCS,D1208,TOPICAL APP FLUORID EX VRNSH,,,,,0
HCPCS,D1301,IMMUNIZATION COUNSELING,,,,,0
HCPCS,D1310,NUTRI COUNSEL-CONTROL CARIES,,,,,0
HCPCS,D1320,TOBACCO COUNSELING,,,,,0
HCPCS,D1321,COUNS FOR HIGH RISK SUB USE,,,,,0
HCPCS,D1330,ORAL HYGIENE INSTRUCTION,,,,,0
HCPCS,D1351,DENTAL SEALANT PER TOOTH,,,,,0
HCPCS,D1352,"PREV RESIN REST, PERM TOOTH",,,,,0
HCPCS,D1353,SEALANT REPAIR PER TOOTH,,,,,0
HCPCS,D1354,INT CARIES MED APP PER TOOTH,,,,,0
HCPCS,D1355,CARIES MED APP PER TOOTH,,,,,0
HCPCS,D1510,SPACE MAINTAINER FXD UNILAT,,,628.23,1256.46,8
HCPCS,D1516,"FIXED BILAT SPACE MAINT, MAX",,,628.23,1256.46,8
HCPCS,D1517,"FIXED BILAT SPACE MAINT, MAN",,,628.23,1256.46,8
HCPCS,D1520,REMOVE UNILAT SPACE MAINTAIN,,,628.23,1256.46,8
HCPCS,D1526,"REMOVE BILAT SPACE MAIN, MAX",,,628.23,1256.46,8
HCPCS,D1527,"REMOVE BILAT SPACE MAIN, MAN",,,628.23,1256.46,8
HCPCS,D1551,RECEMENT SPACE MAINT - MAX,,,628.23,1256.46,8
HCPCS,D1552,RECEMENT SPACE MAINT - MAN,,,628.23,1256.46,8
HCPCS,D1553,RECEMENT UNILAT SPACE MAINT,,,628.23,1256.46,8
HCPCS,D1556,REM FIXED UNILAT SPACE MAINT,,,,,0
HCPCS,D1557,REMOVE FIXED BILAT MAINT MAX,,,,,0
HCPCS,D1558,REMOVE FIXED BILAT MAN,,,,,0
HCPCS,D1575,"DIST SPACE MAINT, FIXED UNIL",,,628.23,1256.46,8
HCPCS,D1701,PFIZER VACC ADMIN 1ST DOSE,,,,,0
HCPCS,D1702,PFIZER VACC ADMIN 2ND DOSE,,,,,0
HCPCS,D1703,MODERNA VACC ADMIN 1ST DOSE,,,,,0
HCPCS,D1704,MODERNA VACC ADMIN 2ND DOSE,,,,,0
HCPCS,D1705,ASTRAZENECA VACC ADM 1ST DOS,,,,,0
HCPCS,D1706,ASTRAZENECA VACC ADM 2ND DOS,,,,,0
HCPCS,D1707,JANSSEN VACCINE ADMIN,,,,,0
HCPCS,D1708,PFIZER VACC ADMIN 3RD DOSE,,,,,0
HCPCS,D1709,PFIZER VACCINE ADMIN BOOSTER,,,,,0
HCPCS,D1710,MODERNA VACC ADMIN 3RD DOSE,,,,,0
HCPCS,D1711,MODERNA VACC ADMIN BOOSTER,,,,,0
HCPCS,D1712,JANSSEN VACC ADMIN BOOSTER,,,,,0
HCPCS,D1713,PFIZER VACC ADM PED 1ST DOSE,,,,,0
HCPCS,D1714,PFIZER VACC ADM PED 2ND DOSE,,,,,0
HCPCS,D1781,VAC ADMIN HUMAN PAP DOSE 1,,,,,0
HCPCS,D1782,VAC ADMIN HUMAN PAP DOSE 2,,,,,0
HCPCS,D1783,VAC ADMIN HUMAN PAP DOSE 3,,,,,0
HCPCS,D1999,UNSPECIFIED PREVENTIVE PROC,,,,,0
HCPCS,D2140,AMALGAM ONE SURFACE PERMANEN,,,628.23,1256.46,8
HCPCS,D2150,AMALGAM TWO SURFACES PERMANE,,,628.23,1256.46,8
HCPCS,D2160,AMALGAM THREE SURFACES PERMA,,,628.23,1256.46,8
HCPCS,D2161,AMALGAM 4 OR > SURFACES PERM,,,628.23,1256.46,8
HCPCS,D2330,RESIN ONE SURFACE-ANTERIOR,,,628.23,1256.46,8
HCPCS,D2331,RESIN TWO SURFACES-ANTERIOR,,,628.23,1256.46,8
HCPCS,D2332,RESIN THREE SURFACES-ANTERIO,,,628.23,1256.46,8
HCPCS,D2335,RESIN 4/> SURF OR W INCIS AN,,,628.23,1256.46,8
HCPCS,D2390,ANT RESIN-BASED CMPST CROWN,,,628.23,1256.46,8
HCPCS,D2391,POST 1 SRFC RESINBASED CMPST,,,628.23,1256.46,8
HCPCS,D2392,POST 2 SRFC RESINBASED CMPST,,,628.23,1256.46,8
HCPCS,D2393,POST 3 SRFC RESINBASED CMPST,,,628.23,1256.46,8
HCPCS,D2394,POST >=4SRFC RESINBASE CMPST,,,628.23,1256.46,8
HCPCS,D2410,DENTAL GOLD FOIL ONE SURFACE,,,628.23,1256.46,8
HCPCS,D2420,DENTAL GOLD FOIL TWO SURFACE,,,628.23,1256.46,8
HCPCS,D2430,DENTAL GOLD FOIL THREE SURFA,,,628.23,1256.46,8
HCPCS,D2510,DENTAL INLAY METALIC 1 SURF,,,628.23,1256.46,8
HCPCS,D2520,DENTAL INLAY METALLIC 2 SURF,,,628.23,1256.46,8
HCPCS,D2530,DENTAL INLAY METL 3/MORE SUR,,,628.23,1256.46,8
HCPCS,D2542,DENTAL ONLAY METALLIC 2 SURF,,,628.23,1256.46,8
HCPCS,D2543,DENTAL ONLAY METALLIC 3 SURF,,,628.23,1256.46,8
HCPCS,D2544,DENTAL ONLAY METL 4/MORE SUR,,,628.23,1256.46,8
HCPCS,D2610,INLAY PORCELAIN/CERAMIC 1 SU,,,628.23,1256.46,8
HCPCS,D2620,INLAY PORCELAIN/CERAMIC 2 SU,,,628.23,1256.46,8
HCPCS,D2630,DENTAL ONLAY PORC 3/MORE SUR,,,628.23,1256.46,8
HCPCS,D2642,DENTAL ONLAY PORCELIN 2 SURF,,,628.23,1256.46,8
HCPCS,D2643,DENTAL ONLAY PORCELIN 3 SURF,,,628.23,1256.46,8
HCPCS,D2644,DENTAL ONLAY PORC 4/MORE SUR,,,628.23,1256.46,8
HCPCS,D2650,INLAY COMPOSITE/RESIN ONE SU,,,628.23,1256.46,8
HCPCS,D2651,INLAY COMPOSITE/RESIN TWO SU,,,628.23,1256.46,8
HCPCS,D2652,DENTAL INLAY RESIN 3/MRE SUR,,,628.23,1256.46,8
HCPCS,D2662,DENTAL ONLAY RESIN 2 SURFACE,,,628.23,1256.46,8
HCPCS,D2663,DENTAL ONLAY RESIN 3 SURFACE,,,628.23,1256.46,8
HCPCS,D2664,DENTAL ONLAY RESIN 4/MRE SUR,,,628.23,1256.46,8
HCPCS,D2710,CROWN RESIN-BASED INDIRECT,,,628.23,1256.46,8
HCPCS,D2712,CROWN 3/4 RESIN-BASED COMPOS,,,628.23,1256.46,8
HCPCS,D2720,CROWN RESIN W/ HIGH NOBLE ME,,,628.23,1256.46,8
HCPCS,D2721,CROWN RESIN W/ BASE METAL,,,628.23,1256.46,8
HCPCS,D2722,CROWN RESIN W/ NOBLE METAL,,,628.23,1256.46,8
HCPCS,D2740,CROWN PORCELAIN/CERAMIC,,,628.23,1256.46,8
HCPCS,D2750,CROWN PORCELAIN W/ H NOBLE M,,,628.23,1256.46,8
HCPCS,D2751,CROWN PORCELAIN FUSED BASE M,,,628.23,1256.46,8
HCPCS,D2752,CROWN PORCELAIN W/ NOBLE MET,,,628.23,1256.46,8
HCPCS,D2753,CROWN PORC FUSED TO TITANIUM,,,628.23,1256.46,8
HCPCS,D2780,CROWN 3/4 CAST HI NOBLE MET,,,628.23,1256.46,8
HCPCS,D2781,CROWN 3/4 CAST BASE METAL,,,628.23,1256.46,8
HCPCS,D2782,CROWN 3/4 CAST NOBLE METAL,,,628.23,1256.46,8
HCPCS,D2783,CROWN 3/4 PORCELAIN/CERAMIC,,,628.23,1256.46,8
HCPCS,D2790,CROWN FULL CAST HIGH NOBLE M,,,628.23,1256.46,8
HCPCS,D2791,CROWN FULL CAST BASE METAL,,,628.23,1256.46,8
HCPCS,D2792,CROWN FULL CAST NOBLE METAL,,,628.23,1256.46,8
HCPCS,D2794,CROWN-TITANIUM,,,628.23,1256.46,8
HCPCS,D2799,INTERIM CROWN,,,628.23,1256.46,8
HCPCS,D2910,RECEMENT INLAY ONLAY OR PART,,,628.23,1256.46,8
HCPCS,D2915,RECEMENT CAST OR PREFAB POST,,,628.23,1256.46,8
HCPCS,D2920,RE-CEMENT OR RE-BOND CROWN,,,628.23,1256.46,8
HCPCS,D2921,REATTACH TOOTH FRAGMENT,,,628.23,1256.46,8
HCPCS,D2928,PREFAB PORC/CER CROWN PERM,,,628.23,1256.46,8
HCPCS,D2929,PREFAB PORC/CERAM CROWN PRI,,,628.23,1256.46,8
HCPCS,D2930,PREFAB STNLSS STEEL CRWN PRI,,,628.23,1256.46,8
HCPCS,D2931,PREFAB STNLSS STEEL CROWN PE,,,628.23,1256.46,8
HCPCS,D2932,PREFABRICATED RESIN CROWN,,,628.23,1256.46,8
HCPCS,D2933,PREFAB STAINLESS STEEL CROWN,,,628.23,1256.46,8
HCPCS,D2934,PREFAB STEEL CROWN PRIMARY,,,628.23,1256.46,8
HCPCS,D2940,PROTECTIVE RESTORATION,,,628.23,1256.46,8
HCPCS,D2949,RESTORATIVE FOUNDATION,,,628.23,1256.46,8
HCPCS,D2950,CORE BUILD-UP INCL ANY PINS,,,628.23,1256.46,8
HCPCS,D2951,TOOTH PIN RETENTION,,,628.23,1256.46,8
HCPCS,D2952,POST AND CORE CAST + CROWN,,,628.23,1256.46,8
HCPCS,D2953,EACH ADDTNL CAST POST,,,,,0
HCPCS,D2954,PREFAB POST/CORE + CROWN,,,628.23,1256.46,8
HCPCS,D2955,POST REMOVAL,,,,,0
HCPCS,D2957,EACH ADDTNL PREFAB POST,,,628.23,1256.46,8
HCPCS,D2960,LABIAL VENEER RESIN DIRECT,,,628.23,1256.46,8
HCPCS,D2961,LABIAL VENEER RESIN INDIRECT,,,628.23,1256.46,8
HCPCS,D2962,LABIAL VENEER PORC INDIRECT,,,628.23,1256.46,8
HCPCS,D2971,ADD PROC CONSTRUCT NEW CROWN,,,628.23,1256.46,8
HCPCS,D2975,COPING,,,628.23,1256.46,8
HCPCS,D2976,BAND STABILIZATION PER TOOTH,,,,,0
HCPCS,D2980,CROWN REPAIR,,,628.23,1256.46,8
HCPCS,D2981,INLAY REPAIR,,,628.23,1256.46,8
HCPCS,D2982,ONLAY REPAIR,,,628.23,1256.46,8
HCPCS,D2983,VENEER REPAIR,,,628.23,1256.46,8
HCPCS,D2989,EXCAVATE TOOTH NON-RESTORABL,,,,,0
HCPCS,D2990,RESIN INFILTRATION OF LESION,,,628.23,1256.46,8
HCPCS,D2991,APP OF HYDROXYAPATITE,,,,,0
HCPCS,D2999,DENTAL UNSPEC RESTORATIVE PR,,,628.23,1256.46,8
HCPCS,D3110,PULP CAP DIRECT,,,628.23,1256.46,8
HCPCS,D3120,PULP CAP INDIRECT,,,628.23,1256.46,8
HCPCS,D3220,THERAPEUTIC PULPOTOMY,,,628.23,1256.46,8
HCPCS,D3221,GROSS PULPAL DEBRIDEMENT,,,628.23,1256.46,8
HCPCS,D3222,PART PULP FOR APEXOGENESIS,,,628.23,1256.46,8
HCPCS,D3230,PULPAL THERAPY ANTERIOR PRIM,,,628.23,1256.46,8
HCPCS,D3240,PULPAL THERAPY POSTERIOR PRI,,,628.23,1256.46,8
HCPCS,D3310,"END THXPY, ANTERIOR TOOTH",,,628.23,1256.46,8
HCPCS,D3320,"END THXPY, PREMOLAR TOOTH",,,628.23,1256.46,8
HCPCS,D3330,"END THXPY, MOLAR TOOTH",,,628.23,1256.46,8
HCPCS,D3331,NON-SURG TX ROOT CANAL OBS,,,628.23,1256.46,8
HCPCS,D3332,INCOMPLETE ENDODONTIC TX,,,628.23,1256.46,8
HCPCS,D3333,INTERNAL ROOT REPAIR,,,628.23,1256.46,8
HCPCS,D3346,RETREAT ROOT CANAL ANTERIOR,,,628.23,1256.46,8
HCPCS,D3347,RETREAT ROOT CANAL PREMOLAR,,,628.23,1256.46,8
HCPCS,D3348,RETREAT ROOT CANAL MOLAR,,,628.23,1256.46,8
HCPCS,D3351,APEXIFICATION/RECALC INITIAL,,,628.23,1256.46,8
HCPCS,D3352,APEXIFICATION/RECALC INTERIM,,,628.23,1256.46,8
HCPCS,D3353,APEXIFICATION/RECALC FINAL,,,628.23,1256.46,8
HCPCS,D3355,PULPAL REGENERATION INITIAL,,,628.23,1256.46,8
HCPCS,D3356,PULPAL REGENERATION INTERIM,,,628.23,1256.46,8
HCPCS,D3357,PULPAL REGENERATION COMPLETE,,,628.23,1256.46,8
HCPCS,D3410,APICOECTOMY - ANTERIOR,,,628.23,1256.46,8
HCPCS,D3421,ROOT SURGERY PREMOLAR,,,628.23,1256.46,8
HCPCS,D3425,ROOT SURGERY MOLAR,,,628.23,1256.46,8
HCPCS,D3426,ROOT SURGERY EA ADD ROOT,,,,,0
HCPCS,D3428,BONE GRAFT PERI PER TOOTH,,,628.23,1256.46,8
HCPCS,D3429,BONE GRAFT PERI EACH ADDL,,,,,0
HCPCS,D3430,RETROGRADE FILLING,,,628.23,1256.46,8
HCPCS,D3431,BIOLOGICAL MATERIALS,,,628.23,1256.46,8
HCPCS,D3432,GUIDED TISSUE REGENERATION,,,628.23,1256.46,8
HCPCS,D3450,ROOT AMPUTATION,,,628.23,1256.46,8
HCPCS,D3460,ENDODONTIC ENDOSSEOUS IMPLAN,,,628.23,1256.46,8
HCPCS,D3470,INTENTIONAL REPLANTATION,,,628.23,1256.46,8
HCPCS,D3471,SURG REP ROOT RES ANTERIOR,,,628.23,1256.46,8
HCPCS,D3472,SURG REP ROOT RES PREMOLAR,,,628.23,1256.46,8
HCPCS,D3473,SURG REP ROOT RES MOLAR,,,628.23,1256.46,8
HCPCS,D3501,SURG EXP ROOT SURF ANTERIOR,,,628.23,1256.46,8
HCPCS,D3502,SURG EXP ROOT SURF PREMOLAR,,,628.23,1256.46,8
HCPCS,D3503,SURG EXP ROOT SURF MOLAR,,,628.23,1256.46,8
HCPCS,D3910,ISOLATION- TOOTH W RUBB DAM,,,628.23,1256.46,8
HCPCS,D3911,INTRAORIFICE BARRIER,,,628.23,1256.46,8
HCPCS,D3920,TOOTH SPLITTING,,,628.23,1256.46,8
HCPCS,D3921,DECOR OR SUBMERG ERUPT TOOTH,,,628.23,1256.46,8
HCPCS,D3950,CANAL PREP/FITTING OF DOWEL,,,628.23,1256.46,8
HCPCS,D3999,ENDODONTIC PROCEDURE,,,628.23,1256.46,8
HCPCS,D4210,GINGIVECTOMY/PLASTY 4 OR MOR,,,3221.84,6443.68,8
HCPCS,D4211,GINGIVECTOMY/PLASTY 1 TO 3,,,3221.84,6443.68,8
HCPCS,D4212,GINGIVECTOMY/PLASTY REST,,,3221.84,6443.68,8
HCPCS,D4230,ANA CROWN EXP 4 OR> PER QUAD,,,3221.84,6443.68,8
HCPCS,D4231,ANA CROWN EXP 1-3 PER QUAD,,,1507.77,3015.54,8
HCPCS,D4240,GINGIVAL FLAP PROC W/ PLANIN,,,3221.84,6443.68,8
HCPCS,D4241,GNGVL FLAP W ROOTPLAN 1-3 TH,,,1507.77,3015.54,8
HCPCS,D4245,APICALLY POSITIONED FLAP,,,1507.77,3015.54,8
HCPCS,D4249,CROWN LENGTHEN HARD TISSUE,,,628.23,1256.46,8
HCPCS,D4260,OSSEOUS SURGERY 4 OR MORE,,,5752.66,11505.32,8
HCPCS,D4261,OSSEOUS SURG 1 TO 3 TEETH,,,3221.84,6443.68,8
HCPCS,D4263,BONE REPLCE GRAFT FIRST SITE,,,628.23,1256.46,8
HCPCS,D4264,BONE REPLCE GRAFT EACH ADD,,,,,0
HCPCS,D4265,BIO MTRLS TO AID SOFT/OS REG,,,628.23,1256.46,8
HCPCS,D4266,GUIDED TISS REGEN RESORBLE,,,1507.77,3015.54,8
HCPCS,D4267,GUIDED TISS REGEN NONRESORB,,,1507.77,3015.54,8
HCPCS,D4268,SURGICAL REVISION PROCEDURE,,,628.23,1256.46,8
HCPCS,D4270,PEDICLE SOFT TISSUE GRAFT PR,,,1507.77,3015.54,8
HCPCS,D4273,AUTO TISSUE GRAFT 1ST TOOTH,,,1507.77,3015.54,8
HCPCS,D4274,MESIAL/DISTAL WEDGE PROC,,,628.23,1256.46,8
HCPCS,D4275,NON-AUTO GRAFT 1ST TOOTH,,,1507.77,3015.54,8
HCPCS,D4276,CON TISSUE W PEDICLE GRAFT,,,1507.77,3015.54,8
HCPCS,D4277,SOFT TISSUE GRAFT FIRSTTOOTH,,,1507.77,3015.54,8
HCPCS,D4278,SOFT TISSUE GRAFT ADDL TOOTH,,,,,0
HCPCS,D4283,AUTO TISSUE GRAFT ADDL TOOTH,,,,,0
HCPCS,D4285,NON-AUTO GRAFT ADDL TOOTH,,,,,0
HCPCS,D4286,REMOVE NON-RESORB BARRIER,,,,,0
HCPCS,D4322,SPLINT INTRA-CORONAL,,,628.23,1256.46,8
HCPCS,D4323,SPLINT EXTRA-CORONAL,,,628.23,1256.46,8
HCPCS,D4341,PERIODONTAL SCALING & ROOT,,,628.23,1256.46,8
HCPCS,D4342,PERIODONTAL SCALING 1-3TEETH,,,628.23,1256.46,8
HCPCS,D4346,SCALING GINGIV INFLAMMATION,,,628.23,1256.46,8
HCPCS,D4355,FULL MOUTH DEBRIDEMENT,,,628.23,1256.46,8
HCPCS,D4381,LOCALIZED DELIVERY ANTIMICRO,,,628.23,1256.46,8
HCPCS,D4910,PERIODONTAL MAINT PROCEDURES,,,628.23,1256.46,8
HCPCS,D4920,UNSCHEDULED DRESSING CHANGE,,,628.23,1256.46,8
HCPCS,D4921,GINGIVAL IRRIGATION PER QUAD,,,129.38,258.76,8
HCPCS,D4999,UNSPECIFIED PERIODONTAL PROC,,,230.16,460.32,8
HCPCS,D5110,DENTURES COMPLETE MAXILLARY,,,,,0
HCPCS,D5120,DENTURES COMPLETE MANDIBLE,,,,,0
HCPCS,D5130,DENTURES IMMEDIAT MAXILLARY,,,,,0
HCPCS,D5140,DENTURES IMMEDIAT MANDIBLE,,,,,0
HCPCS,D5211,DENTURES MAXILL PART RESIN,,,,,0
HCPCS,D5212,DENTURES MAND PART RESIN,,,,,0
HCPCS,D5213,DENTURES MAXILL PART METAL,,,,,0
HCPCS,D5214,DENTURES MANDIBL PART METAL,,,,,0
HCPCS,D5221,IMMED MAX PART DENTURE RESIN,,,,,0
HCPCS,D5222,IMMED MAN PART DENTURE RESIN,,,,,0
HCPCS,D5223,IMMED MAX PART DENT METAL,,,,,0
HCPCS,D5224,IMMED MAND PART DENT METAL,,,,,0
HCPCS,D5225,MAXILLARY PART DENTURE FLEX,,,,,0
HCPCS,D5226,MANDIBULAR PART DENTURE FLEX,,,,,0
HCPCS,D5227,IMMED MAX PART DENTURE,,,,,0
HCPCS,D5228,IMMED MAND PART DENTURE,,,,,0
HCPCS,D5282,"REMOVE UNIL PART DENTURE,MAX",,,,,0
HCPCS,D5283,"REMOVE UNIL PART DENTURE,MAN",,,,,0
HCPCS,D5284,REM UNILAT DENT FLEX BASE,,,,,0
HCPCS,D5286,REM UNILAT DENT 1 PC RESIN,,,,,0
HCPCS,D5410,DENTURES ADJUST CMPLT MAXIL,,,,,0
HCPCS,D5411,DENTURES ADJUST CMPLT MAND,,,,,0
HCPCS,D5421,DENTURES ADJUST PART MAXILL,,,,,0
HCPCS,D5422,DENTURES ADJUST PART MANDBL,,,,,0
HCPCS,D5511,REP BROKE COMP DENT BASE MAN,,,,,0
HCPCS,D5512,REP BROKE COMP DENT BASE MAX,,,,,0
HCPCS,D5520,REPLACE DENTURE TEETH COMPLT,,,,,0
HCPCS,D5611,REP RESIN PART DENT BASE MAN,,,,,0
HCPCS,D5612,REP RESIN PART DENT BASE MAX,,,,,0
HCPCS,D5621,REP CAST PART FRAME MAN,,,,,0
HCPCS,D5622,REP CAST PART FRAME MAX,,,,,0
HCPCS,D5630,REP PARTIAL DENTURE CLASP,,,,,0
HCPCS,D5640,REPLACE PART DENTURE TEETH,,,,,0
HCPCS,D5650,ADD TOOTH TO PARTIAL DENTURE,,,,,0
HCPCS,D5660,ADD CLASP TO PARTIAL DENTURE,,,,,0
HCPCS,D5670,REPLC TTH&ACRLC ON MTL FRMWK,,,,,0
HCPCS,D5671,REPLC TTH&ACRLC MANDIBULAR,,,,,0
HCPCS,D5710,DENTURES REBASE CMPLT MAXIL,,,,,0
HCPCS,D5711,DENTURES REBASE CMPLT MAND,,,,,0
HCPCS,D5720,DENTURES REBASE PART MAXILL,,,,,0
HCPCS,D5721,DENTURES REBASE PART MANDBL,,,,,0
HCPCS,D5725,REBASE HYBRID PROSTHESIS,,,,,0
HCPCS,D5730,DENTURE RELN CMPLT MAX DIR,,,,,0
HCPCS,D5731,DENTURE RELN CMPLT MAND DIR,,,,,0
HCPCS,D5740,DENTURE RELN PART MAX DIR,,,,,0
HCPCS,D5741,DENTURE RELN PART MAND DIR,,,,,0
HCPCS,D5750,DENTURE RELN CMPLT MAX INDIR,,,,,0
HCPCS,D5751,DENTURE RELN CMPLT MAND IND,,,,,0
HCPCS,D5760,DENTURE RELN PART MAX INDIR,,,,,0
HCPCS,D5761,DENTURE RELN PART MAND INDIR,,,,,0
HCPCS,D5765,LINER COMPL/PARTIAL REM DENT,,,,,0
HCPCS,D5810,DENTURE INTERM CMPLT MAXILL,,,,,0
HCPCS,D5811,DENTURE INTERM CMPLT MANDBL,,,,,0
HCPCS,D5820,DENTURE INTERM PART MAXILL,,,,,0
HCPCS,D5821,DENTURE INTERM PART MANDBL,,,,,0
HCPCS,D5850,DENTURE TISS CONDITN MAXILL,,,,,0
HCPCS,D5851,DENTURE TISS CONDTIN MANDBL,,,,,0
HCPCS,D5862,PRECISION ATTACHMENT,,,,,0
HCPCS,D5863,OVERDENTURE COMPLETE MAX,,,,,0
HCPCS,D5864,OVERDENTURE PARTIAL MAX,,,,,0
HCPCS,D5865,OVERDENTURE COMPLETE MANDIB,,,,,0
HCPCS,D5866,OVERDENTURE PARTIAL MANDIB,,,,,0
HCPCS,D5867,REPLACEMENT OF PRECISION ATT,,,,,0
HCPCS,D5875,PROSTHESIS MODIFICATION,,,,,0
HCPCS,D5876,ADD METAL SUB TO ACRYLC DENT,,,,,0
HCPCS,D5899,REMOVABLE PROSTHODONTIC PROC,,,,,0
HCPCS,D5911,FACIAL MOULAGE SECTIONAL,,,628.23,1256.46,8
HCPCS,D5912,FACIAL MOULAGE COMPLETE,,,628.23,1256.46,8
HCPCS,D5913,NASAL PROSTHESIS,,,,,0
HCPCS,D5914,AURICULAR PROSTHESIS,,,,,0
HCPCS,D5915,ORBITAL PROSTHESIS,,,,,0
HCPCS,D5916,OCULAR PROSTHESIS,,,,,0
HCPCS,D5919,FACIAL PROSTHESIS,,,,,0
HCPCS,D5922,NASAL SEPTAL PROSTHESIS,,,,,0
HCPCS,D5923,OCULAR PROSTHESIS INTERIM,,,,,0
HCPCS,D5924,CRANIAL PROSTHESIS,,,,,0
HCPCS,D5925,FACIAL AUGMENTATION IMPLANT,,,,,0
HCPCS,D5926,REPLACEMENT NASAL PROSTHESIS,,,,,0
HCPCS,D5927,AURICULAR REPLACEMENT,,,,,0
HCPCS,D5928,ORBITAL REPLACEMENT,,,,,0
HCPCS,D5929,FACIAL REPLACEMENT,,,,,0
HCPCS,D5931,SURGICAL OBTURATOR,,,,,0
HCPCS,D5932,POSTSURGICAL OBTURATOR,,,,,0
HCPCS,D5933,REFITTING OF OBTURATOR,,,,,0
HCPCS,D5934,MANDIBULAR FLANGE PROSTHESIS,,,,,0
HCPCS,D5935,MANDIBULAR DENTURE PROSTH,,,,,0
HCPCS,D5936,TEMP OBTURATOR PROSTHESIS,,,,,0
HCPCS,D5937,TRISMUS APPLIANCE,,,,,0
HCPCS,D5951,FEEDING AID,,,,,0
HCPCS,D5952,PEDIATRIC SPEECH AID,,,,,0
HCPCS,D5953,ADULT SPEECH AID,,,,,0
HCPCS,D5954,SUPERIMPOSED PROSTHESIS,,,,,0
HCPCS,D5955,PALATAL LIFT PROSTHESIS,,,,,0
HCPCS,D5958,INTRAORAL CON DEF INTER PLT,,,,,0
HCPCS,D5959,INTRAORAL CON DEF MOD PALAT,,,,,0
HCPCS,D5960,MODIFY SPEECH AID PROSTHESIS,,,,,0
HCPCS,D5982,SURGICAL STENT,,,,,0
HCPCS,D5983,RADIATION APPLICATOR,,,628.23,1256.46,8
HCPCS,D5984,RADIATION SHIELD,,,628.23,1256.46,8
HCPCS,D5985,RADIATION CONE LOCATOR,,,628.23,1256.46,8
HCPCS,D5986,FLUORIDE APPLICATOR,,,,,0
HCPCS,D5987,COMMISSURE SPLINT,,,628.23,1256.46,8
HCPCS,D5988,SURGICAL SPLINT,,,628.23,1256.46,8
HCPCS,D5991,VESICULOBULLOUS DISEASE CARR,,,,,0
HCPCS,D5992,ADJUST MAX PROST APPLIANCE,,,,,0
HCPCS,D5993,MAIN/CLEAN MAX PROSTHESIS,,,,,0
HCPCS,D5995,"PERI MEDICAMENT W/SEAL, MAX",,,,,0
HCPCS,D5996,"PERI MEDICAMENT W/SEAL, MAND",,,,,0
HCPCS,D5999,MAXILLOFACIAL PROSTHESIS,,,,,0
HCPCS,D6010,ODONTICS ENDOSTEAL IMPLANT,,,,,0
HCPCS,D6011,SECOND STAGE IMPLANT SURGERY,,,,,0
HCPCS,D6012,ENDOSTEAL IMPLANT,,,,,0
HCPCS,D6013,SURGICAL PLACE MINI IMPLANT,,,,,0
HCPCS,D6040,ODONTICS EPOSTEAL IMPLANT,,,,,0
HCPCS,D6050,ODONTICS TRANSOSTEAL IMPLNT,,,,,0
HCPCS,D6051,INTERIM IMPLANT ABUTMENT,,,,,0
HCPCS,D6055,IMPLANT CONNECTING BAR,,,,,0
HCPCS,D6056,PREFABRICATED ABUTMENT,,,,,0
HCPCS,D6057,CUSTOM ABUTMENT,,,,,0
HCPCS,D6058,ABUTMENT SUPPORTED CROWN,,,,,0
HCPCS,D6059,ABUTMENT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6060,ABUTMENT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6061,ABUTMENT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6062,ABUTMENT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6063,ABUTMENT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6064,ABUTMENT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6065,IMPLANT SUPPORTED CROWN,,,,,0
HCPCS,D6066,IMPLANT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6067,IMPLANT SUPPORTED MTL CROWN,,,,,0
HCPCS,D6068,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6069,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6070,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6071,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6072,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6073,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6074,ABUTMENT SUPPORTED RETAINER,,,,,0
HCPCS,D6075,IMPLANT SUPPORTED RETAINER,,,,,0
HCPCS,D6076,IMPLANT SUPPORTED RETAINER,,,,,0
HCPCS,D6077,IMPLANT SUPPORTED RETAINER,,,,,0
HCPCS,D6080,IMPLANT MAINTENANCE,,,,,0
HCPCS,D6081,"SCALE & DEBRIDE, SINGLE IMP",,,,,0
HCPCS,D6082,IMP CROWN PORC TO BASE ALLOY,,,,,0
HCPCS,D6083,IMP CROWN PORC TO NOBLE ALLO,,,,,0
HCPCS,D6084,IMP CROWN PORC TO TITANIUM,,,,,0
HCPCS,D6085,INTERIM IMPLANT CROWN,,,,,0
HCPCS,D6086,IMP CROWN BASE ALLOYS,,,,,0
HCPCS,D6087,IMPLANT CROWN NOBLE ALLOYS,,,,,0
HCPCS,D6088,IMP CROWN TITANIUM ALLOYS,,,,,0
HCPCS,D6089,ACCESS/RETORQ IMPLANT SCREW,,,,,0
HCPCS,D6090,REPAIR IMPLANT,,,,,0
HCPCS,D6091,REPL SEMI/PRECISION ATTACH,,,,,0
HCPCS,D6092,RECEMENT SUPP CROWN,,,,,0
HCPCS,D6093,RECEMENT SUPP PART DENTURE,,,,,0
HCPCS,D6094,ABUT SUPPORT CROWN TITANIUM,,,,,0
HCPCS,D6096,REMOVE BROKEN IMP RET SCREW,,,,,0
HCPCS,D6097,ABUT CROWN PORC TO TITANIUM,,,,,0
HCPCS,D6098,IMP RETAIN PORC TO BASE ALLO,,,,,0
HCPCS,D6099,IMP RETAINER FOR FPD,,,,,0
HCPCS,D6100,SURG REMOVAL OF IMPLANT BODY,,,,,0
HCPCS,D6101,DEBRIDEMENT OF A PERIIMPLANT,,,,,0
HCPCS,D6102,DEBRIDEMENT & CONTOURING,,,,,0
HCPCS,D6103,BONE GRAFT REPAIR PERIMPLANT,,,,,0
HCPCS,D6104,BONE GRAFT TIME OF IMPLANT,,,,,0
HCPCS,D6105,REMOVE IMPLANT BODY,,,,,0
HCPCS,D6106,TISSUE REGEN RESORBABLE,,,,,0
HCPCS,D6107,TISSUE REGEN NON-RESORBABLE,,,,,0
HCPCS,D6110,IMPLNT/ABUT REMOV DENT MAX,,,,,0
HCPCS,D6111,IMPLNT/ABUT REMOV DENT MAND,,,,,0
HCPCS,D6112,IMP/ABUT REM DENT PART MAX,,,,,0
HCPCS,D6113,IMP/ABUT REM DENT PART MAND,,,,,0
HCPCS,D6114,IMPLNT/ABUT FIXED DENT MAX,,,,,0
HCPCS,D6115,IMPLNT/ABUT FIXED DENT MAND,,,,,0
HCPCS,D6116,IMP/ABUT FIXED DENT PART MAX,,,,,0
HCPCS,D6117,IMP/ABUT FIXED DENT PART MAN,,,,,0
HCPCS,D6118,IMP/ABUT INT FIXED DENT MAN,,,,,0
HCPCS,D6119,INT/ABUT INT FIXED DENT MAX,,,,,0
HCPCS,D6120,IMP RETAIN PORC TO TITANIUM,,,,,0
HCPCS,D6121,RETAIN METAL FPD BASE ALLOYS,,,,,0
HCPCS,D6122,RETAIN METAL FPD NOBLE ALLOY,,,,,0
HCPCS,D6123,RETAIN METAL FPD TITANIUM,,,,,0
HCPCS,D6190,RADIO/SURGICAL IMPLANT INDEX,,,,,0
HCPCS,D6191,SEMI PRECISION ABUTMENT,,,,,0
HCPCS,D6192,SEMI PRECISION ATTACHMENT,,,,,0
HCPCS,D6194,ABUT SUPPORT RETAINER TITANI,,,,,0
HCPCS,D6195,ABUT RETAIN PORC TO TITANIUM,,,,,0
HCPCS,D6197,REPLACE MATERIAL PROSTHESIS,,,,,0
HCPCS,D6198,REMOVE INTERIM IMPLANT,,,,,0
HCPCS,D6199,IMPLANT PROCEDURE,,,,,0
HCPCS,D6205,PONTIC-INDIRECT RESIN BASED,,,,,0
HCPCS,D6210,PROSTHODONT HIGH NOBLE METAL,,,,,0
HCPCS,D6211,BRIDGE BASE METAL CAST,,,,,0
HCPCS,D6212,BRIDGE NOBLE METAL CAST,,,,,0
HCPCS,D6214,PONTIC TITANIUM,,,,,0
HCPCS,D6240,BRIDGE PORCELAIN HIGH NOBLE,,,,,0
HCPCS,D6241,BRIDGE PORCELAIN BASE METAL,,,,,0
HCPCS,D6242,BRIDGE PORCELAIN NOBEL METAL,,,,,0
HCPCS,D6243,PONTIC PORCELAIN TO TITANIUM,,,,,0
HCPCS,D6245,BRIDGE PORCELAIN/CERAMIC,,,,,0
HCPCS,D6250,BRIDGE RESIN W/HIGH NOBLE,,,,,0
HCPCS,D6251,BRIDGE RESIN BASE METAL,,,,,0
HCPCS,D6252,BRIDGE RESIN W/NOBLE METAL,,,,,0
HCPCS,D6253,INTERIM PONTIC,,,,,0
HCPCS,D6545,DENTAL RETAINR CAST METL,,,,,0
HCPCS,D6548,PORCELAIN/CERAMIC RETAINER,,,,,0
HCPCS,D6549,RESIN RETAINER,,,,,0
HCPCS,D6600,PORCELAIN/CERAMIC INLAY 2SRF,,,,,0
HCPCS,D6601,PORC/CERAM INLAY >= 3 SURFAC,,,,,0
HCPCS,D6602,CST HGH NBLE MTL INLAY 2 SRF,,,,,0
HCPCS,D6603,CST HGH NBLE MTL INLAY >=3SR,,,,,0
HCPCS,D6604,CST BSE MTL INLAY 2 SURFACES,,,,,0
HCPCS,D6605,CST BSE MTL INLAY >= 3 SURFA,,,,,0
HCPCS,D6606,CAST NOBLE METAL INLAY 2 SUR,,,,,0
HCPCS,D6607,CST NOBLE MTL INLAY >=3 SURF,,,,,0
HCPCS,D6608,ONLAY PORC/CRMC 2 SURFACES,,,,,0
HCPCS,D6609,ONLAY PORC/CRMC >=3 SURFACES,,,,,0
HCPCS,D6610,ONLAY CST HGH NBL MTL 2 SRFC,,,,,0
HCPCS,D6611,ONLAY CST HGH NBL MTL >=3SRF,,,,,0
HCPCS,D6612,ONLAY CST BASE MTL 2 SURFACE,,,,,0
HCPCS,D6613,ONLAY CST BASE MTL >=3 SURFA,,,,,0
HCPCS,D6614,ONLAY CST NBL MTL 2 SURFACES,,,,,0
HCPCS,D6615,ONLAY CST NBL MTL >=3 SURFAC,,,,,0
HCPCS,D6624,INLAY TITANIUM,,,,,0
HCPCS,D6634,ONLAY TITANIUM,,,,,0
HCPCS,D6710,CROWN-INDIRECT RESIN BASED,,,,,0
HCPCS,D6720,RETAIN CROWN RESIN W HI NBLE,,,,,0
HCPCS,D6721,CROWN RESIN W/BASE METAL,,,,,0
HCPCS,D6722,CROWN RESIN W/NOBLE METAL,,,,,0
HCPCS,D6740,CROWN PORCELAIN/CERAMIC,,,,,0
HCPCS,D6750,CROWN PORCELAIN HIGH NOBLE,,,,,0
HCPCS,D6751,CROWN PORCELAIN BASE METAL,,,,,0
HCPCS,D6752,CROWN PORCELAIN NOBLE METAL,,,,,0
HCPCS,D6753,RETAIN CROWN PORC TO TITANIU,,,,,0
HCPCS,D6780,CROWN 3/4 HIGH NOBLE METAL,,,,,0
HCPCS,D6781,CROWN 3/4 CAST BASED METAL,,,,,0
HCPCS,D6782,CROWN 3/4 CAST NOBLE METAL,,,,,0
HCPCS,D6783,CROWN 3/4 PORCELAIN/CERAMIC,,,,,0
HCPCS,D6784,RETAINER CROWN 3/4 TITANIUM,,,,,0
HCPCS,D6790,CROWN FULL HIGH NOBLE METAL,,,,,0
HCPCS,D6791,CROWN FULL BASE METAL CAST,,,,,0
HCPCS,D6792,CROWN FULL NOBLE METAL CAST,,,,,0
HCPCS,D6793,INTERIM RETAINER CROWN,,,,,0
HCPCS,D6794,CROWN TITANIUM,,,,,0
HCPCS,D6920,DENTAL CONNECTOR BAR,,,628.23,1256.46,8
HCPCS,D6930,RECEMENT/BOND PART DENTURE,,,,,0
HCPCS,D6940,STRESS BREAKER,,,,,0
HCPCS,D6950,PRECISION ATTACHMENT,,,,,0
HCPCS,D6980,FIXED PARTIAL REPAIR,,,,,0
HCPCS,D6985,PEDIATRIC PARTIAL DENTURE FX,,,,,0
HCPCS,D6999,FIXED PROSTHODONTIC PROC,,,,,0
HCPCS,D7111,EXTRACTION CORONAL REMNANTS,,,628.23,1256.46,8
HCPCS,D7140,EXTRACTION ERUPTED TOOTH/EXR,,,628.23,1256.46,8
HCPCS,D7210,REM IMP TOOTH W MUCOPER FLP,,,1507.77,3015.54,8
HCPCS,D7220,IMPACT TOOTH REMOV SOFT TISS,,,628.23,1256.46,8
HCPCS,D7230,IMPACT TOOTH REMOV PART BONY,,,628.23,1256.46,8
HCPCS,D7240,IMPACT TOOTH REMOV COMP BONY,,,628.23,1256.46,8
HCPCS,D7241,IMPACT TOOTH REM BONY W/COMP,,,628.23,1256.46,8
HCPCS,D7250,TOOTH ROOT REMOVAL,,,628.23,1256.46,8
HCPCS,D7251,CORONECTOMY,,,1507.77,3015.54,8
HCPCS,D7260,ORAL ANTRAL FISTULA CLOSURE,,,628.23,1256.46,8
HCPCS,D7261,PRIMARY CLOSURE SINUS PERF,,,628.23,1256.46,8
HCPCS,D7270,TOOTH REIMPLANTATION,,,628.23,1256.46,8
HCPCS,D7272,TOOTH TRANSPLANTATION,,,628.23,1256.46,8
HCPCS,D7280,EXPOSURE OF UNERUPTED TOOTH,,,628.23,1256.46,8
HCPCS,D7282,MOBILIZE ERUPTED/MALPOS TOOT,,,,,0
HCPCS,D7283,PLACE DEVICE IMPACTED TOOTH,,,,,0
HCPCS,D7284,EXC BIOPSY OF SALIV GLANDS,,,,,0
HCPCS,D7285,BIOPSY OF ORAL TISSUE HARD,,,,,0
HCPCS,D7286,BIOPSY OF ORAL TISSUE SOFT,,,,,0
HCPCS,D7287,EXFOLIATIVE CYTOLOG COLLECT,,,,,0
HCPCS,D7288,BRUSH BIOPSY,,,,,0
HCPCS,D7290,REPOSITIONING OF TEETH,,,,,0
HCPCS,D7291,TRANSSEPTAL FIBEROTOMY,,,628.23,1256.46,8
HCPCS,D7292,SCREW RETAINED PLATE,,,,,0
HCPCS,D7293,TEMP ANCHORAGE DEV W FLAP,,,,,0
HCPCS,D7294,TEMP ANCHORAGE DEV W/O FLAP,,,,,0
HCPCS,D7295,"BONE HARVEST,AUTO GRAFT PROC",,,,,0
HCPCS,D7296,"CORTICOTOMY, 1-3 TEETH",,,,,0
HCPCS,D7297,"CORTICOTOMY, 4 OR MORE TEETH",,,,,0
HCPCS,D7298,REMOVE SCREW RETAINED PLATE,,,,,0
HCPCS,D7299,REM ANCHORAGE DEVICE W/FLAP,,,,,0
HCPCS,D7300,REM ANCHORAGE DEV W/O FLAP,,,,,0
HCPCS,D7310,ALVEOPLASTY W/ EXTRACTION,,,1507.77,3015.54,8
HCPCS,D7311,ALVEOLOPLASTY W/EXTRACT 1-3,,,1507.77,3015.54,8
HCPCS,D7320,ALVEOPLASTY W/O EXTRACTION,,,1507.77,3015.54,8
HCPCS,D7321,ALVEOLOPLASTY NOT W/EXTRACTS,,,1507.77,3015.54,8
HCPCS,D7340,VESTIBULOPLASTY RIDGE EXTENS,,,5752.66,11505.32,8
HCPCS,D7350,VESTIBULOPLASTY EXTEN GRAFT,,,5752.66,11505.32,8
HCPCS,D7410,RAD EXC LESION UP TO 1.25 CM,,,1507.77,3015.54,8
HCPCS,D7411,EXCISION BENIGN LESION>1.25C,,,1507.77,3015.54,8
HCPCS,D7412,EXCISION BENIGN LESION COMPL,,,1507.77,3015.54,8
HCPCS,D7413,EXCISION MALIG LESION<=1.25C,,,1507.77,3015.54,8
HCPCS,D7414,EXCISION MALIG LESION>1.25CM,,,1507.77,3015.54,8
HCPCS,D7415,EXCISION MALIG LES COMPLICAT,,,1507.77,3015.54,8
HCPCS,D7440,MALIG TUMOR EXC TO 1.25 CM,,,3221.84,6443.68,8
HCPCS,D7441,MALIG TUMOR > 1.25 CM,,,3221.84,6443.68,8
HCPCS,D7450,REM ODONTOGEN CYST TO 1.25CM,,,3221.84,6443.68,8
HCPCS,D7451,REM ODONTOGEN CYST > 1.25 CM,,,3221.84,6443.68,8
HCPCS,D7460,REM NONODONTO CYST TO 1.25CM,,,628.23,1256.46,8
HCPCS,D7461,REM NONODONTO CYST > 1.25 CM,,,628.23,1256.46,8
HCPCS,D7465,LESION DESTRUCTION,,,,,0
HCPCS,D7471,REM EXOSTOSIS ANY SITE,,,3221.84,6443.68,8
HCPCS,D7472,REMOVAL OF TORUS PALATINUS,,,628.23,1256.46,8
HCPCS,D7473,REMOVE TORUS MANDIBULARIS,,,628.23,1256.46,8
HCPCS,D7485,SURG REDUCT OSSEOUSTUBEROSIT,,,5752.66,11505.32,8
HCPCS,D7490,MAXILLA OR MANDIBLE RESECTIO,,,,,0
HCPCS,D7509,MARSUPIALIZATION ODON CYST,,,,,0
HCPCS,D7510,I&D ABSC INTRAORAL SOFT TISS,,,688.14,1376.28,8
HCPCS,D7511,INCISION/DRAIN ABSCESS INTRA,,,688.14,1376.28,8
HCPCS,D7520,I&D ABSCESS EXTRAORAL,,,688.14,1376.28,8
HCPCS,D7521,INCISION/DRAIN ABSCESS EXTRA,,,688.14,1376.28,8
HCPCS,D7530,REMOVAL FB SKIN/AREOLAR TISS,,,628.23,1256.46,8
HCPCS,D7540,REMOVAL OF FB REACTION,,,628.23,1256.46,8
HCPCS,D7550,REMOVAL OF SLOUGHED OFF BONE,,,628.23,1256.46,8
HCPCS,D7560,MAXILLARY SINUSOTOMY,,,,,0
HCPCS,D7610,MAXILLA OPEN REDUCT SIMPLE,,,,,0
HCPCS,D7620,CLSD REDUCT SIMPL MAXILLA FX,,,,,0
HCPCS,D7630,OPEN RED SIMPL MANDIBLE FX,,,,,0
HCPCS,D7640,CLSD RED SIMPL MANDIBLE FX,,,,,0
HCPCS,D7650,OPEN RED SIMP MALAR/ZYGOM FX,,,,,0
HCPCS,D7660,CLSD RED SIMP MALAR/ZYGOM FX,,,,,0
HCPCS,D7670,CLOSD RDUCTN SPLINT ALVEOLUS,,,3221.84,6443.68,8
HCPCS,D7671,ALVEOLUS OPEN REDUCTION,,,5752.66,11505.32,8
HCPCS,D7680,REDUCT SIMPLE FACIAL BONE FX,,,,,0
HCPCS,D7710,MAXILLA OPEN REDUCT COMPOUND,,,,,0
HCPCS,D7720,CLSD REDUCT COMPD MAXILLA FX,,,,,0
HCPCS,D7730,OPEN REDUCT COMPD MANDBLE FX,,,,,0
HCPCS,D7740,CLSD REDUCT COMPD MANDBLE FX,,,,,0
HCPCS,D7750,OPEN RED COMP MALAR/ZYGMA FX,,,,,0
HCPCS,D7760,CLSD RED COMP MALAR/ZYGMA FX,,,,,0
HCPCS,D7770,OPEN REDUC COMPD ALVEOLUS FX,,,5752.66,11505.32,8
HCPCS,D7771,ALVEOLUS CLSD REDUC STBLZ TE,,,3221.84,6443.68,8
HCPCS,D7780,REDUCT COMPND FACIAL BONE FX,,,,,0
HCPCS,D7810,TMJ OPEN REDUCT-DISLOCATION,,,,,0
HCPCS,D7820,CLOSED TMP MANIPULATION,,,,,0
HCPCS,D7830,TMJ MANIPULATION UNDER ANEST,,,,,0
HCPCS,D7840,REMOVAL OF TMJ CONDYLE,,,,,0
HCPCS,D7850,TMJ MENISCECTOMY,,,,,0
HCPCS,D7852,TMJ REPAIR OF JOINT DISC,,,,,0
HCPCS,D7854,TMJ EXCISN OF JOINT MEMBRANE,,,,,0
HCPCS,D7856,TMJ CUTTING OF A MUSCLE,,,,,0
HCPCS,D7858,TMJ RECONSTRUCTION,,,,,0
HCPCS,D7860,TMJ CUTTING INTO JOINT,,,,,0
HCPCS,D7865,TMJ RESHAPING COMPONENTS,,,,,0
HCPCS,D7870,TMJ ASPIRATION JOINT FLUID,,,,,0
HCPCS,D7871,LYSIS + LAVAGE W CATHETERS,,,,,0
HCPCS,D7872,TMJ DIAGNOSTIC ARTHROSCOPY,,,,,0
HCPCS,D7873,TMJ ARTHROSCOPY LYSIS ADHESN,,,,,0
HCPCS,D7874,TMJ ARTHROSCOPY DISC REPOSIT,,,3179.6,6359.2,8
HCPCS,D7875,TMJ ARTHROSCOPY SYNOVECTOMY,,,,,0
HCPCS,D7876,TMJ ARTHROSCOPY DISCECTOMY,,,,,0
HCPCS,D7877,TMJ ARTHROSCOPY DEBRIDEMENT,,,,,0
HCPCS,D7880,OCCLUSAL ORTHOTIC APPLIANCE,,,,,0
HCPCS,D7881,OCC ORTHOTIC DEVICE ADJUST,,,,,0
HCPCS,D7899,TMJ UNSPECIFIED THERAPY,,,,,0
HCPCS,D7910,DENT SUTUR RECENT WND TO 5CM,,,,,0
HCPCS,D7911,DENTAL SUTURE WOUND TO 5 CM,,,,,0
HCPCS,D7912,SUTURE COMPLICATE WND > 5 CM,,,,,0
HCPCS,D7920,DENTAL SKIN GRAFT,,,,,0
HCPCS,D7921,COLLECT & APPL BLOOD PRODUCT,,,,,0
HCPCS,D7922,PLACE INTRA-SOCKET BIO DRESS,,,628.23,1256.46,8
HCPCS,D7939,INDEXING FOR OSTEOTOMY,,,,,0
HCPCS,D7940,RESHAPING BONE ORTHOGNATHIC,,,628.23,1256.46,8
HCPCS,D7941,BONE CUTTING RAMUS CLOSED,,,,,0
HCPCS,D7943,CUTTING RAMUS OPEN W/GRAFT,,,,,0
HCPCS,D7944,BONE CUTTING SEGMENTED,,,,,0
HCPCS,D7945,BONE CUTTING BODY MANDIBLE,,,,,0
HCPCS,D7946,RECONSTRUCTION MAXILLA TOTAL,,,,,0
HCPCS,D7947,RECONSTRUCT MAXILLA SEGMENT,,,,,0
HCPCS,D7948,RECONSTRUCT MIDFACE NO GRAFT,,,,,0
HCPCS,D7949,RECONSTRUCT MIDFACE W/GRAFT,,,,,0
HCPCS,D7950,MANDIBLE GRAFT,,,5752.66,11505.32,8
HCPCS,D7951,SINUS AUG W BONE OR BONE SUB,,,,,0
HCPCS,D7952,SINUS AUGMENTATION VERTICAL,,,,,0
HCPCS,D7953,BONE REPLACEMENT GRAFT,,,,,0
HCPCS,D7955,REPAIR MAXILLOFACIAL DEFECTS,,,,,0
HCPCS,D7956,TISS REGEN EDENT RESORB,,,,,0
HCPCS,D7957,TISS REGEN EDENT NONRESORB,,,,,0
HCPCS,D7961,BUCCAL/LABIAL FRENECTOMY,,,,,0
HCPCS,D7962,LINGUAL FRENECTOMY,,,,,0
HCPCS,D7963,FRENULOPLASTY,,,,,0
HCPCS,D7970,EXCISION HYPERPLASTIC TISSUE,,,,,0
HCPCS,D7971,EXCISION PERICORONAL GINGIVA,,,,,0
HCPCS,D7972,SURG REDCT FIBROUS TUBEROSIT,,,,,0
HCPCS,D7979,NON-SURGICAL SIALOLITHOTOMY,,,,,0
HCPCS,D7980,SURGICAL SIALOLITHOTOMY,,,,,0
HCPCS,D7981,EXCISION OF SALIVARY GLAND,,,,,0
HCPCS,D7982,SIALODOCHOPLASTY,,,,,0
HCPCS,D7983,CLOSURE OF SALIVARY FISTULA,,,,,0
HCPCS,D7990,EMERGENCY TRACHEOTOMY,,,,,0
HCPCS,D7991,DENTAL CORONOIDECTOMY,,,,,0
HCPCS,D7993,SURG PLACE CRANIOFACIAL IMPL,,,,,0
HCPCS,D7994,SURG PLACE ZYGOMATIC IMPL,,,,,0
HCPCS,D7995,SYNTHETIC GRAFT FACIAL BONES,,,,,0
HCPCS,D7996,IMPLANT MANDIBLE FOR AUGMENT,,,,,0
HCPCS,D7997,APPLIANCE REMOVAL,,,,,0
HCPCS,D7998,INTRAORAL PLACE OF FIX DEV,,,,,0
HCPCS,D7999,ORAL SURGERY PROCEDURE,,,,,0
HCPCS,D8010,LIMITED DENTAL TX PRIMARY,,,,,0
HCPCS,D8020,LIMITED DENTAL TX TRANSITION,,,,,0
HCPCS,D8030,LIMITED DENTAL TX ADOLESCENT,,,,,0
HCPCS,D8040,LIMITED DENTAL TX ADULT,,,,,0
HCPCS,D8070,COMPRE DENTAL TX TRANSITION,,,,,0
HCPCS,D8080,COMPRE DENTAL TX ADOLESCENT,,,,,0
HCPCS,D8090,COMPRE DENTAL TX ADULT,,,,,0
HCPCS,D8210,ORTHODONTIC REM APPLIANCE TX,,,,,0
HCPCS,D8220,FIXED APPLIANCE THERAPY HABT,,,,,0
HCPCS,D8660,PREORTHODONTIC TX VISIT,,,,,0
HCPCS,D8670,PERIODIC ORTHODONTC TX VISIT,,,,,0
HCPCS,D8680,ORTHODONTIC RETENTION,,,,,0
HCPCS,D8681,REMOVABLE RETAINER ADJUST,,,,,0
HCPCS,D8695,REMOVE FIXED ORTHO APPLIANCE,,,,,0
HCPCS,D8696,REP OF ORTHO APPLIANCE MAX,,,,,0
HCPCS,D8697,REP OF ORTHO APPLIANCE MAN,,,,,0
HCPCS,D8698,RECEMENT FIXED RETAINER MAX,,,,,0
HCPCS,D8699,RECEMENT FIXED RETAINER MAN,,,,,0
HCPCS,D8701,REPAIR FIXED RETAINER MAX,,,,,0
HCPCS,D8702,REPAIR OF FIXED RETAINER MAN,,,,,0
HCPCS,D8703,REPLACE BROKEN RETAINER MAX,,,,,0
HCPCS,D8704,REPLACE BROKEN RETAINER MAN,,,,,0
HCPCS,D8999,ORTHODONTIC PROCEDURE,,,,,0
HCPCS,D9110,PALLIATIVE TX DENTAL PAIN,,,,,0
HCPCS,D9120,FIX PARTIAL DENTURE SECTION,,,,,0
HCPCS,D9130,TEMPOROMANDIBULAR JOINT DYSF,,,,,0
HCPCS,D9210,DENT ANESTHESIA W/O SURGERY,,,,,0
HCPCS,D9211,REGIONAL BLOCK ANESTHESIA,,,,,0
HCPCS,D9212,TRIGEMINAL BLOCK ANESTHESIA,,,,,0
HCPCS,D9215,LOCAL ANESTHESIA,,,,,0
HCPCS,D9219,EVAL MOD/DEEP SED/GEN ANEST,,,,,0
HCPCS,D9222,"DEEP ANEST, 1ST 15 MIN",,,,,0
HCPCS,D9223,GENERAL ANESTH EA ADDL 15 MI,,,,,0
HCPCS,D9230,ANALGESIA,,,,,0
HCPCS,D9239,"IV MOD SEDATION, 1ST 15 MIN",,,,,0
HCPCS,D9243,IV SEDATION EA ADDL 15M,,,,,0
HCPCS,D9248,SEDATION (NON-IV),,,,,0
HCPCS,D9310,DENTAL CONSULTATION,,,,,0
HCPCS,D9311,CONSULT W/MED HLTH CARE PROF,,,,,0
HCPCS,D9410,DENTAL HOUSE CALL,,,,,0
HCPCS,D9420,HOSPITAL/ASC CALL,,,,,0
HCPCS,D9430,OFFICE VISIT DURING HOURS,,,,,0
HCPCS,D9440,OFFICE VISIT AFTER HOURS,,,,,0
HCPCS,D9450,CASE PRESENTATION TX PLAN,,,,,0
HCPCS,D9610,DENT THERAPEUTIC DRUG INJECT,,,,,0
HCPCS,D9612,THERA PAR DRUGS 2 OR > ADMIN,,,,,0
HCPCS,D9613,INFILTRATION THERA DRUG,,,,,0
HCPCS,D9630,DRUGS/MEDS DISP FOR HOME USE,,,,,0
HCPCS,D9910,DENT APPL DESENSITIZING MED,,,,,0
HCPCS,D9911,APPL DESENSITIZING RESIN,,,,,0
HCPCS,D9912,PRE-VISIT PATIENT SCREENING,,,,,0
HCPCS,D9920,BEHAVIOR MANAGEMENT,,,,,0
HCPCS,D9930,TREATMENT OF COMPLICATIONS,,,628.23,1256.46,8
HCPCS,D9932,CLEAN & INSPECT REM DENT MAX,,,,,0
HCPCS,D9933,CLEAN & INSPECT REM DENT MAN,,,,,0
HCPCS,D9934,CLEAN REM PART DENTURE MAX,,,,,0
HCPCS,D9935,CLEAN REM PART DENTURE MAND,,,,,0
HCPCS,D9938,FAB REMOVABLE APPLIANCE,,,,,0
HCPCS,D9939,PLACEMNT REMOVABLE APPLIANCE,,,,,0
HCPCS,D9941,FABRICATION ATHLETIC GUARD,,,,,0
HCPCS,D9942,REPAIR/RELINE OCCLUSAL GUARD,,,,,0
HCPCS,D9943,OCCLUSAL GUARD ADJUSTMENT,,,,,0
HCPCS,D9944,"OCC GUARD, HARD, FULL ARCH",,,628.23,1256.46,8
HCPCS,D9945,"OCC GUARD, SOFT, FULL ARCH",,,628.23,1256.46,8
HCPCS,D9946,"OCC GUARD, HARD, PART ARCH",,,628.23,1256.46,8
HCPCS,D9947,SLEEP APNEA APPLIANCE,,,,,0
HCPCS,D9948,ADJUST SLEEP APNEA APPLIANCE,,,,,0
HCPCS,D9949,REPAIR SLEEP APNEA APPLIANCE,,,,,0
HCPCS,D9950,OCCLUSION ANALYSIS,,,628.23,1256.46,8
HCPCS,D9951,LIMITED OCCLUSAL ADJUSTMENT,,,628.23,1256.46,8
HCPCS,D9952,COMPLETE OCCLUSAL ADJUSTMENT,,,628.23,1256.46,8
HCPCS,D9953,RELINE SLEEP APNEA APPLIANCE,,,,,0
HCPCS,D9954,FAB/DEL ORAL APPLIANCE THXPY,,,,,0
HCPCS,D9955,ORAL APP THXPY TITRATION VIS,,,,,0
HCPCS,D9956,ADMIN HOME SLEEP APNEA TEST,,,,,0
HCPCS,D9957,SCREENING SLEEP DISORDERS,,,,,0
HCPCS,D9961,DUP/COPY PATIENT'S RECORDS,,,,,0
HCPCS,D9970,ENAMEL MICROABRASION,,,,,0
HCPCS,D9971,ODONTOPLASTY PER TOOTH,,,,,0
HCPCS,D9972,EXTRNL BLEACHING PER ARCH,,,,,0
HCPCS,D9973,EXTRNL BLEACHING PER TOOTH,,,,,0
HCPCS,D9974,INTRNL BLEACHING PER TOOTH,,,,,0
HCPCS,D9975,EXTERNAL BLEACHING HOME APP,,,,,0
HCPCS,D9985,SALES TAX,,,,,0
HCPCS,D9986,MISSED APPOINTMENT,,,,,0
HCPCS,D9987,CANCELLED APPOINTMENT,,,,,0
HCPCS,D9990,TRANS OR SIGN LANGUAGE SVCS,,,,,0
HCPCS,D9991,"CASE MGMT, APPT BARRIERS",,,,,0
HCPCS,D9992,"CASE MGMT, CARE COORDINATION",,,,,0
HCPCS,D9993,"CASE MGMT, INTERVIEWING",,,,,0
HCPCS,D9994,"CASE MGMT, PT EDUCATION",,,,,0
HCPCS,D9995,TELEDENTISTRY REAL-TIME,,,,,0
HCPCS,D9996,TELEDENTISTRY DENT REVIEW,,,,,0
HCPCS,D9997,DENT CASE MGMT SPECIAL NEEDS,,,,,0
HCPCS,D9999,ADJUNCTIVE PROCEDURE,,,,,0
HCPCS,E0100,DME POS,,,25.53,51.06,8
HCPCS,E0105,DME POS,,,67.81,135.62,8
HCPCS,E0110,DME POS,,,106.64,213.28,8
HCPCS,E0111,DME POS,,,64.5,129.0,8
HCPCS,E0112,DME POS,,,47.91,95.82,8
HCPCS,E0113,DME POS,,,25.61,51.22,8
HCPCS,E0114,DME POS,,,57.17,114.34,8
HCPCS,E0116,DME POS,,,33.62,67.24,8
HCPCS,E0117,DME POS,,,27.45,54.9,8
HCPCS,E0118,CRUTCH SUBSTITUTE,,,,,0
HCPCS,E0130,DME POS,,,57.37,114.74,8
HCPCS,E0135,DME POS,,,57.62,115.24,8
HCPCS,E0140,DME POS,,,36.02,72.04,8
HCPCS,E0141,DME POS,,,60.89,121.78,8
HCPCS,E0143,DME POS,,,60.89,121.78,8
HCPCS,E0144,DME POS,,,34.36,68.72,8
HCPCS,E0147,DME POS,,,507.23,1014.46,8
HCPCS,E0148,DME POS,,,105.3,210.6,8
HCPCS,E0149,DME POS,,,15.69,31.38,8
HCPCS,E0152,"Walker, battery power wheels",,,,,0
HCPCS,E0153,DME POS,,,98.9,197.8,8
HCPCS,E0154,DME POS,,,59.52,119.04,8
HCPCS,E0155,DME POS,,,25.39,50.78,8
HCPCS,E0156,DME POS,,,20.08,40.16,8
HCPCS,E0157,DME POS,,,71.81,143.62,8
HCPCS,E0158,DME POS,,,26.94,53.88,8
HCPCS,E0159,DME POS,,,18.71,37.42,8
HCPCS,E0160,DME POS,,,33.39,66.78,8
HCPCS,E0161,DME POS,,,31.28,62.56,8
HCPCS,E0162,DME POS,,,176.5,353.0,8
HCPCS,E0163,DME POS,,,68.25,136.5,8
HCPCS,E0165,DME POS,,,15.72,31.44,8
HCPCS,E0167,DME POS,,,12.63,25.26,8
HCPCS,E0168,DME POS,,,150.5,301.0,8
HCPCS,E0170,DME POS,,,202.0,404.0,8
HCPCS,E0171,DME POS,,,37.12,74.24,8
HCPCS,E0172,SEAT LIFT MECHANISM TOILET,,,,,0
HCPCS,E0175,DME POS,,,94.39,188.78,8
HCPCS,E0181,DME POS,,,19.77,39.54,8
HCPCS,E0182,DME POS,,,24.53,49.06,8
HCPCS,E0183,DME POS,,,19.77,39.54,8
HCPCS,E0184,DME POS,,,202.16,404.32,8
HCPCS,E0185,DME POS,,,215.85,431.7,8
HCPCS,E0186,DME POS,,,22.53,45.06,8
HCPCS,E0187,DME POS,,,24.56,49.12,8
HCPCS,E0188,DME POS,,,30.06,60.12,8
HCPCS,E0189,DME POS,,,62.41,124.82,8
HCPCS,E0190,POSITIONING CUSHION,,,,,0
HCPCS,E0191,DME POS,,,12.1,24.2,8
HCPCS,E0193,DME POS,,,864.83,1729.66,8
HCPCS,E0194,DME POS,,,4054.55,8109.1,8
HCPCS,E0196,DME POS,,,37.71,75.42,8
HCPCS,E0197,DME POS,,,21.12,42.24,8
HCPCS,E0198,DME POS,,,31.18,62.36,8
HCPCS,E0199,DME POS,,,36.95,73.9,8
HCPCS,E0200,DME POS,,,112.99,225.98,8
HCPCS,E0201,"Penile contracture device, manual, greater than 3 lbs traction force",,,146.52,293.04,8
HCPCS,E0202,DME POS,,,89.25,178.5,8
HCPCS,E0203,THERAPEUTIC LIGHTBOX TABLETP,,,,,0
HCPCS,E0205,DME POS,,,276.56,553.12,8
HCPCS,E0210,DME POS,,,39.56,79.12,8
HCPCS,E0215,DME POS,,,100.96,201.92,8
HCPCS,E0217,DME POS,,,707.53,1415.06,8
HCPCS,E0218,FLUID CIRC COLD PAD W PUMP,,,,,0
HCPCS,E0221,INFRARED HEATING PAD SYSTEM,,,,,0
HCPCS,E0225,DME POS,,,553.88,1107.76,8
HCPCS,E0231,WOUND WARMING DEVICE,,,,,0
HCPCS,E0232,WARMING CARD FOR NWT,,,,,0
HCPCS,E0235,DME POS,,,23.48,46.96,8
HCPCS,E0236,DME POS,,,63.06,126.12,8
HCPCS,E0239,DME POS,,,544.91,1089.82,8
HCPCS,E0240,BATH/SHOWER CHAIR,,,,,0
HCPCS,E0241,BATH TUB WALL RAIL,,,,,0
HCPCS,E0242,BATH TUB RAIL FLOOR,,,,,0
HCPCS,E0243,TOILET RAIL,,,,,0
HCPCS,E0244,TOILET SEAT RAISED,,,,,0
HCPCS,E0245,TUB STOOL OR BENCH,,,,,0
HCPCS,E0246,TRANSFER TUB RAIL ATTACHMENT,,,,,0
HCPCS,E0247,TRANS BENCH W/WO COMM OPEN,,,,,0
HCPCS,E0248,HDTRANS BENCH W/WO COMM OPEN,,,,,0
HCPCS,E0249,DME POS,,,141.94,283.88,8
HCPCS,E0250,DME POS,,,76.95,153.9,8
HCPCS,E0251,DME POS,,,71.12,142.24,8
HCPCS,E0255,DME POS,,,77.94,155.88,8
HCPCS,E0256,DME POS,,,74.17,148.34,8
HCPCS,E0260,DME POS,,,78.16,156.32,8
HCPCS,E0261,DME POS,,,77.86,155.72,8
HCPCS,E0265,DME POS,,,184.01,368.02,8
HCPCS,E0266,DME POS,,,160.11,320.22,8
HCPCS,E0270,HOSPITAL BED INSTITUTIONAL T,,,,,0
HCPCS,E0271,DME POS,,,158.65,317.3,8
HCPCS,E0272,DME POS,,,178.16,356.32,8
HCPCS,E0273,BED BOARD,,,,,0
HCPCS,E0274,OVER-BED TABLE,,,,,0
HCPCS,E0275,DME POS,,,17.05,34.1,8
HCPCS,E0276,DME POS,,,14.21,28.42,8
HCPCS,E0277,DME POS,,,251.55,503.1,8
HCPCS,E0280,DME POS,,,38.17,76.34,8
HCPCS,E0290,DME POS,,,70.6,141.2,8
HCPCS,E0291,DME POS,,,53.75,107.5,8
HCPCS,E0292,DME POS,,,74.79,149.58,8
HCPCS,E0293,DME POS,,,68.19,136.38,8
HCPCS,E0294,DME POS,,,78.02,156.04,8
HCPCS,E0295,DME POS,,,77.86,155.72,8
HCPCS,E0296,DME POS,,,143.57,287.14,8
HCPCS,E0297,DME POS,,,126.69,253.38,8
HCPCS,E0300,DME POS,,,319.91,639.82,8
HCPCS,E0301,DME POS,,,209.92,419.84,8
HCPCS,E0302,DME POS,,,603.69,1207.38,8
HCPCS,E0303,DME POS,,,213.92,427.84,8
HCPCS,E0304,DME POS,,,627.1,1254.2,8
HCPCS,E0305,DME POS,,,13.74,27.48,8
HCPCS,E0310,DME POS,,,145.26,290.52,8
HCPCS,E0315,BED ACCESSORY BRD/TBL/SUPPRT,,,,,0
HCPCS,E0316,DME POS,,,259.52,519.04,8
HCPCS,E0325,DME POS,,,11.01,22.02,8
HCPCS,E0326,DME POS,,,11.79,23.58,8
HCPCS,E0328,"PED HOSPITAL BED, MANUAL",,,,,0
HCPCS,E0329,PED HOSPITAL BED SEMI/ELECT,,,,,0
HCPCS,E0350,CONTROL UNIT BOWEL SYSTEM,,,,,0
HCPCS,E0352,DISPOSABLE PACK W/BOWEL SYST,,,,,0
HCPCS,E0370,AIR ELEVATOR FOR HEEL,,,,,0
HCPCS,E0371,DME POS,,,251.55,503.1,8
HCPCS,E0372,DME POS,,,251.55,503.1,8
HCPCS,E0373,DME POS,,,251.55,503.1,8
HCPCS,E0424,DME POS,,,100.21,200.42,8
HCPCS,E0425,GAS SYSTEM STATIONARY COMPRE,,,,,0
HCPCS,E0430,OXYGEN SYSTEM GAS PORTABLE,,,,,0
HCPCS,E0431,DME POS,,,22.14,44.28,8
HCPCS,E0433,DME POS,,,47.94,95.88,8
HCPCS,E0434,DME POS,,,47.94,95.88,8
HCPCS,E0435,OXYGEN SYSTEM LIQUID PORTABL,,,,,0
HCPCS,E0439,DME POS,,,100.21,200.42,8
HCPCS,E0440,OXYGEN SYSTEM LIQUID STATION,,,,,0
HCPCS,E0441,DME POS,,,68.28,136.56,8
HCPCS,E0442,DME POS,,,68.28,136.56,8
HCPCS,E0443,DME POS,,,61.86,123.72,8
HCPCS,E0444,DME POS,,,61.86,123.72,8
HCPCS,E0445,OXIMETER NON-INVASIVE,,,,,0
HCPCS,E0446,"TOPICAL OX DELIVER SYS, NOS",,,,,0
HCPCS,E0447,DME POS,,,92.79,185.58,8
HCPCS,E0455,OXYGEN TENT EXCL CROUP/PED T,,,,,0
HCPCS,E0457,CHEST SHELL,,,,,0
HCPCS,E0459,CHEST WRAP,,,,,0
HCPCS,E0462,DME POS,,,394.35,788.7,8
HCPCS,E0465,DME POS,,,1360.33,2720.66,8
HCPCS,E0466,DME POS,,,1360.33,2720.66,8
HCPCS,E0467,DME POS,,,1573.04,3146.08,8
HCPCS,E0468,Home vent dual fnct incl all,,,1462.47,2924.94,8
HCPCS,E0469,"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device",,,1567.42,3134.84,8
HCPCS,E0470,DME POS,,,133.94,267.88,8
HCPCS,E0471,DME POS,,,329.87,659.74,8
HCPCS,E0472,DME POS,,,498.67,997.34,8
HCPCS,E0480,DME POS,,,55.98,111.96,8
HCPCS,E0481,INTRPULMNRY PERCUSS VENT SYS,,,,,0
HCPCS,E0482,DME POS,,,612.86,1225.72,8
HCPCS,E0483,DME POS,,,1515.12,3030.24,8
HCPCS,E0484,DME POS,,,52.64,105.28,8
HCPCS,E0485,DME POS,,,,,0
HCPCS,E0486,DME POS,,,,,0
HCPCS,E0487,ELECTRONIC SPIROMETER,,,,,0
HCPCS,E0490,DME POS,,,111.34,222.68,8
HCPCS,E0491,DME POS,,,105.37,210.74,8
HCPCS,E0492,CONTROL UNIT NM STIM W PHONE,,,,,0
HCPCS,E0493,ORAL DV/APP NEUROMUS MOUTHPI,,,,,0
HCPCS,E0500,DME POS,,,145.88,291.76,8
HCPCS,E0530,DME POS,,,37.12,74.24,8
HCPCS,E0550,DME POS,,,71.45,142.9,8
HCPCS,E0555,HUMIDIFIER FOR USE W/ REGULA,,,,,0
HCPCS,E0560,DME POS,,,200.69,401.38,8
HCPCS,E0561,DME POS,,,92.23,184.46,8
HCPCS,E0562,DME POS,,,173.83,347.66,8
HCPCS,E0565,DME POS,,,51.98,103.96,8
HCPCS,E0570,DME POS,,,7.36,14.72,8
HCPCS,E0572,DME POS,,,39.44,78.88,8
HCPCS,E0574,DME POS,,,57.36,114.72,8
HCPCS,E0575,DME POS,,,124.51,249.02,8
HCPCS,E0580,DME POS,,,164.65,329.3,8
HCPCS,E0585,DME POS,,,37.2,74.4,8
HCPCS,E0600,DME POS,,,65.25,130.5,8
HCPCS,E0601,DME POS,,,51.94,103.88,8
HCPCS,E0602,DME POS,,,42.06,84.12,8
HCPCS,E0603,ELECTRIC BREAST PUMP,,,,,0
HCPCS,E0604,HOSP GRADE ELEC BREAST PUMP,,,,,0
HCPCS,E0605,DME POS,,,31.99,63.98,8
HCPCS,E0606,DME POS,,,32.7,65.4,8
HCPCS,E0607,DME POS,,,95.23,190.46,8
HCPCS,E0610,DME POS,,,299.88,599.76,8
HCPCS,E0615,DME POS,,,682.34,1364.68,8
HCPCS,E0616,CARDIAC EVENT RECORDER,,,,,0
HCPCS,E0617,DME POS,,,433.3,866.6,8
HCPCS,E0618,DME POS,,,399.55,799.1,8
HCPCS,E0619,DME POS,,,,,0
HCPCS,E0620,DME POS,,,124.59,249.18,8
HCPCS,E0621,DME POS,,,99.77,199.54,8
HCPCS,E0625,PATIENT LIFT BATHROOM OR TOI,,,,,0
HCPCS,E0627,DME POS,,,324.15,648.3,8
HCPCS,E0629,DME POS,,,322.69,645.38,8
HCPCS,E0630,DME POS,,,74.07,148.14,8
HCPCS,E0635,DME POS,,,144.9,289.8,8
HCPCS,E0636,DME POS,,,1224.53,2449.06,8
HCPCS,E0637,COMBINATION SIT TO STAND SYS,,,,,0
HCPCS,E0638,STANDING FRAME SYS,,,,,0
HCPCS,E0639,DME POS,,,158.98,317.96,8
HCPCS,E0640,DME POS,,,158.98,317.96,8
HCPCS,E0641,MULTI-POSITION STND FRAM SYS,,,,,0
HCPCS,E0642,DYNAMIC STANDING FRAME,,,,,0
HCPCS,E0650,DME POS,,,904.67,1809.34,8
HCPCS,E0651,DME POS,,,1308.85,2617.7,8
HCPCS,E0652,DME POS,,,7555.31,15110.62,8
HCPCS,E0655,DME POS,,,137.65,275.3,8
HCPCS,E0656,DME POS,,,82.35,164.7,8
HCPCS,E0657,DME POS,,,77.37,154.74,8
HCPCS,E0660,DME POS,,,227.66,455.32,8
HCPCS,E0665,DME POS,,,187.4,374.8,8
HCPCS,E0666,DME POS,,,184.64,369.28,8
HCPCS,E0667,DME POS,,,461.41,922.82,8
HCPCS,E0668,DME POS,,,629.74,1259.48,8
HCPCS,E0669,DME POS,,,255.52,511.04,8
HCPCS,E0670,DME POS,,,1791.47,3582.94,8
HCPCS,E0671,DME POS,,,591.94,1183.88,8
HCPCS,E0672,DME POS,,,459.92,919.84,8
HCPCS,E0673,DME POS,,,382.16,764.32,8
HCPCS,E0675,DME POS,,,548.03,1096.06,8
HCPCS,E0676,INTER LIMB COMPRESS DEV NOS,,,,,0
HCPCS,E0677,DME POS,,,82.35,164.7,8
HCPCS,E0678,DME POS,,,46.14,92.28,8
HCPCS,E0679,DME POS,,,25.55,51.1,8
HCPCS,E0680,DME POS,,,755.53,1511.06,8
HCPCS,E0681,DME POS,,,130.89,261.78,8
HCPCS,E0682,DME POS,,,62.97,125.94,8
HCPCS,E0683,"Non-pneumatic, non-sequential, peristaltic wave compression pump",,,81.53,163.06,8
HCPCS,E0691,DME POS,,,1280.61,2561.22,8
HCPCS,E0692,DME POS,,,1608.1,3216.2,8
HCPCS,E0693,DME POS,,,1982.33,3964.66,8
HCPCS,E0694,DME POS,,,6309.58,12619.16,8
HCPCS,E0700,SAFETY EQUIPMENT,,,,,0
HCPCS,E0705,DME POS,,,61.46,122.92,8
HCPCS,E0710,RESTRAINTS ANY TYPE,,,,,0
HCPCS,E0711,UE ENCLOSURE RESTR ROM,,,,,0
HCPCS,E0715,Intravaginal device intended to strengthen pelvic floor muscles during kegel exercises,,,,,0
HCPCS,E0720,DME POS,,,91.39,182.78,8
HCPCS,E0721,Transcutaneous electrical nerve stimulator for nerves in the auricular region,,,,,0
HCPCS,E0730,DME POS,,,92.34,184.68,8
HCPCS,E0731,DME POS,,,114.47,228.94,8
HCPCS,E0732,DME POS,,,52.38,104.76,8
HCPCS,E0733,DME POS,,,52.38,104.76,8
HCPCS,E0734,DME POS,,,448.33,896.66,8
HCPCS,E0735,DME POS,,,52.38,104.76,8
HCPCS,E0736,Transcut tibial nerv stimula,,,52.38,104.76,8
HCPCS,E0737,"Transcutaneous tibial nerve stimulator, controlled by phone application",,,,,0
HCPCS,E0738,Upper extremity rehab,,,2039.64,4079.28,8
HCPCS,E0739,Rehab sys active assist rt,,,1597.66,3195.32,8
HCPCS,E0740,DME POS,,,74.52,149.04,8
HCPCS,E0743,"External lower extremity nerve stimulator for restless legs syndrome, each",,,242.2,484.4,8
HCPCS,E0744,DME POS,,,111.34,222.68,8
HCPCS,E0745,DME POS,,,111.34,222.68,8
HCPCS,E0746,ELECTROMYOGRAPH BIOFEEDBACK,,,,,0
HCPCS,E0747,DME POS,,,5580.94,11161.88,8
HCPCS,E0748,DME POS,,,5544.8,11089.6,8
HCPCS,E0749,DME POS,,,344.47,688.94,8
HCPCS,E0755,ELECTRONIC SALIVARY REFLEX S,,,,,0
HCPCS,E0760,DME POS,,,4607.62,9215.24,8
HCPCS,E0761,NONTHERM ELECTROMGNTC DEVICE,,,,,0
HCPCS,E0762,DME POS,,,156.7,313.4,8
HCPCS,E0764,DME POS,,,1577.14,3154.28,8
HCPCS,E0765,DME POS,,,,,0
HCPCS,E0766,DME POS,,,16384.73,32769.46,8
HCPCS,E0767,"Intrabuccal, systemic delivery of amplitude-modulated, radiofrequency electromagnetic field device, for cancer treatment, includes all accessories",,,,,0
HCPCS,E0769,ELECTRIC WOUND TREATMENT DEV,,,,,0
HCPCS,E0770,FUNCTIONAL ELECTRIC STIM NOS,,,,,0
HCPCS,E0776,DME PEN,,,183.72,367.44,8
HCPCS,E0779,DME POS,,,23.83,47.66,8
HCPCS,E0780,DME POS,,,14.78,29.56,8
HCPCS,E0781,DME POS,,,309.33,618.66,8
HCPCS,E0782,DME POS,,,6118.73,12237.46,8
HCPCS,E0783,DME POS,,,9917.33,19834.66,8
HCPCS,E0784,DME POS,,,557.75,1115.5,8
HCPCS,E0785,DME POS,,,572.38,1144.76,8
HCPCS,E0786,DME POS,,,11380.88,22761.76,8
HCPCS,E0787,CGS DOSE ADJ INSULIN INF PMP,,,,,0
HCPCS,E0791,DME POS,,,367.48,734.96,8
HCPCS,E0830,AMBULATORY TRACTION DEVICE,,,,,0
HCPCS,E0840,DME POS,,,88.76,177.52,8
HCPCS,E0849,DME POS,,,73.45,146.9,8
HCPCS,E0850,DME POS,,,133.7,267.4,8
HCPCS,E0855,DME POS,,,71.63,143.26,8
HCPCS,E0856,DME POS,,,21.93,43.86,8
HCPCS,E0860,DME POS,,,48.42,96.84,8
HCPCS,E0870,DME POS,,,140.9,281.8,8
HCPCS,E0880,DME POS,,,152.07,304.14,8
HCPCS,E0890,DME POS,,,145.84,291.68,8
HCPCS,E0900,DME POS,,,155.23,310.46,8
HCPCS,E0910,DME POS,,,13.95,27.9,8
HCPCS,E0911,DME POS,,,53.02,106.04,8
HCPCS,E0912,DME POS,,,106.41,212.82,8
HCPCS,E0920,DME POS,,,65.78,131.56,8
HCPCS,E0930,DME POS,,,65.1,130.2,8
HCPCS,E0935,DME POS,,,29.95,59.9,8
HCPCS,E0936,"CPM DEVICE, OTHER THAN KNEE",,,,,0
HCPCS,E0940,DME POS,,,26.33,52.66,8
HCPCS,E0941,DME POS,,,61.85,123.7,8
HCPCS,E0942,DME POS,,,24.04,48.08,8
HCPCS,E0944,DME POS,,,59.35,118.7,8
HCPCS,E0945,DME POS,,,61.05,122.1,8
HCPCS,E0946,DME POS,,,76.64,153.28,8
HCPCS,E0947,DME POS,,,752.85,1505.7,8
HCPCS,E0948,DME POS,,,752.85,1505.7,8
HCPCS,E0950,DME POS,,,94.5,189.0,8
HCPCS,E0951,DME POS,,,16.36,32.72,8
HCPCS,E0952,DME POS,,,20.74,41.48,8
HCPCS,E0953,DME POS,,,93.36,186.72,8
HCPCS,E0954,DME POS,,,66.59,133.18,8
HCPCS,E0955,DME POS,,,17.71,35.42,8
HCPCS,E0956,DME POS,,,93.36,186.72,8
HCPCS,E0957,DME POS,,,148.11,296.22,8
HCPCS,E0958,DME POS,,,50.53,101.06,8
HCPCS,E0959,DME POS,,,52.91,105.82,8
HCPCS,E0960,DME POS,,,89.73,179.46,8
HCPCS,E0961,DME POS,,,24.62,49.24,8
HCPCS,E0966,DME POS,,,84.94,169.88,8
HCPCS,E0967,DME POS,,,88.62,177.24,8
HCPCS,E0968,DME POS,,,25.54,51.08,8
HCPCS,E0969,DME POS,,,223.22,446.44,8
HCPCS,E0970,WHEELCHAIR NO. 2 FOOTPLATES,,,,,0
HCPCS,E0971,DME POS,,,38.35,76.7,8
HCPCS,E0973,DME POS,,,70.58,141.16,8
HCPCS,E0974,DME POS,,,89.6,179.2,8
HCPCS,E0978,DME POS,,,30.95,61.9,8
HCPCS,E0980,DME POS,,,40.04,80.08,8
HCPCS,E0981,DME POS,,,51.97,103.94,8
HCPCS,E0982,DME POS,,,53.8,107.6,8
HCPCS,E0983,DME POS,,,356.18,712.36,8
HCPCS,E0984,DME POS,,,272.27,544.54,8
HCPCS,E0985,DME POS,,,25.96,51.92,8
HCPCS,E0986,DME POS,,,693.24,1386.48,8
HCPCS,E0988,DME POS,,,422.47,844.94,8
HCPCS,E0990,DME POS,,,93.12,186.24,8
HCPCS,E0992,DME POS,,,100.61,201.22,8
HCPCS,E0994,DME POS,,,23.86,47.72,8
HCPCS,E0995,DME POS,,,33.4,66.8,8
HCPCS,E1002,DME POS,,,463.44,926.88,8
HCPCS,E1003,DME POS,,,539.4,1078.8,8
HCPCS,E1004,DME POS,,,596.22,1192.44,8
HCPCS,E1005,DME POS,,,647.36,1294.72,8
HCPCS,E1006,DME POS,,,792.95,1585.9,8
HCPCS,E1007,DME POS,,,998.21,1996.42,8
HCPCS,E1008,DME POS,,,1023.89,2047.78,8
HCPCS,E1009,DME POS,,,,,0
HCPCS,E1010,DME POS,,,139.14,278.28,8
HCPCS,E1011,DME POS,,,,,0
HCPCS,E1012,DME POS,,,139.14,278.28,8
HCPCS,E1014,DME POS,,,52.06,104.12,8
HCPCS,E1015,DME POS,,,146.36,292.72,8
HCPCS,E1016,DME POS,,,133.52,267.04,8
HCPCS,E1017,DME POS,,,,,0
HCPCS,E1018,DME POS,,,,,0
HCPCS,E1020,DME POS,,,22.42,44.84,8
HCPCS,E1022,"Wheelchair transportation securement system, any type includes all components and accessories",,,,,0
HCPCS,E1023,"Wheelchair transit securement system, includes all components and accessories",,,,,0
HCPCS,E1028,DME POS,,,17.19,34.38,8
HCPCS,E1029,DME POS,,,45.38,90.76,8
HCPCS,E1030,DME POS,,,143.14,286.28,8
HCPCS,E1031,DME POS,,,52.65,105.3,8
HCPCS,E1032,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface",,,17.19,34.38,8
HCPCS,E1033,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type",,,17.19,34.38,8
HCPCS,E1034,"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type",,,17.19,34.38,8
HCPCS,E1035,DME POS,,,733.41,1466.82,8
HCPCS,E1036,DME POS,,,1044.05,2088.1,8
HCPCS,E1037,DME POS,,,129.67,259.34,8
HCPCS,E1038,DME POS,,,19.04,38.08,8
HCPCS,E1039,DME POS,,,40.46,80.92,8
HCPCS,E1050,DME POS,,,135.84,271.68,8
HCPCS,E1060,DME POS,,,158.57,317.14,8
HCPCS,E1070,DME POS,,,143.89,287.78,8
HCPCS,E1083,DME POS,,,99.22,198.44,8
HCPCS,E1084,DME POS,,,129.2,258.4,8
HCPCS,E1085,HEMI-WHEELCHAIR FIXED ARMS,,,,,0
HCPCS,E1086,HEMI-WHEELCHAIR DETACHABLE A,,,,,0
HCPCS,E1087,DME POS,,,178.44,356.88,8
HCPCS,E1088,DME POS,,,189.23,378.46,8
HCPCS,E1089,WHEELCHAIR LIGHTWT FIXED ARM,,,,,0
HCPCS,E1090,WHEELCHAIR LIGHTWEIGHT DET A,,,,,0
HCPCS,E1092,DME POS,,,183.15,366.3,8
HCPCS,E1093,DME POS,,,157.51,315.02,8
HCPCS,E1100,DME POS,,,125.74,251.48,8
HCPCS,E1110,DME POS,,,144.86,289.72,8
HCPCS,E1130,WHLCHR STAND FXD ARM FT REST,,,,,0
HCPCS,E1140,WHEELCHAIR STANDARD DETACH A,,,,,0
HCPCS,E1150,DME POS,,,103.48,206.96,8
HCPCS,E1160,DME POS,,,75.73,151.46,8
HCPCS,E1161,DME POS,,,337.19,674.38,8
HCPCS,E1170,DME POS,,,108.21,216.42,8
HCPCS,E1171,DME POS,,,97.09,194.18,8
HCPCS,E1172,DME POS,,,120.17,240.34,8
HCPCS,E1180,DME POS,,,125.7,251.4,8
HCPCS,E1190,DME POS,,,141.81,283.62,8
HCPCS,E1195,DME POS,,,152.17,304.34,8
HCPCS,E1200,DME POS,,,106.71,213.42,8
HCPCS,E1220,WHLCHR SPECIAL SIZE/CONSTRC,,,,,0
HCPCS,E1221,DME POS,,,57.56,115.12,8
HCPCS,E1222,DME POS,,,82.09,164.18,8
HCPCS,E1223,DME POS,,,89.66,179.32,8
HCPCS,E1224,DME POS,,,98.31,196.62,8
HCPCS,E1225,DME POS,,,46.81,93.62,8
HCPCS,E1226,DME POS,,,494.01,988.02,8
HCPCS,E1227,DME POS,,,395.48,790.96,8
HCPCS,E1228,DME POS,,,33.95,67.9,8
HCPCS,E1229,PEDIATRIC WHEELCHAIR NOS,,,,,0
HCPCS,E1230,DME POS,,,2739.88,5479.76,8
HCPCS,E1231,DME POS,,,,,0
HCPCS,E1232,DME POS,,,304.78,609.56,8
HCPCS,E1233,DME POS,,,315.76,631.52,8
HCPCS,E1234,DME POS,,,274.91,549.82,8
HCPCS,E1235,DME POS,,,264.72,529.44,8
HCPCS,E1236,DME POS,,,233.55,467.1,8
HCPCS,E1237,DME POS,,,235.57,471.14,8
HCPCS,E1238,DME POS,,,233.55,467.1,8
HCPCS,E1239,PED POWER WHEELCHAIR NOS,,,,,0
HCPCS,E1240,DME POS,,,128.51,257.02,8
HCPCS,E1250,WHEELCHAIR LIGHTWT FIXED ARM,,,,,0
HCPCS,E1260,WHEELCHAIR LIGHTWT FOOT REST,,,,,0
HCPCS,E1270,DME POS,,,102.23,204.46,8
HCPCS,E1280,DME POS,,,178.67,357.34,8
HCPCS,E1285,WHEELCHAIR HEAVY DUTY FIXED,,,,,0
HCPCS,E1290,WHEELCHAIR HVY DUTY DETACH A,,,,,0
HCPCS,E1295,DME POS,,,157.37,314.74,8
HCPCS,E1296,DME POS,,,654.45,1308.9,8
HCPCS,E1297,DME POS,,,133.76,267.52,8
HCPCS,E1298,DME POS,,,603.77,1207.54,8
HCPCS,E1300,WHIRLPOOL PORTABLE,,,,,0
HCPCS,E1301,WHIRLPOOL TUB WALKIN PORTABL,,,,,0
HCPCS,E1310,DME POS,,,3060.36,6120.72,8
HCPCS,E1352,O2 FLOW REG POS INSPIR PRESS,,,,,0
HCPCS,E1353,DME POS,,,40.36,80.72,8
HCPCS,E1354,"WHEELED CART, PORT CYL/CONC",,,,,0
HCPCS,E1355,DME POS,,,30.42,60.84,8
HCPCS,E1356,"BATT PACK/CART, PORT CONC",,,,,0
HCPCS,E1357,"BATTERY CHARGER, PORT CONC",,,,,0
HCPCS,E1358,"DC POWER ADAPTER, PORT CONC",,,,,0
HCPCS,E1372,DME POS,,,163.04,326.08,8
HCPCS,E1390,DME POS,,,100.21,200.42,8
HCPCS,E1391,DME POS,,,100.21,200.42,8
HCPCS,E1392,DME POS,,,47.94,95.88,8
HCPCS,E1399,DURABLE MEDICAL EQUIPMENT MI,,,,,0
HCPCS,E1405,DME POS,,,137.41,274.82,8
HCPCS,E1406,DME POS,,,107.57,215.14,8
HCPCS,E1500,CENTRIFUGE,,,,,0
HCPCS,E1510,KIDNEY DIALYSATE DELIVRY SYS,,,,,0
HCPCS,E1520,HEPARIN INFUSION PUMP,,,,,0
HCPCS,E1530,REPLACEMENT AIR BUBBLE DETEC,,,,,0
HCPCS,E1540,REPLACEMENT PRESSURE ALARM,,,,,0
HCPCS,E1550,BATH CONDUCTIVITY METER,,,,,0
HCPCS,E1560,REPLACE BLOOD LEAK DETECTOR,,,,,0
HCPCS,E1570,ADJUSTABLE CHAIR FOR ESRD PT,,,,,0
HCPCS,E1575,TRANSDUCER PROTECT/FLD BAR,,,,,0
HCPCS,E1580,UNIPUNCTURE CONTROL SYSTEM,,,,,0
HCPCS,E1590,HEMODIALYSIS MACHINE,,,,,0
HCPCS,E1592,AUTO INTERM PERITONEAL DIALY,,,,,0
HCPCS,E1594,CYCLER DIALYSIS MACHINE,,,,,0
HCPCS,E1600,DELI/INSTALL CHRG HEMO EQUIP,,,,,0
HCPCS,E1610,REVERSE OSMOSIS H2O PURI SYS,,,,,0
HCPCS,E1615,DEIONIZER H2O PURI SYSTEM,,,,,0
HCPCS,E1620,REPLACEMENT BLOOD PUMP,,,,,0
HCPCS,E1625,WATER SOFTENING SYSTEM,,,,,0
HCPCS,E1629,TABLO FOR DIALYSIS SERVICE,,,,,0
HCPCS,E1630,RECIPROCATING PERITONEAL DIA,,,,,0
HCPCS,E1632,WEARABLE ARTIFICIAL KIDNEY,,,,,0
HCPCS,E1634,PERITONEAL DIALYSIS CLAMP,,,,,0
HCPCS,E1635,COMPACT TRAVEL HEMODIALYZER,,,,,0
HCPCS,E1636,SORBENT CARTRIDGES PER 10,,,,,0
HCPCS,E1637,"HEMOSTATS FOR DIALYSIS, EACH",,,,,0
HCPCS,E1639,"SCALE, EACH",,,,,0
HCPCS,E1699,DIALYSIS EQUIPMENT NOC,,,,,0
HCPCS,E1700,DME POS,,,49.15,98.3,8
HCPCS,E1701,DME POS,,,15.11,30.22,8
HCPCS,E1702,DME POS,,,32.15,64.3,8
HCPCS,E1800,DME POS,,,148.39,296.78,8
HCPCS,E1801,DME POS,,,183.86,367.72,8
HCPCS,E1802,DME POS,,,465.75,931.5,8
HCPCS,E1803,"Dynamic adjustable elbow extension only device, includes soft interface material",,,148.39,296.78,8
HCPCS,E1804,"Dynamic adjustable elbow flexion only device, includes soft interface material",,,148.39,296.78,8
HCPCS,E1805,DME POS,,,153.06,306.12,8
HCPCS,E1806,DME POS,,,150.97,301.94,8
HCPCS,E1807,"Dynamic adjustable wrist extension only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1808,"Dynamic adjustable wrist flexion only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1810,DME POS,,,150.93,301.86,8
HCPCS,E1811,DME POS,,,191.13,382.26,8
HCPCS,E1812,DME POS,,,122.55,245.1,8
HCPCS,E1813,"Dynamic adjustable knee extension only device, includes soft interface material",,,150.93,301.86,8
HCPCS,E1814,"Dynamic adjustable knee flexion only device, includes soft interface material",,,150.93,301.86,8
HCPCS,E1815,DME POS,,,153.06,306.12,8
HCPCS,E1816,DME POS,,,194.17,388.34,8
HCPCS,E1818,DME POS,,,198.21,396.42,8
HCPCS,E1820,DME POS,,,116.5,233.0,8
HCPCS,E1821,DME POS,,,149.98,299.96,8
HCPCS,E1822,"Dynamic adjustable ankle extension only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1823,"Dynamic adjustable ankle flexion only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1825,DME POS,,,153.06,306.12,8
HCPCS,E1826,"Dynamic adjustable finger extension only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1827,"Dynamic adjustable finger flexion only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1828,"Dynamic adjustable toe extension only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1829,"Dynamic adjustable toe flexion only device, includes soft interface material",,,153.06,306.12,8
HCPCS,E1830,DME POS,,,153.06,306.12,8
HCPCS,E1831,DME POS,,,93.23,186.46,8
HCPCS,E1832,"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories",,,93.23,186.46,8
HCPCS,E1840,DME POS,,,545.42,1090.84,8
HCPCS,E1841,DME POS,,,645.57,1291.14,8
HCPCS,E1902,AAC NON-ELECTRONIC BOARD,,,,,0
HCPCS,E1905,DME POS,,,674.77,1349.54,8
HCPCS,E2000,DME POS,,,73.87,147.74,8
HCPCS,E2001,DME POS,,,65.25,130.5,8
HCPCS,E2100,DME POS,,,903.96,1807.92,8
HCPCS,E2101,DME POS,,,268.71,537.42,8
HCPCS,E2102,DME POS,,,222.5,445.0,8
HCPCS,E2103,DME POS,,,286.15,572.3,8
HCPCS,E2104,Glucose monitor w cartridge,,,54.52,109.04,8
HCPCS,E2120,DME POS,,,404.05,808.1,8
HCPCS,E2201,DME POS,,,393.1,786.2,8
HCPCS,E2202,DME POS,,,552.49,1104.98,8
HCPCS,E2203,DME POS,,,533.68,1067.36,8
HCPCS,E2204,DME POS,,,921.34,1842.68,8
HCPCS,E2205,DME POS,,,42.78,85.56,8
HCPCS,E2206,DME POS,,,46.9,93.8,8
HCPCS,E2207,DME POS,,,54.21,108.42,8
HCPCS,E2208,DME POS,,,98.92,197.84,8
HCPCS,E2209,DME POS,,,100.76,201.52,8
HCPCS,E2210,DME POS,,,6.47,12.94,8
HCPCS,E2211,DME POS,,,42.08,84.16,8
HCPCS,E2212,DME POS,,,7.5,15.0,8
HCPCS,E2213,DME POS,,,35.76,71.52,8
HCPCS,E2214,DME POS,,,38.09,76.18,8
HCPCS,E2215,DME POS,,,12.34,24.68,8
HCPCS,E2216,DME POS,,,55.06,110.12,8
HCPCS,E2217,DME POS,,,48.73,97.46,8
HCPCS,E2218,DME POS,,,55.06,110.12,8
HCPCS,E2219,DME POS,,,48.73,97.46,8
HCPCS,E2220,DME POS,,,36.21,72.42,8
HCPCS,E2221,DME POS,,,32.17,64.34,8
HCPCS,E2222,DME POS,,,27.21,54.42,8
HCPCS,E2224,DME POS,,,115.4,230.8,8
HCPCS,E2225,DME POS,,,22.32,44.64,8
HCPCS,E2226,DME POS,,,47.54,95.08,8
HCPCS,E2227,DME POS,,,264.05,528.1,8
HCPCS,E2228,DME POS,,,115.16,230.32,8
HCPCS,E2230,MANUAL STANDING SYSTEM,,,,,0
HCPCS,E2231,DME POS,,,174.39,348.78,8
HCPCS,E2291,PLANAR BACK FOR PED SIZE WC,,,,,0
HCPCS,E2292,PLANAR SEAT FOR PED SIZE WC,,,,,0
HCPCS,E2293,CONTOUR BACK FOR PED SIZE WC,,,,,0
HCPCS,E2294,CONTOUR SEAT FOR PED SIZE WC,,,,,0
HCPCS,E2295,PED DYNAMIC SEATING FRAME,,,,,0
HCPCS,E2298,Pwr seat elev sys for crt,,,210.34,420.68,8
HCPCS,E2301,PWR STANDING,,,,,0
HCPCS,E2310,DME POS,,,135.7,271.4,8
HCPCS,E2311,DME POS,,,273.84,547.68,8
HCPCS,E2312,DME POS,,,284.66,569.32,8
HCPCS,E2313,DME POS,,,45.22,90.44,8
HCPCS,E2321,DME POS,,,184.38,368.76,8
HCPCS,E2322,DME POS,,,173.22,346.44,8
HCPCS,E2323,DME POS,,,84.91,169.82,8
HCPCS,E2324,DME POS,,,53.82,107.64,8
HCPCS,E2325,DME POS,,,165.45,330.9,8
HCPCS,E2326,DME POS,,,42.65,85.3,8
HCPCS,E2327,DME POS,,,320.87,641.74,8
HCPCS,E2328,DME POS,,,608.66,1217.32,8
HCPCS,E2329,DME POS,,,216.94,433.88,8
HCPCS,E2330,DME POS,,,420.33,840.66,8
HCPCS,E2331,ATTENDANT CONTROL,,,,,0
HCPCS,E2340,DME POS,,,510.69,1021.38,8
HCPCS,E2341,DME POS,,,766.12,1532.24,8
HCPCS,E2342,DME POS,,,638.45,1276.9,8
HCPCS,E2343,DME POS,,,1021.52,2043.04,8
HCPCS,E2351,DME POS,,,858.45,1716.9,8
HCPCS,E2358,GR 34 NONSEALED LEADACID,,,,,0
HCPCS,E2359,DME POS,,,204.66,409.32,8
HCPCS,E2360,DME POS,,,148.49,296.98,8
HCPCS,E2361,DME POS,,,139.43,278.86,8
HCPCS,E2362,DME POS,,,131.09,262.18,8
HCPCS,E2363,DME POS,,,180.28,360.56,8
HCPCS,E2364,DME POS,,,143.33,286.66,8
HCPCS,E2365,DME POS,,,95.44,190.88,8
HCPCS,E2366,DME POS,,,203.76,407.52,8
HCPCS,E2367,DME POS,,,459.04,918.08,8
HCPCS,E2368,DME POS,,,50.01,100.02,8
HCPCS,E2369,DME POS,,,46.72,93.44,8
HCPCS,E2370,DME POS,,,66.29,132.58,8
HCPCS,E2371,DME POS,,,169.31,338.62,8
HCPCS,E2372,DME POS,,,,,0
HCPCS,E2373,DME POS,,,98.86,197.72,8
HCPCS,E2374,DME POS,,,62.53,125.06,8
HCPCS,E2375,DME POS,,,84.05,168.1,8
HCPCS,E2376,DME POS,,,155.35,310.7,8
HCPCS,E2377,DME POS,,,57.55,115.1,8
HCPCS,E2378,DME POS,,,70.14,140.28,8
HCPCS,E2381,DME POS,,,73.56,147.12,8
HCPCS,E2382,DME POS,,,22.79,45.58,8
HCPCS,E2383,DME POS,,,150.07,300.14,8
HCPCS,E2384,DME POS,,,75.95,151.9,8
HCPCS,E2385,DME POS,,,54.69,109.38,8
HCPCS,E2386,DME POS,,,132.13,264.26,8
HCPCS,E2387,DME POS,,,61.67,123.34,8
HCPCS,E2388,DME POS,,,59.52,119.04,8
HCPCS,E2389,DME POS,,,33.27,66.54,8
HCPCS,E2390,DME POS,,,51.51,103.02,8
HCPCS,E2391,DME POS,,,21.21,42.42,8
HCPCS,E2392,DME POS,,,51.22,102.44,8
HCPCS,E2394,DME POS,,,71.04,142.08,8
HCPCS,E2395,DME POS,,,53.46,106.92,8
HCPCS,E2396,DME POS,,,64.29,128.58,8
HCPCS,E2397,DME POS,,,528.65,1057.3,8
HCPCS,E2398,DME POS,,,163.49,326.98,8
HCPCS,E2402,DME POS,,,881.94,1763.88,8
HCPCS,E2500,DME POS,,,557.3,1114.6,8
HCPCS,E2502,DME POS,,,1704.17,3408.34,8
HCPCS,E2504,DME POS,,,2248.05,4496.1,8
HCPCS,E2506,DME POS,,,3296.27,6592.54,8
HCPCS,E2508,DME POS,,,5097.15,10194.3,8
HCPCS,E2510,DME POS,,,9645.69,19291.38,8
HCPCS,E2511,DME POS,,,,,0
HCPCS,E2512,DME POS,,,,,0
HCPCS,E2513,"Accessory for speech generating device, electromyographic sensor",,,4491.0,8982.0,8
HCPCS,E2599,SGD ACCESSORY NOC,,,,,0
HCPCS,E2601,DME POS,,,49.24,98.48,8
HCPCS,E2602,DME POS,,,105.77,211.54,8
HCPCS,E2603,DME POS,,,131.76,263.52,8
HCPCS,E2604,DME POS,,,180.35,360.7,8
HCPCS,E2605,DME POS,,,256.84,513.68,8
HCPCS,E2606,DME POS,,,412.8,825.6,8
HCPCS,E2607,DME POS,,,258.53,517.06,8
HCPCS,E2608,DME POS,,,319.94,639.88,8
HCPCS,E2609,CUSTOM FABRICATE W/C CUSHION,,,,,0
HCPCS,E2610,POWERED W/C CUSHION,,,,,0
HCPCS,E2611,DME POS,,,203.62,407.24,8
HCPCS,E2612,DME POS,,,388.52,777.04,8
HCPCS,E2613,DME POS,,,382.76,765.52,8
HCPCS,E2614,DME POS,,,550.27,1100.54,8
HCPCS,E2615,DME POS,,,432.88,865.76,8
HCPCS,E2616,DME POS,,,581.73,1163.46,8
HCPCS,E2617,CUSTOM FAB W/C BACK CUSHION,,,,,0
HCPCS,E2619,DME POS,,,61.28,122.56,8
HCPCS,E2620,DME POS,,,478.01,956.02,8
HCPCS,E2621,DME POS,,,558.37,1116.74,8
HCPCS,E2622,DME POS,,,388.75,777.5,8
HCPCS,E2623,DME POS,,,491.6,983.2,8
HCPCS,E2624,DME POS,,,395.03,790.06,8
HCPCS,E2625,DME POS,,,488.89,977.78,8
HCPCS,E2626,DME POS,,,768.67,1537.34,8
HCPCS,E2627,DME POS,,,1189.35,2378.7,8
HCPCS,E2628,DME POS,,,929.28,1858.56,8
HCPCS,E2629,DME POS,,,1173.01,2346.02,8
HCPCS,E2630,DME POS,,,790.78,1581.56,8
HCPCS,E2631,DME POS,,,344.9,689.8,8
HCPCS,E2632,DME POS,,,207.43,414.86,8
HCPCS,E2633,DME POS,,,168.05,336.1,8
HCPCS,E3000,DME POS,,,244.84,489.68,8
HCPCS,E3200,"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only",,,1178.66,2357.32,8
HCPCS,E8000,POSTERIOR GAIT TRAINER,,,,,0
HCPCS,E8001,UPRIGHT GAIT TRAINER,,,,,0
HCPCS,E8002,ANTERIOR GAIT TRAINER,,,,,0
HCPCS,G0008,ADMIN INFLUENZA VIRUS VAC,,,45.5,91.0,8
HCPCS,G0009,ADMIN PNEUMOCOCCAL VACCINE,,,45.5,91.0,8
HCPCS,G0010,ADMIN HEPATITIS B VACCINE,,,45.5,91.0,8
HCPCS,G0011,"HIV PREP COUNSEL, MD 15-30M",,,,,0
HCPCS,G0012,INJECTION OF HIV PREP DRUG,,,69.97,139.94,8
HCPCS,G0013,"HIV PREP COUNSEL, CLIN STAFF",,,36.41,72.82,8
HCPCS,G0017,CRISIS PSYCHOTHERAPY 60M,,,,,0
HCPCS,G0018,ONC PRST8 MRNA 18 GEN DRE UR,,,,,0
HCPCS,G0019,COMM HLTH INTG SVS SDOH 60MN,,,98.72,197.44,8
HCPCS,G0022,COMM HLTH INTG SVS ADD 30 M,,,,,0
HCPCS,G0023,PIN SERVICE 60M PER MONTH,,,98.72,197.44,8
HCPCS,G0024,PIN SRV ADD 30 MIN PR M,,,,,0
HCPCS,G0027,SEMEN ANALYSIS,,,6.5,13.0,8
HCPCS,G0029,NO TOB SCR/CESS INT,,,,,0
HCPCS,G0030,PT SCR TOB & CESS INT,,,,,0
HCPCS,G0031,PALL SERV DURING MEAS,,,,,0
HCPCS,G0032,2+ ANTIPSY SCHIZ,,,,,0
HCPCS,G0033,2+ BENZO SEIZ,,,,,0
HCPCS,G0034,PALL SERV DURING MEAS,,,,,0
HCPCS,G0035,PT ED POS 23,,,,,0
HCPCS,G0036,PT/PTN DECLN ASSESS,,,,,0
HCPCS,G0037,PT NOT ABLE TO PARTICIPATE,,,,,0
HCPCS,G0038,CLIN PT NO REF,,,,,0
HCPCS,G0039,"PT NO REF, RN SPEC",,,,,0
HCPCS,G0040,PT PHYS/OCC THERAPY,,,,,0
HCPCS,G0041,PT/PTN DECLN REFERRAL,,,,,0
HCPCS,G0042,REF TO THERAPY,,,,,0
HCPCS,G0043,PT MECH PROS HT VALV,,,,,0
HCPCS,G0044,PT MITRAL STENOSIS,,,,,0
HCPCS,G0045,MRS 90 DAYS POST STK,,,,,0
HCPCS,G0046,NO MRS 90 DAYS POST STK,,,,,0
HCPCS,G0047,PED BLUNT HD TRAUM,,,,,0
HCPCS,G0048,PALL SERV DURING MEAS,,,,,0
HCPCS,G0049,MAIN HEMO IN-CNTR,,,,,0
HCPCS,G0050,PT W/ LMTED LIFE EXPEC,,,,,0
HCPCS,G0051,PT HOSPICE MNTH,,,,,0
HCPCS,G0052,PT PERI DIALYSIS DUR MO,,,,,0
HCPCS,G0053,ADV RHEUM PT CARE MVP,,,,,0
HCPCS,G0054,STRK CR PREV POS OUTCME MVP,,,,,0
HCPCS,G0055,ADV CARE HEART DX MVP,,,,,0
HCPCS,G0057,BEST PCT PT SAFETY EM MVP,,,,,0
HCPCS,G0058,IMPRV CARE LE JNT REPR MVP,,,,,0
HCPCS,G0059,PT SFTY POS EXP W ANETH MVP,,,,,0
HCPCS,G0060,ALLERGY/IMMUNOLOGY SS,,,,,0
HCPCS,G0061,ANESTHESIOLOGY SS,,,,,0
HCPCS,G0062,AUDIOLOGY SS,,,,,0
HCPCS,G0063,CARDIOLOGY SS,,,,,0
HCPCS,G0064,CERT NURSE MIDWIFE SS,,,,,0
HCPCS,G0065,CHIROPRACTIC SS,,,,,0
HCPCS,G0066,CLINICAL SOCIAL WORK SS,,,,,0
HCPCS,G0067,DENTISTRY SS,,,,,0
HCPCS,G0068,ADM IV INFUSION DRUG IN HOME,,,,,0
HCPCS,G0069,ADM SQ INFUSION DRUG IN HOME,,,,,0
HCPCS,G0070,ADM OF CHEMO DRUG IN HOME,,,,,0
HCPCS,G0071,COMM SVCS BY RHC/FQHC 5 MIN,,,,,0
HCPCS,G0076,CARE MANAG H VST NEW PT 20 M,,,,,0
HCPCS,G0077,CARE MANAG H VST NEW PT 30 M,,,,,0
HCPCS,G0078,CARE MANAG H VST NEW PT 45 M,,,,,0
HCPCS,G0079,CARE MANAG H VST NEW PT 60 M,,,,,0
HCPCS,G0080,CARE MANAG H VST NEW PT 75 M,,,,,0
HCPCS,G0081,CARE MAN H V EXT PT 20 MI,,,,,0
HCPCS,G0082,CARE MAN H V EXT PT 30 M,,,,,0
HCPCS,G0083,CARE MAN H V EXT PT 45 M,,,,,0
HCPCS,G0084,CARE MAN H V EXT PT 60 M,,,,,0
HCPCS,G0085,CARE MAN H V EXT PT 75 M,,,,,0
HCPCS,G0086,CARE MAN HOME CARE PLAN 30 M,,,,,0
HCPCS,G0087,CARE MAN HOME CARE PLAN 60 M,,,,,0
HCPCS,G0088,ADM IV DRUG 1ST HOME VISIT,,,,,0
HCPCS,G0089,ADM SUBQ DRUG 1ST HOME VISIT,,,,,0
HCPCS,G0090,ADM IV CHEMO 1ST HOME VISIT,,,,,0
HCPCS,G0101,CA SCREEN;PELVIC/BREAST EXAM,,,98.72,197.44,8
HCPCS,G0102,PROSTATE CA SCREENING; DRE,,,,,0
HCPCS,G0103,PROSTATE SPEC AG SCREEN,248.0,124.0,19.31,255.11,108
HCPCS,G0103,PSA SCREENING,,,,,0
HCPCS,G0104,CA SCREEN;FLEXI SIGMOIDSCOPE,,,903.7,1807.4,8
HCPCS,G0105,COLORECTAL SCRN; HI RISK IND,,,903.7,1807.4,8
HCPCS,G0108,DIAB MANAGE TRN  PER INDIV,,,,,0
HCPCS,G0109,DIAB MANAGE TRN IND/GROUP,,,,,0
HCPCS,G0117,GLAUCOMA SCRN HGH RISK DIREC,,,28.11,56.22,8
HCPCS,G0118,GLAUCOMA SCRN HGH RISK DIREC,,,36.3,72.6,8
HCPCS,G0121,COLON CA SCRN NOT HI RSK IND,,,903.7,1807.4,8
HCPCS,G0123,CYTO GYN SCREEN THIN PREP,245.0,122.5,20.26,237.65,54
HCPCS,G0123,SCREEN CERV/VAG THIN LAYER,,,,,0
HCPCS,G0124,SCREEN C/V THIN LAYER BY MD,,,,,0
HCPCS,G0127,TRIM NAIL(S),,,57.33,114.66,8
HCPCS,G0128,CORF SKILLED NURSING SERVICE,,,,,0
HCPCS,G0129,PHP/IOP OT SERVICE,,,,,0
HCPCS,G0130,SINGLE ENERGY X-RAY STUDY,,,27.9,203.18,24
HCPCS,G0136,ADM OF SOC DTR ASSESS 5-15 M,,,36.41,72.82,8
HCPCS,G0137,"INTEN OUTPT SVS,MIN 9 PR 7 D",,,,,0
HCPCS,G0138,Iv cipaglucosidase alfa-atga,,,618.73,1237.46,8
HCPCS,G0140,NAV SRV PEER SUP 60 MIN PR M,,,98.72,197.44,8
HCPCS,G0141,"SCR C/V CYTO,AUTOSYS AND MD",,,,,0
HCPCS,G0143,"SCR C/V CYTO,THINLAYER,RESCR",,,27.05,54.1,8
HCPCS,G0144,"SCR C/V CYTO,THINLAYER,RESCR",,,43.97,87.94,8
HCPCS,G0145,"SCR C/V CYTO,THINLAYER,RESCR",,,26.49,52.98,8
HCPCS,G0146,NAV SRV PEER SUP ADD 30 PR M,,,,,0
HCPCS,G0147,"SCR C/V CYTO, AUTOMATED SYS",,,18.54,37.08,8
HCPCS,G0148,"SCR C/V CYTO, AUTOSYS, RESCR",,,31.94,63.88,8
HCPCS,G0151,"HHCP-SERV OF PT,EA 15 MIN",,,,,0
HCPCS,G0152,"HHCP-SERV OF OT,EA 15 MIN",,,,,0
HCPCS,G0153,"HHCP-SVS OF S/L PATH,EA 15MN",,,,,0
HCPCS,G0155,"HHCP-SVS OF CSW,EA 15 MIN",,,,,0
HCPCS,G0156,"HHCP-SVS OF AIDE,EA 15 MIN",,,,,0
HCPCS,G0157,HHC PT ASSISTANT EA 15,,,,,0
HCPCS,G0158,HHC OT ASSISTANT EA 15,,,,,0
HCPCS,G0159,HHC PT MAINT EA 15 MIN,,,,,0
HCPCS,G0160,HHC OCCUP THERAPY EA 15,,,,,0
HCPCS,G0161,HHC SLP EA 15 MIN,,,,,0
HCPCS,G0162,"HHC RN E&M PLAN SVS, 15 MIN",,,,,0
HCPCS,G0166,"EXTRNL COUNTERPULSE, PER TX",,,129.29,258.58,8
HCPCS,G0168,WOUND CLOSURE BY ADHESIVE,,,,,0
HCPCS,G0175,"OPPS SERVICE,SCHED TEAM CONF",,,405.48,810.96,8
HCPCS,G0176,OPPS/PHP/IOP; ACTIVITY THRPY,,,,,0
HCPCS,G0177,MH-IOP TRAIN EDUCATE SVCS,259.0,129.5,45.11,251.23,47
HCPCS,G0177,PHP TRAIN EDUCATE SVCS,259.0,129.5,45.11,251.23,47
HCPCS,G0179,PROF MD RECERTIFICATION HHA PT,140.0,70.0,24.38,135.8,47
HCPCS,G0180,MD CERTIFICATION HHA PATIENT,,,,,0
HCPCS,G0181,HOME HEALTH CARE SUPERVISION,,,,,0
HCPCS,G0182,HOSPICE CARE SUPERVISION,,,,,0
HCPCS,G0183,"Quantitative software measurements of cardiac volume, cardiac chambers volumes and left ventricular wall mass derived from CT scan(s) data of the chest/heart (with or without contrast)",,,84.57,169.14,8
HCPCS,G0186,"DSTRY EYE LESN,FDR VSSL TECH",,,534.47,1068.94,8
HCPCS,G0219,PET IMG WHOLBOD MELANO NONCO,,,2001.71,2324.57,16
HCPCS,G0235,PET NOT OTHERWISE SPECIFIED,,,388.48,776.96,8
HCPCS,G0237,THER PROC STRNTH/ENDR/15MIN,206.0,103.0,28.11,199.82,54
HCPCS,G0237,THERAPEUTIC PROCD STRG ENDUR,,,,,0
HCPCS,G0238,"OTH RESP PROC, INDIV",,,,,0
HCPCS,G0238,THER PROC RESP FNCTN/15 MIN,269.0,134.5,28.11,260.93,54
HCPCS,G0239,"OTH RESP PROC, GROUP",,,,,0
HCPCS,G0239,THER PROC RESP FNCTN GRP,281.0,140.5,36.3,272.57,54
HCPCS,G0245,INITIAL FOOT EXAM PT LOPS,,,129.38,258.76,8
HCPCS,G0246,FOLLOWUP EVAL OF FOOT PT LOP,,,129.38,258.76,8
HCPCS,G0247,ROUTINE FOOTCARE PT W LOPS,,,194.97,389.94,8
HCPCS,G0248,DEMONSTRATE USE HOME INR MON,,,129.38,258.76,8
HCPCS,G0249,PROVIDE INR TEST MATER/EQUIP,,,129.38,258.76,8
HCPCS,G0250,MD INR TEST REVIE INTER MGMT,,,,,0
HCPCS,G0252,PET IMAGING INITIAL DX,,,,,0
HCPCS,G0255,CURRENT PERCEP THRESHOLD TST,,,,,0
HCPCS,G0257,DIALYS EMERGUNSCH ESRD OTPT,2199.0,1099.5,383.06,2133.03,53
HCPCS,G0257,UNSCHED DIALYSIS ESRD PT HOS,,,,,0
HCPCS,G0259,INJECT FOR SACROILIAC JOINT,,,,,0
HCPCS,G0260,INJ FOR SACROILIAC JT ANESTH,,,685.95,1371.9,8
HCPCS,G0268,REMOVAL OF IMPACTED WAX MD,,,,,0
HCPCS,G0269,OCCLUSIVE DEVICE IN VEIN ART,,,,,0
HCPCS,G0270,MNT SUBS TX FOR CHANGE DX,,,,,0
HCPCS,G0271,GROUP MNT 2 OR MORE 30 MINS,,,,,0
HCPCS,G0276,PILD/PLACEBO CONTROL CLIN TR,,,7051.31,14102.62,8
HCPCS,G0277,HYPRBARIC O2 PRESS 30MIN,398.0,199.0,69.33,386.06,54
HCPCS,G0278,ILIAC ART ANGIO CARDIAC CATH LT,5622.0,2811.0,979.35,5453.34,47
HCPCS,G0278,ILIAC ART ANGIO CARDIAC CATH RT,5622.0,2811.0,979.35,5453.34,47
HCPCS,G0279,"TOMOSYNTHESIS, MAMMO",,,,,0
HCPCS,G0281,ELEC STIM UNATTEND FOR PRESS,,,,,0
HCPCS,G0282,ELECT STIM WOUND CARE NOT PD,,,,,0
HCPCS,G0283,ELEC STIM OTHER THAN WOUND,,,,,0
HCPCS,G0288,"RECON, CTA FOR SURG PLAN",,,,,0
HCPCS,G0288,RECONSTRUC CTA AORTA SRG PLAN,1618.0,809.0,88.21,1569.46,47
HCPCS,G0289,"ARTHRO, LOOSE BODY + CHONDRO",,,,,0
HCPCS,G0293,"NON-COV SURG PROC,CLIN TRIAL",,,36.3,72.6,8
HCPCS,G0294,"NON-COV PROC, CLINICAL TRIAL",,,36.3,72.6,8
HCPCS,G0295,ELECTROMAGNETIC THERAPY ONC,,,,,0
HCPCS,G0296,VISIT TO DETERM LDCT ELIG,,,98.72,197.44,8
HCPCS,G0299,HHS/HOSPICE OF RN EA 15 MIN,,,,,0
HCPCS,G0300,HHS/HOSPICE OF LPN EA 15 MIN,,,,,0
HCPCS,G0302,PRE-OP SERVICE LVRS COMPLETE,,,362.62,725.24,8
HCPCS,G0303,PRE-OP SERVICE LVRS 10-15DOS,,,209.83,419.66,8
HCPCS,G0304,PRE-OP SERVICE LVRS 1-9 DOS,,,362.62,725.24,8
HCPCS,G0305,POST OP SERVICE LVRS MIN 6,,,362.62,725.24,8
HCPCS,G0306,CBC/DIFFWBC W/O PLATELET,,,7.77,15.54,8
HCPCS,G0307,CBC WITHOUT PLATELET,,,6.47,12.94,8
HCPCS,G0310,IMMUNIZE COUNSEL 5-15 MIN,,,,,0
HCPCS,G0311,IMMUNIZE COUNSEL 16-30 MINS,,,,,0
HCPCS,G0312,IMMUNIZE COUNS < 21YR 5-15 M,,,,,0
HCPCS,G0313,IMMUNIZE COUNS < 21YR 6-30 M,,,,,0
HCPCS,G0314,COUNSEL IMMUNE <21 16-30 M,,,,,0
HCPCS,G0315,COUNSEL IMMUNE <21  5-15 M,,,,,0
HCPCS,G0316,PROLONG INPT EVAL ADD15 M,,,,,0
HCPCS,G0317,PROLONG NURSIN FAC EVAL 15M,,,,,0
HCPCS,G0318,PROLONG HOME EVAL ADD 15M,,,,,0
HCPCS,G0320,TWO-WAY AUDIO AND VIDEO HHS,,,,,0
HCPCS,G0321,AUDIO-ONLY HHS,,,,,0
HCPCS,G0322,HOME H PHYSIO DATA COLLEC TR,,,,,0
HCPCS,G0323,CARE MANAGE BEH SVS 20MINS,,,36.41,72.82,8
HCPCS,G0327,COLON CA SCRN;BLD-BSD BIOMRK,,,,,0
HCPCS,G0328,FECAL BLOOD SCRN IMMUNOASSAY,,,18.05,36.1,8
HCPCS,G0329,ELECTROMAGNTIC TX FOR ULCERS,,,,,0
HCPCS,G0330,FACILITY SVS DENTAL REHAB,,,3221.84,6443.68,8
HCPCS,G0333,DISPENSE FEE INITIAL 30 DAY,,,,,0
HCPCS,G0337,HOSPICE EVALUATION PREELECTI,,,,,0
HCPCS,G0339,"ROBOT LIN-RADSURG COM, FIRST",,,,,0
HCPCS,G0340,ROBT LIN-RADSURG FRACTX 2-5,,,,,0
HCPCS,G0341,PERCUTANEOUS ISLET CELLTRANS,,,,,0
HCPCS,G0342,LAPAROSCOPY ISLET CELL TRANS,,,,,0
HCPCS,G0343,LAPAROTOMY ISLET CELL TRANSP,,,,,0
HCPCS,G0372,MD SERVICE REQUIRED FOR PMD,,,,,0
HCPCS,G0378,OBSERVATION 1 ADD'L HOUR,56.0,28.0,9.75,54.32,47
HCPCS,G0378,OBSERVATION DIRECT ADMIT 1 ADD'L HOUR,56.0,28.0,9.75,54.32,47
HCPCS,G0378,OBSERVATION FIRST HOUR,601.0,300.5,104.69,582.97,47
HCPCS,G0378,REDUCE HOURLY OBSERVATION,56.0,28.0,9.75,54.32,47
HCPCS,G0379,DIRECT ADMIT OBS 1ST HOUR,597.0,298.5,103.99,1157.42,54
HCPCS,G0380,LEV 1 HOSP TYPE B ED VISIT,,,72.23,144.46,8
HCPCS,G0381,LEV 2 HOSP TYPE B ED VISIT,,,90.27,180.54,8
HCPCS,G0382,LEV 3 HOSP TYPE B ED VISIT,,,167.03,334.06,8
HCPCS,G0383,LEV 4 HOSP TYPE B ED VISIT,,,256.84,513.68,8
HCPCS,G0384,LEV 5 HOSP TYPE B ED VISIT,,,399.13,798.26,8
HCPCS,G0390,TRAUMA RESPONSE - RED,6372.0,3186.0,1110.0,6180.84,54
HCPCS,G0390,TRAUMA RESPONSE - YELLOW,5405.0,2702.5,941.55,5242.85,54
HCPCS,G0396,ALCOHOL/SUBS INTERV 15-30MN,,,36.41,72.82,8
HCPCS,G0397,ALCOHOL/SUBS INTERV >30 MIN,,,172.48,344.96,8
HCPCS,G0398,HOME SLEEP TEST/TYPE 2 PORTA,,,209.83,419.66,8
HCPCS,G0399,HOME SLEEP TEST/TYPE 3 PORTA,,,209.83,419.66,8
HCPCS,G0400,HOME SLEEP TEST/TYPE 4 PORTA,,,209.83,419.66,8
HCPCS,G0402,INITIAL PREVENTIVE EXAM,,,129.38,258.76,8
HCPCS,G0403,EKG FOR INITIAL PREVENT EXAM,,,,,0
HCPCS,G0404,EKG TRACING FOR INITIAL PREV,,,28.11,56.22,8
HCPCS,G0405,EKG INTERPRET & REPORT PREVE,,,,,0
HCPCS,G0406,INPT/TELE FOLLOW UP 15,,,,,0
HCPCS,G0407,INPT/TELE FOLLOW UP 25,,,,,0
HCPCS,G0408,INPT/TELE FOLLOW UP 35,,,,,0
HCPCS,G0409,CORF RELATED SERV 15 MINS EA,,,,,0
HCPCS,G0410,GRP PSYCH PHP/IOP 45-50,,,,,0
HCPCS,G0411,INTERACTIVE GRP PSYC PHP/IOP,,,,,0
HCPCS,G0412,OPEN TX ILIAC SPINE UNI/BIL,,,7051.31,14102.62,8
HCPCS,G0413,PELVIC RING FRACTURE UNI/BIL,,,7051.31,14102.62,8
HCPCS,G0414,PELVIC RING FX TREAT INT FIX,,,7051.31,14102.62,8
HCPCS,G0415,OPEN TX POST PELVIC FXCTURE,,,3179.6,6359.2,8
HCPCS,G0416,BIOPSY PROSTATE ANY METHOD,774.0,387.0,134.83,750.78,162
HCPCS,G0416,"PROSTATE BIOPSY, ANY MTHD",,,,,0
HCPCS,G0420,ED SVC CKD IND PER SESSION,,,,,0
HCPCS,G0421,ED SVC CKD GRP PER SESSION,,,,,0
HCPCS,G0422,INTENS CARDIAC REHAB W/EXERC,,,125.27,250.54,8
HCPCS,G0423,INTENS CARDIAC REHAB NO EXER,,,125.27,250.54,8
HCPCS,G0425,INPT/ED TELECONSULT30,,,,,0
HCPCS,G0426,INPT/ED TELECONSULT50,,,,,0
HCPCS,G0427,INPT/ED TELECONSULT70,,,,,0
HCPCS,G0428,COLLAGEN MENISCUS IMPLANT,,,,,0
HCPCS,G0429,DERMAL FILLER INJECTION(S),,,2005.02,4010.04,8
HCPCS,G0432,EIA HIV-1/HIV-2 SCREEN,,,,,0
HCPCS,G0432,HIV1/HIV2 SCREEN EIA,157.0,78.5,13.58,228.92,108
HCPCS,G0433,ELISA HIV-1/HIV-2 SCREEN,,,18.29,36.58,8
HCPCS,G0435,ORAL HIV-1/HIV-2 SCREEN,,,11.98,23.96,8
HCPCS,G0438,"PPPS, INITIAL VISIT",,,,,0
HCPCS,G0439,"PPPS, SUBSEQ VISIT",,,,,0
HCPCS,G0442,ANNUAL ALCOHOL SCREEN 15 MIN,,,36.41,72.82,8
HCPCS,G0443,BRIEF ALCOHOL MISUSE COUNSEL,,,98.72,197.44,8
HCPCS,G0444,DEPRESSION SCREEN ANNUAL,,,36.41,72.82,8
HCPCS,G0445,HIGH INTEN BEH COUNS STD 30M,,,98.72,197.44,8
HCPCS,G0446,INTENS BEHAVE THER CARDIO DX,,,36.41,72.82,8
HCPCS,G0447,BEHAVIOR COUNSEL OBESITY 15M,,,98.72,197.44,8
HCPCS,G0448,PLACE PERM PACING CARDIOVERT,,,,,0
HCPCS,G0451,DEVLOPMENT TEST INTERPT&REP,,,98.72,197.44,8
HCPCS,G0452,MOLECULAR PATHOLOGY INTERPR,,,,,0
HCPCS,G0453,CONTINUOUS IONM REMOTE PER PATIENTT EACH 15 MINUTES,312.0,156.0,54.35,302.64,47
HCPCS,G0454,MD DOCUMENT VISIT BY NPP,,,,,0
HCPCS,G0455,FECAL MICROBIOTA PREP INSTIL,,,903.7,1807.4,8
HCPCS,G0458,LDR PROSTATE BRACHY COMP RAT,,,,,0
HCPCS,G0459,TELEHEALTH INPT PHARM MGMT,,,,,0
HCPCS,G0460,AUTOLOG PRP NOT DIAB ULCER,,,2005.02,4010.04,8
HCPCS,G0463,HOSPITAL OUTPT CLINIC VISIT,,,129.38,258.76,8
HCPCS,G0465,ONC PRST8 MRNA 18 GEN DRE UR,,,2005.02,4010.04,8
HCPCS,G0466,FQHC VISIT NEW PATIENT,,,,,0
HCPCS,G0467,"FQHC VISIT, ESTAB PT",,,,,0
HCPCS,G0468,"FQHC VISIT, IPPE OR AWV",,,,,0
HCPCS,G0469,"FQHC VISIT, MH NEW PT",,,,,0
HCPCS,G0470,"FQHC VISIT, MH ESTAB PT",,,,,0
HCPCS,G0471,VEN BLOOD COLL SNF/HHA,,,11.34,22.68,8
HCPCS,G0472,HEP C SCREEN HIGH RISK/OTHER,,,46.35,92.7,8
HCPCS,G0473,GROUP BEHAVE COUNS 2-10,,,36.41,72.82,8
HCPCS,G0475,HIV COMBINATION ASSAY,,,24.08,48.16,8
HCPCS,G0476,HPV COMBO ASSAY CA SCREEN,,,35.09,70.18,8
HCPCS,G0480,ALKALOIDS DEFINITIVE,435.0,217.5,75.77,421.95,108
HCPCS,G0480,AMITRIPTYLINE (ELAVIL) DEFINITIVE,367.0,183.5,63.4,358.9,108
HCPCS,G0480,AMPHETAMINES DEFINITIVE,499.0,249.5,63.4,614.98,108
HCPCS,G0480,ANTI-EPILEPTICS NOS DEFINITIVE,423.0,211.5,73.68,410.31,108
HCPCS,G0480,ANTI-PSYCHOTICS NOS 1-3 DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,BARBITURATE DEFINITIVE,1093.0,546.5,114.43,1342.48,108
HCPCS,G0480,BENZODIAZEPINES 1-12 DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,BENZODIAZEPINES 13+ DEFINITIVE,1177.5,588.75,114.43,1342.48,108
HCPCS,G0480,BUPRENORPHINE DEFINITIVE,895.0,447.5,70.72,1342.48,108
HCPCS,G0480,CANNABINOIDS NATURAL DEFINITIVE,438.5,219.25,63.4,497.61,108
HCPCS,G0480,CANNABINOIDS SYNTHETIC 7+ DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,CANRENONE SERUM/PLASMA,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,CITALOPRAM (CELEXA),1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,CLOBAZAM (ONFI),1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,COCAINE DEFINITIVE,109.0,54.5,13.58,228.86,108
HCPCS,G0480,COTININE DEFINITIVE,1091.5,545.75,114.43,1342.48,108
HCPCS,G0480,DESIPRAMINE DEFINITIVE,367.0,183.5,63.4,358.9,108
HCPCS,G0480,DEXTROMEHTORPAHN &METAB DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,DIHYDROMORPHINONE,1384.0,692.0,114.43,1342.48,54
HCPCS,G0480,DIHYDROTESTOSTERONE DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,DOXEPINE (SINEQUAN) DEFINITIVE,367.0,183.5,63.4,358.9,108
HCPCS,G0480,DRUG SCREEN QUANTALCOHOLS,874.0,437.0,63.4,1342.48,108
HCPCS,G0480,DRUG SCRN BARBITURATES,920.5,460.25,79.6,1342.48,108
HCPCS,G0480,DRUG TEST DEF 1-7 CLASSES,799.0,399.5,114.43,775.03,54
HCPCS,G0480,DRUGS QL/QNT NOS 1-3 DEFINTIIVE,398.0,199.0,69.33,386.06,108
HCPCS,G0480,ETHYLGLUCURONIDE DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,FELBAMATE (FELBATOL) DEFINITIVE,903.5,451.75,73.68,1342.48,108
HCPCS,G0480,HEROIN METABOLITE DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,HYDROMORPHONE DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,KETAMINE / NORKETAMINE DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,LACOSAMIDE DEFINITIVE,903.5,451.75,73.68,1342.48,108
HCPCS,G0480,MDMA (ECSTASY) DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,MDMA DEFINITIVE,56.0,28.0,9.58,228.86,108
HCPCS,G0480,MEPHEDRON & MDPV DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,MERCAPTOPURINE (6-MP PURIN.),1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,METHADONE LEVEL,361.5,180.75,62.53,353.08,108
HCPCS,G0480,METHAMPHETAMINE/ AMPHET DEFINITIVE,393.0,196.5,63.4,409.34,108
HCPCS,G0480,METHOTREXATE DEFINITIVE,398.0,199.0,69.33,386.06,108
HCPCS,G0480,METHYLONE DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,MITOTANE (LYSODREN) LEVEL,364.0,182.0,63.4,353.08,108
HCPCS,G0480,NICOTINE & METABOLITE DEFINITIVE,548.0,274.0,63.4,710.04,108
HCPCS,G0480,NON-OPIOD ANALGESICS 1-2 DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,NORTRIPTYLINE (AVENTYL) DEFINITIVE,367.0,183.5,63.4,358.9,108
HCPCS,G0480,OPIATES DEFINITIVE,623.5,311.75,78.04,775.03,108
HCPCS,G0480,"OPIODS, 1+ DEFINITIVE",364.0,182.0,63.4,353.08,108
HCPCS,G0480,OXYCODONE DEFINITIVE,438.5,219.25,63.4,497.61,108
HCPCS,G0480,PENTOBARBITAL LEVEL,1384.0,692.0,114.43,1342.48,54
HCPCS,G0480,PHENCYCLIDINE (PCP) DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,PHENCYCLIDINE DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,PREGABALIN DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,PROPOXYPHENE DEFINITIVE,1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,QUETIAPINE (SEROQUEL),1384.0,692.0,114.43,1342.48,108
HCPCS,G0480,RIVAROXABAN LEVEL,364.0,182.0,63.4,353.08,108
HCPCS,G0480,RUFINAMIDE SERUM OR PLASMA,364.0,182.0,63.4,353.08,54
HCPCS,G0480,SEDATIVE HYPNOTICS NON-BENZO DEFINITIVE,364.0,182.0,63.4,353.08,108
HCPCS,G0480,SULFONYLUREA DEFINITIVE,530.0,265.0,66.19,659.6,108
HCPCS,G0480,TRAMADOL DEFINITIVE,56.0,28.0,9.58,228.86,108
HCPCS,G0480,TRAZODONE DEFINITIVE,95.5,47.75,14.8,228.86,108
HCPCS,G0480,TRICYC ANTIDEPRESSANTS 6+ DEFINITIVE,67.0,33.5,11.49,228.86,108
HCPCS,G0480,VENLAFAXINE (EFFEXOR),1384.0,692.0,114.43,1342.48,108
HCPCS,G0481,DRUG TEST DEF 8-14 CLASSES,498.0,249.0,86.75,483.06,54
HCPCS,G0482,DRUG TEST DEF 15-21 CLASSES,632.0,316.0,110.09,613.04,54
HCPCS,G0483,DRUG TEST DEF 22+ CLASSES,593.5,296.75,93.19,632.44,108
HCPCS,G0490,"HOME VISIT RN, LPN BY RHC/FQ",,,,,0
HCPCS,G0491,DIALYSIS ACU KIDNEY NO ESRD,,,,,0
HCPCS,G0492,MD/OTH EVAL ACUT KID NO ESRD,,,,,0
HCPCS,G0493,RN CARE EA 15 MIN HH/HOSPICE,,,,,0
HCPCS,G0494,LPN CARE EA 15MIN HH/HOSPICE,,,,,0
HCPCS,G0495,RN CARE TRAIN/EDU IN HH,,,,,0
HCPCS,G0496,LPN CARE TRAIN/EDU IN HH,,,,,0
HCPCS,G0498,CHEMO EXTEND IV INFUS W/PUMP,1681.5,840.75,289.52,1649.97,108
HCPCS,G0499,HEPB SCREEN HIGH RISK INDIV,,,28.27,56.54,8
HCPCS,G0500,MOD SEDAT ENDO SERVICE >5YRS,,,,,0
HCPCS,G0501,RESOURCE-INTEN SVC DURING OV,,,,,0
HCPCS,G0506,COMP ASSES CARE PLAN CCM SVC,,,,,0
HCPCS,G0508,CRIT CARE TELEHEA CONSULT 60,,,,,0
HCPCS,G0509,CRIT CARE TELEHEA CONSULT 50,,,,,0
HCPCS,G0511,CCM/BHI BY RHC/FQHC 20MIN MO,,,,,0
HCPCS,G0512,COCM BY RHC/FQHC 60 MIN MO,,,,,0
HCPCS,G0513,"PROLONG PREV SVCS, FIRST 30M",,,,,0
HCPCS,G0514,"PROLONG PREV SVCS, ADDL 30M",,,,,0
HCPCS,G0516,"INSERT DRUG DEL IMPLANT, >=4",,,434.11,868.22,8
HCPCS,G0517,REMOVE DRUG IMPLANT,,,434.11,868.22,8
HCPCS,G0518,REMOVE W INSERT DRUG IMPLANT,,,434.11,868.22,8
HCPCS,G0519,"Management of new patient-caregiver dyad with dementia, low complexity, for use in CMMI model",,,,,0
HCPCS,G0520,"Management of new patient-caregiver dyad with dementia, moderate complexity, for use in CMMI model",,,,,0
HCPCS,G0521,"Management of new patient-caregiver dyad with dementia, high complexity, for use in CMMI model",,,,,0
HCPCS,G0522,"Management of a new patient with dementia, low complexity, for use in CMMI model",,,,,0
HCPCS,G0523,"Management of a new patient with dementia, moderate to high complexity, for use in CMMI model",,,,,0
HCPCS,G0524,"Management of established patient-caregiver dyad with dementia, low complexity, for use in CMMI model",,,,,0
HCPCS,G0525,"Management of established patient-caregiver dyad with dementia, moderate complexity, for use in CMMI model",,,,,0
HCPCS,G0526,"Management of established patient-caregiver dyad with dementia, high complexity, for use in CMMI model",,,,,0
HCPCS,G0527,"Management of established patient with dementia, low complexity, for use in CMMI model",,,,,0
HCPCS,G0528,"Management of established patient with dementia, moderate to high complexity, for use in CMMI model",,,,,0
HCPCS,G0529,"In-home respite care, 4-hour unit, for use in CMMI model",,,,,0
HCPCS,G0530,"Adult day center, 8-hour unit, for use in CMMI model",,,,,0
HCPCS,G0531,"Facility-based respite, 24-hour unit, for use in CMMI model",,,,,0
HCPCS,G0532,"Take-home supply of nasal nalmefene hydrochloride; one carton of two, 2.7 mg per 0.1 ml nasal sprays (provision of the services by a Medicare-enrolled opioid treatment program);( List separately in ad",,,,,0
HCPCS,G0533,"Medication assisted treatment, buprenorphine (injectable) administered on a weekly basis; weekly bundle including dispensing and/or administration, substance use counseling, individual and group thera",,,,,0
HCPCS,G0534,"Coordinated care and/or referral services, such as to adequate and accessible community resources to address unmet health-related social needs, including harm reduction interventions and recovery supp",,,,,0
HCPCS,G0535,"Patient navigational services, provided directly or by referral; including helping the patient to navigate health systems and identify care providers and supportive services, to build patient self-adv",,,,,0
HCPCS,G0536,"Peer recovery support services, provided directly or by referral; including leveraging knowledge of the condition or lived experience to provide support, mentorship, or inspiration to meet oud treatme",,,,,0
HCPCS,G0537,"Administration of a standardized, evidence-based atherosclerotic cardiovascular disease (ASCVD) risk assessment, 5-15 minutes, not more often than every 12 months",,,36.41,72.82,8
HCPCS,G0538,Atherosclerotic cardiovascular disease (ASCVD) risk management services; clinical staff time; per calendar month,,,98.72,197.44,8
HCPCS,G0539,"Caregiver training in behavior management/modification for caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified health care professional (w",,,,,0
HCPCS,G0540,"Caregiver training in behavior management/modification for parent(s)/guardian(s)/caregiver(s) of patients with a mental or physical health diagnosis, administered by physician or other qualified healt",,,,,0
HCPCS,G0541,"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to ",,,28.11,56.22,8
HCPCS,G0542,"Caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniques to ",,,,,0
HCPCS,G0543,"Group caregiver training in direct care strategies and techniques to support care for patients with an ongoing condition or illness and to reduce complications (including, but not limited to, techniqu",,,28.11,56.22,8
HCPCS,G0544,"Post discharge telephonic follow-up contacts performed in conjunction with a discharge from the emergency department for behavioral health or other crisis encounter, 4 calls per calendar month",,,98.72,197.44,8
HCPCS,G0545,"Visit complexity inherent to hospital inpatient or observation care associated with a confirmed or suspected infectious disease by an infectious diseases specialist, including disease transmission ris",,,,,0
HCPCS,G0546,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty   whose covered services are limited by statute to services fo,,,,,0
HCPCS,G0547,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,,,0
HCPCS,G0548,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,,,0
HCPCS,G0549,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,,,0
HCPCS,G0550,Interprofessional telephone/internet/electronic health record assessment and management service provided by a practitioner in a specialty whose covered services are limited by statute to services for ,,,,,0
HCPCS,G0551,Interprofessional telephone/internet/electronic health record referral service(s) provided by a treating/requesting practitioner in a specialty whose covered services are limited by statute to service,,,,,0
HCPCS,G0552,"Supply of digital mental health treatment device and initial education and onboarding, per course of treatment that augments a behavioral therapy plan",,,129.38,258.76,8
HCPCS,G0553,First 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (DMHT) device that augments a behavioral therapy plan,,,129.38,258.76,8
HCPCS,G0554,Each additional 20 minutes of monthly treatment management services directly related to the patient's therapeutic use of the digital mental health treatment (DHMT) device that augments a behavioral th,,,,,0
HCPCS,G0555,"Provision of replacement patient electronics system (e.g., system pillow, handheld reader) for home pulmonary artery pressure monitoring",,,834.49,1668.98,8
HCPCS,G0556,"Advanced primary care management services for a patient with one chronic condition [expected to last at least 12 months, or until the death of the patient, which place the patient at significant risk ",,,36.41,72.82,8
HCPCS,G0557,"Advanced primary care management services for a patient with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, which place the patient a",,,36.41,72.82,8
HCPCS,G0558,"Advanced primary care management services for a patient that is a qualified Medicare beneficiary with multiple (two or more) chronic conditions expected to last at least 12 months, or until the death ",,,98.72,197.44,8
HCPCS,G0559,"Post-operative follow-up visit complexity inherent to evaluation and management services addressing surgical procedure(s), provided by a physician or qualified health care professional who is not the ",,,,,0
HCPCS,G0560,SAFETY PLAN INTERVENTION EACH 20 MINUTES,106.0,53.0,18.46,102.82,47
HCPCS,G0561,"Tympanostomy with local or topical anesthesia and insertion of a ventilating tube when performed with tympanostomy tube delivery device, unilateral (List separately in addition to 69433) (Do not use i",,,,,0
HCPCS,G0562,"Therapeutic radiology simulation-aided field setting; complex, including acquisition of PET and CT imaging data required for radiopharmaceutical-directed radiation therapy treatment planning (i.e., mo",,,1855.24,3710.48,8
HCPCS,G0563,"Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more lesions, including image guidance and real-time positron emissions-based delivery adjustments to 1 or more lesions, e",,,3091.75,6183.5,8
HCPCS,G0566,"3D radiodensity-value bone imaging, algorithm derived, from previous magnetic resonance examination of the same anatomy",,,125.04,250.08,8
HCPCS,G0567,"Infectious agent detection by nucleic acid (DNA or RNA); Hepatitis C, screening, amplified probe technique",,,35.09,70.18,8
HCPCS,G0659,DRUG TEST DEF SIMPLE ALL CL,,,62.14,124.28,8
HCPCS,G0913,IMPROVE VISUAL FUNCT,,,,,0
HCPCS,G0914,SURVEY NOT COMPLETE,,,,,0
HCPCS,G0915,NO IMPROVE VISUAL FUNCT,,,,,0
HCPCS,G0916,SATISFY WITH CARE,,,,,0
HCPCS,G0917,CARE SURVEY NOT COMPLETE,,,,,0
HCPCS,G0918,NO SATISFY WITH CARE,,,,,0
HCPCS,G1025,PT MNTH 1 MCP PROV,,,,,0
HCPCS,G1026,PT HEMO > 3MO,,,,,0
HCPCS,G1027,PT HEMO < 3MO,,,,,0
HCPCS,G1028,TAKE HOME SUPPLY 8MG PER 0.1,,,,,0
HCPCS,G2000,BLINDED CONV. TX MDD CLIN TR,,,362.62,725.24,8
HCPCS,G2001,POST D/C H VST NEW PT 20 M,,,,,0
HCPCS,G2002,POST-D/C H VST NEW PT 30 M,,,,,0
HCPCS,G2003,POST-D/C H VST NEW PT 45 M,,,,,0
HCPCS,G2004,POST-D/C H VST NEW PT 60 M,,,,,0
HCPCS,G2005,POST-D/C H VST NEW PT 75 M,,,,,0
HCPCS,G2006,POST-D/C H VST EXT PT 20 M,,,,,0
HCPCS,G2007,POST-D/C H VST EXT PT 30 M,,,,,0
HCPCS,G2008,POST-D/C H VST EXT PT 45 M,,,,,0
HCPCS,G2009,POST-D/C H VST EXT PT 60 M,,,,,0
HCPCS,G2010,PT REMOTE EVAL IMAGE/VIDEO SUBMITTED BY PT,28.0,14.0,4.87,27.16,47
HCPCS,G2010,SP REMOTE EVAL IMAGE/VIDEO SUBMITTED BY PT,28.0,14.0,4.87,27.16,47
HCPCS,G2011,ALCOHOL/SUB MISUSE ASSESS,,,28.11,56.22,8
HCPCS,G2013,POST-D/C H VST EXT PT 75 M,,,,,0
HCPCS,G2014,POST-D/C CARE PLAN OVERS 30M,,,,,0
HCPCS,G2015,POST-D/C CARE PLAN OVERS 60M,,,,,0
HCPCS,G2020,HI INTEN SERV FOR SIP MODEL,,,,,0
HCPCS,G2021,HEA CARE PRACT TX IN PLACE,,,,,0
HCPCS,G2022,"BENEF REFUSES SERVICE, MOD",,,,,0
HCPCS,G2025,DIS SITE TELE SVCS RHC/FQHC,,,,,0
HCPCS,G2067,MED ASSIST TX METH WK,,,,,0
HCPCS,G2068,MED ASSIST TX BUPRE ORAL,,,,,0
HCPCS,G2069,MED ASSIST TX INJECT,,,,,0
HCPCS,G2073,MED TX NALTREXONE,,,,,0
HCPCS,G2074,MED ASSIST TX NO DRUG,,,,,0
HCPCS,G2075,MED TX MEDS NOS,,,,,0
HCPCS,G2076,INTAKE ACT W/MED EXAM,,,,,0
HCPCS,G2077,PERIODIC ASSESSMENT,,,,,0
HCPCS,G2078,TAKE-HOME METH,,,,,0
HCPCS,G2079,TAKE-HOM BUPRENORPHINE,,,,,0
HCPCS,G2080,ADD 30 MINS COUNSEL,,,,,0
HCPCS,G2081,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,G2082,VISIT ESKETAMINE 56M OR LESS,,,999.19,1998.38,8
HCPCS,G2083,"VISIT ESKETAMINE, > 56M",,,1569.89,3139.78,8
HCPCS,G2086,OFF BASE OPIOID TX 70MIN,,,172.48,344.96,8
HCPCS,G2087,"OFF BASE OPIOID TX, 60 M",,,172.48,344.96,8
HCPCS,G2088,"OFF BASE OPIOID TX, ADD30",,,,,0
HCPCS,G2090,PT 66+ FRAILTY AND MED DEM,,,,,0
HCPCS,G2091,PT 66+ FRAILTY AND ADV ILL,,,,,0
HCPCS,G2092,ACE ARB ARNI,,,,,0
HCPCS,G2093,MED DOC RSN NO ACE ARN ARNI,,,,,0
HCPCS,G2094,PT RSN NO ACE ARN ARNI,,,,,0
HCPCS,G2096,NO RSN ACE ARB ARNI,,,,,0
HCPCS,G2097,DX URI 3D AFTER OTHER DX,,,,,0
HCPCS,G2098,PT 66+ FRAILTY AND MED DEM,,,,,0
HCPCS,G2099,PT 66+ FRAILTY AND ADV ILL,,,,,0
HCPCS,G2100,PT 66+ FRAILTY AND MED DEM,,,,,0
HCPCS,G2101,PT 66+ FRAILTY AND ADV ILL,,,,,0
HCPCS,G2105,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,G2106,PT 66+ FRAILTY AND MED DEM,,,,,0
HCPCS,G2107,PT 66+ FRAILTY AND ADV ILL,,,,,0
HCPCS,G2112,PRED<=5 MG RA GLU <6M,,,,,0
HCPCS,G2113,"PRED>5 MG >6M, NO CHG DA",,,,,0
HCPCS,G2115,PT 66-80 FRAILTY AND MED DEM,,,,,0
HCPCS,G2116,PT 66-80 FRAILTY AND ADV ILL,,,,,0
HCPCS,G2118,PT 81+ FRAILTY,,,,,0
HCPCS,G2121,PSY DEP ANX AP AND ICD ASSE,,,,,0
HCPCS,G2122,PSY/DEP/ANX/APANDICD NOASSE,,,,,0
HCPCS,G2125,PT 81+ FRAILTY,,,,,0
HCPCS,G2126,PT 66-80 FRAILTY AND ADV ILL,,,,,0
HCPCS,G2127,PT 66-80 FRAILTY AND MED DEM,,,,,0
HCPCS,G2128,NO ASPIRIN MED RSN,,,,,0
HCPCS,G2129,NO BP OUTPT,,,,,0
HCPCS,G2136,BK PAIN VAS 6-20WK <= 3,,,,,0
HCPCS,G2137,BK PAIN VAS 6-20WK > 3,,,,,0
HCPCS,G2138,BK PAIN VAS 9-15MO <= 3,,,,,0
HCPCS,G2139,BK PAIN VAS 9-15MO > 3,,,,,0
HCPCS,G2140,LEG PAIN VAS 6-20WK <= 3,,,,,0
HCPCS,G2141,LEG PAIN VAS 6-20WK > 3,,,,,0
HCPCS,G2142,FS ODI 9-15MO POSTOP<= 22,,,,,0
HCPCS,G2143,FS ODI 9-15MO > 22,,,,,0
HCPCS,G2144,FS ODI 6-20WK POSTOP <= 22,,,,,0
HCPCS,G2145,FSODI 6-20WK >22 OR CHG 30PT,,,,,0
HCPCS,G2146,LEG PAIN VAS 9-15MO <= 3,,,,,0
HCPCS,G2147,LEG PAIN VAS 9-15MO > 3,,,,,0
HCPCS,G2148,MPM USED,,,,,0
HCPCS,G2149,NO MPM MED RSN,,,,,0
HCPCS,G2150,NO MPM,,,,,0
HCPCS,G2151,DX DEGEN NEURO,,,,,0
HCPCS,G2152,RES CHANGE SC >=0,,,,,0
HCPCS,G2167,RES CHANGE SC < 0,,,,,0
HCPCS,G2168,SVS BY PT IN HOME HEALTH,,,,,0
HCPCS,G2169,SVS BY OT IN HOME HEALTH,,,,,0
HCPCS,G2172,TX FOR OPIOID USE DEMO PROJ,,,,,0
HCPCS,G2173,URI W COMORB 12M OTH DX,,,,,0
HCPCS,G2174,URI NEW RX ANTIBIOTIC 30D,,,,,0
HCPCS,G2175,PT COMORB DX 12M OF EPI,,,,,0
HCPCS,G2176,OUTPT ED OBS W INPT ADMIT,,,,,0
HCPCS,G2177,BRONCH W RX ANTIBX 30D,,,,,0
HCPCS,G2178,PT NOT ELIG LOW NEURO EX,,,,,0
HCPCS,G2179,MED DOC RSN NO LOW EX,,,,,0
HCPCS,G2180,INELIG FOOTWR EVAL,,,,,0
HCPCS,G2181,BMI NOT DOC MEDRSN PTREF,,,,,0
HCPCS,G2182,PT 1ST BIOLOG ANTIRHEUM,,,,,0
HCPCS,G2183,DOC PT UNABLE COMM,,,,,0
HCPCS,G2184,NO CAREGIVER,,,,,0
HCPCS,G2185,CAREGIVER DEM TRAINED,,,,,0
HCPCS,G2186,PT REF APP RSRCS,,,,,0
HCPCS,G2187,CLIN IND IMG HD TRAUMA,,,,,0
HCPCS,G2188,PT 50 YRS W/CLIN IND HD,,,,,0
HCPCS,G2189,IMG HD ABNML NEURO EXAM,,,,,0
HCPCS,G2190,IND IMG HD RAD NECK,,,,,0
HCPCS,G2191,IND IMG HD POS HD ACHE,,,,,0
HCPCS,G2192,>55 YRS TEMP HD ACHE,,,,,0
HCPCS,G2193,<6YR NEW ONSET HD ACHE,,,,,0
HCPCS,G2194,NEW HDACHE PED PT DIS,,,,,0
HCPCS,G2195,OCCIP HDACHE CHILD,,,,,0
HCPCS,G2196,SCREEN UNHLTHY ETOH USE,,,,,0
HCPCS,G2197,SCREEN HLTHY ETOH USE,,,,,0
HCPCS,G2199,NOT SCRN ETOH NO RSN,,,,,0
HCPCS,G2200,UNHLTHY ETOH RCVD COUNS,,,,,0
HCPCS,G2202,NO RSN NO BRIEF COUNS,,,,,0
HCPCS,G2204,PT 45-85 W/ SCOPE,,,,,0
HCPCS,G2205,PREG DRNG ADJV TRTMT,,,,,0
HCPCS,G2206,ADJV TRTMT CHEMO HER2,,,,,0
HCPCS,G2207,RSN NO TRTMT CHEM HER2,,,,,0
HCPCS,G2208,NO TRTMT CHEMO AND HER2,,,,,0
HCPCS,G2209,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G2210,NO NECK FS PROM NO RSN,,,,,0
HCPCS,G2211,COMPLEX E/M VISIT ADD ON,,,,,0
HCPCS,G2212,PROLONG OUTPT/OFFICE VIS,,,,,0
HCPCS,G2213,INITIAT MED ASSIST TX IN ER,,,,,0
HCPCS,G2214,INIT/SUB PSYCH CARE M 1ST 30,,,98.72,197.44,8
HCPCS,G2215,HOME SUPPLY NASAL NALOXONE,,,,,0
HCPCS,G2216,HOME SUPPLY INJECT NALOXON,,,,,0
HCPCS,G2250,"REMOT IMG SUB BY PT, NON E/M",,,,,0
HCPCS,G2251,"BRIEF CHKIN, 5-10, NON-E/M",,,,,0
HCPCS,G2252,"BRIEF CHKIN BY MD/QHP, 11-20",,,,,0
HCPCS,G3002,CHRONIC PAIN MGMT 30 MINS,,,,,0
HCPCS,G3003,CHRONIC PAIN MGMT ADDL 15M,,,,,0
HCPCS,G4000,DERMATOLOGY SS,,,,,0
HCPCS,G4001,DIAGNOSTIC RAD SS,,,,,0
HCPCS,G4002,EP CARDIO SS,,,,,0
HCPCS,G4003,EMERGENCY MED SS,,,,,0
HCPCS,G4004,ENDOCRINOLOGY SS,,,,,0
HCPCS,G4005,FAMILY MEDICINE SS,,,,,0
HCPCS,G4006,GASTROENTEROLOGY SS,,,,,0
HCPCS,G4007,GENERAL SURGERY SS,,,,,0
HCPCS,G4008,GERIATRICS SS,,,,,0
HCPCS,G4009,HOSPITALISTS SS,,,,,0
HCPCS,G4010,INFECTIOUS DISEASE SS,,,,,0
HCPCS,G4011,INTERNAL MEDICINE SS,,,,,0
HCPCS,G4012,INTERVENTIONAL RAD SS,,,,,0
HCPCS,G4013,MNTAL/BEHAV/PSYCH HLTH SS,,,,,0
HCPCS,G4014,NEPHROLOGY SS,,,,,0
HCPCS,G4015,NEUROLOGY SS,,,,,0
HCPCS,G4016,NEUROSURGICAL SS,,,,,0
HCPCS,G4017,NUTRITION/DIETICIAN SS,,,,,0
HCPCS,G4018,OB/GYN SS,,,,,0
HCPCS,G4019,ONCOLOGY/HEMA SS,,,,,0
HCPCS,G4020,OPHTHALMOLOGY/OPTOMETRY SS,,,,,0
HCPCS,G4021,ORTHOPEDIC SURGERY SS,,,,,0
HCPCS,G4022,OTOLARYNGOLOGY SS,,,,,0
HCPCS,G4023,PATHOLOGY SS,,,,,0
HCPCS,G4024,PEDIATRICS SS,,,,,0
HCPCS,G4025,PHYSICAL MEDICINE SS,,,,,0
HCPCS,G4026,PHYS/OCC THERAPY SS,,,,,0
HCPCS,G4027,PLASTIC SURGERY SS,,,,,0
HCPCS,G4028,PODIATRY SS,,,,,0
HCPCS,G4029,PREVENTIVE MEDICINE SS,,,,,0
HCPCS,G4030,PULMONOLOGY SS,,,,,0
HCPCS,G4031,RADIATION ONCOLOGY SS,,,,,0
HCPCS,G4032,RHEUMATOLOGY SS,,,,,0
HCPCS,G4033,SKILLED NURSING FACILITY SS,,,,,0
HCPCS,G4034,SPEECH LANGUAGE PATH SS,,,,,0
HCPCS,G4035,THORACIC SURGERY SS,,,,,0
HCPCS,G4036,URGENT CARE SS,,,,,0
HCPCS,G4037,UROLOGY SS,,,,,0
HCPCS,G4038,VASCULAR SURGERY SS,,,,,0
HCPCS,G6001,ECHO GUIDANCE RADIOTHERAPY,,,,,0
HCPCS,G6002,STEREOSCOPIC X-RAY GUIDANCE,,,,,0
HCPCS,G6003,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6004,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6005,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6006,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6007,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6008,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6009,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6010,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6011,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6012,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6013,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6014,RADIATION TREATMENT DELIVERY,,,,,0
HCPCS,G6015,RADIATION TX DELIVERY IMRT,,,,,0
HCPCS,G6016,DELIVERY COMP IMRT,,,,,0
HCPCS,G6017,INTRAFRACTION TRACK MOTION,,,,,0
HCPCS,G8395,LVEF>=40% DOC NORMAL OR MILD,,,,,0
HCPCS,G8396,LVEF NOT PERFORMED,,,,,0
HCPCS,G8397,DIL MACULA/FUNDUS EXAM/W DOC,,,,,0
HCPCS,G8399,PT W/DXA RESULTS DOCUMENT,,,,,0
HCPCS,G8400,PT W/DXA NO RESULTS DOC,,,,,0
HCPCS,G8404,LOW EXTEMITY NEUR EXAM DOCUM,,,,,0
HCPCS,G8405,LOW EXTEMITY NEUR NOT PERFOR,,,,,0
HCPCS,G8410,EVAL ON FOOT DOCUMENTED,,,,,0
HCPCS,G8415,EVAL ON FOOT NOT PERFORMED,,,,,0
HCPCS,G8416,PT INELIG FOOTWEAR EVALUATIO,,,,,0
HCPCS,G8417,CALC BMI ABV UP PARAM F/U,,,,,0
HCPCS,G8418,CALC BMI BLW LOW PARAM F/U,,,,,0
HCPCS,G8419,CALC BMI OUT NRM PARAM NOF/U,,,,,0
HCPCS,G8420,CALC BMI NORM PARAMETERS,,,,,0
HCPCS,G8421,BMI NOT CALCULATED,,,,,0
HCPCS,G8427,DOCREV CUR MEDS BY ELIG CLIN,,,,,0
HCPCS,G8428,CUR MEDS NOT DOCUMENT,,,,,0
HCPCS,G8430,DOC MED RSN NO MEDREC,,,,,0
HCPCS,G8431,POS CLIN DEPRES SCRN F/U DOC,,,,,0
HCPCS,G8432,"DEP SCR NOT DOC, RNG",,,,,0
HCPCS,G8433,SCR FOR DEP NOT CPT DOC RSN,,,,,0
HCPCS,G8450,BETA-BLOC RX PT W/ABN LVEF,,,,,0
HCPCS,G8451,PT W/ABN LVEF INELIG B-BLOC,,,,,0
HCPCS,G8452,PT W/ABN LVEF B-BLOC NO RX,,,,,0
HCPCS,G8465,HIGH RISK RECURRENCE PRO CA,,,,,0
HCPCS,G8473,ACE/ARB THXPY RX'D,,,,,0
HCPCS,G8474,ACE/ARB NOT RX'D; DOC REAS,,,,,0
HCPCS,G8475,ACE/ARB THXPY NOT RX'D,,,,,0
HCPCS,G8476,BP SYS <140 AND DIAS <90,,,,,0
HCPCS,G8477,BP SYS>=140 AND/OR DIAS >=90,,,,,0
HCPCS,G8478,BP NOT PERFORMED/DOC,,,,,0
HCPCS,G8510,"SCR DEP NEG, NO PLAN REQD",,,,,0
HCPCS,G8511,"SCR DEP POS, NO PLAN DOC RNG",,,,,0
HCPCS,G8535,ELD MALTREATMENT NOT DOC,,,,,0
HCPCS,G8536,NO DOC ELDER MAL SCRN,,,,,0
HCPCS,G8539,DOC FUNCT AND CARE PLAN,,,,,0
HCPCS,G8540,FOA NOT DOC AS BEING PERF,,,,,0
HCPCS,G8541,NO DOC CUR FUNCT ASSESS,,,,,0
HCPCS,G8542,DOC FUNCT NO DEFICIENCIES,,,,,0
HCPCS,G8543,CUR FUNCT ASSES; NO CARE PLN,,,,,0
HCPCS,G8559,PT REF DOC OTO EVAL,,,,,0
HCPCS,G8560,PT HX ACT DRAIN PREV 90 DAYS,,,,,0
HCPCS,G8561,PT INELIG FOR REF OTO EVAL,,,,,0
HCPCS,G8562,PT NO HX ACT DRAIN 90 D,,,,,0
HCPCS,G8563,PT NO REF OTO REAS NO SPEC,,,,,0
HCPCS,G8564,PT REF OTO EVAL,,,,,0
HCPCS,G8565,VER DOC HEAR LOSS,,,,,0
HCPCS,G8566,PT INELIG REF OTO EVAL,,,,,0
HCPCS,G8567,PT NO DOC HEAR LOSS,,,,,0
HCPCS,G8568,PT NO REF OTOLO NO SPEC,,,,,0
HCPCS,G8569,PROL INTUBATION REQ,,,,,0
HCPCS,G8570,NO PROL INTUB REQ,,,,,0
HCPCS,G8575,POSTOP REN FAIL,,,,,0
HCPCS,G8576,NO POSTOP REN FAIL,,,,,0
HCPCS,G8577,REOP REQ BLD GRFT OTH,,,,,0
HCPCS,G8578,NO REOP REQ BLD GRFT OTH,,,,,0
HCPCS,G8598,ASA/ANTIPLAT THER USED,,,,,0
HCPCS,G8599,NO ASA/ANTIPLAT THER USE RNG,,,,,0
HCPCS,G8600,TPA INITI W/IN 4.5 HR,,,,,0
HCPCS,G8601,NO ELIG TPA INIT W/IN 4.5 HR,,,,,0
HCPCS,G8602,NO TPA INIT W/IN 4.5 HR,,,,,0
HCPCS,G8633,PHARM THER OSTEO RX,,,,,0
HCPCS,G8635,NO PHARM THER OSTEO RX,,,,,0
HCPCS,G8647,RAFSCRS KI SCOR >= 0,,,,,0
HCPCS,G8648,RAFSCRS KI SCOR < 0,,,,,0
HCPCS,G8650,RAFS CRS KI NO SCOR NO RSN,,,,,0
HCPCS,G8651,RAFSCRS HI SCOR >=0,,,,,0
HCPCS,G8652,RAFSCRS HI SCOR < 0,,,,,0
HCPCS,G8654,RAFS CRS HI NO SCOR NO SURV,,,,,0
HCPCS,G8655,RAFSCRS LLFAI SCOR >= 0,,,,,0
HCPCS,G8656,RAFSCRS LLFAI SCOR < 0,,,,,0
HCPCS,G8658,RAFSCRS LLFAI NO SCOR + SURV,,,,,0
HCPCS,G8659,RAFSCRS LBI SCOR >= 0,,,,,0
HCPCS,G8660,RAFSCRS LBI SCOR < 0,,,,,0
HCPCS,G8661,RAFSCRS LBI NO SCOR,,,,,0
HCPCS,G8662,RAFS CRS LBI NO SCOR NO SURV,,,,,0
HCPCS,G8663,RAFSCRS SI SCOR >= 0,,,,,0
HCPCS,G8664,RAFSCRS SI SCOR < 0,,,,,0
HCPCS,G8666,RAFS CRS SI NO SCOR NO SURV,,,,,0
HCPCS,G8667,RAFSCRS EWH SCOR >= 0,,,,,0
HCPCS,G8668,RAFSCRS EWH SCOR < 0,,,,,0
HCPCS,G8670,RAFS CRS EWH NO SCOR NO SURV,,,,,0
HCPCS,G8694,LVEF <=40%,,,,,0
HCPCS,G8708,ANTIBIOTIC NOT PRES,,,,,0
HCPCS,G8709,URI EP COMPETE DIAG,,,,,0
HCPCS,G8710,PT PRES ANTIBIOTIC,,,,,0
HCPCS,G8711,PRES ANTIBX ON/WITHIN 3 DAY,,,,,0
HCPCS,G8712,NOT PRES ANTIBIOTIC,,,,,0
HCPCS,G8721,"PT, PN, HIST GRADE DOC",,,,,0
HCPCS,G8722,"MED REAS PT, PN, NOT DOC",,,,,0
HCPCS,G8723,SPEC SIT NOT PRIM TUMOR,,,,,0
HCPCS,G8724,"PT, PN, HIST GRADE NOT DOC",,,,,0
HCPCS,G8733,DOC POS ELDER MAL SCRN PLAN,,,,,0
HCPCS,G8734,DOC NEG ELD REQ,,,,,0
HCPCS,G8735,ELD MAL SCRN POS NO PLAN,,,,,0
HCPCS,G8749,NO SIGNS MELANOMA,,,,,0
HCPCS,G8752,SYS BP LESS 140,,,,,0
HCPCS,G8753,SYS BP > OR = 140,,,,,0
HCPCS,G8754,DIAS BP LESS 90,,,,,0
HCPCS,G8755,DIAS BP > OR = 90,,,,,0
HCPCS,G8756,NO BP MEASURE DOC,,,,,0
HCPCS,G8783,BP SCRN PERF REC INTERVAL,,,,,0
HCPCS,G8785,BP SCRN NO PERF AT INTERVAL,,,,,0
HCPCS,G8797,SPECIMEN SITE NOT ESOPHAGUS,,,,,0
HCPCS,G8798,SPECIMEN SITE NOT PROSTATE,,,,,0
HCPCS,G8806,PERF ULTRSND TO LCT PREG DOC,,,,,0
HCPCS,G8807,NO TA TV ULTRASND,,,,,0
HCPCS,G8808,"ULTRASOUND NOT PERF, RNG",,,,,0
HCPCS,G8815,DOC REAS NO STATIN THERAPY,,,,,0
HCPCS,G8816,STATIN MED PRES AT DISCH,,,,,0
HCPCS,G8817,DOC REAS NO STATIN MED DISCH,,,,,0
HCPCS,G8826,PT DISCH HOME DAY #2 EVAR,,,,,0
HCPCS,G8833,PT NOT DISCH HOME DAY#2 EVAR,,,,,0
HCPCS,G8834,PT DISCH HOME DAY #2 CEA,,,,,0
HCPCS,G8838,NOT DISCH HOME BY DAY #2,,,,,0
HCPCS,G8839,SLEEP APNEA ASSESS,,,,,0
HCPCS,G8840,DOC REAS NO SLEEP APNEA,,,,,0
HCPCS,G8841,NO SLEEP APNEA ASSESS,,,,,0
HCPCS,G8842,AHI OR RDI INITIAL DX,,,,,0
HCPCS,G8843,DOC REAS NO AHI OR RDI,,,,,0
HCPCS,G8844,NO AHI OR RDI INITIAL DX,,,,,0
HCPCS,G8845,POS AIRWAY PRESS PRESCRIBED,,,,,0
HCPCS,G8846,MOD OR SEVERE OSA,,,,,0
HCPCS,G8849,DOC REAS NO POS AIR PRESS,,,,,0
HCPCS,G8850,NO PAP PRESCRIBED,,,,,0
HCPCS,G8851,ADHERE TX ASSESS AT LST ANN,,,,,0
HCPCS,G8854,REAS NO ADHERE THERAPY,,,,,0
HCPCS,G8855,THER NOT ASSESSED ANNUALLY,,,,,0
HCPCS,G8856,REF FOR OTO EVAL,,,,,0
HCPCS,G8857,NO ELIG REF FOR OTO EVAL,,,,,0
HCPCS,G8858,NOT REF FOR OTO EVAL,,,,,0
HCPCS,G8863,NO ASSESS BONE LOSS,,,,,0
HCPCS,G8864,PNEUMOCOCCAL VACCINE ADMIN,,,,,0
HCPCS,G8865,DOC MED REAS NO PNEUMOCOCCAL,,,,,0
HCPCS,G8866,DOC PT REAS NO PNEUMOCOCCAL,,,,,0
HCPCS,G8867,NO PNEUMOCOCCAL ADMIN,,,,,0
HCPCS,G8869,DOC IMMUNE HEP B ANTITNF,,,,,0
HCPCS,G8875,BREAST CANCER DX MIN INVSIVE,,,,,0
HCPCS,G8876,DOC REAS NO MIN INV DX,,,,,0
HCPCS,G8877,NO BRST CNCR DX MIN INVASIVE,,,,,0
HCPCS,G8878,SENT LYMPH NODE BIOPSY,,,,,0
HCPCS,G8880,SEN LYM P NODE BIOP NOT PERF,,,,,0
HCPCS,G8881,BRST CNCR STAGE > T1N0M0,,,,,0
HCPCS,G8882,NO SENT LYMPH NODE BIOPSY,,,,,0
HCPCS,G8907,PT DOC NO EVENTS ON DISCHARG,,,,,0
HCPCS,G8908,PT DOC W BURN PRIOR TO D/C,,,,,0
HCPCS,G8909,PT DOC NO BURN PRIOR TO D/C,,,,,0
HCPCS,G8910,PT DOC TO HAVE FALL IN ASC,,,,,0
HCPCS,G8911,PT DOC NO FALL IN ASC,,,,,0
HCPCS,G8912,PT DOC WITH WRONG EVENT,,,,,0
HCPCS,G8913,PT DOC NO WRONG EVENT,,,,,0
HCPCS,G8914,PT TRANS TO HOSP POST D/C,,,,,0
HCPCS,G8915,PT NOT TRANS TO HOSP AT D/C,,,,,0
HCPCS,G8916,PT W IV AB GIVEN ON TIME,,,,,0
HCPCS,G8917,PT W IV AB NOT GIVEN ON TIME,,,,,0
HCPCS,G8918,PT W/O PREOP ORDER IV AB PRO,,,,,0
HCPCS,G8923,LVEF <= 40% OR LVSD,,,,,0
HCPCS,G8924,SPIR RES DOC FEV1/FVC<70%,,,,,0
HCPCS,G8934,LVEF <=40% OR DEP LV SYS FCN,,,,,0
HCPCS,G8935,RX ACE OR ARB THERAPY,,,,,0
HCPCS,G8936,PT NOT ELIGIBLE ACE/ARB,,,,,0
HCPCS,G8937,NO RX ACE/ARB THERAPY,,,,,0
HCPCS,G8942,DOC FCN/CARE PLAN W/30 DAYS,,,,,0
HCPCS,G8944,AJCC MEL CNR STG 0 - IIC,,,,,0
HCPCS,G8946,MIBM BUT NO DX OF BREAST CA,,,,,0
HCPCS,G8950,"PRE-HTN OR HTN DOC, F/U INDC",,,,,0
HCPCS,G8952,"PRE-HTN/HTN, NO F/U, NOT GVN",,,,,0
HCPCS,G8955,MOST RECENT ASSESS VOL MGMT,,,,,0
HCPCS,G8956,PT RCV HEDIA OUTPT DYLS FAC,,,,,0
HCPCS,G8958,ASSESS VOL MGMT NOT DOC,,,,,0
HCPCS,G8961,CSIT LOWRISK SURG PTS PREOP,,,,,0
HCPCS,G8962,CSIT ON PT ANY REAS 30 DAYS,,,,,0
HCPCS,G8967,WARF OR OTHER FDA DRUG PRESC,,,,,0
HCPCS,G8968,DOC MED NOT PRESB,,,,,0
HCPCS,G8969,DOC PT RSN NO PRESC WARF/FDA,,,,,0
HCPCS,G8970,NO RSK FAC OR 1 MOD RISK TE,,,,,0
HCPCS,G9001,"MCCD, INITIAL RATE",,,,,0
HCPCS,G9002,"MCCD,MAINTENANCE RATE",,,,,0
HCPCS,G9003,"MCCD, RISK ADJ HI, INITIAL",,,,,0
HCPCS,G9004,"MCCD, RISK ADJ LO, INITIAL",,,,,0
HCPCS,G9005,"MCCD, RISK ADJ, MAINTENANCE",,,,,0
HCPCS,G9006,"MCCD, HOME MONITORING",,,,,0
HCPCS,G9007,"MCCD, SCH TEAM CONF",,,,,0
HCPCS,G9008,"MCCD,PHYS COOR-CARE OVRSGHT",,,,,0
HCPCS,G9009,"MCCD, RISK ADJ, LEVEL 3",,,,,0
HCPCS,G9010,"MCCD, RISK ADJ, LEVEL 4",,,,,0
HCPCS,G9011,"MCCD, RISK ADJ, LEVEL 5",,,,,0
HCPCS,G9012,OTHER SPECIFIED CASE MGMT,,,,,0
HCPCS,G9013,ESRD DEMO BUNDLE LEVEL I,,,,,0
HCPCS,G9014,ESRD DEMO BUNDLE-LEVEL II,,,,,0
HCPCS,G9016,DEMO-SMOKING CESSATION COUN,,,,,0
HCPCS,G9050,ONCOLOGY WORK-UP EVALUATION,,,,,0
HCPCS,G9051,ONCOLOGY TX DECISION-MGMT,,,,,0
HCPCS,G9052,ONC SURVEILLANCE FOR DISEASE,,,,,0
HCPCS,G9053,ONC EXPECTANT MANAGEMENT PT,,,,,0
HCPCS,G9054,ONC SUPERVISION PALLIATIVE,,,,,0
HCPCS,G9055,ONC VISIT UNSPECIFIED NOS,,,,,0
HCPCS,G9056,ONC PRAC MGMT ADHERES GUIDE,,,,,0
HCPCS,G9057,ONC PRACT MGMT DIFFERS TRIAL,,,,,0
HCPCS,G9058,ONC PRAC MGMT DISAGREE W/GUI,,,,,0
HCPCS,G9059,ONC PRAC MGMT PT OPT ALTERNA,,,,,0
HCPCS,G9060,ONC PRAC MGMT DIF PT COMORB,,,,,0
HCPCS,G9061,ONC PRAC COND NOADD BY GUIDE,,,,,0
HCPCS,G9062,ONC PRAC GUIDE DIFFERS NOS,,,,,0
HCPCS,G9063,ONC DX NSCLC STGI NO PROGRES,,,,,0
HCPCS,G9064,ONC DX NSCLC STG2 NO PROGRES,,,,,0
HCPCS,G9065,ONC DX NSCLC STG3A NO PROGRE,,,,,0
HCPCS,G9066,ONC DX NSCLC STG3B-4 METASTA,,,,,0
HCPCS,G9067,ONC DX NSCLC DX UNKNOWN NOS,,,,,0
HCPCS,G9068,ONC DX SCLC/NSCLC LIMITED,,,,,0
HCPCS,G9069,ONC DX SCLC/NSCLC EXT AT DX,,,,,0
HCPCS,G9070,ONC DX SCLC/NSCLC EXT UNKNWN,,,,,0
HCPCS,G9071,"ONC DX BRST STG1-2B HR,NOPRO",,,,,0
HCPCS,G9072,ONC DX BRST STG1-2 NOPROGRES,,,,,0
HCPCS,G9073,"ONC DX BRST STG3-HR, NO PRO",,,,,0
HCPCS,G9074,ONC DX BRST STG3-NOPROGRESS,,,,,0
HCPCS,G9075,ONC DX BRST METASTIC/ RECUR,,,,,0
HCPCS,G9077,ONC DX PROSTATE T1NO PROGRES,,,,,0
HCPCS,G9078,ONC DX PROSTATE T2NO PROGRES,,,,,0
HCPCS,G9079,ONC DX PROSTATE T3B-T4NOPROG,,,,,0
HCPCS,G9080,ONC DX PROSTATE W/RISE PSA,,,,,0
HCPCS,G9083,ONC DX PROSTATE UNKNWN NOS,,,,,0
HCPCS,G9084,"ONC DX COLON T1-3,N1-2,NO PR",,,,,0
HCPCS,G9085,"ONC DX COLON T4, N0 W/O PROG",,,,,0
HCPCS,G9086,ONC DX COLON T1-4 NO DX PROG,,,,,0
HCPCS,G9087,ONC DX COLON METAS EVID DX,,,,,0
HCPCS,G9088,ONC DX COLON METAS NOEVID DX,,,,,0
HCPCS,G9089,ONC DX COLON EXTENT UNKNOWN,,,,,0
HCPCS,G9090,ONC DX RECTAL T1-2 NO PROGR,,,,,0
HCPCS,G9091,ONC DX RECTAL T3 N0 NO PROG,,,,,0
HCPCS,G9092,"ONC DX RECTAL T1-3,N1-2NOPRG",,,,,0
HCPCS,G9093,"ONC DX RECTAL T4,N,M0 NO PRG",,,,,0
HCPCS,G9094,ONC DX RECTAL M1 W/METS PROG,,,,,0
HCPCS,G9095,ONC DX RECTAL EXTENT UNKNWN,,,,,0
HCPCS,G9096,ONC DX ESOPHAG T1-T3 NOPROG,,,,,0
HCPCS,G9097,ONC DX ESOPHAGEAL T4 NO PROG,,,,,0
HCPCS,G9098,ONC DX ESOPHAGEAL METS RECUR,,,,,0
HCPCS,G9099,ONC DX ESOPHAGEAL UNKNOWN,,,,,0
HCPCS,G9100,ONC DX GASTRIC NO RECURRENCE,,,,,0
HCPCS,G9101,ONC DX GASTRIC P R1-R2NOPROG,,,,,0
HCPCS,G9102,ONC DX GASTRIC UNRESECTABLE,,,,,0
HCPCS,G9103,ONC DX GASTRIC RECURRENT,,,,,0
HCPCS,G9104,ONC DX GASTRIC UNKNOWN NOS,,,,,0
HCPCS,G9105,ONC DX PANCREATC P R0 RES NO,,,,,0
HCPCS,G9106,ONC DX PANCREATC P R1/R2 NO,,,,,0
HCPCS,G9107,ONC DX PANCREATIC UNRESECTAB,,,,,0
HCPCS,G9108,ONC DX PANCREATIC UNKNWN NOS,,,,,0
HCPCS,G9109,ONC DX HEAD/NECK T1-T2NO PRG,,,,,0
HCPCS,G9110,ONC DX HEAD/NECK T3-4 NOPROG,,,,,0
HCPCS,G9111,ONC DX HEAD/NECK M1 METS REC,,,,,0
HCPCS,G9112,ONC DX HEAD/NECK EXT UNKNOWN,,,,,0
HCPCS,G9113,ONC DX OVARIAN STG1A-B NO PR,,,,,0
HCPCS,G9114,ONC DX OVARIAN STG1A-B OR 2,,,,,0
HCPCS,G9115,ONC DX OVARIAN STG3/4 NOPROG,,,,,0
HCPCS,G9116,ONC DX OVARIAN RECURRENCE,,,,,0
HCPCS,G9117,ONC DX OVARIAN UNKNOWN NOS,,,,,0
HCPCS,G9123,ONC DX CML CHRONIC PHASE,,,,,0
HCPCS,G9124,ONC DX CML ACCELER PHASE,,,,,0
HCPCS,G9125,ONC DX CML BLAST PHASE,,,,,0
HCPCS,G9126,ONC DX CML REMISSION,,,,,0
HCPCS,G9128,ONC DX MULTI MYELOMA STAGE I,,,,,0
HCPCS,G9129,ONC DX MULT MYELOMA STG2 HIG,,,,,0
HCPCS,G9130,ONC DX MULTI MYELOMA UNKNOWN,,,,,0
HCPCS,G9131,ONC DX BRST UNKNOWN NOS,,,,,0
HCPCS,G9132,ONC DX PROSTATE METS NO CAST,,,,,0
HCPCS,G9133,ONC DX PROSTATE CLINICAL MET,,,,,0
HCPCS,G9134,ONC NHLSTG 1-2 NO RELAP NO,,,,,0
HCPCS,G9135,ONC DX NHL STG 3-4 NOT RELAP,,,,,0
HCPCS,G9136,ONC DX NHL TRANS TO LG BCELL,,,,,0
HCPCS,G9137,ONC DX NHL RELAPSE/REFRACTOR,,,,,0
HCPCS,G9138,ONC DX NHL STG UNKNOWN,,,,,0
HCPCS,G9139,ONC DX CML DX STATUS UNKNOWN,,,,,0
HCPCS,G9140,FRONTIER EXTENDED STAY DEMO,,,,,0
HCPCS,G9143,WARFARIN RESPON GENETIC TEST,,,120.72,241.44,8
HCPCS,G9147,OUTPT IV INSULIN TX ANY MEA,,,,,0
HCPCS,G9148,MEDICAL HOME LEVEL 1,,,,,0
HCPCS,G9149,MEDICAL HOME LEVEL II,,,,,0
HCPCS,G9150,MEDICAL HOME LEVEL III,,,,,0
HCPCS,G9151,MAPCP DEMO STATE,,,,,0
HCPCS,G9152,MAPCP DEMO COMMUNITY,,,,,0
HCPCS,G9153,MAPCP DEMO PHYSICIAN,,,,,0
HCPCS,G9156,EVALUATION FOR WHEELCHAIR,,,,,0
HCPCS,G9157,TRANSESOPH DOPPL CARDIAC MON,,,,,0
HCPCS,G9187,BPCI HOME VISIT,,,,,0
HCPCS,G9188,BETA NOT GIVEN NO REASON,,,,,0
HCPCS,G9189,BETA PRES OR ALREADY TAKING,,,,,0
HCPCS,G9190,MEDICAL REASON FOR NO BETA,,,,,0
HCPCS,G9191,PT REASON FOR NO BETA,,,,,0
HCPCS,G9212,DOC OF DSM-IV INIT EVAL,,,,,0
HCPCS,G9213,NO DOC OF DSM-IV,,,,,0
HCPCS,G9223,PJP PROPH ORDERED CD4 LOW,,,,,0
HCPCS,G9225,NORSN NO FOOT EXAM,,,,,0
HCPCS,G9226,3 COMP FOOT EXAM COMPLETED,,,,,0
HCPCS,G9227,"FOA DOC, CARE PLAN NOT DOC",,,,,0
HCPCS,G9228,GC CHL SYP DOCUMENTED,,,,,0
HCPCS,G9230,NORSN FOR GC CHL SYP TEST,,,,,0
HCPCS,G9231,DOC ESRD DIA TRANS PREG,,,,,0
HCPCS,G9242,DOC VIRAL LOAD >=200,,,,,0
HCPCS,G9243,DOC VIRAL LOAD <200,,,,,0
HCPCS,G9246,NO MED VISIT IN 24MO,,,,,0
HCPCS,G9247,1 MED VISIT IN 24MO,,,,,0
HCPCS,G9254,DOC PT DISCHG >2D,,,,,0
HCPCS,G9255,DOC PT DISCHG <=2D,,,,,0
HCPCS,G9273,SYS<140 AND DIA<90,,,,,0
HCPCS,G9274,BP OUT OF NRML LIMITS,,,,,0
HCPCS,G9275,DOC OF NON TOBACCO USER,,,,,0
HCPCS,G9276,DOC OF TOBACCO USER,,,,,0
HCPCS,G9277,DOC DAILY ASPIRIN OR CONTRA,,,,,0
HCPCS,G9278,DOC NO DAILY ASPIRIN,,,,,0
HCPCS,G9279,PNE SCRN DONE DOC VAC DONE,,,,,0
HCPCS,G9280,PNE NOT GIVEN NORSN,,,,,0
HCPCS,G9281,PNE SCRN DONE DOC NOT IND,,,,,0
HCPCS,G9282,DOC MEDRSN NO HISTO TYPE,,,,,0
HCPCS,G9283,HIST TYPE DOC ON REPORT,,,,,0
HCPCS,G9284,NO HIST TYPE DOC ON REPORT,,,,,0
HCPCS,G9285,SITE NOT SMALL CELL LUNG CA,,,,,0
HCPCS,G9286,ANTIBIO RX W IN 10D OF SYMPT,,,,,0
HCPCS,G9287,NO ANTIBIO W IN 10D OF SYMPT,,,,,0
HCPCS,G9288,DOC MEDRSN NO HIST TYPE RPT,,,,,0
HCPCS,G9289,DOC TYPE NSM LUNG CA,,,,,0
HCPCS,G9290,NO DOC TYPE NSM LUNG CA,,,,,0
HCPCS,G9291,NOT NSM LUNG CA,,,,,0
HCPCS,G9292,MEDRSN NO PT CATEGORY,,,,,0
HCPCS,G9293,NO PT CATEGORY ON REPORT,,,,,0
HCPCS,G9294,PT CAT AND THCK ON REPORT,,,,,0
HCPCS,G9295,NON CUTANEOUS LOC,,,,,0
HCPCS,G9296,DOC SHARE DEC PRIOR PROC,,,,,0
HCPCS,G9297,NO DOC SHARE DEC PRIOR PROC,,,,,0
HCPCS,G9298,EVAL RISK VTE CARD 30D PRIOR,,,,,0
HCPCS,G9299,NO EVAL RISK VTE CARD PRIOR,,,,,0
HCPCS,G9305,NO INTERV REQ FOR LEAK,,,,,0
HCPCS,G9306,INTERV REQ FOR LEAK,,,,,0
HCPCS,G9307,NO RET FOR SURG W IN 30D,,,,,0
HCPCS,G9308,UNPL RET OR W/COMPL W/IN 30D,,,,,0
HCPCS,G9309,NO UNPLND HOSP READM IN 30D,,,,,0
HCPCS,G9310,UNPLND HOSP READM IN 30D,,,,,0
HCPCS,G9311,NO SURG SITE INFECTION,,,,,0
HCPCS,G9312,SURGICAL SITE INFECTION,,,,,0
HCPCS,G9313,AMOXIC NOT PRESC AS 1ST LINE,,,,,0
HCPCS,G9314,NORSN NOT FIRST LINE AMOX,,,,,0
HCPCS,G9315,AMOX W/WO CLAV RX,,,,,0
HCPCS,G9316,DOC COMM RISK CALC,,,,,0
HCPCS,G9317,NO DOC COMM RISK CALC,,,,,0
HCPCS,G9318,IMAGE STD NOMENCLATURE,,,,,0
HCPCS,G9319,IMAGE NOT STD NOMENCLATURE,,,,,0
HCPCS,G9321,DOC COUNT OF CT IN 12MO,,,,,0
HCPCS,G9322,NO DOC COUNT OF CT IN 12MO,,,,,0
HCPCS,G9341,SRCH FOR CT W IN 12 MOS,,,,,0
HCPCS,G9342,NO SRCH FOR CT IN 12MO NORSN,,,,,0
HCPCS,G9344,SYSRSN NO DICOM SRCH,,,,,0
HCPCS,G9345,FOLLOW UP PULM NOD,,,,,0
HCPCS,G9347,NO FOLLOW UP PULM NOD NORSN,,,,,0
HCPCS,G9351,DOC >1 SINUS CT W 90D DX,,,,,0
HCPCS,G9352,NOT >1 SINUS CT W 90D DX,,,,,0
HCPCS,G9353,MEDRSN >1 SINUS CT W 90D DX,,,,,0
HCPCS,G9354,1 OR NO CT SINUS W/IN 90D DX,,,,,0
HCPCS,G9355,NO EARLY IND/DELIVERY,,,,,0
HCPCS,G9356,EARLY IND/DELIVERY,,,,,0
HCPCS,G9357,PP EVAL/EDU PERF,,,,,0
HCPCS,G9358,PP EVAL/EDU NOT PERF,,,,,0
HCPCS,G9361,DOC RSN ELECT C-SEC/INDUCT,,,,,0
HCPCS,G9364,SINUS CAUS BAC INX,,,,,0
HCPCS,G9367,>= 2 SAME HI-RSK MED ORD,,,,,0
HCPCS,G9368,>= 2 SAME HI-RSK MED NOT ORD,,,,,0
HCPCS,G9380,OFF ASSIS EOL ISS,,,,,0
HCPCS,G9382,NO OFF ASSIS EOL,,,,,0
HCPCS,G9383,RECD SCRN HCV INFEC,,,,,0
HCPCS,G9384,DOC MED RSN NO HCV SCRN,,,,,0
HCPCS,G9385,DOC PT REAS NOT REC HCV SRN,,,,,0
HCPCS,G9386,SCRN HCV INFEC NOT RECD,,,,,0
HCPCS,G9393,INI PHQ9 >9 REMISS <5,,,,,0
HCPCS,G9394,"DX BIPOL, DEATH, NHRES, HOSP",,,,,0
HCPCS,G9395,INI PHQ9 >9 NO REMISS >=5,,,,,0
HCPCS,G9396,INI PHQ9 >9 NOT ASSESS,,,,,0
HCPCS,G9408,CARD TAMP W/IN 30D,,,,,0
HCPCS,G9409,NO CARD TAMP E/IN 30D,,,,,0
HCPCS,G9410,ADMIT W/IN 180D REQ REMOV,,,,,0
HCPCS,G9411,NO ADMIT W/IN 180D REQ REMOV,,,,,0
HCPCS,G9412,ADMIT W/IN 180D REQ SURG REV,,,,,0
HCPCS,G9413,NO ADMIT REQ SURG REV,,,,,0
HCPCS,G9414,1DOSE MENIG VAC BTWN 11 & 13,,,,,0
HCPCS,G9415,NO 1DOSE MENI VAC BTWN 11&13,,,,,0
HCPCS,G9416,PT 1 TDAP BETW 10-13 YRS,,,,,0
HCPCS,G9417,PT NOT 1 TDAP BETW 10-13 YRS,,,,,0
HCPCS,G9418,LUNGCX BX RPT DOCS CLASS,,,,,0
HCPCS,G9419,MED REAS NOT INCL HISTO TYPE,,,,,0
HCPCS,G9420,SPEC SITE NO LUNG,,,,,0
HCPCS,G9421,LUNG CX BX RPT NO DOC CLASS,,,,,0
HCPCS,G9422,RPT DOC CLASS HISTO TYPE,,,,,0
HCPCS,G9423,MED REAS RPT NO HISTO TYPE,,,,,0
HCPCS,G9424,SITE NO LUNG OR LUNG CX,,,,,0
HCPCS,G9425,SPEC RPT NO DOC CLASS HISTO,,,,,0
HCPCS,G9426,IMPR MED TIME EDARR PAIN MED,,,,,0
HCPCS,G9427,NO IMPRO MED TIME PAIN MED,,,,,0
HCPCS,G9428,PATHO RPT INCL PT CTG,,,,,0
HCPCS,G9429,DOC MED RSN NO PT CAT,,,,,0
HCPCS,G9430,SPEC SITE NO CUTANEOUS,,,,,0
HCPCS,G9431,PATHO RPT NO PT CTG,,,,,0
HCPCS,G9432,ASTH CONTROLLED,,,,,0
HCPCS,G9434,ASTH NOT CONTROLLED,,,,,0
HCPCS,G9452,DOC MED REAS NO HCV TEST,,,,,0
HCPCS,G9455,"ABD IMAG W/US, CT OR MRI",,,,,0
HCPCS,G9456,DOC MED PT REAS NO HCC SCRN,,,,,0
HCPCS,G9457,PT NO ABD IMG NO DOC RSN,,,,,0
HCPCS,G9468,NO RECD CORTICO>=10MG/D >60D,,,,,0
HCPCS,G9470,NO REC CORTICO>60D 1RX 600MG,,,,,0
HCPCS,G9471,W/IN 2YR DXA NOT ORDER,,,,,0
HCPCS,G9473,CHAP SERVICES AT HOSPICE,,,,,0
HCPCS,G9474,DIET COUNSEL AT HOSPICE,,,,,0
HCPCS,G9475,OTHER COUNSELOR AT HOSPICE,,,,,0
HCPCS,G9476,VOLUN SERVICE AT HOSPICE,,,,,0
HCPCS,G9477,CARE COORD AT HOSPICE,,,,,0
HCPCS,G9478,OTHE THERAPIST AT HOSPICE,,,,,0
HCPCS,G9479,PHARMACIST AT HOSPICE,,,,,0
HCPCS,G9480,ADMISSION TO MCCM,,,,,0
HCPCS,G9481,REMOTE E/M NEW PT 10MINS,,,,,0
HCPCS,G9482,REMOTE E/M NEW PT 20MINS,,,,,0
HCPCS,G9483,REMOTE E/M NEW PT 30MINS,,,,,0
HCPCS,G9484,REMOTE E/M NEW PT 45MINS,,,,,0
HCPCS,G9485,REMOTE E/M NEW PT 60MINS,,,,,0
HCPCS,G9486,REMOTE E/M EST. PT 10MINS,,,,,0
HCPCS,G9487,REMOTE E/M EST. PT 15MINS,,,,,0
HCPCS,G9488,REMOTE E/M EST. PT 25MINS,,,,,0
HCPCS,G9489,REMOTE E/M EST. PT 40MINS,,,,,0
HCPCS,G9490,CMMI MOD HOME VISIT,,,,,0
HCPCS,G9497,REC INST NO SMOKE DAY SURG,,,,,0
HCPCS,G9498,ABX REG PRESCRIBED,,,,,0
HCPCS,G9500,RAD EXPOS IND/EXP TM DOC,,,,,0
HCPCS,G9501,RAD EXPOS IND/EXP TM NO DOC,,,,,0
HCPCS,G9502,MED REAS NO PERF FOOT EXAM,,,,,0
HCPCS,G9504,DOC RSN HEP B STAT NOT ASSES,,,,,0
HCPCS,G9505,ABX PRES W/IN 10 DYS OF SYMP,,,,,0
HCPCS,G9507,DOC REAS ON STATIN OR CONTRA,,,,,0
HCPCS,G9508,DOC PT NOT ON STATIN,,,,,0
HCPCS,G9509,ADIT MDD DYS REM 12 MNTHS,,,,,0
HCPCS,G9510,REMIS12M NOT PHQ-9 SCORE <5,,,,,0
HCPCS,G9511,IDX EVT DTE PHQ>9 DOC 12 MO,,,,,0
HCPCS,G9512,INDIV PDC > 0.8,,,,,0
HCPCS,G9513,INDIV PDC NOT > 0.8,,,,,0
HCPCS,G9514,REQ RET OR W/IN 90D OF SURG,,,,,0
HCPCS,G9515,"NO REAS, NO RET OR W/IN 90D",,,,,0
HCPCS,G9516,IMPR VIS ACUIT W/IN 90D,,,,,0
HCPCS,G9517,NO IMPR VIS ACUIT W/IN 90D,,,,,0
HCPCS,G9518,DOC ACTIVE INJ DRUG USE,,,,,0
HCPCS,G9519,FINAL REF +/- 1.0 W/IN 90D,,,,,0
HCPCS,G9520,REFRACT NOT +/- 1.0 W/IN 90D,,,,,0
HCPCS,G9521,ER AND IP HOSP <2 IN 12 MOS,,,,,0
HCPCS,G9522,ER/IP HOSP =/>2 IN 12 MOS,,,,,0
HCPCS,G9529,MINOR BLUNT TRAUMA W/HEAD CT,,,,,0
HCPCS,G9530,PT MBHT HD CT ORD EC PROV,,,,,0
HCPCS,G9531,PT DOC,,,,,0
HCPCS,G9533,INDIC FOR HEAD CT NOT VALID,,,,,0
HCPCS,G9537,IMG HD CLIN TRIAL,,,,,0
HCPCS,G9539,INTENT POT REMV TIME PLACEMT,,,,,0
HCPCS,G9540,PT ALIVE 3 MOS POST PROC,,,,,0
HCPCS,G9541,FILTER REM 3 MON PLMT,,,,,0
HCPCS,G9542,DOC REASS APPR REMO FILT 3MS,,,,,0
HCPCS,G9543,DOC 2X RE-ASSESS FILT REMOV,,,,,0
HCPCS,G9544,NO FILT REMOV W/IN 3MOS PLCM,,,,,0
HCPCS,G9547,CYS REN LES OR ADREN,,,,,0
HCPCS,G9548,NO F/U REC IMAGE STUDY,,,,,0
HCPCS,G9549,DOC MED RSN FOR F/U IMAG,,,,,0
HCPCS,G9550,IMAG REC,,,,,0
HCPCS,G9551,IMAG NO LES,,,,,0
HCPCS,G9552,INC THYR NODE <1.0 IN RPT,,,,,0
HCPCS,G9553,PRIOR THYROID DISE DX,,,,,0
HCPCS,G9554,CT/CTA/MRI/A CHST FOLL REC,,,,,0
HCPCS,G9555,DOC MED RSN FOR FOLLUP IMAGE,,,,,0
HCPCS,G9556,CT/CTA/MRI/A NO FOLLUP IMAG,,,,,0
HCPCS,G9557,CT/CTA/MRI/A NO THYR <1.0CM,,,,,0
HCPCS,G9580,DOOR TO PUNC TIME <2HRS,,,,,0
HCPCS,G9582,"DOOR TO PUNC TIME >2HR, NRG",,,,,0
HCPCS,G9593,LOW PECARN PED HEAD TRAUMA,,,,,0
HCPCS,G9594,PT MBHT HD CT ORD EC PROV,,,,,0
HCPCS,G9595,DOC SHNT/TUM/COAG,,,,,0
HCPCS,G9597,NO LOW PECARN PED HEAD TRAUM,,,,,0
HCPCS,G9598,AOR ANE 5.5-5.9 CM MAX DIAM,,,,,0
HCPCS,G9599,AOR ANE >=6.0 CM MAX DIAM,,,,,0
HCPCS,G9603,PT SURV IMPROV BSLINE TX,,,,,0
HCPCS,G9604,PT SURV RESULTS NOT AVAIL,,,,,0
HCPCS,G9605,SURV SCORE NO IMPROV W/TX,,,,,0
HCPCS,G9606,INTRAOP CYST EVAL TRAC INJ,,,,,0
HCPCS,G9607,DOC MED RSN NOT PERF CYSTOSC,,,,,0
HCPCS,G9608,INTRAOP CYST EVAL NOT DONE,,,,,0
HCPCS,G9609,DOC ORDER ANTI-PLAT,,,,,0
HCPCS,G9610,DOC MD RSN NO ANTIPLA,,,,,0
HCPCS,G9611,NO DOC ORDER ANTI-PLAT RNG,,,,,0
HCPCS,G9621,SCR UNHEAL ETOH W/COUNSEL,,,,,0
HCPCS,G9622,NO UNHEAL ETOH USER,,,,,0
HCPCS,G9624,PT NOT SCRN OR NO COUNSELING,,,,,0
HCPCS,G9625,PT BL SRG 30 DAY PST SRG,,,,,0
HCPCS,G9626,MED RSN NO RPT BLADDER INJ,,,,,0
HCPCS,G9627,PT NO BL SRG 30 DAY PST SRG,,,,,0
HCPCS,G9628,PT BWLI SRG 30 DAY PST SRG,,,,,0
HCPCS,G9629,MED RSN NO RPT BOWEL INJ,,,,,0
HCPCS,G9630,PT NO BWLI SRG 30 DAY SRG,,,,,0
HCPCS,G9637,DOC >1 DOSE REDUC TECH,,,,,0
HCPCS,G9638,NO DOC >1 DOSE REDUC TECH,,,,,0
HCPCS,G9642,CURRENT SMOKER,,,,,0
HCPCS,G9643,ELECTIVE SURGERY,,,,,0
HCPCS,G9644,NO SMOK B/4 ANES DAY OF SURG,,,,,0
HCPCS,G9645,HAD SMOKE B/4 ANES DAY SURG,,,,,0
HCPCS,G9646,PT W/90D MRS 0-2,,,,,0
HCPCS,G9648,PT W/90D MRS >2,,,,,0
HCPCS,G9649,PSOR AS DOC SPC BM,,,,,0
HCPCS,G9651,PSOR AS DOC NO SPC BM,,,,,0
HCPCS,G9654,MON ANESTH CARE,,,,,0
HCPCS,G9655,TOC TOOL INCL KEY ELEM,,,,,0
HCPCS,G9656,PT TRANS FROM ANEST TO PACU,,,,,0
HCPCS,G9658,TOC TOOL INCL ELEM NOT USED,,,,,0
HCPCS,G9659,>=86Y NO HX COLO CA/RSN SCOP,,,,,0
HCPCS,G9660,DOC MED RSN SCOPE PT >= 86Y,,,,,0
HCPCS,G9661,PT >= 86  W/ HI RISK,,,,,0
HCPCS,G9662,PRIOR DX/ACTIVE CLIN ASCVD,,,,,0
HCPCS,G9663,FAST/DIR LDL >= 190 MG/DL,,,,,0
HCPCS,G9664,TAKING STATIN OR REC'D ORDER,,,,,0
HCPCS,G9665,NO STATIN/NO ORDER STATIN,,,,,0
HCPCS,G9674,PT W/CLIN ASCVD DX,,,,,0
HCPCS,G9675,PT W/FAST/DIR LAB LDL-C >190,,,,,0
HCPCS,G9676,40-75Y W/TYPE 1/2 W/LDL-C RS,,,,,0
HCPCS,G9679,ACUTE CARE PNEUMONIA,,,,,0
HCPCS,G9680,ACUTE CARE CONGESTIVE HEART,,,,,0
HCPCS,G9681,ACUTE CARE CHRONIC OBSTRUCT,,,,,0
HCPCS,G9682,ACUTE CARE SKIN INFECTION,,,,,0
HCPCS,G9683,ACUTE FLUID/ELECTRO DISORDER,,,,,0
HCPCS,G9684,ACUTE CARE URINARY TRACT INF,,,,,0
HCPCS,G9685,ACUTE NURSING FACILITY CARE,,,,,0
HCPCS,G9687,HOSPICE ANYTIME MSMT PER,,,,,0
HCPCS,G9688,PT W/HOSP ANYTIME MSMT PER,,,,,0
HCPCS,G9689,INPT ELECT CAROTID INTERVENT,,,,,0
HCPCS,G9690,PT IN HOS,,,,,0
HCPCS,G9691,PT HOSP DUR MSMT PERIOD,,,,,0
HCPCS,G9692,HOSP RECD BY PT DUR MSMT PER,,,,,0
HCPCS,G9693,PT USE HOSP DURING MSMT PER,,,,,0
HCPCS,G9694,HOSP SRV USED PT IN MSMT PER,,,,,0
HCPCS,G9695,LONG ACT INHAL BRONCHDIL PRE,,,,,0
HCPCS,G9696,MED RSN NO PRESC BRONCHDIL,,,,,0
HCPCS,G9698,SYS RSN NO PRESC BRONCHDIL,,,,,0
HCPCS,G9699,LONG INHAL BRONCHDIL NO PRES,,,,,0
HCPCS,G9700,PT IS W/HOSP DURING MSMT PER,,,,,0
HCPCS,G9702,PT USE HOSP DURING MSMT PER,,,,,0
HCPCS,G9703,ANBX 30 PRIOR TO EPISODE,,,,,0
HCPCS,G9704,AJCC BR CA STG I: T1 MIC/T1A,,,,,0
HCPCS,G9705,AJCC BR CA STG IB,,,,,0
HCPCS,G9706,LOW RECUR PROST CA,,,,,0
HCPCS,G9708,BILAT MAST/HX BI /UNILAT MAS,,,,,0
HCPCS,G9709,HOSP SRV USED PT IN MSMT PER,,,,,0
HCPCS,G9710,PT PROV HOSP SRV MSMT PER,,,,,0
HCPCS,G9711,PT HX TOT COL OR COLON CA,,,,,0
HCPCS,G9712,DOC MED RSN PRESC ANBX,,,,,0
HCPCS,G9713,PT USE HOSP DURING MSMT PER,,,,,0
HCPCS,G9714,PT IS W/HOSP DURING MSMT PER,,,,,0
HCPCS,G9716,BMI DOC ONL FUP NOT CMPLTD,,,,,0
HCPCS,G9717,DOC PT DX BIPOL,,,,,0
HCPCS,G9719,PT NOT AMBUL/IMMOB/WC,,,,,0
HCPCS,G9720,HOSPICE ANYTIME MSMT PER,,,,,0
HCPCS,G9721,PT NOT AMBUL/IMMOB/WC,,,,,0
HCPCS,G9722,DOC HX RENAL FAIL OR CR+ >=4,,,,,0
HCPCS,G9723,HOSP RECD BY PT DUR MSMT PER,,,,,0
HCPCS,G9724,PT W/DOC USE ANTICOAG MST YR,,,,,0
HCPCS,G9726,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G9727,PT UNABLE CMPLT LEPF PROM,,,,,0
HCPCS,G9728,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G9729,PT UNBL CMPLT LEPF PROM,,,,,0
HCPCS,G9730,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G9731,PT UNBL CMPLT LEPF PROM,,,,,0
HCPCS,G9732,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G9733,PT UNBL CMPLT LB FS PROM,,,,,0
HCPCS,G9734,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G9735,PT UNBL CMPLT SHLD FS PROM,,,,,0
HCPCS,G9736,REFUSED TO PARTICIPATE,,,,,0
HCPCS,G9737,PT UNBL CMPLT EWH FS PROM,,,,,0
HCPCS,G9740,HOSP SRV TO PT DUR MSMT PER,,,,,0
HCPCS,G9741,PT W/HOSP ANYTIME MSMT PER,,,,,0
HCPCS,G9744,PT NOT ELI D/T ACT DIG HTN,,,,,0
HCPCS,G9745,DOC RSN NO HBP SCRN OR F/U,,,,,0
HCPCS,G9746,"MIT STEN, VALVE OR TRANS AF",,,,,0
HCPCS,G9752,URGENT SURGERY,,,,,0
HCPCS,G9753,"DOC NO DICOM, CT OTHER FAC",,,,,0
HCPCS,G9754,INCID PULM NODULE,,,,,0
HCPCS,G9755,DOC MED RSN NO FLLW UP,,,,,0
HCPCS,G9756,SURG PROC W/SILICONE OIL,,,,,0
HCPCS,G9757,SURG PROC W/SILICONE OIL,,,,,0
HCPCS,G9758,PT IN HOS,,,,,0
HCPCS,G9761,PT W/HOSP ANYTIME MSMT PER,,,,,0
HCPCS,G9762,PT HAD >= 2-3 HPV VACCINES,,,,,0
HCPCS,G9763,PT NOT HAVE 2-3 HPV VACCINES,,,,,0
HCPCS,G9764,PT TREATD W/ORAL SYST OR BIO,,,,,0
HCPCS,G9765,DOC PAT DECLINED THERAPY,,,,,0
HCPCS,G9766,CVA STROKE DX TX TRANSF FAC,,,,,0
HCPCS,G9767,HOSP NEW DX CVA CONSID EVST,,,,,0
HCPCS,G9768,PT W/HOSP ANYTIME MSMT PER,,,,,0
HCPCS,G9769,BN DEN 2YR/GOT OST MED/THER,,,,,0
HCPCS,G9770,PERIP NERVE BLOCK,,,,,0
HCPCS,G9771,"ANES END, 1 TEMP >35.5(95.9)",,,,,0
HCPCS,G9772,DOC MED RSN NO TEMP >= 35.5,,,,,0
HCPCS,G9773,1 BOD TEMP >=35.5,,,,,0
HCPCS,G9775,RECD 2 ANTI-EMET PRE/INTRAOP,,,,,0
HCPCS,G9776,DOC MED RSN NO PROPH ANTIEM,,,,,0
HCPCS,G9777,PT NO ANTIEMET PRE/INTRAOP,,,,,0
HCPCS,G9779,PTS BREASTFEEDING,,,,,0
HCPCS,G9780,PTS DX W/RHABDOMYOLYSIS,,,,,0
HCPCS,G9781,DOC RSN NO STATIN,,,,,0
HCPCS,G9782,HX DX FAM/PURE HYPERCHOLES,,,,,0
HCPCS,G9784,PATH/DERM PROV 2ND BIOP OPIN,,,,,0
HCPCS,G9785,PATH REPORT SENT,,,,,0
HCPCS,G9786,PATH REPORT NOT SENT,,,,,0
HCPCS,G9787,PT ALIVE,,,,,0
HCPCS,G9788,MOST RCT BP </= 140/90,,,,,0
HCPCS,G9789,"RECORD BP IP, ER, URG/SELF",,,,,0
HCPCS,G9790,MOST RCT BP >/= 140/90,,,,,0
HCPCS,G9791,MOST RCT TOB STAT FREE,,,,,0
HCPCS,G9792,MOST RCT TOB STAT NOT FREE,,,,,0
HCPCS,G9793,PT ON DAILY ASA/ANTIPLAT,,,,,0
HCPCS,G9794,DOC MED RSN NO DAILY ASPIRIN,,,,,0
HCPCS,G9795,PT NO DAILY ASA/ANTIPLAT,,,,,0
HCPCS,G9796,PT NOT CURRENTLY ON STATIN,,,,,0
HCPCS,G9797,PT CURRENTLY ON STATIN,,,,,0
HCPCS,G9805,PT W/HOSP ANYTIME MSMT PER,,,,,0
HCPCS,G9806,PT RECD CERV CYTO/HPV,,,,,0
HCPCS,G9807,PT NO RECD CERV CYTO/HPV,,,,,0
HCPCS,G9812,PT DIED DURING INPT/30D AFT,,,,,0
HCPCS,G9813,PT NOT DIED W/IN 30D OF PROC,,,,,0
HCPCS,G9818,DOC SEX ACTIVITY,,,,,0
HCPCS,G9819,PT W/HOSP ANYTIME MSMT PER,,,,,0
HCPCS,G9820,DOC CHLAM SCR TEST W/FOLLOW,,,,,0
HCPCS,G9821,NO DOC CHLAM SCR TS W/FOLLOW,,,,,0
HCPCS,G9822,ENDO ABL PROC YR PREV IND DT,,,,,0
HCPCS,G9823,ENDO SMPL/HYST BX RES DOC,,,,,0
HCPCS,G9824,ENDO SMPL/HYST BX RES NO DOC,,,,,0
HCPCS,G9830,HER-2 POS,,,,,0
HCPCS,G9831,AJCC STG BRT CA DX II OR III,,,,,0
HCPCS,G9832,"BRT CA DX I, NO T1/T1A/T1B",,,,,0
HCPCS,G9838,PT MET DIS AT DX,,,,,0
HCPCS,G9839,ANTI-EGFR MON ANTI THER,,,,,0
HCPCS,G9840,GENE TESTING PERFORMED,,,,,0
HCPCS,G9841,GENE TESTING NOT PERFORMED,,,,,0
HCPCS,G9842,PT MET DIS AT DX,,,,,0
HCPCS,G9843,KRAS OR NRAS GENE MUTATION,,,,,0
HCPCS,G9844,PT NO RECD ANTI-EGFR THER,,,,,0
HCPCS,G9845,PT RECD ANTI-EGFR THER,,,,,0
HCPCS,G9846,PT DIED FROM CANCER,,,,,0
HCPCS,G9847,PT RECD CHEMO LAST 14D LIFE,,,,,0
HCPCS,G9848,PT NO CHEMO LAST 14D LIFE,,,,,0
HCPCS,G9858,PT ENROLL HOSPICE,,,,,0
HCPCS,G9859,PT DIED FROM CANCER,,,,,0
HCPCS,G9860,PT LESS 3D HOSPICE,,,,,0
HCPCS,G9861,PT MORE THAN 3D HOSPICE,,,,,0
HCPCS,G9862,DOC RSN NO 10 YR FOLLOW,,,,,0
HCPCS,G9868,CMMI ASYNTELEHEALTH <10MIN,,,,,0
HCPCS,G9869,CMMI ASYNTELEHEALTH 10-20MIN,,,,,0
HCPCS,G9870,CMMI ASYNTELEHEALTH >20MIN,,,,,0
HCPCS,G9873,1 EM CORE SESSION,,,,,0
HCPCS,G9874,4 EM CORE SESSIONS,,,,,0
HCPCS,G9875,9 EM CORE SESSIONS,,,,,0
HCPCS,G9876,2 EM CORE MS MO 7-9 NO WL,,,,,0
HCPCS,G9877,2 EM CORE MS MO 10-12 NO WL,,,,,0
HCPCS,G9878,2 EM CORE MS MO 7-9 WL,,,,,0
HCPCS,G9879,2 EM CORE MS MO 10-12 WL,,,,,0
HCPCS,G9880,EM 5 PERCENT WL,,,,,0
HCPCS,G9881,EM 9 PERCENT WL,,,,,0
HCPCS,G9882,2 EM ONGOING MS MO 13-15 WL,,,,,0
HCPCS,G9883,2 EM ONGOING MS MO 16-18 WL,,,,,0
HCPCS,G9884,2 EM ONGOING MS MO 19-21 WL,,,,,0
HCPCS,G9885,2 EM ONGOING MS MO 22-24 WL,,,,,0
HCPCS,G9886,IN-PERSON ATTENDANCE G CODE,,,,,0
HCPCS,G9887,DISTANCE LEARNING ATTENDANCE,,,,,0
HCPCS,G9888,5% WL MAINTND FROM BSLINE WT,,,,,0
HCPCS,G9890,EM BRIDGE PAYMENT,,,,,0
HCPCS,G9891,EM SESSION REPORTING,,,,,0
HCPCS,G9894,ADR DEP THRPY PRESCRIBED,,,,,0
HCPCS,G9895,DOC MED RSN NO ADR DEP THRPY,,,,,0
HCPCS,G9896,DOC PT RSN NO ADR DEP THRPY,,,,,0
HCPCS,G9897,PT NT PRSC ADR DEP THRPY RNG,,,,,0
HCPCS,G9898,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,G9899,SCRN MAM PERF RSLTS DOC,,,,,0
HCPCS,G9900,SCRN MAM PERF RSLTS NOT DOC,,,,,0
HCPCS,G9901,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,G9902,PT SCRN TBCO AND ID AS USER,,,,,0
HCPCS,G9903,PT SCRN TBCO ID AS NON USER,,,,,0
HCPCS,G9905,NO PT TBCO SCRN RNG,,,,,0
HCPCS,G9906,PT RECV TBCO CESS INTERV,,,,,0
HCPCS,G9908,NO PT TBCO CESS INTERV RNG,,,,,0
HCPCS,G9910,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,G9911,NODE NEG PRE/POST SYST THER,,,,,0
HCPCS,G9912,HBV STATUS ASSESED AND INT,,,,,0
HCPCS,G9913,NO HBV STATUS ASSESD AND INT,,,,,0
HCPCS,G9914,PT INITIATED ANTI-TNF AGENT,,,,,0
HCPCS,G9915,NO DOCUMNTD HBV RESULTS RCD,,,,,0
HCPCS,G9916,FUNCT STATUS PAST 12 MONTHS,,,,,0
HCPCS,G9917,ADV DEM CRGVR LIMITED,,,,,0
HCPCS,G9918,"NO FUNCT STAT PERF, RSN NOS",,,,,0
HCPCS,G9919,SCRN ND POS ND PROV OF REC,,,,,0
HCPCS,G9920,SCRNING PERF AND NEGATIVE,,,,,0
HCPCS,G9922,SFTY CNCRNS SCRN ND MIT RECS,,,,,0
HCPCS,G9923,SAFTY CNCRNS SCRN AND NEG,,,,,0
HCPCS,G9925,NO SCRN PROV RSN NOS,,,,,0
HCPCS,G9926,SFTY CNCRNS SCRN BUT NO RECS,,,,,0
HCPCS,G9928,NO WARF OR FDA DRUG PRESC,,,,,0
HCPCS,G9929,TRS/REV AF,,,,,0
HCPCS,G9930,COM CARE,,,,,0
HCPCS,G9931,NO CHAD OR CHAD SCR 0 OR 1,,,,,0
HCPCS,G9938,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,G9939,SAME PATH/DERM PERF BIOPSY,,,,,0
HCPCS,G9940,DOC REAS NO STATIN THERAPY,,,,,0
HCPCS,G9943,BK PN NT MSR VAS SCL PRE/PST,,,,,0
HCPCS,G9945,PT W/CANCER SCOLIOSIS,,,,,0
HCPCS,G9946,BK PAIN NO VAS,,,,,0
HCPCS,G9949,LEG PAIN NO VAS,,,,,0
HCPCS,G9954,PT >2 RSK FAC POST-OP VOMIT,,,,,0
HCPCS,G9955,INHLNT ANESTH ONLY FOR INDUC,,,,,0
HCPCS,G9956,COMBO THRPY OF >= 2 PROPHLY,,,,,0
HCPCS,G9957,DOC MED RSN NO COMBO THRPY,,,,,0
HCPCS,G9958,NO COMBO PROHPYL THRP FOR PT,,,,,0
HCPCS,G9959,SYSTEMIC ANTIMICRO NOT PRESC,,,,,0
HCPCS,G9960,MED RSN SYS ANTIMI NT RX,,,,,0
HCPCS,G9961,SYSTEMIC ANTIMICRO PRESC,,,,,0
HCPCS,G9962,EMBOLIZATION DOC SEPARATLY,,,,,0
HCPCS,G9963,EMBOLIZATION NOT DOC SEPARAT,,,,,0
HCPCS,G9964,PT RECV >=1 WELL-CHLD VISIT,,,,,0
HCPCS,G9965,NO WELL-CHLD VIST RECV BY PT,,,,,0
HCPCS,G9968,PT REFRD 2 PVDR/SPCLST IN PP,,,,,0
HCPCS,G9969,PVDR RFRD PT RPRT RCVD,,,,,0
HCPCS,G9970,PVDR RFRD PT NO RPRT RCVD,,,,,0
HCPCS,G9978,REMOTE E/M NEW PT 10MINS,,,,,0
HCPCS,G9979,REMOTE E/M NEW PT 20MINS,,,,,0
HCPCS,G9980,REMOTE E/M NEW PT 30 MINS,,,,,0
HCPCS,G9981,REMOTE E/M NEW PT 45MINS,,,,,0
HCPCS,G9982,REMOTE E/M NEW PT 60MINS,,,,,0
HCPCS,G9983,REMOTE E/M EST. PT 10MINS,,,,,0
HCPCS,G9984,REMOTE E/M EST. PT  15MINS,,,,,0
HCPCS,G9985,REMOTE E/M EST. PT 25MINS,,,,,0
HCPCS,G9986,REMOTE E/M EST. PT 40MINS,,,,,0
HCPCS,G9987,BPCI ADVANCED IN HOME VISIT,,,,,0
HCPCS,G9988,PALL SERV DURING MEAS,,,,,0
HCPCS,G9992,PALL SERV DURING MEAS,,,,,0
HCPCS,G9993,PALL SERV DURING MEAS,,,,,0
HCPCS,G9994,PALL SERV DURING MEAS,,,,,0
HCPCS,G9996,DOC PT PAL OR HOSPICE,,,,,0
HCPCS,G9997,DOC PT PREG DUR MSRMT PD,,,,,0
HCPCS,G9998,DOC MED RSN <3 COLON,,,,,0
HCPCS,G9999,DOC SYS RSN <3 COLON,,,,,0
HCPCS,H0001,ALCOHOL AND/OR DRUG ASSESS,,,,,0
HCPCS,H0002,ALCOHOL AND/OR DRUG SCREENIN,,,,,0
HCPCS,H0003,ALCOHOL AND/OR DRUG SCREENIN,,,,,0
HCPCS,H0004,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0005,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0006,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0007,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0008,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0009,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0010,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0011,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0012,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0013,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0014,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0015,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0016,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0017,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0018,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0019,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0020,ALCOHOL AND/OR DRUG SERVICES,,,,,0
HCPCS,H0021,ALCOHOL AND/OR DRUG TRAINING,,,,,0
HCPCS,H0022,ALCOHOL AND/OR DRUG INTERVEN,,,,,0
HCPCS,H0023,ALCOHOL AND/OR DRUG OUTREACH,,,,,0
HCPCS,H0024,ALCOHOL AND/OR DRUG PREVENTI,,,,,0
HCPCS,H0025,ALCOHOL AND/OR DRUG PREVENTI,,,,,0
HCPCS,H0026,ALCOHOL AND/OR DRUG PREVENTI,,,,,0
HCPCS,H0027,ALCOHOL AND/OR DRUG PREVENTI,,,,,0
HCPCS,H0028,ALCOHOL AND/OR DRUG PREVENTI,,,,,0
HCPCS,H0029,ALCOHOL AND/OR DRUG PREVENTI,,,,,0
HCPCS,H0030,ALCOHOL AND/OR DRUG HOTLINE,,,,,0
HCPCS,H0031,MH HEALTH ASSESS BY NON-MD,,,,,0
HCPCS,H0032,MH SVC PLAN DEV BY NON-MD,,,,,0
HCPCS,H0033,ORAL MED ADM DIRECT OBSERVE,,,,,0
HCPCS,H0034,MED TRNG & SUPPORT PER 15MIN,,,,,0
HCPCS,H0035,MH PARTIAL HOSP TX UNDER 24H,,,,,0
HCPCS,H0036,COMM PSY FACE-FACE PER 15MIN,,,,,0
HCPCS,H0037,COMM PSY SUP TX PGM PER DIEM,,,,,0
HCPCS,H0038,SELF-HELP/PEER SVC PER 15MIN,,,,,0
HCPCS,H0039,ASSER COM TX FACE-FACE/15MIN,,,,,0
HCPCS,H0040,ASSERT COMM TX PGM PER DIEM,,,,,0
HCPCS,H0041,FOS C CHLD NON-THER PER DIEM,,,,,0
HCPCS,H0042,FOS C CHLD NON-THER PER MON,,,,,0
HCPCS,H0043,"SUPPORTED HOUSING, PER DIEM",,,,,0
HCPCS,H0044,"SUPPORTED HOUSING, PER MONTH",,,,,0
HCPCS,H0045,RESPITE NOT-IN-HOME PER DIEM,,,,,0
HCPCS,H0046,"MENTAL HEALTH SERVICE, NOS",,,,,0
HCPCS,H0047,ALCOHOL/DRUG ABUSE SVC NOS,,,,,0
HCPCS,H0048,SPEC COLL NON-BLOOD:A/D TEST,,,,,0
HCPCS,H0049,ALCOHOL/DRUG SCREENING,,,,,0
HCPCS,H0050,ALCOHOL/DRUG SERVICE 15 MIN,,,,,0
HCPCS,H0051,Traditional healing service,,,,,0
HCPCS,H0052,Missing and murdered indigenous persons (MMIP) mental health and clinical care,,,,,0
HCPCS,H0053,Historical trauma (HT) mental health and clinical care for indigenous persons,,,,,0
HCPCS,H1000,PRENATAL CARE ATRISK ASSESSM,,,,,0
HCPCS,H1001,ANTEPARTUM MANAGEMENT,,,,,0
HCPCS,H1002,CARECOORDINATION PRENATAL,,,,,0
HCPCS,H1003,PRENATAL AT RISK EDUCATION,,,,,0
HCPCS,H1004,FOLLOW UP HOME VISIT/PRENTAL,,,,,0
HCPCS,H1005,PRENATALCARE ENHANCED SRV PK,,,,,0
HCPCS,H1010,NONMED FAMILY PLANNING ED,,,,,0
HCPCS,H1011,FAMILY ASSESSMENT,,,,,0
HCPCS,H2000,COMP MULTIDISIPLN EVALUATION,,,,,0
HCPCS,H2001,REHABILITATION PROGRAM 1/2 D,,,,,0
HCPCS,H2010,COMPREHENSIVE MED SVC 15 MIN,,,,,0
HCPCS,H2011,"CRISIS INTERVEN SVC, 15 MIN",,,,,0
HCPCS,H2012,"BEHAV HLTH DAY TREAT, PER HR",,,,,0
HCPCS,H2013,"PSYCH HLTH FAC SVC, PER DIEM",,,,,0
HCPCS,H2014,"SKILLS TRAIN AND DEV, 15 MIN",,,,,0
HCPCS,H2015,"COMP COMM SUPP SVC, 15 MIN",,,,,0
HCPCS,H2016,"COMP COMM SUPP SVC, PER DIEM",,,,,0
HCPCS,H2017,"PSYSOC REHAB SVC, PER 15 MIN",,,,,0
HCPCS,H2018,"PSYSOC REHAB SVC, PER DIEM",,,,,0
HCPCS,H2019,"THER BEHAV SVC, PER 15 MIN",,,,,0
HCPCS,H2020,"THER BEHAV SVC, PER DIEM",,,,,0
HCPCS,H2021,"COM WRAP-AROUND SV, 15 MIN",,,,,0
HCPCS,H2022,"COM WRAP-AROUND SV, PER DIEM",,,,,0
HCPCS,H2023,"SUPPORTED EMPLOY, PER 15 MIN",,,,,0
HCPCS,H2024,"SUPPORTED EMPLOY, PER DIEM",,,,,0
HCPCS,H2025,"SUPP MAINT EMPLOY, 15 MIN",,,,,0
HCPCS,H2026,"SUPP MAINT EMPLOY, PER DIEM",,,,,0
HCPCS,H2027,"PSYCHOED SVC, PER 15 MIN",,,,,0
HCPCS,H2028,"SEX OFFEND TX SVC, 15 MIN",,,,,0
HCPCS,H2029,"SEX OFFEND TX SVC, PER DIEM",,,,,0
HCPCS,H2030,"MH CLUBHOUSE SVC, PER 15 MIN",,,,,0
HCPCS,H2031,"MH CLUBHOUSE SVC, PER DIEM",,,,,0
HCPCS,H2032,"ACTIVITY THERAPY, PER 15 MIN",,,,,0
HCPCS,H2033,MULTISYS THER/JUVENILE 15MIN,,,,,0
HCPCS,H2034,"A/D HALFWAY HOUSE, PER DIEM",,,,,0
HCPCS,H2035,"A/D TX PROGRAM, PER HOUR",,,,,0
HCPCS,H2036,"A/D TX PROGRAM, PER DIEM",,,,,0
HCPCS,H2037,"DEV DELAY PREV DP CH, 15 MIN",,,,,0
HCPCS,H2038,SKILL TRAIN AND DEV/DIEM,,,,,0
HCPCS,H2040,"COORD SPECIALTY CARE, MONTH",,,,,0
HCPCS,H2041,COORD SPECIAL CARE ENCOUNTER,,,,,0
HCPCS,J0120,TETRACYCLIN INJECTION,,,,,0
HCPCS,J0121,"INJ., OMADACYCLINE, 1 MG",,,3.82,7.66,10
HCPCS,J0122,"INJ., ERAVACYCLINE, 1 MG",,,1.24,2.48,10
HCPCS,J0129,ABATACEPT INJECTION,,,41.96,83.92,14
HCPCS,J0130,ABCIXIMAB INJECTION,,,681.52,2676.65,2
HCPCS,J0131,"INJ, ACETAMINOPHEN (NOS)",,,0.06,0.09,2
HCPCS,J0132,ACETYLCYSTEINE INJECTION,,,0.45,0.69,2
HCPCS,J0133,ACYCLOVIR INJECTION,,,0.04,0.06,2
HCPCS,J0134,INJ ACETAMINOPHEN -FRESENIUS,,,0.07,0.11,2
HCPCS,J0136,"INJ, ACETAMINOPHEN (B BRAUN)",,,0.06,0.09,2
HCPCS,J0137,"INJ, ACETAMINOPHEN (HIKMA)",,,0.06,0.09,2
HCPCS,J0138,"Injection, acetaminophen 10 mg and ibuprofen 3 mg",,,0.04,0.41,10
HCPCS,J0139,"Injection, adalimumab, 1 mg",,,111.91,111.91,1
HCPCS,J0153,ADENOSINE INJ 1MG,,,0.56,0.86,2
HCPCS,J0165,"Injection, epinephrine, not otherwise specified, 0.1 mg",,,0.71,1.09,2
HCPCS,J0166,"Injection, epinephrine (BPI), not therapeutically equivalent to J0165, 0.1 mg",,,2.78,4.27,2
HCPCS,J0167,"Injection, epinephrine (Hospira), not therapeutically equivalent to J0165, 0.1 mg",,,0.9,1.39,2
HCPCS,J0168,"Injection, epinephrine (international medication systems), not therapeutically equivalent to J0165, 0.1 mg",,,2.66,4.08,2
HCPCS,J0169,"Injection, epinephrine (adrenalin), not therapeutically equivalent to J0165, 0.1 mg",,,1.61,2.47,2
HCPCS,J0172,"INJ, ADUCANUMAB-AVWA, 2 MG",,,7.3,11.65,5
HCPCS,J0174,"INJ, LECANEMAB-IRMB, 1 MG",,,1.26,2.58,13
HCPCS,J0175,"Injection, donanemab-azbt, 2 mg",,,3.93,8.14,13
HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,296.17,625.7,13
HCPCS,J0178,AFLIBERCEPT INJECTION,,,733.88,1568.8,14
HCPCS,J0179,"INJ, BROLUCIZUMAB-DBLL, 1 MG",,,329.21,662.33,13
HCPCS,J0180,AGALSIDASE BETA INJECTION,,,218.91,437.82,14
HCPCS,J0184,"INJ, AMISULPRIDE, 1 MG",,,9.14,18.28,10
HCPCS,J0185,"INJ., APREPITANT, 1 MG",,,1.56,3.32,10
HCPCS,J0190,INJ BIPERIDEN LACTATE/5 MG,,,,,0
HCPCS,J0200,ALATROFLOXACIN MESYLATE,,,31.82,31.82,1
HCPCS,J0202,"INJECTION, ALEMTUZUMAB",,,2311.21,4622.42,13
HCPCS,J0205,ALGLUCERASE INJECTION,,,36.7,78.72,2
HCPCS,J0206,INJ ALLOPURINOL SODIUM 1 MG,,,4.49,8.98,10
HCPCS,J0207,AMIFOSTINE,,,582.28,2324.96,6
HCPCS,J0208,INJ SODIUM THIOSULFATE 100MG,,,90.46,180.92,13
HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,0.84,1.68,13
HCPCS,J0210,METHYLDOPATE HCL INJECTION,,,61.0,79.42,2
HCPCS,J0211,"Injection, sodium nitrite 3 mg and sodium thiosulfate 125 mg (Nithiodote)",,,2.12,4.24,10
HCPCS,J0215,ALEFACEPT,,,30.78,77.99,3
HCPCS,J0216,"INJ, ALFENTANIL HCL, 500MCG",,,4.81,4.81,1
HCPCS,J0217,INJ VELMANASE ALFA-TYCV 1 MG,,,442.51,885.02,13
HCPCS,J0218,INJ OLIPUDASE ALFA-RPCP 1MG,,,374.43,748.86,13
HCPCS,J0219,INJ AVAL ALFA-NQPT 4MG,,,76.96,153.92,13
HCPCS,J0220,ALGLUCOSIDASE ALFA INJECTION,,,330.63,387.15,2
HCPCS,J0221,LUMIZYME INJECTION,,,196.5,393.0,14
HCPCS,J0222,"INJ., PATISIRAN, 0.1 MG",,,95.09,192.93,13
HCPCS,J0223,INJ GIVOSIRAN 0.5 MG,,,111.63,223.26,10
HCPCS,J0224,"INJ. LUMASIRAN, 0.5 MG",,,312.98,625.96,13
HCPCS,J0225,"INJ, VUTRISIRAN, 1 MG",,,4759.26,9655.44,13
HCPCS,J0248,"INJ, REMDESIVIR, 1 MG",,,6.4,12.8,10
HCPCS,J0256,ALPHA 1 PROTEINASE INHIBITOR,,,5.19,10.38,14
HCPCS,J0257,GLASSIA INJECTION,,,5.36,10.97,14
HCPCS,J0270,ALPROSTADIL FOR INJECTION,,,0.59,19.63,2
HCPCS,J0275,ALPROSTADIL URETHRAL SUPPOS,,,48.17,48.17,1
HCPCS,J0278,AMIKACIN SULFATE INJECTION,,,0.76,1.16,2
HCPCS,J0280,INJECTION AMINOPHYLLIN 500MG,62.0,31.0,10.13,60.14,47
HCPCS,J0281,"Injection, aminocaproic acid, 1 gram",,,1.83,2.81,2
HCPCS,J0282,AMIODARONE HCL,,,0.62,0.96,2
HCPCS,J0283,"INJ, AMIODARONE (NEXTERONE)",,,3.18,4.89,2
HCPCS,J0285,AMPHOTERICIN B,,,41.63,63.91,2
HCPCS,J0287,AMPHOTERICIN B LIPID COMPLEX,,,12.57,19.29,2
HCPCS,J0288,AMPHO B CHOLESTERYL SULFATE,,,26.22,86.42,2
HCPCS,J0289,AMPHOTERICIN B LIPOSOME INJ,,,20.43,42.37,10
HCPCS,J0290,AMPICILLIN 500 MG INJ,,,0.6,0.92,2
HCPCS,J0291,"INJ., PLAZOMICIN, 5 MG",,,3.33,6.69,10
HCPCS,J0295,AMPICILLIN SULBACTAM 1.5 GM,,,1.82,2.79,2
HCPCS,J0300,AMOBARBITAL 125 MG INJ,,,13.81,350.12,2
HCPCS,J0330,SUCCINYCHOLINE CHLORIDE INJ,,,1.57,1.9,2
HCPCS,J0348,ANIDULAFUNGIN INJECTION,,,0.59,0.9,2
HCPCS,J0349,"INJ, REZAFUNGIN, 1 MG",,,10.11,20.3,13
HCPCS,J0350,INJECTION ANISTREPLASE 30 U,,,,,0
HCPCS,J0360,HYDRALAZINE HCL INJECTION,,,6.33,9.72,2
HCPCS,J0364,APOMORPHINE HYDROCHLORIDE,,,64.7,66.32,2
HCPCS,J0365,"APROTONIN, 10,000 KIU",,,3.16,4.96,2
HCPCS,J0380,INJ METARAMINOL BITARTRATE,,,1.18,2.14,2
HCPCS,J0390,CHLOROQUINE INJECTION,,,,,0
HCPCS,J0391,"INJ, ARTESUNATE, 1MG",,,49.3,98.6,10
HCPCS,J0395,ARBUTAMINE HCL INJECTION,,,299.68,299.68,1
HCPCS,J0400,ARIPIPRAZOLE INJECTION,,,0.39,1.4,2
HCPCS,J0401,INJ ARIPIPRAZOLE EXT REL 1MG,,,6.92,13.84,13
HCPCS,J0402,"INJ, ABILIFY ASIMTUFII, 1 MG",,,5.74,11.48,10
HCPCS,J0456,AZITHROMYCIN,,,3.18,4.89,2
HCPCS,J0457,"INJECTION, AZTREONAM, 100 MG",,,3.26,5.0,2
HCPCS,J0461,ATROPINE SULFATE INJECTION,,,0.09,0.13,2
HCPCS,J0470,DIMECAPROL INJECTION,,,102.17,102.17,1
HCPCS,J0475,BACLOFEN 10 MG INJECTION,,,172.37,344.74,10
HCPCS,J0476,BACLOFEN INTRATHECAL TRIAL,,,81.98,125.87,2
HCPCS,J0480,BASILIXIMAB,,,4457.94,8915.88,14
HCPCS,J0485,BELATACEPT INJECTION,,,3.7,7.4,14
HCPCS,J0490,BELIMUMAB INJECTION,,,53.33,106.66,14
HCPCS,J0491,INJ ANIFROLUMAB-FNIA 1MG,,,17.2,34.63,13
HCPCS,J0500,DICYCLOMINE INJECTION,,,14.25,21.88,2
HCPCS,J0515,INJ BENZTROPINE MESYLATE,,,21.07,32.35,2
HCPCS,J0517,"INJ., BENRALIZUMAB, 1 MG",,,156.55,318.13,13
HCPCS,J0520,BETHANECHOL CHLORIDE INJECT,,,8.41,8.41,1
HCPCS,J0558,PENG BENZATHINE/PROCAINE INJ,,,18.57,37.14,10
HCPCS,J0561,PENICILLIN G BENZATHINE INJ,,,28.54,57.08,10
HCPCS,J0565,"INJ, BEZLOTOXUMAB, 10 MG",,,37.88,75.76,10
HCPCS,J0567,"INJ., CERLIPONASE ALFA 1 MG",,,114.48,228.96,12
HCPCS,J0570,BUPRENORPHINE IMPLANT 74.2MG,,,,,0
HCPCS,J0571,BUPRENORPHINE ORAL 1MG,,,0.51,1.54,2
HCPCS,J0572,BUPREN/NAL UP TO 3MG BUPRENO,,,7.94,7.94,1
HCPCS,J0573,BUPREN/NAL 3.1 TO 6MG BUPREN,,,13.38,13.38,1
HCPCS,J0574,BUPREN/NAL 6.1 TO 10MG BUPRE,,,12.13,12.13,1
HCPCS,J0575,BUPREN/NAL OVER 10MG BUPRENO,,,22.57,22.57,1
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,400.1,828.73,13
HCPCS,J0578,"Inj brixadi, more than 7 day",,,1600.37,3314.94,13
HCPCS,J0583,BIVALIRUDIN,,,0.21,0.32,2
HCPCS,J0584,"INJECTION, BUROSUMAB-TWZA 1M",,,460.49,920.98,13
HCPCS,J0585,"INJECTION,ONABOTULINUMTOXINA",,,6.18,12.36,14
HCPCS,J0586,ABOBOTULINUMTOXINA,,,8.32,17.18,14
HCPCS,J0587,"INJ, RIMABOTULINUMTOXINB",,,12.64,25.28,14
HCPCS,J0588,INCOBOTULINUMTOXIN A,,,5.3,10.6,14
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,3.0,6.0,13
HCPCS,J0591,"INJ DEOXYCHOLIC ACID, 1 MG",,,28.66,28.66,1
HCPCS,J0592,BUPRENORPHINE HYDROCHLORIDE,,,5.04,7.74,2
HCPCS,J0593,"INJ., LANADELUMAB-FLYO, 1 MG",,,83.02,166.04,13
HCPCS,J0594,BUSULFAN INJECTION,,,0.84,53.11,14
HCPCS,J0595,BUTORPHANOL TARTRATE 1 MG,,,6.16,9.46,2
HCPCS,J0596,"INJECTION, RUCONEST",,,34.97,69.94,13
HCPCS,J0597,"C-1 ESTERASE, BERINERT",,,64.83,144.32,14
HCPCS,J0598,"C-1 ESTERASE, CINRYZE",,,62.42,124.84,14
HCPCS,J0599,"INJ., HAEGARDA 10 UNITS",,,17.63,23.11,2
HCPCS,J0600,EDETATE CALCIUM DISODIUM INJ,,,6095.39,12190.78,10
HCPCS,J0601,"Sevelamer carbonate (renvela or therapeutically equivalent), oral, 20 mg (for ESRD on dialysis)",,,0.02,0.13,2
HCPCS,J0602,"Sevelamer carbonate (renvela or therapeutically equivalent), oral, powder, 20 mg (for ESRD on dialysis)",,,0.09,0.38,2
HCPCS,J0603,"Sevelamer hydrochloride (renagel or therapeutically equivalent), oral, 20 mg (for ESRD on dialysis)",,,0.17,0.24,2
HCPCS,J0604,"CINACALCET, ESRD ON DIALYSIS",,,0.04,1.21,2
HCPCS,J0605,"Sucroferric oxyhydroxide, oral, 5 mg (for ESRD on dialysis)",,,0.26,0.34,2
HCPCS,J0606,"INJ, ETELCALCETIDE, 0.1 MG",,,2.18,7.89,10
HCPCS,J0607,"Lanthanum carbonate, oral, 5 mg (for ESRD on dialysis)",,,0.07,0.11,2
HCPCS,J0608,"Lanthanum carbonate, oral, powder, 5 mg, not therapeutically equivalent to J0607 (for ESRD on dialysis)",,,0.1,0.11,2
HCPCS,J0609,"Ferric citrate, oral, 3 mg ferric iron, (for ESRD on dialysis)",,,0.04,0.21,2
HCPCS,J0612,CALCIUM GLUCON (FRESENIUS),,,0.05,0.08,5
HCPCS,J0613,CALCIUM GLUCON (WG CRITICAL),,,0.1,0.15,5
HCPCS,J0615,"Calcium acetate, oral, 23 mg (for ESRD on dialysis)",,,0.04,0.04,2
HCPCS,J0616,"Injection, metoprolol tartrate, 1 mg",,,0.16,0.24,2
HCPCS,J0618,"Injection, calcium chloride, 2 mg",,,0.05,0.06,2
HCPCS,J0620,CALCIUM GLYCER & LACT/10 ML,,,13.42,16.76,2
HCPCS,J0630,CALCITONIN SALMON INJECTION,,,1019.68,1528.37,2
HCPCS,J0636,INJ CALCITRIOL PER 0.1 MCG,,,0.56,1.89,6
HCPCS,J0637,CASPOFUNGIN ACETATE,,,2.77,4.25,2
HCPCS,J0638,CANAKINUMAB INJECTION,,,134.68,269.36,14
HCPCS,J0640,LEUCOVORIN CALCIUM INJECTION,,,4.82,7.4,2
HCPCS,J0641,INJ LEVOLEUCOVORIN NOS 0.5MG,,,0.04,3.07,6
HCPCS,J0642,"INJECTION, KHAPZORY, 0.5 MG",,,1.37,2.29,5
HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,9.39,14.42,2
HCPCS,J0651,"Inj, levothyroxine, freskabi",,,6.5,13.3,10
HCPCS,J0652,"Inj, levothyroxine, hikma",,,6.27,9.63,2
HCPCS,J0665,"INJ, BUPIVACAINE, NOS, 0.5MG",,,0.01,0.02,2
HCPCS,J0666,"Injection, bupivacaine liposome, 1 mg",,,1.4,2.8,10
HCPCS,J0670,INJ MEPIVACAINE HCL/10 ML,,,4.66,7.15,2
HCPCS,J0687,"Injection, cefazolin sodium (WG Critical Care), not therapeutically equivalent to J0690, 500 mg",,,1.22,1.87,2
HCPCS,J0688,"INJ CEFAZOLIN SODIUM, HIKMA",,,1.11,1.7,2
HCPCS,J0689,"INJ CEFAZOLIN SODIUM, BAXTER",,,1.62,2.49,2
HCPCS,J0690,CEFAZOLIN SODIUM INJECTION,,,1.02,1.57,2
HCPCS,J0691,INJ LEFAMULIN 1 MG,,,1.0,1.31,2
HCPCS,J0692,CEFEPIME HCL FOR INJECTION,,,1.5,2.3,2
HCPCS,J0694,CEFOXITIN SODIUM INJECTION,,,6.26,9.61,2
HCPCS,J0695,INJ CEFTOLOZANE TAZOBACTAM,,,8.63,17.26,10
HCPCS,J0696,CEFTRIAXONE SODIUM INJECTION,,,0.59,0.9,2
HCPCS,J0697,STERILE CEFUROXIME INJECTION,,,2.79,4.29,2
HCPCS,J0698,CEFOTAXIME SODIUM INJECTION,,,8.69,18.73,2
HCPCS,J0699,"INJ, CEFIDEROCOL, 10 MG",,,2.3,4.6,10
HCPCS,J0701,INJ. CEFEPIME HCL (BAXTER),,,7.16,10.99,2
HCPCS,J0702,BETAMETHASONE ACET&SOD PHOSP,,,8.41,12.9,2
HCPCS,J0703,"INJ, CEFEPIME HCL (B BRAUN)",,,6.19,9.5,2
HCPCS,J0706,CAFFEINE CITRATE INJECTION,,,2.3,2.48,2
HCPCS,J0710,CEPHAPIRIN SODIUM INJECTION,,,2.6,2.6,1
HCPCS,J0712,CEFTAROLINE FOSAMIL INJ,,,4.02,8.04,10
HCPCS,J0713,INJ CEFTAZIDIME PER 500 MG,,,2.0,3.07,2
HCPCS,J0714,CEFTAZIDIME AND AVIBACTAM,,,99.62,199.24,10
HCPCS,J0715,CEFTIZOXIME SODIUM / 500 MG,,,9.81,9.81,1
HCPCS,J0716,CENTRUROIDES IMMUNE F(AB),,,4633.99,10022.46,10
HCPCS,J0717,CERTOLIZUMAB PEGOL INJ 1MG,,,3.72,8.41,13
HCPCS,J0720,CHLORAMPHENICOL SODIUM INJEC,,,47.81,95.62,10
HCPCS,J0725,CHORIONIC GONADOTROPIN/1000U,,,21.36,32.8,2
HCPCS,J0735,CLONIDINE HYDROCHLORIDE,,,21.56,33.1,2
HCPCS,J0736,"INJ, CLINDAMYCIN PHOSP 300MG",,,2.04,3.13,2
HCPCS,J0737,"INJ, CLINDAMYCIN (BAXTER)",,,2.1,3.22,2
HCPCS,J0739,"HIV PREP, INJ, CABOTEGRAVIR",,,6.68,13.36,13
HCPCS,J0740,CIDOFOVIR INJECTION,,,519.61,1040.28,14
HCPCS,J0741,"INJ, CABOTE RILPIVIR 2MG 3MG",,,22.49,45.06,13
HCPCS,J0742,INJ IMIP 4 CILAS 4 RELEB 2MG,,,3.18,4.89,2
HCPCS,J0743,CILASTATIN SODIUM INJECTION,,,8.5,13.05,2
HCPCS,J0744,CIPROFLOXACIN IV,,,2.83,4.35,2
HCPCS,J0745,INJ CODEINE PHOSPHATE /30 MG,,,1.18,1.18,1
HCPCS,J0750,"HIV PREP, FTC/TDF 200/300MG",,,1.65,3.3,10
HCPCS,J0751,"HIV PREP, FTC/TAF 200/25MG",,,67.84,135.68,10
HCPCS,J0770,COLISTIMETHATE SODIUM INJ,,,13.9,21.33,2
HCPCS,J0775,"COLLAGENASE, CLOST HIST INJ",,,60.9,144.4,14
HCPCS,J0780,PROCHLORPERAZINE INJECTION,,,3.07,4.72,2
HCPCS,J0791,INJ CRIZANLIZUMAB-TMCA 5MG,,,123.16,252.28,13
HCPCS,J0795,CORTICORELIN OVINE TRIFLUTAL,,,5.14,17.44,2
HCPCS,J0799,"HIV PREP, FDA APPROVED, NOC",,,,,0
HCPCS,J0801,INJ. ACTHAR GEL TO 40 UNITS,,,3932.69,7865.38,13
HCPCS,J0802,"INJ. (ANI), UP TO 40 UNITS",,,3361.97,6723.94,13
HCPCS,J0834,"INJ., COSYNTROPIN, 0.25 MG",,,34.18,52.48,2
HCPCS,J0840,CROTALIDAE POLY IMMUNE FAB,,,1739.41,3485.9,10
HCPCS,J0841,INJ CROTALIDAE IM F(AB')2 EQ,,,994.1,1988.2,10
HCPCS,J0850,CYTOMEGALOVIRUS IMM IV /VIAL,,,1703.63,3829.15,14
HCPCS,J0870,"Injection, imetelstat, 1 mg",,,54.24,108.48,10
HCPCS,J0872,"Injection, daptomycin (Xellia), unrefrigerated, not therapeutically equivalent to J0878 or J0873, 1 mg",,,0.06,0.09,2
HCPCS,J0873,"INJ, DAPTOMYCIN (XELLIA)",,,0.05,0.07,2
HCPCS,J0874,"INJ, DAPTOMYCIN (BAXTER)",,,0.07,0.11,2
HCPCS,J0875,"INJECTION, DALBAVANCIN",,,14.85,29.7,10
HCPCS,J0877,"INJ, DAPTOMYCIN (HOSPIRA)",,,0.07,0.11,2
HCPCS,J0878,DAPTOMYCIN INJECTION,,,0.04,0.06,2
HCPCS,J0879,"DIFELIKEFALIN, ESRD ON DIALY",,,0.1,0.45,5
HCPCS,J0881,"DARBEPOETIN ALFA, NON-ESRD",,,2.79,7.0,14
HCPCS,J0882,"DARBEPOETIN ALFA, ESRD USE",,,2.79,7.0,14
HCPCS,J0883,ARGATROBAN NONESRD USE 1MG,,,0.76,1.52,10
HCPCS,J0884,ARGATROBAN ESRD DIALYSIS 1MG,,,0.9,1.39,2
HCPCS,J0885,"EPOETIN ALFA, NON-ESRD",,,8.12,20.2,14
HCPCS,J0887,EPOETIN BETA ESRD USE,,,1.72,2.9,6
HCPCS,J0888,EPOETIN BETA NON ESRD,,,1.72,2.9,6
HCPCS,J0889,DAPRODUSTAT ORAL 1MG ESRD,,,7.39,7.47,4
HCPCS,J0890,PEGINESATIDE INJECTION,,,15.36,15.36,1
HCPCS,J0891,ARGATROBAN NONESRD (ACCORD),,,1.73,7.57,10
HCPCS,J0892,ARGATROBAN DIALYSIS (ACCORD),,,5.8,7.57,2
HCPCS,J0893,"INJ, DECITABINE (SUN PHARMA)",,,0.95,1.46,2
HCPCS,J0894,DECITABINE INJECTION,,,1.94,35.41,3
HCPCS,J0895,DEFEROXAMINE MESYLATE INJ,,,11.0,16.89,6
HCPCS,J0896,INJ LUSPATERCEPT-AAMT 0.25MG,,,39.93,80.35,13
HCPCS,J0897,DENOSUMAB INJECTION,,,24.38,55.9,14
HCPCS,J0898,ARGATROBAN NONESRD (AUROMED),,,1.77,2.72,2
HCPCS,J0899,"ARGATROBAN DIALYSIS, AUROMED",,,1.77,2.72,2
HCPCS,J0901,"Vadadustat, oral, 1 mg (for ESRD on dialysis)",,,0.21,0.26,2
HCPCS,J0911,"Instillation, taurolidine 1.35 mg and heparin sodium 100 units (central venous catheter lock for adult patients receiving chronic hemodialysis)",,,6.1,15.92,10
HCPCS,J0945,BROMPHENIRAMINE MALEATE INJ,,,0.39,1.5,2
HCPCS,J1000,DEPO-ESTRADIOL CYPIONATE INJ,,,57.23,87.86,2
HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.15,0.22,2
HCPCS,J1050,MEDROXYPROGESTERONE ACETATE,,,0.54,1.07,3
HCPCS,J1071,INJ TESTOSTERONE CYPIONATE,,,0.04,0.06,2
HCPCS,J1072,"Injection, testosterone cypionate (Azmiro), 1 mg",,,1.27,2.54,10
HCPCS,J1095,"INJECTION, DEXAMETHASONE 9%",,,2.19,3.31,2
HCPCS,J1096,DEXAMETHA OPTH INSERT 0.1 MG,,,97.91,195.82,10
HCPCS,J1097,PHENYLEP KETOROLAC OPTH SOLN,,,92.18,225.43,10
HCPCS,J1100,DEXAMETHASONE SODIUM PHOS,,,0.15,0.22,2
HCPCS,J1105,"DEXMEDETOMIDINE FILM, 1 MCG",,,0.78,0.78,1
HCPCS,J1110,INJ DIHYDROERGOTAMINE MESYLT,,,118.43,181.81,2
HCPCS,J1120,ACETAZOLAMID SODIUM INJECTIO,,,21.02,32.27,2
HCPCS,J1130,INJ DICLOFENAC SODIUM 0.5MG,,,0.39,0.39,1
HCPCS,J1160,DIGOXIN INJECTION,,,4.88,7.49,2
HCPCS,J1162,DIGOXIN IMMUNE FAB (OVINE),,,4915.81,9831.62,10
HCPCS,J1163,"Injection, diltiazem hydrochloride, 0.5 mg",,,0.05,0.07,2
HCPCS,J1165,PHENYTOIN SODIUM INJECTION,,,0.81,1.24,2
HCPCS,J1171,"Injection, hydromorphone, 0.1 mg",,,0.11,0.17,2
HCPCS,J1180,DYPHYLLINE INJECTION,,,,,0
HCPCS,J1190,DEXRAZOXANE HCL INJECTION,,,39.15,234.2,14
HCPCS,J1200,DIPHENHYDRAMINE HCL INJECTIO,,,1.1,1.69,2
HCPCS,J1201,INJ. CETIRIZINE HCL 0.5MG,,,15.71,31.42,10
HCPCS,J1202,Miglustat oral 65 mg,,,49.07,64.04,5
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,86.76,175.03,13
HCPCS,J1205,CHLOROTHIAZIDE SODIUM INJ,,,49.26,75.63,2
HCPCS,J1212,DIMETHYL SULFOXIDE 50% 50 ML,,,338.5,1424.56,11
HCPCS,J1230,METHADONE INJECTION,,,27.95,42.91,2
HCPCS,J1240,DIMENHYDRINATE INJECTION,,,9.44,14.5,2
HCPCS,J1245,PERSANT/DIPYRIDAMOL PER DOSE,320.0,160.0,4.71,310.4,47
HCPCS,J1250,INJ DOBUTAMINE HCL/250 MG,,,9.74,14.95,2
HCPCS,J1260,DOLASETRON MESYLATE,,,4.34,11.56,2
HCPCS,J1265,DOPAMINE INJECTION,,,0.81,1.24,2
HCPCS,J1267,DORIPENEM INJECTION,,,0.79,1.65,2
HCPCS,J1270,"INJECTION, DOXERCALCIFEROL",,,0.45,0.69,2
HCPCS,J1271,"Injection, doxycycline hyclate, 1 mg",,,0.15,0.22,2
HCPCS,J1290,ECALLANTIDE INJECTION,,,551.64,1103.28,14
HCPCS,J1299,"Injection, eculizumab, 2 mg",,,42.63,87.29,13
HCPCS,J1301,"INJECTION, EDARAVONE, 1 MG",,,19.96,39.92,13
HCPCS,J1302,"INJ, SUTIMLIMAB-JOME, 10 MG",,,17.94,35.88,13
HCPCS,J1303,"INJ., RAVULIZUMAB-CWVZ 10 MG",,,214.12,429.21,13
HCPCS,J1304,INJ TOFERSEN INTRATHEC 1 MG,,,151.61,303.22,13
HCPCS,J1305,"INJ, EVINACUMAB-DGNB, 5MG",,,184.3,368.6,13
HCPCS,J1306,"INJECTION, INCLISIRAN, 1 MG",,,11.72,23.91,13
HCPCS,J1307,"Injection, crovalimab-akkz, 10 mg",,,524.57,1049.14,13
HCPCS,J1308,"Injection, famotidine, 0.25 mg",,,0.01,0.02,2
HCPCS,J1320,AMITRIPTYLINE INJECTION,,,4.2,4.2,1
HCPCS,J1322,"ELOSULFASE ALFA, INJECTION",,,293.6,587.2,14
HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,175.08,356.46,13
HCPCS,J1324,ENFUVIRTIDE INJECTION,,,0.98,1.27,2
HCPCS,J1325,EPOPROSTENOL INJECTION,,,19.76,30.34,6
HCPCS,J1326,"Injection, zolbetuximab-clzb, 2 mg",,,32.06,64.12,13
HCPCS,J1327,EPTIFIBATIDE INJECTION,,,2.84,27.83,10
HCPCS,J1330,ERGONOVINE MALEATE INJECTION,,,9.12,9.12,1
HCPCS,J1335,ERTAPENEM INJECTION,,,11.0,16.89,2
HCPCS,J1364,ERYTHRO LACTOBIONATE /500 MG,,,91.56,140.57,2
HCPCS,J1380,ESTRADIOL VALERATE 10 MG INJ,,,9.41,14.44,2
HCPCS,J1410,INJ ESTROGEN CONJUGATE 25 MG,,,372.91,745.82,10
HCPCS,J1411,"INJ, HEMGENIX, PER TX DOSE",,,3505278.25,7010556.5,9
HCPCS,J1412,INJ ROCTAVIAN ML 2X10^13VC G,,,11940.59,23881.18,12
HCPCS,J1413,INJ DELANDISTROGENE MOX ROKL,,,3154486.56,6308973.12,12
HCPCS,J1414,"Injection, fidanacogene elaparvovec-dzkt, per therapeutic dose",,,4526200.0,6615000.0,4
HCPCS,J1426,"INJECTION, CASIMERSEN, 10 MG",,,157.95,315.9,13
HCPCS,J1427,INJ. VILTOLARSEN,,,82.57,107.75,5
HCPCS,J1428,"INJ, ETEPLIRSEN, 10 MG",,,159.18,318.36,13
HCPCS,J1429,ONC BRST SEMIQ MEAS THYM KN,,,234.24,305.67,5
HCPCS,J1430,ETHANOLAMINE OLEATE 100 MG,,,484.1,973.06,10
HCPCS,J1434,"Inj, focinvez, 1mg",,,2.7,5.89,13
HCPCS,J1435,INJECTION ESTRONE PER 1 MG,,,0.39,0.45,2
HCPCS,J1436,ETIDRONATE DISODIUM INJ,,,,,0
HCPCS,J1437,INJ. FE DERISOMALTOSE 10 MG,,,20.94,41.88,10
HCPCS,J1438,ETANERCEPT INJECTION,,,1318.67,1948.09,2
HCPCS,J1439,INJ FERRIC CARBOXYMALTOS 1MG,,,1.06,2.19,13
HCPCS,J1440,FECAL MICROBIOTA JSLM 1 ML,,,60.72,124.56,13
HCPCS,J1442,INJ FILGRASTIM EXCL BIOSIMIL,,,0.95,1.9,14
HCPCS,J1443,INJ FERRIC PYROPHOSPHATE CIT,,,0.06,0.06,1
HCPCS,J1444,FE PYRO CIT POW 0.1 MG IRON,,,0.06,0.06,1
HCPCS,J1445,INJ TRIFERIC AVNU 0.1MG IRON,,,0.34,0.34,1
HCPCS,J1447,INJ TBO FILGRASTIM 1 MICROG,,,0.27,0.67,13
HCPCS,J1448,"INJECTION, TRILACICLIB, 1MG",,,5.19,10.49,13
HCPCS,J1449,INJ EFLAPEGRASTIM-XNST 0.1MG,,,19.85,44.05,13
HCPCS,J1450,FLUCONAZOLE,,,2.76,4.23,2
HCPCS,J1451,"FOMEPIZOLE, 15 MG",,,5.97,24.14,10
HCPCS,J1452,INTRAOCULAR FOMIVIRSEN NA,,,397.08,397.08,1
HCPCS,J1453,FOSAPREPITANT INJECTION,,,0.13,0.21,2
HCPCS,J1454,"INJ FOSNETUPITANT, PALONOSET",,,547.39,1135.69,10
HCPCS,J1455,FOSCARNET SODIUM INJECTION,,,5.81,39.27,6
HCPCS,J1456,"INJ, FOSAPREPITANT (TEVA)",,,0.98,2.12,10
HCPCS,J1457,GALLIUM NITRATE INJECTION,,,1.57,3.9,2
HCPCS,J1458,GALSULFASE INJECTION,,,483.91,967.82,14
HCPCS,J1459,INJ IVIG PRIVIGEN 500 MG,,,48.26,96.52,14
HCPCS,J1460,GAMMA GLOBULIN 1 CC INJ,,,46.64,93.28,10
HCPCS,J1551,INJ CUTAQUIG 100 MG,,,13.54,27.92,13
HCPCS,J1552,"Injection, immune globulin (Alyglo), 500 mg",,,123.88,247.76,13
HCPCS,J1554,INJ. ASCENIV,,,472.48,967.6,13
HCPCS,J1555,"INJ CUVITRU, 100 MG",,,16.02,32.95,13
HCPCS,J1556,"INJ, IMM GLOB BIVIGAM, 500MG",,,61.58,157.0,14
HCPCS,J1557,GAMMAPLEX INJECTION,,,59.65,121.14,14
HCPCS,J1558,"INJ. XEMBIFY, 100 MG",,,14.12,28.24,13
HCPCS,J1559,HIZENTRA INJECTION,,,13.55,27.28,14
HCPCS,J1560,GAMMA GLOBULIN > 10 CC INJ,,,162.15,324.3,10
HCPCS,J1561,GAMUNEX-C/GAMMAKED,,,46.57,93.14,14
HCPCS,J1562,"VIVAGLOBIN, INJ",,,11.05,11.05,1
HCPCS,J1566,"IMMUNE GLOBULIN, POWDER",,,52.97,153.02,14
HCPCS,J1568,OCTAGAM INJECTION,,,45.21,90.62,14
HCPCS,J1569,GAMMAGARD LIQUID INJECTION,,,43.1,89.53,14
HCPCS,J1570,GANCICLOVIR SODIUM INJECTION,,,48.34,115.47,6
HCPCS,J1571,HEPAGAM B IM INJECTION,,,63.39,134.22,10
HCPCS,J1572,FLEBOGAMMA INJECTION,,,57.05,104.72,6
HCPCS,J1573,"HEPAGAM B INTRAVENOUS, INJ",,,63.39,134.22,10
HCPCS,J1574,"INJ, GANCICLOVIR (EXELA)",,,73.2,95.52,2
HCPCS,J1575,HYQVIA 100MG IMMUNEGLOBULIN,,,17.26,34.52,13
HCPCS,J1576,"INJ, PANZYGA, 500 MG",,,69.43,139.46,13
HCPCS,J1580,GARAMYCIN GENTAMICIN INJ,,,3.2,4.91,2
HCPCS,J1595,INJECTION GLATIRAMER ACETATE,,,119.4,195.68,2
HCPCS,J1596,"INJ, GLYCOPYRROLATE, 0.1 MG",,,0.52,0.81,2
HCPCS,J1597,"Injection, glycopyrrolate (Glyrx-pf), 0.1 mg",,,2.39,3.05,2
HCPCS,J1598,"Injection, glycopyrrolate (Fresenius Kabi), not therapeutically equivalent to J1596, 0.1 mg",,,2.26,3.47,2
HCPCS,J1599,"IVIG NON-LYOPHILIZED, NOS",,,284.66,284.66,1
HCPCS,J1600,GOLD SODIUM THIOMALEATE INJ,,,16.18,56.47,2
HCPCS,J1602,GOLIMUMAB FOR IV USE 1MG,,,10.5,38.93,14
HCPCS,J1610,GLUCAGON HYDROCHLORIDE/1 MG,,,173.54,366.71,10
HCPCS,J1611,"INJ GLUCAGON HCL, FRESENIUS",,,141.71,283.42,10
HCPCS,J1620,GONADORELIN HYDROCH/ 100 MCG,,,,,0
HCPCS,J1626,GRANISETRON HCL INJECTION,,,0.28,0.43,2
HCPCS,J1627,"INJ, GRANISETRON, XR, 0.1 MG",,,4.08,9.29,10
HCPCS,J1628,"INJ., GUSELKUMAB, 1 MG",,,72.26,144.52,13
HCPCS,J1630,HALOPERIDOL INJECTION,,,1.02,1.57,2
HCPCS,J1631,HALOPERIDOL DECANOATE INJ,,,5.71,8.77,2
HCPCS,J1632,"INJ., BREXANOLONE, 1 MG",,,140.81,142.33,4
HCPCS,J1640,"HEMIN, 1 MG",,,32.51,65.02,10
HCPCS,J1642,INJ HEPARIN SODIUM PER 10 U,,,0.02,0.04,2
HCPCS,J1643,"INJ HEPARIN, PFIZER, 1000U",,,3.67,5.64,2
HCPCS,J1644,INJ HEPARIN SODIUM PER 1000U,,,0.27,0.41,2
HCPCS,J1645,DALTEPARIN SODIUM,,,22.01,33.79,2
HCPCS,J1650,INJ ENOXAPARIN SODIUM,,,0.7,1.07,2
HCPCS,J1652,FONDAPARINUX SODIUM,,,0.88,1.35,2
HCPCS,J1655,TINZAPARIN SODIUM INJECTION,,,4.34,6.54,2
HCPCS,J1670,TETANUS IMMUNE GLOBULIN INJ,,,564.04,1128.08,10
HCPCS,J1675,HISTRELIN ACETATE,,,1.18,1.54,2
HCPCS,J1700,HYDROCORTISONE ACETATE INJ,,,1.22,1.22,1
HCPCS,J1710,HYDROCORTISONE SODIUM PH INJ,,,8.77,8.77,1
HCPCS,J1720,HYDROCORTISONE SODIUM SUCC I,,,25.86,39.71,2
HCPCS,J1726,"MAKENA, 10 MG",,,35.61,35.81,4
HCPCS,J1729,INJ HYDROXYPROGST CAPOAT NOS,,,26.05,26.05,1
HCPCS,J1730,DIAZOXIDE INJECTION,,,119.96,119.96,1
HCPCS,J1738,INJ. MELOXICAM 1 MG,,,3.03,6.46,5
HCPCS,J1740,IBANDRONATE SODIUM INJECTION,,,37.58,57.69,2
HCPCS,J1741,IBUPROFEN INJECTION,,,3.71,5.69,2
HCPCS,J1742,IBUTILIDE FUMARATE INJECTION,,,163.89,581.77,10
HCPCS,J1743,IDURSULFASE INJECTION,,,531.18,1062.36,14
HCPCS,J1744,ICATIBANT INJECTION,,,133.6,473.09,6
HCPCS,J1745,INFLIXIMAB NOT BIOSIMIL 10MG,,,29.57,126.01,14
HCPCS,J1746,"INJ., IBALIZUMAB-UIYK, 10 MG",,,75.39,150.78,13
HCPCS,J1747,"INJ, SPESOLIMAB-SBZO, 1 MG",,,62.52,125.04,13
HCPCS,J1748,"Injection, infliximab-dyyb (Zymfentra), 10 mg",,,94.89,511.72,10
HCPCS,J1749,"Injection, iloprost, 0.1 mcg",,,6.97,10.69,5
HCPCS,J1750,INJ IRON DEXTRAN,,,17.23,53.79,14
HCPCS,J1756,IRON SUCROSE INJECTION,,,0.27,0.73,6
HCPCS,J1786,IMUGLUCERASE INJECTION,,,41.08,82.16,14
HCPCS,J1790,DROPERIDOL INJECTION,,,6.54,10.04,2
HCPCS,J1800,PROPRANOLOL INJECTION,,,12.32,18.62,2
HCPCS,J1805,"INJ, ESMOLOL HCL, 10MG",,,0.34,0.52,2
HCPCS,J1806,INJ ESMOLOL HCL WG CRIT CARE,,,0.51,0.79,2
HCPCS,J1808,"Injection, folic acid, 0.1 mg",,,0.07,0.11,2
HCPCS,J1811,FIASP FOR INSULIN PUMP USE,,,9.47,14.53,2
HCPCS,J1812,INJ. INSULIN (FIASP),,,2.34,2.77,2
HCPCS,J1813,LYUMJEV FOR INSULIN PUMP USE,,,18.63,28.6,2
HCPCS,J1814,INJ. INSULIN (LYUMJEV),,,2.44,2.62,2
HCPCS,J1815,INSULIN INJECTION,,,0.43,0.68,2
HCPCS,J1817,INSULIN FOR INSULIN PUMP USE,,,3.95,6.07,2
HCPCS,J1823,"INJ. INEBILIZUMAB-CDON, 1 MG",,,471.35,943.66,13
HCPCS,J1826,INTERFERON BETA-1A INJ,,,2687.83,4125.54,2
HCPCS,J1830,INTERFERON BETA-1B / .25 MG,,,600.95,1357.49,2
HCPCS,J1833,"INJECTION, ISAVUCONAZONIUM",,,0.96,2.02,10
HCPCS,J1835,ITRACONAZOLE INJECTION,,,1109.69,1109.69,1
HCPCS,J1836,"INJ, METRONIDAZOLE, 10 MG",,,0.04,0.06,2
HCPCS,J1885,KETOROLAC TROMETHAMINE INJ,,,0.29,0.66,10
HCPCS,J1920,"INJ, LABETALOL HCL, 5MG",,,0.48,0.73,2
HCPCS,J1921,"INJ LABETALOL HCL HIKMA, 5MG",,,1.68,2.58,2
HCPCS,J1930,LANREOTIDE INJECTION,,,32.39,73.13,13
HCPCS,J1931,LARONIDASE INJECTION,,,37.92,82.86,14
HCPCS,J1932,"INJ, LANREOTIDE, (CIPLA) 1MG",,,28.38,56.76,13
HCPCS,J1938,"Injection, furosemide, 1 mg",,,0.02,0.04,2
HCPCS,J1939,"INJ, BUMETANIDE, 0.5 MG",,,0.74,1.14,2
HCPCS,J1941,"INJ, FUROSCIX, 20 MG",,,358.9,452.52,5
HCPCS,J1943,"INJ., ARISTADA INITIO, 1 MG",,,3.09,6.18,13
HCPCS,J1944,ARIPIPRAZOLE LAUROXIL 1 MG,,,3.19,6.38,13
HCPCS,J1945,LEPIRUDIN,,,177.19,1068.62,2
HCPCS,J1950,LEUPROLIDE ACETATE /3.75 MG,,,1441.4,3291.62,14
HCPCS,J1951,INJ FENSOLVI 0.25 MG,,,134.1,268.2,13
HCPCS,J1952,"LEUPROLIDE INJ, CAMCEVI, 1MG",,,62.72,150.14,13
HCPCS,J1953,LEVETIRACETAM INJECTION,,,0.06,0.09,2
HCPCS,J1954,LEUPROLIDE DEPOT CIPLA 7.5MG,,,269.3,1344.32,13
HCPCS,J1955,INJ LEVOCARNITINE PER 1 GM,,,29.63,45.5,2
HCPCS,J1956,LEVOFLOXACIN INJECTION,,,2.39,3.67,2
HCPCS,J1960,LEVORPHANOL TARTRATE INJ,,,3.55,3.55,1
HCPCS,J1961,"INJ, LENACAPAVIR, 1 MG",,,21.07,42.91,13
HCPCS,J1980,HYOSCYAMINE SULFATE INJ,,,11.05,103.16,2
HCPCS,J1990,CHLORDIAZEPOXIDE INJECTION,,,24.46,39.43,2
HCPCS,J2002,"Injection, lidocaine hcl in 5% dextrose, 1 mg",,,0.01,0.02,2
HCPCS,J2003,"Injection, lidocaine hydrochloride, 1 mg",,,0.02,0.07,2
HCPCS,J2004,"Injection, lidocaine hcl with epinephrine, 1 mg",,,0.02,0.05,2
HCPCS,J2010,LINCOMYCIN INJECTION,,,6.84,10.51,2
HCPCS,J2020,LINEZOLID INJECTION,,,4.23,6.5,2
HCPCS,J2021,"INJ, LINEZOLID (HOSPIRA)",,,7.73,11.87,2
HCPCS,J2060,LORAZEPAM INJECTION,,,1.61,2.47,2
HCPCS,J2062,LOXAPINE FOR INHALATION 1 MG,,,15.12,30.24,10
HCPCS,J2150,MANNITOL INJECTION,,,2.73,4.2,2
HCPCS,J2170,MECASERMIN INJECTION,,,538.2,702.34,2
HCPCS,J2175,MEPERIDINE HYDROCHL /100 MG,,,19.14,29.39,2
HCPCS,J2180,MEPERIDINE/PROMETHAZINE INJ,,,7.1,9.08,2
HCPCS,J2182,"INJECTION, MEPOLIZUMAB, 1MG",,,29.74,59.49,13
HCPCS,J2183,"Injection, meropenem (WG Critical Care), not therapeutically equivalent to J2185, 100 mg",,,1.98,3.03,2
HCPCS,J2184,"INJ, MEROPENEM (B. BRAUN)",,,2.54,3.9,2
HCPCS,J2185,MEROPENEM,,,0.54,0.82,2
HCPCS,J2186,"INJ., MEROPENEM, VABORBACTAM",,,2.07,4.25,10
HCPCS,J2210,METHYLERGONOVIN MALEATE INJ,,,26.91,41.32,2
HCPCS,J2212,METHYLNALTREXONE INJECTION,,,2.33,2.72,2
HCPCS,J2246,"Injection, micafungin in sodium (Baxter), not therapeutically equivalent to J2248, 1 mg",,,0.62,0.96,2
HCPCS,J2247,"INJ, MICAFUNGIN (PAR PHARM)",,,0.44,0.67,2
HCPCS,J2248,MICAFUNGIN SODIUM INJECTION,,,0.38,0.58,2
HCPCS,J2249,"INJ, REMIMAZOLAM, 1 MG",,,3.07,4.2,2
HCPCS,J2250,INJ MIDAZOLAM HYDROCHLORIDE,,,0.2,0.3,2
HCPCS,J2251,INJ MIDAZOLAM (WG CRIT CARE),,,0.21,0.32,2
HCPCS,J2252,"Injection, midazolam in 0.8% sodium chloride, intravenous, not therapeutically equivalent to j2250, 1 mg",,,0.1,0.13,2
HCPCS,J2253,"Injection, midazolam (Seizalam), 1 mg",,,,,0
HCPCS,J2260,INJ MILRINONE LACTATE / 5 MG,,,1.71,2.62,2
HCPCS,J2265,MINOCYCLINE HYDROCHLORIDE,,,2.54,5.08,10
HCPCS,J2267,"Injection, mirikizumab-mrkz, 1 mg",,,40.95,92.66,13
HCPCS,J2270,MORPHINE SULFATE INJECTION,,,5.55,8.52,2
HCPCS,J2272,"INJ, MORPHINE (FRESENIUS)",,,9.92,15.23,2
HCPCS,J2274,INJ MORPHINE PF EPID ITHC,,,13.16,20.21,2
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,23.99,49.13,13
HCPCS,J2278,ZICONOTIDE INJECTION,,,9.64,19.28,14
HCPCS,J2280,"INJ, MOXIFLOXACIN 100 MG",,,10.63,16.31,2
HCPCS,J2281,INJ MOXIFLOXACIN (FRES KABI),,,9.47,14.53,2
HCPCS,J2290,"Injection, nafcillin sodium, 20 mg",,,0.07,0.11,2
HCPCS,J2300,INJ NALBUPHINE HYDROCHLORIDE,,,4.28,6.57,2
HCPCS,J2305,"INJ, NITROGLYCERIN, 5 MG",,,1.73,2.66,2
HCPCS,J2312,"Injection, naloxone hydrochloride, not otherwise specified, 0.01 mg",,,0.09,0.13,2
HCPCS,J2313,"Injection, naloxone hydrochloride (Zimhi), 0.01 mg",,,0.02,0.04,2
HCPCS,J2315,"NALTREXONE, DEPOT FORM",,,4.03,8.06,13
HCPCS,J2320,NANDROLONE DECANOATE 50 MG,,,4.73,7.02,2
HCPCS,J2323,NATALIZUMAB INJECTION,,,22.83,45.66,14
HCPCS,J2325,NESIRITIDE INJECTION,,,35.51,112.85,2
HCPCS,J2326,"INJ, NUSINERSEN, 0.1MG",,,1217.72,2435.44,12
HCPCS,J2327,INJ RISANKIZUMAB-RZAA 1 MG,,,14.21,28.95,13
HCPCS,J2329,"INJ UBLITUXIMAB-XIIY, 1 MG",,,67.29,134.67,13
HCPCS,J2350,"INJECTION, OCRELIZUMAB, 1 MG",,,56.51,113.02,13
HCPCS,J2351,"Injection, ocrelizumab, 1 mg and hyaluronidase-ocsq",,,44.92,89.84,13
HCPCS,J2353,"OCTREOTIDE INJECTION, DEPOT",,,193.64,397.45,14
HCPCS,J2354,"OCTREOTIDE INJ, NON-DEPOT",,,0.74,1.78,6
HCPCS,J2355,OPRELVEKIN INJECTION,,,292.02,799.62,2
HCPCS,J2356,"INJ TEZEPELUMAB-EKKO, 1MG",,,17.13,34.61,13
HCPCS,J2357,OMALIZUMAB INJECTION,,,42.42,84.84,14
HCPCS,J2358,OLANZAPINE LONG-ACTING INJ,,,3.56,5.47,2
HCPCS,J2359,"INJ. OLANZAPINE, 0.5MG",,,1.11,1.7,2
HCPCS,J2360,ORPHENADRINE INJECTION,,,11.53,17.7,2
HCPCS,J2371,INJ PHENYLEPHRINE HCL 20 MCG,,,0.01,0.02,2
HCPCS,J2372,"INJ, BIORPHEN, 20 MICROGRAMS",,,0.21,0.32,2
HCPCS,J2373,"Injection, phenylephrine hydrochloride (Immphentiv), 20 micrograms",,,0.16,0.24,2
HCPCS,J2401,CHLOROPROCAINE HCL INJECTION,,,0.05,0.07,2
HCPCS,J2402,CHLOROPROCAINE (CLOROTEKAL),,,0.45,0.58,2
HCPCS,J2403,"CHLOROPROCAINE OPHT GEL, 1MG",,,0.55,1.12,10
HCPCS,J2404,ONC BRST SEMIQ MEAS THYM KN,,,0.11,0.17,2
HCPCS,J2405,ONDANSETRON HCL INJECTION,,,0.11,1.55,2
HCPCS,J2406,"INJECTION, ORITAVANCIN 10 MG",,,40.41,80.82,10
HCPCS,J2407,"INJECTION, ORITAVANCIN",,,27.28,54.56,10
HCPCS,J2410,OXYMORPHONE HCL INJECTION,,,2.76,5.34,2
HCPCS,J2425,PALIFERMIN INJECTION,,,24.94,79.15,14
HCPCS,J2426,"INJ, INVEGA SUSTENNA, 1 MG",,,14.37,28.74,13
HCPCS,J2427,"INJ, INVEGA HAFYERA/TRINZA",,,12.37,24.74,13
HCPCS,J2428,"Injection, paliperidone palmitate extended release (Erzofri), 1 mg",,,15.94,31.88,13
HCPCS,J2430,PAMIDRONATE DISODIUM /30 MG,,,13.62,24.98,6
HCPCS,J2440,PAPAVERIN HCL INJECTION,,,56.05,71.64,2
HCPCS,J2460,OXYTETRACYCLINE INJECTION,,,1.76,1.76,1
HCPCS,J2468,"Injection, palonosetron hydrochloride (Posfrea), 25 micrograms",,,55.4,110.8,10
HCPCS,J2469,PALONOSETRON HCL,,,0.55,0.81,2
HCPCS,J2470,"Injection, pantoprazole sodium, 40 mg",,,3.61,11.64,2
HCPCS,J2471,"Injection, pantoprazole (Hikma), not therapeutically equivalent to J2470, 40 mg",,,6.81,12.42,2
HCPCS,J2472,"Injection, pantoprazole sodium in sodium chloride (Baxter), 40 mg",,,11.69,16.84,2
HCPCS,J2501,PARICALCITOL,,,0.82,1.25,2
HCPCS,J2502,"INJ, PASIREOTIDE LONG ACTING",,,544.98,1089.96,13
HCPCS,J2503,PEGAPTANIB SODIUM INJECTION,,,1107.32,1650.95,3
HCPCS,J2504,"PEGADEMASE BOVINE, 25 IU",,,188.64,689.19,3
HCPCS,J2506,INJ PEGFILGRAST EX BIO 0.5MG,,,38.93,169.96,13
HCPCS,J2507,PEGLOTICASE INJECTION,,,1982.66,6964.08,14
HCPCS,J2508,PEGUNIGALSIDASE ALFA-IWXJ,,,217.02,442.08,13
HCPCS,J2510,PENICILLIN G PROCAINE INJ,,,57.57,87.79,2
HCPCS,J2513,PENTASTARCH 10% SOLUTION,,,23.82,23.82,1
HCPCS,J2515,PENTOBARBITAL SODIUM INJ,,,26.62,100.9,10
HCPCS,J2540,PENICILLIN G POTASSIUM INJ,,,1.07,1.65,2
HCPCS,J2543,PIPERACILLIN/TAZOBACTAM,,,1.35,2.08,2
HCPCS,J2545,PENTAMIDINE NON-COMP UNIT,,,100.49,154.28,2
HCPCS,J2547,"INJECTION, PERAMIVIR",,,1.6,3.2,10
HCPCS,J2550,PROMETHAZINE HCL INJECTION,,,3.5,5.38,2
HCPCS,J2560,PHENOBARBITAL SODIUM INJ,,,33.38,51.25,2
HCPCS,J2561,"INJ, SEZABY, 1 MG",,,1.13,2.55,13
HCPCS,J2562,PLERIXAFOR INJECTION,,,24.09,489.57,14
HCPCS,J2590,OXYTOCIN INJECTION,,,2.45,2.68,2
HCPCS,J2597,INJ DESMOPRESSIN ACETATE,,,4.75,7.29,2
HCPCS,J2598,"INJ, VASOPRESSIN, 1 UNIT",,,1.54,2.36,2
HCPCS,J2599,INJ VASOPRESSIN (AM REG) 1 U,,,0.59,0.9,2
HCPCS,J2601,"Injection, vasopressin (Baxter), 1 unit",,,1.91,5.51,10
HCPCS,J2650,PREDNISOLONE ACETATE INJ,,,0.97,0.97,1
HCPCS,J2670,TOTAZOLINE HCL INJECTION,,,6.44,6.44,1
HCPCS,J2675,INJ PROGESTERONE PER 50 MG,,,0.77,1.18,2
HCPCS,J2679,INJ FLUPHENAZINE HCL 1.25 MG,,,9.06,13.92,2
HCPCS,J2680,FLUPHENAZINE DECANOATE 25 MG,,,9.19,14.1,2
HCPCS,J2690,PROCAINAMIDE HCL INJECTION,,,237.07,560.6,10
HCPCS,J2700,OXACILLIN SODIUM INJECITON,,,1.0,1.54,2
HCPCS,J2704,"INJ, PROPOFOL, 10 MG",,,0.11,0.17,2
HCPCS,J2710,NEOSTIGMINE METHYLSLFTE INJ,,,1.54,1.94,2
HCPCS,J2720,INJ PROTAMINE SULFATE/10 MG,,,2.0,3.07,2
HCPCS,J2724,PROTEIN C CONCENTRATE,,,2.81,28.62,14
HCPCS,J2725,INJ PROTIRELIN PER 250 MCG,,,40.79,40.79,1
HCPCS,J2730,PRALIDOXIME CHLORIDE INJ,,,126.93,165.63,2
HCPCS,J2760,PHENTOLAINE MESYLATE INJ,,,410.92,821.84,10
HCPCS,J2765,METOCLOPRAMIDE HCL INJECTION,,,1.22,1.87,2
HCPCS,J2770,QUINUPRISTIN/DALFOPRISTIN,,,5.2,890.29,2
HCPCS,J2777,"INJ, FARICIMAB-SVOA, 0.1MG",,,32.23,67.65,13
HCPCS,J2778,RANIBIZUMAB INJECTION,,,82.16,626.25,14
HCPCS,J2779,"INJ, SUSVIMO 0.1 MG",,,75.08,155.33,13
HCPCS,J2781,"INJ, PEGCETACOPLAN, 1MG",,,132.38,280.51,13
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,99.99,209.31,13
HCPCS,J2783,RASBURICASE,,,359.08,718.16,14
HCPCS,J2785,REGADENOSON INJECTION,,,3.53,5.41,2
HCPCS,J2786,"INJECTION, RESLIZUMAB, 1MG",,,10.42,20.84,13
HCPCS,J2787,RIBOFLAVIN 5'PHOS OPTH<=3ML,,,3337.92,4355.85,2
HCPCS,J2788,BLD MRHIG,291.0,145.5,33.99,282.27,47
HCPCS,J2790,BLD RHIG,476.0,238.0,82.91,461.72,47
HCPCS,J2791,RHOPHYLAC INJECTION,,,6.06,9.31,6
HCPCS,J2792,"RHO(D) IMMUNE GLOBULIN H, SD",,,24.22,59.04,14
HCPCS,J2793,RILONACEPT INJECTION,,,32.94,51.77,6
HCPCS,J2794,"INJ RISPERDAL CONSTA, 0.5 MG",,,10.44,20.88,13
HCPCS,J2795,ROPIVACAINE HCL INJECTION,,,0.07,0.11,2
HCPCS,J2797,"INJ., ROLAPITANT, 0.5 MG",,,1.69,1.69,1
HCPCS,J2798,"INJ., PERSERIS, 0.5 MG",,,11.55,23.69,13
HCPCS,J2799,"INJ, UZEDY, 1 MG",,,23.82,47.64,10
HCPCS,J2800,METHOCARBAMOL INJECTION,,,5.84,8.97,2
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,12.39,24.78,10
HCPCS,J2802,"Injection, romiplostim, 1 microgram",,,10.47,20.94,13
HCPCS,J2804,"Injection, rifampin, 1 mg",,,0.2,0.3,5
HCPCS,J2805,KINEVAC 5MCG INJ,187.0,93.5,32.57,254.67,47
HCPCS,J2810,INJ THEOPHYLLINE PER 40 MG,,,0.77,1.28,2
HCPCS,J2820,SARGRAMOSTIM INJECTION,,,47.91,113.71,14
HCPCS,J2840,INJ SEBELIPASE ALFA 1 MG,,,513.54,1027.08,13
HCPCS,J2850,INJ SECRETIN SYNTHETIC HUMAN,,,38.54,78.93,14
HCPCS,J2860,"INJECTION, SILTUXIMAB",,,157.73,318.26,13
HCPCS,J2865,"Injection, sulfamethoxazole 5 mg and trimethoprim 1 mg",,,0.06,0.09,2
HCPCS,J2910,AUROTHIOGLUCOSE INJECITON,,,45.89,45.89,1
HCPCS,J2916,NA FERRIC GLUCONATE COMPLEX,,,2.66,6.05,5
HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.32,0.49,2
HCPCS,J2940,SOMATREM INJECTION,,,79.21,79.21,1
HCPCS,J2941,SOMATROPIN INJECTION,,,59.68,296.98,2
HCPCS,J2950,PROMAZINE HCL INJECTION,,,,,0
HCPCS,J2993,RETEPLASE INJECTION,,,2762.72,5771.56,10
HCPCS,J2995,INJ STREPTOKINASE /250000 IU,,,86.82,148.9,2
HCPCS,J2997,ALTEPLASE RECOMBINANT,,,89.84,179.68,10
HCPCS,J2998,INJ PLASMINOGEN TVMH 1MG,,,31.17,69.3,13
HCPCS,J3000,STREPTOMYCIN INJECTION,,,38.25,58.72,2
HCPCS,J3010,FENTANYL CITRATE INJECTION,,,1.17,1.8,2
HCPCS,J3030,SUMATRIPTAN SUCCINATE / 6 MG,,,70.69,199.79,2
HCPCS,J3031,"INJ., FREMANEZUMAB-VFRM 1 MG",,,4.94,6.42,5
HCPCS,J3032,INJ. EPTINEZUMAB-JJMR 1 MG,,,18.99,37.98,13
HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,69.07,138.14,13
HCPCS,J3060,"INJ, TALIGLUCERASE ALFA 10 U",,,39.1,84.54,14
HCPCS,J3070,PENTAZOCINE INJECTION,,,32.35,203.01,2
HCPCS,J3090,INJ TEDIZOLID PHOSPHATE,,,1.86,3.72,10
HCPCS,J3095,TELAVANCIN INJECTION,,,6.76,13.99,10
HCPCS,J3101,TENECTEPLASE INJECTION,,,163.81,327.62,10
HCPCS,J3105,TERBUTALINE SULFATE INJ,,,3.34,5.13,2
HCPCS,J3110,TERIPARATIDE INJECTION,,,88.67,92.51,2
HCPCS,J3111,INJ. ROMOSOZUMAB-AQQG 1 MG,,,11.48,22.96,13
HCPCS,J3121,INJ TESTOSTERO ENANTHATE 1MG,,,0.07,0.11,2
HCPCS,J3145,TESTOSTERONE UNDECANOATE 1MG,,,1.97,3.94,10
HCPCS,J3230,CHLORPROMAZINE HCL INJECTION,,,33.03,50.7,2
HCPCS,J3240,THYROGEN PER DOSE 0.9MG,5423.0,2711.5,944.68,5260.31,54
HCPCS,J3241,INJ. TEPROTUMUMAB-TRBW 10 MG,,,341.65,686.84,13
HCPCS,J3243,TIGECYCLINE INJECTION,,,0.62,0.96,2
HCPCS,J3244,INJ. TIGECYCLINE (ACCORD),,,4.12,4.78,2
HCPCS,J3245,"INJ., TILDRAKIZUMAB, 1 MG",,,121.23,256.1,13
HCPCS,J3246,TIROFIBAN HCL,,,4.18,6.42,2
HCPCS,J3247,"Injection, secukinumab, intravenous, 1 mg",,,16.97,34.53,13
HCPCS,J3250,TRIMETHOBENZAMIDE HCL INJ,,,65.15,100.02,2
HCPCS,J3260,TOBRAMYCIN SULFATE INJECTION,,,3.0,4.61,2
HCPCS,J3262,TOCILIZUMAB INJECTION,,,5.43,10.86,14
HCPCS,J3263,"Injection, toripalimab-tpzi, 1 mg",,,37.49,76.16,13
HCPCS,J3265,INJECTION TORSEMIDE 10 MG/ML,,,4.1,4.1,1
HCPCS,J3280,THIETHYLPERAZINE MALEATE INJ,,,5.53,8.92,2
HCPCS,J3285,TREPROSTINIL INJECTION,,,52.04,104.08,14
HCPCS,J3299,INJ XIPERE 1 MG,,,45.63,91.26,10
HCPCS,J3300,TRIAMCINOLONE A INJ PRS-FREE,,,23.3,46.6,10
HCPCS,J3301,TRIAMCINOLONE ACET INJ NOS,,,1.05,1.61,2
HCPCS,J3302,TRIAMCINOLONE DIACETATE INJ,,,0.39,0.52,2
HCPCS,J3303,TRIAMCINOLONE HEXACETONL INJ,,,11.9,15.53,2
HCPCS,J3304,INJ TRIAMCINOLONE ACE XR 1MG,,,17.41,34.82,10
HCPCS,J3305,INJ TRIMETREXATE GLUCORONATE,,,,,0
HCPCS,J3310,PERPHENAZINE INJECITON,,,11.95,11.95,1
HCPCS,J3315,TRIPTORELIN PAMOATE,,,231.35,965.5,14
HCPCS,J3316,"INJ., TRIPTORELIN XR 3.75 MG",,,3630.84,7261.68,13
HCPCS,J3320,SPECTINOMYCN DI-HCL INJ,,,56.34,56.34,1
HCPCS,J3350,UREA INJECTION,,,141.51,141.51,1
HCPCS,J3355,"UROFOLLITROPIN, 75 IU",,,72.21,118.8,2
HCPCS,J3357,"USTEKINUMAB SUB CU INJ, 1 MG",,,192.37,541.47,6
HCPCS,J3358,"USTEKINUMAB, IV INJECT, 1 MG",,,12.36,24.95,13
HCPCS,J3360,DIAZEPAM INJECTION,,,7.53,11.56,2
HCPCS,J3364,UROKINASE 5000 IU INJECTION,,,17.16,17.16,1
HCPCS,J3365,"UROKINASE 250,000 IU INJ",,,857.33,857.33,1
HCPCS,J3373,"Injection, vancomycin hydrochloride, 10 mg",,,0.04,0.06,2
HCPCS,J3374,"Injection, vancomycin hydrochloride (mylan) not therapeutically equivalent to J3373, 10 mg",,,0.15,0.22,2
HCPCS,J3375,"Injection, vancomycin hydrochloride (xellia), not therapeutically equivalent to J3373, 10 mg",,,0.16,0.24,2
HCPCS,J3380,"INJECTION, VEDOLIZUMAB",,,20.27,41.32,13
HCPCS,J3385,VELAGLUCERASE ALFA,,,362.73,725.46,14
HCPCS,J3391,"Injection, atidarsagene autotemcel, per treatment",,,4284975.8,8569951.6,12
HCPCS,J3392,"Injection, exagamglogene autotemcel, per treatment",,,2218105.12,4436210.24,9
HCPCS,J3393,"Injection, betibeglogene autotemcel, per treatment",,,2801870.06,5603740.12,12
HCPCS,J3394,"Injection, lovotibeglogene autotemcel, per treatment",,,3089791.63,6179583.26,12
HCPCS,J3396,VERTEPORFIN INJECTION,,,10.98,21.96,14
HCPCS,J3397,"INJ., VESTRONIDASE ALFA-VJBK",,,266.26,532.52,13
HCPCS,J3398,INJ LUXTURNA 1 BILLION VEC G,,,2855.93,5756.63,11
HCPCS,J3399,INJ ONASE ABEPAR-XIOI TREAT,,,2335203.01,4670406.02,11
HCPCS,J3400,TRIFLUPROMAZINE HCL INJ,,,20.7,20.7,1
HCPCS,J3401,"VYJUVEK 5X10^9PFU/ML, 0.1 ML",,,975.36,1980.58,13
HCPCS,J3410,HYDROXYZINE HCL INJECTION,,,20.65,31.71,2
HCPCS,J3411,THIAMINE HCL 100 MG,,,2.18,3.35,2
HCPCS,J3415,PYRIDOXINE HCL 100 MG,,,15.62,23.97,2
HCPCS,J3420,VITAMIN B12 INJECTION,,,1.16,1.78,2
HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,4.94,9.88,10
HCPCS,J3425,"INJ, HYDROXOCOBALAMIN",,,0.01,0.02,2
HCPCS,J3430,VITAMIN K PHYTONADIONE INJ,,,3.46,5.32,2
HCPCS,J3465,"INJECTION, VORICONAZOLE",,,0.95,1.46,2
HCPCS,J3470,HYALURONIDASE INJECTION,,,38.49,59.09,2
HCPCS,J3471,"OVINE, UP TO 999 USP UNITS",,,0.42,0.94,6
HCPCS,J3472,"OVINE, 1000 USP UNITS",,,129.83,258.1,2
HCPCS,J3473,HYALURONIDASE RECOMBINANT,,,0.44,0.67,6
HCPCS,J3475,INJ MAGNESIUM SULFATE,,,0.61,0.94,2
HCPCS,J3480,INJ POTASSIUM CHLORIDE,,,0.21,0.32,2
HCPCS,J3485,ZIDOVUDINE,,,1.44,2.88,10
HCPCS,J3486,ZIPRASIDONE MESYLATE,,,3.83,5.88,2
HCPCS,J3489,ZOLEDRONIC ACID 1MG,,,6.34,55.95,6
HCPCS,J3490,AMINO ACID INJECTION 50G/1000 ML (50MG/ML),1666.0,833.0,290.21,1616.02,46
HCPCS,J3520,EDETATE DISODIUM PER 150 MG,,,0.39,2.38,2
HCPCS,J3530,NASAL VACCINE INHALATION,,,,,0
HCPCS,J3535,METERED DOSE INHALER DRUG,,,,,0
HCPCS,J3570,LAETRILE AMYGDALIN VIT B17,,,,,0
HCPCS,J3590,UNCLASSIFIED BIOLOGICS,,,,,0
HCPCS,J3591,ESRD ON DIALYSI DRUG/BIO NOC,,,,,0
HCPCS,J7030,NORMAL SALINE SOLUTION INFUS,,,2.78,4.27,2
HCPCS,J7040,NORMAL SALINE SOLUTION INFUS,,,1.68,2.58,2
HCPCS,J7042,5% DEXTROSE/NORMAL SALINE,,,1.66,2.55,2
HCPCS,J7050,NORMAL SALINE SOLUTION INFUS,,,0.87,1.33,2
HCPCS,J7060,5% DEXTROSE/WATER,,,2.48,3.8,2
HCPCS,J7070,D5W INFUSION,,,3.71,5.69,2
HCPCS,J7100,DEXTRAN 40 INFUSION,,,97.45,127.16,2
HCPCS,J7110,DEXTRAN 75 INFUSION,,,27.2,27.2,1
HCPCS,J7120,RINGERS LACTATE INFUSION,,,3.0,4.61,2
HCPCS,J7121,5% DEXTROSE IN LAC RINGERS,,,7.38,15.25,2
HCPCS,J7131,HYPERTONIC SALINE SOL,,,0.12,0.32,2
HCPCS,J7165,"Inj, human-lans, per i.u",,,1.47,6.01,13
HCPCS,J7168,PROTHROMBIN COMPLEX KCENTRA,,,2.04,5.69,10
HCPCS,J7169,"INJ ANDEXXA, 10 MG",,,124.96,249.92,10
HCPCS,J7170,"INJ., EMICIZUMAB-KXWH 0.5 MG",,,53.36,107.57,10
HCPCS,J7171,"Injection, ADAMTS13, recombinant-krhn, 10 iu",,,33.85,67.7,13
HCPCS,J7172,"Injection, marstacimab-hncq, 0.5 mg",,,48.6,97.2,13
HCPCS,J7175,"INJ, FACTOR X, (HUMAN), 1IU",,,9.3,18.6,13
HCPCS,J7177,"INJ., FIBRYGA, 1 MG",,,1.17,2.34,10
HCPCS,J7178,INJ HUMAN FIBRINOGEN CON NOS,,,1.45,2.9,13
HCPCS,J7179,VONVENDI INJ 1 IU VWF:RCO,,,1.76,3.57,13
HCPCS,J7180,FACTOR XIII ANTI-HEM FACTOR,,,10.23,20.46,13
HCPCS,J7181,FACTOR XIII RECOMB A-SUBUNIT,,,17.27,34.54,14
HCPCS,J7182,FACTOR VIII RECOMB NOVOEIGHT,,,1.46,2.92,14
HCPCS,J7183,WILATE INJECTION,,,1.23,2.46,14
HCPCS,J7185,XYNTHA INJ,,,1.59,3.18,14
HCPCS,J7186,ANTIHEMOPHILIC VIII/VWF COMP,,,1.19,2.38,14
HCPCS,J7187,"HUMATE-P, INJ",,,1.42,2.84,14
HCPCS,J7188,FACTOR VIII RECOMB OBIZUR,,,3.07,6.3,13
HCPCS,J7189,FACTOR VIIA RECOMB NOVOSEVEN,,,2.53,5.06,14
HCPCS,J7190,FACTOR VIII,,,1.04,2.12,14
HCPCS,J7191,FACTOR VIII (PORCINE),,,5.19,10.38,8
HCPCS,J7192,FACTOR VIII RECOMBINANT NOS,,,1.53,3.06,14
HCPCS,J7193,FACTOR IX NON-RECOMBINANT,,,1.33,2.66,14
HCPCS,J7194,FACTOR IX COMPLEX,,,1.62,3.24,14
HCPCS,J7195,FACTOR IX RECOMBINANT NOS,,,1.76,3.52,14
HCPCS,J7196,ANTITHROMBIN RECOMBINANT,,,268.42,268.42,1
HCPCS,J7197,ANTITHROMBIN III INJECTION,,,3.9,7.8,10
HCPCS,J7198,ANTI-INHIBITOR,,,2.29,4.59,14
HCPCS,J7199,HEMOPHILIA CLOT FACTOR NOC,,,,,0
HCPCS,J7200,FACTOR IX RECOMBINAN RIXUBIS,,,1.61,3.22,13
HCPCS,J7201,FACTOR IX ALPROLIX RECOMB,,,3.41,6.82,14
HCPCS,J7202,FACTOR IX IDELVION INJ,,,5.06,10.12,13
HCPCS,J7203,FACTOR IX RECOMB GLY REBINYN,,,4.24,8.58,10
HCPCS,J7204,INJ RECOMBIN ESPEROCT PER IU,,,2.11,4.23,10
HCPCS,J7205,FACTOR VIII FC FUSION RECOMB,,,2.31,4.62,13
HCPCS,J7207,FACTOR VIII PEGYLATED RECOMB,,,2.0,4.09,13
HCPCS,J7208,INJ. JIVI 1 IU,,,2.52,5.04,10
HCPCS,J7209,FACTOR VIII NUWIQ RECOMB 1IU,,,1.07,2.33,13
HCPCS,J7210,"INJ, AFSTYLA, 1 I.U.",,,1.49,2.98,13
HCPCS,J7211,"INJ, KOVALTRY, 1 I.U.",,,1.49,2.98,13
HCPCS,J7212,FACTOR VIIA RECOMB SEVENFACT,,,2.25,4.5,10
HCPCS,J7213,"INJ, IXINITY, 1 I.U.",,,1.82,3.74,13
HCPCS,J7214,ALTUVIIIO PER FACTOR VIII IU,,,4.43,8.96,13
HCPCS,J7294,SEG ACET AND ETH ESTR YEARLY,,,3543.69,4624.36,2
HCPCS,J7295,ETH ESTR AND ETON MONTHLY,,,228.26,234.44,2
HCPCS,J7296,"KYLEENA, 19.5 MG",,,1778.22,2320.52,5
HCPCS,J7297,"LILETTA, 52 MG",,,1364.06,1780.04,5
HCPCS,J7298,"MIRENA, 52 MG",,,1778.22,2320.52,5
HCPCS,J7300,INTRAUT COPPER CONTRACEPTIVE,,,1206.05,2174.74,6
HCPCS,J7301,"SKYLA, 13.5 MG",,,1161.2,1975.84,6
HCPCS,J7304,CONTRACEPTIVE HORMONE PATCH,,,,,0
HCPCS,J7306,LEVONORGESTREL IMPLANT SYS,,,458.56,598.46,2
HCPCS,J7307,ETONOGESTREL IMPLANT SYSTEM,,,1318.37,2320.52,6
HCPCS,J7308,AMINOLEVULINIC ACID HCL TOP,,,372.94,745.88,10
HCPCS,J7309,"METHYL AMINOLEVULINATE, TOP",,,156.75,156.75,1
HCPCS,J7310,GANCICLOVIR LONG ACT IMPLANT,,,5007.82,31766.08,3
HCPCS,J7311,"INJ., RETISERT, 0.01 MG",,,323.69,32220.92,14
HCPCS,J7312,DEXAMETHASONE INTRA IMPLANT,,,194.62,389.24,10
HCPCS,J7313,"INJ., ILUVIEN, 0.01 MG",,,473.81,947.62,10
HCPCS,J7314,"INJ., YUTIQ, 0.01 MG",,,504.01,1021.93,13
HCPCS,J7315,OPHTHALMIC MITOMYCIN,,,821.5,821.5,1
HCPCS,J7316,"INJ, OCRIPLASMIN, 0.125 MG",,,1674.8,1960.9,2
HCPCS,J7318,"INJ, DUROLANE 1 MG",,,6.44,13.51,13
HCPCS,J7320,"GENVISC 850, INJ, 1MG",,,5.49,12.31,13
HCPCS,J7321,HYALGAN SUPARTZ VISCO-3 DOSE,,,89.54,141.78,6
HCPCS,J7322,HYMOVIS INJECTION 1 MG,,,16.76,34.09,13
HCPCS,J7323,EUFLEXXA INJ PER DOSE,,,106.96,243.2,14
HCPCS,J7324,ORTHOVISC INJ PER DOSE,,,108.95,276.21,14
HCPCS,J7325,SYNVISC OR SYNVISC-ONE,,,7.56,20.59,14
HCPCS,J7326,GEL-ONE,,,503.41,1031.24,14
HCPCS,J7327,MONOVISC INJ PER DOSE,,,605.5,1533.52,14
HCPCS,J7328,GELSYN-3 INJECTION 0.1 MG,,,0.67,1.34,13
HCPCS,J7329,"INJ, TRIVISC 1 MG",,,4.46,10.88,13
HCPCS,J7330,CULTURED CHONDROCYTES IMPLNT,,,96363.41,125750.3,2
HCPCS,J7331,"SYNOJOYNT, INJ., 1 MG",,,6.84,16.42,5
HCPCS,J7332,"INJ., TRILURON, 1 MG",,,9.77,20.03,13
HCPCS,J7336,CAPSAICIN 8% PATCH,,,3.25,6.5,14
HCPCS,J7340,CARBIDOPA LEVODOPA ENT 100ML,,,231.71,463.42,10
HCPCS,J7342,CIPROFLOXACIN OTIC SUSP 6 MG,,,41.46,54.09,2
HCPCS,J7345,"AMINOLEVULINIC ACID, 10% GEL",,,1.7,3.4,10
HCPCS,J7351,INJ BIMATOPROST ITC IMP1MCG,,,203.4,408.93,13
HCPCS,J7352,"AFAMELANOTIDE IMPLANT, 1 MG",,,2799.66,6019.05,13
HCPCS,J7353,ANACAULASE-BCDB 8.8% GEL 1 G,,,55.46,110.92,10
HCPCS,J7354,"Cantharidin top, applicator",,,622.78,1254.14,10
HCPCS,J7355,"Injection, travoprost, intracameral implant, 1 microgram",,,186.16,378.74,12
HCPCS,J7356,"Injection, foscarbidopa 0.25 mg/foslevodopa 5 mg",,,1.0,1.31,2
HCPCS,J7402,MOMETASONE SINUS SINUVA,,,10.8,21.6,10
HCPCS,J7500,AZATHIOPRINE ORAL 50MG,,,2.61,4.01,2
HCPCS,J7501,AZATHIOPRINE PARENTERAL,,,241.66,483.32,10
HCPCS,J7502,CYCLOSPORINE ORAL 100 MG,,,2.53,3.88,2
HCPCS,J7503,TACROL ENVARSUS EX REL ORAL,,,2.23,3.43,2
HCPCS,J7504,LYMPHOCYTE IMMUNE GLOBULIN,,,1710.92,9768.58,14
HCPCS,J7505,MONOCLONAL ANTIBODIES,,,1059.57,1059.57,1
HCPCS,J7507,TACROLIMUS IMME REL ORAL 1MG,,,0.18,0.28,2
HCPCS,J7508,TACROL ASTAGRAF EX REL ORAL,,,0.72,1.11,2
HCPCS,J7509,METHYLPREDNISOLONE ORAL,,,0.28,0.43,2
HCPCS,J7510,PREDNISOLONE ORAL PER 5 MG,,,0.33,0.51,2
HCPCS,J7511,ANTITHYMOCYTE GLOBULN RABBIT,,,950.56,1901.12,14
HCPCS,J7512,PREDNISONE IR OR DR ORAL 1MG,,,0.02,1.72,2
HCPCS,J7513,"DACLIZUMAB, PARENTERAL",,,457.38,457.38,1
HCPCS,J7514,"Mycophenolate mofetil (Myhibbin), oral suspension, 100 mg",,,3.2,4.18,2
HCPCS,J7515,CYCLOSPORINE ORAL 25 MG,,,0.94,1.44,2
HCPCS,J7516,CYCLOSPORIN PARENTERAL 250MG,,,61.35,136.15,6
HCPCS,J7517,MYCOPHENOLATE MOFETIL ORAL,,,0.2,0.3,2
HCPCS,J7518,MYCOPHENOLIC ACID,,,0.45,0.69,2
HCPCS,J7519,INJ. MYCOPHENOLATE MOFETIL,,,0.5,0.77,5
HCPCS,J7520,"SIROLIMUS, ORAL",,,1.17,1.8,2
HCPCS,J7521,"Tacrolimus, granules, oral suspension, 0.1 mg",,,1.53,2.6,5
HCPCS,J7525,TACROLIMUS INJECTION,,,250.3,500.6,10
HCPCS,J7527,ORAL EVEROLIMUS,,,2.43,3.73,2
HCPCS,J7599,IMMUNOSUPPRESSIVE DRUG NOC,,,,,0
HCPCS,J7601,"Ensifentrine, inhalation suspension, FDA approved final product, non-compounded, administered through DME, unit dose form, 3 mg",,,63.59,101.54,5
HCPCS,J7604,ACETYLCYSTEINE COMP UNIT,,,,,0
HCPCS,J7605,ARFORMOTEROL NON-COMP UNIT,,,0.96,1.48,2
HCPCS,J7606,"FORMOTEROL FUMARATE, INH",,,2.4,3.69,2
HCPCS,J7607,LEVALBUTEROL COMP CON,,,,,0
HCPCS,J7608,ACETYLCYSTEINE NON-COMP UNIT,,,10.85,16.65,2
HCPCS,J7609,ALBUTEROL COMP UNIT,,,0.96,0.96,1
HCPCS,J7610,ALBUTEROL COMP CON,,,2.3,2.3,1
HCPCS,J7611,ALBUTEROL NON-COMP CON,,,0.2,0.3,2
HCPCS,J7612,LEVALBUTEROL NON-COMP CON,,,0.37,0.56,2
HCPCS,J7613,ALBUTEROL NON-COMP UNIT,,,0.1,0.15,2
HCPCS,J7614,LEVALBUTEROL NON-COMP UNIT,,,0.11,0.17,2
HCPCS,J7615,LEVALBUTEROL COMP UNIT,,,2.37,2.7,2
HCPCS,J7620,ALBUTEROL IPRATROP NON-COMP,,,0.24,0.37,2
HCPCS,J7622,BECLOMETHASONE COMP UNIT,,,,,0
HCPCS,J7624,BETAMETHASONE COMP UNIT,,,,,0
HCPCS,J7626,BUDESONIDE NON-COMP UNIT,,,1.56,2.4,2
HCPCS,J7627,BUDESONIDE COMP UNIT,,,0.58,5.53,2
HCPCS,J7628,BITOLTEROL MESYLATE COMP CON,,,0.41,0.41,1
HCPCS,J7629,BITOLTEROL MESYLATE COMP UNT,,,,,0
HCPCS,J7631,CROMOLYN SODIUM NONCOMP UNIT,,,0.35,0.54,2
HCPCS,J7632,CROMOLYN SODIUM COMP UNIT,,,0.39,0.51,2
HCPCS,J7633,BUDESONIDE NON-COMP CON,,,9.03,9.03,1
HCPCS,J7634,BUDESONIDE COMP CON,,,,,0
HCPCS,J7635,ATROPINE COMP CON,,,,,0
HCPCS,J7636,ATROPINE COMP UNIT,,,,,0
HCPCS,J7637,DEXAMETHASONE COMP CON,,,,,0
HCPCS,J7638,DEXAMETHASONE COMP UNIT,,,,,0
HCPCS,J7639,DORNASE ALFA NON-COMP UNIT,,,67.3,103.31,2
HCPCS,J7640,FORMOTEROL COMP UNIT,,,3.24,3.24,1
HCPCS,J7641,FLUNISOLIDE COMP UNIT,,,12.24,15.96,2
HCPCS,J7642,GLYCOPYRROLATE COMP CON,,,,,0
HCPCS,J7643,GLYCOPYRROLATE COMP UNIT,,,1.42,1.42,1
HCPCS,J7644,IPRATROPIUM BROMIDE NON-COMP,,,0.48,0.73,2
HCPCS,J7645,IPRATROPIUM BROMIDE COMP,,,0.09,0.09,1
HCPCS,J7647,ISOETHARINE COMP CON,,,,,0
HCPCS,J7648,ISOETHARINE NON-COMP CON,,,,,0
HCPCS,J7649,ISOETHARINE NON-COMP UNIT,,,,,0
HCPCS,J7650,ISOETHARINE COMP UNIT,,,,,0
HCPCS,J7657,ISOPROTERENOL COMP CON,,,,,0
HCPCS,J7658,ISOPROTERENOL NON-COMP CON,,,,,0
HCPCS,J7659,ISOPROTERENOL NON-COMP UNIT,,,,,0
HCPCS,J7660,ISOPROTERENOL COMP UNIT,,,,,0
HCPCS,J7665,MANNITOL FOR INHALER,,,1.44,12.57,2
HCPCS,J7667,METAPROTERENOL COMP CON,,,,,0
HCPCS,J7668,METAPROTERENOL NON-COMP CON,,,,,0
HCPCS,J7669,METAPROTERENOL NON-COMP UNIT,,,0.81,0.81,1
HCPCS,J7670,METAPROTERENOL COMP UNIT,,,,,0
HCPCS,J7674,"METHACHOLINE CHLORIDE, NEB",,,2.11,3.24,2
HCPCS,J7676,PENTAMIDINE COMP UNIT DOSE,,,,,0
HCPCS,J7677,REVEFENACIN INH NON-COM 1MCG,,,0.23,0.36,2
HCPCS,J7680,TERBUTALINE SULF COMP CON,,,15.4,20.08,2
HCPCS,J7681,TERBUTALINE SULF COMP UNIT,,,15.4,20.08,2
HCPCS,J7682,TOBRAMYCIN NON-COMP UNIT,,,17.64,100.3,6
HCPCS,J7683,TRIAMCINOLONE COMP CON,,,5.53,7.21,2
HCPCS,J7684,TRIAMCINOLONE COMP UNIT,,,,,0
HCPCS,J7685,TOBRAMYCIN COMP UNIT,,,70.64,92.19,2
HCPCS,J7686,"TREPROSTINIL, NON-COMP UNIT",,,810.3,1498.68,6
HCPCS,J7699,INHALATION SOLUTION FOR DME,,,,,0
HCPCS,J7799,NON-INHALATION DRUG FOR DME,,,,,0
HCPCS,J7999,"COMPOUNDED DRUG, NOC",,,,,0
HCPCS,J8498,ANTIEMETIC RECTAL/SUPP NOS,,,,,0
HCPCS,J8499,ORAL PRESCRIP DRUG NON CHEMO,,,,,0
HCPCS,J8501,ORAL APREPITANT,,,3.32,5.09,2
HCPCS,J8510,ORAL BUSULFAN,,,9.63,262.43,10
HCPCS,J8515,"CABERGOLINE, ORAL 0.25MG",,,3.0,22.36,2
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.04,0.09,10
HCPCS,J8530,CYCLOPHOSPHAMIDE ORAL 25 MG,,,2.42,3.71,2
HCPCS,J8540,ORAL DEXAMETHASONE,,,0.02,0.04,2
HCPCS,J8541,"Dexamethasone (Hemady), oral, 0.25 mg",,,0.5,0.69,2
HCPCS,J8560,ETOPOSIDE ORAL 50 MG,,,73.68,147.36,10
HCPCS,J8562,ORAL FLUDARABINE PHOSPHATE,,,,,0
HCPCS,J8565,GEFITINIB ORAL,,,267.86,355.02,2
HCPCS,J8597,ANTIEMETIC DRUG ORAL NOS,,,,,0
HCPCS,J8600,MELPHALAN ORAL 2 MG,,,15.74,17.49,2
HCPCS,J8610,METHOTREXATE ORAL 2.5 MG,,,0.24,0.37,2
HCPCS,J8611,"Methotrexate (Jylamvo), oral, 2.5 mg",,,17.57,35.14,10
HCPCS,J8612,"Methotrexate (Xatmep), oral, 2.5 mg",,,21.57,43.14,10
HCPCS,J8650,NABILONE ORAL,,,18.54,74.88,2
HCPCS,J8655,"ORAL NETUPITANT, PALONOSETRO",,,402.24,804.48,10
HCPCS,J8670,"ROLAPITANT, ORAL, 1MG",,,1.77,3.54,10
HCPCS,J8700,TEMOZOLOMIDE,,,0.44,0.67,2
HCPCS,J8705,TOPOTECAN ORAL,,,118.73,237.46,10
HCPCS,J8999,ORAL PRESCRIPTION DRUG CHEMO,,,,,0
HCPCS,J9000,DOXORUBICIN HCL INJECTION,,,3.32,6.76,6
HCPCS,J9015,ALDESLEUKIN INJECTION,,,3175.8,11577.39,14
HCPCS,J9017,ARSENIC TRIOXIDE INJECTION,,,7.15,95.08,6
HCPCS,J9019,ERWINAZE INJECTION,,,590.11,867.83,6
HCPCS,J9020,"ASPARAGINASE, NOS",,,62.35,103.3,2
HCPCS,J9021,"INJ, ASPARA, RYLAZE, 0.1 MG",,,52.76,105.93,13
HCPCS,J9022,"INJ, ATEZOLIZUMAB,10 MG",,,86.88,174.14,13
HCPCS,J9023,"INJECTION, AVELUMAB, 10 MG",,,95.2,190.4,13
HCPCS,J9024,"Injection, atezolizumab, 5 mg and hyaluronidase-tqjs",,,30.04,60.15,13
HCPCS,J9025,AZACITIDINE INJECTION,,,0.26,4.88,6
HCPCS,J9026,"Injection, tarlatamab-dlle, 1 mg",,,1488.22,3060.02,13
HCPCS,J9027,CLOFARABINE INJECTION,,,3.99,221.41,14
HCPCS,J9028,"Injection, nogapendekin alfa inbakicept-pmln, for intravesical use, 1 microgram",,,90.04,180.08,13
HCPCS,J9029,"INSTILL ADSTILADRIN, TX DOSE",,,60248.64,123190.11,13
HCPCS,J9030,BCG LIVE INTRAVESICAL 1MG,,,3.1,6.2,13
HCPCS,J9032,"INJECTION, BELINOSTAT, 10MG",,,49.91,99.82,13
HCPCS,J9033,"INJ., TREANDA 1 MG",,,1.79,39.45,14
HCPCS,J9034,"INJ., BENDEKA 1 MG",,,12.83,26.45,13
HCPCS,J9035,BEVACIZUMAB INJECTION,,,69.62,139.24,14
HCPCS,J9036,INJ. BELRAPZO/BENDAMUSTINE,,,11.68,27.65,13
HCPCS,J9038,"Injection, axatilimab-csfr, 0.1 mg",,,52.93,105.86,13
HCPCS,J9039,"INJECTION, BLINATUMOMAB",,,156.23,312.46,13
HCPCS,J9040,BLEOMYCIN SULFATE INJECTION,,,25.5,40.58,6
HCPCS,J9041,"INJECTION, BORTEZOMIB, 0.1MG",,,1.94,74.8,6
HCPCS,J9042,BRENTUXIMAB VEDOTIN INJ,,,191.39,492.02,14
HCPCS,J9043,CABAZITAXEL INJECTION,,,216.18,432.36,14
HCPCS,J9045,CARBOPLATIN INJECTION,,,2.57,6.12,6
HCPCS,J9046,"INJ, BORTEZOMIB, DR. REDDY'S",,,3.29,87.51,10
HCPCS,J9047,"INJECTION, CARFILZOMIB, 1 MG",,,49.69,105.86,14
HCPCS,J9048,"INJ, BORTEZOMIB FRESENIUSKAB",,,6.63,87.51,10
HCPCS,J9049,"INJ, BORTEZOMIB, HOSPIRA",,,1.89,2.9,2
HCPCS,J9050,CARMUSTINE INJECTION,,,211.84,4757.34,14
HCPCS,J9051,"INJ, BORTEZOMIB (MAIA)",,,6.47,6.54,4
HCPCS,J9052,"INJ, CARMUSTINE (ACCORD)",,,0.1,468.06,5
HCPCS,J9054,"Injection, bortezomib (Boruzu), 0.1 mg",,,24.87,49.74,13
HCPCS,J9055,CETUXIMAB INJECTION,,,74.54,149.08,14
HCPCS,J9056,"INJ, BENDAMUSTINE, 1 MG",,,28.39,56.78,13
HCPCS,J9057,"INJ., COPANLISIB, 1 MG",,,165.49,167.28,4
HCPCS,J9060,CISPLATIN 10 MG INJECTION,,,2.38,5.53,6
HCPCS,J9061,"INJ, AMIVANTAMAB-VMJW",,,21.44,42.88,13
HCPCS,J9063,"INJ, ELAHERE, 1 MG",,,66.1,132.61,13
HCPCS,J9064,"INJ, CABAZITAXEL (SANDOZ)",,,,,0
HCPCS,J9065,INJ CLADRIBINE PER 1 MG,,,10.16,33.46,14
HCPCS,J9071,INJ CYCLOPHOSPHAMD AUROMEDIC,,,0.6,1.46,10
HCPCS,J9072,INJ CYCLOPHOS DR.REDDY'S 5MG,,,8.67,17.64,13
HCPCS,J9073,Inj cyclophosphamd (ingenus),,,0.74,2.17,10
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,3.75,7.89,10
HCPCS,J9075,"Inj, cyclophosphamide, nos",,,0.46,1.16,10
HCPCS,J9076,"Injection, cyclophosphamide (Baxter), 5 mg",,,4.77,9.54,13
HCPCS,J9098,CYTARABINE LIPOSOME INJ,,,498.81,1176.94,3
HCPCS,J9100,CYTARABINE HCL 100 MG INJ,,,0.99,1.72,6
HCPCS,J9118,INJ. CALASPARGASE PEGOL-MKNL,,,78.07,156.14,13
HCPCS,J9119,"INJ., CEMIPLIMAB-RWLC, 1 MG",,,27.86,56.33,13
HCPCS,J9120,DACTINOMYCIN INJECTION,,,312.3,1863.31,14
HCPCS,J9130,DACARBAZINE 100 MG INJ,,,4.66,7.15,2
HCPCS,J9144,"DARATUMUMAB, HYALURONIDASE",,,52.86,105.72,13
HCPCS,J9145,"INJECTION, DARATUMUMAB 10 MG",,,67.88,135.76,13
HCPCS,J9150,DAUNORUBICIN INJECTION,,,24.11,47.51,6
HCPCS,J9151,DAUNORUBICIN CITRATE INJ,,,63.14,108.0,3
HCPCS,J9153,"INJ DAUNORUBICIN, CYTARABINE",,,243.58,487.16,13
HCPCS,J9155,DEGARELIX INJECTION,,,4.23,8.46,14
HCPCS,J9161,"Injection, denileukin diftitox-cxdl, 1 mcg",,,,,0
HCPCS,J9165,DIETHYLSTILBESTROL INJECTION,,,,,0
HCPCS,J9171,DOCETAXEL INJECTION,,,0.46,5.58,6
HCPCS,J9172,"DOCETAXEL (INGENUS), 1 MG",,,48.3,96.6,13
HCPCS,J9173,"INJ., DURVALUMAB, 10 MG",,,80.96,163.38,13
HCPCS,J9174,"Injection, docetaxel (Beizray), 1 mg",,,49.91,99.82,10
HCPCS,J9175,ELLIOTTS B SOLUTION PER ML,,,14.08,19.48,2
HCPCS,J9176,"INJECTION, ELOTUZUMAB, 1MG",,,7.5,15.05,13
HCPCS,J9177,INJ ENFORT VEDO-EJFV 0.25MG,,,34.95,71.39,13
HCPCS,J9178,"INJ, EPIRUBICIN HCL, 2 MG",,,1.94,2.98,6
HCPCS,J9179,ERIBULIN MESYLATE INJECTION,,,84.98,213.75,14
HCPCS,J9181,ETOPOSIDE INJECTION,,,0.98,2.43,6
HCPCS,J9185,FLUDARABINE PHOSPHATE INJ,,,87.41,134.2,6
HCPCS,J9190,FLUOROURACIL INJECTION,,,2.1,3.97,6
HCPCS,J9196,INJ GEMCITABINE HCL (ACCORD),,,6.45,16.85,5
HCPCS,J9198,"INJ. INFUGEM, 100 MG",,,72.6,78.47,4
HCPCS,J9200,FLOXURIDINE INJECTION,,,108.3,7852.82,14
HCPCS,J9201,IN GEMCITABINE HCL NOS 200MG,,,3.61,14.75,6
HCPCS,J9202,GOSERELIN ACETATE IMPLANT,,,449.67,1395.68,14
HCPCS,J9203,GEMTUZUMAB OZOGAMICIN 0.1 MG,,,225.06,454.13,13
HCPCS,J9204,"INJ MOGAMULIZUMAB-KPKC, 1 MG",,,236.36,474.6,13
HCPCS,J9205,INJ IRINOTECAN LIPOSOME 1 MG,,,62.78,127.16,13
HCPCS,J9206,IRINOTECAN INJECTION,,,1.71,6.4,6
HCPCS,J9207,IXABEPILONE INJECTION,,,115.33,264.82,14
HCPCS,J9208,IFOSFAMIDE INJECTION,,,28.67,51.53,6
HCPCS,J9209,MESNA INJECTION,,,1.62,4.57,6
HCPCS,J9210,"INJ., EMAPALUMAB-LZSG, 1 MG",,,366.05,743.21,12
HCPCS,J9211,IDARUBICIN HCL INJECTION,,,45.2,108.47,6
HCPCS,J9212,INTERFERON ALFACON-1 INJ,,,7.5,12.27,2
HCPCS,J9213,INTERFERON ALFA-2A INJ,,,41.43,54.07,2
HCPCS,J9214,INTERFERON ALFA-2B INJ,,,15.4,60.23,6
HCPCS,J9215,INTERFERON ALFA-N3 INJ,,,42.78,57.54,6
HCPCS,J9216,INTERFERON GAMMA 1-B INJ,,,12384.93,16161.82,2
HCPCS,J9217,LEUPROLIDE ACETATE SUSPNSION,,,167.83,388.49,14
HCPCS,J9218,LEUPROLIDE ACETATE INJECITON,,,96.31,184.83,2
HCPCS,J9219,LEUPROLIDE ACETATE IMPLANT,,,9027.52,9027.52,1
HCPCS,J9220,"Injection, indigotindisulfonate sodium, 1 mg",,,9.47,19.1,10
HCPCS,J9223,"INJ. LURBINECTEDIN, 0.1 MG",,,197.01,399.43,13
HCPCS,J9225,VANTAS IMPLANT,,,4819.66,9311.32,3
HCPCS,J9226,SUPPRELIN LA IMPLANT,,,35473.35,85643.68,14
HCPCS,J9227,INJ. ISATUXIMAB-IRFC 10 MG,,,77.9,155.8,13
HCPCS,J9228,IPILIMUMAB INJECTION,,,174.52,349.04,14
HCPCS,J9229,INJ INOTUZUMAB OZOGAM 0.1 MG,,,2566.28,5178.34,13
HCPCS,J9230,MECHLORETHAMINE HCL INJ,,,154.7,602.58,3
HCPCS,J9245,INJ MELPHA HYDROCH NOS 50 MG,,,91.22,2056.64,14
HCPCS,J9246,"INJ., EVOMELA, 1 MG",,,17.6,36.03,13
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,756.17,1512.34,10
HCPCS,J9249,"Inj, melphalan (apotex) 1 mg",,,61.62,123.24,13
HCPCS,J9255,"INJ, METHOTREXATE (ACCORD)",,,,,0
HCPCS,J9260,METHOTREXATE SODIUM INJ,,,2.76,4.23,2
HCPCS,J9261,NELARABINE INJECTION,,,75.96,237.71,14
HCPCS,J9262,"INJ, OMACETAXINE MEP, 0.01MG",,,7.27,7.27,1
HCPCS,J9263,OXALIPLATIN,,,0.1,0.77,6
HCPCS,J9264,PACLITAXEL PROTEIN BOUND,,,10.03,23.51,14
HCPCS,J9266,PEGASPARGASE INJECTION,,,9903.59,65250.2,14
HCPCS,J9267,PACLITAXEL INJECTION,,,0.13,0.28,6
HCPCS,J9268,PENTOSTATIN INJECTION,,,2354.37,4961.56,14
HCPCS,J9269,INJ. TAGRAXOFUSP-ERZS 10 MCG,,,339.5,679.0,13
HCPCS,J9270,PLICAMYCIN (MITHRAMYCIN) INJ,,,,,0
HCPCS,J9271,INJ PEMBROLIZUMAB,,,57.35,114.7,13
HCPCS,J9272,"INJ, DOSTARLIMAB-GXLY, 10 MG",,,231.81,467.81,13
HCPCS,J9273,"INJ TISOTU VEDOTIN-TFTV, 1MG",,,179.54,367.51,13
HCPCS,J9274,"INJ, TEBENTAFUSP-TEBN, 1 MCG",,,206.49,418.37,13
HCPCS,J9275,"Injection, cosibelimab-ipdl, 2 mg",,,21.8,43.6,8
HCPCS,J9276,"Injection, zanidatamab-hrii, 2 mg",,,23.83,47.66,13
HCPCS,J9280,MITOMYCIN INJECTION,,,19.36,116.85,14
HCPCS,J9281,MITOMYCIN INSTILLATION,,,302.97,609.75,13
HCPCS,J9285,"INJ, OLARATUMAB, 10 MG",,,71.91,97.53,2
HCPCS,J9286,"INJ GLOFITAMAB GXBM, 2.5 MG",,,2632.7,5401.73,13
HCPCS,J9289,"Injection, nivolumab, 2 mg and hyaluronidase-nvhy",,,26.02,52.04,13
HCPCS,J9292,"Injection, pemetrexed dipotassium, 10 mg",,,78.32,156.64,13
HCPCS,J9293,MITOXANTRONE HYDROCHL / 5 MG,,,22.71,55.44,14
HCPCS,J9294,"INJ PEMETREXED, HOSPIRA 10MG",,,3.38,9.23,13
HCPCS,J9295,"INJECTION, NECITUMUMAB, 1 MG",,,5.45,11.17,13
HCPCS,J9296,INJ PEMETREXED (ACCORD) 10MG,,,9.26,18.96,13
HCPCS,J9297,INJ PEMETREXED (SANDOZ) 10MG,,,1.48,3.39,5
HCPCS,J9298,INJ NIVOL RELATLIMAB 3MG/1MG,,,188.17,378.08,13
HCPCS,J9299,"INJECTION, NIVOLUMAB",,,31.35,62.7,13
HCPCS,J9301,OBINUTUZUMAB INJ,,,75.14,150.28,14
HCPCS,J9302,OFATUMUMAB INJECTION,,,59.19,121.46,14
HCPCS,J9303,PANITUMUMAB INJECTION,,,161.46,329.16,14
HCPCS,J9304,"INJ. PEMETREXED, 10 MG",,,44.06,98.78,13
HCPCS,J9305,INJ. PEMETREXED NOS 10MG,,,4.15,97.94,14
HCPCS,J9306,"INJECTION, PERTUZUMAB, 1 MG",,,16.19,32.38,14
HCPCS,J9307,PRALATREXATE INJECTION,,,340.48,746.9,14
HCPCS,J9308,"INJECTION, RAMUCIRUMAB",,,70.73,141.46,13
HCPCS,J9309,"INJ, POLATUZUMAB VEDOTIN 1MG",,,130.0,260.0,13
HCPCS,J9311,"INJ RITUXIMAB, HYALURONIDASE",,,34.9,73.1,13
HCPCS,J9312,"INJ., RITUXIMAB, 10 MG",,,71.55,148.91,13
HCPCS,J9313,"INJ., LUMOXITI, 0.01 MG",,,22.25,45.57,13
HCPCS,J9314,INJ PEMETREXED (TEVA) 10MG,,,4.62,29.56,10
HCPCS,J9316,"PERTUZU, TRASTUZU, 10 MG",,,59.07,122.72,13
HCPCS,J9317,SACITUZUMAB GOVITECAN-HZIY,,,34.51,69.74,13
HCPCS,J9318,INJ ROMIDEPSIN NON-LYO 0.1MG,,,27.13,60.45,13
HCPCS,J9319,INJ ROMIDEPSIN LYOPHIL 0.1MG,,,29.28,61.45,13
HCPCS,J9320,STREPTOZOCIN INJECTION,,,207.18,2483.6,6
HCPCS,J9321,INJ EPCORITAMAB-BYSP 0.16 MG,,,53.11,106.88,13
HCPCS,J9322,INJ PEMETREXED (BLUEPOINT),,,10.08,20.16,12
HCPCS,J9323,INJ PEMETREXED DITROMETHAMIN,,,0.12,20.15,13
HCPCS,J9324,"INJ, PEMRYDI RTU, 10 MG",,,72.11,150.03,13
HCPCS,J9325,INJ TALIMOGENE LAHERPAREPVEC,,,70.33,140.66,13
HCPCS,J9328,TEMOZOLOMIDE INJECTION,,,9.88,20.46,14
HCPCS,J9329,"Injection, tislelizumab-jsgr, 1mg",,,54.64,109.28,13
HCPCS,J9330,TEMSIROLIMUS INJECTION,,,25.41,100.0,14
HCPCS,J9331,INJ SIROLIMUS PROT PART 1 MG,,,80.44,229.15,13
HCPCS,J9332,INJ EFGARTIGIMOD 2MG,,,30.58,63.07,13
HCPCS,J9333,INJ RONZANOLIXIZUM-NOLI 1 MG,,,22.04,44.5,13
HCPCS,J9334,INJ EFGART-ALFA 2MG HYA-QVFC,,,32.23,65.01,13
HCPCS,J9341,"Injection, thiotepa (Tepylute), 1 mg",,,54.38,70.95,5
HCPCS,J9342,"Injection, thiotepa, not otherwise specified, 1 mg",,,10.03,22.93,10
HCPCS,J9345,"INJ, RETIFANLIMAB-DLWR, 1 MG",,,29.07,58.14,13
HCPCS,J9347,"INJ, TREMELIMUMAB-ACTL, 1 MG",,,134.02,269.32,13
HCPCS,J9348,"INJ. NAXITAMAB-GQGK, 1 MG",,,652.5,1305.0,13
HCPCS,J9349,"INJ., TAFASITAMAB-CXIX",,,13.61,27.22,13
HCPCS,J9350,"INJ MOSUNETUZUMAB-AXGB, 1 MG",,,622.66,1248.66,13
HCPCS,J9351,TOPOTECAN INJECTION,,,1.63,3.28,6
HCPCS,J9352,INJECTION TRABECTEDIN 0.1MG,,,371.97,743.94,13
HCPCS,J9353,"INJ. MARGETUXIMAB-CMKB, 5 MG",,,49.93,99.86,13
HCPCS,J9354,"INJ, ADO-TRASTUZUMAB EMT 1MG",,,40.1,80.2,13
HCPCS,J9355,INJ TRASTUZUMAB EXCL BIOSIMI,,,71.37,142.74,14
HCPCS,J9356,"INJ. HERCEPTIN HYLECTA, 10MG",,,58.44,122.56,13
HCPCS,J9357,VALRUBICIN INJECTION,,,1258.72,2600.18,14
HCPCS,J9358,ONC PNCRTC 59 MTHLTN BLK MRK,,,28.52,57.04,13
HCPCS,J9359,INJ LON TESIRIN-LPYL 0.075MG,,,206.31,413.0,13
HCPCS,J9360,VINBLASTINE SULFATE INJ,,,4.7,9.91,6
HCPCS,J9361,"Injection, efbemalenograstim alfa-vuxw, 0.5 mg",,,217.35,219.7,4
HCPCS,J9370,VINCRISTINE SULFATE 1 MG INJ,,,7.32,14.75,6
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,87.25,174.5,13
HCPCS,J9380,INJ TECLISTAMAB CQYV 0.5 MG,,,31.94,63.88,13
HCPCS,J9381,INJ TEPLIZUMAB MZWV 5 MCG,,,35.82,72.69,13
HCPCS,J9382,"Injection, zenocutuzumab-zbco, 1 mg",,,31.3,62.6,10
HCPCS,J9390,VINORELBINE TARTRATE INJ,,,2.39,16.11,6
HCPCS,J9393,"INJ, FULVESTRANT (TEVA)",,,38.21,79.26,10
HCPCS,J9394,"INJ, FULVESTRANT (FRESENIUS)",,,4.05,50.92,10
HCPCS,J9395,"INJECTION, FULVESTRANT",,,8.52,149.51,6
HCPCS,J9400,"INJ, ZIV-AFLIBERCEPT, 1MG",,,7.5,15.0,14
HCPCS,J9600,PORFIMER SODIUM INJECTION,,,5079.71,46090.2,14
HCPCS,J9999,CHEMOTHERAPY DRUG,,,,,0
HCPCS,K0001,DME POS,,,31.07,62.14,8
HCPCS,K0002,DME POS,,,54.13,108.26,8
HCPCS,K0003,DME POS,,,46.99,93.98,8
HCPCS,K0004,DME POS,,,57.95,115.9,8
HCPCS,K0005,DME POS,,,2634.76,5269.52,8
HCPCS,K0006,DME POS,,,85.68,171.36,8
HCPCS,K0007,DME POS,,,120.78,241.56,8
HCPCS,K0008,CSTM MANUAL WHEELCHAIR/BASE,,,,,0
HCPCS,K0009,DME POS,,,104.93,209.86,8
HCPCS,K0010,DME POS,,,516.03,1032.06,8
HCPCS,K0011,DME POS,,,730.07,1460.14,8
HCPCS,K0012,DME POS,,,463.05,926.1,8
HCPCS,K0013,CUSTOM POWER WHLCHR BASE,,,,,0
HCPCS,K0014,OTHER POWER WHLCHR BASE,,,,,0
HCPCS,K0015,DME POS,,,17.55,35.1,8
HCPCS,K0017,DME POS,,,59.0,118.0,8
HCPCS,K0018,DME POS,,,33.35,66.7,8
HCPCS,K0019,DME POS,,,15.76,31.52,8
HCPCS,K0020,DME POS,,,57.07,114.14,8
HCPCS,K0037,DME POS,,,50.28,100.56,8
HCPCS,K0038,DME POS,,,29.49,58.98,8
HCPCS,K0039,DME POS,,,63.32,126.64,8
HCPCS,K0040,DME POS,,,65.47,130.94,8
HCPCS,K0041,DME POS,,,60.51,121.02,8
HCPCS,K0042,DME POS,,,38.04,76.08,8
HCPCS,K0043,DME POS,,,23.97,47.94,8
HCPCS,K0044,DME POS,,,20.44,40.88,8
HCPCS,K0045,DME POS,,,68.66,137.32,8
HCPCS,K0046,DME POS,,,23.97,47.94,8
HCPCS,K0047,DME POS,,,85.33,170.66,8
HCPCS,K0050,DME POS,,,39.59,79.18,8
HCPCS,K0051,DME POS,,,62.63,125.26,8
HCPCS,K0052,DME POS,,,88.18,176.36,8
HCPCS,K0053,DME POS,,,102.36,204.72,8
HCPCS,K0056,DME POS,,,117.03,234.06,8
HCPCS,K0065,DME POS,,,55.71,111.42,8
HCPCS,K0069,DME POS,,,115.72,231.44,8
HCPCS,K0070,DME POS,,,20.37,40.74,8
HCPCS,K0071,DME POS,,,131.54,263.08,8
HCPCS,K0072,DME POS,,,82.46,164.92,8
HCPCS,K0073,DME POS,,,42.94,85.88,8
HCPCS,K0077,DME POS,,,67.07,134.14,8
HCPCS,K0098,DME POS,,,29.01,58.02,8
HCPCS,K0105,DME POS,,,121.11,242.22,8
HCPCS,K0108,W/C COMPONENT-ACCESSORY NOS,,,,,0
HCPCS,K0195,DME POS,,,13.6,27.2,8
HCPCS,K0455,DME POS,,,377.46,754.92,8
HCPCS,K0462,TEMPORARY REPLACEMENT EQPMNT,,,,,0
HCPCS,K0552,DME POS,,,3.47,6.94,8
HCPCS,K0601,DME POS,,,1.57,3.14,8
HCPCS,K0602,DME POS,,,8.88,17.76,8
HCPCS,K0603,DME POS,,,0.8,1.6,8
HCPCS,K0604,DME POS,,,8.56,17.12,8
HCPCS,K0605,DME POS,,,20.45,40.9,8
HCPCS,K0606,DME POS,,,3588.9,7177.8,8
HCPCS,K0607,DME POS,,,27.69,55.38,8
HCPCS,K0608,DME POS,,,172.74,345.48,8
HCPCS,K0609,DME POS,,,1148.78,2297.56,8
HCPCS,K0669,SEAT/BACK CUS NO DMEPDAC VER,,,,,0
HCPCS,K0672,DME POS,,,104.76,209.52,8
HCPCS,K0730,DME POS,,,245.69,491.38,8
HCPCS,K0733,DME POS,,,34.28,68.56,8
HCPCS,K0738,DME POS,,,47.94,95.88,8
HCPCS,K0739,REPAIR/SVC DME NON-OXYGEN EQ,,,20.11,40.22,8
HCPCS,K0740,REPAIR/SVC OXYGEN EQUIPMENT,,,,,0
HCPCS,K0743,PORTABLE HOME SUCTION PUMP,,,,,0
HCPCS,K0744,ABSORP DRG <= 16 SUC PUMP,,,,,0
HCPCS,K0745,ABSORP DRG >16<=48 SUC PUMP,,,,,0
HCPCS,K0746,ABSORP DRG >48 SUC PUMP,,,,,0
HCPCS,K0800,DME POS,,,1058.25,2116.5,8
HCPCS,K0801,DME POS,,,1902.0,3804.0,8
HCPCS,K0802,DME POS,,,2516.45,5032.9,8
HCPCS,K0806,DME POS,,,1748.83,3497.66,8
HCPCS,K0807,DME POS,,,2710.26,5420.52,8
HCPCS,K0808,DME POS,,,4189.62,8379.24,8
HCPCS,K0812,POWER OPERATED VEHICLE NOC,,,,,0
HCPCS,K0813,DME POS,,,321.66,643.32,8
HCPCS,K0814,DME POS,,,337.11,674.22,8
HCPCS,K0815,DME POS,,,374.57,749.14,8
HCPCS,K0816,DME POS,,,349.8,699.6,8
HCPCS,K0820,DME POS,,,328.99,657.98,8
HCPCS,K0821,DME POS,,,350.14,700.28,8
HCPCS,K0822,DME POS,,,374.95,749.9,8
HCPCS,K0823,DME POS,,,350.31,700.62,8
HCPCS,K0824,DME POS,,,546.25,1092.5,8
HCPCS,K0825,DME POS,,,494.62,989.24,8
HCPCS,K0826,DME POS,,,912.92,1825.84,8
HCPCS,K0827,DME POS,,,803.69,1607.38,8
HCPCS,K0828,DME POS,,,1064.22,2128.44,8
HCPCS,K0829,DME POS,,,1067.47,2134.94,8
HCPCS,K0830,PWC GP2 STD SEAT ELEVATE S/B,,,,,0
HCPCS,K0831,PWC GP2 STD SEAT ELEVATE CAP,,,,,0
HCPCS,K0835,DME POS,,,449.35,898.7,8
HCPCS,K0836,DME POS,,,466.07,932.14,8
HCPCS,K0837,DME POS,,,576.34,1152.68,8
HCPCS,K0838,DME POS,,,510.83,1021.66,8
HCPCS,K0839,DME POS,,,765.58,1531.16,8
HCPCS,K0840,DME POS,,,1175.41,2350.82,8
HCPCS,K0841,DME POS,,,506.38,1012.76,8
HCPCS,K0842,DME POS,,,505.64,1011.28,8
HCPCS,K0843,DME POS,,,600.26,1200.52,8
HCPCS,K0848,DME POS,,,973.66,1947.32,8
HCPCS,K0849,DME POS,,,936.11,1872.22,8
HCPCS,K0850,DME POS,,,1129.38,2258.76,8
HCPCS,K0851,DME POS,,,1085.92,2171.84,8
HCPCS,K0852,DME POS,,,1304.94,2609.88,8
HCPCS,K0853,DME POS,,,1340.51,2681.02,8
HCPCS,K0854,DME POS,,,1775.89,3551.78,8
HCPCS,K0855,DME POS,,,1677.58,3355.16,8
HCPCS,K0856,DME POS,,,1045.09,2090.18,8
HCPCS,K0857,DME POS,,,1066.05,2132.1,8
HCPCS,K0858,DME POS,,,1296.66,2593.32,8
HCPCS,K0859,DME POS,,,1236.63,2473.26,8
HCPCS,K0860,DME POS,,,1852.46,3704.92,8
HCPCS,K0861,DME POS,,,1046.78,2093.56,8
HCPCS,K0862,DME POS,,,1296.66,2593.32,8
HCPCS,K0863,DME POS,,,1852.46,3704.92,8
HCPCS,K0864,DME POS,,,2204.42,4408.84,8
HCPCS,K0868,PWC GP 4 STD SEAT/BACK,,,,,0
HCPCS,K0869,PWC GP 4 STD CAP CHAIR,,,,,0
HCPCS,K0870,PWC GP 4 HD SEAT/BACK,,,,,0
HCPCS,K0871,PWC GP 4 VHD SEAT/BACK,,,,,0
HCPCS,K0877,PWC GP4 STD SING POW OPT S/B,,,,,0
HCPCS,K0878,PWC GP4 STD SING POW OPT CAP,,,,,0
HCPCS,K0879,PWC GP4 HD SING POW OPT S/B,,,,,0
HCPCS,K0880,PWC GP4 VHD SING POW OPT S/B,,,,,0
HCPCS,K0884,PWC GP4 STD MULT POW OPT S/B,,,,,0
HCPCS,K0885,PWC GP4 STD MULT POW OPT CAP,,,,,0
HCPCS,K0886,PWC GP4 HD MULT POW S/B,,,,,0
HCPCS,K0890,PWC GP5 PED SING POW OPT S/B,,,,,0
HCPCS,K0891,PWC GP5 PED MULT POW OPT S/B,,,,,0
HCPCS,K0898,POWER WHEELCHAIR NOC,,,,,0
HCPCS,K0899,POW MOBIL DEV NO DMEPDAC,,,,,0
HCPCS,K0900,CSTM DME OTHER THAN WHEELCHR,,,,,0
HCPCS,K1004,LO FREQ US DIATHERMY DEVICE,,,,,0
HCPCS,K1007,BIL HKAF PC S/D MICRO SENSOR,,,95081.03,190162.06,8
HCPCS,K1027,ORAL DEV WITHOUT FIX MECH,,,,,0
HCPCS,K1030,EXT RECHARGE BAT REPLACEMENT,,,,,0
HCPCS,K1034,COVID TEST SELF-ADMN/COLLECT,,,,,0
HCPCS,K1035,MOL DIAG READER SELF-ADMN,,,,,0
HCPCS,K1036,SUPPLIES FOR ULTRA DIATHERM,,,,,0
HCPCS,K1037,Docking station for oral dev,,,,,0
HCPCS,L0112,DME POS,,,1729.39,3458.78,8
HCPCS,L0113,DME POS,,,352.38,704.76,8
HCPCS,L0120,CERV FLEX N/ADJ FOAM PRE OTS,276.0,138.0,34.57,267.72,54
HCPCS,L0130,DME POS,,,249.97,499.94,8
HCPCS,L0140,DME POS,,,86.25,172.5,8
HCPCS,L0150,DME POS,,,143.84,287.68,8
HCPCS,L0160,DME POS,,,204.81,409.62,8
HCPCS,L0170,DME POS,,,866.65,1733.3,8
HCPCS,L0172,CERV COL SR FOAM 2PC PRE OTS,294.0,147.0,51.21,351.44,54
HCPCS,L0174,DME POS,,,315.67,631.34,8
HCPCS,L0180,DME POS,,,429.3,858.6,8
HCPCS,L0190,DME POS,,,646.26,1292.52,8
HCPCS,L0200,DME POS,,,593.42,1186.84,8
HCPCS,L0220,DME POS,,,140.73,281.46,8
HCPCS,L0450,DME POS,,,145.1,290.2,8
HCPCS,L0452,DME POS,,,,,0
HCPCS,L0454,DME POS,,,428.54,857.08,8
HCPCS,L0455,DME POS,,,269.37,538.74,8
HCPCS,L0456,DME POS,,,1228.92,2457.84,8
HCPCS,L0457,DME POS,,,772.46,1544.92,8
HCPCS,L0458,DME POS,,,1101.98,2203.96,8
HCPCS,L0460,DME POS,,,1240.37,2480.74,8
HCPCS,L0462,DME POS,,,1542.8,3085.6,8
HCPCS,L0464,DME POS,,,1836.64,3673.28,8
HCPCS,L0466,DME POS,,,472.27,944.54,8
HCPCS,L0467,DME POS,,,302.1,604.2,8
HCPCS,L0468,DME POS,,,592.16,1184.32,8
HCPCS,L0469,DME POS,,,384.93,769.86,8
HCPCS,L0470,DME POS,,,843.0,1686.0,8
HCPCS,L0472,DME POS,,,529.16,1058.32,8
HCPCS,L0480,DME POS,,,1636.27,3272.54,8
HCPCS,L0482,DME POS,,,1875.79,3751.58,8
HCPCS,L0484,DME POS,,,2187.12,4374.24,8
HCPCS,L0486,DME POS,,,2166.6,4333.2,8
HCPCS,L0488,DME POS,,,1240.37,2480.74,8
HCPCS,L0490,DME POS,,,349.51,699.02,8
HCPCS,L0491,DME POS,,,948.92,1897.84,8
HCPCS,L0492,DME POS,,,614.99,1229.98,8
HCPCS,L0621,DME POS,,,76.5,153.0,8
HCPCS,L0622,DME POS,,,298.76,597.52,8
HCPCS,L0623,DME POS,,,137.13,274.26,8
HCPCS,L0624,DME POS,,,,,0
HCPCS,L0625,DME POS,,,42.8,85.6,8
HCPCS,L0626,DME POS,,,96.32,192.64,8
HCPCS,L0627,DME POS,,,507.93,1015.86,8
HCPCS,L0628,DME POS,,,65.17,130.34,8
HCPCS,L0629,DME POS,,,,,0
HCPCS,L0630,DME POS,,,200.07,400.14,8
HCPCS,L0631,DME POS,,,1268.47,2536.94,8
HCPCS,L0632,DME POS,,,,,0
HCPCS,L0633,DME POS,,,354.33,708.66,8
HCPCS,L0634,DME POS,,,,,0
HCPCS,L0635,DME POS,,,1313.9,2627.8,8
HCPCS,L0636,DME POS,,,1938.77,3877.54,8
HCPCS,L0637,DME POS,,,1682.1,3364.2,8
HCPCS,L0638,DME POS,,,1629.67,3259.34,8
HCPCS,L0639,DME POS,,,1682.1,3364.2,8
HCPCS,L0640,DME POS,,,1292.96,2585.92,8
HCPCS,L0641,DME POS,,,60.55,121.1,8
HCPCS,L0642,DME POS,,,319.33,638.66,8
HCPCS,L0643,DME POS,,,125.81,251.62,8
HCPCS,L0648,DME POS,,,797.49,1594.98,8
HCPCS,L0649,DME POS,,,222.77,445.54,8
HCPCS,L0650,DME POS,,,922.75,1845.5,8
HCPCS,L0651,DME POS,,,922.75,1845.5,8
HCPCS,L0700,DME POS,,,2660.31,5320.62,8
HCPCS,L0710,DME POS,,,2903.9,5807.8,8
HCPCS,L0720,"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patie",,,2265.94,4531.88,8
HCPCS,L0810,DME POS,,,3084.99,6169.98,8
HCPCS,L0820,DME POS,,,2495.61,4991.22,8
HCPCS,L0830,DME POS,,,3603.4,7206.8,8
HCPCS,L0859,DME POS,,,1399.89,2799.78,8
HCPCS,L0861,DME POS,,,266.32,532.64,8
HCPCS,L0970,DME POS,,,131.34,262.68,8
HCPCS,L0972,DME POS,,,134.25,268.5,8
HCPCS,L0974,DME POS,,,274.31,548.62,8
HCPCS,L0976,DME POS,,,244.99,489.98,8
HCPCS,L0978,DME POS,,,221.2,442.4,8
HCPCS,L0980,DME POS,,,20.07,40.14,8
HCPCS,L0982,DME POS,,,21.87,43.74,8
HCPCS,L0984,DME POS,,,69.77,139.54,8
HCPCS,L0999,ADD TO SPINAL ORTHOSIS NOS,,,,,0
HCPCS,L1000,DME POS,,,2332.97,4665.94,8
HCPCS,L1001,DME POS,,,,,0
HCPCS,L1005,DME POS,,,3954.81,7909.62,8
HCPCS,L1006,"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been t",,,1309.09,2618.18,8
HCPCS,L1010,DME POS,,,93.95,187.9,8
HCPCS,L1020,DME POS,,,128.37,256.74,8
HCPCS,L1025,DME POS,,,145.9,291.8,8
HCPCS,L1030,DME POS,,,97.47,194.94,8
HCPCS,L1040,DME POS,,,117.32,234.64,8
HCPCS,L1050,DME POS,,,101.56,203.12,8
HCPCS,L1060,DME POS,,,114.57,229.14,8
HCPCS,L1070,DME POS,,,117.15,234.3,8
HCPCS,L1080,DME POS,,,81.17,162.34,8
HCPCS,L1085,DME POS,,,225.49,450.98,8
HCPCS,L1090,DME POS,,,105.33,210.66,8
HCPCS,L1100,DME POS,,,185.94,371.88,8
HCPCS,L1110,DME POS,,,314.94,629.88,8
HCPCS,L1120,DME POS,,,50.16,100.32,8
HCPCS,L1200,DME POS,,,1997.03,3994.06,8
HCPCS,L1210,DME POS,,,300.68,601.36,8
HCPCS,L1220,DME POS,,,254.58,509.16,8
HCPCS,L1230,DME POS,,,653.22,1306.44,8
HCPCS,L1240,DME POS,,,112.41,224.82,8
HCPCS,L1250,DME POS,,,110.69,221.38,8
HCPCS,L1260,DME POS,,,113.77,227.54,8
HCPCS,L1270,DME POS,,,113.64,227.28,8
HCPCS,L1280,DME POS,,,101.29,202.58,8
HCPCS,L1290,DME POS,,,114.83,229.66,8
HCPCS,L1300,DME POS,,,1919.53,3839.06,8
HCPCS,L1310,DME POS,,,1975.19,3950.38,8
HCPCS,L1320,Pectus carinatum ortho cust,,,,,0
HCPCS,L1499,SPINAL ORTHOSIS NOS,,,,,0
HCPCS,L1600,DME POS,,,148.08,296.16,8
HCPCS,L1610,DME POS,,,50.45,100.9,8
HCPCS,L1620,DME POS,,,166.13,332.26,8
HCPCS,L1630,DME POS,,,198.25,396.5,8
HCPCS,L1640,DME POS,,,530.24,1060.48,8
HCPCS,L1650,DME POS,,,281.19,562.38,8
HCPCS,L1652,DME POS,,,440.48,880.96,8
HCPCS,L1653,"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf",,,440.48,880.96,8
HCPCS,L1660,DME POS,,,196.66,393.32,8
HCPCS,L1680,DME POS,,,1616.8,3233.6,8
HCPCS,L1681,DME POS,,,2289.0,4578.0,8
HCPCS,L1685,DME POS,,,1705.99,3411.98,8
HCPCS,L1686,DME POS,,,1144.5,2289.0,8
HCPCS,L1690,DME POS,,,2389.39,4778.78,8
HCPCS,L1700,DME POS,,,1987.82,3975.64,8
HCPCS,L1710,DME POS,,,2336.55,4673.1,8
HCPCS,L1720,DME POS,,,1726.01,3452.02,8
HCPCS,L1730,DME POS,,,1302.22,2604.44,8
HCPCS,L1755,DME POS,,,1895.44,3790.88,8
HCPCS,L1810,DME POS,,,149.59,299.18,8
HCPCS,L1812,DME POS,,,85.71,171.42,8
HCPCS,L1820,DME POS,,,148.99,297.98,8
HCPCS,L1821,"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf",,,148.99,297.98,8
HCPCS,L1830,KO IMMOB CANVAS LONG PRE OTS,160.0,80.0,27.87,155.2,54
HCPCS,L1831,DME POS,,,363.64,727.28,8
HCPCS,L1832,DME POS,,,931.51,1863.02,8
HCPCS,L1833,DME POS,,,556.31,1112.62,8
HCPCS,L1834,DME POS,,,1095.91,2191.82,8
HCPCS,L1836,DME POS,,,109.2,218.4,8
HCPCS,L1840,DME POS,,,1151.99,2303.98,8
HCPCS,L1843,DME POS,,,1108.66,2217.32,8
HCPCS,L1844,DME POS,,,1921.07,3842.14,8
HCPCS,L1845,DME POS,,,1157.34,2314.68,8
HCPCS,L1846,DME POS,,,1468.46,2936.92,8
HCPCS,L1847,DME POS,,,710.72,1421.44,8
HCPCS,L1848,DME POS,,,710.72,1421.44,8
HCPCS,L1850,DME POS,,,251.5,503.0,8
HCPCS,L1851,DME POS,,,734.28,1468.56,8
HCPCS,L1852,DME POS,,,700.49,1400.98,8
HCPCS,L1860,DME POS,,,1282.92,2565.84,8
HCPCS,L1900,DME POS,,,347.57,695.14,8
HCPCS,L1902,AFO ANKLE GAUNTLET PRE OTS,186.0,93.0,32.4,188.78,54
HCPCS,L1904,DME POS,,,540.36,1080.72,8
HCPCS,L1906,DME POS,,,157.92,315.84,8
HCPCS,L1907,DME POS,,,695.27,1390.54,8
HCPCS,L1910,DME POS,,,307.3,614.6,8
HCPCS,L1920,DME POS,,,401.73,803.46,8
HCPCS,L1930,DME POS,,,271.84,543.68,8
HCPCS,L1932,DME POS,,,1102.62,2205.24,8
HCPCS,L1933,"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf",,,1102.62,2205.24,8
HCPCS,L1940,DME POS,,,614.33,1228.66,8
HCPCS,L1945,DME POS,,,1128.15,2256.3,8
HCPCS,L1950,DME POS,,,855.92,1711.84,8
HCPCS,L1951,DME POS,,,1037.71,2075.42,8
HCPCS,L1952,"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf",,,1037.71,2075.42,8
HCPCS,L1960,DME POS,,,636.95,1273.9,8
HCPCS,L1970,DME POS,,,942.1,1884.2,8
HCPCS,L1971,DME POS,,,579.17,1158.34,8
HCPCS,L1980,DME POS,,,421.73,843.46,8
HCPCS,L1990,DME POS,,,541.86,1083.72,8
HCPCS,L2000,DME POS,,,1165.54,2331.08,8
HCPCS,L2005,DME POS,,,5063.24,10126.48,8
HCPCS,L2006,DME POS,,,39378.44,78756.88,8
HCPCS,L2010,DME POS,,,1062.5,2125.0,8
HCPCS,L2020,DME POS,,,1341.77,2683.54,8
HCPCS,L2030,DME POS,,,1164.11,2328.22,8
HCPCS,L2034,DME POS,,,2537.13,5074.26,8
HCPCS,L2035,DME POS,,,214.06,428.12,8
HCPCS,L2036,DME POS,,,2131.99,4263.98,8
HCPCS,L2037,DME POS,,,1964.76,3929.52,8
HCPCS,L2038,DME POS,,,1642.94,3285.88,8
HCPCS,L2040,DME POS,,,209.85,419.7,8
HCPCS,L2050,DME POS,,,558.87,1117.74,8
HCPCS,L2060,DME POS,,,717.28,1434.56,8
HCPCS,L2070,DME POS,,,206.05,412.1,8
HCPCS,L2080,DME POS,,,439.45,878.9,8
HCPCS,L2090,DME POS,,,541.63,1083.26,8
HCPCS,L2106,DME POS,,,781.31,1562.62,8
HCPCS,L2108,DME POS,,,1227.78,2455.56,8
HCPCS,L2112,DME POS,,,582.98,1165.96,8
HCPCS,L2114,DME POS,,,666.99,1333.98,8
HCPCS,L2116,DME POS,,,878.76,1757.52,8
HCPCS,L2126,DME POS,,,1563.58,3127.16,8
HCPCS,L2128,DME POS,,,1970.44,3940.88,8
HCPCS,L2132,DME POS,,,926.98,1853.96,8
HCPCS,L2134,DME POS,,,1111.41,2222.82,8
HCPCS,L2136,DME POS,,,1358.95,2717.9,8
HCPCS,L2180,DME POS,,,134.58,269.16,8
HCPCS,L2182,DME POS,,,105.33,210.66,8
HCPCS,L2184,DME POS,,,189.8,379.6,8
HCPCS,L2186,DME POS,,,210.31,420.62,8
HCPCS,L2188,DME POS,,,458.87,917.74,8
HCPCS,L2190,DME POS,,,119.18,238.36,8
HCPCS,L2192,DME POS,,,409.73,819.46,8
HCPCS,L2200,DME POS,,,54.63,109.26,8
HCPCS,L2210,DME POS,,,88.64,177.28,8
HCPCS,L2220,DME POS,,,101.79,203.58,8
HCPCS,L2230,DME POS,,,88.17,176.34,8
HCPCS,L2232,DME POS,,,119.38,238.76,8
HCPCS,L2240,DME POS,,,96.11,192.22,8
HCPCS,L2250,DME POS,,,408.31,816.62,8
HCPCS,L2260,DME POS,,,230.35,460.7,8
HCPCS,L2265,DME POS,,,135.33,270.66,8
HCPCS,L2270,DME POS,,,61.71,123.42,8
HCPCS,L2275,DME POS,,,150.16,300.32,8
HCPCS,L2280,DME POS,,,557.83,1115.66,8
HCPCS,L2300,DME POS,,,314.89,629.78,8
HCPCS,L2310,DME POS,,,141.37,282.74,8
HCPCS,L2320,DME POS,,,236.44,472.88,8
HCPCS,L2330,DME POS,,,451.21,902.42,8
HCPCS,L2335,DME POS,,,265.43,530.86,8
HCPCS,L2340,DME POS,,,626.36,1252.72,8
HCPCS,L2350,DME POS,,,1023.92,2047.84,8
HCPCS,L2360,DME POS,,,59.45,118.9,8
HCPCS,L2370,DME POS,,,294.98,589.96,8
HCPCS,L2375,DME POS,,,129.84,259.68,8
HCPCS,L2380,DME POS,,,141.47,282.94,8
HCPCS,L2385,DME POS,,,153.92,307.84,8
HCPCS,L2387,DME POS,,,208.88,417.76,8
HCPCS,L2390,DME POS,,,125.79,251.58,8
HCPCS,L2395,DME POS,,,192.05,384.1,8
HCPCS,L2397,DME POS,,,134.68,269.36,8
HCPCS,L2405,DME POS,,,107.74,215.48,8
HCPCS,L2415,DME POS,,,150.1,300.2,8
HCPCS,L2425,DME POS,,,177.12,354.24,8
HCPCS,L2430,DME POS,,,177.12,354.24,8
HCPCS,L2492,DME POS,,,117.18,234.36,8
HCPCS,L2500,DME POS,,,362.52,725.04,8
HCPCS,L2510,DME POS,,,970.6,1941.2,8
HCPCS,L2520,DME POS,,,529.38,1058.76,8
HCPCS,L2525,DME POS,,,1816.17,3632.34,8
HCPCS,L2526,DME POS,,,978.93,1957.86,8
HCPCS,L2530,DME POS,,,269.99,539.98,8
HCPCS,L2540,DME POS,,,485.83,971.66,8
HCPCS,L2550,DME POS,,,330.04,660.08,8
HCPCS,L2570,DME POS,,,729.78,1459.56,8
HCPCS,L2580,DME POS,,,691.79,1383.58,8
HCPCS,L2600,DME POS,,,236.01,472.02,8
HCPCS,L2610,DME POS,,,279.07,558.14,8
HCPCS,L2620,DME POS,,,307.25,614.5,8
HCPCS,L2622,DME POS,,,352.39,704.78,8
HCPCS,L2624,DME POS,,,479.06,958.12,8
HCPCS,L2627,DME POS,,,1973.72,3947.44,8
HCPCS,L2628,DME POS,,,2318.48,4636.96,8
HCPCS,L2630,DME POS,,,284.55,569.1,8
HCPCS,L2640,DME POS,,,386.17,772.34,8
HCPCS,L2650,DME POS,,,137.9,275.8,8
HCPCS,L2660,DME POS,,,214.17,428.34,8
HCPCS,L2670,DME POS,,,196.02,392.04,8
HCPCS,L2680,DME POS,,,179.82,359.64,8
HCPCS,L2750,DME POS,,,96.05,192.1,8
HCPCS,L2755,DME POS,,,161.49,322.98,8
HCPCS,L2760,DME POS,,,69.82,139.64,8
HCPCS,L2768,DME POS,,,161.0,322.0,8
HCPCS,L2780,DME POS,,,82.59,165.18,8
HCPCS,L2785,DME POS,,,48.56,97.12,8
HCPCS,L2795,DME POS,,,97.65,195.3,8
HCPCS,L2800,DME POS,,,122.57,245.14,8
HCPCS,L2810,DME POS,,,89.75,179.5,8
HCPCS,L2820,DME POS,,,99.79,199.58,8
HCPCS,L2830,DME POS,,,112.21,224.42,8
HCPCS,L2840,DME POS,,,62.64,125.28,8
HCPCS,L2850,DME POS,,,71.15,142.3,8
HCPCS,L2861,TORSION MECHANISM KNEE/ANKLE,,,,,0
HCPCS,L2999,LOWER EXTREMITY ORTHOSIS NOS,,,,,0
HCPCS,L3000,DME POS,,,388.16,776.32,8
HCPCS,L3001,DME POS,,,163.43,326.86,8
HCPCS,L3002,DME POS,,,199.55,399.1,8
HCPCS,L3003,DME POS,,,215.29,430.58,8
HCPCS,L3010,DME POS,,,215.29,430.58,8
HCPCS,L3020,FOOT LONGITUD/METATARSAL SUP,306.0,153.0,53.3,490.3,54
HCPCS,L3030,FOOT ARCH SUPPORT REMOV PREM,511.0,255.5,89.01,495.67,54
HCPCS,L3031,DME POS,,,151.32,302.64,8
HCPCS,L3040,DME POS,,,58.15,116.3,8
HCPCS,L3050,DME POS,,,58.15,116.3,8
HCPCS,L3060,DME POS,,,91.14,182.28,8
HCPCS,L3070,DME POS,,,39.28,78.56,8
HCPCS,L3080,DME POS,,,39.28,78.56,8
HCPCS,L3090,DME POS,,,50.31,100.62,8
HCPCS,L3100,DME POS,,,53.41,106.82,8
HCPCS,L3140,DME POS,,,110.03,220.06,8
HCPCS,L3150,DME POS,,,100.58,201.16,8
HCPCS,L3160,SHOE STYLED POSITIONING DEV,,,,,0
HCPCS,L3161,"FOOT, ADDUCTUS POSITION, ADJ",,,,,0
HCPCS,L3170,DME POS,,,62.87,125.74,8
HCPCS,L3201,OXFORD W SUPINAT/PRONAT INF,,,,,0
HCPCS,L3202,OXFORD W/ SUPINAT/PRONATOR C,,,,,0
HCPCS,L3203,OXFORD W/ SUPINATOR/PRONATOR,,,,,0
HCPCS,L3204,HIGHTOP W/ SUPP/PRONATOR INF,,,,,0
HCPCS,L3206,HIGHTOP W/ SUPP/PRONATOR CHI,,,,,0
HCPCS,L3207,HIGHTOP W/ SUPP/PRONATOR JUN,,,,,0
HCPCS,L3208,SURGICAL BOOT EACH INFANT,,,,,0
HCPCS,L3209,SURGICAL BOOT EACH CHILD,,,,,0
HCPCS,L3211,SURGICAL BOOT EACH JUNIOR,,,,,0
HCPCS,L3212,BENESCH BOOT PAIR INFANT,,,,,0
HCPCS,L3213,BENESCH BOOT PAIR CHILD,,,,,0
HCPCS,L3214,BENESCH BOOT PAIR JUNIOR,,,,,0
HCPCS,L3215,ORTHOPEDIC FTWEAR LADIES OXF,,,,,0
HCPCS,L3216,ORTHOPED LADIES SHOES DPTH I,,,,,0
HCPCS,L3217,LADIES SHOES HIGHTOP DEPTH I,,,,,0
HCPCS,L3219,ORTHOPEDIC MENS SHOES OXFORD,,,,,0
HCPCS,L3221,ORTHOPEDIC MENS SHOES DPTH I,,,,,0
HCPCS,L3222,MENS SHOES HIGHTOP DEPTH INL,,,,,0
HCPCS,L3224,DME POS,,,67.57,135.14,8
HCPCS,L3225,DME POS,,,77.73,155.46,8
HCPCS,L3230,CUSTOM SHOES DEPTH INLAY,,,,,0
HCPCS,L3250,CUSTOM MOLD SHOE REMOV PROST,,,,,0
HCPCS,L3251,SHOE MOLDED TO PT SILICONE S,,,,,0
HCPCS,L3252,SHOE MOLDED PLASTAZOTE CUST,,,,,0
HCPCS,L3253,SHOE MOLDED PLASTAZOTE CUST,,,,,0
HCPCS,L3254,ORTH FOOT NON-STNDARD SIZE/W,,,,,0
HCPCS,L3255,ORTH FOOT NON-STANDARD SIZE/,,,,,0
HCPCS,L3257,ORTH FOOT ADD CHARGE SPLIT S,,,,,0
HCPCS,L3260,AMBULATORY SURGICAL BOOT EAC,,,,,0
HCPCS,L3265,PLASTAZOTE SANDAL EACH,,,,,0
HCPCS,L3300,DME POS,,,64.41,128.82,8
HCPCS,L3310,DME POS,,,100.58,201.16,8
HCPCS,L3320,SHOE LIFT ELEV HEEL/SOLE COR,,,,,0
HCPCS,L3330,DME POS,,,699.28,1398.56,8
HCPCS,L3332,DME POS,,,91.14,182.28,8
HCPCS,L3334,DME POS,,,47.13,94.26,8
HCPCS,L3340,DME POS,,,105.33,210.66,8
HCPCS,L3350,DME POS,,,28.26,56.52,8
HCPCS,L3360,DME POS,,,44.0,88.0,8
HCPCS,L3370,DME POS,,,61.3,122.6,8
HCPCS,L3380,DME POS,,,61.3,122.6,8
HCPCS,L3390,DME POS,,,61.3,122.6,8
HCPCS,L3400,DME POS,,,50.31,100.62,8
HCPCS,L3410,DME POS,,,114.74,229.48,8
HCPCS,L3420,DME POS,,,67.55,135.1,8
HCPCS,L3430,DME POS,,,198.0,396.0,8
HCPCS,L3440,DME POS,,,94.31,188.62,8
HCPCS,L3450,DME POS,,,130.4,260.8,8
HCPCS,L3455,DME POS,,,50.31,100.62,8
HCPCS,L3460,DME POS,,,42.41,84.82,8
HCPCS,L3465,DME POS,,,72.28,144.56,8
HCPCS,L3470,DME POS,,,76.99,153.98,8
HCPCS,L3480,DME POS,,,76.99,153.98,8
HCPCS,L3485,SHOE HEEL PAD REMOVABLE FOR,,,,,0
HCPCS,L3500,DME POS,,,36.18,72.36,8
HCPCS,L3510,DME POS,,,36.18,72.36,8
HCPCS,L3520,DME POS,,,39.28,78.56,8
HCPCS,L3530,DME POS,,,39.28,78.56,8
HCPCS,L3540,DME POS,,,62.87,125.74,8
HCPCS,L3550,DME POS,,,11.02,22.04,8
HCPCS,L3560,DME POS,,,28.26,56.52,8
HCPCS,L3570,DME POS,,,105.33,210.66,8
HCPCS,L3580,DME POS,,,80.14,160.28,8
HCPCS,L3590,DME POS,,,66.01,132.02,8
HCPCS,L3595,DME POS,,,51.85,103.7,8
HCPCS,L3600,DME POS,,,94.31,188.62,8
HCPCS,L3610,DME POS,,,124.12,248.24,8
HCPCS,L3620,DME POS,,,94.31,188.62,8
HCPCS,L3630,DME POS,,,124.12,248.24,8
HCPCS,L3640,DME POS,,,53.41,106.82,8
HCPCS,L3649,ORTHOPEDIC SHOE MODIFICA NOS,,,,,0
HCPCS,L3650,CLAVICLE STRAP,583.0,291.5,67.31,565.51,54
HCPCS,L3660,DME POS,,,115.57,231.14,8
HCPCS,L3670,DME POS,,,161.08,322.16,8
HCPCS,L3671,DME POS,,,1013.24,2026.48,8
HCPCS,L3674,DME POS,,,1329.23,2658.46,8
HCPCS,L3675,DME POS,,,197.34,394.68,8
HCPCS,L3677,SO HARD PLAS STABILI PRE CST,,,,,0
HCPCS,L3678,SO HARD PLAS STABILI PRE OTS,,,,,0
HCPCS,L3702,EO W/O JOINTS CF,998.0,499.0,173.85,968.06,54
HCPCS,L3710,EO W/METAL JOINTS PF,2765.0,1382.5,163.06,2682.05,54
HCPCS,L3720,DME POS,,,813.4,1626.8,8
HCPCS,L3730,DME POS,,,1070.75,2141.5,8
HCPCS,L3740,EO W/JOINTS CF,2747.0,1373.5,478.52,2664.59,54
HCPCS,L3760,DME POS,,,562.35,1124.7,8
HCPCS,L3761,DME POS,,,562.35,1124.7,8
HCPCS,L3762,EO RIDGID WO JOINTS,1192.0,596.0,120.93,1156.24,54
HCPCS,L3763,EWHO RIGID W/O JNTS CF,2738.0,1369.0,476.95,2655.86,54
HCPCS,L3764,EWHO W/JOINTS CF,3148.0,1574.0,548.38,3053.56,54
HCPCS,L3765,EWHFO RIGID W/O JNTS CF,4308.0,2154.0,750.45,4178.76,54
HCPCS,L3766,EWHFO W/JOINTS CF,4564.0,2282.0,795.04,4427.08,54
HCPCS,L3806,WHFO W/JOINTS CUSTOM FAB,2352.0,1176.0,409.71,2281.44,54
HCPCS,L3807,WHFO W/JOINT PREFAB,1327.0,663.5,231.16,1287.19,54
HCPCS,L3807,WHFO W/O JOINTS PREFAB,219.0,109.5,38.14,562.38,54
HCPCS,L3808,WHFO RIGID W/O JOINTS,1151.0,575.5,200.5,1116.47,54
HCPCS,L3809,DME POS,,,281.19,562.38,8
HCPCS,L3891,TORSION MECHANISM WRIST/ELBO,,,,,0
HCPCS,L3900,DME POS,,,1756.7,3513.4,8
HCPCS,L3901,DME POS,,,1969.72,3939.44,8
HCPCS,L3904,DME POS,,,4009.81,8019.62,8
HCPCS,L3905,DME POS,,,1115.21,2230.42,8
HCPCS,L3906,WHO W/O JOINTS CF,1455.0,727.5,253.46,1411.35,54
HCPCS,L3908,SPLINT WRIST,138.0,69.0,24.03,134.74,54
HCPCS,L3908,WHO COCK-UP NONMOLDE PRE OTS,502.0,251.0,67.37,486.94,54
HCPCS,L3908,WHO COCKUP NONMOLDED,751.0,375.5,67.37,728.47,54
HCPCS,L3912,FLEX GLOVE W/ELASTIC FINGER,683.0,341.5,108.07,662.51,54
HCPCS,L3913,HFO W/O JOINTS CF,962.0,481.0,167.58,933.14,54
HCPCS,L3915,WHO W NONTOR JNTS PREFAB,1936.0,968.0,337.25,1877.92,54
HCPCS,L3916,DME POS,,,597.78,1195.56,8
HCPCS,L3917,PREFAB METACARPL FX ORTHOSIS,1194.0,597.0,118.79,1158.18,54
HCPCS,L3918,DME POS,,,118.79,237.58,8
HCPCS,L3919,HO W/O JOINTS CF,936.0,468.0,163.05,907.92,54
HCPCS,L3921,HFO W/JOINTS CF,1343.0,671.5,233.95,1302.71,54
HCPCS,L3923,HAND FINGER ORTHOSIS PREFAB,935.0,467.5,97.81,906.95,54
HCPCS,L3923,HFO W/O JOINTS PF,1876.0,938.0,97.81,1819.72,54
HCPCS,L3924,DME POS,,,97.81,195.62,8
HCPCS,L3925,FO PIP/DIP WITH JOINT/SPRING,769.0,384.5,59.39,745.93,54
HCPCS,L3927,FO PIP/DIP W/O JOINT/SPRING,701.0,350.5,39.34,679.97,54
HCPCS,L3929,HFO NONTORSION JOINT PREFAB,1031.0,515.5,94.67,1000.07,54
HCPCS,L3930,DME POS,,,94.67,189.34,8
HCPCS,L3931,WHFO NONTORSION JOINT PREFAB,1543.0,771.5,229.01,1496.71,54
HCPCS,L3933,FO W/O JOINTS CF,734.0,367.0,127.86,711.98,54
HCPCS,L3935,DME POS,,,248.47,496.94,8
HCPCS,L3956,DME POS,,,,,0
HCPCS,L3960,DME POS,,,926.91,1853.82,8
HCPCS,L3961,DME POS,,,1889.33,3778.66,8
HCPCS,L3962,DME POS,,,965.12,1930.24,8
HCPCS,L3967,DME POS,,,2230.66,4461.32,8
HCPCS,L3971,DME POS,,,2117.37,4234.74,8
HCPCS,L3973,DME POS,,,2230.66,4461.32,8
HCPCS,L3975,DME POS,,,1889.33,3778.66,8
HCPCS,L3976,DME POS,,,1889.33,3778.66,8
HCPCS,L3977,DME POS,,,2117.37,4234.74,8
HCPCS,L3978,DME POS,,,2230.66,4461.32,8
HCPCS,L3980,DME POS,,,347.63,695.26,8
HCPCS,L3981,DME POS,,,1131.9,2263.8,8
HCPCS,L3982,DME POS,,,429.48,858.96,8
HCPCS,L3984,DME POS,,,458.44,916.88,8
HCPCS,L3995,DME POS,,,38.45,76.9,8
HCPCS,L3999,UPPER LIMB ORTHOSIS NOS,,,,,0
HCPCS,L4000,DME POS,,,1499.07,2998.14,8
HCPCS,L4002,REPLACE STRAP ANY ORTHOSIS,22.0,11.0,3.83,21.34,47
HCPCS,L4010,DME POS,,,843.58,1687.16,8
HCPCS,L4020,DME POS,,,1053.71,2107.42,8
HCPCS,L4030,DME POS,,,580.17,1160.34,8
HCPCS,L4040,DME POS,,,469.07,938.14,8
HCPCS,L4045,DME POS,,,376.94,753.88,8
HCPCS,L4050,DME POS,,,474.4,948.8,8
HCPCS,L4055,DME POS,,,307.2,614.4,8
HCPCS,L4060,DME POS,,,365.19,730.38,8
HCPCS,L4070,DME POS,,,348.4,696.8,8
HCPCS,L4080,DME POS,,,122.83,245.66,8
HCPCS,L4090,DME POS,,,108.72,217.44,8
HCPCS,L4100,DME POS,,,122.63,245.26,8
HCPCS,L4110,DME POS,,,97.45,194.9,8
HCPCS,L4130,DME POS,,,670.68,1341.36,8
HCPCS,L4205,ORTHO DVC REPAIR PER 15 MIN,,,29.95,59.9,8
HCPCS,L4210,ORTH DEV REPAIR/REPL MINOR P,,,,,0
HCPCS,L4350,ANKLE CONTROL ORTHO PRE OTS,293.0,146.5,51.04,284.21,54
HCPCS,L4360,DME POS,,,338.06,676.12,8
HCPCS,L4361,DME POS,,,338.06,676.12,8
HCPCS,L4370,DME POS,,,216.94,433.88,8
HCPCS,L4386,WALKING BOOT NON-PNEUM PREFAB,811.0,405.5,141.27,786.67,54
HCPCS,L4387,DME POS,,,195.89,391.78,8
HCPCS,L4392,DME POS,,,29.1,58.2,8
HCPCS,L4394,DME POS,,,21.24,42.48,8
HCPCS,L4396,DME POS,,,207.41,414.82,8
HCPCS,L4397,DME POS,,,207.41,414.82,8
HCPCS,L4398,DME POS,,,95.45,190.9,8
HCPCS,L4631,DME POS,,,1843.94,3687.88,8
HCPCS,L5000,DME POS,,,647.9,1295.8,8
HCPCS,L5010,DME POS,,,1564.83,3129.66,8
HCPCS,L5020,DME POS,,,2657.4,5314.8,8
HCPCS,L5050,DME POS,,,2939.57,5879.14,8
HCPCS,L5060,DME POS,,,3381.38,6762.76,8
HCPCS,L5100,DME POS,,,2946.06,5892.12,8
HCPCS,L5105,DME POS,,,4252.97,8505.94,8
HCPCS,L5150,DME POS,,,4299.18,8598.36,8
HCPCS,L5160,DME POS,,,4676.12,9352.24,8
HCPCS,L5200,DME POS,,,4478.06,8956.12,8
HCPCS,L5210,DME POS,,,2970.73,5941.46,8
HCPCS,L5220,DME POS,,,3376.78,6753.56,8
HCPCS,L5230,DME POS,,,4657.24,9314.48,8
HCPCS,L5250,DME POS,,,6352.07,12704.14,8
HCPCS,L5270,DME POS,,,6323.89,12647.78,8
HCPCS,L5280,DME POS,,,6275.46,12550.92,8
HCPCS,L5301,DME POS,,,3367.55,6735.1,8
HCPCS,L5312,DME POS,,,4820.42,9640.84,8
HCPCS,L5321,DME POS,,,4881.34,9762.68,8
HCPCS,L5331,DME POS,,,6219.83,12439.66,8
HCPCS,L5341,DME POS,,,6474.88,12949.76,8
HCPCS,L5400,DME POS,,,1667.22,3334.44,8
HCPCS,L5410,DME POS,,,511.51,1023.02,8
HCPCS,L5420,DME POS,,,2043.12,4086.24,8
HCPCS,L5430,DME POS,,,616.07,1232.14,8
HCPCS,L5450,DME POS,,,501.19,1002.38,8
HCPCS,L5460,DME POS,,,667.75,1335.5,8
HCPCS,L5500,DME POS,,,1572.33,3144.66,8
HCPCS,L5505,DME POS,,,2174.6,4349.2,8
HCPCS,L5510,DME POS,,,1782.34,3564.68,8
HCPCS,L5520,DME POS,,,1760.53,3521.06,8
HCPCS,L5530,DME POS,,,2114.56,4229.12,8
HCPCS,L5535,DME POS,,,2076.09,4152.18,8
HCPCS,L5540,DME POS,,,2215.83,4431.66,8
HCPCS,L5560,DME POS,,,2379.43,4758.86,8
HCPCS,L5570,DME POS,,,2473.76,4947.52,8
HCPCS,L5580,DME POS,,,2887.94,5775.88,8
HCPCS,L5585,DME POS,,,3554.08,7108.16,8
HCPCS,L5590,DME POS,,,2943.01,5886.02,8
HCPCS,L5595,DME POS,,,5199.23,10398.46,8
HCPCS,L5600,DME POS,,,5588.93,11177.86,8
HCPCS,L5610,DME POS,,,2534.66,5069.32,8
HCPCS,L5611,DME POS,,,1972.47,3944.94,8
HCPCS,L5613,DME POS,,,3083.91,6167.82,8
HCPCS,L5614,DME POS,,,2089.13,4178.26,8
HCPCS,L5615,DME POS,,,6841.95,13683.9,8
HCPCS,L5616,DME POS,,,1666.52,3333.04,8
HCPCS,L5617,DME POS,,,692.69,1385.38,8
HCPCS,L5618,DME POS,,,366.46,732.92,8
HCPCS,L5620,DME POS,,,340.36,680.72,8
HCPCS,L5622,DME POS,,,443.82,887.64,8
HCPCS,L5624,DME POS,,,445.08,890.16,8
HCPCS,L5626,DME POS,,,583.7,1167.4,8
HCPCS,L5628,DME POS,,,624.13,1248.26,8
HCPCS,L5629,DME POS,,,389.06,778.12,8
HCPCS,L5630,DME POS,,,549.44,1098.88,8
HCPCS,L5631,DME POS,,,537.91,1075.82,8
HCPCS,L5632,DME POS,,,300.21,600.42,8
HCPCS,L5634,DME POS,,,372.4,744.8,8
HCPCS,L5636,DME POS,,,311.94,623.88,8
HCPCS,L5637,DME POS,,,353.67,707.34,8
HCPCS,L5638,DME POS,,,616.08,1232.16,8
HCPCS,L5639,DME POS,,,1372.6,2745.2,8
HCPCS,L5640,DME POS,,,782.83,1565.66,8
HCPCS,L5642,DME POS,,,758.5,1517.0,8
HCPCS,L5643,DME POS,,,1905.46,3810.92,8
HCPCS,L5644,DME POS,,,723.09,1446.18,8
HCPCS,L5645,DME POS,,,976.81,1953.62,8
HCPCS,L5646,DME POS,,,670.77,1341.54,8
HCPCS,L5647,DME POS,,,973.84,1947.68,8
HCPCS,L5648,DME POS,,,806.01,1612.02,8
HCPCS,L5649,DME POS,,,2920.65,5841.3,8
HCPCS,L5650,DME POS,,,597.66,1195.32,8
HCPCS,L5651,DME POS,,,1470.22,2940.44,8
HCPCS,L5652,DME POS,,,533.75,1067.5,8
HCPCS,L5653,DME POS,,,712.51,1425.02,8
HCPCS,L5654,DME POS,,,406.02,812.04,8
HCPCS,L5655,DME POS,,,344.08,688.16,8
HCPCS,L5656,DME POS,,,461.57,923.14,8
HCPCS,L5658,DME POS,,,445.13,890.26,8
HCPCS,L5661,DME POS,,,745.01,1490.02,8
HCPCS,L5665,DME POS,,,626.84,1253.68,8
HCPCS,L5666,DME POS,,,85.69,171.38,8
HCPCS,L5668,DME POS,,,138.23,276.46,8
HCPCS,L5670,DME POS,,,332.2,664.4,8
HCPCS,L5671,DME POS,,,703.98,1407.96,8
HCPCS,L5672,DME POS,,,365.06,730.12,8
HCPCS,L5673,DME POS,,,870.51,1741.02,8
HCPCS,L5676,DME POS,,,443.63,887.26,8
HCPCS,L5677,DME POS,,,603.62,1207.24,8
HCPCS,L5678,DME POS,,,48.61,97.22,8
HCPCS,L5679,DME POS,,,725.39,1450.78,8
HCPCS,L5680,DME POS,,,405.77,811.54,8
HCPCS,L5681,DME POS,,,1628.51,3257.02,8
HCPCS,L5682,DME POS,,,765.63,1531.26,8
HCPCS,L5683,DME POS,,,1628.51,3257.02,8
HCPCS,L5684,DME POS,,,58.93,117.86,8
HCPCS,L5685,DME POS,,,158.57,317.14,8
HCPCS,L5686,DME POS,,,62.55,125.1,8
HCPCS,L5688,DME POS,,,74.78,149.56,8
HCPCS,L5690,DME POS,,,119.8,239.6,8
HCPCS,L5692,DME POS,,,162.67,325.34,8
HCPCS,L5694,DME POS,,,222.1,444.2,8
HCPCS,L5695,DME POS,,,205.01,410.02,8
HCPCS,L5696,DME POS,,,226.51,453.02,8
HCPCS,L5697,DME POS,,,98.28,196.56,8
HCPCS,L5698,DME POS,,,160.7,321.4,8
HCPCS,L5699,DME POS,,,289.51,579.02,8
HCPCS,L5700,DME POS,,,3507.7,7015.4,8
HCPCS,L5701,DME POS,,,4212.49,8424.98,8
HCPCS,L5702,DME POS,,,5329.4,10658.8,8
HCPCS,L5703,DME POS,,,2758.03,5516.06,8
HCPCS,L5704,DME POS,,,656.22,1312.44,8
HCPCS,L5705,DME POS,,,1172.55,2345.1,8
HCPCS,L5706,DME POS,,,1149.39,2298.78,8
HCPCS,L5707,DME POS,,,1515.28,3030.56,8
HCPCS,L5710,DME POS,,,457.86,915.72,8
HCPCS,L5711,DME POS,,,639.88,1279.76,8
HCPCS,L5712,DME POS,,,536.15,1072.3,8
HCPCS,L5714,DME POS,,,550.71,1101.42,8
HCPCS,L5716,DME POS,,,892.28,1784.56,8
HCPCS,L5718,DME POS,,,1115.26,2230.52,8
HCPCS,L5722,DME POS,,,1178.22,2356.44,8
HCPCS,L5724,DME POS,,,1847.9,3695.8,8
HCPCS,L5726,DME POS,,,2129.66,4259.32,8
HCPCS,L5728,DME POS,,,2913.09,5826.18,8
HCPCS,L5780,DME POS,,,1401.65,2803.3,8
HCPCS,L5781,DME POS,,,4953.58,9907.16,8
HCPCS,L5782,DME POS,,,5222.21,10444.42,8
HCPCS,L5783,Add low ext mec limb vol sys,,,3150.07,6300.14,8
HCPCS,L5785,DME POS,,,787.9,1575.8,8
HCPCS,L5790,DME POS,,,880.26,1760.52,8
HCPCS,L5795,DME POS,,,1752.61,3505.22,8
HCPCS,L5810,DME POS,,,596.04,1192.08,8
HCPCS,L5811,DME POS,,,892.86,1785.72,8
HCPCS,L5812,DME POS,,,692.06,1384.12,8
HCPCS,L5814,DME POS,,,4597.89,9195.78,8
HCPCS,L5816,DME POS,,,1047.44,2094.88,8
HCPCS,L5818,DME POS,,,1175.67,2351.34,8
HCPCS,L5822,DME POS,,,2084.77,4169.54,8
HCPCS,L5824,DME POS,,,1877.46,3754.92,8
HCPCS,L5826,DME POS,,,3866.22,7732.44,8
HCPCS,L5827,"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping",,,7007.5,14015.0,8
HCPCS,L5828,DME POS,,,3457.19,6914.38,8
HCPCS,L5830,DME POS,,,2323.05,4646.1,8
HCPCS,L5840,DME POS,,,4295.32,8590.64,8
HCPCS,L5841,Addition endoskletl knee-shi,,,2870.47,5740.94,8
HCPCS,L5845,DME POS,,,2219.05,4438.1,8
HCPCS,L5848,DME POS,,,1331.26,2662.52,8
HCPCS,L5850,DME POS,,,156.61,313.22,8
HCPCS,L5855,DME POS,,,420.83,841.66,8
HCPCS,L5856,DME POS,,,29719.96,59439.92,8
HCPCS,L5857,DME POS,,,10545.73,21091.46,8
HCPCS,L5858,DME POS,,,23009.05,46018.1,8
HCPCS,L5859,DME POS,,,17962.99,35925.98,8
HCPCS,L5910,DME POS,,,443.39,886.78,8
HCPCS,L5920,DME POS,,,649.58,1299.16,8
HCPCS,L5925,DME POS,,,548.48,1096.96,8
HCPCS,L5926,DME POS,,,697.41,1394.82,8
HCPCS,L5930,DME POS,,,4167.07,8334.14,8
HCPCS,L5940,DME POS,,,614.1,1228.2,8
HCPCS,L5950,DME POS,,,960.18,1920.36,8
HCPCS,L5960,DME POS,,,1180.22,2360.44,8
HCPCS,L5961,DME POS,,,5627.8,11255.6,8
HCPCS,L5962,DME POS,,,776.72,1553.44,8
HCPCS,L5964,DME POS,,,1146.54,2293.08,8
HCPCS,L5966,DME POS,,,1460.97,2921.94,8
HCPCS,L5968,DME POS,,,4498.91,8997.82,8
HCPCS,L5969,AK/FT POWER ASST INCL MOTORS,,,,,0
HCPCS,L5970,DME POS,,,248.63,497.26,8
HCPCS,L5971,DME POS,,,248.63,497.26,8
HCPCS,L5972,DME POS,,,464.44,928.88,8
HCPCS,L5973,DME POS,,,21299.94,42599.88,8
HCPCS,L5974,DME POS,,,285.29,570.58,8
HCPCS,L5975,DME POS,,,573.98,1147.96,8
HCPCS,L5976,DME POS,,,685.61,1371.22,8
HCPCS,L5978,DME POS,,,357.27,714.54,8
HCPCS,L5979,DME POS,,,2793.44,5586.88,8
HCPCS,L5980,DME POS,,,4539.15,9078.3,8
HCPCS,L5981,DME POS,,,3667.02,7334.04,8
HCPCS,L5982,DME POS,,,707.75,1415.5,8
HCPCS,L5984,DME POS,,,697.41,1394.82,8
HCPCS,L5985,DME POS,,,349.58,699.16,8
HCPCS,L5986,DME POS,,,775.79,1551.58,8
HCPCS,L5987,DME POS,,,8906.07,17812.14,8
HCPCS,L5988,DME POS,,,2473.19,4946.38,8
HCPCS,L5990,DME POS,,,2246.04,4492.08,8
HCPCS,L5991,DME POS,,,11755.04,23510.08,8
HCPCS,L5999,LOWR EXTREMITY PROSTHES NOS,,,,,0
HCPCS,L6000,DME POS,,,1626.65,3253.3,8
HCPCS,L6010,DME POS,,,1810.19,3620.38,8
HCPCS,L6020,DME POS,,,1687.71,3375.42,8
HCPCS,L6026,DME POS,,,6119.92,12239.84,8
HCPCS,L6028,"Partial hand including fingers, flexible or non-flexible interface, endoskeletal system, molded to patient model, for use without external power, not including inserts described by l6692",,,,,0
HCPCS,L6029,"Upper extremity addition, test socket/interface, partial hand including fingers",,,,,0
HCPCS,L6030,"Upper extremity addition, external frame, partial hand including fingers",,,,,0
HCPCS,L6031,"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power",,,,,0
HCPCS,L6032,"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)",,,,,0
HCPCS,L6033,"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material",,,,,0
HCPCS,L6037,"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers",,,,,0
HCPCS,L6050,DME POS,,,2325.6,4651.2,8
HCPCS,L6055,DME POS,,,3241.3,6482.6,8
HCPCS,L6100,DME POS,,,2356.19,4712.38,8
HCPCS,L6110,DME POS,,,2499.14,4998.28,8
HCPCS,L6120,DME POS,,,2912.39,5824.78,8
HCPCS,L6130,DME POS,,,3169.22,6338.44,8
HCPCS,L6200,DME POS,,,3339.85,6679.7,8
HCPCS,L6205,DME POS,,,4458.17,8916.34,8
HCPCS,L6250,DME POS,,,3499.39,6998.78,8
HCPCS,L6300,DME POS,,,4561.09,9122.18,8
HCPCS,L6310,DME POS,,,3938.3,7876.6,8
HCPCS,L6320,DME POS,,,2151.39,4302.78,8
HCPCS,L6350,DME POS,,,4795.29,9590.58,8
HCPCS,L6360,DME POS,,,4312.59,8625.18,8
HCPCS,L6370,DME POS,,,2580.53,5161.06,8
HCPCS,L6380,DME POS,,,1495.35,2990.7,8
HCPCS,L6382,DME POS,,,2249.69,4499.38,8
HCPCS,L6384,DME POS,,,3112.22,6224.44,8
HCPCS,L6386,DME POS,,,491.64,983.28,8
HCPCS,L6388,DME POS,,,538.21,1076.42,8
HCPCS,L6400,DME POS,,,2840.74,5681.48,8
HCPCS,L6450,DME POS,,,3795.18,7590.36,8
HCPCS,L6500,DME POS,,,3970.5,7941.0,8
HCPCS,L6550,DME POS,,,4772.61,9545.22,8
HCPCS,L6570,DME POS,,,5358.37,10716.74,8
HCPCS,L6580,DME POS,,,2045.72,4091.44,8
HCPCS,L6582,DME POS,,,1852.87,3705.74,8
HCPCS,L6584,DME POS,,,2905.79,5811.58,8
HCPCS,L6586,DME POS,,,2719.34,5438.68,8
HCPCS,L6588,DME POS,,,3573.15,7146.3,8
HCPCS,L6590,DME POS,,,3393.93,6787.86,8
HCPCS,L6600,DME POS,,,229.64,459.28,8
HCPCS,L6605,DME POS,,,226.75,453.5,8
HCPCS,L6610,DME POS,,,217.74,435.48,8
HCPCS,L6611,DME POS,,,509.7,1019.4,8
HCPCS,L6615,DME POS,,,234.61,469.22,8
HCPCS,L6616,DME POS,,,86.93,173.86,8
HCPCS,L6620,DME POS,,,375.39,750.78,8
HCPCS,L6621,DME POS,,,2831.71,5663.42,8
HCPCS,L6623,DME POS,,,1047.08,2094.16,8
HCPCS,L6624,DME POS,,,4662.49,9324.98,8
HCPCS,L6625,DME POS,,,743.95,1487.9,8
HCPCS,L6628,DME POS,,,586.48,1172.96,8
HCPCS,L6629,DME POS,,,179.11,358.22,8
HCPCS,L6630,DME POS,,,263.85,527.7,8
HCPCS,L6632,DME POS,,,91.64,183.28,8
HCPCS,L6635,DME POS,,,215.63,431.26,8
HCPCS,L6637,DME POS,,,459.92,919.84,8
HCPCS,L6638,DME POS,,,3095.98,6191.96,8
HCPCS,L6640,DME POS,,,408.59,817.18,8
HCPCS,L6641,DME POS,,,196.4,392.8,8
HCPCS,L6642,DME POS,,,266.21,532.42,8
HCPCS,L6645,DME POS,,,491.37,982.74,8
HCPCS,L6646,DME POS,,,3904.74,7809.48,8
HCPCS,L6647,DME POS,,,642.83,1285.66,8
HCPCS,L6648,DME POS,,,4027.16,8054.32,8
HCPCS,L6650,DME POS,,,510.16,1020.32,8
HCPCS,L6655,DME POS,,,100.26,200.52,8
HCPCS,L6660,DME POS,,,112.37,224.74,8
HCPCS,L6665,DME POS,,,56.38,112.76,8
HCPCS,L6670,DME POS,,,62.34,124.68,8
HCPCS,L6672,DME POS,,,247.39,494.78,8
HCPCS,L6675,DME POS,,,147.02,294.04,8
HCPCS,L6676,DME POS,,,169.95,339.9,8
HCPCS,L6677,DME POS,,,367.3,734.6,8
HCPCS,L6680,DME POS,,,284.03,568.06,8
HCPCS,L6682,DME POS,,,314.04,628.08,8
HCPCS,L6684,DME POS,,,426.74,853.48,8
HCPCS,L6686,DME POS,,,963.67,1927.34,8
HCPCS,L6687,DME POS,,,706.16,1412.32,8
HCPCS,L6688,DME POS,,,701.89,1403.78,8
HCPCS,L6689,DME POS,,,840.96,1681.92,8
HCPCS,L6690,DME POS,,,916.41,1832.82,8
HCPCS,L6691,DME POS,,,424.15,848.3,8
HCPCS,L6692,DME POS,,,684.63,1369.26,8
HCPCS,L6693,DME POS,,,3514.73,7029.46,8
HCPCS,L6694,DME POS,,,870.51,1741.02,8
HCPCS,L6695,DME POS,,,725.39,1450.78,8
HCPCS,L6696,DME POS,,,1628.51,3257.02,8
HCPCS,L6697,DME POS,,,1628.51,3257.02,8
HCPCS,L6698,DME POS,,,703.98,1407.96,8
HCPCS,L6700,"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement",,,29510.19,59020.38,8
HCPCS,L6703,DME POS,,,445.07,890.14,8
HCPCS,L6704,DME POS,,,716.96,1433.92,8
HCPCS,L6706,DME POS,,,427.16,854.32,8
HCPCS,L6707,DME POS,,,1574.47,3148.94,8
HCPCS,L6708,DME POS,,,1029.27,2058.54,8
HCPCS,L6709,DME POS,,,1483.22,2966.44,8
HCPCS,L6711,DME POS,,,832.33,1664.66,8
HCPCS,L6712,DME POS,,,1532.52,3065.04,8
HCPCS,L6713,DME POS,,,1934.13,3868.26,8
HCPCS,L6714,DME POS,,,1638.27,3276.54,8
HCPCS,L6715,DME POS,,,3908.64,7817.28,8
HCPCS,L6721,DME POS,,,2911.82,5823.64,8
HCPCS,L6722,DME POS,,,2510.19,5020.38,8
HCPCS,L6805,DME POS,,,416.53,833.06,8
HCPCS,L6810,DME POS,,,236.08,472.16,8
HCPCS,L6880,DME POS,,,29579.67,59159.34,8
HCPCS,L6881,DME POS,,,5061.33,10122.66,8
HCPCS,L6882,DME POS,,,3839.33,7678.66,8
HCPCS,L6883,DME POS,,,1942.73,3885.46,8
HCPCS,L6884,DME POS,,,2883.44,5766.88,8
HCPCS,L6885,DME POS,,,4312.59,8625.18,8
HCPCS,L6890,DME POS,,,208.23,416.46,8
HCPCS,L6895,DME POS,,,766.02,1532.04,8
HCPCS,L6900,DME POS,,,2186.02,4372.04,8
HCPCS,L6905,DME POS,,,2173.6,4347.2,8
HCPCS,L6910,DME POS,,,1858.64,3717.28,8
HCPCS,L6915,DME POS,,,937.1,1874.2,8
HCPCS,L6920,DME POS,,,8170.29,16340.58,8
HCPCS,L6925,DME POS,,,10998.63,21997.26,8
HCPCS,L6930,DME POS,,,8220.96,16441.92,8
HCPCS,L6935,DME POS,,,11169.31,22338.62,8
HCPCS,L6940,DME POS,,,10741.21,21482.42,8
HCPCS,L6945,DME POS,,,13124.47,26248.94,8
HCPCS,L6950,DME POS,,,12208.9,24417.8,8
HCPCS,L6955,DME POS,,,14621.82,29243.64,8
HCPCS,L6960,DME POS,,,16562.87,33125.74,8
HCPCS,L6965,DME POS,,,17664.91,35329.82,8
HCPCS,L6970,DME POS,,,18407.12,36814.24,8
HCPCS,L6975,DME POS,,,20131.45,40262.9,8
HCPCS,L7007,DME POS,,,4212.72,8425.44,8
HCPCS,L7008,DME POS,,,6630.37,13260.74,8
HCPCS,L7009,DME POS,,,4298.3,8596.6,8
HCPCS,L7040,DME POS,,,3451.37,6902.74,8
HCPCS,L7045,DME POS,,,1978.79,3957.58,8
HCPCS,L7170,DME POS,,,9111.07,18222.14,8
HCPCS,L7180,DME POS,,,39992.59,79985.18,8
HCPCS,L7181,DME POS,,,49605.45,99210.9,8
HCPCS,L7185,DME POS,,,8997.32,17994.64,8
HCPCS,L7186,DME POS,,,10829.14,21658.28,8
HCPCS,L7190,DME POS,,,9450.26,18900.52,8
HCPCS,L7191,DME POS,,,11315.81,22631.62,8
HCPCS,L7259,DME POS,,,3912.59,7825.18,8
HCPCS,L7360,DME POS,,,292.13,584.26,8
HCPCS,L7362,DME POS,,,306.73,613.46,8
HCPCS,L7364,DME POS,,,487.84,975.68,8
HCPCS,L7366,DME POS,,,657.13,1314.26,8
HCPCS,L7367,DME POS,,,481.97,963.94,8
HCPCS,L7368,DME POS,,,624.83,1249.66,8
HCPCS,L7400,DME POS,,,379.46,758.92,8
HCPCS,L7401,DME POS,,,424.81,849.62,8
HCPCS,L7402,DME POS,,,458.7,917.4,8
HCPCS,L7403,DME POS,,,455.94,911.88,8
HCPCS,L7404,DME POS,,,688.07,1376.14,8
HCPCS,L7405,DME POS,,,899.94,1799.88,8
HCPCS,L7406,"Addition to upper extremity, user adjustable, mechanical, residual limb volume management system",,,3150.07,6300.14,8
HCPCS,L7499,UPPER EXTREMITY PROSTHES NOS,,,,,0
HCPCS,L7510,PROSTHETIC DEVICE REPAIR REP,,,,,0
HCPCS,L7520,REPAIR PROSTHESIS PER 15 MIN,,,40.67,81.34,8
HCPCS,L7600,PROSTHETIC DONNING SLEEVE,,,,,0
HCPCS,L7700,DME POS,,,138.17,276.34,8
HCPCS,L7900,MALE VACUUM ERECTION SYSTEM,,,,,0
HCPCS,L7902,"TENSION RING, VAC ERECT DEV",,,,,0
HCPCS,L8000,DME POS,,,53.85,107.7,8
HCPCS,L8001,DME POS,,,155.28,310.56,8
HCPCS,L8002,DME POS,,,204.28,408.56,8
HCPCS,L8015,DME POS,,,74.19,148.38,8
HCPCS,L8020,DME POS,,,279.11,558.22,8
HCPCS,L8030,DME POS,,,403.72,807.44,8
HCPCS,L8031,DME POS,,,403.72,807.44,8
HCPCS,L8032,DME POS,,,48.49,96.98,8
HCPCS,L8033,"NIPPLE PROSTHESIS CUSTOM, EA",,,,,0
HCPCS,L8035,DME POS,,,4535.66,9071.32,8
HCPCS,L8039,BREAST PROSTHESIS NOS,,,,,0
HCPCS,L8040,DME POS,,,2992.53,5985.06,8
HCPCS,L8041,DME POS,,,3606.94,7213.88,8
HCPCS,L8042,DME POS,,,4052.7,8105.4,8
HCPCS,L8043,DME POS,,,4539.05,9078.1,8
HCPCS,L8044,DME POS,,,5025.35,10050.7,8
HCPCS,L8045,DME POS,,,3147.02,6294.04,8
HCPCS,L8046,DME POS,,,3242.18,6484.36,8
HCPCS,L8047,DME POS,,,1661.59,3323.18,8
HCPCS,L8048,UNSPEC MAXILLOFACIAL PROSTH,,,,,0
HCPCS,L8049,REPAIR MAXILLOFACIAL PROSTH,,,,,0
HCPCS,L8300,DME POS,,,119.24,238.48,8
HCPCS,L8310,DME POS,,,183.33,366.66,8
HCPCS,L8320,DME POS,,,80.07,160.14,8
HCPCS,L8330,DME POS,,,79.38,158.76,8
HCPCS,L8400,DME POS,,,23.21,46.42,8
HCPCS,L8410,DME POS,,,26.4,52.8,8
HCPCS,L8415,DME POS,,,26.24,52.48,8
HCPCS,L8417,DME POS,,,93.1,186.2,8
HCPCS,L8420,DME POS,,,30.67,61.34,8
HCPCS,L8430,DME POS,,,33.75,67.5,8
HCPCS,L8435,DME POS,,,30.27,60.54,8
HCPCS,L8440,DME POS,,,64.18,128.36,8
HCPCS,L8460,DME POS,,,89.33,178.66,8
HCPCS,L8465,DME POS,,,79.62,159.24,8
HCPCS,L8470,DME POS,,,8.17,16.34,8
HCPCS,L8480,DME POS,,,11.27,22.54,8
HCPCS,L8485,DME POS,,,13.62,27.24,8
HCPCS,L8499,UNLISTED MISC PROSTHETIC SER,,,,,0
HCPCS,L8500,DME POS,,,807.95,1615.9,8
HCPCS,L8501,TRACH SPEAKING VALVE,200.0,100.0,34.84,358.84,54
HCPCS,L8501,VOICE PROSTH PASSY MUIR VALVE,468.0,234.0,81.52,453.96,54
HCPCS,L8505,"ARTIFICIAL LARYNX, ACCESSORY",,,,,0
HCPCS,L8507,DME POS,,,51.86,103.72,8
HCPCS,L8509,TRACH-ESOPH VOICE PROS MD IN,778.0,389.0,135.22,754.66,54
HCPCS,L8510,DME POS,,,312.86,625.72,8
HCPCS,L8511,INDWELLING TRACH INSERT,2192.0,1096.0,90.05,2126.24,54
HCPCS,L8512,GEL CAP FOR TRACH VOICE PROS,51.0,25.5,2.7,49.47,54
HCPCS,L8513,TRACH PROS CLEANING DEVICE,141.0,70.5,6.47,136.77,54
HCPCS,L8514,REPL TRACH PUNCTURE DILATOR,298.0,149.0,51.91,289.06,54
HCPCS,L8515,GEL CAP APP DEVICE FOR TRACH,199.0,99.5,34.66,193.03,54
HCPCS,L8600,DME POS,,,764.47,1528.94,8
HCPCS,L8603,DME POS,,,536.91,1073.82,8
HCPCS,L8604,DEXTRANOMER/HYALURONIC ACID,,,,,0
HCPCS,L8605,DME POS,,,886.74,1773.48,9
HCPCS,L8606,DME POS,,,281.84,563.68,8
HCPCS,L8607,DME POS,,,53.12,106.24,9
HCPCS,L8608,ARG II EXT COM/SUP/ACC MISC,,,,,0
HCPCS,L8609,DME POS,,,8066.32,16132.64,8
HCPCS,L8610,DME POS,,,784.19,1568.38,8
HCPCS,L8612,DME POS,,,827.06,1654.12,8
HCPCS,L8613,DME POS,,,370.27,740.54,8
HCPCS,L8614,DME POS,,,23437.87,46875.74,8
HCPCS,L8615,DME POS,,,558.37,1116.74,8
HCPCS,L8616,DME POS,,,130.06,260.12,8
HCPCS,L8617,DME POS,,,113.64,227.28,8
HCPCS,L8618,DME POS,,,32.46,64.92,8
HCPCS,L8619,DME POS,,,10053.97,20107.94,8
HCPCS,L8621,DME POS,,,0.77,1.54,8
HCPCS,L8622,DME POS,,,0.4,0.8,8
HCPCS,L8623,DME POS,,,80.07,160.14,8
HCPCS,L8624,DME POS,,,199.62,399.24,8
HCPCS,L8625,DME POS,,,233.81,467.62,8
HCPCS,L8627,DME POS,,,8522.43,17044.86,8
HCPCS,L8628,DME POS,,,1531.57,3063.14,8
HCPCS,L8629,DME POS,,,221.67,443.34,8
HCPCS,L8630,DME POS,,,412.46,824.92,8
HCPCS,L8631,DME POS,,,2768.01,5536.02,8
HCPCS,L8641,DME POS,,,447.67,895.34,8
HCPCS,L8642,DME POS,,,367.48,734.96,8
HCPCS,L8658,DME POS,,,384.04,768.08,8
HCPCS,L8659,DME POS,,,2388.97,4777.94,8
HCPCS,L8670,DME POS,,,681.49,1362.98,8
HCPCS,L8678,DME POS,,,13.24,26.48,8
HCPCS,L8679,DME POS,,,10330.2,20660.4,8
HCPCS,L8680,IMPLT NEUROSTIM ELCTR EACH,,,,,0
HCPCS,L8681,DME POS,,,1398.33,2796.66,8
HCPCS,L8682,DME POS,,,7380.72,14761.44,8
HCPCS,L8683,DME POS,,,6496.7,12993.4,8
HCPCS,L8684,DME POS,,,853.14,1706.28,8
HCPCS,L8685,IMPLT NROSTM PLS GEN SNG REC,,,,,0
HCPCS,L8686,IMPLT NROSTM PLS GEN SNG NON,,,,,0
HCPCS,L8687,IMPLT NROSTM PLS GEN DUA REC,,,,,0
HCPCS,L8688,IMPLT NROSTM PLS GEN DUA NON,,,,,0
HCPCS,L8689,DME POS,,,2135.51,4271.02,8
HCPCS,L8690,DME POS,,,5889.51,11779.02,8
HCPCS,L8691,DME POS,,,2132.09,4264.18,8
HCPCS,L8692,NON-OSSEOINTEGRATED SND PROC,,,,,0
HCPCS,L8693,DME POS,,,1877.27,3754.54,8
HCPCS,L8694,DME POS,,,1169.21,2338.42,8
HCPCS,L8695,DME POS,,,20.61,41.22,8
HCPCS,L8696,DME POS,,,268.36,536.72,8
HCPCS,L8698,MISC USED WITH TOT ART HEART,,,,,0
HCPCS,L8699,PROSTHETIC IMPLANT NOS,,,,,0
HCPCS,L8701,EWH S/D UPRT MICRO SENSOR,,,34970.13,69940.26,8
HCPCS,L8702,EWHF S/D UPRT MICRO SENSOR,,,68801.71,137603.42,8
HCPCS,L8720,"External lower extremity sensory prosthesis, cutaneous stimulation of mechanoreceptors proximal to the ankle, per leg",,,,,0
HCPCS,L8721,"Receptor sole for use with L8720, replacement, each",,,,,0
HCPCS,L9900,O&P SUPPLY/ACCESSORY/SERVICE,,,,,0
HCPCS,M0001,ADVANCING CANCER CARE MVP,,,,,0
HCPCS,M0002,OPT CARE KIDNEY HLTH MVP,,,,,0
HCPCS,M0004,SUPPORT CARE NEUR COND MVP,,,,,0
HCPCS,M0005,VALUE IN PRIMARY CARE MVP,,,,,0
HCPCS,M0010,EOM MEOS PAYMENT,,,,,0
HCPCS,M0075,CELLULAR THERAPY,,,,,0
HCPCS,M0076,PROLOTHERAPY,,,,,0
HCPCS,M0100,INTRAGASTRIC HYPOTHERMIA,,,,,0
HCPCS,M0201,PNE FLU HEPB COV HOME ADMIN,,,35.05,70.1,8
HCPCS,M0224,"Intravenous infusion, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, who e",,,428.5,857.0,8
HCPCS,M0237,"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ve",,,428.5,857.0,8
HCPCS,M0238,"Intravenous infusion, tocilizumab-anoh, for hospitalized adult patients withCOVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ven",,,428.5,857.0,8
HCPCS,M0249,TOCILIZU COVID-19 2YRS 1ST ADM_INFU,747.0,373.5,130.12,857.0,54
HCPCS,M0250,ADM TOCILIZU COVID-19 2ND,,,428.5,857.0,8
HCPCS,M0300,IV CHELATIONTHERAPY,,,,,0
HCPCS,M0301,FABRIC WRAPPING OF ANEURYSM,,,,,0
HCPCS,M1003,TB SCR 12 MO PRI FST BIO DZ,,,,,0
HCPCS,M1004,DOC MED RSN NO SRN TB,,,,,0
HCPCS,M1005,TB SCR NO PERF,,,,,0
HCPCS,M1006,"DZ NOT ASES, NO RSN",,,,,0
HCPCS,M1007,>=50% TOTAL PT OUTPT RA ENCT,,,,,0
HCPCS,M1008,<50% TOTAL PT OUTPT RA ENCTS,,,,,0
HCPCS,M1009,DC EOC DOC MED REC,,,,,0
HCPCS,M1010,DC EOC DOC MED REC,,,,,0
HCPCS,M1011,DC EOC DOC MED REC,,,,,0
HCPCS,M1012,DC EOC DOC MED REC,,,,,0
HCPCS,M1013,DC EOC DOC MED REC,,,,,0
HCPCS,M1014,DC EPI CARE DOC MEDREC,,,,,0
HCPCS,M1016,PT DX MEOP OR SUR STERI,,,,,0
HCPCS,M1018,PT DX HST CR PT SK LG CR SCR,,,,,0
HCPCS,M1019,ADL PT MJ DEP DS RS 12 PHQ<5,,,,,0
HCPCS,M1020,ADL PT MJ DEP DS NO RS 12 MO,,,,,0
HCPCS,M1021,PT UC IN PP,,,,,0
HCPCS,M1027,IMG HEAD (CT OR MRI) OBTND,,,,,0
HCPCS,M1028,DOC OF PT PRM HDA DX AND OTR,,,,,0
HCPCS,M1029,DOC SYSM RSN IMG HD,,,,,0
HCPCS,M1032,ADT TKNG PHARMTHRY FOR OUD,,,,,0
HCPCS,M1034,ADT 180 DYS PHARMTHRY OUD,,,,,0
HCPCS,M1035,ADT PD OUT MAT PR 180 DYS TX,,,,,0
HCPCS,M1036,ADT NO 180 DYS PHARMTHRY OUD,,,,,0
HCPCS,M1037,PT DX LUM SP REG CACR,,,,,0
HCPCS,M1038,PT DX LUM SP REG FRACT,,,,,0
HCPCS,M1039,PT DX LUM SP REG INF,,,,,0
HCPCS,M1040,PT DX LUM IDI OR CONG SCOL,,,,,0
HCPCS,M1041,PT CR FT INF LM OR PT ID SL,,,,,0
HCPCS,M1043,FS NO ODI 9-15MO,,,,,0
HCPCS,M1045,FS OKS 9-15MO >= 37 >= 71,,,,,0
HCPCS,M1046,FS OKS 9-15MO < 37 < 71,,,,,0
HCPCS,M1049,FS WTH SCR NO ODI PRE AND P,,,,,0
HCPCS,M1051,PT W/CANCER SCOLIOSIS,,,,,0
HCPCS,M1052,LG PN NOT MEAS W/ VAS 1YR PO,,,,,0
HCPCS,M1054,PT UC IN PP,,,,,0
HCPCS,M1055,ASPIRIN USED,,,,,0
HCPCS,M1056,PRESC ANTICO MED IN PP,,,,,0
HCPCS,M1057,"ASPIRIN NOT USED, NO RSN",,,,,0
HCPCS,M1058,PT PRM NURS HM RES IN PP,,,,,0
HCPCS,M1059,PT NO PRM NURS HM RES IN PP,,,,,0
HCPCS,M1060,PT DIED IN PP,,,,,0
HCPCS,M1067,HSPC PT PRV TIME MEAM PER,,,,,0
HCPCS,M1068,PT NOT AMBULATORY,,,,,0
HCPCS,M1069,PT SCR FT FALL RSK,,,,,0
HCPCS,M1070,PT NOT SCRN FUT FALL NO RSN,,,,,0
HCPCS,M1106,START EOC DOC MED REC,,,,,0
HCPCS,M1107,DOCU DX DEGEN NEURO,,,,,0
HCPCS,M1108,OC NI PT HOME PROG,,,,,0
HCPCS,M1109,OC NI PT DC,,,,,0
HCPCS,M1110,OC NOT P PT SELFDC,,,,,0
HCPCS,M1111,START EOC DOC MED REC,,,,,0
HCPCS,M1112,DOCU DX DEGEN NEURO,,,,,0
HCPCS,M1113,OC NI PT HOME PROG,,,,,0
HCPCS,M1114,OC NI PT DC,,,,,0
HCPCS,M1115,OC NI PT SELFDC,,,,,0
HCPCS,M1116,START EOC DOC MED REC,,,,,0
HCPCS,M1117,DOCU DX DEGEN NEURO,,,,,0
HCPCS,M1118,OC NI PT HOME PROG,,,,,0
HCPCS,M1119,OC NI PT DC,,,,,0
HCPCS,M1120,OC NI PT SELFDC,,,,,0
HCPCS,M1121,START EOC DOC MED REC,,,,,0
HCPCS,M1122,DOCU DX DEGEN NEURO,,,,,0
HCPCS,M1123,OC NI PT HOME PROG,,,,,0
HCPCS,M1124,OC NI PT DC 1-2 VIS,,,,,0
HCPCS,M1125,OC NI PT SELFDC 1-2 VIS,,,,,0
HCPCS,M1126,START EOC DOC MED REC,,,,,0
HCPCS,M1127,DOCU DX DEGEN NEURO,,,,,0
HCPCS,M1128,OC NI PT HOME PROG,,,,,0
HCPCS,M1129,OC NI PT DC,,,,,0
HCPCS,M1130,OC NI PT SELFDC,,,,,0
HCPCS,M1131,DOCU DX DEGEN NEURO,,,,,0
HCPCS,M1132,OC NI PT HOME PROG,,,,,0
HCPCS,M1133,OC NI PT DC,,,,,0
HCPCS,M1134,OC NI PT SELFDC,,,,,0
HCPCS,M1135,START EOC DOC MED REC,,,,,0
HCPCS,M1141,FS NO OKS,,,,,0
HCPCS,M1142,EMERGE CASES,,,,,0
HCPCS,M1143,NI REHAB MED CHIRO,,,,,0
HCPCS,M1146,ONGOING CARE NOT IND,,,,,0
HCPCS,M1147,CARE NOT POSS MED RSN,,,,,0
HCPCS,M1148,PT SELF DSCHG,,,,,0
HCPCS,M1149,NO NECK FS PROM INCAP,,,,,0
HCPCS,M1150,LVEF <=40% OR MOD/SEV L VSF,,,,,0
HCPCS,M1151,PT W/ HX TRNSPLT OR LVAD,,,,,0
HCPCS,M1152,PT W/ HX TRNSPLT OR LVAD,,,,,0
HCPCS,M1153,PT W/ DX OSTEO DOE,,,,,0
HCPCS,M1159,HOSPC SERV DUR MEAS PD,,,,,0
HCPCS,M1160,PT ANPHX DUE TO MENGB BEF 13,,,,,0
HCPCS,M1161,PT ANPHX DUE TO DTP BEF 13,,,,,0
HCPCS,M1162,PT ENCEPH DUE TO DTP BEF 13,,,,,0
HCPCS,M1163,PT ANPHX DUE TO HPV BEF 13,,,,,0
HCPCS,M1164,PT W/ DEMENTIA ANY TIME,,,,,0
HCPCS,M1165,PT USE HSPC DUR MEAS PD,,,,,0
HCPCS,M1166,PATH RPT TIS SPEC WLE/REEXC,,,,,0
HCPCS,M1167,HSPC DUR MEAS PD,,,,,0
HCPCS,M1168,PT RECD FLU VAX 7/1-6/30,,,,,0
HCPCS,M1169,DOC MED RSN NO FLU VAX,,,,,0
HCPCS,M1170,PT W/O FLU VAX 7/1-6/30,,,,,0
HCPCS,M1171,PT RECD 1 TD/TDAP 9YRS PRIOR,,,,,0
HCPCS,M1172,DOC MED RSN NO TD/TDAP,,,,,0
HCPCS,M1173,PT NO REC TD/TDAP 9YRS PRIOR,,,,,0
HCPCS,M1174,PT W 2 HZV ON/AFT 50,,,,,0
HCPCS,M1175,DOC MED RSN NO HZV,,,,,0
HCPCS,M1176,PT W/O HZV ON/AFT AGE 50,,,,,0
HCPCS,M1177,PT RECD PCV ON/AFT 60,,,,,0
HCPCS,M1178,DOC MED RSN NO PCV,,,,,0
HCPCS,M1179,NO PCV RECD,,,,,0
HCPCS,M1180,PT IMM CKPT INHIB THERAPY,,,,,0
HCPCS,M1181,GR 2 OR> DIA OR GR2 OR> COL,,,,,0
HCPCS,M1182,NOT ELG PRE EX IBD/UC/CROHN,,,,,0
HCPCS,M1183,DOC IMM CKPT INHIB HLD,,,,,0
HCPCS,M1184,DOC MED RSN NO CST/IST RX,,,,,0
HCPCS,M1185,IMM CKPT INHIB NOT HLD NO RX,,,,,0
HCPCS,M1186,PT W/ RX FOR HSPC/PLLTV CARE,,,,,0
HCPCS,M1187,PT W/ ESRD,,,,,0
HCPCS,M1188,PT W/ CKD STG 5,,,,,0
HCPCS,M1189,DOC KHE PEF W/EFGR/UACR,,,,,0
HCPCS,M1190,DOC KHE NOT PEF W/EFGR/UACR,,,,,0
HCPCS,M1191,HSPC SVC ANY TIME IN MEAS PD,,,,,0
HCPCS,M1192,PT W/ DX SQ CELL CA OF ESOPH,,,,,0
HCPCS,M1193,RPTS W/ IMP/CON MMR/MSI,,,,,0
HCPCS,M1194,MED RSN NO IMP/CON MMR/MSI,,,,,0
HCPCS,M1195,RPT WO IMP/CON MMR/MSI,,,,,0
HCPCS,M1196,IXV NRS VRS IQA >=4,,,,,0
HCPCS,M1197,ISA REDUCED >=3 FR IXV,,,,,0
HCPCS,M1198,ISA NOT RED 3PTS /NO ASSESS,,,,,0
HCPCS,M1199,PT REC'G RRT,,,,,0
HCPCS,M1200,ACE-I/ARB RX,,,,,0
HCPCS,M1201,MED RSN NO ACE-I/ARB RX,,,,,0
HCPCS,M1202,PT RSN NO ACE-I/ARB RX,,,,,0
HCPCS,M1203,NO RSN ACE-I/ARB RX,,,,,0
HCPCS,M1204,IXV NRS VRS IQA >=4,,,,,0
HCPCS,M1205,ISA REDUCED >=3,,,,,0
HCPCS,M1206,ISA NOT RED 3PTS/NO ASSESS,,,,,0
HCPCS,M1207,PT SCRN SDOH,,,,,0
HCPCS,M1208,PT NO SCRN SDOH,,,,,0
HCPCS,M1209,>=2 SAME HI-RSK MED W/O DIAG,,,,,0
HCPCS,M1210,>=2 SAME MEDS TBL4 NOT ORD,,,,,0
HCPCS,M1211,HEMOGLOBIN A1C LEVEL >9.0%,,,,,0
HCPCS,M1212,MISSING HB A1C LEVEL,,,,,0
HCPCS,M1213,NO HX SPIRO PRS SPIRO>=70%,,,,,0
HCPCS,M1214,SPIRO RESULTS WTH OBS DOC,,,,,0
HCPCS,M1215,MED RSN FOR NO DOC SPIRO,,,,,0
HCPCS,M1216,NO SPIRO DOC NO RES DOC,,,,,0
HCPCS,M1217,SYS RSN NO DOC SPIRO,,,,,0
HCPCS,M1218,PT COPD SYMPTOMS,,,,,0
HCPCS,M1220,DRE WTH INTERP RTNOPTHY,,,,,0
HCPCS,M1221,DRE W/O RTNOPTHY,,,,,0
HCPCS,M1222,GLAUCOMA PLN OF CARE NOT DOC,,,,,0
HCPCS,M1223,GLAUCOMA PLAN OF CARE DOC,,,,,0
HCPCS,M1224,IOP DEC <20% FROM BASE,,,,,0
HCPCS,M1225,IOP DEC>=20% FROM BASE,,,,,0
HCPCS,M1226,IOP NOT DOC,,,,,0
HCPCS,M1227,EB THERAPY PRESCRIBED,,,,,0
HCPCS,M1228,PT + HCV ABY +VIR W/ RX 3 MO,,,,,0
HCPCS,M1229,PT W/ +HCV +VIR REF WIN 1 MO,,,,,0
HCPCS,M1230,PT HCV RCTV ABY NO F/U TST,,,,,0
HCPCS,M1231,PT HCV TST NO REACTIVE RES,,,,,0
HCPCS,M1232,PT HCV TST REACTIVE RESULT,,,,,0
HCPCS,M1233,PT NO HCV ABY OR RESULT,,,,,0
HCPCS,M1234,PT HCV RCTV ABY F/U NEG,,,,,0
HCPCS,M1235,DOC PT HCV ABY RNA TST,,,,,0
HCPCS,M1236,BASELINE MRS > 2,,,,,0
HCPCS,M1237,PT RSN NO SCRN,,,,,0
HCPCS,M1238,DOC 2ND RECOM HZV 2-6 MO INT,,,,,0
HCPCS,M1239,PT NO RESP HEARD,,,,,0
HCPCS,M1240,PT NO RESP BEST INT,,,,,0
HCPCS,M1241,PT NO RESP SEEN AS PERSON,,,,,0
HCPCS,M1242,PT NO RESP IMPRT TO ME,,,,,0
HCPCS,M1243,PT OTHR THN TRUE HEARD,,,,,0
HCPCS,M1244,PT OTHR THN TRUE BEST INT,,,,,0
HCPCS,M1245,PT OTHR THN TRUE PERSON,,,,,0
HCPCS,M1246,PT OTHR THN TRUE IMPRT TO ME,,,,,0
HCPCS,M1247,PT RESP TRUE BEST INT,,,,,0
HCPCS,M1248,PT RESP TRUE SEEN AS PERSON,,,,,0
HCPCS,M1249,PT RESP TRUE IMPRT TO ME,,,,,0
HCPCS,M1250,PT RESP TRUE HEARD,,,,,0
HCPCS,M1251,PTS PROXY CMPLT HU SURV,,,,,0
HCPCS,M1252,PTS NO CMPLT HU SURVEY,,,,,0
HCPCS,M1253,PTS HU SURV NO AMB PLLTV,,,,,0
HCPCS,M1254,PTS DECEASED PRIOR HU SURV,,,,,0
HCPCS,M1255,"PTS W/ OTHR RSN VST,+PRG TST",,,,,0
HCPCS,M1256,PRIOR HISTORY OF KNOWN CVD,,,,,0
HCPCS,M1257,CVD RISK ASSESS NOT PERF,,,,,0
HCPCS,M1258,CVD RISK ASSESS PERF,,,,,0
HCPCS,M1259,PT KID TRANSPLT WTLST LV DON,,,,,0
HCPCS,M1260,PT NO KD TRNSPLT WTLST LV DO,,,,,0
HCPCS,M1261,PTS ON WTLIST BEF DIALYSIS,,,,,0
HCPCS,M1262,PTS TRANSPLT BEF DIALYSIS,,,,,0
HCPCS,M1263,PTS HOSP DIALYSIS DT,,,,,0
HCPCS,M1265,CMS 2728 COMPLETED,,,,,0
HCPCS,M1266,PTS ADMIT SNF,,,,,0
HCPCS,M1267,PT NO ACT KID TRANSPLT WTLST,,,,,0
HCPCS,M1268,PT AC STAT KID TRNSPLT WTLST,,,,,0
HCPCS,M1269,REC'D ESRD MCP LST DAY OF MO,,,,,0
HCPCS,M1270,PTS NO KID TRANSPLT WTLST,,,,,0
HCPCS,M1271,PTS DEM ANY TIME/DUR MO,,,,,0
HCPCS,M1272,PTS KID TRANSPLT WTLST,,,,,0
HCPCS,M1273,PTS SNF 1 YR DIALYSIS,,,,,0
HCPCS,M1274,PTS SNF EXL MO,,,,,0
HCPCS,M1275,PTS HOSP EXL,,,,,0
HCPCS,M1276,CALC BMI OUT NRM PARAM NOF/U,,,,,0
HCPCS,M1277,COLORECTAL CA SCREEN DOC REV,,,,,0
HCPCS,M1278,"PRE-HTN OR HTN DOC, F/U INDC",,,,,0
HCPCS,M1279,"PRE-HTN/HTN, NO F/U, NOT GVN",,,,,0
HCPCS,M1280,BILAT MAST/HX BI /UNILAT MAS,,,,,0
HCPCS,M1281,BP SCRN NO PERF AT INTERVAL,,,,,0
HCPCS,M1282,PT SCRN TBCO ID AS NON USER,,,,,0
HCPCS,M1283,PT SCRN TBCO AND ID AS USER,,,,,0
HCPCS,M1284,PT 66+ SNP OR LTC POS > 90D,,,,,0
HCPCS,M1285,SCRN MAM PERF RSLTS NOT DOC,,,,,0
HCPCS,M1286,BMI DOC ONL FUP NOT CMPLTD,,,,,0
HCPCS,M1287,CALC BMI BLW LOW PARAM F/U,,,,,0
HCPCS,M1288,DOC RSN NO HBP SCRN OR F/U,,,,,0
HCPCS,M1289,NO PT TBCO CESS INTERV RNG,,,,,0
HCPCS,M1290,PT NOT ELI D/T ACT DIG HTN,,,,,0
HCPCS,M1291,PT 66+ FRAILTY AND MED DEM,,,,,0
HCPCS,M1292,PT 66+ FRAIL INPT ADV ILL,,,,,0
HCPCS,M1293,CALC BMI ABV UP PARAM F/U,,,,,0
HCPCS,M1294,BP SCRN PERF REC INTERVAL,,,,,0
HCPCS,M1295,PT HX TOT COL OR COLON CA,,,,,0
HCPCS,M1296,CALC BMI NORM PARAMETERS,,,,,0
HCPCS,M1297,BMI NOT DOC MEDRSN PTREF,,,,,0
HCPCS,M1298,DOC PT PREG DUR MSRMT PD,,,,,0
HCPCS,M1299,FLU IMMUNIZE ORDER/ADMIN,,,,,0
HCPCS,M1300,FLU IMM NO ADMIN DOC REA,,,,,0
HCPCS,M1301,PT RECV TBCO CESS INTERV,,,,,0
HCPCS,M1302,SCRN MAM PERF RSLTS DOC,,,,,0
HCPCS,M1303,HOSPC SERV DUR MEAS PD,,,,,0
HCPCS,M1304,NO PNEUM VAX ADMIN 19+,,,,,0
HCPCS,M1305,PNEUM VAX ADMIN 19+,,,,,0
HCPCS,M1306,PT ANPHX DUE TO PNEUM,,,,,0
HCPCS,M1307,DOC PT PAL OR HOSPICE,,,,,0
HCPCS,M1308,FLU IMMUNIZE NO ADMIN,,,,,0
HCPCS,M1309,PALL SERV DURING MEAS,,,,,0
HCPCS,M1310,PT SCR TOB & CESS INT,,,,,0
HCPCS,M1311,APHLX TO VAX BEF ENC,,,,,0
HCPCS,M1312,NO PT TBCO SCRN RNG,,,,,0
HCPCS,M1313,NO TOB SCR/CESS INT,,,,,0
HCPCS,M1314,BMI NOT CALCULATED,,,,,0
HCPCS,M1315,CRC NO DOC NO RSN,,,,,0
HCPCS,M1316,TOBACCO NON-USER,,,,,0
HCPCS,M1317,PTS COUNSL CPT OPT OUT,,,,,0
HCPCS,M1318,PTS NO CSP DOC CONTACT,,,,,0
HCPCS,M1319,PTS CSP DOC CONTACT,,,,,0
HCPCS,M1320,PTS SCRN + HRSN,,,,,0
HCPCS,M1321,"PTS NO 7WK INJ,NO IOP,IOP>25",,,,,0
HCPCS,M1322,"PTS 7WK INJ, SCRN IOP =<25",,,,,0
HCPCS,M1323,"PTS 7WK INJ, SCRN IOP >25",,,,,0
HCPCS,M1324,PTS INTRAVITREAL/PCI,,,,,0
HCPCS,M1325,DOC MED RSN NOT SEEN,,,,,0
HCPCS,M1326,PTS DX HYPOTONY,,,,,0
HCPCS,M1327,PTS NO EVAL INI XM NO 8 WKS,,,,,0
HCPCS,M1328,PTS DX ACUTE VITREOUS HEM,,,,,0
HCPCS,M1329,PTS ACT PVD 2 WKS 8 WKS,,,,,0
HCPCS,M1330,DOC PTS RSN NO F/U XM,,,,,0
HCPCS,M1331,PTS EVAL INI XM 8 WKS,,,,,0
HCPCS,M1332,PTS NO EVAL INI XM NO 2 WKS,,,,,0
HCPCS,M1333,ACUTE VITREOUS HEMORRHAGE,,,,,0
HCPCS,M1334,PTS ACT PVD 2 WKS 2 WKS,,,,,0
HCPCS,M1335,DOC PTS RSN NO F/U XM,,,,,0
HCPCS,M1336,PTS EVAL INI XM 2 WKS,,,,,0
HCPCS,M1337,ACUTE PVD,,,,,0
HCPCS,M1338,PT F/U 30-180 DYS NO + IMPRV,,,,,0
HCPCS,M1339,PTS F/U 30-180 DYS + IMPROV,,,,,0
HCPCS,M1340,INDX WHODAS 2.0 OR SDS,,,,,0
HCPCS,M1341,PT NO F/U 30-180 DYS,,,,,0
HCPCS,M1342,PTS DIED PERF PER,,,,,0
HCPCS,M1343,PT PAM LVL 4 BASE OR SRT LIN,,,,,0
HCPCS,M1344,PTS NO BSLN OR 2ND PAM SCORE,,,,,0
HCPCS,M1345,"PT BSLN PAM, 2ND SCR 6-12 MO",,,,,0
HCPCS,M1346,PTS NO PAM 6 PTS 6-12 MO,,,,,0
HCPCS,M1347,PT PAM INCR 3 PT 6-12 MO,,,,,0
HCPCS,M1348,PT PAM INCR 6 PT 6-12 MO,,,,,0
HCPCS,M1349,PT NO PAM 3 PTS 6-12 MO,,,,,0
HCPCS,M1350,PT W/ SUIC SAF PLN INIT REV,,,,,0
HCPCS,M1351,PT CMPLT SUICD SAF PLN 120DY,,,,,0
HCPCS,M1352,"SUICD C-SSRS ASSESSMENT, EQU",,,,,0
HCPCS,M1353,PTS NO CMPLT SUICD SAF PLN,,,,,0
HCPCS,M1354,PT NO SUICD SAF PLN 120DY,,,,,0
HCPCS,M1355,SUICD BASED CLN EVAL,,,,,0
HCPCS,M1356,PT DIED DUR MEAS PD,,,,,0
HCPCS,M1357,PT W/RED SUIC IDEA 120 DAYS,,,,,0
HCPCS,M1358,PTS NO <SUICD IDEA 120 DYS,,,,,0
HCPCS,M1359,"INDX SUICD IDEA, NO 0 SCR",,,,,0
HCPCS,M1360,SUICD C-SSRS ASSESSMENT,,,,,0
HCPCS,M1361,SUICD BASED CLN EVAL,,,,,0
HCPCS,M1362,PT DIED DUR MEAS PD,,,,,0
HCPCS,M1363,PTS NO F/U 120 DYS,,,,,0
HCPCS,M1364,ASCVD RISK >=20PCT,,,,,0
HCPCS,M1365,HOSP+PALL CARE SPEC CODE 17,,,,,0
HCPCS,M1366,FOCUS ON WOMEN'S HEALTH MVP,,,,,0
HCPCS,M1367,QUAL CARE ENT DISORDER MVP,,,,,0
HCPCS,M1368,PREV TRT INF D/O HIV/HEP MVP,,,,,0
HCPCS,M1369,QUALCARE MENTAL HLTH/SUD MVP,,,,,0
HCPCS,M1370,REHAB SUPPORT MSK CARE MVP,,,,,0
HCPCS,M1371,Most recent glycemic status assessment (HBA1c or GMI) level < 7.0%,,,,,0
HCPCS,M1372,Most recent glycemic status assessment (HBA1c or GMI) level >= 7.0% and < 8.0%,,,,,0
HCPCS,M1373,Most recent glycemic status assessment (HBA1c or GMI) level >= 8.0% and <= 9.0%,,,,,0
HCPCS,M1374,An additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance,,,,,0
HCPCS,M1375,An additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance,,,,,0
HCPCS,M1376,An additional encounter with an RA diagnosis during the performance period or prior performance period that is at least 90 days before or after an encounter with an RA diagnosis during the performance,,,,,0
HCPCS,M1377,Recommended follow-up interval for repeat colonoscopy of 10 years documented  in colonoscopy report and communicated with patient,,,,,0
HCPCS,M1378,"Documentation of medical reason(s) for not recommending a 10 year follow-up interval (e.g., inadequate prep, familial or personal history of colonic polyps, patient had no adenoma and age is >= 66 yea",,,,,0
HCPCS,M1379,"A 10 year follow-up interval for colonoscopy not recommended, reason not otherwise specified",,,,,0
HCPCS,M1380,"Filled at least two prescriptions during the performance period for any combination of the qualifying oral antipsychotic medications listed under ""denominator note"" or the long-acting injectable antip",,,,,0
HCPCS,M1381,"Patients with secondary stroke (e.g., a subsequent stroke that may occur with vasospasm in the setting of subarachnoid hemorrhage) within 5 days of the initial procedure",,,,,0
HCPCS,M1382,Patient encounter during the performance period with place of service code 11,,,,,0
HCPCS,M1383,Acute PVD,,,,,0
HCPCS,M1384,Patients who died during the performance period,,,,,0
HCPCS,M1385,"Documentation of patient reasons for patients who were not seen for the second PAM survey (e.g., less than four months between baseline PAM assessment and follow-up",,,,,0
HCPCS,M1386,"Patients with an excisional surgery for melanoma or melanoma in situ in the past 5 years with an initial ajcc staging of 0, i, or ii at the start of the performance period",,,,,0
HCPCS,M1387,Patients who died during the performance period,,,,,0
HCPCS,M1388,Patients with documentation of an exam performed for recurrence of melanoma,,,,,0
HCPCS,M1390,Patients who do not have a documented exam performed for recurrence of melanoma or no documentation within the performance period,,,,,0
HCPCS,M1391,All patients who were diagnosed with recurrent melanoma during the current performance period,,,,,0
HCPCS,M1392,"Documentation of patient reasons for no examination, i.e., refusal of examination or lost to follow-up (documentation must include information that the clinician was unable to reach the patient by pho",,,,,0
HCPCS,M1393,Patients who were not diagnosed with recurrent melanoma during the current performance period,,,,,0
HCPCS,M1394,Stages I-III breast cancer,,,,,0
HCPCS,M1395,Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group,,,,,0
HCPCS,M1396,Patients on a therapeutic clinical trial,,,,,0
HCPCS,M1397,Patients with recurrence/disease progression,,,,,0
HCPCS,M1398,Patients with baseline and follow-up promis surveys documented in the medical record,,,,,0
HCPCS,M1399,Patients who leave the practice during the follow-up period,,,,,0
HCPCS,M1400,Patients who died during the follow-up period,,,,,0
HCPCS,M1401,Stages I-III breast cancer,,,,,0
HCPCS,M1402,Patients receiving an initial chemotherapy regimen with a defined duration with the eligible clinician or group,,,,,0
HCPCS,M1403,Patients with baseline and follow-up PROMIS surveys documented in the medical record,,,,,0
HCPCS,M1404,Patients on a therapeutic clinical trial,,,,,0
HCPCS,M1405,Patients with recurrence/disease progression,,,,,0
HCPCS,M1406,Patients who leave the practice during the follow-up period,,,,,0
HCPCS,M1407,Patients who died during the follow-up period,,,,,0
HCPCS,M1408,"Patients who have germline BRCA testing completed before diagnosis of epithelial ovarian, fallopian tube, or primary peritoneal cancer",,,,,0
HCPCS,M1409,Patients who received germline testing for BRCA1 and BRCA2 or genetic counseling completed within 6 months of diagnosis,,,,,0
HCPCS,M1410,Patients who did not have germline testing for BRCA1 and BRCA2 or genetic counseling completed within 6 months of diagnosis,,,,,0
HCPCS,M1411,Currently on first-line immune checkpoint inhibitors without chemotherapy,,,,,0
HCPCS,M1412,"Patients with metastatic NSCLC with epidermal growth factor receptor (EGFR) mutations, ALK genomic tumor aberrations, or other targetable genomic abnormalities with approved first-line targeted therap",,,,,0
HCPCS,M1413,Patients who had a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy,,,,,0
HCPCS,M1414,"Documentation of medical reason(s) for not performing the PD-L1 biomarker expression test prior to initiation of first-line immune checkpoint inhibitor therapy (e.g., patient is in an urgent or emerge",,,,,0
HCPCS,M1415,Patients who did not have a positive PD-L1 biomarker expression test result prior to the initiation of first-line immune checkpoint inhibitor therapy,,,,,0
HCPCS,M1416,Patient received hospice services any time during the performance period,,,,,0
HCPCS,M1417,Patients who are up to date on their COVID-19 vaccinations as defined by CDC recommendations on current vaccination,,,,,0
HCPCS,M1418,Patients who are not up to date on their COVID-19 vaccinations as defined by CDC recommendations on current vaccination because of a medical contraindication documented by clinician,,,,,0
HCPCS,M1419,Patients who are not up to date on their COVID-19 vaccinations as defined by CDC recommendations on current vaccination,,,,,0
HCPCS,M1420,Complete ophthalmologic care MIPS value pathway,,,,,0
HCPCS,M1421,Dermatological care MIPS value pathway,,,,,0
HCPCS,M1422,Gastroenterology care MIPS value pathway,,,,,0
HCPCS,M1423,Optimal care for patients with urologic conditions MIPS value pathway,,,,,0
HCPCS,M1424,Pulmonology care MIPS value pathway,,,,,0
HCPCS,M1425,Surgical care MIPS value pathway,,,,,0
HCPCS,P2028,CEPHALIN FLOCULATION TEST,,,4.95,9.9,8
HCPCS,P2029,CONGO RED BLOOD TEST,,,4.95,9.9,8
HCPCS,P2031,HAIR ANALYSIS,,,4.95,9.9,8
HCPCS,P2033,BLOOD THYMOL TURBIDITY,,,4.95,9.9,8
HCPCS,P2038,BLOOD MUCOPROTEIN,,,4.95,9.9,8
HCPCS,P3000,CYTO GYN SCREEN CONVENTIONL,230.0,115.0,18.54,223.1,54
HCPCS,P3000,SCREEN PAP BY TECH W MD SUPV,,,,,0
HCPCS,P3001,SCREENING PAP SMEAR BY PHYS,,,,,0
HCPCS,P7001,CULTURE BACTERIAL URINE,,,,,0
HCPCS,P9010,BLD WHOLE FOR TRANSFUSION PER UNIT,3648.0,1824.0,180.57,3538.56,54
HCPCS,P9011,BLD BLOOD SPLIT UNIT,1938.0,969.0,148.23,1879.86,54
HCPCS,P9012,BLD CRYOPRECIPITATE EACH UNIT,353.0,176.5,61.49,342.41,54
HCPCS,P9016,BLD RBC LEUKOCYTES REDUCED,1494.0,747.0,175.88,1449.18,54
HCPCS,P9017,BLD PLASMA 1 DONOR FRZ W/IN 8 HR,360.0,180.0,62.71,349.2,54
HCPCS,P9019,"BLD PLATELETS, EACH UNIT",1970.0,985.0,50.57,1910.9,54
HCPCS,P9020,BLD PLAELET RICH PLASMA UNIT,2007.0,1003.5,349.61,1946.79,54
HCPCS,P9021,BLD RED BLOOD CELLS UNIT,2601.0,1300.5,143.22,2522.97,54
HCPCS,P9022,BLD WASHED RED BLOOD CELLS UNIT,3412.0,1706.0,350.58,3309.64,54
HCPCS,P9023,"BLD FROZEN PLASMA, POOLED, SD",1268.0,634.0,53.23,1229.96,54
HCPCS,P9025,PLASMA CRYO REDU PATH EACH,,,127.23,254.46,8
HCPCS,P9026,CRYO FIB COMP PATH REDU EACH,,,522.45,1044.9,8
HCPCS,P9027,"Red blood cells, leukocytes reduced, oxygen/ carbon dioxide reduced, each unit",,,486.6,973.2,8
HCPCS,P9031,BLD PLATELETS LEUKOCYTES REDUCED,692.0,346.0,120.54,671.24,54
HCPCS,P9032,BLD PLATELETS IRRADIATED,2657.0,1328.5,373.78,2577.29,54
HCPCS,P9033,BLD PLATELETS LEUKOREDUCED IRRAD,647.0,323.5,112.7,627.59,54
HCPCS,P9034,BLD PLATELETS PHERESIS,7096.0,3548.0,293.87,6883.12,54
HCPCS,P9035,BLD PLATELET PHERES LEUKOREDUCED,3724.0,1862.0,486.6,3612.28,54
HCPCS,P9036,BLD PLATELET PHERESIS IRRADIATED,8815.0,4407.5,902.77,8550.55,54
HCPCS,P9037,BLD PLATE PHERES LEUKOREDU IRRAD,4168.0,2084.0,647.37,4042.96,54
HCPCS,P9038,BLD RBC IRRADIATED,1087.0,543.5,138.13,1054.39,54
HCPCS,P9039,BLD DEGLYCED RBC,3995.0,1997.5,297.71,3875.15,54
HCPCS,P9039,BLD RBC DEGLYCEROLIZED,4315.0,2157.5,297.71,4185.55,54
HCPCS,P9040,BLD RBC LEUKOREDUCED IRRADIATED,1938.0,969.0,252.45,1879.86,54
HCPCS,P9041,"ALBUMIN (HUMAN),5%, 50ML",,,10.1,62.65,10
HCPCS,P9043,"PLASMA PROTEIN FRACT,5%,50ML",,,7.71,43.02,9
HCPCS,P9044,BLD CRYOPRECIPITATEREDUCEDPLASMA,371.0,185.5,64.62,359.87,54
HCPCS,P9045,"ALBUMIN (HUMAN), 5%, 250 ML",,,50.49,100.98,10
HCPCS,P9046,"ALBUMIN (HUMAN), 25%, 20 ML",,,20.19,52.84,10
HCPCS,P9047,"ALBUMIN (HUMAN), 25%, 50ML",,,50.49,100.98,10
HCPCS,P9048,"PLASMAPROTEIN FRACT,5%,250ML",,,33.6,101.05,9
HCPCS,P9050,BLD GRANULOCYTES PHERESIS UNIT,14960.0,7480.0,2606.03,14511.2,47
HCPCS,P9051,BLD BLOOD L/R CMV-NEG,3194.0,1597.0,144.18,3098.18,54
HCPCS,P9052,BLD PLATELETS HLA-M L/R UNIT,11234.0,5617.0,673.48,10896.98,54
HCPCS,P9053,PLT PHER L/R CMV-NEG IRR,4162.0,2081.0,478.86,4037.14,54
HCPCS,P9054,BLD BLOOD L/R FROZ/DEGLY/WASH,2906.0,1453.0,252.24,2818.82,54
HCPCS,P9055,BLD PLT APH/PHER L/R CMV-NEG,7367.0,3683.5,238.26,7145.99,54
HCPCS,P9056,BLD BLOOD L/R IRRADIATED,2032.0,1016.0,80.42,1971.04,54
HCPCS,P9057,BLD RBC FRZ/DEG/WSH L/R IRRAD,4261.0,2130.5,402.05,4133.17,54
HCPCS,P9058,BLD RBC L/R CMV-NEG IRRAD,1245.0,622.5,216.87,1207.65,54
HCPCS,P9059,BLD PLASMA FRZ BETWEEN 8-24HOUR,360.0,180.0,62.71,349.2,54
HCPCS,P9060,BLD FR FRZ PLASMA DONOR RETESTED,820.0,410.0,50.65,795.4,54
HCPCS,P9070,BLD PATHOGEN REDUCED PLASMA POOL,1165.0,582.5,53.06,1130.05,54
HCPCS,P9071,BLD PATHOGEN REDUCED PLASMA SING,1156.0,578.0,201.37,1121.32,54
HCPCS,P9073,PLATELETS PHERESIS PATHOGEN REDUCED,3717.0,1858.5,577.76,3605.49,54
HCPCS,P9099,BLOOD COMPONENT/PRODUCT NOC,,,33.6,67.2,8
HCPCS,P9100,PATHOGEN TEST FOR PLATELETS,479.0,239.5,57.33,464.63,54
HCPCS,P9603,ONE-WAY ALLOW PRORATED MILES,,,,,0
HCPCS,P9604,ONE-WAY ALLOW PRORATED TRIP,,,,,0
HCPCS,P9612,CATHETERIZE FOR URINE SPEC,,,,,0
HCPCS,P9612,POC CATH FOR URINE COLLECTN,132.0,66.0,9.34,128.04,54
HCPCS,P9615,URINE SPECIMEN COLLECT MULT,,,9.34,18.68,8
HCPCS,Q0035,CARDIOKYMOGRAPHY,,,36.3,72.6,8
HCPCS,Q0081,INFUSION THER OTHER THAN CHE,,,,,0
HCPCS,Q0083,CHEMO BY OTHER THAN INFUSION,,,,,0
HCPCS,Q0084,CHEMOTHERAPY BY INFUSION,,,,,0
HCPCS,Q0085,CHEMO BY BOTH INFUSION AND O,,,,,0
HCPCS,Q0091,OBTAINING SCREEN PAP SMEAR,,,28.11,56.22,8
HCPCS,Q0092,SET UP PORT XRAY EQUIPMENT,,,,,0
HCPCS,Q0111,WET MOUNTS/ W PREPARATIONS,,,18.54,37.08,8
HCPCS,Q0112,POTASSIUM HYDROXIDE PREPS,,,5.83,11.66,8
HCPCS,Q0113,PINWORM EXAMINATIONS,,,4.27,8.54,8
HCPCS,Q0114,FERN TEST,,,9.74,19.48,8
HCPCS,Q0115,POST-COITAL MUCOUS EXAM,,,25.0,50.0,8
HCPCS,Q0138,"FERUMOXYTOL, NON-ESRD",,,0.3,0.64,13
HCPCS,Q0139,"FERUMOXYTOL, ESRD USE",,,0.3,0.64,13
HCPCS,Q0144,"AZITHROMYCIN DIHYDRATE, ORAL",,,15.4,47.18,2
HCPCS,Q0155,"Dronabinol (Syndros), 0.1 mg, oral, FDA approved prescription anti-emetic, for use as a complete therapeutic substitute for an IV anti-emetic at the time of chemotherapy treatment, not to exceed a 48 ",,,4.75,6.2,2
HCPCS,Q0161,CHLORPROMAZINE HCL 5MG ORAL,,,0.62,0.62,1
HCPCS,Q0162,ONDANSETRON ORAL,,,0.01,0.02,2
HCPCS,Q0163,DIPHENHYDRAMINE HCL 50MG,,,0.04,1.61,2
HCPCS,Q0164,PROCHLORPERAZINE MALEATE 5MG,,,0.66,0.9,2
HCPCS,Q0166,GRANISETRON HCL 1 MG ORAL,,,5.73,62.95,2
HCPCS,Q0167,DRONABINOL 2.5MG ORAL,,,2.05,3.15,2
HCPCS,Q0169,PROMETHAZINE HCL 12.5MG ORAL,,,0.17,0.34,2
HCPCS,Q0173,TRIMETHOBENZAMIDE HCL 250MG,,,0.79,1.57,2
HCPCS,Q0174,THIETHYLPERAZINE MALEATE10MG,,,0.79,1.18,2
HCPCS,Q0175,PERPHENAZINE 4MG ORAL,,,0.79,0.9,2
HCPCS,Q0177,HYDROXYZINE PAMOATE 25MG,,,0.19,2.37,2
HCPCS,Q0180,DOLASETRON MESYLATE ORAL,,,115.23,175.4,2
HCPCS,Q0181,UNSPECIFIED ORAL ANTI-EMETIC,,,,,0
HCPCS,Q0224,"Injection, pemivibart, for the pre-exposure prophylaxis only, for certain adults and adolescents (12 years of age and older weighing at least 40 kg) with no known SARS-CoV-2 exposure, and who either h",,,8831.58,12131.76,2
HCPCS,Q0237,"Injection, tocilizumab-anoh, for hospitalized adult patients with COVID-19 who are receiving systemic corticosteroids and require supplemental oxygen, non-invasive or invasive mechanical ventilation, ",,,,,0
HCPCS,Q0249,TOCILIZUMAB FOR COVID-19,,,9.24,12.68,2
HCPCS,Q0477,DME POS,,,960.54,1921.08,8
HCPCS,Q0478,DME POS,,,227.5,455.0,8
HCPCS,Q0479,DME POS,,,14835.04,29670.08,8
HCPCS,Q0480,DME POS,,,111502.61,223005.22,8
HCPCS,Q0481,DME POS,,,17989.68,35979.36,8
HCPCS,Q0482,DME POS,,,5634.71,11269.42,8
HCPCS,Q0483,DME POS,,,23212.4,46424.8,8
HCPCS,Q0484,DME POS,,,4507.79,9015.58,8
HCPCS,Q0485,DME POS,,,435.21,870.42,8
HCPCS,Q0486,DME POS,,,362.21,724.42,8
HCPCS,Q0487,DME POS,,,422.6,845.2,8
HCPCS,Q0488,"PWR PACK BASE ELEC VAD, REP",,,,,0
HCPCS,Q0489,DME POS,,,20123.89,40247.78,8
HCPCS,Q0490,DME POS,,,870.47,1740.94,8
HCPCS,Q0491,DME POS,,,1368.43,2736.86,8
HCPCS,Q0492,DME POS,,,110.28,220.56,8
HCPCS,Q0493,DME POS,,,313.85,627.7,8
HCPCS,Q0494,DME POS,,,265.6,531.2,8
HCPCS,Q0495,DME POS,,,5171.38,10342.76,8
HCPCS,Q0496,DME POS,,,1856.1,3712.2,8
HCPCS,Q0497,DME POS,,,579.54,1159.08,8
HCPCS,Q0498,DME POS,,,635.9,1271.8,8
HCPCS,Q0499,DME POS,,,206.62,413.24,8
HCPCS,Q0500,DME POS,,,37.8,75.6,8
HCPCS,Q0501,DME POS,,,632.25,1264.5,8
HCPCS,Q0502,DME POS,,,804.93,1609.86,8
HCPCS,Q0503,DME POS,,,1609.89,3219.78,8
HCPCS,Q0504,DME POS,,,849.48,1698.96,8
HCPCS,Q0506,DME POS,,,1057.44,2114.88,8
HCPCS,Q0507,MISC SUP/ACC EXT VAD,,,,,0
HCPCS,Q0508,MIS SUP/ACC IMP VAD,,,,,0
HCPCS,Q0509,MIS SUP/AC IMP VAD NOPAY MED,,,,,0
HCPCS,Q0510,DISPENS FEE IMMUNOSUPRESSIVE,,,,,0
HCPCS,Q0511,"SUP FEE ANTIEM,ANTICA,IMMUNO",,,,,0
HCPCS,Q0512,PX SUP FEE ANTI-CAN SUB PRES,,,,,0
HCPCS,Q0513,DISP FEE INHAL DRUGS/30 DAYS,,,,,0
HCPCS,Q0514,DISP FEE INHAL DRUGS/90 DAYS,,,,,0
HCPCS,Q0515,SERMORELIN ACETATE INJECTION,,,1.57,3.37,2
HCPCS,Q0521,Pharmacy supplying fee for HIV pre-exposure prophylaxis FDA approved prescription,,,,,0
HCPCS,Q1004,NTIOL CATEGORY 4,,,,,0
HCPCS,Q1005,NTIOL CATEGORY 5,,,,,0
HCPCS,Q2004,BLADDER CALCULI IRRIG SOL,,,16.97,16.97,1
HCPCS,Q2009,FOSPHENYTOIN INJ PE,,,1.4,8.92,10
HCPCS,Q2017,"TENIPOSIDE, 50 MG",,,586.54,4768.41,6
HCPCS,Q2026,RADIESSE INJECTION,,,332.14,664.28,9
HCPCS,Q2028,"INJ, SCULPTRA, 0.5MG",,,1.22,4.1,10
HCPCS,Q2034,AGRIFLU VACCINE,,,,,0
HCPCS,Q2035,"AFLURIA VACC, 3 YRS & >, IM",,,22.27,31.4,2
HCPCS,Q2036,"FLULAVAL VACC, 3 YRS & >, IM",,,16.05,16.05,1
HCPCS,Q2037,"FLUVIRIN VACC, 3 YRS & >, IM",,,14.6,32.81,2
HCPCS,Q2038,"FLUZONE VACC, 3 YRS & >, IM",,,22.42,58.65,2
HCPCS,Q2039,"INFLUENZA VIRUS VACCINE, NOS",,,,,0
HCPCS,Q2041,AXICABTAGENE CILOLEUCEL CAR+,,,507187.21,1014374.42,12
HCPCS,Q2042,TISAGENLECLEUCEL CAR-POS T,,,562826.29,1127511.66,12
HCPCS,Q2043,SIPULEUCEL-T AUTO CD54+,,,52572.82,111075.77,13
HCPCS,Q2049,IMPORTED LIPODOX INJ,,,284.15,952.29,11
HCPCS,Q2050,DOXORUBICIN INJ 10MG,,,103.17,710.13,14
HCPCS,Q2052,"HOME IVIG, SERVICES/SUPPLIES",,,,,0
HCPCS,Q2053,BREXUCABTAGENE CAR POS T,,,465406.97,953404.97,12
HCPCS,Q2054,LISOCABTAGENE MARA CAR POS T,,,535063.82,1070127.64,12
HCPCS,Q2055,IDECABTAGENE VICLEUCEL CAR,,,530098.52,1060197.04,12
HCPCS,Q2056,CILTACABTAGENE CAR-POS T,,,538231.91,1077636.42,12
HCPCS,Q2057,"Afamitresgene autoleucel, including leukapheresis and dose preparation procedures, per therapeutic dose",,,732982.92,1465965.84,12
HCPCS,Q2058,"Obecabtagene autoleucel, 10 up to 400 million CD19 CAR-positive viable T cells, including leukapheresis and dose preparation procedures, per infusion",,,264660.27,992250.0,12
HCPCS,Q3001,BRACHYTHERAPY RADIOELEMENTS,,,73.0,73.0,1
HCPCS,Q3014,TELEHEALTH FACILITY FEE (ORIGINATING SITE),114.0,57.0,19.85,110.58,47
HCPCS,Q3027,INJ BETA INTERFERON IM 1 MCG,,,70.11,137.52,2
HCPCS,Q3028,INJ BETA INTERFERON SQ 1 MCG,,,57.17,79.53,2
HCPCS,Q3031,COLLAGEN SKIN TEST,,,,,0
HCPCS,Q4001,DME POS,,,62.36,124.72,8
HCPCS,Q4002,DME POS,,,235.64,471.28,8
HCPCS,Q4003,DME POS,,,44.78,89.56,8
HCPCS,Q4004,DME POS,,,155.03,310.06,8
HCPCS,Q4005,DME POS,,,16.51,33.02,8
HCPCS,Q4006,DME POS,,,37.2,74.4,8
HCPCS,Q4007,DME POS,,,8.25,16.5,8
HCPCS,Q4008,DME POS,,,18.59,37.18,8
HCPCS,Q4009,DME POS,,,11.03,22.06,8
HCPCS,Q4010,DME POS,,,24.8,49.6,8
HCPCS,Q4011,DME POS,,,5.5,11.0,8
HCPCS,Q4012,DME POS,,,12.43,24.86,8
HCPCS,Q4013,DME POS,,,20.07,40.14,8
HCPCS,Q4014,DME POS,,,33.84,67.68,8
HCPCS,Q4015,DME POS,,,10.05,20.1,8
HCPCS,Q4016,DME POS,,,16.91,33.82,8
HCPCS,Q4017,DME POS,,,11.6,23.2,8
HCPCS,Q4018,DME POS,,,18.48,36.96,8
HCPCS,Q4019,DME POS,,,5.8,11.6,8
HCPCS,Q4020,DME POS,,,9.28,18.56,8
HCPCS,Q4021,DME POS,,,8.59,17.18,8
HCPCS,Q4022,DME POS,,,15.5,31.0,8
HCPCS,Q4023,DME POS,,,4.31,8.62,8
HCPCS,Q4024,DME POS,,,7.76,15.52,8
HCPCS,Q4025,DME POS,,,48.12,96.24,8
HCPCS,Q4026,DME POS,,,150.32,300.64,8
HCPCS,Q4027,DME POS,,,24.08,48.16,8
HCPCS,Q4028,DME POS,,,75.2,150.4,8
HCPCS,Q4029,DME POS,,,36.82,73.64,8
HCPCS,Q4030,DME POS,,,96.92,193.84,8
HCPCS,Q4031,DME POS,,,18.39,36.78,8
HCPCS,Q4032,DME POS,,,48.46,96.92,8
HCPCS,Q4033,DME POS,,,34.35,68.7,8
HCPCS,Q4034,DME POS,,,85.39,170.78,8
HCPCS,Q4035,DME POS,,,17.17,34.34,8
HCPCS,Q4036,DME POS,,,42.73,85.46,8
HCPCS,Q4037,DME POS,,,20.92,41.84,8
HCPCS,Q4038,DME POS,,,52.48,104.96,8
HCPCS,Q4039,DME POS,,,10.5,21.0,8
HCPCS,Q4040,DME POS,,,26.23,52.46,8
HCPCS,Q4041,DME POS,,,25.48,50.96,8
HCPCS,Q4042,DME POS,,,43.49,86.98,8
HCPCS,Q4043,DME POS,,,12.74,25.48,8
HCPCS,Q4044,DME POS,,,21.78,43.56,8
HCPCS,Q4045,DME POS,,,14.79,29.58,8
HCPCS,Q4046,DME POS,,,23.79,47.58,8
HCPCS,Q4047,DME POS,,,7.36,14.72,8
HCPCS,Q4048,DME POS,,,11.9,23.8,8
HCPCS,Q4049,DME POS,,,2.68,5.36,8
HCPCS,Q4050,CAST SUPPLIES UNLISTED,,,,,0
HCPCS,Q4051,SPLINT SUPPLIES MISC,,,,,0
HCPCS,Q4074,ILOPROST NON-COMP UNIT DOSE,,,180.44,297.66,6
HCPCS,Q4081,"EPOETIN ALFA, 100 UNITS ESRD",,,0.94,2.02,6
HCPCS,Q4082,DRUG/BIO NOC PART B DRUG CAP,,,,,0
HCPCS,Q4100,"SKIN SUBSTITUTE, NOS",,,,,0
HCPCS,Q4101,APLIGRAF,,,36.97,241.86,10
HCPCS,Q4102,OASIS WOUND MATRIX,,,14.27,241.86,10
HCPCS,Q4103,OASIS BURN MATRIX,,,15.1,241.86,10
HCPCS,Q4104,INTEGRA BMWD,,,65.59,241.86,10
HCPCS,Q4105,INTEGRA DRT OR OMNIGRAFT,,,31.83,241.86,10
HCPCS,Q4106,DERMAGRAFT,,,62.15,84.17,2
HCPCS,Q4107,GRAFTJACKET,,,120.93,241.86,10
HCPCS,Q4108,INTEGRA MATRIX,,,59.93,241.86,10
HCPCS,Q4110,PRIMATRIX,,,79.8,241.86,10
HCPCS,Q4111,GAMMAGRAFT,,,8.69,241.86,10
HCPCS,Q4112,CYMETRA INJECTABLE,,,1633.41,1633.41,1
HCPCS,Q4113,GRAFTJACKET XPRESS,,,1428.87,2436.95,2
HCPCS,Q4114,INTEGRA FLOWABLE WOUND MATRI,,,1881.53,2888.62,2
HCPCS,Q4115,ALLOSKIN,,,17.67,241.86,10
HCPCS,Q4116,ALLODERM,,,58.27,241.86,9
HCPCS,Q4117,HYALOMATRIX,,,36.51,241.86,10
HCPCS,Q4118,MATRISTEM MICROMATRIX,,,3.12,4.79,2
HCPCS,Q4121,THERASKIN LARGE 102TSL,6063.0,3031.5,59.6,5881.11,54
HCPCS,Q4122,"DERMACELL, AWM, POROUS SQ CM",,,120.93,241.86,10
HCPCS,Q4123,ALLOSKIN,,,87.29,241.86,10
HCPCS,Q4124,OASIS TRI-LAYER WOUND MATRIX,,,3.03,241.86,10
HCPCS,Q4125,ARTHROFLEX,,,120.93,241.86,8
HCPCS,Q4126,MEMODERM/DERMA/TRANZ/INTEGUP,,,72.97,241.86,10
HCPCS,Q4127,TALYMED,,,83.56,241.86,10
HCPCS,Q4128,FLEXHD/ALLOPATCHHD/SQ CM,,,37.45,241.86,10
HCPCS,Q4130,STRATTICE TM,,,120.93,241.86,8
HCPCS,Q4132,GRAFIX CORE 1.5X2 CM,6304.0,3152.0,108.8,6114.88,54
HCPCS,Q4132,GRAFIX CORE 2X3 CM,7038.0,3519.0,108.8,6826.86,54
HCPCS,Q4132,GRAFIX CORE 3X4 CM,9416.0,4708.0,108.8,9133.52,54
HCPCS,Q4133,GRAFIX PRIME 1.5X2 CM,6304.0,3152.0,120.93,6114.88,54
HCPCS,Q4133,GRAFIX PRIME 16MM DISC.,3897.0,1948.5,120.93,3780.09,54
HCPCS,Q4133,GRAFIX PRIME 2X3 CM,6934.0,3467.0,120.93,6725.98,54
HCPCS,Q4133,GRAFIX PRIME 3X3 CM,8601.0,4300.5,120.93,8342.97,54
HCPCS,Q4133,GRAFIX PRIME 3X4 CM,8106.0,4053.0,120.93,7862.82,54
HCPCS,Q4133,GRAFIX PRIME 5X5 CM,14617.0,7308.5,120.93,14178.49,54
HCPCS,Q4134,HMATRIX,,,120.93,303.58,9
HCPCS,Q4135,MEDISKIN,,,120.93,241.86,8
HCPCS,Q4136,EZDERM,,,120.93,241.86,8
HCPCS,Q4137,AMNIOEXCEL BIODEXCEL 1SQ CM,,,120.93,241.86,10
HCPCS,Q4138,"BIODFENCE DRYFLEX, 1CM",,,120.93,241.86,10
HCPCS,Q4139,"AMNIO OR BIODMATRIX, INJ 1CC",,,,,0
HCPCS,Q4140,BIODFENCE 1CM,,,120.93,308.75,10
HCPCS,Q4141,"ALLOSKIN AC, 1 CM",,,79.0,241.86,10
HCPCS,Q4142,XCM BIOLOGIC TISS MATRIX 1CM,,,120.93,241.86,8
HCPCS,Q4143,"REPRIZA, 1CM",,,41.38,241.86,10
HCPCS,Q4145,"EPIFIX, INJ, 1MG",,,23.77,36.49,2
HCPCS,Q4146,"TENSIX, 1CM",,,120.93,241.86,8
HCPCS,Q4147,ARCHITECT ECM PX FX 1 SQ CM,,,90.95,1923.06,10
HCPCS,Q4148,NEOX NEOX RT OR CLARIX CORD,,,120.93,241.86,10
HCPCS,Q4149,"EXCELLAGEN, 0.1 CC",,,212.28,277.02,2
HCPCS,Q4150,ALLOWRAP DS OR DRY 1 SQ CM,,,103.53,241.86,10
HCPCS,Q4151,"AMNIOBAND, GUARDIAN 1 SQ CM",,,120.93,256.96,10
HCPCS,Q4152,DERMAPURE 1 SQUARE CM,,,55.4,241.86,10
HCPCS,Q4153,"DERMAVEST, PLURIVEST SQ CM",,,120.93,241.86,10
HCPCS,Q4154,BIOVANCE 1 SQUARE CM,,,120.93,267.58,10
HCPCS,Q4155,NEOXFLO OR CLARIXFLO 1 MG,,,33.32,51.15,2
HCPCS,Q4156,NEOX 100 OR CLARIX 100,,,80.95,241.86,10
HCPCS,Q4157,REVITALON 1 SQUARE CM,,,120.93,333.64,10
HCPCS,Q4158,"KERECIS OMEGA3, PER SQ CM",,,80.91,241.86,10
HCPCS,Q4159,AFFINITY1 SQUARE CM,,,120.93,440.47,10
HCPCS,Q4160,NUSHIELD 1 SQUARE CM,,,120.93,992.69,10
HCPCS,Q4161,BIO-CONNEKT PER SQUARE CM,,,120.93,3097.6,10
HCPCS,Q4162,"WNDEX FLW, BIOSKN FLW, 0.5CC",,,3131.34,3502.51,2
HCPCS,Q4163,"WOUNDEX, BIOSKIN, PER SQ CM",,,120.93,341.22,10
HCPCS,Q4164,"HELICOLL, PER SQUARE CM",,,120.93,3073.46,10
HCPCS,Q4165,"KERAMATRIX, KERASORB SQ CM",,,84.75,5124.34,10
HCPCS,Q4166,"CYTAL, PER SQUARE CENTIMETER",,,25.44,241.86,10
HCPCS,Q4167,"TRUSKIN, PER SQ CENTIMETER",,,120.93,241.86,10
HCPCS,Q4168,"AMNIOBAND, 1 MG",,,31.93,31.93,1
HCPCS,Q4169,"ARTACENT WOUND, PER SQ CM",,,120.93,4159.13,10
HCPCS,Q4170,"CYGNUS, PER SQ CM",,,50.69,241.86,10
HCPCS,Q4171,"INTERFYL, 1 MG",,,12.94,19.87,2
HCPCS,Q4173,PALINGEN OR PALINGEN XPLUS,,,120.93,667.82,10
HCPCS,Q4174,PALINGEN OR PROMATRX,,,1758.63,2378.52,2
HCPCS,Q4175,MIRODERM,,,82.62,241.86,10
HCPCS,Q4176,"NEOPATCH OR THERION, 1 SQ CM",,,120.93,302.49,10
HCPCS,Q4177,"FLOWERAMNIOFLO, 0.1 CC",,,219.6,286.57,2
HCPCS,Q4178,"FLOWERAMNIOPATCH, PER SQ CM",,,113.59,241.86,10
HCPCS,Q4179,"FLOWERDERM, PER SQ CM",,,120.93,241.86,8
HCPCS,Q4180,"REVITA, PER SQ CM",,,120.93,2041.7,10
HCPCS,Q4181,"AMNIO WOUND, PER SQUARE CM",,,120.93,243.46,9
HCPCS,Q4182,"TRANSCYTE, PER SQ CENTIMETER",,,75.14,241.86,9
HCPCS,Q4183,"SURGIGRAFT, 1 SQ CM",,,120.93,241.86,10
HCPCS,Q4184,CELLESTA OR DUO PER SQ CM,,,97.65,241.86,10
HCPCS,Q4185,CELLESTA FLOWAB AMNION 0.5CC,,,,,0
HCPCS,Q4186,EPIFIX 1 SQ CM,,,120.93,281.57,10
HCPCS,Q4187,EPICORD 1 SQ CM,,,120.93,453.02,10
HCPCS,Q4188,AMNIOARMOR 1 SQ CM,,,120.93,913.26,10
HCPCS,Q4189,"ARTACENT AC, 1 MG",,,39.84,39.84,1
HCPCS,Q4190,ARTACENT AC 1 SQ CM,,,120.93,242.4,10
HCPCS,Q4191,RESTORIGIN 1 SQ CM,,,120.93,1368.1,10
HCPCS,Q4192,"RESTORIGIN, 1 CC",,,,,0
HCPCS,Q4193,COLL-E-DERM 1 SQ CM,,,120.93,3208.79,10
HCPCS,Q4194,NOVACHOR 1 SQ CM,,,120.93,1344.4,10
HCPCS,Q4195,PURAPLY 1 SQ CM,,,120.93,241.86,10
HCPCS,Q4196,PURAPLY AM 2X4 (PER SQ CM),2294.0,1147.0,120.22,2225.18,54
HCPCS,Q4197,PURAPLY XT 1 SQ CM,,,86.67,241.86,10
HCPCS,Q4198,GENESIS AMNIO MEMBRANE 1SQCM,,,120.93,241.86,8
HCPCS,Q4199,"CYGNUS MATRIX, PER SQ CM",,,120.93,243.98,10
HCPCS,Q4200,SKIN TE 1 SQ CM,,,120.93,241.86,8
HCPCS,Q4201,MATRION 1 SQ CM,,,96.66,241.86,10
HCPCS,Q4202,"KEROXX (2.5G/CC), 1CC",,,,,0
HCPCS,Q4203,"DERMA-GIDE, 1 SQ CM",,,120.93,1632.08,10
HCPCS,Q4204,XWRAP 1 SQ CM,,,120.93,7070.14,10
HCPCS,Q4205,MEMBRANE GRAFT OR WRAP SQ CM,,,120.93,2229.69,10
HCPCS,Q4206,FLUID FLOW OR FLUID GF 1 CC,,,,,0
HCPCS,Q4208,NOVAFIX PER SQ CM,,,120.93,764.18,9
HCPCS,Q4209,SURGRAFT PER SQ CM,,,120.93,241.86,8
HCPCS,Q4211,AMNION BIO OR AXOBIO SQ CM,,,120.93,241.86,8
HCPCS,Q4212,"ALLOGEN, PER CC",,,,,0
HCPCS,Q4213,"ASCENT, 0.5 MG",,,84.16,109.76,2
HCPCS,Q4214,CELLESTA CORD PER SQ CM,,,120.93,241.86,8
HCPCS,Q4215,"AXOLOTL AMBIENT, CRYO 0.1 MG",,,,,0
HCPCS,Q4216,ARTACENT CORD PER SQ CM,,,120.93,241.86,8
HCPCS,Q4217,WOUNDFIX BIOWOUND PLUS XPLUS,,,120.93,595.61,10
HCPCS,Q4218,SURGICORD PER SQ CM,,,120.93,241.86,9
HCPCS,Q4219,SURGIGRAFT DUAL PER SQ CM,,,120.93,1910.46,10
HCPCS,Q4220,"BELLACELL HD, SUREDERM SQ CM",,,120.93,241.86,8
HCPCS,Q4221,AMNIOWRAP2 PER SQ CM,,,120.93,3672.95,10
HCPCS,Q4222,"PROGENAMATRIX, PER SQ CM",,,120.93,241.86,10
HCPCS,Q4224,HHF10-P PER SQ CM,,,,,0
HCPCS,Q4225,"AMNIO OR DERMA TL, PER SQ CM",,,120.93,2567.38,10
HCPCS,Q4226,MYOWN HARV PREP PROC SQ CM,,,2292.55,2292.55,1
HCPCS,Q4227,AMNIOCORE PER SQ CM,,,120.93,2182.78,10
HCPCS,Q4229,COGENEX AMNIO MEMB PER SQ CM,,,120.93,618.67,10
HCPCS,Q4230,COGENEX FLOW AMNION 0.5 CC,,,,,0
HCPCS,Q4232,"CORPLEX, PER SQ CM",,,120.93,243.7,10
HCPCS,Q4233,SURFACTOR /NUDYN PER 0.5 CC,,,,,0
HCPCS,Q4234,"XCELLERATE, PER SQ CM",,,120.93,364.92,10
HCPCS,Q4235,AMNIOREPAIR OR ALTIPLY SQ CM,,,98.19,241.86,10
HCPCS,Q4236,CAREPATCH PER SQ CM,,,120.93,905.88,10
HCPCS,Q4237,"CRYO-CORD, PER SQ CM",,,120.93,795.03,10
HCPCS,Q4238,"DERM-MAXX, PER SQ CM",,,120.93,3231.0,10
HCPCS,Q4239,AMNIO-MAXX OR LITE PER SQ CM,,,120.93,3818.11,10
HCPCS,Q4240,CORECYTE TOPICAL ONLY 0.5 CC,,,,,0
HCPCS,Q4241,"POLYCYTE, TOPICAL ONLY 0.5CC",,,,,0
HCPCS,Q4242,"AMNIOCYTE PLUS, PER 0.5 CC",,,,,0
HCPCS,Q4245,"AMNIOTEXT, PER CC",,,,,0
HCPCS,Q4246,"CORETEXT OR PROTEXT, PER CC",,,3928.4,7689.6,2
HCPCS,Q4247,"AMNIOTEXT PATCH, PER SQ CM",,,120.93,5858.74,10
HCPCS,Q4248,DERMACYTE AMN MEM ALLO SQ CM,,,120.93,5290.29,10
HCPCS,Q4249,"AMNIPLY, PER SQ CM",,,120.93,3351.83,10
HCPCS,Q4250,AMNIOAMP-MP PER SQ CM,,,120.93,5434.81,10
HCPCS,Q4251,"VIM, PER SQUARE CENTIMETER",,,120.93,286.57,10
HCPCS,Q4252,"VENDAJE, PER SQUARE CENTIMET",,,64.66,241.86,10
HCPCS,Q4253,ZENITH AMNIOTIC MEMBRANE PSC,,,101.48,241.86,10
HCPCS,Q4254,NOVAFIX DL PER SQ CM,,,120.93,764.18,9
HCPCS,Q4255,"REGUARD, TOPICAL USE PER SQ",,,120.93,241.86,8
HCPCS,Q4256,"MLG COMPLET, PER SQ CM",,,120.93,1523.14,10
HCPCS,Q4257,"RELESE, PER SQ CM",,,120.93,1222.43,10
HCPCS,Q4258,"ENVERSE, PER SQ CM",,,100.54,241.86,10
HCPCS,Q4259,CELERA PER SQ CM,,,120.93,1763.35,10
HCPCS,Q4260,"SIGNATURE APATCH, PER SQ CM",,,120.93,241.86,8
HCPCS,Q4261,"TAG, PER SQUARE CENTIMETER",,,120.93,1152.38,10
HCPCS,Q4262,"DUAL LAYER IMPAX, PER SQ CM",,,76.68,241.86,10
HCPCS,Q4263,"SURGRAFT TL, PER SQ CM",,,120.93,3208.45,10
HCPCS,Q4264,"COCOON MEMBRANE, PER SQ CM",,,120.93,698.42,10
HCPCS,Q4265,NEOSTIM TL PER SQ CM,,,120.93,3191.65,10
HCPCS,Q4266,NEOSTIM PER SQ CM,,,120.93,1049.95,10
HCPCS,Q4267,NEOSTIM DL PER SQ CM,,,120.93,543.21,10
HCPCS,Q4268,SURGRAFT FT PER SQ CM,,,120.93,2328.38,10
HCPCS,Q4269,SURGRAFT XT PER SQ CM,,,120.93,4298.54,10
HCPCS,Q4270,COMPLETE SL PER SQ CM,,,120.93,6313.51,10
HCPCS,Q4271,COMPLETE FT PER SQ CM,,,120.93,2267.23,10
HCPCS,Q4272,"ESANO A, PER SQ CM",,,120.93,557.22,10
HCPCS,Q4273,"ESANO AAA, PER SQ CM",,,120.93,241.86,8
HCPCS,Q4274,"ESANO AC, PER SQ CM",,,120.93,3431.94,10
HCPCS,Q4275,"ESANO ACA, PER SQ CM",,,120.93,5011.17,10
HCPCS,Q4276,"ORION, PER SQ CM",,,120.93,489.34,10
HCPCS,Q4278,"EPIEFFECT, PER SQ CM",,,120.93,496.55,10
HCPCS,Q4279,"VENDAJE AC, PER SQ CM",,,120.93,4467.11,10
HCPCS,Q4280,XCELL AMNIO MATRIX PER SQ CM,,,120.93,5418.31,10
HCPCS,Q4281,BARRERA SLOR DL PER SQ CM,,,120.93,1019.01,10
HCPCS,Q4282,CYGNUS DUAL PER SQ CM,,,120.93,630.75,10
HCPCS,Q4283,"BIOVANCE TRI OR 3L, SQ CM",,,120.93,856.56,10
HCPCS,Q4284,"DERMABIND SL, PER SQ CM",,,120.93,241.86,8
HCPCS,Q4285,NUDYN DL OR DL MESH PR SQ CM,,,120.93,318.73,10
HCPCS,Q4286,"NUDYN SL OR SLW, PER SQ CM",,,120.93,340.77,10
HCPCS,Q4287,"DERMABIND DL, PER SQ CM",,,120.93,241.86,8
HCPCS,Q4288,"DERMABIND CH, PER SQ CM",,,120.93,241.86,8
HCPCS,Q4289,"REVOSHIELD+ AMNIO, PER SQ CM",,,120.93,2749.77,10
HCPCS,Q4290,MEMBRANE WRAP HYDR PER SQ CM,,,120.93,3492.6,10
HCPCS,Q4291,"LAMELLAS XT, PER SQ CM",,,120.93,5559.44,10
HCPCS,Q4292,"LAMELLAS, PER SQ CM",,,120.93,2292.55,10
HCPCS,Q4293,"ACESSO DL, PER SQ CM",,,120.93,2968.14,10
HCPCS,Q4294,"AMNIO QUAD-CORE, PER SQ CM",,,120.93,5459.8,10
HCPCS,Q4295,"AMNIO TRI-CORE, PER SQ CM",,,120.93,4804.62,10
HCPCS,Q4296,"REBOUND MATRIX, PER SQ CM",,,120.93,2725.48,10
HCPCS,Q4297,"EMERGE MATRIX, PER SQ CM",,,120.93,3179.14,10
HCPCS,Q4298,"AMNICORE PRO, PER SQ CM",,,120.93,4164.0,10
HCPCS,Q4299,"AMNICORE PRO+, PER SQ CM",,,120.93,5350.6,10
HCPCS,Q4300,"ACESSO TL, PER SQ CM",,,120.93,3960.83,10
HCPCS,Q4301,"ACTIVATE MATRIX, PER SQ CM",,,120.93,3383.27,10
HCPCS,Q4302,"COMPLETE ACA, PER SQ CM",,,120.93,2381.71,10
HCPCS,Q4303,"COMPLETE AA, PER SQ CM",,,120.93,6308.26,10
HCPCS,Q4304,"GRAFIX PLUS, PER SQ CM",,,120.93,1149.42,10
HCPCS,Q4305,Amer am ac tri-lay per sq cm,,,120.93,241.86,8
HCPCS,Q4306,Americ amnion ac per sq cm,,,120.93,241.86,8
HCPCS,Q4307,"American amnion, per sq cm",,,120.93,241.86,8
HCPCS,Q4308,"Sanopellis, per sq cm",,,120.93,241.86,8
HCPCS,Q4309,"Via matrix, per sq cm",,,120.93,2450.91,10
HCPCS,Q4310,"Procenta, per 100 mg",,,1607.18,2467.42,2
HCPCS,Q4311,"Acesso, per square centimeter",,,120.93,3980.13,10
HCPCS,Q4312,"Acesso AC, per square centimeter",,,120.93,4139.33,10
HCPCS,Q4313,"DermaBind FM, per square centimeter",,,120.93,6594.25,10
HCPCS,Q4314,"Reeva FT, per square cenitmeter",,,120.93,3502.51,10
HCPCS,Q4315,"RegeneLink amniotic membrane allograft, per square centimeter",,,120.93,241.86,8
HCPCS,Q4316,"AmchoPlast, per square centimeter",,,120.93,8271.11,10
HCPCS,Q4317,"VitoGraft, per square centimeter",,,120.93,6581.91,9
HCPCS,Q4318,"E-Graft, per square centimeter",,,120.93,2437.97,9
HCPCS,Q4319,"SanoGraft, per square centimeter",,,120.93,3980.13,10
HCPCS,Q4320,"PelloGraft, per square centimeter",,,120.93,1432.85,10
HCPCS,Q4321,"RenoGraft, per square centimeter",,,120.93,5731.38,10
HCPCS,Q4322,"CaregraFT, per square centimeter",,,120.93,3355.09,10
HCPCS,Q4323,"alloPLY, per square centimeter",,,120.93,2949.11,10
HCPCS,Q4324,"AmnioTX, per square centimeter",,,120.93,3152.26,10
HCPCS,Q4325,"ACAPatch, per square centimeter",,,120.93,3831.9,10
HCPCS,Q4326,"WoundPlus, per square centimeter",,,120.93,2028.37,10
HCPCS,Q4327,"DuoAmnion, per square centimeter",,,120.93,241.86,8
HCPCS,Q4328,"MOST, per square centimeter",,,120.93,6880.11,10
HCPCS,Q4329,"Singlay, per square centimeter",,,120.93,241.86,8
HCPCS,Q4330,"TOTAL, per square centimeter",,,120.93,241.86,8
HCPCS,Q4331,"Axolotl Graft, per square centimeter",,,120.93,3067.13,10
HCPCS,Q4332,"Axolotl DualGraft, per square centimeter",,,120.93,3153.14,10
HCPCS,Q4333,"ArdeoGraft, per square centimeter",,,120.93,1432.85,10
HCPCS,Q4334,"Amnioplast 1, per square centimeter",,,120.93,241.86,8
HCPCS,Q4335,"Amnioplast 2, per square centimeter",,,120.93,241.86,8
HCPCS,Q4336,"Artacent C, per square centimeter",,,120.93,241.86,8
HCPCS,Q4337,"Artacent Trident, per square centimeter",,,120.93,241.86,8
HCPCS,Q4338,"Artacent Velos, per square centimeter",,,120.93,241.86,8
HCPCS,Q4339,"Artacent VeriClen, per square centimeter",,,120.93,3849.65,10
HCPCS,Q4340,"SimpliGraft, per square centimeter",,,120.93,4107.49,10
HCPCS,Q4341,"SimpliMax, per square centimeter",,,120.93,5752.51,10
HCPCS,Q4342,"TheraMend, per square centimeter",,,120.93,3984.08,10
HCPCS,Q4343,"Dermacyte AC matrix amniotic membrane allograft, per square centimeter",,,120.93,5529.28,10
HCPCS,Q4344,"Tri-Membrane Wrap, per square centimeter",,,120.93,5037.4,10
HCPCS,Q4345,"Matrix HD Allograft Dermis, per square centimeter",,,120.93,4776.15,10
HCPCS,Q4346,"Shelter DM matrix, per square centimeter",,,120.93,6686.61,10
HCPCS,Q4347,"Rampart DL matrix, per square centimeter",,,120.93,4696.55,10
HCPCS,Q4348,"Sentry SL matrix, per square centimeter",,,120.93,3725.4,10
HCPCS,Q4349,"Mantle DL matrix, per square centimeter",,,120.93,6686.61,10
HCPCS,Q4350,"Palisade DM matrix, per square centimeter",,,120.93,6686.61,10
HCPCS,Q4351,"Enclose TL matrix, per square centimeter",,,120.93,7164.23,10
HCPCS,Q4352,"Overlay SL matrix, per square centimeter",,,120.93,3725.4,10
HCPCS,Q4353,"Xceed TL matrix, per square centimeter",,,120.93,7259.75,10
HCPCS,Q4354,"PalinGen Dual-Layer Membrane, per square centimeter",,,120.93,1948.67,10
HCPCS,Q4355,"Abiomend XPlus Membrane and Abiomend XPlus Hydromembrane, per square centimeter",,,120.93,5731.38,10
HCPCS,Q4356,"Abiomend Membrane and Abiomend Hydromembrane, per square centimeter",,,120.93,4776.15,10
HCPCS,Q4357,"XWRAP Plus, per square  centimeter",,,120.93,8934.21,10
HCPCS,Q4358,"XWRAP Dual, per square  centimeter",,,120.93,10889.62,10
HCPCS,Q4359,"ChoriPly, per square centimeter",,,120.93,5009.23,10
HCPCS,Q4360,"Amchoplast FD, per square centimeter",,,120.93,3488.0,9
HCPCS,Q4361,"Epixpress, per square centimeter",,,120.93,2978.07,10
HCPCS,Q4362,"Cygnus Disk, per square centimeter",,,120.93,803.63,9
HCPCS,Q4363,"Amnio Burgeon Membrane and Hydromembrane, per square centimeter",,,120.93,241.86,8
HCPCS,Q4364,"Amnio Burgeon XPlus membrane and XPlus hydromembrane, per square centimeter",,,120.93,5899.5,10
HCPCS,Q4365,"Amnio Burgeon Dual-Layer Membrane, per square centimeter",,,120.93,241.86,8
HCPCS,Q4366,"Dual layer Amnio Burgeon X-Membrane, per square centimeter",,,120.93,241.86,8
HCPCS,Q4367,"AmnioCore SL, per square centimeter",,,120.93,992.69,10
HCPCS,Q4368,"AmchoThick, per square centimeter",,,120.93,5696.29,9
HCPCS,Q4369,"AmnioPlast 3, per square centimeter",,,120.93,241.86,8
HCPCS,Q4370,"AeroGuard, per square centimeter",,,120.93,241.86,8
HCPCS,Q4371,"NeoGuard, per square centimeter",,,120.93,241.86,8
HCPCS,Q4372,"AmchoPlast Excel, per square centimeter",,,120.93,241.86,8
HCPCS,Q4373,"Membrane Wrap Lite, per square centimeter",,,120.93,6862.37,10
HCPCS,Q4375,"duoGRAFT AC, per square centimeter",,,120.93,241.86,8
HCPCS,Q4376,"duoGRAFT AA, per square centimeter",,,120.93,241.86,8
HCPCS,Q4377,"triGRAFT FT, per square centimeter",,,120.93,241.86,8
HCPCS,Q4378,"Renew FT Matrix, per square centimeter",,,120.93,7355.27,10
HCPCS,Q4379,"AmnioDefend FT Matrix, per square centimeter",,,120.93,5444.81,10
HCPCS,Q4380,"AdvoGraft One, per square centimeter",,,120.93,241.86,8
HCPCS,Q4382,"AdvoGraft Dual, per square centimeter",,,120.93,241.86,8
HCPCS,Q4392,GRAFIX DUO PER SQ CM,177.0,88.5,30.83,241.86,54
HCPCS,Q5001,HOSPICE OR HOME HLTH IN HOME,,,,,0
HCPCS,Q5002,HOSPICE/HOME HLTH IN ASST LV,,,,,0
HCPCS,Q5003,HOSPICE IN LT/NON-SKILLED NF,,,,,0
HCPCS,Q5004,HOSPICE IN SNF,,,,,0
HCPCS,Q5005,"HOSPICE, INPATIENT HOSPITAL",,,,,0
HCPCS,Q5006,HOSPICE IN HOSPICE FACILITY,,,,,0
HCPCS,Q5007,HOSPICE IN LTCH,,,,,0
HCPCS,Q5008,HOSPICE IN INPATIENT PSYCH,,,,,0
HCPCS,Q5009,"HOSPICE/HOME HLTH, PLACE NOS",,,,,0
HCPCS,Q5010,HOSPICE HOME CARE IN HOSPICE,,,,,0
HCPCS,Q5098,"Injection, ustekinumab-srlf (Imuldosa), biosimilar, 1 mg",,,21.82,77.14,2
HCPCS,Q5099,"Injection, ustekinumab-stba (Steqeyma), biosimilar, 1 mg",,,2.94,4.46,5
HCPCS,Q5100,"Injection, ustekinumab-kfce (Yesintek), biosimilar, 1 mg",,,3.87,47.52,13
HCPCS,Q5101,"INJECTION, ZARXIO",,,0.44,0.88,13
HCPCS,Q5103,"INJECTION, INFLECTRA",,,19.01,38.02,13
HCPCS,Q5104,"INJECTION, RENFLEXIS",,,25.68,52.74,13
HCPCS,Q5105,INJ RETACRIT ESRD ON DIALYSI,,,0.93,1.42,5
HCPCS,Q5106,INJ RETACRIT NON-ESRD USE,,,7.47,14.94,13
HCPCS,Q5107,INJ MVASI 10 MG,,,26.5,54.04,13
HCPCS,Q5108,"INJECTION, FULPHILA",,,94.29,219.92,13
HCPCS,Q5109,"INJECTION, IXIFI, 10 MG",,,,,0
HCPCS,Q5110,NIVESTYM,,,0.29,0.58,13
HCPCS,Q5111,"INJECTION, UDENYCA 0.5 MG",,,101.14,318.71,13
HCPCS,Q5112,INJ ONTRUZANT 10 MG,,,18.07,47.56,13
HCPCS,Q5113,INJ HERZUMA 10 MG,,,65.98,145.14,13
HCPCS,Q5114,INJ OGIVRI 10 MG,,,38.32,84.87,13
HCPCS,Q5115,INJ TRUXIMA 10 MG,,,27.95,59.86,13
HCPCS,Q5116,"INJ., TRAZIMERA, 10 MG",,,26.62,53.61,13
HCPCS,Q5117,"INJ., KANJINTI, 10 MG",,,45.23,90.46,13
HCPCS,Q5118,"INJ., ZIRABEV, 10 MG",,,24.51,49.02,13
HCPCS,Q5119,"INJ RUXIENCE, 10 MG",,,26.49,52.98,13
HCPCS,Q5120,INJ PEGFILGRASTIM-BMEZ 0.5MG,,,28.84,57.68,13
HCPCS,Q5121,"INJ. AVSOLA, 10 MG",,,19.41,39.13,13
HCPCS,Q5122,"INJ, NYVEPRIA",,,124.75,261.53,13
HCPCS,Q5123,"INJ. RIABNI, 10 MG",,,25.22,56.04,10
HCPCS,Q5124,"INJ. BYOOVIZ, 0.1 MG",,,58.78,162.62,13
HCPCS,Q5125,"INJ, RELEUKO 1 MCG",,,0.36,0.77,13
HCPCS,Q5126,INJ ALYMSYS 10 MG,,,35.97,83.78,13
HCPCS,Q5127,"INJ, STIMUFEND, 0.5 MG",,,175.88,489.45,13
HCPCS,Q5128,"INJ, CIMERLI, 0.1 MG",,,81.95,285.9,13
HCPCS,Q5129,"INJ, VEGZELMA, 10 MG",,,38.01,87.95,13
HCPCS,Q5130,"INJ, FYLNETRA, 0.5 MG",,,131.23,319.79,13
HCPCS,Q5133,"Inj, tofidence, 1 mg",,,5.27,10.84,13
HCPCS,Q5134,"Inj, tyruko, 1 mg",,,23.2,46.4,8
HCPCS,Q5135,"Injection, tocilizumab-aazg (Tyenne), biosimilar, 1 mg",,,4.2,8.78,13
HCPCS,Q5136,"Injection, denosumab-bbdz (Jubbonti/Wyost), biosimilar, 1 mg",,,26.19,52.38,13
HCPCS,Q5137,"Injection, ustekinumab-auub (Wezlana), biosimilar, subcutaneous, 1 mg",,,116.94,269.22,5
HCPCS,Q5138,"Injection, ustekinumab-auub (Wezlana), biosimilar, intravenous, 1 mg",,,11.08,22.16,13
HCPCS,Q5140,"Injection, adalimumab-fkjp, biosimilar, 1 mg",,,106.31,106.31,1
HCPCS,Q5141,"Injection, adalimumab-aaty, biosimilar, 1 mg",,,53.16,53.16,1
HCPCS,Q5142,"Injection, adalimumab-ryvk biosimilar, 1 mg",,,12.98,24.78,5
HCPCS,Q5143,"Injection, adalimumab-adbm, biosimilar, 1 mg",,,12.72,12.72,1
HCPCS,Q5144,"Injection, adalimumab-aacf (Idacio), biosimilar, 1 mg",,,10.88,42.93,5
HCPCS,Q5145,"Injection, adalimumab-afzb (Abrilada), biosimilar, 1 mg",,,32.49,32.49,1
HCPCS,Q5146,"Injection, trastuzumab-strf (Hercessi), biosimilar, 10 mg",,,38.07,166.7,13
HCPCS,Q5147,"Injection, aflibercept-ayyh (Pavblu), biosimilar, 1 mg",,,817.39,1634.78,13
HCPCS,Q5148,"Injection, filgrastim-txid (Nypozi), biosimilar, 1 microgram",,,0.52,1.04,13
HCPCS,Q5149,"Injection, aflibercept-abzv (Enzeevu), biosimilar, 1 mg",,,,,0
HCPCS,Q5150,"Injection, aflibercept-mrbb (Ahzantive), biosimilar, 1 mg",,,,,0
HCPCS,Q5151,"Injection, eculizumab-aagh (Epysqli), biosimilar, 2 mg",,,29.82,59.64,13
HCPCS,Q5152,"Injection, eculizumab-aeeb (Bkemv), biosimilar, 2 mg",,,38.34,76.68,13
HCPCS,Q5153,"Injection, aflibercept-yszy (Opuviz), biosimilar, 1 mg",,,,,0
HCPCS,Q9001,CHAPLAIN ASSESSMENT,,,,,0
HCPCS,Q9002,CHAPLAIN COUNSEL INDIVIDU,,,,,0
HCPCS,Q9003,CHAPLAIN COUNSEL GROUP,,,,,0
HCPCS,Q9004,VA WHOLE HEALTH PARTNER SERV,,,,,0
HCPCS,Q9950,INJ SULF HEXA LIPID MICROSPH,,,22.68,34.82,2
HCPCS,Q9951,"LOCM >= 400 MG/ML IODINE,1ML",,,,,0
HCPCS,Q9953,"INJ FE-BASED MR CONTRAST,1ML",,,116.22,116.22,1
HCPCS,Q9954,"ORAL MR CONTRAST, 100 ML",,,,,0
HCPCS,Q9955,"INJ PERFLEXANE LIP MICROS,ML",,,24.82,24.82,1
HCPCS,Q9956,"INJ OCTAFLUOROPROPANE MIC,ML",,,50.26,77.17,2
HCPCS,Q9957,"INJ PERFLUTREN LIP MICROS,ML",,,50.26,77.17,2
HCPCS,Q9958,"HOCM <=149 MG/ML IODINE, 1ML",,,0.09,0.13,2
HCPCS,Q9959,"HOCM 150-199MG/ML IODINE,1ML",,,,,0
HCPCS,Q9960,"HOCM 200-249MG/ML IODINE,1ML",,,0.52,0.52,1
HCPCS,Q9961,"HOCM 250-299MG/ML IODINE,1ML",,,0.35,0.54,2
HCPCS,Q9962,"HOCM 300-349MG/ML IODINE,1ML",,,0.34,0.34,1
HCPCS,Q9963,"HOCM 350-399MG/ML IODINE,1ML",,,0.27,0.41,2
HCPCS,Q9964,"HOCM>= 400MG/ML IODINE, 1ML",,,0.54,0.54,1
HCPCS,Q9965,"LOCM 100-199MG/ML IODINE,1ML",,,2.2,3.37,2
HCPCS,Q9966,"LOCM 200-299MG/ML IODINE,1ML",,,0.55,0.84,2
HCPCS,Q9967,"LOCM 300-399MG/ML IODINE,1ML",,,0.18,0.28,2
HCPCS,Q9968,VISUALIZATION ADJUNCT,,,5.15,16.6,10
HCPCS,Q9969,NON-HEU TC-99M ADD-ON/DOSE,380.0,190.0,12.2,368.6,47
HCPCS,Q9982,FLUTEMETAMOL F18 PER STUDY DOSE UP TO 5 MCI,8268.0,4134.0,1315.21,8716.42,108
HCPCS,Q9983,FLORBETABEN F18 DIAGNOSTIC,,,1507.27,6495.56,10
HCPCS,Q9991,BUPRENORPH XR 100 MG OR LESS,,,1917.94,3835.88,13
HCPCS,Q9992,BUPRENORPHINE XR OVER 100 MG,,,1917.94,3835.88,13
HCPCS,Q9996,"Injection, ustekinumab-ttwe (Pyzchiva), subcutaneous, 1 mg",,,87.14,88.09,4
HCPCS,Q9997,"Injection, ustekinumab-ttwe (Pyzchiva), intravenous, 1 mg",,,8.84,17.68,12
HCPCS,Q9998,"Injection, ustekinumab-aekn (Selarsdi), biosimilar, 1 mg",,,20.35,76.76,13
HCPCS,Q9999,"Injection, ustekinumab-aauz (Otulfi), biosimilar, 1 mg",,,24.51,62.94,13
HCPCS,R0070,TRANSPORT PORTABLE X-RAY,,,,,0
HCPCS,R0075,TRANSPORT PORT X-RAY MULTIPL,,,,,0
HCPCS,R0076,TRANSPORT PORTABLE EKG,,,,,0
HCPCS,S0012,"BUTORPHANOL TARTRATE, NASAL",,,115.85,115.85,1
HCPCS,S0014,"TACRINE HYDROCHLORIDE, 10 MG",,,4.65,4.65,1
HCPCS,S0021,"INJECTION, CEFOPERAZONE SOD",,,28.66,28.66,1
HCPCS,S0023,"INJECTION, CIMETIDINE HYDROC",,,4.57,4.57,1
HCPCS,S0034,"INJECTION, OFLOXACIN, 400 MG",,,42.03,42.03,1
HCPCS,S0040,"INJECTION, TICARCILLIN DISOD",,,25.47,25.47,1
HCPCS,S0078,"INJECTION, FOSPHENYTOIN SODI",,,73.5,73.5,1
HCPCS,S0081,"INJECTION, PIPERACILLIN SODI",,,3.33,3.33,1
HCPCS,S0088,IMATINIB 100 MG,,,5.68,5.68,1
HCPCS,S0090,"SILDENAFIL CITRATE, 25 MG",,,0.51,0.51,1
HCPCS,S0091,GRANISETRON 1MG,,,5.73,5.73,1
HCPCS,S0092,HYDROMORPHONE 250 MG,,,159.37,159.37,1
HCPCS,S0093,MORPHINE 500 MG,,,20.77,20.77,1
HCPCS,S0104,"ZIDOVUDINE, ORAL, 100 MG",,,2.9,2.9,1
HCPCS,S0106,BUPROPION HCL SR 60 TABLETS,,,29.41,29.41,1
HCPCS,S0108,MERCAPTOPURINE 50 MG,,,5.9,5.9,1
HCPCS,S0109,METHADONE ORAL 5MG,,,0.58,0.58,1
HCPCS,S0117,TRETINOIN TOPICAL 5 G,,,7.17,7.17,1
HCPCS,S0119,ONDANSETRON 4 MG,,,0.86,0.86,1
HCPCS,S0122,INJ MENOTROPINS 75 IU,,,482.32,482.32,1
HCPCS,S0126,INJ FOLLITROPIN ALFA 75 IU,,,461.39,461.39,1
HCPCS,S0128,INJ FOLLITROPIN BETA 75 IU,,,415.53,415.53,1
HCPCS,S0132,INJ GANIRELIX ACETAT 250 MCG,,,358.89,358.89,1
HCPCS,S0136,"CLOZAPINE, 25 MG",,,1.24,1.24,1
HCPCS,S0137,"DIDANOSINE, 25 MG",,,1.07,1.07,1
HCPCS,S0138,"FINASTERIDE, 5 MG",,,0.28,0.28,1
HCPCS,S0139,"MINOXIDIL, 10 MG",,,0.88,0.88,1
HCPCS,S0140,"SAQUINAVIR, 200 MG",,,2.32,2.32,1
HCPCS,S0142,COLISTIMETHATE INH SOL MG,,,,,0
HCPCS,S0145,PEG INTERFERON ALFA-2A/180,,,2127.15,2127.15,1
HCPCS,S0148,PEG INTERFERON ALFA-2B/10,,,287.39,287.39,1
HCPCS,S0155,EPOPROSTENOL DILUTANT,,,27.7,27.7,1
HCPCS,S0156,"EXEMESTANE, 25 MG",,,3.18,3.18,1
HCPCS,S0157,"BECAPLERMIN GEL 1%, 0.5 GM",,,86.59,86.59,1
HCPCS,S0160,DEXTROAMPHETAMINE,,,1.33,1.33,1
HCPCS,S0169,CALCITROL,,,0.52,0.52,1
HCPCS,S0170,ANASTROZOLE 1 MG,,,0.92,0.92,1
HCPCS,S0172,CHLORAMBUCIL 2 MG,,,504.64,504.64,1
HCPCS,S0174,DOLASETRON 50 MG,,,56.47,56.47,1
HCPCS,S0175,FLUTAMIDE 125 MG,,,85.09,85.09,1
HCPCS,S0176,HYDROXYUREA 500 MG,,,0.77,0.77,1
HCPCS,S0177,LEVAMISOLE 50 MG,,,5.66,5.66,1
HCPCS,S0178,LOMUSTINE 10 MG,,,232.1,232.1,1
HCPCS,S0179,MEGESTROL 20 MG,,,0.52,0.52,1
HCPCS,S0182,"PROCARBAZINE, ORAL",,,283.74,283.74,1
HCPCS,S0183,PROCHLORPERAZINE 5 MG,,,0.66,0.66,1
HCPCS,S0187,TAMOXIFEN 10 MG,,,0.37,0.37,1
HCPCS,S0190,"MIFEPRISTONE, ORAL, 200 MG",,,68.46,68.46,1
HCPCS,S0191,"MISOPROSTOL, ORAL, 200 MCG",,,1.85,1.85,1
HCPCS,S0194,VITAMIN SUPPL 100 CAPS,,,18.82,18.82,1
HCPCS,S0197,PRENATAL VITAMINS 30 DAY,,,,,0
HCPCS,S0199,MED ABORTION INC ALL EX DRUG,,,,,0
HCPCS,S0201,PARTIAL HOSPITALIZATION SERV,,,,,0
HCPCS,S0207,PARAMEDICINTERCEP NONHOSPALS,,,,,0
HCPCS,S0208,PARAMED INTRCEPT NONVOL,,,,,0
HCPCS,S0209,WC VAN MILEAGE PER MI,,,,,0
HCPCS,S0215,NONEMERG TRANSP MILEAGE,,,,,0
HCPCS,S0220,MEDICAL CONFERENCE BY PHYSIC,,,,,0
HCPCS,S0221,"MEDICAL CONFERENCE, 60 MIN",,,,,0
HCPCS,S0250,COMP GERIATR ASSMT TEAM,,,,,0
HCPCS,S0255,HOSPICE REFER VISIT NONMD,,,,,0
HCPCS,S0257,END OF LIFE COUNSELING,,,,,0
HCPCS,S0260,H&P FOR SURGERY,,,,,0
HCPCS,S0265,GENETIC COUNSEL 15 MINS,,,,,0
HCPCS,S0270,HOME STD CASE RATE 30 DAYS,,,,,0
HCPCS,S0271,HOME HOSPICE CASE 30 DAYS,,,,,0
HCPCS,S0272,HOME EPISODIC CASE 30 DAYS,,,,,0
HCPCS,S0273,MD HOME VISIT OUTSIDE CAP,,,,,0
HCPCS,S0274,NURSE PRACTR VISIT OUTS CAP,,,,,0
HCPCS,S0280,"MEDICAL HOME, INITIAL PLAN",,,,,0
HCPCS,S0281,"MEDICAL HOME, MAINTENANCE",,,,,0
HCPCS,S0285,CNSLT BEFORE SCREEN COLONOSC,,,,,0
HCPCS,S0302,COMPLETED EPSDT,,,,,0
HCPCS,S0310,HOSPITALIST VISIT,,,,,0
HCPCS,S0311,COMP MGMT CARE COORD ADV ILL,,,,,0
HCPCS,S0315,DISEASE MANAGEMENT PROGRAM,,,,,0
HCPCS,S0316,FOLLOW-UP/REASSESSMENT,,,,,0
HCPCS,S0317,DISEASE MGMT PER DIEM,,,,,0
HCPCS,S0320,RN TELEPHONE CALLS TO DMP,,,,,0
HCPCS,S0340,LIFESTYLE MOD 1ST STAGE,,,,,0
HCPCS,S0341,LIFESTYLE MOD 2 OR 3 STAGE,,,,,0
HCPCS,S0342,LIFESTYLE MOD 4TH STAGE,,,,,0
HCPCS,S0353,CANCER TREATMENTPLAN INITIAL,,,,,0
HCPCS,S0354,CANCER TREATMENT PLAN CHANGE,,,,,0
HCPCS,S0390,ROUT FOOT CARE PER VISIT,,,,,0
HCPCS,S0395,IMPRESSION CASTING FT,,,,,0
HCPCS,S0400,GLOBAL ESWL KIDNEY,,,,,0
HCPCS,S0500,DISPOS CONT LENS,,,,,0
HCPCS,S0504,SINGL PRSCRP LENS,,,,,0
HCPCS,S0506,BIFOC PRSCP LENS,,,,,0
HCPCS,S0508,TRIFOC PRSCRP LENS,,,,,0
HCPCS,S0510,NON-PRSCRP LENS,,,,,0
HCPCS,S0512,DAILY CONT LENS,,,,,0
HCPCS,S0514,COLOR CONT LENS,,,,,0
HCPCS,S0515,SCLERAL LENS LIQUID BANDAGE,,,,,0
HCPCS,S0516,SAFETY FRAMES,,,,,0
HCPCS,S0518,SUNGLASS FRAMES,,,,,0
HCPCS,S0580,POLYCARB LENS,,,,,0
HCPCS,S0581,NONSTND LENS,,,,,0
HCPCS,S0590,MISC INTEGRAL LENS SERV,,,,,0
HCPCS,S0592,COMP CONT LENS EVAL,,,,,0
HCPCS,S0595,NEW LENSES IN PTS OLD FRAME,,,,,0
HCPCS,S0596,PHAKIC IOL REFRACTIVE ERROR,,,,,0
HCPCS,S0601,SCREENING PROCTOSCOPY,,,,,0
HCPCS,S0610,ANNUAL GYNECOLOGICAL EXAMINA,,,,,0
HCPCS,S0612,ANNUAL GYNECOLOGICAL EXAMINA,,,,,0
HCPCS,S0613,ANN BREAST EXAM,,,,,0
HCPCS,S0618,AUDIOMETRY FOR HEARING AID,,,,,0
HCPCS,S0620,ROUTINE OPHTHALMOLOGICAL EXA,,,,,0
HCPCS,S0621,ROUTINE OPHTHALMOLOGICAL EXA,,,,,0
HCPCS,S0622,PHYS EXAM FOR COLLEGE,,,,,0
HCPCS,S0630,REMOVAL OF SUTURES,,,,,0
HCPCS,S0800,LASER IN SITU KERATOMILEUSIS,,,,,0
HCPCS,S0810,PHOTOREFRACTIVE KERATECTOMY,,,,,0
HCPCS,S0812,PHOTOTHERAP KERATECT,,,,,0
HCPCS,S1001,DELUXE ITEM,,,,,0
HCPCS,S1002,CUSTOM ITEM,,,,,0
HCPCS,S1015,IV TUBING EXTENSION SET,,,,,0
HCPCS,S1016,NON-PVC INTRAVENOUS ADMINIST,,,,,0
HCPCS,S1030,GLUC MONITOR PURCHASE,,,,,0
HCPCS,S1031,GLUC MONITOR RENTAL,,,,,0
HCPCS,S1034,ART PANCREAS SYSTEM,,,,,0
HCPCS,S1035,ART PANCREAS INV DISP SENSOR,,,,,0
HCPCS,S1036,ART PANCREAS EXT TRANSMITTER,,,,,0
HCPCS,S1037,ART PANCREAS EXT RECEIVER,,,,,0
HCPCS,S1040,CRANIAL REMOLDING ORTHOSIS,,,,,0
HCPCS,S1091,STENT NON-CORONARY PROPEL,,,3295.54,3295.54,1
HCPCS,S2053,TRANSPLANTATION OF SMALL INT,,,,,0
HCPCS,S2054,TRANSPLANTATION OF MULTIVISC,,,,,0
HCPCS,S2055,HARVESTING OF DONOR MULTIVIS,,,,,0
HCPCS,S2060,LOBAR LUNG TRANSPLANTATION,,,,,0
HCPCS,S2061,DONOR LOBECTOMY (LUNG),,,,,0
HCPCS,S2065,SIMULT PANC KIDN TRANS,,,,,0
HCPCS,S2066,BREAST GAP FLAP RECONST,,,,,0
HCPCS,S2067,"BREAST """"STACKED"""" DIEP/GAP",,,,,0
HCPCS,S2068,BREAST DIEP OR SIEA FLAP,,,,,0
HCPCS,S2070,CYSTO LASER TX URETERAL CALC,,,,,0
HCPCS,S2079,LAP ESOPHAGOMYOTOMY,,,,,0
HCPCS,S2080,LAUP,,,,,0
HCPCS,S2083,ADJUSTMENT GASTRIC BAND,,,,,0
HCPCS,S2095,TRANSCATH EMBOLIZ MICROSPHER,,,,,0
HCPCS,S2102,ISLET CELL TISSUE TRANSPLANT,,,,,0
HCPCS,S2103,ADRENAL TISSUE TRANSPLANT,,,,,0
HCPCS,S2107,ADOPTIVE IMMUNOTHERAPY,,,,,0
HCPCS,S2112,KNEE ARTHROSCP HARV,,,,,0
HCPCS,S2115,PERIACETABULAR OSTEOTOMY,,,,,0
HCPCS,S2117,"ARTHROEREISIS, SUBTALAR",,,,,0
HCPCS,S2118,TOTAL HIP RESURFACING,,,,,0
HCPCS,S2120,LOW DENSITY LIPOPROTEIN(LDL),,,,,0
HCPCS,S2140,CORD BLOOD HARVESTING,,,,,0
HCPCS,S2142,CORD BLOOD-DERIVED STEM-CELL,,,,,0
HCPCS,S2150,BMT HARV/TRANSPL 28D PKG,,,,,0
HCPCS,S2152,SOLID ORGAN TRANSPL PKG,,,,,0
HCPCS,S2202,ECHOSCLEROTHERAPY,,,,,0
HCPCS,S2205,MINIMALLY INVASIVE DIRECT CO,,,,,0
HCPCS,S2206,MINIMALLY INVASIVE DIRECT CO,,,,,0
HCPCS,S2207,MINIMALLY INVASIVE DIRECT CO,,,,,0
HCPCS,S2208,MINIMALLY INVASIVE DIRECT CO,,,,,0
HCPCS,S2209,MINIMALLY INVASIVE DIRECT CO,,,,,0
HCPCS,S2225,MYRINGOTOMY LASER-ASSIST,,,,,0
HCPCS,S2230,IMPLANT SEMI-IMP HEAR,,,,,0
HCPCS,S2235,IMPLANT AUDITORY BRAIN IMP,,,,,0
HCPCS,S2260,INDUCED ABORTION 17-24 WEEKS,,,,,0
HCPCS,S2265,INDUCED ABORTION 25-28 WKS,,,,,0
HCPCS,S2266,INDUCED ABORTION 29-31 WKS,,,,,0
HCPCS,S2267,INDUCED ABORTION 32 OR MORE,,,,,0
HCPCS,S2300,"ARTHROSCOPY, SHOULDER, SURGI",,,,,0
HCPCS,S2325,HIP CORE DECOMPRESSION,,,,,0
HCPCS,S2340,CHEMODENERVATION OF ABDUCTOR,,,,,0
HCPCS,S2341,CHEMODENERV ADDUCT VOCAL,,,,,0
HCPCS,S2342,NASAL ENDOSCOP PO DEBRID,,,,,0
HCPCS,S2348,DECOMPRESS DISC RF LUMBAR,,,,,0
HCPCS,S2350,"DISKECTOMY, ANTERIOR, WITH D",,,,,0
HCPCS,S2351,"DISKECTOMY, ANTERIOR, WITH D",,,,,0
HCPCS,S2400,FETAL SURG CONGEN HERNIA,,,,,0
HCPCS,S2401,FETAL SURG URIN TRAC OBSTR,,,,,0
HCPCS,S2402,FETAL SURG CONG CYST MALF,,,,,0
HCPCS,S2403,FETAL SURG PULMON SEQUEST,,,,,0
HCPCS,S2404,FETAL SURG MYELOMENINGO,,,,,0
HCPCS,S2405,FETAL SURG SACROCOC TERATOMA,,,,,0
HCPCS,S2409,FETAL SURG NOC,,,,,0
HCPCS,S2411,FETOSCOP LASER THER TTTS,,,,,0
HCPCS,S2900,SURGICAL TEC REQ ROBOT SYSTEM,204.0,102.0,35.53,197.88,47
HCPCS,S3000,BILAT DIL RETINAL EXAM,,,,,0
HCPCS,S3005,EVAL SELF-ASSESS DEPRESSION,,,,,0
HCPCS,S3600,STAT LAB,,,,,0
HCPCS,S3601,STAT LAB HOME/NF,,,,,0
HCPCS,S3620,NEWBORN METABOLIC SCREENING,,,,,0
HCPCS,S3630,EOSINOPHIL BLOOD COUNT,,,,,0
HCPCS,S3645,HIV-1 ANTIBODY TESTING OF OR,,,,,0
HCPCS,S3650,"SALIVA TEST, HORMONE LEVEL;",,,,,0
HCPCS,S3652,"SALIVA TEST, HORMONE LEVEL;",,,,,0
HCPCS,S3655,ANTISPERM ANTIBODIES TEST,,,,,0
HCPCS,S3708,GASTROINTESTINAL FAT ABSORPT,,,,,0
HCPCS,S3722,DOSE OPTIMIZATION AUC - 5FU,,,,,0
HCPCS,S3800,GENETIC TESTING ALS,,,,,0
HCPCS,S3840,DNA ANALYSIS RET-ONCOGENE,,,,,0
HCPCS,S3841,GENE TEST RETINOBLASTOMA,,,,,0
HCPCS,S3842,GENE TEST HIPPEL-LINDAU,,,,,0
HCPCS,S3844,DNA ANALYSIS DEAFNESS,,,,,0
HCPCS,S3845,GENE TEST ALPHA-THALASSEMIA,,,,,0
HCPCS,S3846,GENE TEST BETA-THALASSEMIA,,,,,0
HCPCS,S3849,GENE TEST NIEMANN-PICK,,,,,0
HCPCS,S3850,GENE TEST SICKLE CELL,,,,,0
HCPCS,S3852,DNA ANALYSIS APOE ALZHEIMER,,,,,0
HCPCS,S3853,GENE TEST MYO MUSCLR DYST,,,,,0
HCPCS,S3854,GENE PROFILE PANEL BREAST,,,,,0
HCPCS,S3861,GENETIC TEST BRUGADA,,,,,0
HCPCS,S3865,COMP GENET TEST HYP CARDIOMY,,,,,0
HCPCS,S3866,SPEC GENE TEST HYP CARDIOMY,,,,,0
HCPCS,S3870,CGH TEST DEVELOPMENTAL DELAY,,,,,0
HCPCS,S3900,SURFACE EMG,,,,,0
HCPCS,S3902,BALLISTOCARDIOGRAM,,,,,0
HCPCS,S3904,MASTERS TWO STEP,,,,,0
HCPCS,S4005,INTERIM LABOR FACILITY GLOBA,,,,,0
HCPCS,S4011,IVF PACKAGE,,,,,0
HCPCS,S4013,COMPL GIFT CASE RATE,,,,,0
HCPCS,S4014,COMPL ZIFT CASE RATE,,,,,0
HCPCS,S4015,COMPLETE IVF NOS CASE RATE,,,,,0
HCPCS,S4016,FROZEN IVF CASE RATE,,,,,0
HCPCS,S4017,IVF CANC A STIM CASE RATE,,,,,0
HCPCS,S4018,F EMB TRNS CANC CASE RATE,,,,,0
HCPCS,S4020,IVF CANC A ASPIR CASE RATE,,,,,0
HCPCS,S4021,IVF CANC P ASPIR CASE RATE,,,,,0
HCPCS,S4022,ASST OOCYTE FERT CASE RATE,,,,,0
HCPCS,S4023,INCOMPL DONOR EGG CASE RATE,,,,,0
HCPCS,S4024,"Air polymer-type A intrauterine foam, per study dose",,,1776.73,1776.73,1
HCPCS,S4025,DONOR SERV IVF CASE RATE,,,,,0
HCPCS,S4026,PROCURE DONOR SPERM,,,,,0
HCPCS,S4027,STORE PREV FROZ EMBRYOS,,,,,0
HCPCS,S4028,MICROSURG EPI SPERM ASP,,,,,0
HCPCS,S4030,SPERM PROCURE INIT VISIT,,,,,0
HCPCS,S4031,SPERM PROCURE SUBS VISIT,,,,,0
HCPCS,S4035,STIMULATED IUI CASE RATE,,,,,0
HCPCS,S4037,CRYO EMBRYO TRANSF CASE RATE,,,,,0
HCPCS,S4040,MONIT STORE CRYO EMBRYO 30 D,,,,,0
HCPCS,S4042,OVULATION MGMT PER CYCLE,,,,,0
HCPCS,S4981,INSERT LEVONORGESTREL IUS,,,,,0
HCPCS,S4989,CONTRACEPT IUD,,,,,0
HCPCS,S4990,NICOTINE PATCH LEGEND,,,,,0
HCPCS,S4991,NICOTINE PATCH NONLEGEND,,,,,0
HCPCS,S4993,CONTRACEPTIVE PILLS FOR BC,,,,,0
HCPCS,S4995,SMOKING CESSATION GUM,,,,,0
HCPCS,S5000,"PRESCRIPTION DRUG, GENERIC",,,,,0
HCPCS,S5001,"PRESCRIPTION DRUG,BRAND NAME",,,,,0
HCPCS,S5010,5% DEXTROSE AND 0.45% SALINE,,,15.02,15.02,1
HCPCS,S5012,5% DEXTROSE WITH POTASSIUM,,,9.08,9.08,1
HCPCS,S5013,5%DEXTROSE/0.45%SALINE1000ML,,,,,0
HCPCS,S5014,D5W/0.45NS W KCL AND MGS04,,,,,0
HCPCS,S5035,HIT ROUTINE DEVICE MAINT,,,,,0
HCPCS,S5036,HIT DEVICE REPAIR,,,,,0
HCPCS,S5100,ADULT DAYCARE SERVICES 15MIN,,,,,0
HCPCS,S5101,ADULT DAY CARE PER HALF DAY,,,,,0
HCPCS,S5102,ADULT DAY CARE PER DIEM,,,,,0
HCPCS,S5105,CENTERBASED DAY CARE PERDIEM,,,,,0
HCPCS,S5108,HOMECARE TRAIN PT 15 MIN,,,,,0
HCPCS,S5109,HOMECARE TRAIN PT SESSION,,,,,0
HCPCS,S5110,FAMILY HOMECARE TRAINING 15M,,,,,0
HCPCS,S5111,FAMILY HOMECARE TRAIN/SESSIO,,,,,0
HCPCS,S5115,NONFAMILY HOMECARE TRAIN/15M,,,,,0
HCPCS,S5116,NONFAMILY HC TRAIN/SESSION,,,,,0
HCPCS,S5120,CHORE SERVICES PER 15 MIN,,,,,0
HCPCS,S5121,CHORE SERVICES PER DIEM,,,,,0
HCPCS,S5125,ATTENDANT CARE SERVICE /15M,,,,,0
HCPCS,S5126,ATTENDANT CARE SERVICE /DIEM,,,,,0
HCPCS,S5130,HOMAKER SERVICE NOS PER 15M,,,,,0
HCPCS,S5131,HOMEMAKER SERVICE NOS /DIEM,,,,,0
HCPCS,S5135,ADULT COMPANIONCARE PER 15M,,,,,0
HCPCS,S5136,ADULT COMPANIONCARE PER DIEM,,,,,0
HCPCS,S5140,ADULT FOSTER CARE PER DIEM,,,,,0
HCPCS,S5141,ADULT FOSTER CARE PER MONTH,,,,,0
HCPCS,S5145,CHILD FOSTERCARE TH PER DIEM,,,,,0
HCPCS,S5146,THER FOSTERCARE CHILD /MONTH,,,,,0
HCPCS,S5150,UNSKILLED RESPITE CARE /15M,,,,,0
HCPCS,S5151,UNSKILLED RESPITECARE /DIEM,,,,,0
HCPCS,S5160,EMER RESPONSE SYS INSTAL&TST,,,,,0
HCPCS,S5161,EMER RSPNS SYS SERV PERMONTH,,,,,0
HCPCS,S5162,EMER RSPNS SYSTEM PURCHASE,,,,,0
HCPCS,S5165,HOME MODIFICATIONS PER SERV,,,,,0
HCPCS,S5170,HOMEDELIVERED PREPARED MEAL,,,,,0
HCPCS,S5175,"LAUNDRY SERV,EXT,PROF,/ORDER",,,,,0
HCPCS,S5180,HH RESPIRATORY THRPY IN EVAL,,,,,0
HCPCS,S5181,HH RESPIRATORY THRPY NOS/DAY,,,,,0
HCPCS,S5185,MED REMINDER SERV PER MONTH,,,,,0
HCPCS,S5190,WELLNESS ASSESSMENT BY NONPH,,,,,0
HCPCS,S5199,PERSONAL CARE ITEM NOS EACH,,,,,0
HCPCS,S5497,HIT CATH CARE NOC,,,,,0
HCPCS,S5498,HIT SIMPLE CATH CARE,,,,,0
HCPCS,S5501,HIT COMPLEX CATH CARE,,,,,0
HCPCS,S5502,HIT INTERIM CATH CARE,,,,,0
HCPCS,S5517,HIT DECLOTTING KIT,,,,,0
HCPCS,S5518,HIT CATH REPAIR KIT,,,,,0
HCPCS,S5520,HIT PICC INSERT KIT,,,,,0
HCPCS,S5521,HIT MIDLINE CATH INSERT KIT,,,,,0
HCPCS,S5522,HIT PICC INSERT NO SUPP,,,,,0
HCPCS,S5523,HIP MIDLINE CATH INSERT KIT,,,,,0
HCPCS,S5550,INSULIN RAPID 5 U,,,0.45,0.45,1
HCPCS,S5551,INSULIN MOST RAPID 5 U,,,0.69,0.69,1
HCPCS,S5552,INSULIN INTERMED 5 U,,,0.45,0.45,1
HCPCS,S5553,INSULIN LONG ACTING 5 U,,,1.85,1.85,1
HCPCS,S5560,INSULIN REUSE PEN 1.5 ML,,,,,0
HCPCS,S5561,INSULIN REUSE PEN 3 ML,,,81.83,81.83,1
HCPCS,S5565,INSULIN CARTRIDGE 150 U,,,,,0
HCPCS,S5566,INSULIN CARTRIDGE 300 U,,,51.34,51.34,1
HCPCS,S5570,INSULIN DISPOS PEN 1.5 ML,,,191.05,191.05,1
HCPCS,S5571,INSULIN DISPOS PEN 3 ML,,,60.78,60.78,1
HCPCS,S8030,TANTALUM RING APPLICATION,,,,,0
HCPCS,S8035,MAGNETIC SOURCE IMAGING,,,,,0
HCPCS,S8037,MRCP,,,508.77,590.83,16
HCPCS,S8040,TOPOGRAPHIC BRAIN MAPPING,,,,,0
HCPCS,S8042,MRI LOW FIELD,,,,,0
HCPCS,S8055,US GUIDANCE FETAL REDUCT,,,,,0
HCPCS,S8080,SCINTIMAMMOGRAPHY,,,,,0
HCPCS,S8085,FLUORINE-18 FLUORODEOXYGLUCO,,,,,0
HCPCS,S8092,ELECTRON BEAM COMPUTED TOMOG,,,,,0
HCPCS,S8096,PORTABLE PEAK FLOW METER,,,,,0
HCPCS,S8097,ASTHMA KIT,,,,,0
HCPCS,S8100,SPACER WITHOUT MASK,,,,,0
HCPCS,S8101,SPACER WITH MASK,,,,,0
HCPCS,S8110,PEAK EXPIRATORY FLOW RATE (P,,,,,0
HCPCS,S8120,O2 CONTENTS GAS CUBIC FT,,,,,0
HCPCS,S8121,O2 CONTENTS LIQUID LB,,,,,0
HCPCS,S8130,INTERFERENTIAL STIM 2 CHAN,,,,,0
HCPCS,S8131,INTERFERENTIAL STIM 4 CHAN,,,,,0
HCPCS,S8185,FLUTTER DEVICE,,,,,0
HCPCS,S8186,SWIVEL ADAPTOR,,,,,0
HCPCS,S8189,TRACH SUPPLY NOC,,,,,0
HCPCS,S8210,MUCUS TRAP,,,,,0
HCPCS,S8265,HABERMAN FEEDER,,,,,0
HCPCS,S8270,ENURESIS ALARM,,,,,0
HCPCS,S8301,INFECT CONTROL SUPPLIES NOS,,,,,0
HCPCS,S8415,SUPPLIES FOR HOME DELIVERY,,,,,0
HCPCS,S8420,CUSTOM GRADIENT SLEEV/GLOV,,,,,0
HCPCS,S8421,READY GRADIENT SLEEV/GLOV,,,,,0
HCPCS,S8422,CUSTOM GRAD SLEEVE MED,,,,,0
HCPCS,S8423,CUSTOM GRAD SLEEVE HEAVY,,,,,0
HCPCS,S8424,READY GRADIENT SLEEVE,,,,,0
HCPCS,S8425,CUSTOM GRAD GLOVE MED,,,,,0
HCPCS,S8426,CUSTOM GRAD GLOVE HEAVY,,,,,0
HCPCS,S8427,READY GRADIENT GLOVE,,,,,0
HCPCS,S8428,READY GRADIENT GAUNTLET,,,,,0
HCPCS,S8429,GRADIENT PRESSURE WRAP,,,,,0
HCPCS,S8430,PADDING FOR COMPRSSN BDG,,,,,0
HCPCS,S8431,COMPRESSION BANDAGE,,,,,0
HCPCS,S8450,SPLINT DIGIT,,,,,0
HCPCS,S8451,SPLINT WRIST OR ANKLE,,,,,0
HCPCS,S8452,SPLINT ELBOW,,,,,0
HCPCS,S8460,CAMISOLE POST-MAST,,,,,0
HCPCS,S8490,100 INSULIN SYRINGES,,,,,0
HCPCS,S8930,AURICULAR ELECTROSTIMULATION,,,,,0
HCPCS,S8940,HIPPOTHERAPY PER SESSION,,,,,0
HCPCS,S8948,LOW-LEVEL LASER TRMT 15 MIN,,,,,0
HCPCS,S8950,"COMPLEX LYMPHEDEMA THERAPY,",,,,,0
HCPCS,S8990,PT OR MANIP FOR MAINT,,,,,0
HCPCS,S8999,RESUSCITATION BAG,,,,,0
HCPCS,S9001,HOME UTERINE MONITOR WITH OR,,,,,0
HCPCS,S9002,Intra-vag motion sens biofk,,,,,0
HCPCS,S9007,ULTRAFILTRATION MONITOR,,,,,0
HCPCS,S9024,PARANASAL SINUS ULTRASOUND,,,,,0
HCPCS,S9025,OMNICARDIOGRAM/CARDIOINTEGRA,,,,,0
HCPCS,S9034,ESWL FOR GALLSTONES,,,,,0
HCPCS,S9055,PROCUREN OR OTHER GROWTH FAC,,,,,0
HCPCS,S9056,COMA STIMULATION PER DIEM,,,,,0
HCPCS,S9061,MEDICAL SUPPLIES AND EQUIPME,,,,,0
HCPCS,S9083,URGENT CARE CENTER GLOBAL,,,,,0
HCPCS,S9088,SERVICES PROVIDED IN URGENT,,,,,0
HCPCS,S9090,VERTEBRAL AXIAL DECOMPRESSIO,,,,,0
HCPCS,S9097,HOME VISIT WOUND CARE,,,,,0
HCPCS,S9098,HOME PHOTOTHERAPY VISIT,,,,,0
HCPCS,S9110,TELEMONITORING/HOME PER MNTH,,,,,0
HCPCS,S9117,BACK SCHOOL VISIT,,,,,0
HCPCS,S9122,HOME HEALTH AIDE OR CERTIFIE,,,,,0
HCPCS,S9123,NURSING CARE IN HOME RN,,,,,0
HCPCS,S9124,"NURSING CARE, IN THE HOME; B",,,,,0
HCPCS,S9125,"RESPITE CARE, IN THE HOME, P",,,,,0
HCPCS,S9126,"HOSPICE CARE, IN THE HOME, P",,,,,0
HCPCS,S9127,"SOCIAL WORK VISIT, IN THE HO",,,,,0
HCPCS,S9128,"SPEECH THERAPY, IN THE HOME,",,,,,0
HCPCS,S9129,"OCCUPATIONAL THERAPY, IN THE",,,,,0
HCPCS,S9131,PT IN THE HOME PER DIEM,,,,,0
HCPCS,S9140,"DIABETIC MANAGEMENT PROGRAM,",,,,,0
HCPCS,S9141,"DIABETIC MANAGEMENT PROGRAM,",,,,,0
HCPCS,S9145,INSULIN PUMP INITIATION,,,,,0
HCPCS,S9150,EVALUATION BY OCULARIST,,,,,0
HCPCS,S9152,"SPEECH THERAPY, RE-EVAL",,,,,0
HCPCS,S9208,HOME MGMT PRETERM LABOR,,,,,0
HCPCS,S9209,HOME MGMT PPROM,,,,,0
HCPCS,S9211,HOME MGMT GEST HYPERTENSION,,,,,0
HCPCS,S9212,HM POSTPAR HYPER PER DIEM,,,,,0
HCPCS,S9213,HM PREECLAMP PER DIEM,,,,,0
HCPCS,S9214,HM GEST DM PER DIEM,,,,,0
HCPCS,S9325,HIT PAIN MGMT PER DIEM,,,,,0
HCPCS,S9326,HIT CONT PAIN PER DIEM,,,,,0
HCPCS,S9327,HIT INT PAIN PER DIEM,,,,,0
HCPCS,S9328,HIT PAIN IMP PUMP DIEM,,,,,0
HCPCS,S9329,HIT CHEMO PER DIEM,,,,,0
HCPCS,S9330,HIT CONT CHEM DIEM,,,,,0
HCPCS,S9331,HIT INTERMIT CHEMO DIEM,,,,,0
HCPCS,S9335,HT HEMODIALYSIS DIEM,,,,,0
HCPCS,S9336,HIT CONT ANTICOAG DIEM,,,,,0
HCPCS,S9338,HIT IMMUNOTHERAPY DIEM,,,,,0
HCPCS,S9339,HIT PERITON DIALYSIS DIEM,,,,,0
HCPCS,S9340,HIT ENTERAL PER DIEM,,,,,0
HCPCS,S9341,HIT ENTERAL GRAV DIEM,,,,,0
HCPCS,S9342,HIT ENTERAL PUMP DIEM,,,,,0
HCPCS,S9343,HIT ENTERAL BOLUS NURS,,,,,0
HCPCS,S9345,HIT ANTI-HEMOPHIL DIEM,,,,,0
HCPCS,S9346,HIT ALPHA-1-PROTEINAS DIEM,,,,,0
HCPCS,S9347,HIT LONGTERM INFUSION DIEM,,,,,0
HCPCS,S9348,HIT SYMPATHOMIM DIEM,,,,,0
HCPCS,S9349,HIT TOCOLYSIS DIEM,,,,,0
HCPCS,S9351,HIT CONT ANTIEMETIC DIEM,,,,,0
HCPCS,S9353,HIT CONT INSULIN DIEM,,,,,0
HCPCS,S9355,HIT CHELATION DIEM,,,,,0
HCPCS,S9357,HIT ENZYME REPLACE DIEM,,,,,0
HCPCS,S9359,HIT ANTI-TNF PER DIEM,,,,,0
HCPCS,S9361,HIT DIURETIC INFUS DIEM,,,,,0
HCPCS,S9363,HIT ANTI-SPASMOTIC DIEM,,,,,0
HCPCS,S9364,HIT TPN TOTAL DIEM,,,,,0
HCPCS,S9365,HIT TPN 1 LITER DIEM,,,,,0
HCPCS,S9366,HIT TPN 2 LITER DIEM,,,,,0
HCPCS,S9367,HIT TPN 3 LITER DIEM,,,,,0
HCPCS,S9368,HIT TPN OVER 3L DIEM,,,,,0
HCPCS,S9370,HT INJ ANTIEMETIC DIEM,,,,,0
HCPCS,S9372,HT INJ ANTICOAG DIEM,,,,,0
HCPCS,S9373,HIT HYDRA TOTAL DIEM,,,,,0
HCPCS,S9374,HIT HYDRA 1 LITER DIEM,,,,,0
HCPCS,S9375,HIT HYDRA 2 LITER DIEM,,,,,0
HCPCS,S9376,HIT HYDRA 3 LITER DIEM,,,,,0
HCPCS,S9377,HIT HYDRA OVER 3L DIEM,,,,,0
HCPCS,S9379,HIT NOC PER DIEM,,,,,0
HCPCS,S9381,HIT HIGH RISK/ESCORT,,,,,0
HCPCS,S9401,ANTICOAG CLINIC PER SESSION,,,,,0
HCPCS,S9430,PHARMACY COMP/DISP SERV,,,,,0
HCPCS,S9432,MED FOOD NON INBORN ERR META,,,,,0
HCPCS,S9433,MEDICAL FOOD ORAL 100% NUTR,,,,,0
HCPCS,S9434,MOD SOLID FOOD SUPPL,,,,,0
HCPCS,S9435,MEDICAL FOODS FOR INBORN ERR,,,,,0
HCPCS,S9436,LAMAZE CLASS,,,,,0
HCPCS,S9437,CHILDBIRTH REFRESHER CLASS,,,,,0
HCPCS,S9438,CESAREAN BIRTH CLASS,,,,,0
HCPCS,S9439,VBAC CLASS,,,,,0
HCPCS,S9441,ASTHMA EDUCATION,,,,,0
HCPCS,S9442,BIRTHING CLASS,,,,,0
HCPCS,S9443,OP CONSULT EACH ADDL 15 MIN,58.0,29.0,10.1,56.26,47
HCPCS,S9443,OP LACTATION CONSULT 105 MIN,398.0,199.0,69.33,386.06,47
HCPCS,S9443,OP LACTATION CONSULT 120 MIN,454.0,227.0,79.08,440.38,47
HCPCS,S9443,OP LACTATION CONSULT 15 MIN,58.0,29.0,10.1,56.26,47
HCPCS,S9443,OP LACTATION CONSULT 30 MIN,113.0,56.5,19.68,109.61,47
HCPCS,S9443,OP LACTATION CONSULT 45 MIN,172.0,86.0,29.96,166.84,47
HCPCS,S9443,OP LACTATION CONSULT 60 MIN,227.0,113.5,39.54,220.19,47
HCPCS,S9443,OP LACTATION CONSULT 75 MIN,285.0,142.5,49.64,276.45,47
HCPCS,S9443,OP LACTATION CONSULT 90 MIN,341.0,170.5,59.4,330.77,47
HCPCS,S9444,PARENTING CLASS,,,,,0
HCPCS,S9445,PT EDUCATION NOC INDIVID,,,,,0
HCPCS,S9446,PT EDUCATION NOC GROUP,,,,,0
HCPCS,S9447,INFANT SAFETY CLASS,,,,,0
HCPCS,S9449,WEIGHT MGMT CLASS,,,,,0
HCPCS,S9451,EXERCISE CLASS,,,,,0
HCPCS,S9452,NUTRITION CLASS,,,,,0
HCPCS,S9453,SMOKING CESSATION CLASS,,,,,0
HCPCS,S9454,STRESS MGMT CLASS,,,,,0
HCPCS,S9455,"DIABETIC MANAGEMENT PROGRAM,",,,,,0
HCPCS,S9460,"DIABETIC MANAGEMENT PROGRAM,",,,,,0
HCPCS,S9465,"DIABETIC MANAGEMENT PROGRAM,",,,,,0
HCPCS,S9470,"NUTRITIONAL COUNSELING, DIET",,,,,0
HCPCS,S9472,CARDIAC REHABILITATION PROGR,,,,,0
HCPCS,S9473,PULMONARY REHABILITATION PRO,,,,,0
HCPCS,S9474,ENTEROSTOMAL THERAPY BY A RE,,,,,0
HCPCS,S9475,AMBULATORY SETTING SUBSTANCE,,,,,0
HCPCS,S9476,VESTIBULAR REHAB PER DIEM,,,,,0
HCPCS,S9480,INTENSIVE OUTPATIENT PSYCHIA,,,,,0
HCPCS,S9482,FAMILY STABILIZATION 15 MIN,,,,,0
HCPCS,S9484,CRISIS INTERVENTION PER HOUR,,,,,0
HCPCS,S9485,CRISIS INTERVENTION MENTAL H,,,,,0
HCPCS,S9490,HIT CORTICOSTEROID/DIEM,,,,,0
HCPCS,S9494,HIT ANTIBIOTIC TOTAL DIEM,,,,,0
HCPCS,S9497,HIT ANTIBIOTIC Q3H DIEM,,,,,0
HCPCS,S9500,HIT ANTIBIOTIC Q24H DIEM,,,,,0
HCPCS,S9501,HIT ANTIBIOTIC Q12H DIEM,,,,,0
HCPCS,S9502,HIT ANTIBIOTIC Q8H DIEM,,,,,0
HCPCS,S9503,HIT ANTIBIOTIC Q6H DIEM,,,,,0
HCPCS,S9504,HIT ANTIBIOTIC Q4H DIEM,,,,,0
HCPCS,S9529,VENIPUNCTURE HOME/SNF,,,,,0
HCPCS,S9537,HT HEM HORM INJ DIEM,,,,,0
HCPCS,S9538,HIT BLOOD PRODUCTS DIEM,,,,,0
HCPCS,S9542,HT INJ NOC PER DIEM,,,,,0
HCPCS,S9558,HT INJ GROWTH HORM DIEM,,,,,0
HCPCS,S9559,HIT INJ INTERFERON DIEM,,,,,0
HCPCS,S9560,HT INJ HORMONE DIEM,,,,,0
HCPCS,S9562,HT INJ PALIVIZUMAB/AB DIEM,,,,,0
HCPCS,S9563,HT INJ IMMUNO DIEM,,,,,0
HCPCS,S9590,HT IRRIGATION DIEM,,,,,0
HCPCS,S9810,HT PHARM PER HOUR,,,,,0
HCPCS,S9900,CHRISTIAN SCI PRACT VISIT,,,,,0
HCPCS,S9901,CHRISTIAN SCI NURSE VISIT,,,,,0
HCPCS,S9960,AIR AMBULANC NONEMERG FIXED,,,,,0
HCPCS,S9961,AIR AMBULAN NONEMERG ROTARY,,,,,0
HCPCS,S9970,HEALTH CLUB MEMBERSHIP YR,,,,,0
HCPCS,S9975,TRANSPLANT RELATED PER DIEM,,,,,0
HCPCS,S9976,LODGING PER DIEM,,,,,0
HCPCS,S9977,MEALS PER DIEM,,,,,0
HCPCS,S9981,MED RECORD COPY ADMIN,,,,,0
HCPCS,S9982,MED RECORD COPY PER PAGE,,,,,0
HCPCS,S9986,NOT MEDICALLY NECESSARY SVC,,,,,0
HCPCS,S9988,SERV PART OF PHASE I TRIAL,,,,,0
HCPCS,S9989,SERVICES OUTSIDE US,,,,,0
HCPCS,S9990,SERVICES PROVIDED AS PART OF,,,,,0
HCPCS,S9991,SERVICES PROVIDED AS PART OF,,,,,0
HCPCS,S9992,TRANSPORTATION COSTS TO AND,,,,,0
HCPCS,S9994,LODGING COSTS (E.G. HOTEL CH,,,,,0
HCPCS,S9996,MEALS FOR CLINICAL TRIAL PAR,,,,,0
HCPCS,S9999,SALES TAX,,,,,0
HCPCS,T1000,PRIVATE DUTY/INDEPENDENT NSG,,,,,0
HCPCS,T1001,NURSING ASSESSMENT/EVALUATN,,,,,0
HCPCS,T1002,RN SERVICES UP TO 15 MINUTES,,,,,0
HCPCS,T1003,LPN/LVN SERVICES UP TO 15MIN,,,,,0
HCPCS,T1004,NSG AIDE SERVICE UP TO 15MIN,,,,,0
HCPCS,T1005,RESPITE CARE SERVICE 15 MIN,,,,,0
HCPCS,T1006,FAMILY/COUPLE COUNSELING,,,,,0
HCPCS,T1007,TREATMENT PLAN DEVELOPMENT,,,,,0
HCPCS,T1009,CHILD SITTING SERVICES,,,,,0
HCPCS,T1010,MEALS WHEN RECEIVE SERVICES,,,,,0
HCPCS,T1012,ALCOHOL/SUBSTANCE ABUSE SKIL,,,,,0
HCPCS,T1013,SIGN LANG/ORAL INTERPRETER,,,,,0
HCPCS,T1014,"TELEHEALTH TRANSMIT, PER MIN",,,,,0
HCPCS,T1015,CLINIC SERVICE,,,,,0
HCPCS,T1016,CASE MANAGEMENT,,,,,0
HCPCS,T1017,TARGETED CASE MANAGEMENT,,,,,0
HCPCS,T1018,SCHOOL-BASED IEP SER BUNDLED,,,,,0
HCPCS,T1019,PERSONAL CARE SER PER 15 MIN,,,,,0
HCPCS,T1020,PERSONAL CARE SER PER DIEM,,,,,0
HCPCS,T1021,HH AIDE OR CN AIDE PER VISIT,,,,,0
HCPCS,T1022,CONTRACTED SERVICES PER DAY,,,,,0
HCPCS,T1023,PROGRAM INTAKE ASSESSMENT,,,,,0
HCPCS,T1024,TEAM EVALUATION & MANAGEMENT,,,,,0
HCPCS,T1025,"PED COMPR CARE PKG, PER DIEM",,,,,0
HCPCS,T1026,"PED COMPR CARE PKG, PER HOUR",,,,,0
HCPCS,T1027,FAMILY TRAINING & COUNSELING,,,,,0
HCPCS,T1028,HOME ENVIRONMENT ASSESSMENT,,,,,0
HCPCS,T1029,DWELLING LEAD INVESTIGATION,,,,,0
HCPCS,T1030,RN HOME CARE PER DIEM,,,,,0
HCPCS,T1031,LPN HOME CARE PER DIEM,,,,,0
HCPCS,T1032,SV DOULA BRTH WRK PER 15 MIN,,,,,0
HCPCS,T1033,SV DOULA BRTH WRK PER DIEM,,,,,0
HCPCS,T1040,COMM BH CLINIC SVC PER DIEM,,,,,0
HCPCS,T1041,COMM BH CLINIC SVC PER MONTH,,,,,0
HCPCS,T1502,MEDICATION ADMIN VISIT,,,,,0
HCPCS,T1503,"MED ADMIN, NOT ORAL/INJECT",,,,,0
HCPCS,T1505,"ELEC MED COMP DEV, NOC",,,,,0
HCPCS,T1999,NOC RETAIL ITEMS ANDSUPPLIES,,,,,0
HCPCS,T2001,N-ET; PATIENT ATTEND/ESCORT,,,,,0
HCPCS,T2002,N-ET; PER DIEM,,,,,0
HCPCS,T2003,N-ET; ENCOUNTER/TRIP,,,,,0
HCPCS,T2004,N-ET; COMMERC CARRIER PASS,,,,,0
HCPCS,T2005,N-ET; STRETCHER VAN,,,,,0
HCPCS,T2007,NON-EMER TRANSPORT WAIT TIME,,,,,0
HCPCS,T2010,PASRR LEVEL I,,,,,0
HCPCS,T2011,PASRR LEVEL II,,,,,0
HCPCS,T2012,"HABIL ED WAIVER, PER DIEM",,,,,0
HCPCS,T2013,HABIL ED WAIVER PER HOUR,,,,,0
HCPCS,T2014,"HABIL PREVOC WAIVER, PER D",,,,,0
HCPCS,T2015,HABIL PREVOC WAIVER PER HR,,,,,0
HCPCS,T2016,HABIL RES WAIVER PER DIEM,,,,,0
HCPCS,T2017,HABIL RES WAIVER 15 MIN,,,,,0
HCPCS,T2018,HABIL SUP EMPL WAIVER/DIEM,,,,,0
HCPCS,T2019,HABIL SUP EMPL WAIVER 15MIN,,,,,0
HCPCS,T2020,DAY HABIL WAIVER PER DIEM,,,,,0
HCPCS,T2021,DAY HABIL WAIVER PER 15 MIN,,,,,0
HCPCS,T2022,"CASE MANAGEMENT, PER MONTH",,,,,0
HCPCS,T2023,TARGETED CASE MGMT PER MONTH,,,,,0
HCPCS,T2024,SERV ASMNT/CARE PLAN WAIVER,,,,,0
HCPCS,T2025,"WAIVER SERVICE, NOS",,,,,0
HCPCS,T2026,SPECIAL CHILDCARE WAIVER/D,,,,,0
HCPCS,T2027,SPEC CHILDCARE WAIVER 15 MIN,,,,,0
HCPCS,T2028,"SPECIAL SUPPLY, NOS WAIVER",,,,,0
HCPCS,T2029,"SPECIAL MED EQUIP, NOSWAIVER",,,,,0
HCPCS,T2030,ASSIST LIVING WAIVER/MONTH,,,,,0
HCPCS,T2031,ASSIST LIVING WAIVER/DIEM,,,,,0
HCPCS,T2032,"RES CARE, NOS WAIVER/MONTH",,,,,0
HCPCS,T2033,"RES, NOS WAIVER PER DIEM",,,,,0
HCPCS,T2034,CRISIS INTERVEN WAIVER/DIEM,,,,,0
HCPCS,T2035,UTILITY SERVICES WAIVER,,,,,0
HCPCS,T2036,CAMP OVERNITE WAIVER/SESSION,,,,,0
HCPCS,T2037,CAMP DAY WAIVER/SESSION,,,,,0
HCPCS,T2038,COMM TRANS WAIVER/SERVICE,,,,,0
HCPCS,T2039,VEHICLE MOD WAIVER/SERVICE,,,,,0
HCPCS,T2040,FINANCIAL MGT WAIVER/15MIN,,,,,0
HCPCS,T2041,SUPPORT BROKER WAIVER/15 MIN,,,,,0
HCPCS,T2042,HOSPICE ROUTINE HOME CARE,,,,,0
HCPCS,T2043,HOSPICE CONTINUOUS HOME CARE,,,,,0
HCPCS,T2044,HOSPICE RESPITE CARE,,,,,0
HCPCS,T2045,HOSPICE GENERAL CARE,,,,,0
HCPCS,T2046,"HOSPICE LONG TERM CARE, R&B",,,,,0
HCPCS,T2047,HAB PREVO WAIVER PER 15,,,,,0
HCPCS,T2048,"BH LTC RES R&B, PER DIEM",,,,,0
HCPCS,T2049,"N-ET; STRETCHER VAN, MILEAGE",,,,,0
HCPCS,T2050,FINANCIAL MGT WAIVER/DIEM,,,,,0
HCPCS,T2051,SUPPORT BROKER WAIVER/DIEM,,,,,0
HCPCS,T2101,BREAST MILK PROC/STORE/DST OZ,23.0,11.5,4.0,22.31,47
HCPCS,T2101,BREAST MILK W PROLACTA +6 30ML,1607.0,803.5,279.93,1558.79,47
HCPCS,T2101,BREAST MILK W PROLACTA +8 40ML,1950.0,975.0,339.69,1891.5,47
HCPCS,T2101,BREAST MLK PROC/STORE/DIST OZ,22.0,11.0,3.83,21.34,47
HCPCS,T4521,ADULT SIZE BRIEF/DIAPER SM,,,,,0
HCPCS,T4522,ADULT SIZE BRIEF/DIAPER MED,,,,,0
HCPCS,T4523,ADULT SIZE BRIEF/DIAPER LG,,,,,0
HCPCS,T4524,ADULT SIZE BRIEF/DIAPER XL,,,,,0
HCPCS,T4525,ADULT SIZE PULL-ON SM,,,,,0
HCPCS,T4526,ADULT SIZE PULL-ON MED,,,,,0
HCPCS,T4527,ADULT SIZE PULL-ON LG,,,,,0
HCPCS,T4528,ADULT SIZE PULL-ON XL,,,,,0
HCPCS,T4529,PED SIZE BRIEF/DIAPER SM/MED,,,,,0
HCPCS,T4530,PED SIZE BRIEF/DIAPER LG,,,,,0
HCPCS,T4531,PED SIZE PULL-ON SM/MED,,,,,0
HCPCS,T4532,PED SIZE PULL-ON LG,,,,,0
HCPCS,T4533,YOUTH SIZE BRIEF/DIAPER,,,,,0
HCPCS,T4534,YOUTH SIZE PULL-ON,,,,,0
HCPCS,T4535,DISPOSABLE LINER/SHIELD/PAD,,,,,0
HCPCS,T4536,REUSABLE PULL-ON ANY SIZE,,,,,0
HCPCS,T4537,REUSABLE UNDERPAD BED SIZE,,,,,0
HCPCS,T4538,DIAPER SERV REUSABLE DIAPER,,,,,0
HCPCS,T4539,REUSE DIAPER/BRIEF ANY SIZE,,,,,0
HCPCS,T4540,REUSABLE UNDERPAD CHAIR SIZE,,,,,0
HCPCS,T4541,LARGE DISPOSABLE UNDERPAD,,,,,0
HCPCS,T4542,SMALL DISPOSABLE UNDERPAD,,,,,0
HCPCS,T4543,ADULT DISP BRIEF/DIAP ABV XL,,,,,0
HCPCS,T4544,ADLT DISP UND/PULL ON ABV XL,,,,,0
HCPCS,T4545,INCON DISPOSABLE PENILE WRAP,,,,,0
HCPCS,T5001,POSITION SEAT SPEC ORTH NEED,,,,,0
HCPCS,T5999,"SUPPLY, NOS",,,,,0
HCPCS,U0001,2019-NCOV DIAGNOSTIC P,,,,,0
HCPCS,U0001,CDC 2019-NCOV RT-PCR DIAG PANEL (COVID-19),114.0,57.0,19.85,110.58,108
HCPCS,U0002,COVID-19 LAB TEST NON-CDC,,,,,0
HCPCS,U0002,"NON-CDC 2019-NCOV, SARS-COV-2/2019-NCOV (COVID-19) ANY TECH",165.0,82.5,28.39,161.99,108
HCPCS,V2020,DME POS,,,98.67,197.34,8
HCPCS,V2025,EYEGLASSES DELUX FRAMES,,,,,0
HCPCS,V2100,DME POS,,,47.96,95.92,8
HCPCS,V2101,DME POS,,,50.53,101.06,8
HCPCS,V2102,DME POS,,,71.68,143.36,8
HCPCS,V2103,DME POS,,,41.63,83.26,8
HCPCS,V2104,DME POS,,,46.12,92.24,8
HCPCS,V2105,DME POS,,,56.47,112.94,8
HCPCS,V2106,DME POS,,,57.3,114.6,8
HCPCS,V2107,DME POS,,,60.22,120.44,8
HCPCS,V2108,DME POS,,,58.41,116.82,8
HCPCS,V2109,DME POS,,,67.14,134.28,8
HCPCS,V2110,DME POS,,,78.36,156.72,8
HCPCS,V2111,DME POS,,,69.07,138.14,8
HCPCS,V2112,DME POS,,,68.16,136.32,8
HCPCS,V2113,DME POS,,,94.15,188.3,8
HCPCS,V2114,DME POS,,,83.29,166.58,8
HCPCS,V2115,DME POS,,,90.56,181.12,8
HCPCS,V2118,DME POS,,,89.78,179.56,8
HCPCS,V2121,DME POS,,,92.69,185.38,8
HCPCS,V2199,LENS SINGLE VISION NOT OTH C,,,,,0
HCPCS,V2200,DME POS,,,62.77,125.54,8
HCPCS,V2201,DME POS,,,68.41,136.82,8
HCPCS,V2202,DME POS,,,80.5,161.0,8
HCPCS,V2203,DME POS,,,63.32,126.64,8
HCPCS,V2204,DME POS,,,68.67,137.34,8
HCPCS,V2205,DME POS,,,75.34,150.68,8
HCPCS,V2206,DME POS,,,91.73,183.46,8
HCPCS,V2207,DME POS,,,76.56,153.12,8
HCPCS,V2208,DME POS,,,77.5,155.0,8
HCPCS,V2209,DME POS,,,85.24,170.48,8
HCPCS,V2210,DME POS,,,109.67,219.34,8
HCPCS,V2211,DME POS,,,93.51,187.02,8
HCPCS,V2212,DME POS,,,101.77,203.54,8
HCPCS,V2213,DME POS,,,104.36,208.72,8
HCPCS,V2214,DME POS,,,111.84,223.68,8
HCPCS,V2215,DME POS,,,121.04,242.08,8
HCPCS,V2218,DME POS,,,123.83,247.66,8
HCPCS,V2219,DME POS,,,54.51,109.02,8
HCPCS,V2220,DME POS,,,44.21,88.42,8
HCPCS,V2221,DME POS,,,118.11,236.22,8
HCPCS,V2299,LENS BIFOCAL SPECIALITY,,,,,0
HCPCS,V2300,DME POS,,,81.51,163.02,8
HCPCS,V2301,DME POS,,,94.52,189.04,8
HCPCS,V2302,DME POS,,,103.54,207.08,8
HCPCS,V2303,DME POS,,,85.79,171.58,8
HCPCS,V2304,DME POS,,,89.78,179.56,8
HCPCS,V2305,DME POS,,,110.1,220.2,8
HCPCS,V2306,DME POS,,,102.66,205.32,8
HCPCS,V2307,DME POS,,,101.79,203.58,8
HCPCS,V2308,DME POS,,,108.62,217.24,8
HCPCS,V2309,DME POS,,,127.06,254.12,8
HCPCS,V2310,DME POS,,,139.77,279.54,8
HCPCS,V2311,DME POS,,,133.12,266.24,8
HCPCS,V2312,DME POS,,,117.34,234.68,8
HCPCS,V2313,DME POS,,,160.16,320.32,8
HCPCS,V2314,DME POS,,,175.44,350.88,8
HCPCS,V2315,DME POS,,,194.77,389.54,8
HCPCS,V2318,DME POS,,,179.58,359.16,8
HCPCS,V2319,DME POS,,,60.8,121.6,8
HCPCS,V2320,DME POS,,,64.14,128.28,8
HCPCS,V2321,DME POS,,,191.98,383.96,8
HCPCS,V2399,LENS TRIFOCAL SPECIALITY,,,,,0
HCPCS,V2410,DME POS,,,109.77,219.54,8
HCPCS,V2430,DME POS,,,142.9,285.8,8
HCPCS,V2499,VARIABLE ASPHERICITY LENS,,,,,0
HCPCS,V2500,DME POS,,,99.5,199.0,8
HCPCS,V2501,DME POS,,,151.57,303.14,8
HCPCS,V2502,DME POS,,,186.72,373.44,8
HCPCS,V2503,DME POS,,,178.66,357.32,8
HCPCS,V2510,DME POS,,,135.83,271.66,8
HCPCS,V2511,DME POS,,,195.17,390.34,8
HCPCS,V2512,DME POS,,,230.62,461.24,8
HCPCS,V2513,DME POS,,,193.62,387.24,8
HCPCS,V2520,DME POS,,,127.67,255.34,8
HCPCS,V2521,DME POS,,,222.28,444.56,8
HCPCS,V2522,DME POS,,,216.33,432.66,8
HCPCS,V2523,DME POS,,,184.35,368.7,8
HCPCS,V2524,DME POS,,,154.45,308.9,8
HCPCS,V2525,"CL, HYDROPHILIC, DUAL FOCUS",,,,,0
HCPCS,V2526,CNTCT LENS BLUE VIOLET,,,,,0
HCPCS,V2530,DME POS,,,273.05,546.1,8
HCPCS,V2531,DME POS,,,670.31,1340.62,8
HCPCS,V2599,CONTACT LENS/ES OTHER TYPE,,,,,0
HCPCS,V2600,HAND HELD LOW VISION AIDS,,,,,0
HCPCS,V2610,SINGLE LENS SPECTACLE MOUNT,,,,,0
HCPCS,V2615,TELESCOP/OTHR COMPOUND LENS,,,,,0
HCPCS,V2623,DME POS,,,1098.93,2197.86,8
HCPCS,V2624,DME POS,,,74.53,149.06,8
HCPCS,V2625,DME POS,,,482.76,965.52,8
HCPCS,V2626,DME POS,,,306.28,612.56,8
HCPCS,V2627,DME POS,,,1753.44,3506.88,8
HCPCS,V2628,DME POS,,,400.9,801.8,8
HCPCS,V2629,PROSTHETIC EYE OTHER TYPE,,,,,0
HCPCS,V2630,DME POS,,,145.73,291.46,8
HCPCS,V2631,DME POS,,,145.73,291.46,8
HCPCS,V2632,DME POS,,,145.73,291.46,8
HCPCS,V2700,DME POS,,,53.63,107.26,8
HCPCS,V2702,DELUXE LENS FEATURE,,,,,0
HCPCS,V2710,DME POS,,,78.5,157.0,8
HCPCS,V2715,DME POS,,,14.23,28.46,8
HCPCS,V2718,DME POS,,,34.95,69.9,8
HCPCS,V2730,DME POS,,,25.81,51.62,8
HCPCS,V2744,DME POS,,,26.78,53.56,8
HCPCS,V2745,DME POS,,,15.18,30.36,8
HCPCS,V2750,DME POS,,,31.15,62.3,8
HCPCS,V2755,DME POS,,,22.52,45.04,8
HCPCS,V2756,EYE GLASS CASE,,,,,0
HCPCS,V2760,DME POS,,,19.61,39.22,8
HCPCS,V2761,MIRROR COATING,,,,,0
HCPCS,V2762,DME POS,,,73.81,147.62,8
HCPCS,V2770,DME POS,,,25.31,50.62,8
HCPCS,V2780,DME POS,,,20.45,40.9,8
HCPCS,V2781,PROGRESSIVE LENS PER LENS,,,,,0
HCPCS,V2782,DME POS,,,79.68,159.36,8
HCPCS,V2783,DME POS,,,89.85,179.7,8
HCPCS,V2784,DME POS,,,58.43,116.86,8
HCPCS,V2785,CORNEAL TISSUE PROCESSING,,,,,0
HCPCS,V2786,DME POS,,,,,0
HCPCS,V2787,ASTIGMATISM-CORRECT FUNCTION,,,,,0
HCPCS,V2788,PRESBYOPIA-CORRECT FUNCTION,,,,,0
HCPCS,V2790,AMNIOTIC MEMBRANE,,,,,0
HCPCS,V2797,VIS ITEM/SVC IN OTHER CODE,,,,,0
HCPCS,V2799,MISC VISION ITEM OR SERVICE,,,,,0
HCPCS,V5008,HEARING SCREENING,,,,,0
HCPCS,V5010,ASSESSMENT FOR HEARING AID,,,,,0
HCPCS,V5011,HEARING AID FITTING/CHECKING,,,,,0
HCPCS,V5014,HEARING AID REPAIR/MODIFYING,,,,,0
HCPCS,V5020,CONFORMITY EVALUATION,,,,,0
HCPCS,V5030,BODY-WORN HEARING AID AIR,,,,,0
HCPCS,V5040,BODY-WORN HEARING AID BONE,,,,,0
HCPCS,V5050,H AID MON ITE,2.0,1.0,0.34,1.94,47
HCPCS,V5060,BEHIND EAR HEARING AID,,,,,0
HCPCS,V5070,GLASSES AIR CONDUCTION,,,,,0
HCPCS,V5080,GLASSES BONE CONDUCTION,,,,,0
HCPCS,V5090,DISPENSING ASSIST LISTENG ALD,293.0,146.5,51.04,284.21,47
HCPCS,V5095,IMPLANT MID EAR HEARING PROS,,,,,0
HCPCS,V5100,BODY-WORN BILAT HEARING AID,,,,,0
HCPCS,V5110,HEARING AID DISPENSING FEE,,,,,0
HCPCS,V5120,BODY-WORN BINAUR HEARING AID,,,,,0
HCPCS,V5130,IN EAR BINAURAL HEARING AID,,,,,0
HCPCS,V5140,BEHIND EAR BINAUR HEARING AI,,,,,0
HCPCS,V5150,GLASSES BINAURAL HEARING AID,,,,,0
HCPCS,V5160,DISPENSING FEE BINAURAL,,,,,0
HCPCS,V5171,HEARING AID MONAURAL ITE,,,,,0
HCPCS,V5172,HEARING AID MONAURAL ITC,,,,,0
HCPCS,V5181,HEARING AID MONAURAL BTE,,,,,0
HCPCS,V5190,HEARING AID MONAURAL GLASSES,,,,,0
HCPCS,V5200,DISP FEE CONTRALATERAL MONAU,,,,,0
HCPCS,V5211,HEARING AID BINAURAL ITE/ITE,,,,,0
HCPCS,V5212,HEARING AID BINAURAL ITE/ITC,,,,,0
HCPCS,V5213,HEARING AID BINAURAL ITE/BTE,,,,,0
HCPCS,V5214,HEARING AID BINAURAL ITC/ITC,,,,,0
HCPCS,V5215,HEARING AID BINAURAL ITC/BTE,,,,,0
HCPCS,V5221,HEARING AID BINAURAL BTE/BTE,,,,,0
HCPCS,V5230,HEARING AID BINAURAL GLASSES,,,,,0
HCPCS,V5240,DISP FEE CONTRALATERAL BINAU,,,,,0
HCPCS,V5241,"DISPENSING FEE, MONAURAL",,,,,0
HCPCS,V5242,"HEARING AID, MONAURAL, CIC",,,,,0
HCPCS,V5243,"HEARING AID, MONAURAL, ITC",,,,,0
HCPCS,V5244,"HEARING AID, PROG, MON, CIC",,,,,0
HCPCS,V5245,"HEARING AID, PROG, MON, ITC",,,,,0
HCPCS,V5246,"HEARING AID, PROG, MON, ITE",,,,,0
HCPCS,V5247,"HEARING AID, PROG, MON, BTE",,,,,0
HCPCS,V5248,"HEARING AID, BINAURAL, CIC",,,,,0
HCPCS,V5249,"HEARING AID, BINAURAL, ITC",,,,,0
HCPCS,V5250,"HEARING AID, PROG, BIN, CIC",,,,,0
HCPCS,V5251,"HEARING AID, PROG, BIN, ITC",,,,,0
HCPCS,V5252,"HEARING AID, PROG, BIN, ITE",,,,,0
HCPCS,V5253,"HEARING AID, PROG, BIN, BTE",,,,,0
HCPCS,V5254,"HEARING ID, DIGIT, MON, CIC",,,,,0
HCPCS,V5255,"HEARING AID, DIGIT, MON, ITC",,,,,0
HCPCS,V5256,"HEARING AID, DIGIT, MON, ITE",,,,,0
HCPCS,V5257,"HEARING AID, DIGIT, MON, BTE",,,,,0
HCPCS,V5258,"HEARING AID, DIGIT, BIN, CIC",,,,,0
HCPCS,V5259,"HEARING AID, DIGIT, BIN, ITC",,,,,0
HCPCS,V5260,"HEARING AID, DIGIT, BIN, ITE",,,,,0
HCPCS,V5261,"HEARING AID, DIGIT, BIN, BTE",,,,,0
HCPCS,V5262,"HEARING AID, DISP, MONAURAL",,,,,0
HCPCS,V5263,"HEARING AID, DISP, BINAURAL",,,,,0
HCPCS,V5264,EAR MOLD/INSERT,,,,,0
HCPCS,V5265,"EAR MOLD/INSERT, DISP",,,,,0
HCPCS,V5266,BATTERY FOR HEARING DEVICE,,,,,0
HCPCS,V5267,HEARING AID SUP/ACCESS/DEV,,,,,0
HCPCS,V5268,ALD TELEPHONE AMPLIFIER,,,,,0
HCPCS,V5269,"ALERTING DEVICE, ANY TYPE",,,,,0
HCPCS,V5270,"ALD, TV AMPLIFIER, ANY TYPE",,,,,0
HCPCS,V5271,"ALD, TV CAPTION DECODER",,,,,0
HCPCS,V5272,TDD,,,,,0
HCPCS,V5273,ALD FOR COCHLEAR IMPLANT,,,,,0
HCPCS,V5274,ALD UNSPECIFIED,,,,,0
HCPCS,V5275,EAR IMPRESSION EACH,88.0,44.0,15.32,85.36,47
HCPCS,V5281,"ALD FM/DM SYSTEM, MONAURAL",,,,,0
HCPCS,V5282,ALD FM/DM SYSTEM BINAURAL,,,,,0
HCPCS,V5283,"ALD NECK, LOOP IND RECEIVER",,,,,0
HCPCS,V5284,ALD FM/DM EAR LEVEL RECEIVER,,,,,0
HCPCS,V5285,ALD FM/DM AUD INPUT RECEIVER,,,,,0
HCPCS,V5286,ALD BLU TOOTH FM/DM RECEIVER,,,,,0
HCPCS,V5287,"ALD FM/DM RECEIVER, NOS",,,,,0
HCPCS,V5288,ALD FM/DM TRANSMITTER ALD,,,,,0
HCPCS,V5289,ALD FM/DM ADAPT/BOOT COUPLIN,,,,,0
HCPCS,V5290,ALD TRANSMITTER MICROPHONE,,,,,0
HCPCS,V5298,HEARING AID NOC,,,,,0
HCPCS,V5299,HEARING SERVICE,,,,,0
HCPCS,V5336,REPAIR COMMUNICATION DEVICE,,,,,0
HCPCS,V5362,SPEECH SCREENING,,,,,0
HCPCS,V5363,LANGUAGE SCREENING,,,,,0
HCPCS,V5364,DYSPHAGIA SCREENING,,,,,0
MS-DRG,1,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,268237.2,595872.19,21
MS-DRG,10,PANCREAS TRANSPLANT,,,68683.86,152576.91,21
MS-DRG,100,SEIZURES WITH MCC,,,17464.21,39125.3,21
MS-DRG,101,SEIZURES WITHOUT MCC,,,7824.18,18233.42,21
MS-DRG,102,HEADACHES WITH MCC,,,10499.53,22643.3,21
MS-DRG,103,HEADACHES WITHOUT MCC,,,8004.84,16894.1,21
MS-DRG,11,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,51164.06,115970.53,21
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,22504.09,49991.44,21
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,12950.55,28768.84,21
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,14691.65,32636.58,21
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,17306.65,38445.63,21
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,10384.37,23068.23,21
MS-DRG,12,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,40354.41,89644.81,21
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,9312.75,23499.82,21
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,5873.74,15873.95,21
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,7643.98,16132.52,21
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,,12664.36,26727.94,21
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,7349.17,15510.33,21
MS-DRG,13,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,27583.81,61275.71,21
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,20770.65,46140.71,21
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,9718.18,21588.32,21
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,11846.38,31749.91,21
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,8482.47,18843.27,21
MS-DRG,139,SALIVARY GLAND PROCEDURES,,,11827.79,26274.69,21
MS-DRG,14,ALLOGENEIC BONE MARROW TRANSPLANT,,,115032.09,253049.55,21
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,40826.3,90693.07,21
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,20876.9,46376.73,21
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,15280.31,33944.25,21
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,,33794.67,79663.96,21
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,,14594.12,36846.65,21
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,,8484.86,25564.5,21
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,17860.83,42773.6,21
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,12170.45,25685.57,21
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,7629.63,16102.22,21
MS-DRG,149,DYSEQUILIBRIUM,,,7194.11,15183.07,21
MS-DRG,150,EPISTAXIS WITH MCC,,,11654.7,26897.63,21
MS-DRG,151,EPISTAXIS WITHOUT MCC,,,7025.65,14827.53,21
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,,,11071.51,23881.62,21
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,,,5506.7,14912.38,21
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,,14965.4,31584.26,21
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,,7601.91,18514.22,21
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,,6324.39,13960.91,21
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,,,16432.75,34681.08,21
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,,,8708.36,18378.87,21
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,5966.52,14312.41,21
MS-DRG,16,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,56757.49,119785.87,21
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,42898.58,95296.51,21
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,24159.05,53667.81,21
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,18322.21,40701.63,21
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,35776.26,79474.72,21
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,17261.66,38345.69,21
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,13078.81,29053.76,21
MS-DRG,17,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,51996.51,109737.89,21
MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,,28489.3,63287.19,21
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,13147.73,27748.09,21
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,7705.24,16261.81,21
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,14957.74,31568.1,21
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,9342.01,19716.18,21
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,7226.66,15251.76,21
MS-DRG,18,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,413334.1,872335.74,21
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,16903.68,35674.97,21
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,10251.32,21635.27,21
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,7215.17,15227.51,21
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,14643.79,30905.51,21
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,10185.28,21495.88,21
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,7528.17,15888.09,21
MS-DRG,186,PLEURAL EFFUSION WITH MCC,,,14917.54,31483.26,21
MS-DRG,187,PLEURAL EFFUSION WITH CC,,,9467.4,19980.81,21
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,6864.84,14488.16,21
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,11824.92,24956.32,21
MS-DRG,19,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,68290.46,151703.0,21
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,10602.61,22376.65,21
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,8068.97,17029.44,21
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,6145.05,12969.04,21
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,12444.87,26552.19,21
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,7713.86,16279.99,21
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,5915.55,12696.33,21
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,18063.77,38123.33,21
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,9084.53,19172.77,21
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,6855.27,14467.96,21
MS-DRG,199,PNEUMOTHORAX WITH MCC,,,14555.38,35636.58,21
MS-DRG,2,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,108464.93,266526.4,21
MS-DRG,20,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,75318.03,167314.29,21
MS-DRG,200,PNEUMOTHORAX WITH CC,,,9432.04,22206.96,21
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,6844.74,14445.74,21
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,8393.1,19619.21,21
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,5144.75,13534.67,21
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,7688.58,16310.29,21
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,14987.68,36988.03,21
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,8688.78,19011.16,21
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,61591.21,129987.37,21
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,24783.71,55526.49,21
MS-DRG,21,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,50670.82,112562.07,21
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,,104083.95,231215.99,21
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,83458.94,211715.69,21
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,93638.32,208011.68,21
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,62937.0,139810.6,21
MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,62937.0,139810.6,21
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,73494.61,163263.69,21
MS-DRG,22,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,30413.21,67561.06,21
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,50930.58,113391.33,21
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,41796.25,107169.77,21
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,47355.18,105196.57,21
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,30146.16,66967.82,21
MS-DRG,23,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,54848.88,121843.37,21
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,80688.73,179244.96,21
MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,58029.57,128909.06,21
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,,70126.02,162559.89,21
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,,52287.49,116153.39,21
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,56172.65,124784.04,21
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,40094.06,89066.45,21
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,47109.18,104650.11,21
MS-DRG,24,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,37443.65,83178.73,21
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,27284.22,60610.18,21
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,13251.1,29436.5,21
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,30560.62,67888.51,21
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,20396.4,45309.33,21
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,17300.9,38432.87,21
MS-DRG,245,AICD GENERATOR PROCEDURES,,,43670.06,97010.31,21
MS-DRG,25,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,43519.78,96676.48,21
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,17278.65,46406.5,21
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,14304.95,31777.55,21
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,33389.07,74171.72,21
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,24844.38,55190.24,21
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,17053.95,37884.29,21
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,25818.78,57354.82,21
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,15825.77,36102.45,21
MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,10454.24,23223.45,21
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,30075.33,66810.47,21
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,11823.95,42995.91,21
MS-DRG,26,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,29760.42,66110.92,21
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,31134.92,69164.29,21
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,18095.36,40197.7,21
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,15600.96,34656.56,21
MS-DRG,263,VEIN LIGATION AND STRIPPING,,,29264.61,65009.5,21
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,31975.32,71031.18,21
MS-DRG,265,AICD LEAD PROCEDURES,,,34632.43,76933.79,21
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,58659.39,130308.17,21
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,43942.45,101228.89,21
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,65833.4,146244.79,21
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,39011.81,89797.9,21
MS-DRG,27,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,24148.52,53644.42,21
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,50503.32,112189.97,21
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,34039.94,75617.61,21
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,22020.67,54284.44,21
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,,39488.17,87720.51,21
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,,31507.26,69991.42,21
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,68250.26,151613.7,21
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,53385.7,127718.34,21
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,43842.53,98203.17,21
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,53278.16,118354.11,21
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,34519.49,76682.88,21
MS-DRG,28,SPINAL PROCEDURES WITH MCC,,,57509.83,127754.48,21
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,15354.01,32404.42,21
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,8797.38,18566.74,21
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,6921.32,14607.34,21
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,18959.68,40014.14,21
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,6625.55,13983.13,21
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,5732.51,12098.38,21
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,,21180.32,44700.77,21
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,,10242.71,21617.09,21
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,25903.02,54667.95,21
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,16337.99,34481.09,21
MS-DRG,29,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,31249.82,72540.85,21
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,8898.84,18780.87,21
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,12288.19,25934.04,21
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,8126.4,17150.65,21
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,5417.6,11433.77,21
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,14950.09,31551.94,21
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,6068.48,12807.43,21
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,4356.09,9193.48,21
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,13035.2,32982.17,21
MS-DRG,3,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,203161.88,451311.43,21
MS-DRG,30,SPINAL PROCEDURES WITHOUT CC/MCC,,,17397.94,46676.54,21
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,10217.82,21564.57,21
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,6888.77,14538.66,21
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,11453.53,24172.52,21
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,6443.69,13599.31,21
MS-DRG,304,HYPERTENSION WITH MCC,,,11390.36,24039.19,21
MS-DRG,305,HYPERTENSION WITHOUT MCC,,,7227.61,15253.78,21
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,14465.66,31832.74,21
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,8550.11,18447.55,21
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,11524.36,24322.0,21
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,7041.92,14861.88,21
MS-DRG,31,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,42886.14,95268.87,21
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,5418.56,11435.79,21
MS-DRG,311,ANGINA PECTORIS,,,6718.4,14179.08,21
MS-DRG,312,SYNCOPE AND COLLAPSE,,,8342.72,17607.19,21
MS-DRG,313,CHEST PAIN,,,6891.65,14544.72,21
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,19958.97,42123.13,21
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,9220.45,19459.62,21
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6528.88,13779.1,21
MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,64001.37,142175.05,21
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,42717.67,94894.64,21
MS-DRG,32,VENTRICULAR SHUNT PROCEDURES WITH CC,,,15417.94,45311.45,21
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,23022.88,51143.89,21
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,26042.76,57852.37,21
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,16874.96,37486.67,21
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,41420.7,92013.51,21
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,30160.52,66999.71,21
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,30729.08,68262.74,21
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,,43800.73,106047.09,21
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,,22908.72,51971.02,21
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,,10583.14,34069.7,21
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,43996.46,97735.38,21
MS-DRG,33,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,13470.56,35358.24,21
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,22945.35,50971.66,21
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,16108.26,35783.5,21
MS-DRG,332,RECTAL RESECTION WITH MCC,,,34656.36,76986.94,21
MS-DRG,333,RECTAL RESECTION WITH CC,,,22418.91,49802.2,21
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,15677.54,34826.67,21
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,34179.69,75928.05,21
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,20183.91,44837.29,21
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,14692.61,32638.71,21
MS-DRG,34,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,37049.3,82302.69,21
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,17970.94,54918.08,21
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,13073.95,31994.44,21
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,10791.13,25222.17,21
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,21972.86,48811.34,21
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,10617.8,27829.01,21
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,8156.56,18511.57,21
MS-DRG,35,CAROTID ARTERY STENT PROCEDURES WITH CC,,,21113.26,50829.2,21
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,23851.79,52985.27,21
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,14592.1,32415.44,21
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,9436.12,24830.93,21
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,27777.16,61705.23,21
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,16103.48,35772.87,21
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,12748.7,28598.74,21
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,42046.7,93404.11,21
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,22033.93,49447.11,21
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,13380.32,29723.55,21
MS-DRG,36,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,16143.87,41309.76,21
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,15237.24,32157.97,21
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,9573.64,20205.04,21
MS-DRG,37,EXTRACRANIAL PROCEDURES WITH MCC,,,31511.09,69999.92,21
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,6332.55,14156.86,21
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,16971.63,35818.39,21
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,9772.74,20625.22,21
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,6679.2,14694.21,21
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,20471.06,43203.88,21
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,11577.96,24435.13,21
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,8847.15,18671.78,21
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,17497.12,36927.43,21
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,9387.0,19811.12,21
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,6034.02,12734.71,21
MS-DRG,38,EXTRACRANIAL PROCEDURES WITH CC,,,15531.09,34501.34,21
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,18781.65,39638.4,21
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,10370.97,21887.78,21
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,7663.13,16172.92,21
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,9100.68,27891.52,21
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,8181.91,17267.81,21
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,15145.35,31964.04,21
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,9344.88,19722.24,21
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,6521.22,13762.94,21
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,14135.53,29832.84,21
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,7559.75,15954.75,21
MS-DRG,39,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,11251.57,24994.66,21
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,5207.02,10989.34,21
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,,12139.83,25620.93,21
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,,7462.12,15748.7,21
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,15308.07,32307.46,21
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,8956.27,18902.08,21
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6212.05,13110.45,21
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,,,22923.34,50922.76,21
MS-DRG,398,APPENDIX PROCEDURES WITH CC,,,14487.77,32183.68,21
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,,,10598.43,24339.76,21
MS-DRG,4,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,132581.86,294522.32,21
MS-DRG,40,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,36958.36,82100.7,21
MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,38076.86,85487.89,21
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,52362.15,116319.24,21
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,27181.74,61666.95,21
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,21245.41,47195.35,21
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,34128.96,75815.35,21
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,17934.24,46295.93,21
MS-DRG,41,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,21045.36,46750.96,21
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,15197.04,33759.27,21
MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,29394.2,70238.07,21
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,20124.56,44705.46,21
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,15893.86,35307.21,21
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,34100.25,75751.56,21
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,17724.2,43944.24,21
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,13049.14,28987.85,21
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,21432.38,50742.02,21
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,16136.73,35968.49,21
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,13073.07,29041.01,21
MS-DRG,42,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,13478.72,36736.09,21
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,32611.84,72445.17,21
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,16630.88,36944.46,21
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,13395.64,29757.57,21
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,39751.39,88305.24,21
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,20941.99,46521.32,21
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,14360.47,31900.88,21
MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,103359.93,234343.78,21
MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,68118.49,153489.09,21
MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,53812.27,119540.59,21
MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,86237.46,191571.12,21
MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,54222.77,122625.85,21
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,18839.08,39759.61,21
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,10109.66,21336.3,21
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,6819.86,14393.21,21
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,17580.4,37103.18,21
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,10826.58,22849.35,21
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,8167.56,17237.51,21
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,15603.83,32931.67,21
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,8051.74,16993.08,21
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,5947.87,12552.9,21
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,17178.38,36254.73,21
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,9239.59,19500.03,21
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,6697.34,14134.64,21
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,15993.4,33753.85,21
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,10475.3,22107.97,21
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,7918.69,16712.29,21
MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,63954.47,142070.86,21
MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,40591.79,90172.13,21
MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,51013.49,113323.28,21
MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,30920.52,68688.0,21
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,,80435.08,218515.0,21
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,,51510.72,176531.0,21
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,,39939.0,140543.0,20
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,52864.66,121721.0,21
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,25460.8,96790.0,21
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,50897.95,121188.47,21
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,29813.07,66227.87,21
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,17455.96,38777.33,21
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,49824.68,121125.0,21
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,33755.66,89353.0,21
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,26303.11,64638.0,21
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,29032.97,81666.0,21
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,18462.91,49815.0,20
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,46219.01,118033.0,21
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,27164.4,67075.0,21
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,21598.57,54475.0,21
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,41090.48,91279.93,21
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,21782.39,48388.21,21
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,11296.56,25094.59,21
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,33066.5,73455.16,21
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,23538.8,52289.97,21
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,17792.89,39525.79,21
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,27875.75,61924.23,21
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,20047.99,44535.35,21
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,15433.23,34679.95,21
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,,26531.88,58938.91,21
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,30888.93,68617.83,21
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,20015.44,44463.06,21
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,13573.54,33302.11,21
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,16931.43,37612.12,21
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,10689.71,23746.52,21
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,,35143.56,75590.0,21
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,,23182.98,50105.73,21
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,,16240.73,39642.42,21
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,34704.22,77093.26,21
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,17266.44,38356.33,21
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,11565.52,25692.08,21
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,28876.0,64146.22,21
MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,12666.12,42840.69,21
MS-DRG,5,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,98689.32,219232.16,21
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,30292.61,67293.14,21
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,16732.34,37169.85,21
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,12480.56,28617.87,21
MS-DRG,503,FOOT PROCEDURES WITH MCC,,,26715.66,59347.16,21
MS-DRG,504,FOOT PROCEDURES WITH CC,,,17891.48,39744.8,21
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,15626.95,38120.31,21
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,12914.18,28688.04,21
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,17290.37,38409.48,21
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,13883.48,32200.69,21
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,27405.02,64224.89,21
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,19903.46,44214.28,21
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,14420.8,35198.77,21
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,14712.4,33474.34,21
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,9317.85,21737.16,21
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,30504.15,67763.05,21
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,19891.01,44186.64,21
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,14708.88,32674.85,21
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,28838.54,73837.84,21
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,19145.37,42148.0,21
MS-DRG,52,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,17337.27,36590.07,21
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,14299.21,29514.98,21
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,27472.78,61029.06,21
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,20270.05,45028.66,21
MS-DRG,53,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,9372.64,19780.82,21
MS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,13470.56,31669.11,21
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,7715.77,16284.03,21
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,12270.96,25897.68,21
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,7730.13,16314.33,21
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,9134.3,19277.81,21
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,6894.52,14550.78,21
MS-DRG,539,OSTEOMYELITIS WITH MCC,,,18853.44,39789.91,21
MS-DRG,54,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,14615.07,30844.91,21
MS-DRG,540,OSTEOMYELITIS WITH CC,,,12407.83,26186.56,21
MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,6906.57,15906.27,21
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,16908.46,35685.07,21
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,9839.74,20766.63,21
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,7222.83,15243.67,21
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,21864.68,50132.82,21
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,11040.03,23299.83,21
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,8003.88,16892.08,21
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,18482.05,39006.11,21
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,11554.99,24386.65,21
MS-DRG,55,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,8874.34,20596.94,21
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,8366.65,17657.69,21
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,16043.18,33858.9,21
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,9201.3,19419.22,21
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,12407.83,26186.56,21
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,7945.49,16768.85,21
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,12651.91,26701.68,21
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,7950.28,16778.95,21
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,14232.21,30036.87,21
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,7226.71,18043.53,21
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,17850.32,37672.84,21
MS-DRG,56,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,22236.09,46928.94,21
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,10778.73,22748.35,21
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,7694.71,16239.58,21
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,,11838.23,28782.38,21
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,,8571.48,18090.0,21
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,14774.92,31182.26,21
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,9326.69,19683.85,21
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,7172.1,15136.61,21
MS-DRG,57,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,12401.13,26172.42,21
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,28151.42,62536.61,21
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,16171.44,35923.84,21
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,10745.25,24373.78,21
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,62708.23,139302.42,21
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,33227.3,73812.38,21
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,17200.4,38209.61,21
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,46912.96,104214.22,21
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,25371.78,56361.83,21
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,10556.63,34156.88,21
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,30998.05,68860.23,21
MS-DRG,58,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,16362.87,34533.61,21
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,16078.62,36742.46,21
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,12499.93,30684.64,21
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,18440.9,40965.3,21
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,16505.49,36665.92,21
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,15030.5,45517.7,21
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,15030.5,41018.45,21
MS-DRG,59,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,11877.56,25067.42,21
MS-DRG,592,SKIN ULCERS WITH MCC,,,18524.17,39095.0,21
MS-DRG,593,SKIN ULCERS WITH CC,,,11354.94,23964.45,21
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,8296.78,17510.23,21
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,20029.45,42840.26,21
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,7361.3,21867.58,21
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,15957.03,33677.09,21
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,10828.5,22853.39,21
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,7364.49,15542.65,21
MS-DRG,6,LIVER TRANSPLANT WITHOUT MCC,,,44384.11,148644.75,21
MS-DRG,60,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,8804.08,18580.88,21
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,9186.33,21041.36,21
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,5554.62,12221.61,21
MS-DRG,602,CELLULITIS WITH MCC,,,13604.3,28711.68,21
MS-DRG,603,CELLULITIS WITHOUT MCC,,,8243.22,17593.05,21
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,,14090.54,29737.89,21
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,,8767.7,18504.12,21
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,14179.16,30568.15,21
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,8675.82,18310.19,21
MS-DRG,61,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,26390.22,55696.18,21
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,18293.12,46604.24,21
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,13393.72,29753.32,21
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,33380.45,74152.59,21
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,17902.01,39768.19,21
MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,13575.58,30157.31,21
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,3503.0,61394.79,25
MS-DRG,62,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,16819.44,35497.2,21
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,3503.0,34027.18,25
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,3503.0,32073.11,25
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,34067.7,75679.27,21
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,17170.73,38143.7,21
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,8535.84,26619.15,21
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,28907.58,64216.39,21
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,14351.85,31881.74,21
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,12123.71,28243.64,21
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,30102.8,79242.95,21
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,20854.89,46327.82,21
MS-DRG,63,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,13436.79,28358.16,21
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,13969.94,31033.35,21
MS-DRG,637,DIABETES WITH MCC,,,13751.7,29022.78,21
MS-DRG,638,DIABETES WITH CC,,,8578.18,18104.14,21
MS-DRG,639,DIABETES WITHOUT CC/MCC,,,5945.96,12548.86,21
MS-DRG,64,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,19248.75,40624.21,21
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,,12784.0,26980.46,21
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,,7448.72,15720.42,21
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,13587.81,28727.84,21
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,15756.02,33252.87,21
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,9811.02,20706.03,21
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,6917.78,15520.43,21
MS-DRG,65,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,9670.32,20409.07,21
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,45000.53,138058.98,21
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,35470.92,92566.93,21
MS-DRG,652,KIDNEY TRANSPLANT,,,30911.9,129687.3,21
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,49738.54,110491.05,21
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,26794.14,59521.52,21
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,20259.52,45005.27,21
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,25110.99,67697.14,21
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,17516.27,38911.29,21
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,14853.41,32995.92,21
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,24320.81,54027.16,21
MS-DRG,66,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,6550.89,13825.56,21
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,12570.28,28103.31,21
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,8886.57,22015.71,21
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,29076.1,65096.67,21
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,14550.94,32324.01,21
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,10020.64,22260.23,21
MS-DRG,665,PROSTATECTOMY WITH MCC,,,29875.28,66366.08,21
MS-DRG,666,PROSTATECTOMY WITH CC,,,16743.83,37195.37,21
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,10588.25,23521.13,21
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,27949.45,62087.96,21
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,14855.33,33000.18,21
MS-DRG,67,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,14058.0,29669.21,21
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,9354.45,20780.33,21
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,,,17181.26,38167.09,21
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,10332.68,22953.41,21
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,40216.58,89338.62,21
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,22384.45,49725.65,21
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,15711.04,34901.09,21
MS-DRG,68,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,8273.8,17461.74,21
MS-DRG,682,RENAL FAILURE WITH MCC,,,14175.73,29917.68,21
MS-DRG,683,RENAL FAILURE WITH CC,,,8382.92,17692.04,21
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,5745.91,12126.66,21
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,17264.53,36436.54,21
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,10029.26,21166.61,21
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,7564.54,15964.85,21
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,11106.08,23439.22,21
MS-DRG,69,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,7645.9,16136.56,21
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,7729.36,16352.71,21
MS-DRG,693,URINARY STONES WITH MCC,,,12813.96,27160.24,21
MS-DRG,694,URINARY STONES WITHOUT MCC,,,6902.49,15791.12,21
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,10948.14,23105.9,21
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,6594.92,13918.49,21
MS-DRG,697,URETHRAL STRICTURE,,,10316.41,21772.64,21
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,15835.47,33420.53,21
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,9715.31,20504.02,21
MS-DRG,7,LUNG TRANSPLANT,,,123955.82,275360.1,21
MS-DRG,70,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,,,15935.02,33630.62,21
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,6603.54,13936.67,21
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,19146.33,42532.38,21
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,14684.95,32621.69,21
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,22274.37,49481.13,21
MS-DRG,71,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,,,9820.6,20726.23,21
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,13411.91,29793.72,21
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,,,19945.57,44307.84,21
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,,,10526.03,23382.92,21
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,14390.14,31966.79,21
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,10121.15,22483.5,21
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,20413.83,47571.71,21
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,14080.01,31277.87,21
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,18095.36,40197.7,21
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,8663.29,28558.34,21
MS-DRG,72,NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,7238.14,15276.0,21
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,17321.96,36557.75,21
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,10937.62,23083.68,21
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,6276.18,13245.8,21
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,11200.84,23639.21,21
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,6910.79,14585.12,21
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,14193.92,29956.06,21
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,7564.19,16387.05,21
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,10133.59,21386.8,21
MS-DRG,73,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,15355.93,32408.46,21
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6432.2,13575.07,21
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,20387.78,45290.19,21
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,12878.76,28609.37,21
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,34214.15,76004.59,21
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,19723.51,43814.54,21
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,13101.47,31224.72,21
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,,34293.59,76181.08,21
MS-DRG,74,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,9866.54,20823.19,21
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,,16334.53,38477.52,21
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,13650.24,30323.16,21
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,15293.55,39013.35,21
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,11018.49,26381.0,21
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,17685.46,43570.01,21
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,10887.84,24186.66,21
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,13322.72,36935.96,21
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,7529.52,18279.8,21
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,13278.86,29498.16,21
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,24576.37,54594.88,21
MS-DRG,75,VIRAL MENINGITIS WITH CC/MCC,,,10139.62,38735.42,21
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,14125.96,31379.94,21
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,17628.26,37204.18,21
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,10412.13,21974.65,21
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,9193.65,19403.06,21
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,13705.76,28925.81,21
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,7962.84,19776.78,21
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,5929.82,13405.38,21
MS-DRG,76,VIRAL MENINGITIS WITHOUT CC/MCC,,,5269.14,16669.87,21
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,8450.2,20352.51,21
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,5460.67,11524.67,21
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,,1566.0,20514.14,28
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,15232.38,35930.22,21
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,8502.19,21320.41,21
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,5159.02,13225.59,21
MS-DRG,779,ABORTION WITHOUT D&C,,,6361.1,16995.1,21
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,2025.0,46999.1,28
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,2025.0,20293.98,28
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,2025.0,18335.6,28
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,2025.0,31577.14,28
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,2025.0,21379.42,28
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,2025.0,18354.74,28
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,,2044.0,35231.21,21
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,,2044.0,113779.16,21
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,,,2044.0,77703.3,21
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,1434.0,46886.16,21
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,2044.0,79820.58,21
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,1434.0,28253.84,21
MS-DRG,795,NORMAL NEWBORN,,,652.0,3824.86,25
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,1566.0,22340.42,28
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,1566.0,19151.12,28
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,1566.0,18322.2,28
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,,,43349.41,96298.0,21
MS-DRG,8,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,53645.72,119170.61,21
MS-DRG,80,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,17324.83,36563.81,21
MS-DRG,800,SPLENIC PROCEDURES WITH CC,,,23061.65,59736.27,21
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,,,18271.48,40588.94,21
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,27557.96,84713.92,21
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,17792.89,39525.79,21
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,12979.27,28832.63,21
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,,1566.0,20659.62,28
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,,1566.0,14434.16,28
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,,1566.0,12906.52,28
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,21133.42,44601.79,21
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,12116.85,25572.45,21
MS-DRG,81,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,6713.87,18092.02,21
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,6984.05,21142.37,21
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,,,13441.58,28368.26,21
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,8788.76,18548.56,21
MS-DRG,813,COAGULATION DISORDERS,,,14599.76,30812.59,21
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,20356.2,42961.47,21
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,8082.13,20483.81,21
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,6001.19,12767.03,21
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,16194.85,48513.66,21
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,11095.55,24648.07,21
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,8230.73,18284.05,21
MS-DRG,82,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,21877.15,46171.41,21
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,56136.28,124703.24,21
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,21427.27,47599.35,21
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,10148.8,25600.65,21
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,43884.47,97486.6,21
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,21685.71,48173.45,21
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,12916.09,28692.29,21
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,44774.64,99464.06,21
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,22122.18,49143.05,21
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,16308.31,36227.9,21
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,30246.67,67191.08,21
MS-DRG,83,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,13360.22,28196.56,21
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,14405.45,32000.82,21
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,9076.21,24291.7,21
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,6840.3,14577.04,21
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,5005.06,10563.1,21
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,,,52547.84,112434.34,21
MS-DRG,835,ACUTE LEUKEMIA WITH CC,,,19964.71,42135.25,21
MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC,,,11672.72,24635.12,21
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,39502.22,97051.66,21
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,15184.46,42167.57,21
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,11702.62,29168.22,21
MS-DRG,84,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,8661.25,19308.12,21
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,30963.59,65348.21,21
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,15615.32,32955.91,21
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,9671.28,20411.09,21
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,19093.69,40296.95,21
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,11652.62,24592.7,21
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,8151.29,17203.17,21
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,19294.34,52371.09,21
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,12521.74,26426.95,21
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,7925.12,17158.73,21
MS-DRG,849,RADIOTHERAPY,,,20490.3,54734.61,21
MS-DRG,85,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,18446.06,45894.65,21
MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,68452.91,184126.95,21
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,47270.95,105009.45,21
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,19125.27,42485.6,21
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,14330.79,31834.96,21
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,38819.11,96719.01,21
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,20497.86,45534.71,21
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,13332.46,29617.23,21
MS-DRG,86,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,11342.72,26315.84,21
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,13253.39,36840.56,21
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,8584.78,20158.58,21
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,,,6961.62,17932.43,21
MS-DRG,865,VIRAL ILLNESS WITH MCC,,,9843.95,30267.16,21
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,,,6487.52,17566.79,21
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,20035.55,42284.73,21
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,9869.41,20829.25,21
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,6984.49,14740.67,21
MS-DRG,87,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,5545.44,18477.85,21
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,66157.88,139625.27,21
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,,18593.09,39240.44,21
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,,9794.75,20671.68,21
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,36993.78,82179.37,15
MS-DRG,88,CONCUSSION WITH MCC,,,12939.06,27307.71,21
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,9190.78,19397.0,15
MS-DRG,881,DEPRESSIVE NEUROSES,,,9006.04,19007.12,15
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,10278.12,21691.83,15
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,18820.89,39721.23,15
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,15399.96,32501.39,15
MS-DRG,885,PSYCHOSES,,,13369.79,28216.76,15
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,19864.21,41923.14,15
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,10250.37,21633.25,15
MS-DRG,89,CONCUSSION WITH CC,,,10260.95,22192.82,21
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,5904.8,12462.0,15
MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,13549.74,28596.54,15
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,16703.63,35252.77,15
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,,8449.92,17833.44,15
MS-DRG,90,CONCUSSION WITHOUT CC/MCC,,,7879.45,16629.46,21
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,40168.72,89232.31,21
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,18325.08,40708.01,21
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,11195.1,24869.2,21
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,35157.92,78101.13,21
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,14198.7,31541.53,21
MS-DRG,906,HAND PROCEDURES FOR INJURIES,,,18801.75,41766.91,21
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,36748.74,81635.04,21
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,19097.52,42423.94,21
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,11647.57,27911.94,21
MS-DRG,91,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,16809.87,35477.0,21
MS-DRG,913,TRAUMATIC INJURY WITH MCC,,,15645.95,33020.55,21
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,,,8145.34,17887.99,21
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,,,16095.82,33970.0,21
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,,,6377.64,13459.93,21
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,15012.3,31683.25,21
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,8002.6,17314.28,21
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,16710.75,36983.99,21
MS-DRG,92,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,9791.88,20665.62,21
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,9593.75,20247.46,21
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,5944.09,13906.37,21
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,16744.78,35339.63,21
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,9519.73,20558.56,21
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,202425.43,453975.68,21
MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,44309.49,152513.12,21
MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,19317.79,68483.87,21
MS-DRG,93,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,7621.97,16086.06,21
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,37274.23,78666.73,21
MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,11684.27,44656.33,21
MS-DRG,935,NON-EXTENSIVE BURNS,,,12345.97,41614.06,21
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,34731.02,77152.8,21
MS-DRG,94,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,33686.75,71095.4,21
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,22368.18,49689.5,21
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,19408.6,43114.99,21
MS-DRG,945,REHABILITATION WITH CC/MCC,,,2361.0,30595.69,15
MS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,2361.0,22657.33,15
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,12150.35,25643.15,21
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,7662.17,16170.9,21
MS-DRG,949,AFTERCARE WITH CC/MCC,,,11387.49,24415.16,21
MS-DRG,95,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,24687.41,52102.42,21
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,6008.17,15987.32,21
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,2991.42,11231.76,21
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,64428.27,143123.38,21
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,36018.42,80012.67,21
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,68946.38,162021.93,21
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,40334.31,89600.16,21
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,22585.51,62600.4,21
MS-DRG,96,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,24687.41,52102.42,21
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,26167.2,55225.49,21
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,14669.63,30960.05,21
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,8965.08,18999.04,21
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,58591.43,130157.2,21
MS-DRG,97,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,34571.17,72961.97,21
MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,20760.48,56079.04,21
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,27624.01,58300.09,21
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,12395.39,26160.3,21
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,8640.4,18235.44,21
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,11512.98,26214.84,21
MS-DRG,98,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,21966.16,46359.27,21
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,44908.64,99761.74,21
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,23532.1,52275.09,21
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,14442.21,36444.78,21
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,32815.72,72898.07,21
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,15732.1,34947.87,21
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,11478.42,25498.59,21
MS-DRG,99,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,13040.53,27521.84,21
MS-DRG,998,PRINCIPAL DIAGNOSIS INVALID AS DISCHARGE DIAGNOSIS,,,,,0
MS-DRG,999,UNGROUPABLE,,,,,0
RC,115,Room And Board Private (One Bed) Hospice,,,1206.0,1206.0,1
RC,125,Room And Board Semiprivate (Two Beds) Hospice,,,1206.0,1206.0,1
RC,135,Room And Board (3 And 4 Beds) Hospice,,,1206.0,1206.0,1
RC,145,Room And Board Deluxe Private Hospice,,,1206.0,1206.0,1
RC,155,Room And Board Ward Hospice,,,1206.0,1206.0,1
RC,22,Skilled Nursing Facility (Snf)Pps,,,1588.0,1588.0,1
RC,250,Pharmacy General,,,10.0,10.0,1
RC,251,Pharmacy Generic Drugs,,,10.0,10.0,1
RC,252,Pharmacy Nongeneric Drugs,,,10.0,10.0,1
RC,253,Pharmacy Take-Home Drugs,,,,,0
RC,254,Pharmacy Drugs Incident To Other Diagnostic Services,,,10.0,10.0,1
RC,255,Pharmacy Drugs Incident To Radiology,,,10.0,10.0,1
RC,256,Pharmacy Experimental Drugs,,,,,0
RC,257,Pharmacy Nonprescription,,,10.0,10.0,1
RC,258,Pharmacy Ivsolutions,,,10.0,10.0,1
RC,259,Pharmacy Other,,,10.0,10.0,1
RC,274,"Medical/Surgical Supplies And Devices, Prosthetic/Orthotic Devices",,,,,0
RC,275,Medical/Surgical Supplies And Devices Pacemaker,,,,,0
RC,276,Medical/Surgical Supplies And Devices Intracular Lens,,,,,0
RC,278,Medical/Surgical Supplies And Devices Other Implants,,,,,0
RC,510,Clinic General,,,,,0
RC,511,"Clinic, Chronic Pain Center",,,,,0
RC,512,Clinic Dental Clinic,,,,,0
RC,513,Clinic Psychiatric Clinic,,,,,0
RC,514,"Clinic, Obstetrics/Gynecology (Ob/Gyn)",,,,,0
RC,515,Clinic Pediatric Clinic,,,,,0
RC,516,Clinic Urgent Care Clinic,,,,,0
RC,517,Clinic Family Practice Clinic,,,,,0
RC,519,"Clinic, Other",,,,,0
RC,520,Freestanding Clinic General,,,,,0
RC,521,Freestanding Clinic Clinic Visit By Member Torhc/Fqhc,,,,,0
RC,522,Freestanding Clinic Home Visit Byrhc/Fqhcpractitioner,,,,,0
RC,523,Freestanding Clinic Family Practice Clinic,,,,,0
RC,524,Freestanding Clinic Visit Byrhc/Fqhcpractitioner To Member In A Part A Covered Stay Insnf,,,,,0
RC,525,Freestanding Clinic Visit Byrhc/Fqhcpractitioner To Member In A Stay Not Covered By Part A In A,,,,,0
RC,526,"Snf,Nfor Icfmror Other Residential Facility Urgent Care Clinic",,,,,0
RC,527,"Snf,Nfor Icfmror Other Residential Facility Visiting Nurse Services To Member'S Home In A Home Health Shortage Area",,,,,0
RC,528,"Snf,Nfor Icfmror Other Residential Facility Visit Byrhc/Fqhcpractitioner To Other Non-Rhc/Fqhcsite (E.G., Scene Of Accident)",,,,,0
RC,529,"Snf,Nfor Icfmror Other Residential Facility Other",,,,,0
RC,550,Skilled Nursing General,,,1588.0,1588.0,1
RC,551,Skilled Nursing Visit Charge,,,1588.0,1588.0,1
RC,552,Skilled Nursing Hourly Charge,,,1588.0,1588.0,1
RC,559,Skilled Nursing Other,,,1588.0,1588.0,1